Erythropoietin Sales

Erythropoietin Sales Market Outlook

The global erythropoietin sales market is anticipated to reach USD 15 billion by 2035, exhibiting a remarkable CAGR of 6.5% during the forecast period from 2025 to 2035. This growth is primarily driven by the increasing prevalence of anemia, particularly in chronic diseases such as chronic kidney disease (CKD) and cancer, where erythropoietin-stimulating agents play a critical role in managing hemoglobin levels. Furthermore, advancements in biotechnology and the introduction of biosimilar erythropoietin products are broadening treatment access and enhancing affordability for patients. The growing awareness around the importance of anemia management in improving patient outcomes is also contributing to market expansion. Additionally, the rise in healthcare expenditure and the development of novel erythropoietin formulations present lucrative opportunities for market players.

Growth Factor of the Market

The growth of the erythropoietin sales market can be attributed to several factors, including the increasing incidence of anemia, especially among older populations and patients with chronic diseases. In particular, the rise in the number of patients undergoing dialysis for chronic kidney disease necessitates effective management of anemia, thereby driving demand for erythropoietin. Additionally, the ongoing research and development efforts aimed at creating more effective and safer formulations of erythropoietin are paving the way for market growth. The implementation of stringent regulations and guidelines for anemia management in clinical settings also supports the use of erythropoietin. Furthermore, the growing prevalence of cancer and the associated treatments that lead to anemia underscore the importance of erythropoietin in the therapeutic landscape.

Key Highlights of the Market

• Projected global market size of USD 15 billion by 2035.
• A robust CAGR of 6.5% anticipated from 2025 to 2035.
• Rising incidence of anemia and chronic kidney disease driving demand.
• Advancements in biotechnology leading to new erythropoietin formulations.
• Increasing awareness regarding the significance of anemia management in patients.

By Product Type

Epoetin Alfa:

Epoetin Alfa is one of the most commonly used forms of erythropoietin, primarily indicated for the treatment of anemia associated with chronic kidney disease and cancer chemotherapy. It is a recombinant form of human erythropoietin and is known for its efficacy in stimulating erythropoiesis, thus increasing hemoglobin levels in patients. The product's proven track record in clinical settings and its established market presence contribute significantly to its popularity among healthcare providers. However, the introduction of biosimilars has begun to challenge its market dominance by providing cost-effective alternatives.

Epoetin Beta:

Epoetin Beta is similar to Epoetin Alfa in terms of its mechanism of action and therapeutic applications; however, it has a slightly different glycosylation profile, which may influence its pharmacokinetics. This product is also utilized in treating anemia in patients with chronic kidney disease and those undergoing cancer treatments. The differentiating factors, such as the specific production process and clinical efficacy, play a crucial role in its market positioning. Despite facing competition from Epoetin Alfa, Epoetin Beta maintains a loyal user base due to its established clinical effectiveness and safety profile.

Darbepoetin Alfa:

Darbepoetin Alfa is a longer-acting erythropoietin-stimulating agent designed to improve hemoglobin levels while reducing the frequency of administration. This product has gained considerable traction, especially among patients who require regular erythropoietin treatment. Its extended half-life allows for less frequent dosing, which enhances patient compliance and convenience. As a result, many healthcare professionals prefer Darbepoetin Alfa for managing anemia in chronic kidney disease and chemotherapy-induced anemia, further solidifying its role in the market.

Epoetin Theta:

Epoetin Theta is a biosimilar erythropoietin product that has emerged in response to the growing demand for cost-effective alternatives to branded erythropoietin therapies. It offers comparable safety and efficacy profiles to its reference products while significantly lowering treatment costs. The increasing adoption of biosimilars in various clinical settings is anticipated to drive the market growth of Epoetin Theta. As healthcare systems globally strive to improve access to affordable therapies, products like Epoetin Theta are becoming essential components in the anemia management landscape.

Biosimilar Erythropoietin:

The biosimilar erythropoietin segment has gained momentum due to the need for affordable treatment options in managing anemia. With several biosimilars entering the market, their cost-effectiveness compared to traditional erythropoietin products is appealing to both healthcare providers and patients. These products exhibit similar efficacy and safety profiles to their reference biologics, which encourages their adoption in clinical practice. The ongoing patent expirations of originator erythropoietin products further facilitate the market penetration of biosimilars, contributing to a shift in treatment paradigms in favor of these alternatives.

By Application

Anemia Treatment:

Anemia treatment is the primary application of erythropoietin products, with a substantial focus on managing anemia in patients suffering from chronic kidney disease, cancer, and other conditions. The rising prevalence of these diseases necessitates effective anemia management, significantly increasing the demand for erythropoietin therapies. Healthcare professionals prioritize the use of erythropoietin to improve patient outcomes, enhance quality of life, and reduce fatigue associated with anemia. With ongoing efforts to raise awareness regarding anemia management, this application segment is projected to experience continued growth in the coming years.

Kidney Disease:

The application of erythropoietin in kidney disease management is critical due to the high incidence of anemia among patients with chronic kidney disease. Erythropoietin therapy is essential for stimulating red blood cell production, combating the anemia that often accompanies renal impairment. As the global prevalence of chronic kidney disease rises, the corresponding demand for erythropoietin therapies is also expected to grow. Moreover, advancements in kidney disease treatment protocols and an increasing understanding of anemia's impact on patient health further reinforce the significance of erythropoietin in this application.

Cancer Treatment:

Anemia is a common complication of cancer treatment, particularly in patients undergoing chemotherapy. Erythropoietin plays an essential role in alleviating treatment-induced anemia, thereby improving patients' overall quality of life and reducing the need for blood transfusions. The growing number of cancer diagnoses and advancements in cancer therapies are driving the demand for erythropoietin products in this application. Additionally, as healthcare providers increasingly focus on managing the side effects of cancer treatment, erythropoietin's role becomes more prominent in clinical practice.

HIV/AIDS Treatment:

Patients with HIV/AIDS often experience anemia as a result of the disease itself or due to antiretroviral therapy. The use of erythropoietin can significantly improve hemoglobin levels in these patients, enhancing their overall health and well-being. The increasing global prevalence of HIV/AIDS necessitates effective anemia management solutions, placing erythropoietin as a valuable therapeutic option in this application area. As awareness and understanding of the importance of anemia management in HIV/AIDS treatment grow, the demand for erythropoietin products is expected to rise.

Others:

In addition to the primary applications mentioned, erythropoietin is also utilized in various other clinical scenarios, including surgical patients with anticipated blood loss and those with chronic inflammatory diseases. These applications contribute to the overall demand for erythropoietin therapies, as healthcare providers seek to manage anemia in diverse patient populations. The versatility of erythropoietin in treating different types of anemia further solidifies its importance in the therapeutic landscape, positioning it as a critical component in comprehensive anemia management strategies.

By Distribution Channel

Hospitals:

Hospitals are one of the primary distribution channels for erythropoietin products, as they provide critical care for patients with chronic diseases and those undergoing cancer treatment. In hospital settings, healthcare professionals can administer erythropoietin therapies as part of an integrated treatment plan, enabling close monitoring of patient responses and side effects. The growing number of patients treated in hospitals for anemia further drives the demand for erythropoietin products through this channel. Additionally, the presence of specialized hematology and oncology departments within hospitals supports the consistent use of these therapies.

Retail Pharmacies:

Retail pharmacies serve as important distribution channels for erythropoietin products, particularly for patients managing their conditions on an outpatient basis. With the increasing prevalence of chronic diseases, the demand for erythropoietin prescriptions at retail pharmacies continues to grow. Moreover, retail pharmacies often provide valuable patient support services, such as medication management and education regarding the administration of erythropoietin therapies. As healthcare systems prioritize outpatient care and patient convenience, retail pharmacies increasingly contribute to the overall distribution of erythropoietin products.

Online Pharmacies:

The rise of online pharmacies has transformed the distribution landscape for erythropoietin products, offering convenience and accessibility for patients seeking treatment. Online pharmacies provide a platform for patients to order their medications discreetly and often at competitive prices, making them an attractive option for many. The growth of telemedicine and remote healthcare consultations further bolsters the demand for online pharmacy services, enabling patients to receive prescriptions for erythropoietin therapies without the need for in-person visits. This distribution channel is expected to expand significantly as patients increasingly embrace digital healthcare solutions.

Specialty Clinics:

Specialty clinics focusing on chronic disease management, such as nephrology and oncology, are critical distribution channels for erythropoietin products. These clinics have specialized expertise in anemia management and often provide comprehensive care for patients with chronic kidney disease or those undergoing cancer treatment. The close relationship between healthcare providers and patients in specialty clinics fosters a higher level of adherence to prescribed therapies, including erythropoietin. As the prevalence of chronic diseases continues to rise, the role of specialty clinics in the distribution of erythropoietin products is expected to grow.

Others:

Other distribution channels for erythropoietin may include long-term care facilities, home healthcare providers, and other healthcare settings where patients receive treatment. These channels play a vital role in ensuring that erythropoietin therapies reach patients who may have limited access to traditional healthcare services. As the healthcare landscape evolves, the importance of alternative distribution channels will become increasingly significant in meeting patient needs and improving access to essential therapies like erythropoietin.

By Ingredient Type

Human Recombinant Erythropoietin:

Human recombinant erythropoietin is the most widely used ingredient type in the production of erythropoietin therapies. It is produced using recombinant DNA technology, ensuring high purity and efficacy in stimulating red blood cell production. The effectiveness of human recombinant erythropoietin in treating anemia associated with chronic kidney disease and cancer has established its position as the gold standard in the market. As research continues to validate its benefits, the demand for human recombinant erythropoietin is expected to remain strong in the coming years.

Animal-derived Erythropoietin:

Animal-derived erythropoietin is less common than human recombinant versions but may still be used in specific clinical situations. The use of animal-derived products raises concerns regarding immunogenicity and safety, which can limit their acceptance among healthcare providers and patients. Consequently, the market share for animal-derived erythropoietin products is relatively small compared to human recombinant formulations. Regulatory scrutiny and evolving patient preferences toward recombinant therapies further diminish the prospects for this ingredient type in the erythropoietin market.

Biotech-derived Erythropoietin:

Biotech-derived erythropoietin represents a growing segment in the market, characterized by the utilization of advanced biotechnological methods to develop and manufacture erythropoietin products. These innovative approaches often result in enhanced efficacy, safety, and stability compared to traditional erythropoietin formulations. As biotechnology continues to advance, the demand for biotech-derived erythropoietin is expected to rise, particularly among healthcare providers seeking cutting-edge treatment options. The introduction of these products could significantly reshape the competitive landscape within the erythropoietin market.

DNA-derived Erythropoietin:

DNA-derived erythropoietin represents a novel approach to erythropoietin production, utilizing synthesized DNA to create recombinant proteins that stimulate red blood cell production. This method has the potential to enhance the safety and efficacy of erythropoietin therapies while reducing the risk of contamination associated with traditional production processes. Although still in the early stages of commercialization, DNA-derived erythropoietin could play a vital role in the future of anemia management, especially as the biotechnology sector continues to innovate.

Others:

The "Others" category may include various experimental or emerging ingredient types that are being explored as alternatives to traditional erythropoietin formulations. These may involve novel production methods, alternative sources of erythropoietin, or combination therapies aimed at enhancing the efficacy of existing treatments. As the field of biotechnology continues to evolve, the exploration of new ingredients may yield innovative erythropoietin therapies that can address unmet clinical needs and improve patient outcomes.

By Region

The regional analysis of the erythropoietin sales market highlights several key areas, including North America, Europe, Asia Pacific, Latin America, and the Middle East & Africa. North America holds a significant share of the market, driven by the high prevalence of chronic diseases, advanced healthcare infrastructure, and increasing awareness surrounding anemia management. The United States, in particular, leads the market due to its robust healthcare system and the presence of major pharmaceutical companies that develop and manufacture erythropoietin products. The North American segment is projected to grow at a CAGR of 6.2% during the forecast period, contributing to the overall market expansion.

Europe is another major region for the erythropoietin sales market, primarily fueled by the rising incidence of chronic kidney disease and cancer. The increasing adoption of biosimilars in European countries, coupled with favorable healthcare policies, supports the growth of this market segment. Additionally, the growing focus on anemia management within healthcare systems further drives demand for erythropoietin therapies in Europe. On the other hand, the Asia Pacific region is expected to witness the highest growth rate, with a projected CAGR of 7.5% due to improving healthcare access, rising disposable incomes, and increasing awareness of anemia-related issues among the population.

Opportunities

There are numerous opportunities for growth in the erythropoietin sales market, particularly as advancements in biotechnology and pharmacology continue to evolve. The introduction of novel formulations, such as long-acting erythropoietin products, represents a significant opportunity to enhance patient compliance and improve treatment outcomes. The rising demand for biosimilars presents another lucrative opportunity for market players, as these cost-effective alternatives can provide substantial savings for healthcare systems and patients alike. Furthermore, expanding clinical indications for erythropoietin therapies, such as their potential use in treating anemia due to inflammatory diseases or surgical procedures, could broaden the market's application scope.

Additionally, emerging markets, particularly in the Asia Pacific and Latin America regions, present enormous potential for growth in the erythropoietin sales market. As these regions continue to develop their healthcare infrastructure and increase access to essential therapies, the demand for erythropoietin products is expected to rise. Market players who can effectively navigate regulatory hurdles and establish strong distribution networks within these regions will be well-positioned to capture market share. Collaborations with local healthcare providers and investment in patient education initiatives can also help drive adoption and create additional market opportunities.

Threats

Despite the promising outlook for the erythropoietin sales market, several threats could impede growth. One of the primary concerns is the increasing competition from biosimilars and alternative anemia treatments, which may exert downward pressure on pricing and market share for traditional erythropoietin products. As patient preferences shift toward more cost-effective options, the market could experience a decline in demand for established erythropoietin therapies. Additionally, regulatory challenges and stringent approval processes for new erythropoietin formulations could slow the entry of innovative products into the market, limiting growth potential. Furthermore, the threat of adverse reactions or complications associated with erythropoietin therapy may raise concerns among healthcare providers and patients, potentially impacting the overall uptake of these products.

Another significant restraining factor for the erythropoietin sales market is the rising concerns regarding the safety and side effects of erythropoietin therapies. Instances of thromboembolic events and hypertension associated with erythropoietin use may lead healthcare providers to reconsider their prescribing practices. Increased scrutiny from regulatory authorities regarding the use of erythropoietin in specific patient populations could further complicate the market landscape. Moreover, the ongoing evolution of treatment guidelines and standards of care for anemia management may influence clinical decision-making, impacting the overall utilization of erythropoietin products.

Competitor Outlook

• Amgen Inc.
• Roche Holding AG
• Johnson & Johnson
• Pfizer Inc.
• Novartis AG
• Bristol-Myers Squibb Company
• Hikma Pharmaceuticals PLC
• Teva Pharmaceutical Industries Ltd.
• Mylan N.V.
• Sandoz (a Novartis Division)
• Merck & Co., Inc.
• Seattle Genetics, Inc.
• UCB S.A.
• AbbVie Inc.
• Grifols S.A.

The competitive landscape of the erythropoietin sales market is characterized by a mix of established pharmaceutical companies and emerging players in the biosimilar space. Major companies such as Amgen Inc. and Roche Holding AG dominate the market with their extensive portfolios of erythropoietin products, leveraging their research and development capabilities to innovate and improve existing therapies. These companies benefit from economies of scale, robust distribution networks, and strong brand recognition. However, the increasing presence of biosimilars is reshaping the competitive dynamics, as these products often offer comparable efficacy at reduced prices, appealing to cost-conscious healthcare systems and patients.

Companies like Mylan N.V. and Sandoz are making significant inroads in the biosimilar erythropoietin market, capitalizing on the growing demand for affordable treatment alternatives. Their ability to navigate complex regulatory environments and demonstrate the equivalence of their biosimilars to reference products will be critical for their market success. Additionally, the entry of new players will likely intensify competition, prompting established companies to invest in research and development and explore strategic partnerships to maintain their market position.

Furthermore, collaboration between pharmaceutical companies and biotechnology firms is becoming increasingly prevalent in the erythropoietin sales market. Partnerships can enhance product development capabilities, streamline manufacturing processes, and facilitate access to novel technologies that improve erythropoietin formulations. As companies continue to innovate and adapt to evolving market demands, the competitive landscape will remain dynamic, with numerous opportunities for growth and collaboration. Companies that can successfully harness advancements in biotechnology while addressing patient needs will be well-positioned to thrive in this market.

• 1 Appendix

  • 1.1 List of Tables
  • 1.2 List of Figures

• 2 Introduction

  • 2.1 Market Definition
  • 2.2 Scope of the Report
  • 2.3 Study Assumptions
  • 2.4 Base Currency & Forecast Periods

• 3 Market Dynamics

  • 3.1 Market Growth Factors
  • 3.2 Economic & Global Events
  • 3.3 Innovation Trends
  • 3.4 Supply Chain Analysis

• 4 Consumer Behavior

  • 4.1 Market Trends
  • 4.2 Pricing Analysis
  • 4.3 Buyer Insights

• 5 Key Player Profiles

  • 5.1 UCB S.A.
    • 5.1.1 Business Overview
    • 5.1.2 Products & Services
    • 5.1.3 Financials
    • 5.1.4 Recent Developments
    • 5.1.5 SWOT Analysis
  • 5.2 Amgen Inc.
    • 5.2.1 Business Overview
    • 5.2.2 Products & Services
    • 5.2.3 Financials
    • 5.2.4 Recent Developments
    • 5.2.5 SWOT Analysis
  • 5.3 Mylan N.V.
    • 5.3.1 Business Overview
    • 5.3.2 Products & Services
    • 5.3.3 Financials
    • 5.3.4 Recent Developments
    • 5.3.5 SWOT Analysis
  • 5.4 AbbVie Inc.
    • 5.4.1 Business Overview
    • 5.4.2 Products & Services
    • 5.4.3 Financials
    • 5.4.4 Recent Developments
    • 5.4.5 SWOT Analysis
  • 5.5 Novartis AG
    • 5.5.1 Business Overview
    • 5.5.2 Products & Services
    • 5.5.3 Financials
    • 5.5.4 Recent Developments
    • 5.5.5 SWOT Analysis
  • 5.6 Pfizer Inc.
    • 5.6.1 Business Overview
    • 5.6.2 Products & Services
    • 5.6.3 Financials
    • 5.6.4 Recent Developments
    • 5.6.5 SWOT Analysis
  • 5.7 Grifols S.A.
    • 5.7.1 Business Overview
    • 5.7.2 Products & Services
    • 5.7.3 Financials
    • 5.7.4 Recent Developments
    • 5.7.5 SWOT Analysis
  • 5.8 Roche Holding AG
    • 5.8.1 Business Overview
    • 5.8.2 Products & Services
    • 5.8.3 Financials
    • 5.8.4 Recent Developments
    • 5.8.5 SWOT Analysis
  • 5.9 Johnson & Johnson
    • 5.9.1 Business Overview
    • 5.9.2 Products & Services
    • 5.9.3 Financials
    • 5.9.4 Recent Developments
    • 5.9.5 SWOT Analysis
  • 5.10 Merck & Co., Inc.
    • 5.10.1 Business Overview
    • 5.10.2 Products & Services
    • 5.10.3 Financials
    • 5.10.4 Recent Developments
    • 5.10.5 SWOT Analysis
  • 5.11 Seattle Genetics, Inc.
    • 5.11.1 Business Overview
    • 5.11.2 Products & Services
    • 5.11.3 Financials
    • 5.11.4 Recent Developments
    • 5.11.5 SWOT Analysis
  • 5.12 Hikma Pharmaceuticals PLC
    • 5.12.1 Business Overview
    • 5.12.2 Products & Services
    • 5.12.3 Financials
    • 5.12.4 Recent Developments
    • 5.12.5 SWOT Analysis
  • 5.13 Bristol-Myers Squibb Company
    • 5.13.1 Business Overview
    • 5.13.2 Products & Services
    • 5.13.3 Financials
    • 5.13.4 Recent Developments
    • 5.13.5 SWOT Analysis
  • 5.14 Sandoz (a Novartis Division)
    • 5.14.1 Business Overview
    • 5.14.2 Products & Services
    • 5.14.3 Financials
    • 5.14.4 Recent Developments
    • 5.14.5 SWOT Analysis
  • 5.15 Teva Pharmaceutical Industries Ltd.
    • 5.15.1 Business Overview
    • 5.15.2 Products & Services
    • 5.15.3 Financials
    • 5.15.4 Recent Developments
    • 5.15.5 SWOT Analysis

• 6 Market Segmentation

  • 6.1 Erythropoietin Sales Market, By Application
    • 6.1.1 Anemia Treatment
    • 6.1.2 Kidney Disease
    • 6.1.3 Cancer Treatment
    • 6.1.4 HIV/AIDS Treatment
    • 6.1.5 Others
  • 6.2 Erythropoietin Sales Market, By Product Type
    • 6.2.1 Epoetin Alfa
    • 6.2.2 Epoetin Beta
    • 6.2.3 Darbepoetin Alfa
    • 6.2.4 Epoetin Theta
    • 6.2.5 Biosimilar Erythropoietin
  • 6.3 Erythropoietin Sales Market, By Ingredient Type
    • 6.3.1 Human Recombinant Erythropoietin
    • 6.3.2 Animal-derived Erythropoietin
    • 6.3.3 Biotech-derived Erythropoietin
    • 6.3.4 DNA-derived Erythropoietin
    • 6.3.5 Others
  • 6.4 Erythropoietin Sales Market, By Distribution Channel
    • 6.4.1 Hospitals
    • 6.4.2 Retail Pharmacies
    • 6.4.3 Online Pharmacies
    • 6.4.4 Specialty Clinics
    • 6.4.5 Others

• 7 Competitive Analysis

  • 7.1 Key Player Comparison
  • 7.2 Market Share Analysis
  • 7.3 Investment Trends
  • 7.4 SWOT Analysis

• 8 Research Methodology

  • 8.1 Analysis Design
  • 8.2 Research Phases
  • 8.3 Study Timeline

• 9 Future Market Outlook

  • 9.1 Growth Forecast
  • 9.2 Market Evolution

• 10 Geographical Overview

  • 10.1 Europe - Market Analysis
    • 10.1.1 By Country
      • 10.1.1.1 UK
      • 10.1.1.2 France
      • 10.1.1.3 Germany
      • 10.1.1.4 Spain
      • 10.1.1.5 Italy
  • 10.2 Asia Pacific - Market Analysis
    • 10.2.1 By Country
      • 10.2.1.1 India
      • 10.2.1.2 China
      • 10.2.1.3 Japan
      • 10.2.1.4 South Korea
  • 10.3 Latin America - Market Analysis
    • 10.3.1 By Country
      • 10.3.1.1 Brazil
      • 10.3.1.2 Argentina
      • 10.3.1.3 Mexico
  • 10.4 North America - Market Analysis
    • 10.4.1 By Country
      • 10.4.1.1 USA
      • 10.4.1.2 Canada
  • 10.5 Erythropoietin Sales Market by Region
  • 10.6 Middle East & Africa - Market Analysis
    • 10.6.1 By Country
      • 10.6.1.1 Middle East
      • 10.6.1.2 Africa

• 11 Global Economic Factors

  • 11.1 Inflation Impact
  • 11.2 Trade Policies

• 12 Technology & Innovation

  • 12.1 Emerging Technologies
  • 12.2 AI & Digital Trends
  • 12.3 Patent Research

• 13 Investment & Market Growth

  • 13.1 Funding Trends
  • 13.2 Future Market Projections

• 14 Market Overview & Key Insights

  • 14.1 Executive Summary
  • 14.2 Key Trends
  • 14.3 Market Challenges
  • 14.4 Regulatory Landscape

Segments Analyzed in the Report

The global Erythropoietin Sales market is categorized based on

By Product Type

• Epoetin Alfa
• Epoetin Beta
• Darbepoetin Alfa
• Epoetin Theta
• Biosimilar Erythropoietin

By Application

• Anemia Treatment
• Kidney Disease
• Cancer Treatment
• HIV/AIDS Treatment
• Others

By Distribution Channel

• Hospitals
• Retail Pharmacies
• Online Pharmacies
• Specialty Clinics
• Others

By Ingredient Type

• Human Recombinant Erythropoietin
• Animal-derived Erythropoietin
• Biotech-derived Erythropoietin
• DNA-derived Erythropoietin
• Others

By Region

• North America
• Europe
• Asia Pacific
• Latin America
• Middle East & Africa

Key Players

• Amgen Inc.
• Roche Holding AG
• Johnson & Johnson
• Pfizer Inc.
• Novartis AG
• Bristol-Myers Squibb Company
• Hikma Pharmaceuticals PLC
• Teva Pharmaceutical Industries Ltd.
• Mylan N.V.
• Sandoz (a Novartis Division)
• Merck & Co., Inc.
• Seattle Genetics, Inc.
• UCB S.A.
• AbbVie Inc.
• Grifols S.A.