Full-year 2011 revenues were $67.4 billion, an increase of 1% compared with $67.1 billion in full-year 2010, which reflects an operational decline of $1.6 billion, or 2%, and the favorable impact of foreign exchange of $1.9 billion, or 3%. For full-year 2011, U.S. revenues were $26.9 billion, a decrease of 7% compared with full-year 2010. International revenues were $40.5 billion, an increase of 6% compared with the prior-year, which reflects 1% operational growth and a 5% favorable impact of foreign exchange. U.S. revenues represented 40% of total revenues in full-year 2011 compared with 43% in full-year 2010, while international revenues represented 60% of total revenues in full-year 2011 compared with 57% in full-year 2010.
Primary Care unit revenues were favorably impacted primarily by foreign exchange, growth from Celebrex, Lyrica, Pristiq and Spiriva, among others, and the addition of $93 million, or 2%, from legacy King products, while negatively impacted by the loss of exclusivity of Lipitor and Caduet in the U.S. in November 2011, Lipitor in various other developed markets during 2010, as well as Aricept in the U.S. in November 2010. Taken together, these losses of exclusivity reduced Primary Care(4) unit revenues by $775 million, or 13%, in comparison with fourth-quarter 2010.
Specialty Care unit revenues were positively impacted by foreign exchange and growth in Enbrel in developed markets and Prevenar (7-valent) in Japan. U.S. Prevnar 13 revenues in fourth-quarter 2011 were lower than in the prior-year quarter primarily because most patients eligible to receive the Prevnar 13 catch-up dose have already been vaccinated. Specialty Care unit revenues were also negatively impacted by the loss of exclusivity of Vfend and Xalatan in the U.S. in February and March 2011, respectively. Collectively, these losses of exclusivity reduced Specialty Care unit revenues by $205 million, or 5%, in comparison with fourth-quarter 2010.
Emerging Markets unit revenues were impacted by several factors. Volume growth was more than offset by the negative impact of foreign exchange and increased pricing pressures as well as by certain other events, including changes in institutional purchase patterns in Turkey and Brazil, currency devaluation in Venezuela as well as the loss of exclusivity of Lipitor in Brazil and Mexico in 2010. These losses of exclusivity reduced Emerging Markets unit revenues by $29 million, or 1%, in comparison with fourth-quarter 2010.
Established Products unit revenues were mainly impacted by the loss of exclusivity of Effexor XR, Protonix and Zosyn in the U.S., which taken together reduced Established Products unit revenues by $208 million, or 9%, in comparison with fourth-quarter 2010. Additionally, fourth-quarter 2011 revenues were negatively impacted in comparison with fourth-quarter 2010 by the entry of multi-source generic competition in the U.S. following the end of the 180-day exclusivity period for donepezil (Aricept) in May 2011. These declines were partially offset by $150 million, or 6%, from the addition of legacy King products, as well as by foreign exchange and by revenue from our agreement granting Watson Pharmaceuticals, Inc. the exclusive right to sell the authorized generic version of Lipitor in the U.S. Total revenues from established products in both the Established Products and Emerging Markets units were $3.3 billion, with $954 million generated in emerging markets.
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