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Besides Italy, where Menarini is one of the leading pharmaceutical groups, sales are mainly concentrated in Europe: Austria, Benelux, France, Germany, United Kingdom, Greece, Ireland, Portugal, Spain, Turkey and Switzerland. Menarini has now reached important positions in Eastern and Central Europe where it ranks no. 6 in the total market of this region including: Russia, Poland, Ukraine, the Baltic States, Czech Rep., Romania, Kazakhstan, Bulgaria, Belarus, Hungary, Slovak Rep., Uzbekistan, the Caucasian countries, Albania, Moldova and ex-Yugoslavia. Menarini is the leader on the market in the Baltic States, Ukraine, Belarus and ranking no. 2 in Russia and Kazakhstan.

Menarini has been present in Central America (Guatemala, Dominican Republic, Nicaragua, Honduras, Costa Rica, Panama, El Salvador) since the beginning of the 1980's and today is among the top five companies on the market.
In Argentina an affiliate was opened early 2001, and in Mexico in 2008.
In 2004 in Venezuela a cardiovascular product was launched. Colombia and Ecuador are two countries where Menarini has already introduced various products and will make new launches in the near future.

In Asia, Menarini created the first Joint Venture in India in 1995. Since then, Menarini has gradually increased its presence throughout the entire Asian territory, thanks above all, to the purchase of the Invida Group at the end of 2011 which merged with the Group under the name of Menarini Asia Pacific. Currently Menarini is therefore present and distributes its own products in India, China, Singapore, Australia, Hong Kong, Indonesia, Malaysia, New Zealand, South Korea, Taiwan, Thailand, the Philippines, Vietnam, Pakistan and Macao.

Menarini is present in Africa with a Joint Venture in South Africa, a market soon to be consolidated with the launch of new products currently under registration. Menarini is also consolidating its presence throughout North Africa (Morocco, Tunisia, Algeria, Libya, Egypt) and in French-speaking Africa. In the Middle East Menarini is consolidating its position mainly in Jordan, Lebanon, Syria, Saudi Arabia and the Gulf region where it has gained important market shares.