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28 public sector bases most purchasing decisions largely on price and is very often more receptive to less expensive products even if the quality might be questionable. Main Competitors U.S, companies have 65 percent of the Dominican import market for medical equipment and supplies. There is extensive local production of surgical instruments and supplies. However, 95 percent of this production is exported through the Free Trade Zone (FTZ) Program. Products manufactured in these FTZs include; wound management products (wadding, gauze, and bandages), general surgery and minimally invasive surgery Instruments, ophthalmic surgery instruments, disposables (syringes, needles, catheters, surgical gloves, clothing for operating rooms, and surgery sponges). There is limited manufacture of surgical supplies beyond the FTZs and this production is not sophisticated, mainly involving textile products (gauzes, bandages, and surgical drapes). Current Demand Best Prospects: 1. Surgical Instruments and Disposable Supplies: Public hospitals and private clinics are by far the largest potential users of surgical instruments and supplies. For disposable surgical products such as gauze, adhesive dressings, sterile surgical catgut, sterile suture materials and sterile tissue adhesives for surgical wound closure, the primary purchaser and user is the Dominican government. For more technologically advanced surgical products, such as sterilizers, the most important purchasers are the private clinics. 2. Homecare Medical: The incidence of respiratory difficulties and diabetes, the aging of the Dominican population, and the CAFTA-DR free trade agreement are the primary factors behind the industry’s 10 percent growth over the next three years. The market for these products is almost entirely supplied by imports and U.S. products enjoy a positive receptivity (65 percent of the market). 3. Used/Refurbished Medical Equipment: The Dominican market offers opportunities to exporters of used and refurbished medical equipment, especially that which has been refurbished by the manufacturer, who can use original replacement parts and provide a limited guarantee. In addition, buyers of used equipment usually require assurances that parts and maintenance can be obtained locally. Therefore, U.S. firms interested in this market should appoint a local distributor. The market for used devices (not refurbished) is limited to hospital furniture such as operating tables and hospital beds. There are good opportunities for these products, which do not always need to be refurbished and will generally be accepted with minor defects such as scratches and tears. The Dominican government does not impose restrictions on the importation of used/refurbished medical equipment. All imports of both new and used equipment are treated equally. 4. Diagnostic Equipment: Tomography equipment represents a very large percentage (approximately 69.1%) of the imports for diagnosis and imagery medical equipment, along with the corresponding supplies and spare parts. Barriers There are no significant trade barriers. Registration of healthcare products is required for drugs and medical devices only. The Dominican government institution responsible for issuing the Sanitary Registration certificates is the Department of Drugs and Pharmacies (Departamento de Drogas y Farmacias). For more information on the Sanitary Registrations, please visit drogasyfarmacias.gov.do. Available Market Research • Regulations on Registration of Pharmaceutical Products • Dominican Market for Used/Refurbished Medical Equipment U.S. Commercial Service Healthcare Technologies Resource Guide | 2012–2013
Egypt Summary The healthcare sector in Egypt, although large compared to its Middle East counterpart, has been relatively stagnant over the past few years. That being said, there should be a variety of investment opportunities as the Egyptian government is very keen on expanding the healthcare industry, especially relating to medical devices. In 2011, healthcare was responsible for 6.3% of GDP and total spending is expected to amount to $16.6 billion in 2012. Consumer healthcare grew by 12.6% in 2011 and spending is expected to reach $7.1 billion in 2012. The World Bank estimates that the average life expectancy for Egyptians has increased from 69 to 73 from the years 2000 to 2009. While the government has done much to mitigate disease in the country by way of supplying cleaner water and increasing immunization rates, hepatitis C still remains rampant as 9.8% of the population is believed to be infected with it and it seems to grow at a fixed rate of 500,000 new cases a year. The Ministry of Health operates 1300 hospitals which correspond to a supply of 60% of beds. Universities, the Army and the private sector constitute the other 40%. Healthcare expenditures by the government totaled $4 billion which is a 17% year-on-year increase. Market Entry U.S. medical equipment and products are traditionally well-received in Egypt due to their perceived high quality. Egyptian law requires that for public tenders, foreign companies must retain Egyptian commercial agents. However, most U.S. companies have found it beneficial to engage a local agent to handle the problems associated with communications, bureaucratic procedures, local business practices, and marketing. Based on geographical location or product basis, a firm can appoint multiple agents in Egypt to further enhance its success. Agent commissions would vary with services provided and the amount of individual contracts. Supplying reliable after sales service as well as spare parts and maintenance services is a key to maintaining a competitive advantage. Agents of medical equipment have found that keeping approximately 40% inventories of spare parts will satisfy the needs and demands of their clients. FDA approval is a key to having medical products registered and approved by the MOH in Egypt, although the MOH may still do additional testing on any medical device. The importation of used and refurbished medical equipment and supplies into Egypt is banned without prior approval of the MOH. Statistics Capital: Cairo Population: 82 million Currency: Egyptian Pound Language: Arabic U.S. Commercial Service Healthcare Technologies Resource Guide | 2012–2013 Contact Rania Mekhail Commercial Specialist rania.mekhail@trade.gov +202 2797-3487 29
Page 1: Healthcare Technologies Resource Gu
Page 4 and 5: iv What Can the U.S. Commercial Ser
Page 6 and 7: 2 Argentina Summary Overall healthc
Page 8 and 9: 4 Australia Summary The medical equ
Page 10 and 11: 6 Austria Summary Austria is a dyna
Page 12 and 13: 8 The Austrian market for medical e
Page 14 and 15: 10 potential. Orthopedic products,
Page 16 and 17: 12 to replace bigger and more expen
Page 18 and 19: 14 • Demand for invasive and noni
Page 20 and 21: 16 Chile Summary As the United Stat
Page 22 and 23: 18 Barriers Chile has a favorable i
Page 24 and 25: 20 driving factors include demand f
Page 26 and 27: 22 Czech Republic Summary The healt
Page 28 and 29: 24 EXPODENT October • Prague •
Page 30 and 31: 26 the best solution, possibly by b
Page 34 and 35: 30 Current Market Trends Egypt’s
Page 36 and 37: 32 human body solely or principally
Page 38 and 39: 34 Other than the risk assessment s
Page 40 and 41: 36 Coming Soon: New Regulatory Fram
Page 42 and 43: 38 Finland Summary High quality and
Page 44 and 45: 40 France Summary Total market dema
Page 46 and 47: 42 Barriers There are no significan
Page 48 and 49: 44 surgery where, according to an e
Page 50 and 51: 46 Tariffs, Import Regulation There
Page 52 and 53: 48 Trade Events MEDICA with Compame
Page 54 and 55: 50 the private sector’s expenditu
Page 56 and 57: 52 Main Competitors In the Greek ma
Page 58 and 59: 54 Guatemala Summary Present situat
Page 60 and 61: 56 Medical equipment is constantly
Page 62 and 63: 58 distributors handle several bran
Page 64 and 65: 60 India Summary The Indian healthc
Page 66 and 67: 62 The opportunity also exists for
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Page 74 and 75: 70 Italy Summary Italy is a mature
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78 seeking treatment in the Kingdom
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80 Kenya Summary Kenya is the most
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82 Republic of Korea Summary The Ko
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84 Tariffs Tariffs of medical devic
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86 In summary, selecting the approp
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88 Main Competitors Most large inte
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90 The Inspectorate and the RIVM en
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92 New Zealand Summary All New Zeal
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94 Nigeria Summary Nigeria is a net
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96 Norway Summary Norway is one of
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98 The Philippines Summary The medi
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100 The Center for Device Regulatio
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106 component of the Portuguese med
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110 the National Health Project in
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112 Saudi Arabia Summary The Saudi
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114 3. King Faisal Medical City in
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116 Trade Events MEDEXPO Saudi Arab
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118 The Serbian market is very rece
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124 Main Competitors Slovakia’s m
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126 Spain Summary According to the
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128 Main Competitors The United Sta
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130 Current Market Trends Two main
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132 Taiwan Summary Taiwan, an islan
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134 Trade Events Taiwan Internation
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136 Medical tourism is a new sector
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138 Ukraine Summary In 2011, the Uk
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140 The Ukrainian market is recepti
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142 Current Market Trends • The U
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144 U.S. Commercial Service Healthc
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146 U.S. Commercial Service Healthc
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148 Certification Reference Chart E
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150 Subsector Reference Chart Ratin
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152 Contacts The U.S. Commercial Se
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154 Vermont Susan Murray—Montpeli
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1208-05-17
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