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Medical Device Market - Supply Chain Trends in Emerging Markets - 2011 Report
1.
18 May 2011
Supply Chain Trends in Emerging Markets MEDICAL DEVICE SUPPLY CHAIN COUNCIL Management Consultants Where Innovation Operates
2.
Emerging Markets Growing
in Importance Mature markets are becoming more challenging Growth is slowing Reimbursement pressure is growing Medical device companies are increasingly turning to emerging markets to accelerate growth Five-year medical device CAGR in mature markets is estimated to be 7.5% vs. an emerging markets rate of 15%* BRIC five-year CAGR is forecasted to be 20% What supply chain trends and operational challenges result from this increased focus on emerging markets? * Source: The World Medical Markets Fact Book, 2010 PRTM MDSCC Presentation—18 May 2011 | © 2011 PRTM Proprietary CONFIDENTIAL | 2
3.
Supply Chain Priorities
in Emerging Markets PRTM MDD Emerging Markets Study set out to explore the implications of emerging market expansion on supply chains How important is emerging market growth for medical device companies? How are companies managing emerging market supply chains? Which countries/regions are the highest priorities? What are the current operating models deployed (distributors, JVs, mfg/label in country/region, etc.) and what changes are being considered in key emerging markets? What are the primary risks, concerns in each market? PRTM MDSCC Presentation—18 May 2011 | © 2011 PRTM Proprietary CONFIDENTIAL | 3
4.
Strong Growth Expected
in Emerging Markets While emerging markets represent ~8% of median revenue today…this is expected to change What is your forecasted 2011 % sales How do emerging market sales growth for emerging markets? growth plans compare to overall company growth plans? 7% 7% Significantly higher 21% 14% Slightly higher 0–5% 36% 5–10% Same 43% 10–20% Lower 29% > 20% 43% No emerging market objectives 50% report forecasted 2011 growth Over 80% indicate three-year growth projections of 10% or higher in emerging in these markets are slightly or significantly markets higher than overall company growth projections Source: PRTM Medical Device Supply Chain Priorities in Emerging Markets Survey, April 2011 PRTM MDSCC Presentation—18 May 2011 | © 2011 PRTM Proprietary CONFIDENTIAL | 4
5.
Implications for Emerging
Market Supply Chains Over 50% of respondents are considering changes to emerging market distribution models and 30% are considering changes to manufacturing models Are you considering changing your operations, distribution or repack/re-label models in any emerging markets? 100% 80% 46% 69% 60% 77% No 40% Yes 54% 20% 31% 23% 0% Mfg Model Distribution Model Repack/Relabel Model Source: PRTM Medical Device Supply Chain Priorities in Emerging Markets Survey, April 2011 PRTM MDSCC Presentation—18 May 2011 | © 2011 PRTM Proprietary CONFIDENTIAL | 5
6.
Changing Strategy to
Enhance Market Access Market access is the most often cited driver of potential changes to operations and distribution models in key markets Which of the following factors is Which of the following factors is influencing potential emerging influencing potential emerging markets operations strategy markets distribution strategy change? change? 10 10 8 8 6 6 4 4 2 2 0 0 China India Brazil Russia Eastern Latin SE Asia China India Brazil Russia Eastern Latin SE Asia Europe America Europe America Cost Reduction Cost Reduction Market Access/Sales Growth Market Access/Sales Growth Tax Optimization Tax Optimization Risk Mitigation Risk Mitigation Source: PRTM Medical Device Supply Chain Priorities in Emerging Markets Survey, April 2011 PRTM MDSCC Presentation—18 May 2011 | © 2011 PRTM Proprietary CONFIDENTIAL | 6
7.
Evolving Manufacturing Operations
Models Which option best describes your If you are planning to change current manufacturing operations models, which manufacturing model in each country/region? models are you considering? SE Asia SE Asia Latin America Latin America Eastern Europe Eastern Europe Russia Russia Brazil Brazil India India China China 0% 50% 100% 0% 50% 100% Make in country (region) for sale in country Make in country (region) for sale in country Make in country (region) for export Make in country (region) for export Make in country (region) for both local sale and export Make in country (region) for both local sale and export No manufacturing presence in country (region) Import products for sale Limited emerging market manufacturing today, but models for leveraging local manufacturing are being considered—particularly in China and India Source: PRTM Medical Device Supply Chain Priorities in Emerging Markets Survey, April 2011 PRTM MDSCC Presentation—18 May 2011 | © 2011 PRTM Proprietary CONFIDENTIAL | 7
8.
Evolving Distribution Models
Which option best describes your If you are planning to change current distribution model in each models, which distribution models country/region? are you considering? SE Asia SE Asia Latin America Latin America Eastern Europe Eastern Europe Russia Russia Brazil Brazil India India China China 0% 20% 40% 60% 80% 100% 0% 50% 100% Distributor(s) Distributor(s) 3PL(s) or joint venture 3PL(s) or joint venture Company owned or managed sales and distribution Company owned or managed sales and distribution Distributors are most common supply chain strategy in emerging markets but increasing interest in employing 3PLs in some key markets Source: PRTM Medical Device Supply Chain Priorities in Emerging Markets Survey, April 2011 PRTM MDSCC Presentation—18 May 2011 | © 2011 PRTM Proprietary CONFIDENTIAL | 8
9.
Risks and Challenges
Vary by Market What areas represent the greatest risks and challenges in each emerging market? Latin Eastern China India Brazil America Russia SE Asia Europe Limited internal knowledge of market IP risk Level of local competition Regulatory/reimbursement uncertainty Level of supply chain infrastructure Availability of qualified local partners (JV, 3PL, etc.) Availability (and turnover) of qualified resources in market High Risk/Challenge Each emerging market presents its own unique characteristics and challenges Source: PRTM Medical Device Supply Chain Priorities in Emerging Markets Survey, April 2011 PRTM MDSCC Presentation—18 May 2011 | © 2011 PRTM Proprietary CONFIDENTIAL | 9
10.
China, Brazil, and
India—Most Important Markets Respondents reported China, Brazil, and India as being the most significant markets in their emerging markets strategy What countries or regions are of most significance in your emerging market strategy? Medium Importance High 29% Importance 29% 36% 36% 50% 57% 50% 36% 43% 43% 36% 7% 7% China Brazil India Latin SE Asia Russia Eastern America Europe Source: PRTM Medical Device Supply Chain Priorities in Emerging Markets Survey, April 2011 PRTM MDSCC Presentation—18 May 2011 | © 2011 PRTM Proprietary CONFIDENTIAL | 10
11.
Market Dynamics Vary
in Three Priority Markets 13.6% projected five-year CAGR for medical devices Three-year $124B government investment in health care reform—will primarily benefit mass market equipment and consumables China Reform provision to “Buy China” gives preference to domestic suppliers MNCs dominate high-end market but domestic companies are increasing investment Slow registration process and China-specific standards protocols 6.1% projected five-year CAGR for medical devices (significant slowdown from 27% CAGR in previous five years) Brazil Strong domestic production from MNCs and local competitors geared toward the local market, limited exports Distribution infrastructure struggling to keep pace with increasing access to health care outside of major cities Highly complex and changing regulatory environment (ANVISA) 15.6% projected five-year CAGR for medical devices Domestic production growth is surging to fulfill domestic demand—growing at 17% CAGR India Infrastructure for manufacturing and R&D facilities is still in the early stages of implementation Uncertain, evolving regulatory environment Local distributors/agents play significant role as hospitals do not purchase direct from manufacturers Sources: Medistat Outlook China Report; Medistat Outlook Brazil Report; Medistat Outlook India Report; PRTM Research and Analysis PRTM MDSCC Presentation—18 May 2011 | © 2011 PRTM Proprietary CONFIDENTIAL | 11
12.
China Risks, Challenges,
and Trends IP risk and regulatory/reimbursement uncertainty present the greatest challenges in China IP risk Regulatory/Reimbursement uncertainty Limited internal knowledge of market Availability of qualified local partners (JV, 3PL, etc.) Level of supply chain infrastructure Level of local competition Availability (and turnover) of qualified resources in market Low High Level of Challenge IP Risk Regulatory/Reimbursement Uncertainty Joining the WTO in 2001 led to initial improvements in Inefficient regulation and registration processes create supporting intellectual property rights significant market entry barriers Progress has been inconsistent and varies from region Opaque and complex tendering processes often raise to region suppliers’ selling expense and cycle time Securing government tenders will increasingly require Local suppliers can have significant influence on IP development in China, not just manufacturing technical panel experts and decision makers in Recent changes to patent law will make patent litigation tendering process tougher to enforce Pricing controls under consideration would negatively impact profitability of imported products PRTM MDSCC Presentation—18 May 2011 | © 2011 PRTM Proprietary CONFIDENTIAL | 12
13.
Brazil Risks, Challenges,
and Trends Regulatory/reimbursement uncertainty and local competition present the greatest challenges in Brazil Regulatory/Reimbursement uncertainty Level of local competition Limited internal knowledge of market Level of supply chain infrastructure Availability of qualified local partners (JV, 3PL, etc.) Availability (and turnover) of qualified resources in market IP risk Low High Level of Challenge Regulatory/Reimbursement Uncertainty Level of Local Competition MD companies doing business in Brazil must Imports make up relatively low share of total MD market necessarily be well acquainted with ANVISA, Brazil’s as compared to other emerging markets health surveillance agency Strong local competitors, particularly in low-tech Regulated medical devices must undergo a lengthy, and products (low cost, adequate quality, relationships) highly variable, registration and licensing process Challenging regulatory process for medical device ANVISA known to implement disruptive regulatory importation change Relatively high import tariffs and cumbersome customs system PRTM MDSCC Presentation—18 May 2011 | © 2011 PRTM Proprietary CONFIDENTIAL | 13
14.
India Risks, Challenges,
and Trends Availability of partners and S/C infrastructure present the greatest challenges in India Availability of qualified local partners (JV, 3PL, etc.) Limited internal knowledge of market Level of supply chain infrastructure Regulatory/Reimbursement uncertainty Level of local competition Availability (and turnover) of qualified resources in market IP risk Low High Level of Challenge Availability of Qualified Local Partners Limited Internal Knowledge of Market Many major global device firms operate fully owned Complex landscape with significant regional variations, subsidiaries due to few local partnership options 24 major languages, and multi-tier health care system Some are choosing to create joint ventures with similarly Local expertise is essential to navigate changing large local players (GE/Wipro) registration, regulatory, tax environments, and also to Complexity of market often requires multiple distributor find and manage local partners and distributors partners; most distributors lack full market reach Hospital consolidation is on the rise but 80%+ hospitals Physician community perception of local companies is are small (<30 beds), which challenges marketing, “low-cost and low-quality” products sales, and distribution PRTM MDSCC Presentation—18 May 2011 | © 2011 PRTM Proprietary CONFIDENTIAL | 14
15.
Conclusions Emerging markets are
an important growth area for medical device companies China, Brazil, and India are the primary areas of focus The primary risks and challenges vary from market to market and present a complex playing field for supply chain executives Companies that lack a well-thought-out, proactive emerging market supply chain strategy are at risk of ending up with a sub-optimal supply chain that limits growth and profitability PRTM MDSCC Presentation—18 May 2011 | © 2011 PRTM Proprietary CONFIDENTIAL | 15
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