succeed in germany‘s healthcare market · global digital health market projection global digital...
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30.11.2015
Succeed in Germany‘s Healthcare Market
GTAI Seminar @ MEDICA 2015
Brief Introduction to Germany Trade and Invest
Germany’s healthcare system and market
Growing your business in an aging society
Realize opportunities in connected health
Market Access
Funding and partnering options in medical technology clusters
Agenda
Succeed in Germany‘s Healthcare Market
November 2014 2Germany Trade & Invest
Germany Trade and Invest is the foreign trade
and inward investment promotion agency of
the Federal Republic of Germany.
Succeed in Germany‘s Healthcare Market
3Germany Trade & Invest
www.gtai.com
November 2015 www.gtai.com
We help international companies
establish business operations
in Germany.
Succeed in Germany‘s Healthcare Market
4Germany Trade & InvestNovember 2015 www.gtai.com
Publications
Succeed in Germany‘s Healthcare Market
Germany Trade & Invest 5November 2015 www.gtai.com
Individual Consulting:
Market and industry reports
Market entry analyses
Site selection
Partnering
Tax and legal information
Funding and financing
Our services:
Succeed in Germany‘s Healthcare Market
6Germany Trade & InvestNovember 2015 www.gtai.com
Healthcare Market Germany
One of Germany’s largest growth markets at a glance
7
80.8 million inhabitants
70 million people have public health
insurance
124 public and 45 private health
insurance companies
5.16 million people are
employed in the German healthcare industry
9 million people
privately insured
Source: Statistisches Bundesamt 2015; Bundesministerium für Gesundheit 2015
EUR 315 billion
healthcare expenditure
21,000 pharmacies
1996 hospitals
with 500,671
beds
11.3 % of GDP
208,000 GPs,
dentists and other specialists
2.3 million other
healthcare professionals
3 % p.a. growth
rate healthcare
sector
November 2015 Germany Trade & Invest www.gtai.com
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Healthcare Market Germany
158
195
212
234
288300
315
0
50
100
150
200
250
300
350
1992 1996 2000 2004 2010 2012 2013
Healthcare expenditure in Germany 1992-2013 (in EUR billion)
Healthcare expenditure in Germany exceeded the EUR 300 billion mark
Source: Statistisches Bundesamt 2015
8Germany Trade & InvestNovember 2015
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Private
694
(35%)
Charity
based
706
(35%)
Public 596
(30%)
1996 Hospitals
Germany has 1996 hospitals under either private, charity based or public
ownership
Source: Statistisches Bundesamt (Hrsg.), Grunddaten der Krankenhäuser 2013
Germany‘s Healthcare Market – hospitals
9
Number of hospitals and
ownership in 2013
16.2%
34.8%
40.4% 35.4%
43.5%
29.9%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0%
50.0%
private charity based public
Development of share of hospital
ownership 1993-2013
Germany Trade & InvestNovember 2015
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Germany‘s Healthcare Market – medtech spotlight
German Expenses and
German Production
Germany spends € 28 bn on medical technology p.a.
Source: BVMED – Branchenbericht 2013
10Germany Trade & Invest
German Market Segments
0
5
10
15
20
25
30
German Market Size German Production
Exports
Sold in
Germany
Medical Devices
€ 12.6 bn
44%
Medical Aids
€ 14.7 bn
52%
Dressings
€ 1 bn
4%+4%
28 bn
22.3 bn
November 2015
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Germany‘s medical technology industry is comprised of more than
11,000 companies with about 175,000 employees.
Germany‘s Healthcare Market – medtech spotlight
Germany Trade & Invest 11
Source: BVMed Annual Report 2012
> 20 employees
~ 1,250 companies
Total: ~ 98,900 employees
< 20 employees
~ 10,000 companies
Total: ~ 75,000 employees
~ 86 %; < 100 employees
~ 11 %; 100 – 499 employees
~ 3%; > 500 employees
November 2015
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Germany‘s Healthcare Market – medtech spotlight
Ranking of Products Made in
Germany
(Share of Total Medtech
Production)
Despite a competitive domestic medical device industry, Germany is a
significant importer.
Source: DESTATIS: Grunddaten der Krankenhäuser 2013; BVMED – Branchenbericht 2013
12Germany Trade & Invest
German Medical Technology
imports account for € 10 bn p.a.
• X-Ray and other radio active apparatus…… 30%
• Devices and Materials for Dental……………… 17%
• Prostheses and artificial joint implants……… 10%
• Endoscopes and surgical instruments…… 8%
• Orthopaedic apparatus……………………………… 6%
• EEG and other electrical diagnosti apps…… 5%
• Transfusion and Infusion…………………………… 5%
• Disposables………………………………………………… 5%
• Medical needs furniture……………………………… 4%
• Artificial kidneys…………………………………… 4%
• Apparatus for anaesthetics/breathing……… 3%
• Ophthalmic segment………………………………… 2%
• Wheel chairs…………………………………………… 1%
EU
Rest of Europe
North America
Asia
Middle- and
South AmericaMiddle East
Rest of World
33%
15%28%
1%
18%
3%
November 2015
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Source: DB Research 2010, Statista 2014, Statistische Bundesamt 2014
Demographic Challenges
13
Growing demand for healthcare services drives the development of
digital healthcare solutions in Germany
Chronic Diseases• Chronic and long-term diseases account for about 80 percent of
the German healthcare spending (EUR 200 billion)• Within 14 years the number of people with diabetes mellitus has
risen from 5.8 to 7.2 million people.
Care dependency• 2020: 2.5 to 3 million • 2050: 3.25 to 4 million
Aging Society• 2035: 24 million people aged 65 years or older
(31 percent of the population)
Germany Trade & InvestNovember 2015
14
Business opportunities in an aging society
Self-medication
Preventive
Healthcare
Med Tech
Medical and Technical
Aids
E-Health
Pharma
Healthcare ingredients
€ 34 Billion
(+5% vs. LYP)
€ 6.5 Billion
€ 6.8 Billion Euro
(+5% vs. LYP)Source: Statistisches Bundesamt, Statista, 2013
+4% vs. LYP
non-prescription
medicinal products:
€ 7.3 Billion
(+6% vs. LYP)
November 2015 www.gtai.com
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Germany‘s growing digital economy offers outstanding conditions for
new products and solutions in the healthcare industry
Source: BITKOM 2014, eMarketer 2013
Digital Market Opportunities
15
Use of Internet• Around 77 percent (63 million) of the German population
are regularly online• Most internet users in Europe
Software Market• Single largest software market in Europe • 24.5 percent of the European software market by
value
Mobile Devices• About 24.2 million smartphones were sold in 2014
(23 percent increase compared to 2012)
Germany Trade & InvestNovember 2015
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Global Digital Health Market Projection
Global digital health market
2013-2020 in USD billion
The global digital health market will more than double by 2017 and
exceed USD 200 billion in 2020
Source: Arthur D. Little 2014
23.8
59.7
103.2
20.024.8
29.1
6.4
24.2
55.9
0.44.5 6.3
10.1
22.6
38.9
0.0
50.0
100.0
150.0
2013 2017 2020
Wireless Health EHR / EMR Mobile Health
Telehealth Other
233.3135.9
Germany Trade & Invest 16
46%
36%
23%
6%
21%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Telehealth Mobile
Health
Wireless
Health
EHR/EMR Other
60.8
Annual growth rate by segment
2013-2020 in percent
November 2015
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eHealth
• market growth 2010-2020:
5% p.a.
• revenue in 2020: EUR 34 billion
Telemedicine
• market growth 2010-2020:
10% p.a.
• revenue in 2020: EUR 19 billion
Growth Market eHealth
17
eHealth
• revenue in 2013: EUR 6.5 billion
• market growth: 10% p.a.
Telemedicine
• market growth: 10% p.a.
• current market share: 25%
(expected to rise up to 30%)
GermanyEurope
Source: EU-Commission Health Information Network (HINE), Roland Berger, BCC Research DB Research 2010, Deloitte 2014
Steady growth of revenue is predicted for both eHealth and Telemedicine
in Europe and in Germany
Germany Trade & InvestNovember 2015
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General Practitioners
Pharmacists
Specialists
Dentists
Healthcare Professionals
Insured People
Health Insurances
Rehabilitation Centers
Hospitals
Connected Health
Source: gematik GmbH 2014, Statistisches Bundesamt 2015
2.3 million other healthcare
professionals
124 public
health insurances
80.9 million inhabitants
2,000 hospitals
21,000 pharmacies
217,000 GPs, dentists and specialists (incl. psychotherapists)
Electronic
Health Card
Germany Trade & Invest 18November 2015
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Growth Market M(obile)Health
427612
8331097
1419
1743
110
123
138
154
173
194
36
53
73
98
144
186
322
407
497
593
695
755
12
25
37
52
60
69
0
500
1000
1500
2000
2500
3000
2012 2013 2014 2015 2016 2017
Advertisment Distribution & Transaction Services Software Hardware
907
1220
1578
1994
2491
2967
Development of the mHealth market in Germany through 2017
(in EUR million)
19
The German mHealth market will grow to around EUR 3 billion in 2017
Source: A.T. Kearney 2013
Germany Trade & InvestNovember 2015
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Health and Fitness Apps
Downloads of health and fitness apps: user share by category in
Germany in 2013
20
The most popular mHealth apps are related to nutrition and workout
Source: Statista 2015, research2guidance
21%
42%
13%
8%
3%
%
10%
3%
37%
34%
12%
5%
5%
2%
%
5%
0.0% 20.0% 40.0% 60.0% 80.0% 100.0%
nutrition & calorie counting
workout
tracking
giving up smoking
apps for women
health news
sleep
othersubject to a charge
free of charge
Germany Trade & InvestNovember 2015
www.gtai.com 21Germany Trade & Invest
Start in 2012:
European
Commission
Proposal
European
Parliament
First Reading
EU Council
First ReadingTrialogue
Proposal
adoption
2018 Conclusion:
Proposal
adoption
effective
Regulatory Framework Revision
Regulatory Update
Revision Timeline and Involved Bodies
November 2015
06/2015: Now: Next 2016:2014:
22Germany Trade & Invest
Market Access
Buyers and Sales Channels
▪ Hospitals
▪ Purchasing Groups
▪ Tenders
▪ Practices
▪ Care homes
▪ Homecare medical supply stores
▪ Out of pocket consumption
Multiple Buyer Options Direct Sales Preferred
▪ Digital Sales
▪ „Distributors“:
▪ License out to Manufacturers
▪ Fee-For-Service Sales Teams
▪ Agents/Sales Reps
▪ Wholesalers
▪ Consultants
▪ Direct Sales: Subsidiary
November 2015 www.gtai.com
23Germany Trade & Invest
Market Access
Common Strategy: Direct Sales out of German Subsidiary
Risk class
Liability
Margin
Training
Service
Regulatory
F(x) = Need for own subsidiary in Germany
1
I IIa IIb III
X =
The need for a subsidiary depends on the product to be sold
V
November 2015 www.gtai.com
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9% of revenue spend on R&D
15% of the employees work in the
R&D departments
32% of the products less than 3
years old
1,381 patent applications in 2014
2nd in the world in terms of number
of med tech applications
Highly innovative industry!!!
Funding and Partnering
R&D Spending of German MedTech
Companies 2012 (bn US $)
German medical technology companies are highly innovative.
Source: Spectaris 2015, BVMed 2015, Statista 2015, European Patent Office 2015
2.4
2.72.6
2.8
2010 2011 2012 2013
24November 2015 Germany Trade & Invest
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Funding and Partnering
German Medical Technology Clusters
The German Medical Technology Clusters play a central role in
Germany´s med tech innovation landscape.
More than 30 specialized cluster networks focusing on medical technology.
Goal:
• connecting companies, hospitals, universities, and other research institutions
• Support continuous innovation in R&D
• help obtain funding for joint R&D projects,
• provide shared facilities, and
• organize educational training programs
25November 2015 Germany Trade & Invest
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A great number of funding programs on various levels are available for
medical technology companies in Germany.
Funding and Partnering
Berlin
Hamburg
Bremen
Schleswig-Holstein
Mecklenburg-Vorpommern
Brandenburg
Saxony-Anhalt
Saxony
Niedersachsen
Thuringia
North-RhineWestphalia
Hessen
Rheinland-Pfalz
Bavaria
Baden-Württemberg
Saarland
Europe GermanyFederal States
Horizon 2020e.g.
BayMedPro FIT
26November 2015 Germany Trade & Invest
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Funding and Partnering
The combination of first class companies, strong clusters and various
funding options lead to excellent cooperation possibilities.
Excellent Cooperation Possibilities
Clu
ste
rs
Co
mp
an
ies
Fu
nd
ing
German MedTech Excellence
27November 2015 Germany Trade & Invest
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In combination with the German Medical Technology Clusters we are the
gate to your success in Germany.
Funding and Partnering
German
MedTech Cluster
Funding Options
&
Strategic Partnerships!
28November 2015 Germany Trade & Invest
Berlin Headquarters
Friedrichstraße 60
10117 Berlin
Germany
T. +49 (0)30 200 099-0
F. +49 (0)30 200 099-111
www.gtai.com
Contact
© 2014 Germany Trade & InvestAll information provided by Germany Trade & Invest has been put together with the utmost care. However we assume no liability for the accuracy of the
information provided.
Germany Trade & Invest
Dr. Marcus Schmidt
Director Healthcare
T. +49 (0)30 200 099-600
Germany Trade & Invest
Foreign Trade and Inward Investment Promotion Agency
29Germany Trade & InvestNovember 2015