dubai’s healthcare sector, 2017 – outlook and trends

Dubai’s Healthcare Sector, 2017 – Outlook and Trends

Dubai’s PPP model and Mandatory health insurance: Big investment opportunity for private healthcare providers

Dubai Economy in collaboration with Frost & Sullivan have undertaken detailed studies of key industry and business segments in Dubai with a focus on trends and opportunities.



Healthcare Industry in DubaiEvolving healthcare infrastructure, strategic location supported by connectivity, and economic growth has helped Dubai become a major healthcare destination

Healthcare

Healthcare Infrastructure Healthcare Delivery Services

Medical Technology Pharmaceuticals



To meet growing demand, 18 private hospitals and 4 Government hospitals will be added by 2020 in Dubai

Hospitals:Dubai’s largely privatised healthcare sector has resulted in almost 70% of the patients in Dubai approaching private healthcare facilities

Clinics:Clinics to become more popular as a result of their specialised treatments and low treatment cost compared to hospitals

(DHA Statistics as till 2016)

Skin Care Clinics:

Hospitals Clinics and Health Centres

Outpatients and Inpatients (in Million)

28Private

1866Private

6Public

52Public

10.4 (72.4% private

and 27.6% public)

The number of clinics in Dubai is on a rise due to increased demand for healthcare and low establishment costs compared to hospitals. (Establishment of hospitals approximately costs between AED 350 and 550 Million, while establishment of clinics falls between AED 35 and 40 Million). High treatment costs in hospitals vs. clinics has led to increased demand for treatments in clinics.

• Dubai’s young population is one of the highest spenders on skin care in the world, which is expected to drive the demand for skin care clinics.• The number of skin treatments

performed in the private health care sector increased from 77,344 in 2012 to 226,037 in 2016.

Healthcare Infrastructure



Dental Clinics:Innovations in dental healthcare has resulted in affordable dental health services

Specialty Care Services:Dubai is positioning itself in highly specialised care services such as IVF and cosmetic surgeries

Cosmetic Surgery / Plastic Surgery

In Vitro Fertilisation


• In 2016, Dubai had 548 private clinics, 19 DHA clinics and 10 MoHAP clinics providing dentistry services.

• These dental clinics had 2,094 dentists in 2016 compared to 1,220 dentists in 2010.

• The highest number of dental treatments performed were related to periodontics followed by orthodontics.

• Dubai’s cosmetic surgery industry is expected to grow at an average rate of 12-14% till 2020.

• Liposuction was the most popular procedure followed by rhinoplasty, breast augmentation, and face lifts.

• Patients undergoing procedures are mainly in the 25 to 40 age group.

• IVF is one of the popular services, and is a major attraction for medical tourists due to the high quality care supported by clear laws (IVF treatment is free for Dubai’s Emirati couples and the costs are covered by the DHA).

• The number of IVF cycles conducted in 2015 was ~6,000 and it is expected to be more than 9,500 by 2025 in Dubai.

• The success rate of IVF treatments in Dubai is 60%; greater than the global average success rate which ranges from 45%-50%.



Healthcare Manpower:Apart from improving the quality of hospitals and clinics, the DHA is focused on increasing the skilled healthcare manpower in the Emirate


Dubai had 3.4 physicians per 1,000 population (2016) – Highest in the GCC and the 2nd highest in the world.

The Emirate had ~36,000 healthcare manpower in total (2016) - majority of it non-nationals.

3.9

3.4

2.8

2.7

2.5

Germany

Dubai

UK

Qatar

UAE

11.3

9.8

9.4

7.7

7.3

7.2

Germany

USA

UK

UAE

Qatar

Dubai

Physicians per 1,000 population (2016)

Nurses per 1,000 population (2016)



Healthcare Delivery ServicesMedical Tourism:Advancements in specialised care services and well-defined laws are expected to attract medical tourists from world-over

• Medical tourism revenue was AED 1.4 Billion in 2016 and is expected to reach AED 2.6 Billion by 2020.

• Dubai received 326,649 medical tourists in 2016 mainly from Asia (37%), the Middle East (31%) and Europe (15%).

• Predominantly young population in the age group of 25 to 45 years visit Dubai for services such as IVF and cosmetic surgeries.

• Dubai Health Experience (DXH) launched by the DHA is a healthcare portal that helps medical tourists with everything related to their travel to Dubai such as booking consultations, hospitality, travel, and visas.

Dubai ranked 16th in the world and 1st in the GCC

for medical tourism in 2016

Specialties in focusOrthopaedics

Sports MedicinePlastic Surgery

Dental proceduresDermatology & Skin care

Aesthetic surgeriesWellness

500,000Medical tourists expected in

Dubai by 2020



Healthcare Delivery ServicesIn Vitro Diagnostics: Market worth AED ~2.7 Bn in 2016, to reach AED ~3.4 Bn in 2020; molecular diagnostics in high demand; private lab check-up packages to drive IVD demand

In-Vitro Diagnostics(IVD)• High incidence of diseases such as diabetes, cardiovascular due to a sedentary lifestyle, DHA’s initiative

to emphasise preventive care through regular check-ups and health packages offered by private labs are expected to drive the demand for IVDs.

• The UAE’s In-Vitro Diagnostics market was worth ~ AED 2.7 Billion in 2016; to grow at a CAGR of 5.9% between 2016 and 2020 to reach ~ AED 3.4 Billion by 2020.

In-Vitro Diagnostics Market: Revenue (%) Forecast by Segment, 2017

Immunohistochemistry

SMBG

Clinical Microbiology

Tissue Diagnostics

Hematology

Hemostasis

Molecular Diagnostics

POCT

42%15%

5%

6%

4%

3%12%

13%

Key companies



Medical TechnologyMedical Devices:Increasing healthcare consumerism to boost sales of medical devices – Brand consciousness of consumers in Dubai to benefit international players

Medical Devices• The UAE’s medical devices market was worth ~AED 3.5 Billion in 2016; to grow at CAGR of 4% to reach

AED 4-4.2 Billion by 2020.

• Orthopaedic devices dominate the market - branded medical devices have higher preference in the UAE.

Medical Device Market: Revenue (%) Forecast by Segment, 2017

14%

10%

12%

9%6%5%

5%2%

2%3%

2%

30%

Ortho Cardio Minimally Invasive

Ophthalmology Wound Care Audiology

Respiratory Anesthesia Uro-Gyno Aesthetics

Neuro Robotics- Navigation Others

Key companies



Medical TechnologyDiagnostic Imaging Equipment:High demand for X-ray imaging equipment due to increasing significance of diagnostic imaging in physicians’ diagnosis

Diagnostic Imaging Equipment• High incidence of chronic diseases, ageing population, and use of diagnostic imaging by physicians for

decision making expected to boost demand for diagnostic imaging equipment.

• The UAE’s Imaging equipment market was worth ~AED 1 Billion in 2016 and is expected to reach ~AED 2.5 Billion by 2020.

Diagnostic Imaging Equipment Market: Revenue (%) Forecast by Segment, 2017

Key companies26%

21%

16%

15%

12%

6% 4%

Ultrasound MRGeneral X-ray CTInterventional X-ray MolecularMammographic X-ray



Medical TechnologyHealthcare IT:Digital transformation in healthcare to improve the quality of healthcare services for patients and reduce operational costs for healthcare providers

Healthcare IT- Digital Healthcare shift• The GCC’s Healthcare IT market was ~AED 1.95 Billion (2016).

• Digital transformation of the healthcare sector has connected patients and healthcare professionals through online portals, smart devices, mobile applications.

• Mobile health management is expected to witness the maximum growth as a result of smartphone based apps and other online tools.

• Health analytics – All the information collected through different technologies is analysed by healthcare providers using analytics and helps identify trends as well as monitor the effect of treatments.

Salama Project• The DHA plans to digitise patient’s health records and aims to go paperless in all its DHA facilities by the

end of 2017.

• The DHA has digitised ~1.4 Million patient records.

NABIDH Project• It enables exchange of patient data across all healthcare facilities in Dubai, which will help healthcare

providers to understand the patient’s medical history.



PharmaceuticalsFocus on pharmaceutical sector in Dubai’s Industrial Strategy is expected to attract pharmaceutical manufacturers to Dubai and reduce import dependency

Pharmaceutical Industry in the UAE• The UAE’s pharmaceutical industry was worth ~AED 10 Billion in 2016 and is expected to reach ~AED 15 Billion by 2020 at a CAGR of 10.5%.

• In the UAE, both branded drugs and generic drugs are sold in the market.

• Branded drugs dominate the pharmaceutical market in the UAE - almost 80% of the requirement is imported.

• Majority of the drugs manufactured in the UAE are generic drugs – only contribute to 30% of the

total drugs sold.

• The UAE Government aims to become a global hub for international pharmaceutical companies and plans to double the number of pharmaceutical factories from 19 to 36 by 2021.

Opportunity in Halal Pharmaceuticals• Global spending on halal pharmaceuticals was ~AED 285 Billion (2016).

• The main drivers are

- Increasing consumer awareness

- growing population, especially Muslims (25% of the world population)

Dubai Industrial Strategy 2030 - Pharmaceuticals and medical equipment industry one of the six industries in focus• Objective - To make Dubai a destination of choice for international pharmaceutical companies for

investments and production.



HC Outlook & Mega Trends for DubaiPatient centric models with focus on artificial intelligence and IT for patient engagement are the future prospects of Dubai’s healthcare sector

• Dubai is expected to become a global hub for healthcare and medical tourism – growing population, medical tourism and mandatory health insurance are expected to drive the growth.

• Dubai’s PPP law is expected to provide more protection for private players and the growing demand for healthcare are expected to attract healthcare providers.

• The DHA is expected to focus on the following to provide a world-class healthcare system: - Shift focus from curative care to preventive care through DHA’s initiatives and awareness programmes; patient engagement and regular check-ups to play a key role. - Clearly defined laws and high quality standards for specialised treatments such as IVF, cosmetic surgery, dental procedures (3D printing) are the USP of healthcare industry in Dubai – medical tourism in Dubai thrives on this aspect of the industry. - Focus on pharmaceuticals is expected to have increased investments on R&D and innovation. - Integration of healthcare services such as use of artificial intelligence in diagnosis expected to increase the efficiency of physicians. - HealthCare IT for patient engagement is expected to grow in the future; this improves the quality of healthcare services and reduces the operational costs for healthcare providers.

• Overall, focus on adopting a patient-centric model and improving the overall delivery system will continue to drive the growth of the healthcare industry.



HC Outlook & Mega Trends for DubaiWellness to drive the shift from curative care to preventive care

Some of the Smart Technologies in Dubai and the Future of HealthcareUse of information in healthcare sector is expected to drive for more customised care in a way that provides enhanced accessibility and improves quality while controlling costs.

From To

Provider-centric

Centralised, Hospital-based

Treating Sickness

Patient-centric

Decentralised,Community-basedPreventing Sickness(Wellness)

Focus

Location

Objective

Mobile Health Ultrasound Imaging Electronic Health Records (EHR)

• DHA also has launched several apps to enhance patient engagement. Some apps are:

- Dubai health Experience (DXH) - Hayati - Tifli - SEHHATY

• Ultrasound systems are capable of providing a higher image quality and a higher temporal resolution that allow for real-time imaging.

• Dubai has already launched Salama and NABIDH initiatives in public hospitals to digitise all patient records.



HC Outlook & Mega Trends for DubaiGlobal Healthcare investment to increase to improve the quality of healthcare and meet growing demand

2010 (USD Tn. )

2020 (USD Tn. )

• Healthcare expenditure as a percentage of GDP is expected to grow from 10% in 2012 to 12% globally in 2020.

• Dubai has a higher per capita health expenditure (AED 5,800) in comparison with the global average (AED 4,000).

• With the aim to provide a world-class healthcare system, it is expected that there will be an increase in spending with more emphasis on preventives services.

• Dubai’s healthcare industry was worth ~AED 44 Billion in 2016 and is expected to reach ~AED 75-80 Billion by 2020.

• Pharmaceutical industry in Dubai was worth ~AED 10 Billion in 2016 and is expected to grow with increased focus in Dubai Industrial Strategy.

• The UAE’s medical devices market was worth ~AED 3.5 Billion in 2016. It is expected to grow as a result of rise in healthcare consumerism.

• *Medical devices revenue includes therapeutic medical devices, diagnostic tools, patient monitoring equipment and supplies, and advanced medical imaging equipment and accessories.

6.12

10.83

0.86

1.52

0.34

0.59

Healthcare Medical Devices*Pharmaceutical and Biotechnology

Healthcare InvestmentGlobal Healthcare Spending Growth, Private

271 366

428588

0

200

400

600

800

1000

1200

Pvt. Public

2020 2011

Healthcare Verticals Revenue, Global, 2010 and 2020



AppendixGlossary and Definitions

Abbreviation Expansion

AED United Arab Emirates Dirham

CAGR Compounded Annual Growth Rate

CT Computed Tomography

DHA Dubai Health Authority

DHCC Dubai Health Care City

GCC Gulf Cooperation Council

IVD In Vitro Diagnostics

IVF In Vitro Fertilisation

MOHAP Ministry of Health and Prevention

MR Magnetic Resonance

NRL National Reference Laboratory

PPP Public Private Partnership

UAE United Arab Emirates

UK United Kingdom

USA United States of America

WHO World Health Organisation

Definition

Middle EastBahrain, Iran, Iraq, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syrian ArabRepublic, the United Arab Emirates and Yemen

Gulf Cooperation Council

Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates

United Arab Emirates

Emirate of Abu Dhabi, Emirate of Ajman, Emirate of Dubai, Emirate of Fujairah, Emirate of Ras al-Khaimah, Emirate of Sharjah, and Emirate of Umm al-Quwain

Crude Birth Rate

It is the number of live births occurring among the population of a given geographical area during a given year, per 1,000 mid-year total population of the given geographical area during the same year.

Perinatal Mortality Rate

Rate of stillbirths and deaths during the perinatal period, per 1000 births

Infant Mortality Rate

it is the probability of a child born in a specific year or period dying before reaching the age of one.



AppendixDHA strives to provide world-class healthcare system – increase access to healthcare, improve overall care quality, build a patient-centric model…

1. Dubai Health Strategy 2016-2021

2. Dubai Health Strategy 2013-2025

3. Ten-year Healthcare Plan

• Strategy aims to increase quality of healthcare services to ailing patients, while also developing the culture of early detection through regular check-ups.

• The strategy has more than 100 initiatives, which are to be implemented between 2016 and 2021.

• The objectives of the strategy are:

• The objective of the strategy is to establish Dubai as a hub for healthcare and medical tourism by providing its citizens with world-class healthcare services.

• The main goals of the strategy are prevention and awareness, easy access to healthcare services, quality, and investment and competitiveness

• The key highlights of this strategy are:

• The plan focuses on building a patient-centric model of care and is assessed and updated every two years by the DHA.

• It mainly focuses on developing the healthcare manpower in the Emirate.

• The key features of the plan are:

- To ensure a healthy and safe environment for its citizens

- To ensure provision of comprehensive high-quality healthcare services on par with international standards

- To achieve innovation in healthcare services and products

- To improve efficiency in healthcare services provided

- To create an integrated database that can work with Smart Government initiatives

- To promote public and private collaboration in healthcare sector

- To revamp the Rashid Hospital with a 900 bed capacity at a cost of AED 3 Billion.

- To build three new hospitals and 40 new primary healthcare centres.

- To expand the trauma centre with 160 treatment rooms

- To set up new specialty centres for cancer, heart, kidney, and cosmetic surgeries.

- To expand out-patient treatment rooms in order to reduce the pressure on hospitals at a cost AED 38 Billion.

- The DHA plans to build three new medical colleges and five nursing schools by 2025 in order to meet Dubai’s healthcare manpower requirement.

- To make the nursing profession more attractive, the DHA plans to increase the nurses’ wages at par with western countries and allow flexible shifts.

- To develop the residency programme for expatriate healthcare professionals, while sending Emirati nationals for medical degrees in fields that have shortages.



AppendixThe DHA plans to build three new medical colleges and five nursing schools by 2025 in order to meet Dubai’s healthcare manpower requirement.

4. Mandatory Health Insurance Law

5. Dubai Health Care City (DHCC) – World’s largest

healthcare free zone6. UAE Vision 2021

7. Dubai Plan 2021

• According to the law, the Government of Dubai will provide insurance coverage for all Emiratis, while expatriates will be covered by their respective employees.

• As of 2016, only 2% of the population were not covered under the health insurance scheme.

• Health insurance coverage has been made mandatory for visa applications and renewals in Dubai and requires visitors to Dubai also to be covered under the scheme.

• Expo 2020 is likely to bring in a surge of visitors to Dubai, which is expected to add to the growth of the domestic healthcare market, especially out-patient services.

• Mandatory health insurance scheme only covers basic medical treatments. For any life and critical illness the patients will have to pay extra premium.

• It is also expected to increase private participation in the healthcare industry, with clear reimbursement rates and procedures in place.

• Its vision is to become an internationally-recognised destination for quality of healthcare, integrated clinical and wellness services, medical education, and research.

• Set of key themes that showcases UAE’s vision for socio-economic development in the next decade.

• On the agenda is achieving a world-class healthcare system for which the Government plans to provide healthcare services at the highest quality on par with international standards.

• It plans to emphasise the importance of preventive care over curative care and encourage its citizens to lead a healthy lifestyle.

• The plan is built on six different themes and the theme that focuses on healthcare is ‘The People: Educated, Cultured, and Healthy Individuals’.

• Objective of the theme is to encourage individuals to take care of their own health and their family by taking preventive care and leading a healthy lifestyle so that they can contribute to the economy and society.

- The Dubai Healthcare City Authority is the regulatory authority that governs the DHCC, while the Centre for Healthcare Planning and Quality is the licensing authority.

- The DHCC comprises two phases

- Phase I is dedicated to healthcare and medical education, while

- Phase II is dedicated to wellness.

- In 2016, the DHCC had approximately 160 healthcare facilities such as hospitals, clinics, and laboratories.

- The DHCC provides healthcare providers with clinical spaces, commercial/ retail spaces, freehold/ land leasing solutions, and business centres.

dubai’s healthcare sector, 2017 – outlook and trends

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