Medical Devices Market in BRIC (Brazil, Russia, India & China)

Putting things in perspective

With a combined population of 3.0 billion people and with significant unmet medical need, the challenges and opportunities of the BRIC markets are considerable. The economic downturn has affected these markets varyingly; for example, the Brazilian import market may be affected by disadvantageous US$ exchange rates, but China is affected more by a weak economy in the USA, its major market. Significant growth rates are impressive, but the low starting point – along with a range of other operational issues – means companies must be targeted in the opportunities they pursue.

Opportunities do exist

There are, of course, wide regional differences in expenditure levels within the BRIC countries, far more so than in developed countries where health systems have evolved to provide a more uniform level of coverage. All four countries have a relatively wealthy urban population with a far greater spending power than their respective national average. These urban populations have grown rapidly, and number hundreds of millions. The challenge for these countries is to extend this level of wealth to the rest of the population, in order that better levels of healthcare become affordable.

A long haul

The prevailing economic woes have to be seen over the long term. This is evolution not revolution, and change will be incremental. Short-term opportunities exist in meeting the health demands of the burgeoning middle classes, and future prospects are bright, where steady growth in BRIC markets will erode commercial differences with the established markets in North America, Japan and Europe.
Highlights from the Region

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Brazil

Brazil has the largest economy and medical device market in Latin America, but per capita medical expenditure is still very low. The highest expenditure is in the large cities, such as Sao Paulo or Rio de Janeiro, but producers are moving into regional markets outside the major state capitals. Dilma Roussef, who took office as President on 1st January 2011, has largely followed in the footsteps of former president Lula da Silva, maintaining market-friendly policies and ensuring broad policy continuity. The next elections will be held in 2014. GDP is forecast to grow 3.5% in 2013 and at an average of 4.1% through to 2018. With a growing economy, if inflation is kept in check, there will be more money available to spend on healthcare both in the public and private sectors.

Russia

In 2012, the Russian market for medical equipment and supplies is estimated at US$5,455.7 million. Per capita spending is low by European standards at US$39 per capita. This is despite rapid growth, especially of imported products, in the 2007-11 period. Russian medical device manufacturers are generally small and under-capitalised, and tend to produce obsolete products; they can only compete with Western products in terms of cost. The country has a strong scientific research base but has no experience of commercialising new products. Exports are low and centred on other former USSR markets. In November 2010, the government developed a strategy that will help the medical device industry to attract investment, create new jobs and produce competitive, safe, good quality and affordable products to fulfil the healthcare system’s requirements. Currently, the bulk of high-tech medical equipment comes from abroad. If the objectives of the plan are realised, by 2020, the local industry will be able to meet 50% of the local demand for medical devices.

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India

The Indian market for medical equipment and supplies ranks among the world’s top 20 but, despite strong growth rates, the market remains disproportionately small with per capita spending of US$2.4. The private sector is the dominant healthcare provider, particularly in urban areas, and as such is the major end-user of medical equipment. High quality, high tech products are sought after, particularly by facilities run by corporate groups such as Apollo Hospitals and Fortis Healthcare. The latest Five Year Plan (2012-17) proposes an ambitious expansion of healthcare services including doubling the level of public health spending to 2.5% of GDP and increasing health insurance coverage from 25% to 75%. Given the lack of healthcare infrastructure, the government’s plans mark an opportunity for private investors, and manufacturers of medical devices, as new facilities are constructed and existing ones are upgraded. Detailed regulation of medical devices is still under consideration. New regulations were to have been published as the Drugs, Cosmetics and Medical Device bill in the winter 2012 parliamentary session, but implementation has been further delayed.

China

For 2012, Espicom estimates market growth to be in the region of 21.4%; one of the fastest growing markets in the world. High rates of growth are not uncommon in the Asian region, but on the back of a huge market size, China’s growth is particularly pronounced. Latest annual data to December 2012 show that imports have grown very strongly during the period, rising by 20.8% to reach US$10,329 million. All product categories posted strong growth during the period, with orthopaedic & prosthetic products leading the way with a rise of 51.4% over the previous year. All other categories achieved at least 15% growth during the period. The prospects for medical device spending is huge; the government has committed heavily in the construction of thousands of hospitals, healthcare centres, clinics and this will inevitably lead to spending on capital goods, most notably medical devices, equipment and furniture at an unprecedented rate in a relatively short space of time. In addition, the government is actively encouraging the development of the private sector to cater for the growing needs of China’s middle classes and restrictions on foreign investors operating hospitals have been lifted.

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Table of Content

Executive Summary 1

Key Background Data 3
Geographic  3
Political  3
Economic  3
Healthcare System  4
Mais Saude Programme  4
Main World Bank Health-Related Projects  4
Health Insurance  5
Health Expenditure  5

Market Developments 7
Output of Medical Devices Stalls despite Government Measures to Support Local Industry 7
Medical Device Imports Falter in Third Quarter of 2012  8
Medical Device Exports Record Weak Performance in 2012 8
Ministries Sign Partnership to Support Health Research 9
Toshiba’s Production Facility to Start Operations in Early 2013 9
Siemens Opens Diagnostic Imaging Plant in Brazil  9
Fanem Reports Strong Growth in Neonatology Sales in First Half of 2012 9
Multinationals Set to Boost Medical Device Production in Booming Medical Market 9
Ministry of Health to Invest R$505 million in Radiotherapy 10

Medical Market Analysis 11
Overview  11
The Market in 2012  12
Past Performance 2007-11  13
Future Performance 2012-17  14
The Brazilian Market for Consumables 21
The Brazilian Market for Diagnostic Imaging Apparatus 24
The Brazilian Market for Dental Products 27
The Brazilian Market for Orthopaedic & Prosthetic Devices 30
The Brazilian Market for Patient Aids 32
The Brazilian Market for Other Medical Devices  34

Annual Imports 36
Consumables 37
Diagnostic Imaging Apparatus  37
Dental Products  37
Orthopaedic & Prosthetic Products 37
Patient Aids  37
Other Medical Products  37

Monthly Imports 54

Annual Exports 55
Consumables 56
Diagnostic Imaging Apparatus  56
Dental Products  56
Orthopaedic & Prosthetic Products 56
Patient Aids  56
Other Medical Products  56

Monthly Exports 73

Domestic Production  74
Trade Associations 81
ABIMED  81
ABIMED’s Members 2011  81
ABIMO  82
ABIÓTICA 82
ABRAIDI  82
ABRASP  82
ABRASP’s Members 2011  82
ASSIBRAL 83
CBDL 83

Domestic Manufacturing 84
National Manufacturers  86
Cremer  87
Dabi Atlante  88
EDLO 88
Erwin Guth  88
Fanem  88
GMReis  88
Gnatus  89
JP Indústria Farmacêutica & Olidef 89
Lifemed  89
Mediphacos  89
MV Sistemas  89
Neodent 90
Olsen Odontomédica  90
Samtronic 90
Segmenta 90
Sercon  90
Silimed  90
Sismatec  91
WEM  91
Multinational Manufacturers 92
3M 92
Agfa Healthcare  92
Air Liquide 92
Apotheka 92
Baxter 92
Becton Dickinson 93
Braun 93
Carefusion 93
Covidien 93
Fresenius 93
GE Healthcare 93
Getinge - Maquet 94
Guerbet  94
Johnson & Johnson  94
Kavo  94
Nipro 95
Philips  95
Scantek Medical  95
Siemens  95
St. Jude Medical  95
Synthes  96
Toshiba  96

Multinational Activity  97
Accessing the Market  99
Market Environment 99
Distribution 100
Mercosur  100
Import Duties & Taxes  100
Procurement  104
Trade Fairs  104
FIOSP  104
HEMO EXPO 104
Hospitalar  104
Hospital Business  105
JPR  105
MD & M Brazil  105
Reatech Expo  105

Medical Device Regulations 106
Registration 106
Labelling Requirements  107
Used/Refurbished Equipment 107

Methodology & Sources 108
Trade Code Classifications  108
Methodology  111
Sources  112