With an ageing population and an increase in ‘lifestyle’ conditions, demand for healthcare has never been greater. What are the biggest health challenges and how can medical technology help to address them? On Target reports.

Last month, On Target provided an overview of medical technology in Europe, outlining its most developed regions and the emerging markets where steady growth is being predicted. In a global environment plagued by fiscal turbulence, our article told a remarkably positive story: the medtech industry is in pretty good health.

According to analysts, the European medtech sector has been growing steadily and consistently for a number of years. With the medical device market in Western Europe forecast to grow by 40% inside the next five years and rapid acceleration predicted in Central and Eastern Europe, the prospects for the wider industry appear strong.

But what is driving this anticipated growth? This month, On Target explores the health challenges facing the global community and looks at the therapeutic areas where medical technology really makes a difference.

Dial M for medtech

Consensus supports the recent claims by management consultants McKinsey that the industry is growing at a rate of 5–6% each year. John Wilkinson, former Director General of the ABHI and now Chief Executive of Europe’s trade association for medtech companies, Eucomed, believes the latest data is an accurate reflection of progress. “My instincts are that the level of growth has been pretty consistent over the last few years,” he told On Target. “Of course, it’s very sector-specific: some mature sectors are growing more slowly than that, while some of the newer technologies are growing at a much more dynamic rate. So that headline figure covers a multitude of individual stories.”

Growth is, of course, directly linked to demand; and with an ageing population requiring greater healthcare provision and an increase in ‘lifestyle-related diseases’, demand is not going to drop any time soon. These societal challenges are reflected in the high-growth areas acknowledged by the industry. “Those markets showing the most rapid growth line up with the key healthcare challenges associated with ageing and ‘metabolic syndrome’ – which is basically obesity,” said John Wilkinson. “These are the key drivers of change in healthcare. Orthopaedic intervention for hip and knee problems is a key driver; and, increasingly, so is spinal intervention – due to both ageing and overweight in the population. The metabolic syndrome associated with a sedentary population is driving two further areas: diabetes care – it’s predicted that 7% of the population will be diabetic by 2020 – and cardiology.”

These headline conditions feature prominently in analysis, both retrospective and forward-looking, of medtech industry performance. Data from Credit Suisse First Boston, based on estimated revenues in 2004, show that alongside diagnostics, orthopaedic and cardiovascular therapies make the biggest contributions to the global medical technology industry. Back then, the medtech sector had an estimated value of $215 billion, with some of the most significant contributions to that figure being diagnostics ($25 billion), cardiovascular ($17 billion) and orthopaedics ($16 billion).

In the years since 2004, these common global healthcare challenges have remained – and diagnostics, cardiovascular devices and orthopaedic implants have continued to set the pace. In addition, developments in neurodevices and advanced technologies designed to bring healthcare closer to patients’ homes are also stimulating growth. This is particularly relevant in Europe, and is driving opportunities for medical device companies.

“There is going to be increasing growth in areas targeted at managing patients in their homes. Some of this is advanced technology – but a lot of it is fundamental technologies for fighting chronic conditions, adapted for the home and the community,” said John Wilkinson.

The usual suspects

These new technological advances relate primarily to the delivery of healthcare, and are driven by governmental objectives to move that delivery away from hospitals and into the community. However, the major clinical challenges for medical science have remained strikingly consistent. It’s worth looking in more detail at the three biggest therapy areas in the medtech sector to see how they align with today’s societal challenges.

1. Diagnostics

The global market for in vitro diagnostics was valued in excess of $38 billion in 2007, and has been forecast to grow by 6.7% year on year until 2012. Growth is being propelled not only by the emergence of new technologies and increasing patient awareness, but also by an increase in the prevalence of several chronic and infectious diseases. Molecular diagnostics and point-of-care tests are also fuelling growth. Molecular diagnostics is the fastest-growing segment of the IVD market, and has been projected to enjoy compound annual growth (CAG) of 14% until 2010 from a base value of $2.6 billion in 2005. Likewise, point of care tests, which can be used at the patient’s bedside, in doctors’ surgeries and at home, now account for around a third of the global IVD market. This segment was valued at $12 billion in 2005, and analysts have predicted a CAG of 7.8% for it by 2010.

The pace of technological change in the IVD market is certainly enabling earlier and more accurate diagnoses of disease, improving clinical decisions and assisting more effective monitoring of treatment. However, as in the device market, the adoption of new IVD technology is being forced to overcome reimbursement and regulatory obstacles that can potentially slow progress and adversely affect health outcomes.

2. Orthopaedics

The impact of orthopaedic problems on the health of the global population, and thus on the global health economy, is huge. According to the Bone and Joint Decade (www.boneandjointdecade.org), bone and joint diseases affect hundreds of millions of people over the world and are the leading cause of pain and disability. They account for half of all chronic conditions in people over the age of 50 in developed countries, a figure which is set to double by 2020. In addition, 10–15 million people (many of them young) are injured or disabled each year through road accidents. With the number of musculo-skeletal diseases set to rise sharply in the next decade, the impact on health economies around the globe will be significant. Currently, a fifth of all visits to outpatient clinics worldwide are for musculo-skeletal conditions.

It’s not surprising, therefore, that the orthopaedic sector is a major market for the medtech industry. In 2005, worldwide sales of orthopaedic products reached $25.9 billion. By 2010, analysts predict that the sector will top $44 billion in global revenues. The orthopaedic product sector is divided into a variety of segments: reconstructive devices and joint replacements, spinal implants and instrumentation, fracture repair and orthobiologics. In recent years, the spinal sector has proved the most dynamic, with growth in the early 2000s of almost 30%. While this has slowed since, it remains a growth area. Reconstructive and joint replacement devices have also slowed – and while they still lead the way in orthopaedic sales, knee and hip replacements no longer command premium prices. The small bone market has emerged in recent years as a new growth area for joint replacement technologies.

In 2007, the European market for orthopaedic devices was valued at around $3 billion. Leading players in the market include Smith & Nephew, DePuy (J&J), Stryker, Zimmer, Biomet and Synthes.

3. Cardiovascular

The global cost of cardiovascular disease (CVD) is vast. In the US alone, heart disease and stroke are estimated to have cost $448.5 billion in 2008 (according to the American Heart Association and the National Heart, Lung, and Blood Institute). Likewise, CVD is the main cause of death in the European Union, killing over 2 million people each year and costing the EU economy over €192 billion annually. According to the World Health Organisation (WHO):
• More people die worldwide each year from CVD than from any other cause (see table opposite).
• An estimated 17.5 million people died from CVD in 2005, representing 30% of all global deaths. Of these deaths, an estimated 7.6 million were due to coronary heart disease and 5.7 million were due to stroke.
• In 2015, almost 20 million people will die from CVD – mainly from heart disease and stroke, which are projected to remain the leading causes of death.

The global market for cardiovascular devices is tipped for strong growth in the next five years. This is, of course, in keeping with the demands of an ageing population and a sustained rise in obesity. The latter has not only helped to cement CVD as the leading global killer, but has also led to diabetes becoming almost a global epidemic. WHO predicts that within the next ten years, diabetes deaths will increase worldwide by more than 50%.

The cardiovascular device market is expected to reach $40.46 billion by 2011 in North America alone. One of the most significant innovations in this market has been the development of the drug-eluting stent, a market-leading device in angioplasty procedures. The European drug-eluting stent market has been forecast to reach $4.5 billion by 2009, up from $1.6 billion in 2001 (source: Eucomed). Other cardiovascular solutions provided by the medtech industry include cardiac rhythm management, heart valves, cardiac surgery systems, minimally-invasive image-guided technologies, interventional neurovascular technologies and heart assist devices.

The leading players in the cardiovascular device market include Cordis (J&J), Medtronic, Boston Scientific, Guidant, St Jude Medical, Abbot, Sorin, Conor Medsystems and Biotronik.

Paying the price

Clearly, the medical technology industry has a well-deserved reputation for providing innovative solutions to health challenges across the world. However, in an era where the escalating population is placing increased pressure on global health economies, the speed of innovation may be thwarted by the age-old question: who pays the price?

Health economics, as well as the current market economics created by the liquidity crisis, will play a major role in the evolution of medtech. “Cost pressures may force the way the industry goes, but there’s plenty of scope for the industry to contribute in terms of productivity and better patient outcomes,” said John Wilkinson. “There is a huge amount of innovation going on in Europe. The medtech industry relies on clinicians, scientists and engineers – they are the creative engine of the industry. The industry channels that innovation into products that can be used in the clinical environment. We see no decline in the innovation potential in Europe, but we do see some short-term clouds on the horizon in terms of who is funding that innovation.”

The precise impact of the current financial crisis on the medtech sector is difficult to predict, but there will be an impact. In all probability, this will have a greater effect on early-stage companies looking for funding than on established players in the market. For the medtech industry as a whole, John Wilkinson feels, the opportunities will still be out there:

“I think the opportunity for industry is its increasing ability to radically restructure the way we do healthcare. There are industrial parallels for this. The business of delivering healthcare is overwhelmingly people-driven, and some of these innovations allow you to change the sites and the human resource demands of treating patients. Minimally-invasive surgery is clearly a major driver for reducing hospital stays by facilitating day-case surgery. Telemedicine enables patients to be monitored and managed in their homes rather than in a high-cost environment.

“So really the main opportunity for the medtech industry, and a message that the industry often struggles to get across, is the fact that we can profoundly change healthcare delivery and what it costs. If you draw the trend lines for demand for doctors and nurses and so on, you can see that we are going to need to use technology as a key enabler – otherwise, we’re going to run out of people.”

Next month, On Target will take a closer look at regulatory issues affecting the medtech sector and explore HTAs in Europe.

 

 

 

Saving lives for fun and profit

A glance at the newspapers will give you one consistent message: this is the year of the Grinch. Your Christmas, like most people’s, has been stolen by the credit crunch, the declining job and housing markets, and the new climate of austerity. How can the industry you work in make a difference?

But medtech does make a difference – to you, to health service providers and to the public. As the need for healthcare increases and the cost of service provision rises, new medical technologies are providing clinically and economically effective solutions. It’s not rocket science, it’s much more: diagnostic imaging, e-health, nanotechnology, remote surgery, grafts, implants…

This month, we look at the therapy areas that make up the healthcare market. We identify three key areas of need that refl ect social changes: diagnostic, orthopaedic and cardiovascular therapies. In addition, we consider how new technology is leading healthcare solutions at the level of service provision.

The global reach of medtech is illustrated by our interview with Chris Francis of UKTI on the challenges and rewards of the export market. As he notes: “Even within the constraints of the current dire economic conditions, the medtech industry is holding up robustly because we’re spread around the world and our products are highly regarded.”

In November, On Target exhibited at Wounds UK – which brought us further evidence of the power of medtech innovation to save life and limb. We saw how new wound care therapies are accelerating the healing process, and how companies are working in partnership with health and social care providers to deliver those therapies in the community. (See our report on page 23.)

Our review of the year in On Target highlights major positive developments in NHS provision, supported by new medical technologies. Lord Darzi’s Next Stage Review of the NHS had a dual emphasis: the need to shift the focus of healthcare from the hospital to the community, and the need to place innovation at the heart of a drive towards quality. Major policy initiatives of 2008 that reflect these priorities, with clear positive implications for medtech, include new screening programmes, a large-scale project to road-test telehealth solutions, and the recommendation of angioplasty as the first line of treatment for heart attacks.

Like Santa’s reindeer, medtech companies are helping to improve people’s lives by delivering to their homes. So, with apologies to Dr Seuss, On Target presents its own seasonal verse:

 

 

We look back over the year in On Target – a year of change, turbulence and opportunity for the UK healthcare industry.

January

The Council for Science and Technology, a Government advisory group, highlighted medical devices and e-health as two of six key technology areas it judged crucial to the UK’s future prosperity. Alan Johnson launched a five-year plan to improve cancer services, including investment to increase the capacity for breast cancer screening, bowel screening and radiotherapy. In On Target, Thoreya Swage discussed how the new Health Innovation Council will improve the development and deployment of innovative medical technologies in the NHS.

February

PM Gordon Brown outlined a programme of new screening processes for cancer, heart disease, stroke and other health problems. He stressed the importance of making new technologies for diagnosis available to all patients. The Government committed an initial £11m of funding to recruit donor transplant co-ordinators and strengthen organ retrieval teams. This could result in an additional 1,200 transplants per year. Our article ‘The waiting time’ looked at how the medtech industry could help the NHS to achieve the 18-week target by improving its diagnostic and perioperative services.

March

The DH announced that it would make available a revolutionary islet transplant therapy for type 1 diabetes patients at six UK hospitals. The DH also launched the Heathcare Technology Co-operative, a pilot scheme to bring clinicians, researchers and suppliers together to develop new medical technologies for the treatment of debilitating conditions. New NICE guidelines denied treatment with high-intensity focused ultrasound to NHS prostate cancer patients, reversing a previous decision. Our article on the PACS revolution looked at how medtech companies are supplying the NHS with new technologies to meet the need created by the national rollout of digital imaging.

April

The foundation of the Hamlyn Centre for Robotic Surgery at Imperial College London created an international centre for medical robotics in the UK. The Scottish Government committed an additional £8m to develop interactive home-based telecare services across Scotland over the next two years. The Suppliers Registration System, a web-based listing of medtech SMEs for NHS Trust purchasers, went live. In an exclusive interview, Sir Michael Rawlins of NICE discussed medtech innovation in relation to the NHS and UK healthcare need. He emphasised that products always need to be suitable for a particular healthcare system, and highlighted the electronic patient record (EPR) as an area where medtech can help the NHS to move forward. Tony Davis of MedilinkWM described how the Government’s planned ‘polyclinics’ will create new opportunities for medtech in the fields of diagnostics, monitoring, data handling and communication.

May

Seven medtech companies were among the winners of the UK’s most prestigious annual prize for business success: the Queen’s Award for Enterprise. The DH approved three more independent sector treatment centre schemes and confirmed that in future, independent sector provision would be procured locally rather than centrally. The DH also appointed a new ‘transplant tsar’, and announced a new NHS programme of regular vascular health checks for everyone aged 40–74. In an interview, Roger Green of the British Association of Plastic, Reconstructive and Aesthetic Surgeons discussed the commissioning, regulatory and marketing issues affecting this rapidly evolving area of healthcare.

June

The DH launched the Whole System Demonstrator Programme, a major project to road-test telehealth and telecare systems with 6000 patients in England over two years. Digital imaging specialist Digital Healthcare won an NHS Framework contract to supply the NHS with clinical IT services. Douglas Anderson of Optos, the Scottish inventor of a laser scanner for the eye, was among four winners of the European Inventor of the Year 2008 Award. Athlete Richard Whitehead, a bilateral amputee, ran four marathons in six weeks using prosthetic limbs from Össur. Our article on telehealth looked at how UK companies are developing a new model of community-based healthcare technology and service provision in partnership with the NHS.

July

In a bad month for NHS outsourcing, a King’s Fund report called for PCTs to consider alternatives to the ‘polyclinic’ model, while the NHS axed Fujitsu from a £898 contract to provide an EPR database for the UK. According to a Healthcare Commission report, one in four NHS Trusts in England had failed to meet core hygiene standards, with the decontamination of reusable medical devices proving the chief problem area. Martin Goldman’s article ‘How green is your medical device?’ looked at the growing tendency among UK medtech companies to make their operations more sustainable by reducing their use of materials and energy.

September

Lord Darzi’s Next Stage Review of the NHS was welcomed by the healthcare industry. The review shifted health service emphasis from increasing the quantity of care to improving its quality, and stated that giving patients access to innovative treatments will be central to the NHS. September saw a relaunch of On Target with a new focus on market access as the core concern for all those in the healthcare industry. Two articles examined the implications for industry of the Darzi review: Gordon Blackwell considered the importance of the shift towards ‘quality’ as a driver in NHS procurement and the emphasis on patient-centred care. “If your product really can improve the quality of patient care, then never before have you had such a receptive marketplace.” Ruth Lessar discussed the impact of the review for healthcare sales on the ground: the market access opportunities related to changes in ‘patient power’, NICE technology appraisals, assessment of local needs at PCT level, screening and disease prevention. On Target visited the i-House technology demonstrator in West Bromwich, and explored its significance as a new model both for community-based healthcare and for medtech marketing. In the first of a new series of interviews on healthcare market access, Ray Hodgkinson of BHTA discussed how changes in NHS procurement will transform the market landscape for assistive technologies.

October

Medtech companies were enlisted in the war against healthcare-associated infections (HCAIs) by the Government’s Showcase Hospital Scheme, which will use seven hospitals across England to trial innovative products that reduce or prevent HCAIs. In an interview, Katy Draper of Marketing Medicine discussed how medtech companies can negotiate the NHS procurement system – and why this is the right time to try. Michael Norell examined the ups and downs of the stent market in the UK and concluded that despite the challenges of recent years, this iconic device remains central to the landscape of cardiac care. On Target introduced its fi rst nationwide Healthcare Company Perception, Motivation and Satisfaction Survey: a groundbreaking piece of research that enables companies to assess and benchmark their employees’ job satisfaction, and gives sales and marketing professionals a voice!

November

A report published by the DH recommended that primary angioplasty should replace thrombolytic drugs as the NHS’s first line of treatment for heart attacks. The national rollout of this strategy, which will greatly increase the role of the stent in UK healthcare, is expected to save many lives. On Target surveyed the European healthcare industry and found that, despite the current economic crisis, the medtech sector is showing consistent growth due to the combined effect of increasing demand and technological advancement. In an interview, Alan Connington of Innovations Factory argued that companies need to have a global sales strategy informed by detailed market intelligence: “As a player in this environment, you must do your homework and learn the rules – there are no short cuts.”

 

 

In the fourth of our series of interviews on key market access issues for the UK medtech sector, Chris Francis, UKTI Healthcare Sector Advisory Group Chairman, discusses the growing importance of the export market.

Few UK medtech companies would dispute the principle that in order to be successful they need to sell their products overseas, since the UK market is too small to remain viable in the longer term. But accessing the export market takes more than a passport and a plane ticket. As Chris Francis of UK Trade & Investment (UKTI) and the UK India Business Council (UKIBC) explains, to sell overseas you need to be well-informed and well-connected enough to negotiate the competitive, economic and regulatory barriers to trade.

Why are so many UK medical technology companies looking to the export market to sell their products and services?

If you look at the background of the medtech sector, including life sciences and healthcare but excluding biotechnology and pharmaceuticals, the sector overall exports about £24 billion worth of goods per year – and it’s growing year on year by about 7%. So as an industry sector we’re extremely powerful and important to the UK economy. About 80% of this sector consists of SMEs – there are a few very large companies, but on the whole we’re quite a small, scientifically based, innovative group of companies (including many consultancy experts).

Exhibitions should form a key part of the export trading mix. For many companies they provide an ideal platform to meet both new and established distributors and partners, seek out new suppliers and check the competition.

In the UK, we have a long history of exporting. Although the NHS is a major buyer, our technologies and businesses are largely creating niche products in specialist areas within the healthcare sector, and thus the UK market isn’t big enough for us and we’ve always had to export. We’re very good at exporting around the world, and we continue to do that in spite of growing competition. Even within the constraints of the current dire economic conditions, the medtech sector is holding up robustly because we’re spread around the world and our products are highly regarded. So when you’re asking why so many medtech companies are looking to the export market, I think anyone who is in the sector would typically be looking at an overseas market as part of their business planning – there’s no choice, as the UK market simply isn’t big enough to support you.

Which are the most important overseas markets for UK-produced medical technologies, and why?

The biggest market globally is the USA, which accounts for a large percentage of all exports in the medtech sector. Germany is the largest in Europe, and France, Italy, Spain and Portugal are all very substantial markets. But our real focus of attention for future overseas sales, where our drive is from UKTI’s (i.e. from the Government’s) perspective, is the USA, Japan, China and India: these are the major potential growth areas for us. Russia is looking very promising at the moment, and looks to be another big market opportunity. So is Brazil, which has a Government to Government ‘Year of Collaboration’ agreement to assist co-operation and collaboration on healthcare projects between the two countries. Europe remains a very good market for the majority of our companies.

The fastest-growing healthcare markets are generally in the developing world. The Middle East is growing very rapidly for us – and so is Southern Africa, which has 160 million people. These are substantial markets, needing all the things we can supply: not just technology but the ability (through our universities) to educate, to train, to undertake distance learning programmes, to help build in the infrastructure, to provide IT management systems. We’re involved in many different product and service support areas, which gives us a good spread of business opportunities.

It’s important for UK medtech companies to sell into well-established export markets where we have strong links, such as the USA, Europe and Japan. But the developing export markets have such huge potential that we also need to devote time and effort to building strong links there. As people in the developing world become wealthier, the demand for modern healthcare increases.

What are the major challenges or potential risks that UK healthcare companies face when trying to sell overseas?

The biggest challenge is that the competition can sometimes be quite vigorous in the way they sell their products or services. By and large, we in the UK have a reputation for being honest and straight trades people with a range of excellent products – but there are many nations and businesses around the world that are perfectly happy to provide incentives for people to buy their products. In some countries that’s almost a daily practice and a way of life, but the majority of UK companies simply don’t engage in it. We believe our products or services stand on their own merit without the need to provide added incentives.

A related threat is that very often, a country (including some European nations) will provide ‘tied aid’ for government healthcare projects where some cooperative funding is required – maybe 2% or 4% of the cost of a hospital, for example – as part of the deal when they purchase a nation’s product. We can’t provide that in the UK, due to a Government decision years ago that ‘tied aid’ would no longer be part of our selling platform. So that’s quite a challenge to exporters as companies become more desperate to sell their wares.

We try to make sure all the UK companies play the game and don’t provide backhanders or special bonuses. I’m sure that it does go on, but there’s very little of it – I have never heard of any specific instances.

Then regulations are a big threat. Some countries are constantly changing their import regulations and tariffs to hinder companies from outside and so ensure that their domestic industry is protected. Protectionism is quite a challenging trading barrier in the global market. China, for example, is going through another regulatory upheaval, which makes it difficult for UK companies, especially SMEs, to get their products into that market. Even registering one product, let alone all the derivatives of that product, costs about £10,000, and it takes about a year to gain approval. This is a means by which China is able to protect its home-grown industries, while having the freedom to trade freely in our markets provided they meet CE or FDA regulatory standards.

Japan is also quite difficult to get into: it takes about a year to gain regulatory approval, and that mechanism may be extended depending on what approvals committees are involved. India is just about to change its system of regulatory mechanisms for medical devices: they’re proposing to introduce new standards that are different from those of the CE standards in Europe or FDA regulation in the USA (the latter approval being the most difficult to achieve, and the one medical device companies ought to have). India’s creating its own standards will be a barrier to entry and a means of protecting their home-grown industries.

These things are constant challenges and potential risks – but we’re pretty adept at working with all of these issues. UKTI is very active in almost all of the overseas markets: providing alerts and advice, gaining access and having an influence in important trading meetings, and trying to fi nd ways in which we can overcome these trading barriers and challenges. It’s an ongoing part of the export process that the Government, through UKTI, helps the medtech sector to perform better than it would otherwise to break down these barriers. But the risks and the threats are always there, and it’s never easy.

How important are exhibitions such as Medica and Arab Health in enabling UK companies to reach customers worldwide?

Such international exhibitions are absolutely essential: the exposure they provide could not be achieved in any other cost-effective way. Whether your trading strategy includes exporting products to specific countries, across regions or worldwide, it makes absolute sense to participate in relevant exhibitions in order to access customers, source potential distributors and partners, and get acclimatised to the healthcare and business cultures of the countries you are planning to export to.

And whether you are new to exporting or an experienced exporter, you should maintain communication links with trade associations (such as ABHI) and UKTI, since these organisations provide many opportunities to network at exhibitions through seminars and contact introductions.

For companies that are new to exporting, UKTI often provides grants towards the cost of travel; but any company wanting to export should ensure that it has the financial resources and an appropriately-skilled team to support exporting activities. If the deciding factor in whether a company decides to exhibit is whether it will receive a financial grant from UKTI, then it is likely that the company should reconsider whether it has thought through its export trading strategy. Trading in overseas markets requires considerable persistence and resilience, as well as the financial means to cover the travel and promotional costs over a sustained period of time.

The first step into exporting needs to be market research, which should include contacting UKTI or one of the regional development organisations. There is a wealth of free advice available, and country-specific market reports (called OMIS reports) can be commissioned inexpensively from UKTI that will provide solid market intelligence, as well as a list of contacts and potential distributors and partners.

Exhibitions should form a key part of the export trading mix. For many companies they provide an ideal platform to meet both new and established distributors and partners, seek out new suppliers and check the competition.

What advice would you give to a medical technology SME looking to access the global export market?

Any new medical device company should have gone through a detailed analysis of its market relevance and know where its product fits into the clinical delivery process. The regulatory approval requirements must be thoroughly understood and followed before the product can be offered to the marketplace, with CE registration for Europe and FDA registration in the USA.

As discussed in the answer to the last question, any company’s export ambitions need to have been thoroughly considered and researched, using trade associations or overseas trade promoters and export experts who can be accessed through UKTI.

In developing an export strategy, the company needs to consider the resources and skills it has to draw on. The first market exposure could well be a major international exhibition such as Medica – or even a UK exhibition, in order to get a feel for the customer base. Many overseas visitors attend UK specific-sector exhibitions looking for new products and opportunities.

In principle, it is much easier and less expensive and risky if the near markets of Europe are addressed first. Germany is our largest market in Europe, but Holland is often regarded as an ideal first export market to enter because of its UK-friendly culture.

How is the healthcare export market changing?

Healthcare delivery in any market is becoming more expensive, and governments find the spiralling costs of hospital treatment prohibitive – so there is a shift in emphasis across almost all markets to primary and community-based care. New technology solutions for healthcare delivery through remote treatment and management can significantly reduce costs and provide better patient care.

All countries demand healthcare product improvements as treatment costs increase and people live longer. It is a global challenge faced by the developed as well as the developing nations. The recent WHO report Now More than Ever calls for political and economic measures to address global health inequalities, and the medtech industry has a major part to play in making this possible.

Whereas in the past we would have relied on doctors and consultants to analyse healthcare needs and design services, we now have to get smarter at doing these things and driving down the costs to make the service affordable. That’s where things are really changing. It’s new technology that’s helping to change the way healthcare is delivered, rather than changes in patient demographics.