Look Towards A New Future

Feb 7, 2013

Central and Eastern Europe Medical Devices Industry Research Report

The countries of Central and Eastern Europe represented a total market of 302 million people and a combined GDP of US$3.3 trillion in 2012.

Central & Eastern Europe is composed of a diverse range of markets, all at different stages of development. Markets throughout the region grew very rapidly until 2008, as many countries joined the EU between 2004 and 2007. All have healthcare systems in great need of renovation and updating, and spending on new diagnostic equipment in particular has been very strong. Most new equipment is imported, as Russia, Poland, the Czech Republic, Ukraine and Hungary represent the five largest markets in the region. Slovenia is a small market, but has the highest per capita expenditure, on a par with much of Western Europe.

The Economic Situation
All countries in the CEE region were affected by the global economic crisis to some extent; Ukraine was particularly hard hit with its economy contracting by 14.8% in 2009. However, most of the region emerged from recession in 2010 and all CEE countries were exhibiting positive growth rates by 2011. The regional economy is expected to grow by an annual average of 3.1% between 2012 and 2016, although the ongoing eurozone crisis may negatively impact this rate. The CEE region contains export-dependent countries such as the Czech Republic and Hungary, which will be vulnerable to any depressed demand in the eurozone. However, financial assistance provided by the IMF has helped countries such as Romania to strengthen their economies and limit the effects of the recession on the health sector; overall demand for medical devices has therefore remained strong, particularly in the consumables field.

Regional Health Expenditure
Total health expenditure for the CEE region is projected to reach an estimated US$329.0 billion by 2016, equal to 6.7% of GDP. At present, only 29% of spending in the region is private, but over 85% of this is composed of out-of-pocket payments. The area of private healthcare plans remains largely undeveloped within most markets. Slovenia, the wealthiest country per capita in the region, is the only state in which private plans have become a strong feature, representing almost half of total private spending.

Focus on market opportunities: Diagnostic Imaging
The table below shows the rise in demand for imported diagnostic imaging equipment since the end of the economic crisis, following a period of slow-moderate growth. Between 2006 and 2010, the CAGR for such equipment did not exceed 20% in the countries listed below; however, import performance was much more encouraging in the year ending October 2011, particularly in Romania and Poland where growth rates reached 47.8% and 34.0%, respectively. Only modest growth was observed in the Czech Republic and Slovakia, however. It will take time for countries such as Ukraine to return to pre-crisis growth rates; renewed investment in high-tech equipment will ensue as their economies strengthen.

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Highlights from the region

The Czech Republic was one of the larger and richer former Soviet countries to join the EU in May 2004. Its regulation and trade rules are now generally aligned to EU standards. It is well-located in central Europe and has an estimated population of 10.5 million in 2011. Healthcare funding is largely public, and mainly through health insurance. Private spending only accounts for an estimated 16.6% of total health expenditure in 2011. Provision of care is also largely public; the Czech Republic has yet to develop a substantial private sector. Around 80% of the Czech Republic medical device market is supplied by imports, which have risen rapidly in the past decade. In 2011, 35.7% were sourced from Germany. Other major suppliers were the Netherlands, Belgium, Switzerland and France. In 2011, imports rose by 6.6% over 2010 and by a 2007-2011 CAGR of 8.2%.

In 2011, the Hungarian market for medical equipment and supplies is estimated at US$573 million, or US$58 per capita. The market value has stalled since 2008, but it is expected that it will bounce back to expand at a CAGR of 4.5% per annum in the 2011-16 period, reaching US$715 million by 2016, equal to US$73 per capita.
Around 84% of the medical device market is supplied by imports. Most are sourced from the European Union, principally the Netherlands and Germany. There is a sizeable domestic production sector, with X-ray apparatus as a particular historic specialty, but this is largely geared towards export markets.

The size of the private healthcare sector is slowly expanding. The availability of private facilities improved significantly in 2000, when bed numbers increased three-fold. Around a quarter of health expenditure is private, although out-of-pocket payments account for most of this. In 2011, the Polish market for medical equipment and supplies is estimated at US$2,013.4 million, or US$53 per capita. The market experienced rapid growth until the end of 2008, but imports fell back sharply in the early part of 2009. The economic downturn has so far proved short, however, with growth resuming in 2010, albeit at a slightly lower rate than in previous years. Around 85% of the Polish medical device market is supplied by imports. Germany and the Netherlands were the leading suppliers in 2011, together accounting for around nearly half of imports. Germany was the leading supplier of most categories of medical equipment.

The Russian medical market is potentially huge, given its population and potential wealth of natural resources. Health expenditure remains low however, and patients are often forced to rely on out-of-pocket payments for treatment. A system of medical insurance is in place, but it is badly managed and the quality of treatment varies from region to region. The Russian healthcare system retains many of its Soviet-era characteristics, remaining bureaucratic and inefficient. However, the government’s national ‘health’ project aims to improve healthcare standards. Since the project’s implementation, numerous medical facilities have been upgraded and a substantial number of medical personnel have been awarded salary increases. In 2011, the Russian market for medical equipment and supplies is estimated at US$5,961.3 million. Per capita spending is low by European standards at US$42 per capita. This is despite rapid growth, especially of imported products, in the 2006-08 period.

11 Key Markets Covered
Czech Republic

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