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CENTRE FOR THE PROMOTION OF IMPORTS FROM DEVELOPING COUNTRIES

MEDICAL DEVICES ANDMEDICAL DISPOSABLES

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EU MARKET SURVEY 2002

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II VOLUME II


MEDICAL DEVICES AND MEDICAL DISPOSABLES

Compiled for CBI by:

Netherlands Economic Institute

in collaboration withMr. W.K. Hoppe

June 2002

DISCLAIMERThe information provided in this survey is believed to be accurate at the time of writing. It is, however, passed on to the reader without any responsibility on the part of CBI or the authors and it does not release the reader from theobligation to comply with all applicable legislation.

Neither CBI nor the authors of this publication make any warranty, expressed or implied, concerning the accuracy of the information presented, and will not be liable for injury or claims pertaining to the use of this publication or the information contained therein.

No obligation is assumed for updating or amending this publication for any reason, be it new or contrary informationor changes in legislation, regulations or jurisdiction.

Update of CBI market survey ‘Medical Devices and Medical Disposables’ (March 2001).

Photo courtesy:

Medeco / The NetherlandsSherwood Medical / The Netherlands

CONTENTS

REPORT SUMMARY 6

1 PRODUCT CHARACTERISTICS 8 1.1 Product groups 81.2 Customs/statistical product classification 8

2 INTRODUCTION TO THE EU MARKET 11

3 CONSUMPTION 133.1 Market size 133.2 Market segmentation 153.3 Consumption patterns and trends 16

4 PRODUCTION 20

5 IMPORTS 225.1 Total imports 225.2 Imports by product group 255.3 The role of the developing countries 30

6 EXPORTS 336.1 Total exports 33

7 TRADE STRUCTURE 357.1 EU trade channels 357.2 Distribution channels for developing country exporters 36

8 PRICES AND MARGINS 378.1 Prices and margins 378.2 Sources of price information 38

9 OPPORTUNITIES FOR EXPORTERS 40

APPENDICES 411 Detailed import/export statistics 412 Standards organisations 503 Sources of price information 514 Trade associations 525 Trade fair organisers 576 Trade press 607 Business support organisations 628 Other useful addresses 639 List of developing countries 6410 List of Netherlands importers and most important EU importers 6511 Useful Internet sites 74

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REPORT SUMMARY

This survey profiles the EU market for Medical Devicesand Medical Disposables. The emphasis of the surveylies on those products, which are of importance todeveloping country suppliers. The major nationalmarkets within the EU for those products arehighlighted. The survey includes contact details ofimporters, trade associations, and other relevantorganisations. Furthermore statistical marketinformation on consumption, production and trade,and information on trade structure and prices andmargins is provided.

As an exporter you need this information to formulateyour own market and product strategies. In order toassist you with this, CBI has developed a matching EUStrategic Marketing Guide Medical Devices andMedical Disposables. It aims to offer a practicalhandbook for exporters engaged, or wishing to engagein exporting Medical Devices and Medical Disposablesto the European Union. It aims to facilitate exporters informulating their own markets and product strategiesthrough the provision of practical information and amethodology of analysis and ready-to-fill-inframeworks.

As mentioned above, statistical market information onconsumption, production and trade, and informationon trade structure and prices and margins, which isrequired for the ready-to-fill-in frameworks, can befound in this EU Market Survey.

The medical devices and medical disposables studiedin this Market Survey include:

• Medical disposables:– Wadding, gauze and bandages;– Latex medical disposables;– Syringes, needles and catheters;– Wound closure products;– Nappies and similar hygiene products;

• Medical devices:– Preparation for x-ray examinations;– Surgical instruments and appliances;– Electro-diagnostic apparatus;– Dental instruments.

ConsumptionBased on CBS Datashop information and estimatedper capita health care expenses, total value of EUconsumption in 1999 of medical devices and medicaldisposables amounted to US$ 11,578 million (€ 12,585 million). Medical disposables are the largestmarket segment, accounting for 61 percent of thisfigure, while medical devices account for the remaining39 percent of total consumption.

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The main markets for medical devices and medicaldisposables in the EU are Germany, Italy, France andthe UK, followed at a distance by Spain, theNetherlands and Ireland.

The products with the highest consumption levels are‘Nappies and similar hygiene products’ and ‘Syringes,needles and catheters’, both accounting forapproximately 20 percent of consumption, and‘Wadding, gauze and bandages’, ‘Electro-diagnosticapparatus’, ‘Preparations for x-ray examinations’ and‘Surgical instruments and appliances’, with shares ofbetween 10 and 14 percent. Together these six groupsaccount for 88 percent of consumption of medicaldevices and medical disposables.

ProductionWithin the EU, the medical devices and medicaldisposables industry is characterised by high marketconcentration, i.e. a few large enterprises control themarket. At the same time the EU is facing greatercompetition from non-EU countries. The size of themedical devices and medical disposables productionindustry reflects the size of individual country markets.Hence, the main producing countries are Germany,Italy, France and UK.

ImportsIn 2000, total EU imports of medical devices and medicaldisposables amounted to a volume of 1,040,978 tonnes,with a total value of US$ 10,169 million or € 11,053 million. Between 1998 and 2000 total EUimports of medical devices and medical disposablesincreased by 3 percent in value and 24 percent involume, marking a decline in average US$ prices.

Leading importers of medical devices and medicaldisposables in 2000 include, in order of importvolumes, Germany, France, the Netherlands,United Kingdom and Belgium.

In 2000 EU imports of medical devices and medicaldisposables from developing countries amounted toapproximately 133,000 tonnes, with a value of US$ 714 million (€ 776 million). Overall thisrepresents 7 percent of the value and 13 percent of thevolume of the total EU imports of medical devices andmedical disposables.

In the period 1998 – 2000, imports of medical devicesand medical disposables from developing countriesincreased 15 percent in volume (from 116,000 to133,000 tonnes). Nevertheless, the share of developingcountries in the total volume of imports experienced asmall decline compared to 1998. EU imports of medical

devices and medical disposables from developingcountries decreased in value (from US$ 728 toUS$ 714 million), reflected by a 0.4 percent declinein their share in total imports.

The EU imports of medical devices and medicaldisposables from developing countries were particularlyhigh for ‘Latex medical disposables’ (63 percent of totalEU import value), and to a lesser extent for ‘Wadding,gauze and bandages’ and ‘Surgical instruments andappliances’ (both 8.0 percent), and ‘Syringes, needlesand catheters’ (3 percent).

ExportsIn 2000 the EU exported 1,006 thousand tonnes ofmedical devices and medical disposables, with a valueof US$ 11,116 million (€ 12.082 million). Since 1998, the total value of exports has increasedby 7 percent, while the volume increase was evenbigger: 13 percent. Medical disposables accountedfor 63 percent of exports, and medical devices for37 percent.

The most important export products in value included‘Syringes, needles and catheters’ (29 percent),‘Nappies and similar hygiene products’ (16 percent),‘Electro-diagnostic apparatus’ (12 percent) and‘Wadding, gauze and bandages’ (10 percent).

The leading EU exporters of medical devices andmedical disposables in 1999 were Germany (26 percentof total EU export value), the Netherlands (13 percent),United Kingdom and Belgium (both 11 percent) andFrance (10 percent).

Opportunities for exportersDue to the increasing importance of time savingproducts and extramural health care, the EU demandfor medical devices and medical disposables is expectedto exhibit modest growth in the near future.

There are opportunities for these products since it is toocostly for producers to produce low profile bulk goodswithin the EU. Moreover, some developing countrieshave important natural resources, like cotton, availableat hand. In 2000, products from developing countriesthat were imported into the EU in relatively largeamounts, and which have therefore good opportunitiesfor exporters, were:

• Latex medical disposables;• Wadding, gauze, and bandages;• Surgical instruments and appliances; and• Syringes, needles and catheters.

The trade channel offering the best chances fordeveloping countries is the importer/manufacturer orthe agent because of their knowledge of the EU market.

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A few large companies manufacturing medical devicesand medical disposables in the EU are Lohmann(Germany), Smiths & Nephew (UK), Brunswick(Belgium) and Philips Medical (the Netherlands).

Market researchThis EU Market Survey and the EU StrategicMarketing Guide serve as a basis for further marketresearch: after you have read this survey and filled inthe frameworks in the strategic marketing guide it isimportant to further research your target markets,sales channels and potential customers.

Market research depends on secondary data (data thathave been compiled and published earlier) and primarydata (information that you collect yourself). An example of secondary data is this EU Market Survey.Primary data are needed when secondary data arefalling short of your needs, for example whenresearching your specific type of consumer about theacceptance of your specific product. Sources ofinformation are among others (statistical) databanks,newspapers and magazines, market reports, (annual)reports from branch associations, but also shops intarget countries, products or catalogues from yourcompetitors, and conversations with suppliers,specialists, colleagues and even competitors. In order to judge the attractiveness of the market,sales channel or customer it is advised to use/developa classification or score system.

For more detailed information on market researchreference is made to CBI’s Export Planner (2000).

1 PRODUCT CHARACTERISTICS

1.1 Product GroupsThis chapter focuses on the product characteristics ofmedical devices and medical disposables.

The medical devices and medical disposables discussedin this survey can be classified in the following groups:

Medical disposables:• Wadding, gauze and bandages• Latex medical disposables• Syringes, needles and catheters• Wound closure products• Nappies and similar hygiene products

Medical devices:• Preparations for x-ray examinations• Surgical instruments and appliances• Electro-diagnostic apparatus• Dental instruments

Strictly speaking according to the HS codeclassification syringes, needles and catheters areclassified as surgical instruments. In this survey,however, these products are classified as medicaldisposables as they are, in most cases, only used once.Furthermore, the product group called preparations forx-ray examinations is sometimes referred to as apharmaceutical. Both classifications are possible.

1.2 Customs/Statistical ProductClassification

On January 1, 1988 a unified coding system wasintroduced to harmonise the trading classificationsystems used world-wide and to allow for improvedinternational comparability of foreign trade statistics.This system, the Harmonised System (HS), is based ona ten digit product classification. Table 1.1 gives a list of the HS codes relevant for thissurvey.

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Table 1.1 HS code classification of medical devices and medical disposables

1. Wadding, gauze, bandages

HS 3005 Wadding, gauze, bandages and the like, e.g. dressings, adhesive plasters clean non sterile, poultices, impregnatedor covered with pharmaceutical substances or put up for retail sale for medical, surgical, dental or veterinarypurposes

2. Wound closure products

HS 300610 Sterile surgical catgut, similar sterile suture materials and sterile tissue adhesives for surgical wound closure;sterile laminaria and sterile laminaria tents; sterile absorbable surgical or dental haemostatics

3. Preparations for x-ray examinations

HS 300620 Reagents for determining blood groups or blood factors HS 300630 Opacifying preparations for x-ray examinations; diagnostic reagents for administration to patients

4. Latex medical disposables

HS 401511 Surgical gloves, of vulcanised rubber other than hard rubber (excl. fingerstalls) HS 40151990 Gloves, of vulcanised rubber other than hard rubber (excl. household and surgical gloves)

5. Nappies and similar hygiene products

HS 48184091 Nappies and similar hygiene products, of paper pulp, paper, cellulose wadding or webs of cellulose fibres (excl.those put up for retail sale)

HS 48184099 Nappies and similar hygiene products, of paper pulp, paper, cellulose wadding or webs of cellulose fibres, put upfor retail sale

Continued

Compared to the previous edition of this EU MarketSurvey the product group of ‘Gloves, of vulcanisedrubber other than hard rubber’ was added to the list.Typical products registered in this product group areexamination gloves, characterised by less stringentquality standards (e.g. sterility) than surgical gloves.Since numerous developing countries have access torubber resources, examination gloves are considered tobe a product of high interest. Together with ‘Surgicalgloves’, this product is grouped under a new headingreferred to as ‘Latex medical disposables’.

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Note that the list of medical devices and medicaldisposables does not cover all products in a particularproduct group.

Other products interesting for exporters in developingcountries may include sheath contraceptives,ophthalmic instruments and hospital furniture.

Given the negligible export from developing countriesthe relevant HS codes are mentioned in Table 1.2,but these groups are not discussed in this survey.

Table 1.1 Continue

6. Syringes, needles and catheters

HS 901831 Syringes, whether or not with needles, used in medical, surgical, dental or veterinary sciences HS 901832 Tubular metal needles and needles for sutures, used in medical, surgical, dental or veterinary sciences HS 901839 Catheters metal needles, plastic cannulae and the like, used in medical, surgical, dental or veterinary sciences

(excl. syringes, tubular metal needles and needles for sutures)

7. Surgical instruments and appliances

HS 90189010 Instruments and apparatus for measuring blood-pressure HS 90189020 Endoscopes used in medical, surgical, dental or veterinary sciences HS 90189050 Transfusion apparatus used in medical, surgical, dental or veterinary sciences HS 90189060 Anaesthetic apparatus and instruments

8. Electro-diagnostic apparatus

HS 901811 Electro-cardiographs HS 901819 Electro-diagnostic apparatus, incl. apparatus for functional exploratory examination or for checking

physiological parameters (excl. electro-cardiographs)

9. Dental instruments

HS 901841 Dental drill engines, whether or not combined on a single base with other dental equipment HS 901849 Dental Instruments and appliances n.e.s.

Note: For a full description of the Harmonised Commodity Description and Coding System please refer to the RAMON Eurostat Classifications Server at http://europa.eu.int/comm/eurostat/ramon.

Table 1.2 Other relevant HS codes of medical devices and medical disposables

HS-code Description

401410 Sheath contraceptives of vulcanised rubber (i.e. condoms) 901850 Ophthalmic instruments and appliances not elsewhere specified (n.e.s.) 90185010 Ophthalmic instruments, non-optical 90185090 Ophthalmic instruments, optical 90189085 Instruments and appliances used in medical, surgical or veterinary sciences, n.e.s. 940290 Operating and examination tables; other medical, dental, surgical or veterinary furniture

The pictures hereunder give some examples of themedical devices and medical disposables, which areaddressed in this survey.

1. “Single patient use stethoscope”

2. “Filter needle”

3. “Adhesive wound closure”

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4. “Sterile syringes”

5. “Latex surgical gloves”

6. “Sterile latex examination glove”

2 INTRODUCTION TO THE EU MARKET

The European Union (EU) is the current name for theformer European Community. Since 1 January 1995the EU has consisted of 15 Member States.Negotiations are in progress with a number of candidateMember States, many of whom already have extensivetrade and co-operation agreements with the EU.It is envisaged that a number of these countries willbecome EU Member States in 2004.

In 2000, the size of the EU population totalled376.4 million. Total GDP in 2001 equalledUS$ 7,894.5 billion at current prices, while theaverage GDP per capita (at current exchange rates)amounted to US$ 20,742 in 2000 (OECD, 2002).

The most important aspect of the process of marketunification of the former EC countries which affectstrade is the harmonisation of rules in the EU countries.As market unification allows free movement of capital,goods, services and people, the internal borders havebeen removed. Goods produced or imported into oneMember State can be moved around between the otherMember States without restrictions. A preconditionfor this free movement is uniformity in the rules andregulations concerning locally produced or importedproducts. Although the European Union is already afact, not all regulations have yet been harmonised.Work is in progress on uniform regulations in the fieldsof environmental pollution, health, safety, quality andeducation.

On 1 January 2002, the national currencies of twelveEU Member States were replaced by one transnationalcurrency: the Euro (€). Austria, Belgium, Finland,France, Germany, Greece, Italy, Ireland, Luxembourg,The Netherlands, Spain, and Portugal currentlygradually replace their national currency notes andcoins by the Euro. By the 1st of July 2002, the Eurowill be the only legal tender throughout the Eurozone.

The most recent Eurostat trade statistics quoted in thissurvey are from the year 2000. On 1 January 1999,statistical and contractual values in ECU wereconverted into Euro’s on a 1:1 exchange rate. The € / US$ exchange rate currently (March 2002)stands at US$ 0.88 for one Euro. In this market survey,the US$ is the basic currency unit used to indicatevalue. Values for dates after 1 January 1999 are alsoexpressed in Euro’s.

Trade figures quoted in this survey must be interpretedand used with extreme caution. The collection of dataregarding trade flows has become more difficult sincethe establishment of the Single Market on 1 January1993. Until that date, trade was registered by means ofcompulsory customs procedures at border crossings,but, since the removal of the intra-EU borders, this isno longer the case. Statistical bodies like Eurostat canno longer depend on the automatic generation of tradefigures. In the case of intra-EU trade, statisticalreporting is only compulsory for exporting and

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Exchange rates of EU currencies in US$

Country Currency 1998 1999 2000 2001 March 2002

European Union ECU 1.12 - - - - € - 1.06 0.92 0.90 0.88

Austria Ash 0.081 0.077 0.067 0.066 -Belgium/Luxembourg Bfr 0.028 0.026 0.023 0.023 -Denmark Dkr 0.15 0.13 0.12 0.117 0.115France Ffr 0.17 0.16 0.14 0.137 -Finland FM 0.19 0.18 0.16 0.157 -Germany DM 0.57 0.54 0.47 0.46 -Greece GRD 0.0034 0.0033 0.0027 0.0026 -Ireland I£ 1.42 1.35 1.17 1.14 -Italy L 0.00058 0.00055 0.00048 0.00047 -Netherlands NLG 0.51 0.48 0.42 0.411 -Portugal Esc 0.0056 0.0053 0.0046 0.0045 -Spain Ptas 0.0067 0.0064 0.0055 0.0054 -Sweden Skr 0.13 0.12 0.11 0.108 0.105United Kingdom GB£ 1.66 1.62 1.51 1.48 1.44

Source: CBS Statline (March 2002)

importing firms whose trade exceeds a certain annualvalue. The threshold varies considerably from countryto country, but it is typically about € 100,000. As a consequence, although figures for trade betweenthe EU and the rest of the world are accuratelyrepresented, trade within the EU is generallyunderestimated.

Moreover, given the time lag between obtaining andpresenting statistical information by the various nationalstatistical bureaus and Eurostat, the figures for 1998and 1999 in this EU Market Survey may differ from thefigures for the same years as presented in the previousedition.

This survey provides more detail on six specific EUMember States. These countries are Belgium, France,Germany, Italy, the Netherlands, and the UnitedKingdom. The reason for selecting these countries isthat they have high production and/or (per capita)consumption figures, accompanied by the highestfigures for import and export of medical devices andmedical disposables. These countries are thereforepotentially very interesting markets for exporters fromdeveloping countries.

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3 CONSUMPTION

3.1 Market sizeTogether with the United States, the European Union isthe world’s leading market for medical devices andmedical disposables. Both the total size of populationand the strong economy are major causes for thispredominance. With a population of 364 million people,the EU has an abundant availability of potential end-users and their strong economies stimulate highper capita consumption of medical devices and medicaldisposables.

A third factor determining the market size, and whichmakes the EU an attractive market for exporters fromdeveloping countries, is the sophisticated state of themarket. For example, stringent monitoring of sterilityprocedures and preventive inoculation of whole sectorsof population are common practice in the EU and leadto high figures for consumption of medical disposables.

The intensity of medical procedures and products beingpaid for by either the government or insurancecompanies varies between the EU Member States,but the essential medical facilities are covered in all15 countries. The variation between the Member Statesis caused by a different assessment as to whether

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certain procedures are medically essential or mereluxury procedures. A good example in which differentinterpretation apply is female breast size adjustmentswith plastic surgery. Whilst this is included in thecompulsory healthcare insurance in the Netherlands,this is taken to be a luxury product in, for example,Spain.

Figure 3.1 below presents the consumption of medicaldevices and medical disposables valued in US$ millions.The European Union is one of the leading markets formedical devices and medical disposables in the world,with consumption amounting to US$ 11,578 million in1999 (€ 12,585 million). Germany is by far the largestmarket for medical devices and medical disposableswithin the European Union, with over 30 percent oftotal EU consumption of medical devices and medicaldisposables. Italy is the second largest market with a17 percent share, followed by France (14 percent) andthe United Kingdom (12 percent).

Please note that the consumption data presented in thissurvey are derived from data on production, importsand exports. The data are, therefore, indicative and maybe distorted for various reasons.

0 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000

United kingdom

Sweden

Finland

Portugal

Austria

Netherlands

Italy

Ireland

France

Spain

Greece

Germany

Denmark

Belgium

1,413.9

225.0

122.0

183.4

175.0

410.2

2,013.6

306.8

1,597.4

931.4

164.3

258.1

204.3

Figure 3.1 Consumption of medical devices and medical disposables in EU markets, 1999Value in US$ million

Source: CBS Datashop (2002)Note: Due to incompleteness of data, available CBS Datashop data have been modified on the basis of per capita consumption

estimates. Data for Luxembourg are not available.

First, an indirect methodology of estimatingconsumption figures is used, introducing inaccuracy ofimport and export figures (due to the threshold valuefor statistical reporting as indicated in Section 2) into theestimate of consumption. Second, the indirect method isdistorted by time differences between, or varyingvaluation methods applied to the part of imports whichis (re-) exported (so-called transition trade). Third, thedisaggregated production data (CBS Datashop) used areincomplete because some figures are not reported forvarious reasons, please see Section 4 for furtherexplanation on this.

Concerning the individual EU markets, the production(and consequently consumption) data on Germany,France, Italy, UK, Denmark and Finland are fairlycomplete since only a few product groups areunreported by the national statistical offices. For Spain,Portugal and the Netherlands several product groups arenot reported, while most reported production data showzero production. Also the data for Belgium, Irelandand Sweden are rather incomplete. Production andconsumption figures have therefore been calculated onthe basis of estimated per capita figures for 1999. These per capita figures have, in turn, been estimatedon World Bank figures for total per capita expenditureon health care in 1998.

Differences of consumption levels between countriesare caused by two main factors: the welfare level of thecountry and the government’s concern with health carein general. A higher welfare level leads to more

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spending on medical devices and medical disposables.For example consumption of medical products per headis higher in the Netherlands, Germany, Belgium, Franceand Italy than in EU countries where welfare levels arelower. The role of the government is important forhealth care, since governments generally play a majorrole in financing the health system, including healthinsurance, targeted subsidies and the ownership of realestate in the sector. Germany, in particular, is known forits well-organised health system and high per capitaconsumption of medical devices and medicaldisposables. By contrast, both Greece and especiallyIreland recently started to recover from the backlogtraditionally existing in their health care system.

In addition, the market for various products in the EUused to be differentiated on the basis of local labourcosts. For example, countries like France, Spain andItaly traditionally consumed relatively large amounts ofclassical style re-usable syringes and needles, sincecleaning, re-packing and sterilisation was done byabundant and relatively cheap labour. At present,however, with tight labour markets and increasing costsof labour, disposable alternatives for syringes andneedles have become standard practice throughout theEU. The serious lack of trained medical staff incountries like the Netherlands, Belgium, Germany andthe United Kingdom also causes an increase in the useof special labour-saving medical devices. Medicaldevices like disposable balloon catheters and urine bagsfor post-operative patients save time in the after-care ofthe patient. The price of a balloon catheter plus a urinebag is far lower than the cost of nursing time that wouldotherwise be necessary.

Finally, an important factor in the EU market is thediscrepancy in demand for health care betweenimmigrants and native inhabitants. While the number oftreatments of native patients continuously declines toreduce the serious burden on society of long waitinglists in health care, immigrants increasingly find theirway to health care, resulting in an overall growth ofhealth care demand.

The relative importance of the nine major productgroups as distinguished in Section 1.1, is shown inFigure 3.2 on the next page. The Figure presents theshare of each particular product group in the totalconsumption of medical devices and medicaldisposables in 1999.

The statistics show that the consumption of the medicaldisposables, i.e. 61 percent, is larger than theconsumption of medical devices, i.e. 39 percent.The largest product groups within the medicaldisposables are ‘Nappies and similar hygiene products’(20 percent), Syringes, needles and catheters’(20 percent), and Wadding, gauze and bandages’

Table 3.1 Total per capita expenditure on health care, 1998, US$

Country Health expenditure per capita, US$

Germany 2,769France 2,377Belgium 2,184Austria 2,162Sweden 2,146The Netherlands 2,140Finland 1,722Italy 1,701United Kingdom 1,597Ireland 1,428Spain 1,043Greece 957Portugal 803Denmark n.a.Luxemburg n.a.

Source: World Development Indicators 2001n.a. = not available

(14 percent). This could be explained, among otherthings, by the trend in EU member state policiestowards a reduction in public expenditure since themid-nineties. This reduction decreases hospitaltreatment and increases home nursing. This leads to anincrease in the market for user-friendly products suchas Wadding, gauze and bandages and Nappies andsimilar hygiene products. Another large product group,accounting for the main part of the medical devicesconsumption, is ‘Electro-diagnostic apparatus’(12 percent). The share of demand for Electro-diagnostic apparatushas increased from 1 percent in 1998 (see Appendix 1).This might among others be explained by the averagewage increase of nurses, making the costly electronicmonitoring apparatus attractive substitutes for hospitalmanagement.

The sales of disposable products generally show astable pattern. Delivery arrangements can be made onannual contracts with regular monthly shipments.Note that numbers of examination gloves, disposablesyringes and needles used in hospitals are huge sincethe products are discarded after each examination.Therefore, the products need an efficient warehousingand distribution system to ensure continuous supply tothe end-user. The sales of medical devices require moreprofound knowledge of the product and its applications.Although some stock is useful, a delivery time of 6 to8 weeks is usually acceptable. Warehousing andlogistics play a somewhat less important role formedical devices.

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3.2 Market segmentationThe market for medical devices and medicaldisposables can broadly be divided into two major and two minor segments:• Intramural market, which consists of:

– Hospitals;– Nursing homes;– Psychiatric institutions.

• Extramural market, which consists of:– General practitioner’s (GP’s);– Specialist doctor practices.

• Private dental practices and jaw and dental surgerydepartments of hospitals.

• Private veterinary practices and veterinarydepartments of university hospitals.

The latter market segments are much smaller in size.Due to the similarity in the manufacturing process anddesign, the trade figures are usually included in importand export figures of the first two groups. In general,both segments use the same or similar distributionarrangements as the two major market segments.

Note that there is a small consumer market segmentfor example for gloves, wadding and gauze as well,but this segment is estimated to be very small (around 2 – 3 percent of the consumption of medicaldevices and medical disposables) and will be neglectedin the rest of this survey.

Electro-diagnosticapparatus

12%

Dental Instruments5%

Wadding, gauze,bandages

14%

Latex medicaldisposables

3%

Syringes, needlesand catheters

20%

Wound closureproducts

4%

Nappies and similarhygiene products

20%

Preparations forx-ray examinations

12%

Surgical instrumentsand appliances

10%

Figure 3.2 EU consumption of medical devices and medical disposables by product group, 1999. Share of total value (%)

Source: CBS Datashop (2002)

Intramural marketIn most EU Member States a tendency can be observedtowards a decrease in the number of hospital andpsychiatric beds. This can partly be explained bygovernment measures taken to cut down on publicexpenditures. Table 3.1 shows a decrease in the number of bedsbetween 1998 and 2000 for the Netherlands and forGermany.

Presently, the intramural market exceeds the extramuralmarket in size with respect to the consumption ofmedical devices and medical disposables.

The majority of the hospitals, approximately 80 percent,purchase their medical products through a buying co-operative. These co-operatives are regionally orientedand represent hospitals within a certain geographiccoverage. The major benefit of joining a co-operative isthe reduction of prices (discounts) that result fromincreased bargaining power with potential suppliers.

Extramural marketThe same problems with respect to data gatheringappear in the extramural market. Table 3.2 gives anindication of the size of the extramural market in 1999and 2000 and suggests that the number of practices isincreasing.

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Overall the consumption of medical devices andmedical disposables in the extramural market isincreasing.

3.3 Consumption patterns and trendsThis section will highlight various factors that influencethe consumption of medical devices and medicaldisposables. It will be indicated how these factors willcreate opportunities for providers from developingcountries. Reference is also made to Section 3.1, inwhich a country’s socio-political background wasdescribed as an important determinant of health careexpenditure.

DemographyThe first and most important factor that influences theconsumption of medical devices is the demographicstructure of the market. The life span of the EUpopulation has increased considerably over the lastdecades. The consequence is an ageing population,which causes an ever-increasing need for medical care.

The table on the next page shows that Italy, Greece andGermany have the highest share of people older than60 years. For Germany this implies a high level ofconsumption of medical devices and medicaldisposables, in fact Table 3.1 showed it is the highestin the EU.

Table 3.1 Size of the intramural market by the absolute number of beds in hospitals (1999-2000) and psychiatric institutions (1998-1999)

Country Number of hospital beds Number of psychiatric beds1999 2000 1998 1999

The Netherlands 78,340 75,409 26,657 26,013France 492,031 485,803 n.a. 67,458Germany 754,865 n.a. 62,185 60,808

Source: CBS Datashop (2002) n.a. = not available

Table 3.2 Size of the extramural market by the absolute number of practices

Country Number of physicans Number of dentists Number of or doctors physiotherapists

1999 2000 1999 2000 1999 2000

The Netherlands 48,987 50,856 8,501 8,819 29,188 30,337Belgium 41,331 42,036 n.a. n.a. 26,050 n.a.France 193,200 194,000 40,088 40,539 50,474 52,056Germany 291,171 294,676 62,564 63,120 23,519 n.a.The United Kingdom n.a. n.a. 26,424 n.a. n.a. n.a.

Source: CBS Datashop (2002) n.a. = not available

Table 3.1 also showed high levels of consumption ofmedical devices and medical disposables for Italy.However, for Greece, though having a large share ofolder people, the consumption level of medical devicesand medical disposables is not very high. Since healthcare standards in Greece are relatively low, and despitethe high percentage of older people, the consumptionlags behind.

Socio-economicsThe generally tight labour market in the EU countrieshas a considerable influence on the consumption ofmedical devices and, especially, on the consumptionof medical disposables. The tight labour market hasmade hospital personnel increasingly expensive andhas forced hospital management to find substitutes forlabour intensive practices. For example, heart monitorsallow one nurse to care of a number of patientssimultaneously; disposable catheters avoid regularchanging of diapers and bed sheets, etc.Other disposables that are increasingly popular includesyringes and needles, disposable apparel and accessories.

EnvironmentCare for the environment is an important issue in theEuropean Union. Over the last decade awareness ofenvironmental issues has grown among governments,industries and consumers alike. The consumer isincreasingly taking environmental aspects into accountin his or her buying decision. The EU as well as thenational governments have taken initiatives towardsmore stringent environmental legislation. Manufacturersnowadays must adhere to all local environmentalregulations and EU-wide regulations.

17

Medical devices and medical disposables, oftencomposed of different materials such as rubber, metalsand textiles, are subject to a number of environmentalregulations. Through setting standards for the allowableenvironmental impact, these regulations affect theproduction process itself. For example if nickel andchromium plating is used for the manufacture ofsurgical instruments, then the production process shouldcomply with all relevant local and internationalregulations and standards. Also the packaging materialshould comply with EU standards aiming at a recoveryquota and at controlling the presence of mercury, lead,cadmium and hexavalent chromium in the packaging.

In Appendix 8 addresses are given where you can findspecific information on the operational regulations. See also the CBI publication ‘Strategic MarketingGuide Medical Devices and Medical Disposables 2001’.It is essential that the products offered on the EUmarket adhere to the respective standards in the fieldof environment.

Product Quality and DesignChanging the product quality or design in anyappreciable manner is a sometimes long and difficultprocess, since the market regulations could require thatthe “Annex 10” of the Council Directive be applied.This would imply an official evaluation to assesswhether the material is clinically suitable for thepurpose for which the product is intended.

Short run changes in quality or design are thereforegenerally limited to the material inputs used for certainproducts.

Table 3.3 Demographic structure within the European Union (1999)

Country < 20 years 20-39 years 40-59 years > 60 years Total

Germany 21.4 29.6 26.7 22.3 100 %Austria 23.0 31.0 26.2 19.8 100 %Belgium 23.7 28.7 25.8 21.8 100 %Denmark 23.6 29.3 27.5 19.6 100 %Spain 22.2 32.4 23.9 21.5 100 %Finland 24.8 26.8 28.9 19.5 100 %France 24.6 28.1 26.0 21.3 100 %Greece 22.3 29.8 25.0 22.9 100 %Ireland 31.4 30.3 23.2 15.1 100 %Italy 20.0 30.5 26.0 23.5 100 %Luxembourg 24.3 30.4 26.3 19.0 100 %The Netherlands 24.4 30.5 27.1 18.0 100 %Portugal 23.9 31.1 24.5 20.5 100 %The United Kingdom 25.4 29.1 25.1 20.4 100 %Sweden 24.3 26.8 26.8 22.1 100 %EU average 23.1 29.8 25.7 21.4 100 %

Source: Eurostat (2000)

Examples of innovations that create new marketopportunities, include:• Traditional latex may be replaced by so called low

protein latex, medical grade plastics or siliconerubber;

• P.V.C. products, catheters, infusion- transfusionsystems, connecting tubes etc. may be replaced byother plastic materials for more patient comfortand better biological suitability.

Price sensitivity and brandsThe usefulness of brands in the Medical Devices marketis very limited. Since manufacturers are obliged toregister their name and address with the healthauthorities and all products must bear the CE mark,the producer of an unknown brand is directly traceable.In most cases the name and brand of the Europeanimporter will be printed on the labels, as well as themanufacturer’s name and country.

In general, prices for medical devices and medicaldisposables are fairly stable, although a growingnumber of developing countries increasingly succeedin placing a downward pressure on prices. Especially with regard to labour intensive products,exporters in developing countries deploy their abundantresources of cheap labour and sell their productsdirectly to EU manufacturers. The EU manufacturerthen adds a final polish or inspection to the productand subsequently sells the product under its own label. This way of organising production enables exportersto sell products that they could not sell under theirown brand name, whilst it allows EU manufacturer toreduce operational costs and, hence, the market price. A genuine example of a developing country puttingdownward pressure on market prices is China,especially with regard to the production of surgicalinstruments and latex medical disposables.

Yet another factor in the determination of prices aresuccessful price negotiations. These negotiations mayresult in a considerable decline of the margin for thedistributors and offer the exporter additionalopportunities with respect to market entry and customerrelations (for more information see the CBI publication“EU Strategic Marketing Guide Medical Devices andMedical Disposables 2001”). Factors that determinethe discount include:• The size of the order;• The duration of the contract;• The degree of competition with respect to the

product in question.

PromotionDue to the establishment of a single market and freemovement of goods within the EU, the degree ofcompetition has increased. An important way for amanufacturer or trader to promote products is visiting

18

trade fairs. Two major annual trade fairs in Europe are‘Medica’ in Düsseldorf and ‘Interhospital’ in Nürnberg,Germany. Both trade fairs are regarded as the premiermedical industry events in Europe and are visited bypotential customers from all over the world.

When visiting a trade fair, it is useful for themanufacturer or exporter to have a full colour productcatalogue available. This catalogue should provide asystematic overview of the product range available inall medical disciplines, as to allow the customer toidentify his needs easily. For more information withrespect to trade fair organisers, places and dates seeAppendix 5 and the CBI publication ‘EU StrategicMarketing Guide 2001 Medical Devices and MedicalDisposables’.

20

4 PRODUCTION

The total EU production of medical devices and medicaldisposables in 1999 amounted to US$ 10,486 million(€ 11,398 million). The main players in the industryare Germany (over 40 percent of production),Italy (14 percent), the United Kingdom and France(both 11 percent) and Ireland (7 percent). Figure 4.1 presents the production figures for theEU Member States for 1999.

Note that production data, as collected through thenational statistical offices, are not complete at the levelof disaggregation applied in this study. Importantreasons for reporting incomplete data include thereluctance of producers to make their productionfigures available and the fact that statistical offices areoften not allowed to publish data. The latter generallyapplies if there are less than three producers of aspecific type of product, or if one producer controlsmore than 70 percent of total production. Notably, the European market for medical devicesand medical disposables consists of a small numberof large producers.

As can be seen from Figure 4.2 the production of medicaldisposables, accounting for 53 percent of the total,exceeds the production of medical devices (47 percent).Syringes, needles and catheters (19 percent) are thelargest product group produced within the EU.

Nappies and similar hygiene products (18 percent) andElectric-diagnostic apparatus (14 percent) follow thisproduct group.

Table 4.1 shows the six most important Europeanmanufacturers of medical devices and medicaldisposables. Generally, these manufacturers do notproduce their products in the country of origin. Becauseof high labour costs in Europe, a lot of the productionof parts and components takes place in foreignaffiliates, often established in developing countries.These parts and components are then being imported tothe EU, where the final product will be assembled.Germany is the largest manufacturer, as well as thelargest importer, which demonstrates the trans-nationalcharacter of the manufacturing process.

The leading manufacturers presented in Table 4.1 havedeveloped strategies to obtain strong world marketpositions. Strategically they are looking for threeelements: low wages, low local taxes, and shortdistribution routes. How they develop this strategy inpractice depends on the type of product and the market.For example, the largest surgical instrumentmanufacturer in the world, a German company calledAesculap, has manufacturing sites all over the world.These manufacturing sites provide the mother companywith bulk instruments produced to Aesculap standards

0 500 1000 1500 2000 2500 3000 3500 4000 4500 5000

United kingdom

Finland

Portugal

Austria

Netherlands

Italy

Ireland

France

Spain

Greece

Germany

Denmark

Belgium

1,139.4

144.7

21.9

123.9

178.5

1,508.7

714.6

1,168.4

518.4

15.3

480.3

95.9

Figure 4.1 Production of medical devices and medical disposables in EU countries 1999Value in US$ million

Source: CBS Datashop (2002)Note: due to incompleteness of data the estimates for Belgium, Greece, Austria, Portugal, and the Netherlands are corrected onthe basis of opinions of experts. Data for Sweden and Luxembourg are not available.

21

and specifications, and simultaneously organise thelocal distribution of the medical devices and medicaldisposables. More technically complex and advancedproducts are still designed and manufactured inGermany.

Yet another organisation of production is applied in thesyringe and needle industry. Since producing theseproducts involves a lot of research and technology,the availability of sufficient capital and humanresources is a prerequisite for success. It also requiresa well-organised marketing, guaranteeing that oncethe product is ready for the market it can be sold ona sufficiently large scale to warrant the originalinvestment. Three mayor players dominate the syringeand needle industry, i.e. Becton & Dickinson USA,Terumo Japan and Braun medical in Germany.

They all operate in their own geographical area,characterised by the availability of skilled humanresources and capital and infrastructure that limitsthe costs for transportation and distribution. Next to these three dominant market players, a numberof manufacturers in the USA purchase products in

developing countries and put them up for re-sale in theEU under their own brand. This applies particularly tolatex medical disposables and diagnostic devices suchas stethoscopes, blood pressure meters and revalidationequipment.

The role of developing countries in such processes isgenerally limited to supplying intermediary inputs tothe EU manufacturer, and usually only develops afterthe brand name has already been well established inthe international market. Smith & Nephew UK, forexample, buys bandages, gauze and similar productsin developing countries because of the low wages.The quantities required are usually very large (bulk),allowing cheap container transportation, and profits aremarginal. Other companies buy their intermediaryinputs in developing countries to benefit from the localavailability of, for example, cotton and rubber.

A part from buying the intermediaries, in some casesthe EU company buys the complete company in thedeveloping country, in order to ensure continuoussupply and to be able to monitor the quality of theproducts more closely.

Electro-diagnosticapparatus

14%

Dental instruments8%

Wadding, gauze,bandages

11%

Latex medicaldisposables

0%

Syringes, needles andcatheters

19%

Wound closure products4%

Nappies and similarhygiene products

18%

Preparations for x-rayexaminations

15%

Surgical instruments andappliances

11%

Figure 4.2 EU production of medical devices and medical disposables by product group, 1999. Share of total value (%)

Source: CBS Datashop (2002)

Table 4.1 Top 6 largest manufacturers medical devices and medical disposables in the EU

Manufacturer Country Products

Philips Medical Systems The Netherlands Electro-diagnostic apparatusLohmann Germany Wadding, gauze and bandagesB. Braun Germany Catheters, wound closure products and other special productsSmiths & Nephew The United Kingdom Wadding, gauze and bandagesBecton & Dickinson Spain Syringes and needlesBrunswick Belgium Syringes and needles

22

5 IMPORTS

The statistics presented in this chapter are official tradefigures provided by Eurostat. After unification of theEuropean Union in 1992, customs authorities stoppedrecording the intra-EU trade. Since then, import andexport figures have been based on reports given by thecompanies themselves. In the case of intra-EU trade,statistical reporting is only compulsory for EUexporting and importing firms, whose trade exceeds€ 100,000. Companies, whose trade does not exceedthis threshold value of € 100,000, are not obliged toreport and are therefore excluded from the statisticsprovided by Eurostat. Imports from non-EU sources,however, are still registered by customs authorities.

Moreover, CBS, which provides the Dutch trade figuresto Eurostat, is not allowed to publish figures withrespect to certain medical products for similar reasonsas discussed in chapter 4. These figures are consideredto be too sensitive, as in the case of dominant marketparticipant they might lead to conclusions with regardto its specific performance.

For these reasons, all statistics must be regarded withcaution. The data are not complete, and are intendedto give an indication of trends in the respective productgroups and of the relative importance of European sub-markets.

The statistics specify total imports, imports from non-EU countries (extra-EU) and imports from developing

countries, both in volumes as well as in value.Developing countries, as defined by the OECD,are listed in Appendix 9. Appendix 1 lists importstatistics of the EU and the selected markets withinthe EU and gives detailed breakdowns of the statisticsby product group and supplying country.

5.1 Total importsIn 2000, the EU imported 1,040,978 tonnes of medicaldevices and disposables, which represented a value ofUS$ 10,169 million or € 11,053 million.Germany is the largest EU importer of medical devicesand medical disposables, as presented in Figure 5.1.Germany’s imports amount to US$ 2,132 million(€ 2,317 million) for almost 185 thousand tonnes in2000, accounting for 21 percent of total EU importsof medical devices and medical disposables in 2000.France is the second largest importer of medical devicesand medical disposables (14 percent of EU imports in2000), followed by the United Kingdom and theNetherlands (both 11 percent), Belgium (10 percent),Italy (9 percent), Spain (6 percent), Ireland (4 percent),and Austria and Sweden (both 3 percent).

Table 5.1 presents the imports of medical devices andmedical disposables by EU country for 1998-2000.From the table it appears that the EU Member Statesregistered an average increase in import volume of24 percent. Sweden was the only country to register adecline in import volume. Imports in value in the year

Figure 5.1 EU imports of medical devices and medical disposables by major EU country, 2000,as percent of total value


Other8%

Germany21%

France14%

UK11%

Netherlands11%

Belgium10%

Sweden3%

Austria3%

Ireland4%

Spain6%

Italy9%

10,169

23

2000, however, are only a mere 3 percent higher thanin 1998. Amongst the largest importers, only theNetherlands and the UK were confronted with priceincreases of their imports over the three-year period.Ireland experienced a remarkable 51 percent increase ofimport value, but its total imports still remain relativelysmall. The downward pressure on prices and upwardpressure on volume represents the increasing role ofexporting countries like China and Vietnam.Especially cotton and latex based products, productswith relatively less stringent quality standards areaggressively being marketed to the EU. These countriesoffer gauze, bandages and gloves below market pricesto gain market share.

Figure 5.2 shows that EU imports of medicaldisposables are substantially larger than imports ofmedical devices. More than half of the importsoriginate from other EU countries; imports fromdeveloping countries comprise 7 percent of totalimports. Developing countries are relatively moreactive in the supply of medical disposables, amountingto 8 percent of EU imports of medical disposables,than in the supply of medical devices, accounting for3 percent of the EU imports of medical devices.The leading supplier of medical devices and medicaldisposables from outside the EU is the United Statesof America, please see Figure 5.3. The USA exported 49 thousand tonnes to the EU,

Table 5.1 EU Imports of medical devices and medical disposables by EU country,1998 - 2000, US$ 1,000 / € 1,000 / tonnes

1998 1999 2000Value US$ Volume Value US$ Value € Volume Value US$ Value € Volume

EU Total 9,849,551 840,341 10,625,067 10,023,648 905,239 10,168,656 11,555,291 1,040,978Germany 2,186,628 152,561 2,270,202 2,141,700 163,868 2,132,814 2,423,652 184,894France 1,433,882 142,377 1,480,558 1,396,753 162,937 1,376,539 1,564,248 167,552 United Kingdom 1,107,914 91,936 1,185,057 1,117,978 100,396 1,126,476 1,280,086 103,886Netherlands 1,008,345 79,151 1,156,267 1,090,818 89,553 1,098,936 1,248,791 151,557Belgium 834,156 77,787 1,100,145 1,037,873 86,034 1,057,834 1,202,084 94,066Italy 917,453 75,076 950,195 896,410 70,748 931,144 1,058,119 79,160Spain 568,190 47,232 580,365 547,514 48,769 606,389 689,079 56,987Ireland 269,424 14,514 369,307 348,402 13,338 407,997 463,633 15,705Austria 355,923 32,799 366,932 346,162 34,918 349,015 396,608 34,246Sweden 400,891 34,457 347,848 328,159 34,661 309,114 351,266 27,467Denmark 242,433 20,841 247,708 233,686 20,688 233,639 265,499 21,995Greece 196,186 25,816 187,880 177,245 30,566 187,681 213,274 53,043Portugal 175,998 32,806 203,926 192,383 32,448 180,647 205,281 33,697Finland 152,140 12,988 156,704 147,834 14,311 148,533 168,788 14,478Luxembourg n.a. n.a. 21,968 20,724 2,004 21,905 24,892 2,245

Source: Eurostat (2002)Note: Data for Belgium 1998 include Luxembourg n.a. = not available

1998 1999 2000 1998 1999 2000 1998 1999 2000

12,000

10,000

8,000

6,000

4,000

2,000

0

4,5004,0003,5003,0002,5002,0001,5001,000

5000 0

100200300400500600700800

EU Total Extra EU Developing countr ies

Medical devices

Medical disposables

Figure 5.2 Total EU imports, EU imports from extra-EU countries and EU imports from developing countries,1998-2000, US$ million


24

valued at US$ 2,081 million (€ 2,262 million). Over the past three years, the USA saw their export tothe EU grow by 18 percent and experienced a 3 percentpoint market share increase to 20 percent of total EUimports in 2000. Apart from Ireland, USA was the onlytop 10 exporter to the EU that saw its exports increasecompared to 1999.

Although Germany saw a sharp decline in its exportsto the other EU countries, it still ranks second withUS$ 1,538 million (€ 1,672 million). The other top 5 countries, i.e. The Netherlands, Franceand Belgium lag behind with total exports valued ataround US$ 700 million or € 761 million. The fact thatall main sources of intra-EU exports in 2000 alsoemerge in the top 10 of EU importing countriesrepresents the intensive trade relations within the EU.Switzerland, Japan and Malaysia complete the top tenof suppliers of EU imports of medical devices andmedical disposables. Over the three-year period,Japan increased its exports to the EU by 10 percent,whilst Switzerland and Malaysia experienced a declineof 20 percent and 13 percent respectively.

Germany was the largest EU importer of Wadding,gauze and bandages in 2000. Germany imported23 thousand tonnes of wadding, gauze and bandages,which was worth US$ 336 million (€ 365 million) andrepresented 26 percent of total value of EU imports.France imported 17 percent, the United Kingdom11 percent, Belgium 8 percent, and the Netherlands7 percent, which leaves 31 percent which was importedby the other EU countries.

The United Kingdom imported US$ 113 million(€ 123 million) of Latex medical disposables,

which makes it the largest EU importer in this productgroup. The United Kingdom is closely followed byGermany, which also had a share of approximately19 percent. Next in line are France (12 percent),Belgium (10 percent) and the Netherlands (7 percent).

Belgium was the largest EU importer of Syringes,needles and catheters, accounting for 19 percent oftotal EU imports. The Netherlands are the secondlargest importer in 2000, with imports worthUS$ 550 million (€ 598 million). Germany importedUS$ 475 million (€ 516 million) and rank third with15 percent. France accounted for 10 percent of EUimports of syringes, needles and catheters, the UnitedKingdom for 9 percent and other EU countries for29 percent.

The main EU importers of Wound closure products areFrance, Germany, the United Kingdom, the Netherlandsand Belgium, accounting for respectively, 20, 18, 15, 5and 5 percent of EU imports in 2000.The largest EU importer of Nappies and similarhygiene products is France (20 percent of total EUimports), followed by Germany (16 percent), theNetherlands and the United Kingdom (both 10 percent)and Belgium (7 percent).

Major EU importers of Preparations for X-rayexaminations in 2000 include Germany (21 percentof total EU imports), France (12 percent),the United Kingdom (9 percent) and Belgium(9 percent). The Netherlands only had a share of3 percent of total EU imports.

More than two fifth of imported Surgical instrumentsand appliances by the EU in 2000 were imported by

0 500 1,000 1,500 2,000 2,500

2000

1999

1998

Malaysia

Switzerland

Japan

Ireland

United Kingdom

Belgium

France

Netherlands

Germany

USA

Figure 5.3 Main suppliers of medical devices and medical disposables to the EU, 1998-2000, value in US$ million


25

Germany (US$ 488 million or € 530 million ofimports). The United Kingdom was the second largestimporter, with imports amounting to US$ 134 million(€ 146 million). With values at around US$ 99 millionor € 108 million, both the Netherlands and France hada 9 percent share in total EU imports.

Germany accounted for 21 percent of total EU importsof Electro-diagnostic apparatus, followed by theUnited Kingdom, 14 percent, France, 13 percent,the Netherlands, 10 percent and Belgium, with 4 percent.

France imported most Dental instruments:US$ 98 million (€ 107 million) or 16 percent oftotal EU imports. France is followed by Germany

(16 percent), the United Kingdom (10 percent),the Netherlands (7 percent) and Belgium (4 percent).

5.2 Imports by product groupTable 5.2 gives a breakdown of EU imports of medicaldevices and medical disposables by product group. For each product group total imports obtained fromoutside the EU and the imports supplied by developingcountries are presented. This table thus gives insight inthe opportunities per product group for developingcountry exporters.

In 2000 EU imports of medical disposables were morethan twice as much as EU imports of medical devices.The largest product group described is Syringes,

Table 5.2 EU imports of medical disposables and medical devices by product group, 1998-2000, US$ 1,000 / € 1,000 / tonnes


Medical 6,629,459 793,616 7,203,850 6,796,085 853,201 6,925,931 7,528,186 978,341disposablesWadding, gauze and bandages 1,359,436 79,157 1,421,557 1,341,091 89,103 1,303,890 1,417,272 96,874Extra-EU 595,425 27,199 590,041 556,643 30,191 529,703 575,764 32,554Developing countries 92,472 11,468 95,983 90,550 11,857 104,420 113,500 13,333Latex medical disposables 647,334 122,694 616,911 581,991 131,442 586,511 637,511 205,026Extra-EU 480,321 100,625 459,678 433,659 107,640 440,604 478,917 114,629Developing countries 408,738 93,051 388,810 366,802 100,474 371,826 404,159 107,327Syringes, needles and catheters 2,737,731 79,590 3,236,921 3,053,699 92,069 3,187,021 3,464,153 103,867Extra-EU 973,418 20,568 1,360,104 1,283,117 25,655 1,398,790 1,520,423 34,310Developing countries 98,223 4,760 103,599 97,735 5,055 103,197 112,171 5,493Wound closure products 493,247 2,725 493,238 465,319 3,235 445,256 483,974 3,155Extra-EU 129,239 532 125,485 118,382 621 130,207 141,529 912Developing countries 4,581 34 3,036 2,865 29 5,611 6,099 90Nappies and similar hygiene 1,391,711 509,450 1,435,224 1,353,985 537,352 1,403,254 1,525,276 569,419productsExtra-EU 75,240 24,806 106,896 100,845 33,048 144,267 156,811 46,417Developing countries 9,688 2,899 12,616 11,902 3,866 10,836 11,778 3,316Medical devices 3,220,092 46,725 3,421,217 3,227,563 52,038 3,242,725 3,524,701 62,637Preperations for x-ray 437,537 5,545 501,146 472,779 6,821 469,632 510,470 7,764examinationsExtra-EU 153,493 2,400 141,850 133,821 2,487 153,999 167,391 2,501Developing countries 1,093 11 878 828 3 607 659 3Surgical instruments and 1,145,169 24,188 1,198,940 1,131,075 27,846 1,154,668 1,255,074 28,784appliancesExtra-EU 500,303 8,652 538,117 507,657 9,858 489,922 532,524 9,209Developing countries 85,896 3,254 89,411 84,350 3,474 89,851 97,664 2,838Electro-diagnostic apparatus 1,026,422 7,961 1,071,308 1,010,668 7,884 1,015,075 1,103,342 9,663Extra-EU 504,381 2,688 563,998 532,074 3,456 573,637 623,518 3,565Developing countries 14,970 148 14,689 13,857 165 14,976 16,278 133Dental instruments 610,965 9,031 649,823 613,041 9,487 603,351 655,816 16,426Extra-EU 237,252 2,041 248,325 234,268 2,125 247,659 269,195 1,930Developing countries 12,095 358 12,563 11,852 365 12,621 13,719 336Total: 9,849,551 840,341 10,625,067 10,023,648 905,239 10,168,656 11,052,887 1,040,978

26

needles and catheters, with total imports valued atUS$ 3,187 million (€ 3,464 million). Other medicaldisposables that the EU imports in large amounts areNappies and similar hygiene products, worthUS$ 1,403 million (€ 1,525 million) and Wadding,gauze and bandages, worth US$ 1,304 million(€ 1,417 million). With respect to medical devices,Surgical instruments and appliances (US$1,155 millionor € 1,255 million) and Electro-diagnostic apparatus(US$ 1,015 million or € 1,103 million) are the mostimportant product groups imported by the EU. Main sources of EU imports by product group can befound in Figure 5.5 – Figure 5.13.

Wadding, gauze and bandagesAs one of the bigger product groups, EU imports ofWadding, gauze and bandages accumulated toUS$ 1,304 million (€ 1,417 million) or 13 percentof total EU imports in 2000. Compared to 1998,this figures remained more or less stable, but itrepresents an 8 percent decrease compared to the EUimports in 1999. Volume increased by 22 percent over1998-2000, which indicates that the general price levelfor wadding, gauze and bandages went down in thistime frame. This holds especially for countries outsidethe EU: imports from these countries increased with20 percent in volume, while in value terms EU importsdecreased by 11 percent. Also for intra-EU importsthe value/volume ratio decreased, although much less

than for extra-EU countries. The 24 percent increasein volume was accompanied by a 1.3 percent increasein value. Developing countries are an exception to thetrend of declining export value, but also experiencedan – albeit small - decline in prices: whilst EU importsfrom developing countries increased 16 percent involume, its value increased 13 percent.

20%0% 40% 60% 80% 100%

Germany

France

UK

Belgium

The Netherlands

Other EU

Wadding, gauze and bandages

Latex medical disposables

Syringes, needles and catheters

Wound closure products

Nappies and similar hygiene products

Total

Preparations for x-ray examinations

Surgical instruments and appliances

Electro-diagnostic apparatus

Dental instruments

Figure 5.4 Share of selected EU markets in total value of EU imports by product group, 2000, percentage


Other8%

Switzerland9%

USA17%

INTRA-EU60%

Czech Rep.2%

China4%

Figure 5.5 Sources of EU imports of wadding,gauze and bandages as percentage oftotal value of imports


27

In 2000 EU imports from developing countriesamounted to US$ 104 million (€ 113 million),which is 13 thousand tonnes.

The United States were the main suppliers of EUimports of these products with US$ 218 million(€ 237 million) or 17 percent of total imports.Developing countries contribute 8 percent in valueand 14 percent in volume to the EU imports in 2000 ofWadding, gauze and bandages. This is relatively highcompared to the other product groups. This high shareof developing countries can mainly be explained bythe presence of natural resources, i.e. cotton, in thesecountries and the relatively labour intensive productionprocess of these products. In this respect, China is agood example. China has a large cotton industry and isthe largest supplier from developing countries ofwadding, gauze and bandages to the EU. In 2000, total EU imports of wadding, gauze andbandages from China amounted to US$ 57 million(€ 62 million), with which China ranked third in theoverall list of main suppliers. Other important suppliersfrom developing countries include Mexico, India,Indonesia and Thailand.

Latex medical disposablesOverall, total EU imports of latex medical disposablesfell by 9 percent in value to US$ 587 million(€ 638 million), despite the tremendous growth involume of 67 percent. Extra-EU imports exceed intra-EU imports: 75 percent of total EU imports oflatex medical disposables in 2000 originated from non-EU countries (worth US$ 440 million or€ 478 million).

Imports from developing countries shrunk in value by9 percent, resulting in US$ 372 million (€ 404 million)worth of EU-imports in 2000. Nevertheless, developingcountries remain the most dominant source of EUimports: over 63 percent of imports in 2000 originatedfrom developing countries. Thus, latex medicaldisposables is the sole product group discussed in thissurvey in which developing countries are the majorsource of EU imports.

Two developing countries rank first and second on thelist of top ten suppliers of latex medical disposables,see Figure 5.6: Malaysia, supplying 38 percent of totalEU imports or US$ 223 million (€ 242 million), andThailand, with exports accumulating to US$ 75 million(€ 82 million) representing 13 percent of total EUimports. Hungary, next in line, supplied US$ 29 million(€ 32 million). The United States suppliedUS$ 26 million (€ 28 million) worth of latex medicaldisposables. Indonesia (4 percent) and Sri Lanka(3 percent) can also be found in the top ten suppliers.

An important reason why Malaysia, Indonesia andSri Lanka appear in the top ten of suppliers of latexmedical disposables is again the access to the requirednatural resources, i.e. all three countries have largerubber plantations.

Syringes, needles and cathetersSyringes, needles and catheters is the largest productgroup, with EU imports worth US$ 3,187 million(€ 3,464 million) in 2000. Their share in EU importsof medical disposables amounts to almost 50 percent.

Other8%

INTRA-EU25%

Sri Lanka3%

Indonesia4%

USA4%

Hungary5%

Thailand13%

Malaysia38%

ZFigure 5.6 Sources of EU imports of latex medicaldisposables as percentage of total valueof imports


Other8%

INTRA-EU57%USA

28%

Switzerland3%

Japan3%

Israel4%

Figure 5.7 Sources of EU imports of syringes,needles and catheters as percentage oftotal value of imports


28

Furthermore, imports have strongly increased from1998 to 2000: Total volume of imports increased with30 percent, accompanied by a 16 percent increase invalue. Extra-EU imports amounted to 44 percent in2000, 8 percent more than in 1998. Imports fromdeveloping countries remained more or less stableduring this three year interval at three percent of totalvalue (US$ 103 million or € 112 million in 2000) oraround five percent of total volume (5,493 tonnesin 2000). Since the rise in value and volume wascomparable, the price effect over the period isnegligible.

Within this product group the catheters represent thelargest share of imports, worth US$ 2,276 million(€ 2,474 million) in 2000, which is comparable to the1999 figure. Over the three year period, the import ofcatheters and plastic syringes increased by 23 and14 percent respectively, accompanied by an 18 and44 percent increase in volume. The imports of non-plastic syringes, tubular needles and needles forsutures declined in value but sharply increased involume, to even 43 percent for non-plastic syringes.

As can be seen from Figure 5.7 most EU imports – 28 percent – came from the United States, amountingto US$ 891 million (€ 968 million). Each with an11 percent share, Ireland and The Netherlands arethe largest EU source countries of total EU importsof syringes, needles and catheters. Ireland suppliedUS$ 359 million (€ 390 million) and the Netherlandssupplied US$ 350 million (€ 380 million),closely followed by Belgium (US$ 310 million or€ 337 million). Israel (4 percent of total EU imports),and Japan and Switzerland (both 3 percent) have

significantly smaller shares in EU import of syringes,needles and catheters.

Wound closure productsTotal imports of wound closure products amounted toUS$ 445 million (€ 484 million) in 2000, which is10 percent less than in 1998. From Figure 5.8 it can beseen that intra-EU imports accounted for 70 percent oftotal imports. The USA (27 percent of total EU importsof wound closure products) dominates the extra-EUimports. A little more than 1 percent was imported fromdeveloping countries.

Nappies and similar hygiene productsIn 2000 the EU imported US$ 1,403 million(€ 1,525 million) worth of nappies and similar hygieneproducts, mostly for retail sale. The 1 percent increasein total value and 12 percent increase in total volume,was largely realised by an increase in the extra-EUimport; over the three year period, the extra-EU importsshowed a 92 percent increase in value and a 87 percentincrease in volume. Intra-EU imports, accounting for90 percent of total EU imports, experienced a 5 percentdecline in value since 1998. Although imports fromdeveloping countries increased substantially over thelast few years, they still only amount to 1 percent oftotal EU imports of nappies.

Preparations for x-ray examinationsTotal EU imports amounted to US$ 470 million(€ 511 million) for 7,764 tonnes of preparations for x-ray examinations in 2000, which was 7 percent morein value than in 1998. Extra-EU imports account for33 percent in 2000, yet imports from developingcountries were negligible. In the period 1998-2000,

INTRA-EU89%

USA4%

Other4%

Japan3%

Figure 5.9 Sources of EU imports of nappies andsimilar hygiene products as percentageof total value of imports


Other3%

USA27%

INTRA-EU70%

Figure 5.8 Sources of EU imports of wound closureproducts as percentage of total value ofimports


extra-EU imports remained more or less stable in valueand increased by 4 percent in volume. This indicatesthat prices have changed in favour of the EU countries.Intra-EU imports rose by 40 percent in volume.

Imports of preparations for X-ray examinationsoriginate mainly from other EU countries (67 percentof total EU imports), the USA (16 percent),Canada (8 percent), and Norway and Switzerland(both 4 percent), please see Figure 5.10. Imports from developing countries amounted to a mereUS$ 607 thousand (€ 658 thousand). This may beexplained, among other things, by the high qualitystandards that are applied to products in this group. In this respect western buyers seem to be reluctant tosupplies from developing countries.

Surgical instruments and appliancesDuring 2000 the European countries imported29 thousand tonnes of surgical instruments andappliances. This amounted to US$ 1,155 million(€ 1,255 million) and makes Surgical instruments andappliances the largest product group on the EU-marketfor medical devices, accounting for 36 percent of EUimports of medical devices. Compared to 1998, importsrose by 19 percent in volume and 1 percent in value,which implies a sharp price fall. This price fall wasmuch stronger within the EU than in non- membercountries. In contrast, prices of imports from developingcountries rose, which is reflected by a 5 percent increasein value and a 13 percent decline in volume.Approximately 40 percent of the imported surgicalinstruments and appliances were transfusion apparatus,

29

with EU imports amounting to US$ 463 million(€ 503 million). This is a 6 percent decline vis-à-vis1998. Volume rose with 18 percent, resulting in23 thousand tonnes in 2000. Endoscopes accountedfor US$ 406 million (€ 441 million) and blood pressuremeasures for US$ 200 million (€ 217 million). The imported volume of endoscopes declined with4 percent, while value rose with 10 percent. Volume of blood pressure measures increased with30 percent, which was three times as much as theincrease in value, indicating falling prices. The increased volume of EU imports of anaestheticapparatus and instruments was accompanied by a17 percent decrease in value, resulting in EU importsof US$ 86 million (€ 93 million) for 1,139 tonnes.

Figure 5.11 shows that in 2000 58 percent of the valueof EU imports of surgical instruments and appliancesresulted from intra-EU trade. Japan and USA togetheraccount for almost one third of EU imports, i.e.16 percent respectively 14 percent. Developing countries supplied 8 percent of totalimported value, equalling 10 percent of total imports intonnes. In comparison to 1998 EU imports of surgicalinstruments and appliances from developing countriesincreased by 5 percent in value and decreased by13 percent in volume. In 2000 China was the largestexporter among developing countries with a 4 percentshare in total EU-imports. Also Malaysia and Indonesiaplay a role in EU imports in the category. Other in Figure 5.11. The increasing value of EUimports of surgical appliances suggests that this productgroup offers relatively good export opportunities forexporters in developing countries.

Other1%

Switzerland4%Norway

4%

Canada8%

USA16%

INTRA-EU67%

Figure 5.10 Sources of EU imports of preparationsfor x-ray examinations as percentage oftotal value of imports


Other8%

USA14%

INTRA-EU58%

China4%

Japan16%

Figure 5.11 Sources of EU imports of surgicalinstruments and appliances aspercentage of total value of imports


30

Electro-diagnostic apparatusEU imports of electro-diagnostic apparatus in 2000amounted to US$ 1,015 million (€ 1,103 million) and9,633 tonnes. This is 21 percent more in volumecompared to 1998. Because the dollar value of therecorded imports fell by 1 percent, this product groupalso experienced an overall price deflation. This trend isseen in the intra-EU trade and in exports coming fromoutside the EU, which were 43 and 57 percent of totalEU imports respectively. In contrast, developingcountries saw their import value to the EU rise by1 percent, accompanied by a decrease in volumealmost of 10 percent.The contribution of developing countries in total EUimports of electro-diagnostic apparatus is one percentin value. Prospects for developing countries on themarket for electro-diagnostic apparatus remain meager.Electro-diagnostic apparatus is a high technologyproduct that is subject to high quality standards inthe EU market. The US is the biggest supplier ofelectro-diagnostic apparatus with US$ 444 million(€ 483 million) worth EU imports, accounting for44 percent of EU imports of this product group.

Dental instrumentsImports of dental instruments amounted toUS$ 602 million (€ 654 million) for 16 thousand tonnesin 2000, respectively 1 percent less and 82 percent morethan in 1998. Intra-EU imports amounted to 59 percentof dental instruments’ imports. EU-imports fromdeveloping countries amount to a mere 2 percent ofboth value and volume of total imports, with a mainrole for Pakistan and Brazil. Over the last three years,EU imports from developing countries rose by 4percent in value, but declined by 6 percent in volume.

It follows that a better price was paid for the productssupplied. Extra-EU imports of dental instrumentsoriginate mainly from Switzerland and USA.

5.3 The role of developing countriesTotal EU imports of medical devices and medicaldisposables from developing countries amounted toUS$ 714 million (€ 776 million) in 1999, which isapproximately 133,000 tonnes. Overall this represents7 percent of the value and 13 percent of the volume ofthe total EU imports of medical devices and medicaldisposables. From 1998 to 2000 the volume of EUimports from developing countries increased from115,983 to 132,869 tonnes, but the share in totalvolume decreased by 1 percent. The value of imports from developing countriesdecreased from US$ 728 million to US$ 714 million,or from € 791 million to € 776 million, since 1998.Taking into account the rise in volume and the2 percent decline in value, imports from developingcountries follow the global trend of declining pricesfor medical devices and medical disposables.

Figure 5.14 shows the shares of imports fromdeveloping countries as a percentage of total value ofEU imports by product group. The only exception tothe small share of developing country supplies is theEU imports of latex medical disposables: 63 percent oftotal value of EU imports of latex medical disposablesare imported from developing countries. On the otherhand, with EU imports amounting to US$ 356 million(€ 387 million), the product group Latex medicaldisposables is the smallest product group in absoluteterms within the market for medical devices and

Other6%

Switzerland2%

USA43%

INTRA-EU44%

Japan5%

Figure 5.12 Sources of EU imports of electro-diagnostic apparatus as percentageof total value of imports


Other4%

Switzerland18%

USA17%

INTRA-EU59%

Japan2%

Figure 5.13 Sources of EU imports of dentalinstruments as percentage of total value of imports


medical disposables. Imports from developingcountries for this group amount to a relatively lowsum of US$ 372 million (€ 404 million). In addition, during the period 1998-2000 EU importsof latex medical disposables from developing countriesshowed a marked decline of 9 percent in value.

Other product groups with relatively high shares ofEU imports from developing countries are Surgicalinstruments and appliances, Wadding, gauze andbandages and Syringes, needles and catheters. Though the share of developing countries in EUimports is low compared to latex medical disposables,

31

total value of the export of these product groups ismuch larger. EU imports in absolute terms have beensubstantial: in 2000 the EU imports from developingcountries amounted to US$ 90 million, US$ 104 millionand US$ 103 million (or € 98 million, € 113 millionand € 112 million) for the respective product groups. In addition, since 1998 the share of developingcountries in EU imports of the product groups Surgicalinstruments and appliances and Waddding, gauze andbandages has increased.Table 5.3 presents the top ten of developing countriessupplying medical devices and medical disposablesto EU.

8%

63%

3%1% 1% 0%

8%

1% 2%

0%

10%

20%

30%

40%

50%

60%

70%

199819992000

Wad

ding,

gauz

e and

band

ages

Dental

instr

umen

ts

Electro

-diag

nosti

c app

aratus

Surgic

al ins

trumen

ts an

d app

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es

Prepara

tions

for x

-ray e

xamina

tions

Nappie

s and

simila

r hyg

iene p

rodu

cts

Wou

nd cl

osur

e pro

ducts

Syring

es, n

eedle

s and

cathe

ters

Latex m

edica

l disp

osab

les

Figure 5.14 Share of imports from developing countries as percentage of total imported value by product group,1998-2000


Table 5.3 Top ten of developing countries supplying medical devices and medical disposables to the EU, 2000

Developing country EU imports (in US$ million) EU imports (tonnes)

1. Malaysia 279 63,2122. China 134 12,0593. Thailand 86 26,3954. Mexico 46 2,5955. Indonesia 40 11,3146. South Korea 22 6317. Sri Lanka 18 4,9718. India 16 3,0109. Slovenia 9 1,58510. Pakistan 8 308

32

In 2000 the EU imported 63 thousand tonnes ofmedical devices and medical disposables fromMalaysia, adding up to a value of US$ 279 million(€ 303 million). This puts Malyasia on the first placeamong developing countries, accounting for over40 percent of EU imports of medical devices andmedical disposables from developing countries. China is the second largest country to the EU. In 2000 the EU imported 12 thousand tonnes, worthUS$ 134 million (€ 146 million), of medical devicesand medical disposables from China.

Whilst China saw its export value to the EU increaseby 5 percent, Malaysia experienced a 13 percent declinein export value of medical devices and disposables, albeita 10 percent increase in volume. Thailand remains thirdon the list, attaining an increase of 10 percent in volume,and an 8 percent decrease in value, which resulted inUS$ 6 million (€ 93 million) for 26 thousand tonnesof exports. Imports from Mexico grew explosively.The EU doubled its imports from Mexico in the threeyear period. Mexico supplies 7 percent of total EUimports from developing countries.

The large exports of developing countries for productssuch as Latex medical disposables, Syringes, needlesand catheters and Wadding, gauze and bandagesactually illustrate that developing countries have abetter position at the lower end of the market which ischaracterised by small margins and lower prices.

For each of the 4 main product groups identified above,Table 5.4 shows the most important EU importingcountries and the most important supplying developingcountries. Except for the top-10 countries mentioned inthe table, important producers of these product groupsinclude Brazil, South Africa, Egypt and the DominicanRepublic. The main EU importers are Germany, France,UK, Belgium and the Netherlands.

Table 5.4 Main EU importers and supplying developing countries for four main product groups, 2000

Product group EU importing country* Source of import (developing countries only)*

Wadding, gauze and bandages Germany, France, UK, Belgium China, Mexico, Indonesia, India, South Africa,Egypt, Malaysia

Latex medical disposables UK, Germany, France, Belgium Malaysia, Thailand, Indonesia, Sri Lanka, China,India, Mexico, Pakistan

Syringes, needles and catheters Belgium, the Netherlands, Malaysia, Mexico, Thailand, China, Brazil,Germany, France, UK India, Dominican Republic

Surgical instruments and appliances Germany, UK, the Netherlands, China, Malaysia, Indonesia, DominicanFrance Republic, Thailand

* Countries are listed in order of importance.

6 EXPORTS

6.1 Total ExportsTogether the 15 EU Member States exported1,006 thousand tonnes of medical devices andmedical disposables in 2000. This was worth a totalof US$ 11,116 million or € 12,632 million.Compared to 1998 exports grew by 6.8 percent invalue. Over the same period volume increased by 13 percent.The Netherlands (22 percent), Spain (21 percent),Belgium (65 percent) and Austria (40 percent)experienced a remarkable growth in their export value.Ex port volumes also rose, although less dramatic. For Germany, Greece, Portugal, and Finland both valueand volume dropped. Greece underwent the mostdramatic decline in exports: both value and volumefell by more than 20 percent compared to 1998. This can be explained by a historically relatively lowquality/price ratio.

More than half of the EU exports of medical devicesand medical disposables did not leave the EU, but wastraded between Member States themselves. Of theremaining 42 percent, 10 percent point (in US$) wasexported to developing countries. With respect tovolumes, however, 74 percent remained within the EU,

while only 6 percent of the EU export was exported todeveloping countries. Being the largest manufacturer,Germany is also the largest exporter of medical devicesand medical disposables in the European Union.Germany accounted for more than a quarter of total EUexports in 2000, i.e. 227,972 tonnes with a value ofUS$ 2,936 million (€ 3,191 million). The Netherlands(13 percent), United Kingdom and Belgium (both11 percent), and France (10 percent) are the other mainexporters.

The difference in exported value between medicaldevices versus medical disposables is significant;respectively 37 versus 63 percent. Appendix 1 listsexport statistics of the EU. Medical devices andmedical disposables exported by the EU in 2000 as apercentage of total US$ value of the EU exports:Syringes, needles and catheters (29 percent),Nappies and similar hygiene products (16 percent),Electro-diagnostic apparatus (12 percent), Wadding,gauze and bandages (10 percent), Preparations for x-rayexaminations (10 percent), Surgical instruments andappliances (9 percent), Dental instruments (7 percent),Wound closure products (5 percent) and Surgicalgloves (2 percent).

33

15 337

257275311311

456474533

9331,0591,170

1,205

1,452

2,936

0

500

1,000

1,500

2,000

2,500

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German

y

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ndsUK

Belgium

France

Irelan

d

Denmark Ita

ly

Sweden

Spain

Austri

a

Finlan

d

Portu

gal

Greece

Luxem

bour

g

1998

1999

2000

Figure 6.1 EU exports of medical devices and medical disposables by country, million US$, 1998-2000

Source: Eurostat (2002) Note: Data for Belgium 1998 include Luxembourg

34

Germany

As Figure 6.1 shows the leading exporter of medicaldevices and medical disposables in the EU over 2000was Germany. Germany exported US$ 2,936 million(€ 3,191 million) worth of medical devices, which is6 percent less than in 1998. Half of these exports weremeant for other EU countries; half found their way toother countries, a fifth of which reached theirdestination in developing countries. Most importantproducts for Germany were surgical instruments andappliances (US$ 580 million or € 630 million),preparations for x-ray examinations (US$ 538 millionor € 585 million), and nappies and similar hygieneproducts (US$ 436 million or € 474 million).

The Netherlands

The Netherlands is the EU’s second largest exporter ofmedical devices and medical disposables. For the 117 thousand tonnes it exported it receivedUS$ 1,452 million (€ 1,578 million). The volume rosemore than twice as much than value, suggesting a pricedecrease in exports. In 2000, 66 percent of Dutchexports had other EU countries as destination and9 percent had developing countries as destination.Medical disposables formed most of these exports:82 percent of total exports of medical devices andmedical disposables. Most important product groupwas syringes, needles and catheters. Especially catheters have proven to be very successfulexport products for the Netherlands: with a value ofUS$ 832 million (€ 904 million).

The United Kingdom

With US$ 1,205 million (€ 1,310 million) the UnitedKingdom was the third largest exporter in 2000.UK exports rose 1 percent in value since 1998.Destination countries of UK exports were similar tothose of Germany: half was within the EU, half outside.Exports to developing countries were slightly more incomparison to Germany: 15 percent of total UK exportsagainst 12 percent of total German exports. UK exportswere spread over all 9 product groups, with exports ofwadding, gauze and bandages ranking first atUS$ 241 million (€ 262 million). Latex medical disposables and dental instrumentswere the product groups with the smallest UK exports(2 percent or less), and surgical instruments andappliances also comprised a small share in total exports(almost 6 percent).

Belgium

Belgium is the forth-largest EU exporter, exportingUS$ 1,170 million (€ 1,272 million) worth of medicaldevices and disposables. Of those exports, whichincreased by a tremendous 65 percent in value and21 percent in volume since 1998, 18 percent wasexported outside the EU and 6 percent was deliveredto developing countries. In 2000, 88 percent ofBelgium’ exports were medical disposables, withsyringes, needles and catheters (US$ 615 million or€ 668 million) and wadding, gauze and bandages(US$ 247 million or € 268 million) as most importantproduct groups. Nappies and similar hygiene productswere the third most important export product of Belgium,but these exports only amounted to US$ 95 million(€ 103 million).

France

France exported only slightly less than Belgium:US$ 1,059 million (€ 1,151 million) in 2000. Medical disposables formed 73 percent of its exports,which was primarily caused by high exports of syringesand catheters (US$ 201 million or € 218 million) andwadding, gauze and bandages (US$ 119 million or€ 129 million). Extra-EU countries received 25 percent,and 11 percent was destined to developing countries.

Recipients of EU exports

The United States were not only the largest source ofEU imports, as was shown in the previous section,they were also the largest recipients of EU exports.US$ 1,378 million (or € 1,498 million) of EU exportswent there. With 7 EU countries Japan and Switzerlandcomplete the top ten of buyers of EU exports of medicaldevices and medical disposables (as they also show upin the top ten of suppliers to the EU). They imported respectively US$ 567 million andUS$ 308 million (€ 335 million) of medical devicesand medical disposables from the EU.

Of developing countries, Turkey received the most EUexports: US$ 126 million (€ 137 million). South Africa,however, received almost twice as much as measured involume. Brazil imported US$ 73 million (€ 79 million)of EU exports, China received medical devices anddisposables worth US$ 48 million (€ 52 million),closely followed by India with US$ 47 million(€ 51 million).

7 TRADE STRUCTURE

7.1 EU trade channelsThe figure below gives a schematic overview of thetrade structure of the medical devices and disposablesindustry in the EU. The figure presents two main tradechannels by which the distribution of medical devicesand medical disposables can take place. The differenttrade channels are:

• Direct distribution– The manufacturer offers his products directly

to the end-user, such as hospitals and buying co-operatives. This kind of distribution is not verycommon. The company needs its own distributionchannel to operate this way. Usually only largecompanies with subsidiaries of transnationaloperating enterprises can afford this.

– Direct trading with local distributors andwholesalers. This kind of distribution is also notfrequently used. The volume of the shipment islikely to be small.

A buying co-operative is a co-operation of several endusers (not independent), e.g. hospitals, which togetherform a strong and influential partner in the market.Over the past ten years these buying co-operatives havegrown substantially and have significantly improved thebargaining position of hospitals.

• Distribution with intermediary serviceIn most cases importers or agents with a lot ofknowledge of the specific market are the linkbetween the producers and the local dealer/wholesalers or the market. Within the EU, agents andimporters are the most commonly used distributionchannel for medical devices and medical disposables.In certain cases it is possible to rent space from anagent in a bonded warehouse. The agent thenadministrates the products and can also arrangeinsurance for pilferage during transport in thewarehouse or to the customer. It is even possiblefor an agent to use the name of the manufacturer onthe invoice form that is sent out to the customer. The manufacturer then only has to open a bankaccount in the respective country.

Which type of distribution channel is preferable dependson the specific circumstances, but is also influenced bythe Council Directive 93/42/EEC, which requires themanufacturer to appoint a responsible representativein the EU. This representative has to be appointedbefore the manufacturer is allowed to sell its productson the European market. In the initial stages ofexporting it is usually more effective to concentrate onone representative per country, which is in conformitywith the EEC Directive also.

35

Figure 7.1 Typical distribution structure for medical devices in the EU markets

frequentlynot frequently

Intramural market / Extramural market

buying co-operative

■ Hospital ■ GP’s■ Nursing ■ Dental practices

agent/import

Manufacturer

local dealer/wholesaler

36

The traded product is also a factor that determines whichtrade channel should be used. Surgical instrumentsfor example require a different type of sales channel,as more product knowledge is required than is the caseof examination gloves and syringes and needles forexample. Products like catheters and sutures on theother hand ask for salesmen, familiar with the exactneeds of the customer with respect to the differentmedical procedures. The selling of these products oftenrequires a lot of investment in time before the medicalstaff can be persuaded to use the product. Furthermore,the salesmen are often well educated and thereforeexpensive.

7.2 Distribution channels for developingcountry exporters

For the purpose of choosing your trade channels,it is necessary to make a distinction between twocategories of products.

The first group of products involves continuousresearch and development and usually large capitalinvestments. A specific example is the product groupelectro-diagnostic apparatus, such as cardiographs. In general these systems are updated as soon as newand better methods become available. This also impliesthat most new products must be clinically proven andapproved by the health authorities. It is evident thatthis development can only be successful if enoughcapital and suitable manpower is available. It alsorequires a well-organised marketing, which is able tosell the product on a sufficient large scale to warrantthe original investment. Furthermore, it is importantthat a service and repair facility is available nearby.This market is in the hands of large companies, whichhave a world-wide service level. Phillips Medical in the Netherlands and Siemens inGermany are the leaders in diagnostic apparatus. These companies hardly purchase any products fromdeveloping countries directly, but may apply simpleproduct components indirectly through their mainsuppliers. The opportunities for exporters from thedeveloping countries in this group of products are small.

The second group consists of products where there isrelatively little research and development needed,e.g. bandages, gauze and similar products. EU basedcompanies often buy these products from thedeveloping countries attracted by low labour cost.Smith & Nephew in the United Kingdom and Lohmannin Germany are such companies. The quantities theexporter will trade are usually very large, while theprofit margins usually are low. It is therefore difficultfor the manufacturer to be able to compete on such acompetitive market.

With respect to the product groups ‘Wadding, gauzeand bandages’ and ‘Latex medical disposables’ themanufacturer preferably is located in the rightgeographical area, close to readily available cotton andrubber. Furthermore, the logistics must allow forcontainer transportation and wages must be suitable forthe low priced products. Thailand for example used tobe a large supplier of wadding and gauze, but becametoo expensive. The same increasingly applies to India aswell.

Please refer to Appendix 10 of this survey for a list ofthe key EU importers of medical devices and medicaldisposables.

A trade fair is a good way to get into contact withcompanies from all over the world, which could beinterested in new suppliers. Please refer to the EUStrategic Market Guide for more information on tradefairs and to Appendix 5 of this survey for contactdetails of trade fair organisers. Contact details ofimporters in The Netherlands and other Europeancountries can be found in Appendix 10. Many of theseimporters have an Internet site, where interested partiescan find more information on the field in which theseimporters are active. Besides Internet sites ofcompanies, www.europages.com is another good sourcefor finding contact details and information on theactivities of importers.

8 PRICES AND MARGINS

8.1 Prices and margins The market for medical devices and medicaldisposables is not set by any (inter) nationalorganisation or institution. This means prices are setby the market and thus free and competitive. The price the end-user or the consumer pays generallyconsists of the following components, please refer alsoto the CBI publication “EU Strategic Marketing GuideMedical Disposables and Medical Devices 2001” forinformation on FOB/ CIF prices and VAT:

Factory cost price, including transport to port (i.e. FOB)

+ Transportation and insurance costs (i.e. CIF)+ Other costs (storage, banking, etc) + Import duties

= Landed-cost price + Margin Importer and Wholesaler + Value Added Tax (VAT)

= Consumer price

Cost price Costing and pricing are often being treated as onesubject. As a matter of fact these two are totallydifferent variables, handled by different companydepartments.

In order to be able to calculate a cost price one needsto collect the complete information on:• Raw materials• Packaging materials• Labor costs• Overhead expenses• Other cost components (shipping expenses)

It is also important to be familiar with the productionprocesses and maximum production capacity. The above statistics must be available and regularlyupdated by the responsible department of the exportingcompany.

The approach to pricing calculation starts withreviewing the following aspects:• The specific market segment of your product• The promotional activities needed to penetrate that

segment• The price levels of comparable competing products• The anticipated reaction of competitors on your entry

into their market• Your actual manufacturing cost price• The decision you have to make whether you want

to enter the market at a high price with a high profitand low turnover or a low price with a low profit(or even a loss) and high turnover

• Total strategy for the initial export marketpenetration

For the final determination of the cost price fourelements must be available. These elements are:• Fixed production costs• Variable production costs• Overhead expenses• Hidden profits.

One should realise that overhead expenses couldsometimes contain a hidden profit. Let us presumethat a company sells on annual basis 200,000 pieceswith an overhead of US$150,000 (or € 163 million). The overhead expenses can then be calculated atUS$ 0.75 or € 0.82 per unit. If however throughadditional sales the number of units sold increases to300,000, the actual overhead expenses are loweredto US$ 0.50 or € 0.54 per unit.

The conclusion is that the increase in sales volume willaffect the actual profit margin. Other factors that effectcosting are:• The increase in production will tend to lower the

purchasing costs of various components such as rawmaterials and packaging materials. Thus increasingthe overall profit level including local sales.

• Full utilisation of the existing production capacity,will also affect the costs in a positive manner. Larger sales volume per year will induce the fixedgeneral cost (per unit) to drop.

Be careful not to oversell your production capacity,because you may lose reliability and money.

Consumer priceThe pricing strategy the exporter should choose dependson several factors mostly inherent to the product sold.When choosing a strategy the exporter should, amongothers, look closely to factors such as research anddevelopment costs and investments, production costsand volume of the shipment. For more information onbusiness practices, please refer to the CBI publication“EU Strategic Marketing Guide Medical Disposablesand Medical Devices 2001”.

The following pricing strategies could be applied:

• Cost plus method.If the exporter receives an enquiry from an overseascustomer, often the cost price is used as a basis(for example 100) to calculate the sales price to be

37

38

offered, which could be 115 if 15 percent profit isincluded. The exporter, however, does not know whathis competitors are offering. By using this method ofcalculation the exporter might miss the opportunityfor a higher profit. To increase his price to the goingmarket level will take a number of years in whichpotential profits are lost. On the other hand the exportermay lose the order because the competition is offeringthe same product at 114. In case the manufacturerknows this, he could decide to offer 112, especiallywhen this results in a higher volume of sales. A highervolume of sales leads to a reduction of the fixed costsper product.

• Profit oriented pricing.In this pricing strategy the profit margin is fixed ata certain level. This system is also based on the “cost-plus” method, but it means that the manufacturerwill not consider a price not meeting the profit target.

• Turnover oriented pricing.The sales price in this case depends on parameters thatare not related to the level of profit. The manufacturermay want to decide on a specific sales volume,which he wants to reach in a given time span.Sales volume then becomes the first priority, at the bestobtainable price.

• Survival oriented pricing.For a limited period of time, simply surviving in adifficult market situation can be an objective. This situation can occur when there is a temporaryoversupply. A pricing strategy under these difficultcircumstances depends on a number of factors. If the manufacturer has other outlets, which generatesufficient profit, he could consider such a strategy fora difficult market and even use this strategy to pushcompetitors out of that market. If it is a general markettrend of a temporary nature and the manufacturer hasenough financial reserves, it can consider taking theloss for a period of time.

• Competition oriented pricing.This strategy has two possibilities. First, themanufacturer can consider quoting prices that willdiscourage others from entering the specific market(region). Secondly, the manufacturer takes the pricelevel of the leader in that market as a guide. Dependingon the quality of his product he can then adjust hisprice level to just below or slightly above thecompetitor’s price.

• Image oriented pricing.This strategy is based on the image the manufacturerwants to give his product in the market and the amountof money one is willing to spend on promotion. In thiscase the manufacturer makes the buyer pay for thebrand. The companies that work at the low end of the

market tend to have lower marketing expenses, lowermargins of profit, and hopefully compensate it throughhigher sales volume.

• Derivatives of the above.There are a number of variations to the strategiesmentioned before. The company may decide tointroduce its products in a new market at a low priceand in doing so reach a high sales volume. In thesecond stage it can then gradually increase its price to amore profitable level. Another possibility is to enter themarket at the high end and give your product the imageof superior quality. This will involve spending a lot ofmoney on marketing. Eventually, in order to obtainmore sales volume the price can be gradually lowered.

MarginsThe margins for the different intermediaries in thetrade structure (importers, agent, etc.) are difficultto determine, because they are influenced by manyfactors, such as:• Size of the order;• Length of the trade channel;• Quality of the product;• Availability of the product;• Added value

The box below gives an assessment of the ranges ofmark-ups per intermediary. Of the four intermediarieslisted below, only the agent acts on behalf of theexporter. The agent, therefore, is reimbursed (5 - 10 percent of invoice value) by the exporter for hisservices. The other intermediaries buy goods from theexporter on their own account and for their own risk, theexporter is not paying them. Their costs include, forexample, insurance, transport, stock and staff. Tocompensate for these costs, the intermediaries increasetheir selling price by the percentages shown in the table.

8.2 Sources of price informationThe market for medical devices and medical disposablesis not very transparent. Medical products are sold incombination with other products, based on conditionsthat vary case by case. Moreover, each product issupplied in various qualities, wich makes assessing theprice-quality ratios for each product a complex job.It is therefore difficult to obtain relevant market pricesin an objective manner.

Intermediary Low High

Agent 5% 10%Importer 35% 50%Local dealer/whole-saler 10% 15%Buying co-operative 10% 15%

To get up-to-date price information one has to turn tothe actual importers of the different products. Appendix 3 gives an enumeration of sources of priceinformation. In Appendix 11 also a few Internet sitesare given. The Internet sites given are virtual marketplaces for all sorts of medical devices and medicaldisposables. The sites are a good source for obtainingan idea of recent retail prices for medical devices anddisposables. The Internet sites are www.esurg.com forexample, and a similar site, although a bit moreinformative with respect to articles and news, iswww.medmarket.com.

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40

9 OPPORTUNITIES FOR EXPORTERS

Below, an overview is provided of product groupsand particular products interesting for exporters indeveloping countries, their main EU markets andpotentially interesting companies. Please refer tothe EU Strategic Marketing Guide ‘Medical Devicesand Medical Disposables’ for product profiles of:• Medical gloves;• Bandages and gauze including specialities;• Catheters and associated products;• Suture materials;• Surgical and Dental Instruments.

The selection of the products described in theMarketing Guide is that these can be consideredstandard products with specifications that are wellknown throughout the trade, and that the demand forthese products is stable.

The EU Strategic Marketing Guide also includes a“Business Guide”, which enables an exporter to buildhis own market and product strategy through amethodology of analysis and ready-to-fill-inframeworks.

For the EU market for medical devices and medicaldisposables a modest growth is expected due to cuttingof government expenditures on health. The larger marketsegment, consumption in the intramural market appearsto decline, due to a slight reduction in the number ofbeds. Within this market a shift can be observed towardsincreased use of disposable products that are timesaving for the nurses. At the same time, consumptionin the extramural market, which is a smaller marketsegment, increases due to an apparent shift of hospitalnursing towards home nursing. The consumption of disposable products with homenursing is usually considerable. The market for medicaldisposables, therefore, is expected to show relativelygood growth prospects, and to provide opportunities fordeveloping countries. The trade channel offering thebest chances for developing countries is the importer/EU manufacturer or the agent because of the knowledgeof the EU market.

Medical devices and medical disposables productgroups that have good opportunities in the EU marketinclude:• Wadding, gauze, bandages;• Latex medical disposables;• Syringes, needles and catheters; and• Surgical instruments and appliances.

The strengths of developing countries are their lowwages and, though not for all of them, the localavailability of cotton.

The products need to be manufactured in bulk at lowmargins and at specifications of the client, includingrequirements on various quality standards. Except forlatex medical disposables, all of these product groupsexperienced an increase of EU imports from developingcountries. Over the past three years, EU imports roseto approximately US$ 100 million (€ 109 million)in 2000 for each product group. In the same year, EUimports of latex medical disposables from developingcountries were four times higher and amounted toUS$ 370 million (€ 402 million).

EU countries that are particularly interesting forexporters from developing countries are theNetherlands, Belgium, the UK, Germany, Italy andFrance. These countries are the top-6 importers ofmedical devices and medical disposables and rankamong the main producers. A few large companiesdominate the EU market for medical devices andmedical disposables. These include Lohmann(Germany, wadding, gauze and bandages),Smiths & Nephew (UK, wadding, gauze and bandages), Brunswick (Belgium, syringes and needles)and Philips Medical Systems (the Netherlands,electro-diagnostic apparatus).

APPENDIX 1

EUROPEAN UNION – TOTAL IMPORTS

EU Imports of medical devices and medical disposables by product group detailed, 1998 – 2000,US$ 1,000 / € 1,000 / Tonnes


Total 9,849.6 840,341 10,625.1 10,023.6 905,239 10,168.7 11,052.9 1,040,978

Extra-EU 3,649.1 189,511 4,134.5 3,900.5 215,081 4,108.8 4,466.1 246,027

Developing countries 727.8 115,983 721.6 680.7 125,288 713.9 776.0 132,869

Detailed product groups:

Medical disposables

Wadding, gauze and bandages 1,359.4 79,157 1,421.6 1,341.1 89,103 1,303.9 1,417.3 96,874

With adhesive dressings or layers 689.0 26,566 742.1 700.1 27,582 688.7 748.6 38,467

Other wadding and gauze 670.4 52,591 679.4 641.0 61,521 615.2 668.7 58,407

Latex medical disposables 647.3 122,694 616.9 582.0 131,442 586.5 637.5 205,026

Surgical gloves 358.5 65,795 329.9 311.2 69,341 298.6 324.5 134,243

Examination gloves 288.8 56,899 287.0 270.8 62,101 287.9 313.0 70,783

Syringes, needles and catheters 3,134.2 195,817 3,592.5 3,389.1 216,130 3,534.2 3,841.6 299,622

Syringes with and without needles 1,053.8 156,526 1,104.3 1,041.8 173,120 1,051.2 1,142.6 253,625

Metal needles 225.6 6,722 223.5 210.8 7,496 207.5 225.5 7,683

Plastic or latex catheters 1,854.9 32,569 2,264.6 2,136.5 35,514 2,275.6 2,473.4 38,314

Wound closure products 493.2 2,725 493.2 465.3 3,235 445.3 484.0 3,155

Nappies and similar hygiene prod. 1,391.7 509,450 1,435.2 1,354.0 537,352 1,403.3 1,525.3 569,419

not for retail sale 160.3 74,805 154.5 145.8 77,120 159.1 172.9 87,568

for retail sale 1,231.4 434,645 1,280.7 1,208.2 460,232 1,244.2 1,352.4 481,851

Medical devices

Preperations for x-ray exam. 437.5 5,545 501.1 472.8 6,821 469.6 510.5 7,764

Blood grouping reagents 102.0 750 108.4 102.3 743 87.0 94.6 779

Opacifying preperations 335.6 4,795 392.7 370.5 6,078 382.6 415.9 6,985

Surgical instruments and appl. 1,145.2 24,188 1,198.9 1,131.1 27,846 1,154.7 1,255.1 28,784

Blood-pressure measures 182.5 2,775 223.0 210.4 3,926 200.1 217.5 3,594

Endoscopes 369.5 653 360.6 340.2 608 406.1 441.4 630

Transfusion apparatus 490.3 19,877 531.6 501.5 22,392 462.7 502.9 23,421

Anaesthetic apparatus and instr. 102.9 883 83.8 79.0 920 85.8 93.3 1,139

Electro-diagnostic apparatus 1,026.4 7,961 1,071.3 1,010.7 7,884 1,015.1 1,103.3 9,663

Electro-cardiographs, parts and acc. 154.9 1,380 150.9 142.4 1,393 131.4 142.8 2,032

Electro-diagnostic apparatus 871.5 6,581 920.4 868.3 6,491 883.7 960.6 7,631

Dental instruments 611.0 9,031 649.8 613.0 9,487 603.4 655.8 16,426

Dental drill engines 53.6 924 62.0 58.5 981 61.8 67.1 1,119

Dental instruments and appliances 557.4 8,107 587.8 554.6 8,506 541.6 588.7 15,307

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42

EU Imports of medical devices and medical disposables by major source, 1998 - 2000, US$ 1,000 / € 1,000 / Tonnes


Total 9,849,551 840,341 10,625,067 10,023,648 905,239 10,168,656 11,052,887 1,040,978Extra EU 3,649,072 189,511 4,134,493 3,900,465 215,081 4,108,786 4,466,072 246,027Developing Countries 727,757 115,983 721,586 680,742 125,288 713,945 776,027 132,869

Major SourcesUSA 1,711,132 31,863 2,037,354 1,922,032 41,827 2,086,331 2,267,751 49,296Fr Germany 1,685,671 225,953 1,729,108 1,631,234 212,649 1,538,077 1,671,823 212,257Netherlands 773,588 62,377 792,855 747,976 67,418 766,730 833,402 72,870France 726,992 105,163 746,470 704,217 119,214 743,061 807,675 122,358Belgium & Luxembourg 568,875 62,713 720,279 679,508 71,987 669,347 727,552 86,285Utd. Kingdom 755,145 68,685 755,221 712,473 79,377 621,993 676,079 140,607Ireland 483,383 13,602 512,214 483,221 15,687 541,247 588,312 16,160Japan 372,642 4,361 417,456 393,827 5,344 409,813 445,449 13,671Switzerland 475,301 11,591 494,805 466,798 12,011 380,308 413,379 12,228Malaysia 327,032 57,783 298,755 281,845 60,106 285,246 310,050 63,694Sweden 251,534 19,527 305,282 288,002 29,054 273,208 296,965 34,180Denmark 279,264 17,708 281,887 265,931 18,832 257,327 279,704 18,543Spain 228,214 40,581 240,833 227,201 45,578 236,631 257,207 50,651Italy 238,396 23,081 216,882 204,606 20,963 198,326 215,572 33,033Israel 27,985 1,573 121,026 114,175 2,418 173,981 189,110 4,670China 127,609 11,255 128,051 120,803 11,267 133,972 145,622 12,077Austria 128,946 8,188 108,464 102,325 6,136 110,045 119,614 6,506Finland 91,731 2,668 97,619 92,093 1,932 102,293 111,188 2,187Thailand 97,764 24,404 104,717 98,790 27,678 94,904 103,157 27,099Canada 76,167 1,073 68,297 64,431 1,219 67,660 73,544 1,878Hungary 51,971 6,293 54,957 51,846 5,740 53,944 58,635 6,277Czech Rep. 54,691 8,176 60,769 57,329 11,015 50,831 55,251 10,342Mexico 23,445 2,008 34,722 32,757 3,421 46,077 50,084 2,595Indonesia 29,401 7,500 34,281 32,340 8,657 40,085 43,571 11,314Poland 20,670 2,406 28,138 26,545 3,357 37,507 40,769 6,144

43

EU IMPORTS OF SELECTED PRODUCT GROUPS BY SOURCE

EU Imports of wadding, gauze and bandages by source, 1998 - 2000, US$, 1,000 / € 1,000 / Tonnes


Total 1,359,436 79,157 1,421,557 1,506,850 89,103 1,303,890 1,199,579 96,874Extra EU 595,425 27,199 590,041 625,444 30,191 529,703 487,326 32,554Developing Countries 92,472 11,468 95,983 101,742 11,857 104,420 96,067 13,333

Top 3 suppliers:USA 259,418 7,145 241,167 255,637 7,691 217,554 200,150 6,717Fr Germany 159,860 11,473 192,386 203,929 13,385 170,238 156,619 15,148Belgium 0 0 146,135 154,904 5,781 151,093 139,006 4,902

Top 10 developing countries:China 58,814 6,551 56,531 59,923 6,386 56,506 51,986 6,563Mexico 6,345 331 8,851 9,382 345 12,399 11,407 445Indonesia 3,768 555 4,072 4,317 663 9,421 8,668 1,430India 4,420 794 5,221 5,535 914 6,164 5,671 1,254South Africa 4,281 501 4,210 4,462 510 4,352 4,004 433Turkey 3,945 1,236 3,713 3,936 1,223 3,206 2,950 1,226Croatia 3,207 516 3,959 4,197 661 2,817 2,591 604Egypt 1,027 69 1,241 1,315 99 1,887 1,736 187Malaysia 1,263 100 1,312 1,391 111 1,252 1,152 149Thailand 1,086 83 1,512 1,603 145 1,194 1,098 182

EU Imports of latex medical disposables by source, 1998 - 2000, US$, 1,000 / € 1,000 / Tonnes


Total 647,334 122,694 616,911 653,925 131,442 586,511 539,590 205,026Extra EU 480,321 100,625 459,678 487,259 107,640 440,604 405,356 114,629Developing Countries 408,738 93,051 388,810 412,139 100,474 371,826 342,080 107,327

Top 3 suppliers:Malaysia 255,089 54,245 234,718 248,801 56,976 222,982 205,143 60,324Thailand 82,436 23,276 85,503 90,633 26,452 74,949 68,953 25,515Belgium 0 0 37,872 40,145 6,020 35,206 32,390 7,623

Top 10 developing countries:Malaysia 255,089 54,245 234,718 248,801 56,976 222,982 205,143 60,324Thailand 82,436 23,276 85,503 90,633 26,452 74,949 68,953 25,515Indonesia 22,783 6,890 22,402 23,746 7,826 24,507 22,546 9,664Sri Lanka 18,633 3,314 17,094 18,120 3,649 17,642 16,231 4,970China 13,007 2,867 12,238 12,973 2,898 12,805 11,780 3,236India 5,811 1,280 5,102 5,408 1,221 6,116 5,627 1,653Mexico 5,117 418 3,827 4,057 357 5,560 5,115 664Pakistan 1,975 70 3,953 4,190 236 2,295 2,111 127Vietnam 669 212 990 1,050 308 1,635 1,504 631Tunisia 990 33 880 933 38 1,213 1,116 28

44

EU Imports of syringes, needles and catheters by source, 1998 - 2000, US$, 1,000 / € 1,000 / Tonnes


Total 2,737,731 79,590 3,236,921 3,431,136 92,069 3,187,021 2,932,059 103,867Extra EU 973,418 20,568 1,360,104 1,441,710 25,655 1,398,790 1,286,886 34,310Developing Countries 98,223 4,760 103,599 109,815 5,055 103,197 94,941 5,493

Top 3 suppliers:USA 569,323 6,089 829,387 879,150 9,625 890,610 819,361 17,932Ireland 347,473 10,941 332,744 352,709 10,990 358,602 329,914 10,607Netherlands 345,828 2,650 384,390 407,453 1,788 349,742 321,763 2,171

Top 10 developing countries:Malaysia 51,541 2,363 47,245 50,080 2,016 44,564 40,999 2,203Mexico 7,605 500 13,613 14,430 836 24,432 22,478 1,273Thailand 7,585 534 9,434 10,000 630 9,098 8,370 631China 7,477 465 6,758 7,164 452 7,258 6,678 584South Korea 1,498 12 2,424 2,569 86 3,879 3,568 151Brazil 5,192 82 4,250 4,505 63 1,974 1,816 41India 2,511 44 1,911 2,026 76 1,773 1,631 74Malta 2,031 33 2,334 2,474 24 1,751 1,611 23Turkey 785 82 1,310 1,388 136 1,488 1,369 217Dominican R. 1,888 11 3,396 3,599 23 1,474 1,356 14

EU Imports of wound closure products (sterile surgical catgut) by source, 1998 - 2000, US$, 1,000 / € 1,000 / Tonnes


Total 493,247 2,725 493,238 522,832 3,235 445,256 409,635 3,155Extra EU 129,239 532 125,485 133,014 621 130,207 119,790 912Developing Countries 4,581 34 3,036 3,219 29 5,611 5,162 90

Top 3 suppliers:USA 118,775 462 116,600 123,596 549 117,993 108,554 728Utd. Kingdom 100,293 367 102,548 108,701 782 93,999 86,479 438Fr Germany 104,727 733 104,864 111,156 850 76,790 70,647 928

Top 10 developing countries:Mexico 103 1 78 82 0 1,756 1,616 55Saudi Arabia 82 2 716 759 8 1,590 1,463 16Brazil 15 0 92 97 0 801 737 7South Korea 2,479 12 180 191 0 660 607 1Tunisia 10 0 28 29 0 283 260 3China 346 10 211 224 8 176 162 8Slovenia 35 0 185 197 1 103 95 0Yemen 0 0 0 0 0 56 52 0South Africa 96 0 70 75 0 32 30 0Kenya 0 0 1 1 0 30 27 0

45

EU Imports of nappies and similar hygiene products by source, 1998 - 2000, US$, 1,000 / € 1,000 / Tonnes



Top 3 suppliers:Fr Germany 512,659 195,229 462,956 490,733 176,710 404,369 372,019 166,308France 260,750 90,118 258,907 274,441 102,730 224,670 206,696 97,933Utd. Kingdom 164,347 47,795 177,515 188,166 59,235 171,101 157,413 60,920

Top 10 developing countries:Slovenia 234 139 2,586 2,741 922 5,033 4,630 1,501Tunisia 0 0 125 132 45 985 906 324Nigeria 131 12 274 290 50 859 791 142Lebanon 989 243 101 107 36 541 498 202Benin 0 0 778 825 109 478 439 169Mexico 2,487 711 6,653 7,052 1,855 455 419 148Morocco 1 0 0 0 0 387 356 112Turkey 169 98 890 943 294 365 336 117Senegal 0 0 0 0 0 293 270 78Ghana 0 0 139 147 43 250 230 76

EU Imports of preparations for x-ray examinations by source, 1998 - 2000, US$, 1,000 / € 1,000 / Tonnes


Total 437,537 5,545 501,146 531,214 6,821 469,632 432,061 7,764Extra EU 153,493 2,400 141,850 150,361 2,487 153,999 141,679 2,501Developing Countries 1,093 11 878 931 3 607 558 3

Top 3 suppliers:Fr Germany 89,927 1,160 130,149 137,958 1,678 108,904 100,192 1,494Ireland 88,531 785 98,022 103,903 1,017 98,508 90,627 1,116USA 62,006 1,449 67,634 71,692 1,600 74,274 68,332 1,684

Top 10 developing countries:South Korea 1 0 11 11 0 425 391 2Oman 0 0 0 0 0 75 69 0South Africa 522 2 787 834 3 42 39 0Tunisia 0 0 0 0 0 31 29 0Pakistan 0 0 0 0 0 10 9 1Mexico 37 0 11 11 0 6 6 0India 1 0 0 0 0 6 5 0Turkey 80 1 0 0 0 6 5 0Malta 0 0 0 0 0 5 4 0China 2 0 28 29 0 1 1 0

46

EU Imports of surgical instruments and appliances by source, 1998 - 2000, US$, 1,000 / € 1,000 / Tonnes



Top 3 suppliers:Fr Germany 257,878 2,808 248,369 263,272 3,328 244,100 224,572 3,698Japan 198,900 858 219,819 233,008 999 180,981 166,502 604USA 170,335 2,286 166,618 176,615 2,285 161,785 148,842 2,33

Top 10 developing countries:China 43,095 1,086 44,182 46,833 1,278 50,404 46,372 1,493South Korea 6,758 149 7,599 8,055 173 13,028 11,986 287Malaysia 8,899 566 8,090 8,576 523 8,966 8,249 510Indonesia 2,776 52 7,608 8,064 158 5,933 5,458 167Dominican R. 0 0 17 18 0 4,039 3,716 117Slovenia 263 10 2,009 2,130 13 2,306 2,121 18Uruguay 24 0 653 693 23 1,028 946 37Malta 18,692 1,043 14,121 14,968 1,073 725 667 23Thailand 2,085 185 1,325 1,404 99 722 664 57South Africa 188 2 1,296 1,374 5 323 297 4

EU Imports of electro-diagnostic apparatus by source, 1998 - 2000, US$, 1,000 / € 1,000 / Tonnes


otal 1,026,422 7,961 1,071,308 1,135,587 7,884 1,015,075 933,869 9,663Extra EU 504,381 2,688 563,998 597,838 3,456 573,637 527,746 3,565Developing Countries 14,970 148 14,689 15,570 165 14,976 13,778 133

Top 3 suppliers:USA 371,075 1,879 434,955 461,053 2,639 443,557 408,072 2,565Fr Germany 166,778 1,259 174,091 184,536 1,543 152,217 140,040 3,543Netherlands 66,509 421 63,886 67,719 891 56,014 51,533 329

Top 10 developing countries:China 3,540 45 6,875 7,288 77 5,934 5,459 79South Korea 3,403 37 2,763 2,928 39 2,053 1,889 12India 867 11 623 661 9 1,384 1,273 11Malaysia 105 0 225 238 3 775 713 4Morocco 77 0 91 96 0 507 467 1South Africa 493 9 485 514 1 443 408 2Egypt 234 1 172 182 3 404 372 2Saudi Arabia 54 0 173 183 4 397 366 1Brazil 428 1 52 55 0 362 333 0Mexico 290 2 746 791 2 354 326 4

47

EU Imports of dental instruments by source, 1998 - 2000, US$, 1,000 / € 1,000 / Tonnes


Total 610,965 9,031 649,823 688,813 9,487 603,351 555,083 16,426Extra EU 237,252 2,041 248,325 263,224 2,125 247,659 227,846 1,930Developing Countries 12,095 358 12,563 13,317 365 12,621 11,612 336

Top 3 suppliers:Fr Germany 178,408 3,336 179,919 190,714 3,855 163,617 150,528 10,217Switzerland 108,414 402 112,816 119,585 438 108,400 99,728 416USA 90,040 1,041 94,874 100,566 1,092 100,353 92,325 944

Top 10 developing countries:Pakistan 4,396 97 4,808 5,096 97 4,613 4,244 102Brazil 1,759 61 1,966 2,084 118 2,208 2,031 111Slovenia 2,026 14 1,861 1,973 14 1,086 999 8Mexico 248 0 479 507 3 939 863 0Malaysia 605 14 784 831 13 688 633 18China 1,029 140 1,014 1,074 68 498 458 53Turkey 294 8 354 375 34 417 383 23South Korea 244 5 271 287 3 397 366 4India 184 2 116 123 2 341 314 5Lebanon 39 1 75 79 0 253 232 4

48

EU Imports of medical devices and medical disposables from developing countries, 1998 - 2000, US$ 1,000 / € 1,000 / Tonnes


Total 9,560,752 783,442 10,338,027 9,752,855 843,138 9,880,722 10,739,915 970,195Extra EU 3,435,149 141,031 3,924,409 3,702,272 161,966 3,897,607 4,236,529 187,249Developing Countries 727,757 115,983 721,586 680,742 125,288 713,945 776,027 132,869

Malaysia 206,533 29,742 185,355 174,863 30,531 172,037 186,997 31,384China 118,134 9,539 117,998 111,319 9,157 123,647 134,398 9,703Thailand 62,358 15,172 62,172 58,653 16,311 51,749 56,249 15,059Mexico 18,324 1,590 30,912 29,162 3,065 40,519 44,043 1,931Indonesia 19,134 4,055 23,938 22,583 4,759 29,554 32,123 6,911South Korea 18,794 1,335 14,692 13,860 632 21,630 23,510 580India 11,858 1,524 10,980 10,358 1,554 12,763 13,873 1,948Slovenia 3,433 241 7,412 6,993 1,004 9,265 10,070 1,576Sri Lanka 10,255 1,432 9,001 8,491 1,496 7,611 8,272 1,704Pakistan 6,110 435 6,188 5,838 165 6,183 6,721 181Turkey 5,562 1,437 7,076 6,675 1,701 6,059 6,586 1,591South Africa 5,805 530 7,058 6,658 526 6,013 6,536 482Dominican R. 1,904 11 3,496 3,298 29 5,922 6,437 168Brazil 7,727 160 6,613 6,239 189 5,416 5,887 162Croatia 3,556 551 4,320 4,075 687 3,289 3,576 624Egypt 1,767 88 2,030 1,915 151 2,899 3,151 278Malta 21,525 1,187 16,811 15,859 1,192 2,879 3,130 67Saudi Arabia 2,287 531 1,326 1,251 30 2,279 2,477 18Tunisia 3,505 353 4,570 4,311 429 2,122 2,307 368Bosnia-Herz. 2,312 274 2,505 2,363 329 2,035 2,212 315Uruguay 2,272 63 1,896 1,789 61 1,353 1,471 42Morocco 454 18 533 503 36 1,246 1,355 260Lebanon 1,478 249 690 651 46 1,197 1,301 219Nigeria 135 12 304 287 50 993 1,079 142Syria 210 29 857 808 141 851 925 185

49

EUROPEAN UNION - TOTAL EXPORTS

EU exports of medical devices and medical disposables by product group detailed, 1998 - 2000,US$ 1,000 / € 1,000 / Tonnes


Total 10,412,306 892,575 11,574,232 10,919,087 991,058 11,115,856 12,082,452 1,006,022Extra-EU 4,119,897 228,499 4,638,547 4,375,988 241,812 4,650,052 5,054,404 259,269Developing countries 1,062,696 63,891 1,092,467 1,030,629 63,011 1,156,542 1,257,111 64,342

Detailed product groups:Medical disposables 6,433,877 843,851 7,322,388 6,907,913 938,035 6,987,420 7,595,022 953,454Wadding, gauze and bandages 982,182 54,710 1,150,188 1,085,083 60,807 1,137,850 1,236,794 66,030With adhesive dressings or layers 529,166 20,309 618,804 583,777 21,241 606,513 659,253 23,707Other wadding and gauze 453,017 34,401 531,384 501,306 39,566 531,337 577,540 42,323

Latex medical disposables 248,180 33,883 263,279 248,376 34,768 235,550 256,033 32,590Surgical gloves 136,701 21,709 151,269 142,707 22,572 116,390 126,511 17,058Examination gloves 111,479 12,174 112,009 105,669 12,196 119,160 129,522 15,532

Syringes, needles and catheters 2,820,067 80,896 3,428,727 3,234,648 85,056 3,280,026 3,565,246 90,344Syringes with and without needles 634,522 50,277 733,266 691,761 50,675 733,976 797,800 53,879Metal needles 176,049 5,875 187,797 177,167 6,569 176,622 191,980 6,591Plastic or latex catheters 2,009,496 24,744 2,507,664 2,365,721 27,812 2,369,428 2,575,465 29,874

Wound closure products 607,278 4,760 592,601 559,058 3,254 582,544 633,200 3,452Nappies and similar hygiene prod. 1,776,170 669,602 1,887,593 1,780,748 754,150 1,751,450 1,903,750 761,038not for retail sale 280,185 121,579 303,353 286,182 141,821 288,340 313,413 148,976for retail sale 1,495,985 548,023 1,584,240 1,494,566 612,329 1,463,109 1,590,336 612,062

Medical devices 3,978,429 48,724 4,251,844 4,011,174 53,023 4,128,436 4,487,430 52,568Preperations for x-ray exam. 893,133 9,573 1,070,405 1,009,816 9,594 1,068,422 1,161,328 10,723Blood grouping reagents 93,881 868 103,440 97,585 945 104,660 113,761 561Opacifying preperations 799,252 8,705 966,965 912,231 8,649 963,762 1,047,567 10,162

Surgical instrumentsand appl. 1,069,745 20,929 1,092,139 1,030,320 22,864 1,037,540 1,127,760 21,207Blood-pressuremeasures 93,730 1,059 106,244 100,231 1,436 90,956 98,865 1,526Endoscopes 369,157 417 370,995 349,995 471 381,877 415,084 405Transfusion apparatus 448,701 17,871 465,409 439,065 19,527 418,589 454,988 17,900Anaestheticapparatus and instr. 158,158 1,582 149,491 141,029 1,430 146,118 158,824 1,376

Electro-diagnostic apparatus 1,199,094 7,736 1,276,998 1,204,715 9,861 1,209,621 1,314,805 9,449Electro-cardiographs,parts and accesories 196,221 1,679 204,055 192,505 2,090 152,968 166,269 1,795Electro-diagnostic apparatus 1,002,873 6,057 1,072,943 1,012,210 7,771 1,056,653 1,148,536 7,654

Dental instruments 816,456 10,486 812,301 766,322 10,704 812,853 883,536 11,189Dental drill engines 222,671 2,724 118,236 111,543 1,870 106,471 115,729 1,958Dental instruments and appliances 593,785 7,762 694,066 654,779 8,834 706,383 767,807 9,231

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APPENDIX 2 STANDARDS ORGANISATIONS

INTERNATIONALInternational Standardisation Institute (ISO)Address: P.O. Box 56, CH-1211 Geneva, SwitzerlandTelephone: + 41 (0) 22 7490111Telefax: + 41 (0) 22 7333430E-mail: [email protected]: www.iso.ch

EUROPEAN UNIONComité Européen de Normalisation (CEN)European Committee for NormalisationAddress: rue de Stassart 36, B-1050 Brussels, BelgiumTelephone: + 32 (0) 2 5500811Telefax: + 32 (0) 2 5500819E-mail: [email protected]: www.cenorm.be

BELGIUMInstitut Belge de Normalisation (IBN)Address: avenue de la Brabançonne 29,

B-1000 Brussels, BelgiumTelephone: + 32 (0) 2 7380111Telefax: + 32 (0) 2 7334264 E-mail: [email protected] Internet: www.ibn.be

FRANCEAssociation Française de Normalisation (AFNOR)Address: Avenue Francis de Pressensé 11,

93571 Saint-Denis La Plaine Cedex, FranceTelephone: + 33 (0) 1 41628000Telefax: + 33 (0) 1 49179000E-mail: [email protected]: www.afnor.fr

GERMANYDeutsches Institut für Normung e.V. (DIN)Address: Burggrafenstrasse 6,

D-10787 Berlin, GermanyTelephone: + 49 (0) 30 26010Telefax: + 49 (0) 30 26011260E-mail: [email protected] Internet: www.din.de

LUXEMBOURGService de l’Energie de l’Etat (SEE)Address: Département Normalisation, P.O. Box 10,

L-2010 LuxembourgTelephone: + 352 (0) 46 97461Telefax: + 352 (0) 22 2524E-mail: [email protected]: www.etat.lu/SEE

THE NETHERLANDSNederlands Normalisatie-instituut (NEN)Netherlands Standardisation InstituteAddress: P.O. Box 5059,

2600 GB Delft, The NetherlandsTelephone: + 31 (0) 15 2690390Telefax: + 31 (0) 15 2690190E-mail: [email protected]: www.nni.nl

Rijksinstituut voor Volksgezondheid en Milieu (RIVM)(National Institute for Public Health and Environment)Address: A. van Leeuwenhoeklaan 9,

3721 MA Bilthoven, The NetherlandsTelephone: + 31 (0) 30 2749111Telefax: + 31 (0) 30 2742971E-mail: [email protected]: www.rivm.nl

UNITED KINGDOMBritish Standards Institution (BSI)Address: 389 Chiswick High Road,

London W4 4AL, United KingdomTelephone: + 44 (0) 20 89969000 Telefax: + 44 (0) 20 89967400 E-mail: [email protected]: www.bsi-global.com

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APPENDIX 3 SOURCES OF PRICE INFORMATION

NORWAYNORADNorwegian Agency for Development CooperationAddress: P.O. Box 8034 Dep. 0030, Oslo, NorwayTelephone: + 47 (0) 22 242030Telefax: + 47 (0) 22 242031E-mail: [email protected]: www.norad.no

SWITSERLANDInternational Trade Centre (ITC)Address: Palais des Nations,

1211 Geneva 10, SwitzerlandTelephone: + 41 (0) 22 7300111Telefax: + 41 (0) 22 7334439E-mail: [email protected]: www.intracen.org

World Health Organisation (WHO)Address: 20 Avenue Appia,

1211 Geneva 27, SwitzerlandTelephone: + 41 (0) 22 7912111Telefax: + 41 (0) 22 7913111E-mail: [email protected]: www.who.int

UNITED STATESEsurg.comAddress: 1016 East Pike, suite 300,

WA 98122 Seattle, United StatesTelephone: + 01 206 4054026Telefax: + 01 206 3811561E-mail: [email protected]: www.esurg.com

Medmarket.comAddress: 1200 ironwooddrive, suite309,

coeur d’Arlène, ID 83814, United StatesTelephone: + 01 888 5801010Telefax: + 01 208 415 0178E-mail: [email protected]: www.medmarket.com

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APPENDIX 4 TRADE ASSOCIATIONS

EUROPEAN UNIONEuropean Confederation of Medical SuppliersAssociations (Eucomed)Address: Place Saint Lambert 14, B-1200 Woluwe

Saint Lambert Brussels, BelgiumTelephone: + 32 (0) 2 7722212Telefax: + 32 (0) 2 7713909E-mail: [email protected]: www.eucomed.be

European Diagnostic Manufacturers Association (EDMA)Address: Place Saint Lambert 14, B-1200 Woluwe

Saint Lambert Brussels, BelgiumTelephone: + 32 (0) 2 7722225Telefax: + 32 (0) 2 7722329E-mail: [email protected]: www.edma-ivd.be

European Federation of Precision, Mechanical andOptical Industries– EUROM II: Optics, Laser and Laboratory Instrumentation– EUROM V1 - Medical Technology– Federation of the European Dental Industry (FIDE)Address: c/o Verband der deutschen feinmechanischen

und optischen Industrie (F+ O) e.V.Kirchstrasse 2, D-50858 Köln, Germany

Telephone: + 49 (0) 221 9486280Telefax: + 49 (0) 221 483428

La Fédération Européenne des Patrons ProthésistesDentaires (FEPPD)Federation of European Dental Laboratory OwnersAddress: rue des deux Eglises 29,

B-1000 Brussels, BelgiumTelephone: + 32 (0) 2 2380581Telefax: + 32 (0) 2 2309354E-mail: [email protected]: www.feppd.org

AUSTRIAEuropean Surgical Dressings Manufacturer’s Association(ESDREMA)European Surgical Dressings Manufacturer’s AssociationAddress: Testarellogasse 31, A-1130 Vienna, AustriaTelephone: + 43 (0) 1 8777012Telefax: + 43 (0) 1 8777013

Fachverband der Electro-und-Electronikindustrie (FEEI)Association of the Electro and Electronic IndustryAddress: Mariahilfer Strasse 37-39,

A-1060 Vienna, AustriaTelephone: + 43 (0) 1 58839-0Telefax: + 43 (0) 1 5866971E-mail: [email protected]: www.feei.at

Interessenvertretung des Medzinisch-TechnischeFachhandels in Österreich (IMFÖ)Austrian Association for Medical-TechnologyAddress: Baldassgasse 5, A-1211 Vienna, AustriaTelephone: + 43 (0) 1 25046129Telefax: + 43 (0) 1 25046100

Österreichische Ärztekammer Bundeskurie ZahnärzteAustrian Dental AssociationAddress: Weihburggasse 10-12, A-1010 Vienna, AustriaTelephone: + 43 (0) 1 5125126Telefax: + 43 (0) 1 512512667

Vereinigung der Medical-Industrie Österreich(AUSTROMED)Austrian Medical AssociationAddress: Testarellogasse 31, A-1130 Vienna, AustriaTelephone: + 43 (0) 1 8777012Telefax: + 43 (0) 1 8777013

BELGIUMAgoriaMultisector federation for the technology industryAddress: August Reyerslaan 80,

B-1030 Brussels, BelgiumTelephone: + 32 (0) 2 7067800Telefax: + 32 (0) 2 7067801E-mail: [email protected] : www.agoria.be

Association Professionelle des Fabricants, Importateurs etDistributeurs de Matérial et Equipement Médicaux(UNAMEC)Association of Manufacturers, Importers and Distributers ofMedical EquipmentAddress: Leuvensestraat 29,

B-1800 Vilvoorde, BelgiumTelephone: + 32 (0) 2 2570590Telefax: + 32 (0) 2 2524398E-mail: [email protected]: www.unamec.be

European Disposables And Nonwovens Association(EDANA)Address: avenue Eugène Plasky 157,

B-1030 Brussels, BelgiumTelephone: + 32 (0) 2 7349310Telefax: + 32 (0) 2 7333518E-mail : [email protected] : www.edana.org

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Féderation des Importateurs et Distributeurs deDiagnostic-Association Générale de l’Industrie duMédicament (FIDIAG-AGIM)Association of Diagnostic Importers and DistributorsAddress: Maria-Louizasquare 49,

B-1000 Brussels, BelgiumTelephone: + 32 (0) 2 2389976Telefax: + 32 (0) 2 2311164E-mail: [email protected]: www.agim-avgi.be

Union de Constructeurs et Importateurs d’AppareilsScientifique, Medicaux et de Controle (UDIAS)Manufacturers’ and Importers’ Association of Scientific,Medical and Monitoring EquipmentAddress: Paul Hymanslaan 47,

B-1200 Brussels, BelgiumTelephone: + 32 (0) 2 7713912Telefax: + 32 (0) 2 7711264E-mail : [email protected] : www.udias.be

Verband der V1aamse Tandartsen (VVT)Flamish Dental AssociationAddress: Vrijheidslaan 61, B-1081, Brussels, BelgiumTelephone: + 32 (0) 2 4130013Telefax: + 32 (0) 2 4148727E-mail: [email protected]: www.vvt.be

DENMARKDanish Medical Device Association (DMDA)Address: Nivaagaard, Gammel Strandvej 16,

DK-2990 Nivaa, DenmarkTelephone: + 45 (0) 49 184700Telefax: + 45 (0) 49 184707E-mail: [email protected]: www.dmda.dk

Danish Society of Healthcare IndustriesAddress: H.C. Andersens Boulevard 18,

DK-1790 Copenhagen, DenmarkTelephone: + 45 (0) 33 773377Telefax: + 45 (0) 33 773300

Dansk TandlœgeforeningDanish Dental AssociationAddress: Amaliegade 17,

DK-1256 Copenhagen, DenmarkTelephone: + 45 (0) 33 157711Telefax: + 45 (0) 33 151637

FINLANDSuomen HammalääkäriliittoFinish Dental AssociationAddress: Fabianinkatu 9B, SF-00130 Helsinki, FinlandTelephone: + 358 (0) 9 6220250Telefax: + 358 (0) 9 6223050E-mail: [email protected]: www.hammasll.fi

The Association of Laboratory and Healthcare ProductsSuppliers (SAI-LAB)Address: P.O. Box 150, SF-00251 Helsinki, FinlandTelephone: + 358 (0) 0 441651Telefax: + 358 (0) 0 496142

FRANCEAssociation Dentaire Française (ADF)French Dental AssociationAddress: 7, rue Mariotte, F-75017 Paris, FranceTelephone: + 33 (0) 1 58221710Telefax: + 33 (0) 1 58221740E-mail: [email protected]: www.adf.asso.fr

Confédération Nationale des Syndicats Dentaires (CNSD)National Committee for Dental ScienceAddress: 22, Avenue de Villers, F-75017 Paris, FranceTelephone: + 33 (0) 1 56792020Telefax: + 33 (0) 1 56792031E-mail: [email protected]: www.cnsd.fr

Groupement Accesoires, Pansements, Petit Appareillage àusage Médical (Appa Med)Assocation of Medical DevicesAddress: 37, rue de Neuilly, F-92249 Clichy, FranceTelephone: + 33 (0) 1 47379454Telefax: + 33 (0) 1 47379454

Syndicat National de L’industrie des TechnologiesMédicales (SNITEM)National Syndicate of Medical Technology IndustryAddress: 39-41, rue Louis-Blanc,

F-92400 Courbevoie, FranceTelephone: + 33 (0) 1 47176388Telefax: + 33 (0) 1 47176389E-mail: [email protected]: www.snitem.fr

GERMANYBundesverband Medizintechnologie e.V. (BVMed)German Medical Technology AssociationAddress: Reinhardtstrasse 29b,

D-65189 Wiesbaden, GermanyTelephone: + 49 (0) 246 255-0Telefax: + 49 (0) 246 255 91E-mail: [email protected]: www.bvmed.de

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BundeszahnärztekammerNational Association for DentistsAddress: Chaussestrasse 13, D-10115 Berlin, GermanyTelephone: + 49 (0) 30 400050Telefax: + 49 (0) 30 40005200E-mail: [email protected]: www.bzaek.de

European Surgical Trade Association (ESTA)Address: Georg-Gröning-Strasse 16,

D-28209 Bremen, GermanyTelephone: + 49 (0) 421 3478608Telefax: + 49 (0) 421 3491866E-mail: [email protected]: www.esta-office.com

Verband der Deutschen Dental Industrie e.V. (VDDI)Association of the German Dental IndustryAddress: Kirchweg 2, D-50858 Köln, GermanyTelephone: + 49 (0) 221 94862833Telefax: + 49 (0) 221 483428E-mail: [email protected]: www.vddi.de

Zentralverband Elektrotechnik- und Elektronikindustriee.V. (ZVEI) (Trade Association for Electro-medical and X-ray Devices)Address: Stresemannallee 19,

D-60596 Frankfurt am Main, GermanyTelephone: + 49 (0) 69 63020Telefax: + 49 (0) 69 6302317E-mail: [email protected]: www.zvei.de

IRELANDFederation of Irish Chemical Industries (FICI)Address: Franklin House, 140 Pembroke Road,

Dublin 4 Leinster, IrelandTelephone: + 353 (0) 1 6603350Telefax: + 353 (0) 1 6686672

Irish Dental Association (IDA)Address: Boyne, 10 Richview Office Park,

Clonskeagh Road, Dublin 14, IrelandTelephone: + 353 (0) 1 2830499Telefax: + 353 (0) 1 2830515E-mail: [email protected]: www.dentist.ie

Irish Medical Devices Association (IMDA)Address: Confederation House,

84 Lower Baggot Street, Dublin 2, IrelandTelephone: + 353 (0) 1 6601011Telefax: + 353 (0) 1 8450852

ITALYAssociazione Nazionale Dentisti Italiani (ANDI)National Italian Dental AssociationAddress: Via Sicilia 43, 00187 Roma, ItalyTelephone: + 39 (0) 6 42011536Telefax: + 39 (0) 6 42011506E-mail: [email protected]: www.andi.it

Associazione nazionale per le tecnologie biomediche ediagnostiche (ASSOBIOMEDICA)National Association of Biomedical and Diagnostic ProductsSuppliersAddress: Via Giovanni Da Procida 11,

20149 Milan, ItalyTelephone: + 39 (0) 2 34531165Telefax: + 39 (0) 2 34592072 E-mail: [email protected]: www.assobiomedica.it

Federazione Nazionale Imprese Elettrotecniche edElettroniche (ANIE)Italian Federation of Electrotechnical and ElectronicsIndustriesAddress: Via Gattamelata 34, 20149 Milan, ItalyTelephone: + 39 (0) 2 3264.1Telefax: + 39 (0) 2 3264.212E-mail: [email protected]: www.anie.it

LUXEMBOURGAssociation des Médecins et Médecins-Dentistes duGrand-Duché de Luxembourg (AMMD)Association of Medical Doctors and Dentists of LuxembourgAddress: rue de Vianden 29,

L-2680 Luxembourg, LuxembourgTelephone: + 35 (0) 2 4440331Telefax: + 35 (0) 2 458349E-mail: [email protected]: www.ammd.lu

PORTUGALAssociação Nacional dos Dentistas Portugueses (ANDEP)National Association of Portuguese DentistsAddress: Rua Pascoal de Melo 15B,

P-1100 Lisbon, PortugalTelephone: + 351 (0) 1 3526389Telefax: + 351 (0) 1 3525402

Associação Portuguesa da Industria e/ou Comercio deProdutos Irrecuperaveis de Uso Clinico não Farmaceutico(APORMED)Portuguese Association for Medical DisposablesAddress: Appartado 2968, P-1124 Lisbon, PortugalTelephone: + 351 (0) 1 342131020Telefax: + 351 (0) 1 3462034

55

Ordem dos Médicos Dentistas (OMD)Association for Dental MedicinesAddress: Av. Dr. Antunes Guimarães 463, P-4100-080 Porto,

PortugalTelephone: + 351 (0) 2 26197690Telefax: + 351 (0) 2 26197699E-mail: [email protected]: www.ordemedicosdentistas.ptordem.sede@

ordemedicosdentistas.pt

Surgical Trade Association c/o Medicination (SARL)Address: Rua Conde Redondo 74, P.O. Box 21023,

P-1126 Lisbon, PortugalTelephone: + 351 (0) 1 562106Telefax: n.a.

SPAINAsociacion Nacional de Industrias Electronicas (ANIEL)National Association of the Industry for Electronic EquipmentAddress: Principe de Vergara 74, 4th planta,

E-28006 Madrid, SpainTelephone: + 34 (0) 91 5902300Telefax: + 34 (0) 91 4114000E-mail: [email protected]: www.aniel.es

Consejo General de Colegios Oficiales de Odontólogos yEstomatólogos de EspañaAddress: Alcalá 79, 2nd planta, E-28009 Madrid, SpainTelephone: + 34 (0) 91 4264410Telefax: + 34 (0) 91 5770639E-mail: [email protected]: www.consejodentistas.org

Federación Nacional de Empresas de Instrumentación,Cientifica, Médica, Técnica y Dental (FENIN)National Association for Scientific, Medical, Technical and DentalInstrumentsAddress: Juan Bravo 10, 3rd planta,

E-28006 Madrid, SpainTelephone: + 34 (0) 91 5759800Telefax: + 34 (0) 91 4353478Internet: www.servicom.es/fenin

SWEDEN– The Swedish Association of Suppliers of Hospital Equipment

(SLF)– Swedish Dental Trade Association (SDF)– Swedish Association of Suppliers of Instrumentation

Measurements and Components (IM)Address: Sveavägen 17, P.O. Box 1416,

S-11184 Stockholm, SwedenTelephone: + 46 (0) 8 240700Telefax: + 46 (0) 8 218496

The Swedish Dental AssociationAddress: P.O. Box 1217, S-11182 Stockholm, SwedenTelephone: + 46 (0) 8 6661500Telefax: + 46 (0) 8 6625842E-mail: [email protected]: www.tandlakarforbundet.se

THE NETHERLANDSFederatie Het Instrument, NederlandseBrancheorganisatie voor Medische Technologie (FHI)Branch Organisation for Medical TechnologyAddress: P.O. Box 2099,

3800 CB Amersfoort, The NetherlandsTelephone: + 31 (0) 33 4657507Telefax: + 31 (0) 33 4616638E-mail: [email protected]: www.fhi.nl

Landelijke Huisartsenvereniging (LHV)(National GPs Association & Netherlands GPs Society)Address: P.O. Box 20056,

3502 LB Utrecht, The NetherlandsTelephone: + 31 (0) 30 2823723Telefax: + 31 (0) 30 2890400E-mail: [email protected]: www.lhv.nl

Nederlandse Federatie van producenten, importeurs enhandelaren van Medische producten (NEFEMED)Netherlands Federation Medical DisposablesAddress: Reitseplein 1,

5037 AA Tilburg, The NetherlandsTelephone: + 31 (0) 13 5944342Telefax: + 31 (0) 13 5944749E-mail: [email protected]: www.nefemed.nl

Nederlandse Maatschappij tot Bevordering derTandheelkunde (NMT)Netherlands Society for the Promotion of Dental ScienceAddress: Geelgors 1, P.O. Box 2000,

3430 CA Nieuwegein, The NetherlandsTelephone: + 31 (0) 30 6076276Telefax: + 31 (0) 30 6048994E-mail: [email protected]: www.nmt.nl

Nederlandse Vereniging voor de Inkopen in deGezondheidszorg (NVIG)Netherlands Association for Purchases in the Healthcare sectorAddress: P.O. Box 9015,

6500 GS Nijmegen, The NetherlandsTelephone: + 31 (0) 24 3658660Telefax: + 31 (0) 24 3658664

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Vereniging FMEAssociation for Metal, and Electronics and Electro-technics,and related sectorsAddress: Boerhaavelaan 40, P.O. Box 190,

2700 AD Zoetermeer, The NetherlandsTelephone: + 31 (0) 79 3531100Telefax: + 31 (0) 79 3531365E-mail: [email protected]: www.fme.nl

Vereniging van de Nederlandse Industrie voor DentaleProdukten (INDENT)Association of the Netherlands Industry for Dental ProductsAddress: Boerhaavelaan 40, P.O. Box 190,

2700 AD Zoetermeer, The NetherlandsTelephone: + 31 (0) 79 3531357Telefax: + 31 (0) 79 3531365E-mail: [email protected]: www.indent.nl

UNITED KINGDOMAssociation of British Health-Care Industries (ABHI)Address: St. Georges House, 195-203 Waterloo Road,

London SE1 8WD, United KingdomTelephone: + 44 (0) 20 77873060Telefax: + 44 (0) 20 77873061E-mail: www.abhi.org.uk/about/abo_con.aspInternet: www.abhi.org.uk

Association of the Laboratory Supply Industry (BLWA)Address: St. Georges House, 195-203 Waterloo Road,

London SE1 8WB, United KingdomTelephone: + 44 (0) 207 2079666Telefax: + 44 (0) 207 2079659E-mail: [email protected]: www.mortex.co.uk/blwa/index.htm

British Anaesthetic & Respiratory Equipmentmanufacturers Association (BAREMA)Address: The Stables, Sugworth Lane, Radley,

Oxford OX14 2HX, United KingdomTelephone: + 44 (0) 1865 736393Telefax: + 44 (0) 1865 736393E-mail: [email protected]: www.barema.org.uk

British Healthcare Trades Association (BHTA)Address: 1 Webbs Court, Buckhurst Avenue, Sevenoaks,

Kent TN13 1LZ, United KingdomTelephone: + 44 (0) 1732 458868Telefax: + 44 (0) 1732 459225E-mail: [email protected]: www.bhta.com

The British Dental Association (BDA)Address: 64 Wimpole Street,

London W1G 8YS, United KingdomTelephone: + 44 (0) 20 79350875 Telefax: + 44 (0) 20 74875232E-mail: [email protected]: www.bda-dentistry.org.uk

The British Dental Trade Association (BDTA)Address: Merritt House, Mineral Lane, Chesham,

Buckinghamshire HP5 3EA, United KingdomTelephone: + 44 (0) 1 494 782873Telefax: + 44 (0) 1 494 786659E-mail: [email protected]: www.bdta-dentistry.org.uk

World Dental Federation (FDI)Address: 7 Carlisle Street,

London W1D 3BW, United KingdomTelephone: + 44 (0) 20 79357852Telefax: + 44 (0) 20 74860183E-mail: [email protected]: www.fdi.org.uk

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APPENDIX 5 TRADE FAIR ORGANISERS

AUSTRIAFDI 2002 worlddental congressItems: Dental EquipmentLocation: ViennaDate: 5-10 October 2002Organizer: FDI Worlddental FederationAddress: 13 Chemin du Levant,

F 01210 Ferney-VoltaireTelephone: + 33 (0) 450405050Telefax: + 33 (0) 450405555E-mail: [email protected]: www.fdiworldental.org

PARACESLSUSItems: Health Care in generalLocation: ViennaDate: -Organizer: GBÖAddress: Alentin Leitgebstrasse 11,

A-9020 Klagenfurt, AustriaTelephone: + 43 (0) 1 504758Telefax: + 43 (0) 1 5047495

BELGIUMHEALTHCAREItems: Medical, paramedical and hospital equipmentLocation: International Exhibition Centre BrusselsDate: 9-10 October 2002Organizer: Tentoonstellingscentrum BrusselAddress: Belgiëplein, 1020 Brussels, BelgiumTelephone: + 32 (0) 2 4748277Telefax: + 32 (0) 2 4748390E-mail: [email protected]: www.bruexpo.be

DENMARKSCANDEFAItems: Dental EquipmentLocation: CopenhagenDate: March 2003Organizer: Bella Center A/SAddress: Center Boulevard 5,

DK-2300 Copenhagen, DenmarkTelephone: + 45 (0) 32 528811Telefax: + 45 (0) 32 519636E-mail: [email protected]: www.bellacenter.dk

FINLANDMEDICINEItems: Health Care and NursingLocation: HelsinkiDate: -Organizer: Finnexpo-Suomen MessutAddress: Messuaukio 1, P.O. Box 21,

FIN-00521 Helsinki, FinlandTelephone: + 358 (0) 9 15091Telefax: + 358 (0) 9 142358E-mail: [email protected]: www.finnexpo.fi

FRANCEHOPITAL EXPO-INTERMEDICA 2002Items: International hospital and medical equipment

exhibitionLocation: Paris Expo-Porte de VersaillesDate: 21-24 May 2002Organizer: PG PromotionAddress: 119, rue de Créqui, F-69006 Lyon, FranceTelephone: + 33 (0) 472 830830Telefax: + 33 (0) 472 830849E-mail: [email protected]: www.pgpromotion.fr

GERMANYDental InformaItems: Dental Equipment and NeedsLocation: HannoverDate: 7-8 June, 2002Organizer: Fachausstellungen Heckmann GmbHAddress: Hohenzollernstrasse 4,

D-30161 Hannover, GermanyTelephone: + 49 (0) 511 990950Telefax: + 49 (0) 511 9909550E-mail: [email protected]: www.heckmanngmbh.de

Fachdental Items: Dental Equipment and NeedsLocation: LeipzigDate: 30-13 August 2002 and 19-20 September 2003Organizer: Durma Messe Stuttgart InternationalAddress: Am Kochenhof 16,

D-70192 Stuttgart, GermanyTelephone: + 49 (0) 711 25890Telefax: + 49 (0) 711 2589440E-mail: [email protected]: www.durma-messe.de

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INTERFAB/INTERHOSPITALItems: Medical and Dental Equipment and NeedsLocation: NürnbergDate: 4-7 June, 2002Organizer: Nürnberg Messe GmbHAddress: Messezentrum, D-90471 NürnbergTelephone: + 49 (0) 911 86060Telefax: + 49 (0) 911 8606228E-mail: [email protected]: www.nuernbergmesse.de

MEDICA Items: Forum and trade fair on biotechnologyLocation: Messegelände, DüsseldorfDate: 20-23 November 2002Organizer: Messe Düsseldorf GmbH Address: P.O. Box 101006,

D-40001 Düsseldorf, GermanyTelephone: + 49 (0) 211 456001Telefax: + 49 (0) 211 4560668E-mail: [email protected]: www.messe-duesseldorf.de

MEDIZINItems: Medical Technology, Pharmacy, and Clinical

EquipmentLocation: StuttgartDate: 31 January – 2 February 2003Organizer: Messe Stuttgart InternationalAddress: Am Kochenhof 16,

D-70192 Stuttgart, GermanyTelephone: + 49 (0) 711 25890Telefax: + 49 (0) 711 2589440E-mail: [email protected]/medizin/Internet: www.messe-stuttgart.de

GREECEHYGEIAItems: Medical, Pharmaceutical and Dental

EquipmentLocation: ThessalonikiDate: 15-17 November 2002Organizer: HELEXPOAddress: 154 Egnatia str., 54636 Thessaloniki, GreeceTelephone: + 30 (0) 31 291204Telefax: + 30 (0) 31 291674E-mail: [email protected]: www.helexpo.gr

ITALYExposanita’ (Hospital)Items: Hospital EquipmentLocation: BolognaDate: 22-25 May, 2002Organizer: SENAF (Agenzia Bologna)Address: Via Michelino 69, 40127 Bologna, ItalyTelephone: + 39 (0) 51 503318Telefax: + 39 (0) 51 505282E-mail: [email protected]: www.senaf.it

MIDOItems: Optics, optometry and ophthalmology

exhibitionLocation: MilanDate: 2002Organizer: EFOPAddress: Via Petitti 16, 20149 Milan, ItalyTelephone: + 39 (0) 2 32673673Telefax: + 39 (0) 2 324233E-mail: [email protected]: www.mido.it

PORTUGALEXPOSAUDEItems: Health, Hospital, Medicins, Laboratory

and PharmacyLocation: LisbonDate: -Organizer: ExpoliderAddress: Avenue Maria da Conceição 177,

r/c 2775 Carcavelos, PortugalTelephone: + 351 (0) 1 4568340Telefax: + 351 (0) 1 4568341E-mail: [email protected]: www.cynergi.net/expolider

NORMÉDICAItems: Medical Equipment and Medical NeedsLocation: PortoDate: 3-6 October, 2002Organizer: EXPONORAddress: Leça da Palmeira 4450-617, Porto, PortugalTelephone: + 351 (0) 2 9981400Telefax: + 351 (0) 2 9957499E-mail: [email protected]: www.exponor.pt

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SPAINEXPODENTALItems: Dental Equipment and NeedsLocation: MadridDate: 11-13 March 2004Organizer: IFEMAAddress: Parque Ferial Juan Carlos 1,

28042 Madrid, SpainTelephone: + 34 (0) 91 7225000Telefax: + 34 (0) 91 7225791E-mail: [email protected]: www.ifema.es

EXPOÓPTICAItems: Optics and optometry exhibitionLocation: MadridDate: 28 February – 3 March 2003Organizer: IFEMAAddress: Parque Ferial Juan Carlos 1,

28042 Madrid, SpainTelephone: + 34 (0) 91 7225000Telefax: + 34 (0) 91 7225791E-mail: [email protected]: www.ifema.es

SWEDENMED.XPO 02, MEDICINE FAIRItems: Products within Medicine & pharmaceuticals,

Medical equipment Location: StockholmDate: 27-29 November 2002

and 26-28 November 2003Organizer: Stockholm International FairsAddress: 12580 Stockholm, SwedenTelephone: + 46 (0) 8 7494100Telefax: + 46 (0) 8 992044E-mail: [email protected]: www.stofair.se

SWEDENTALItems: Dental Equipment and NeedsLocation: StockholmDate: 23-25 October, 2002Organizer: Stockholm International FairsAddress: 12580 Stockholm, SwedenTelephone: + 46 (0) 8 7494100Telefax: + 46 (0) 8 992044E-mail: [email protected]: www.stofair.se

THE NETHERLANDSMedicaItems: Medical equipment and instrumentsLocation: UtrechtDate: 4-7 March 2003Organizer: Jaarbeurs Exhibitions & MediaAddress: P.O. Box 8500,

3503 RM Utrecht, The NetherlandsTelephone: + 31 (0) 30 2955851Telefax: + 31 (0) 30 2955869E-mail: [email protected]: www.jaarbeursutrecht.nl /

www.medica-online.nl

UNITED KINGDOMHealth & Safety ExpoItems: Health products, food, vitamins

and supplementsLocation: National Exhibition Centre, BirminghamDate: 13-16 May, 2002Organizer: United Business Media International LtdAddress: Riverbank House, Angel Lane,

Tonbridge, Kent TN9 1SE, United KingdomTelephone: + 44 (0) 17 32377646Telefax: n.a.E-mail: [email protected]: www.safety-health-expo.co.uk

Medical Device TechnologyItems: Medical TechnologyLocation: National Exhibition Centre, BirminghamDate: 12-13 Februari, 2003Organizer: Advanstar CommunicationsAddress: Advanstar House, Park West, Sealand Road,

Chester CHl 4RN, United KingdomTelephone: + 44 (0) 1244 378888Telefax: + 44 (0) 1244 370011E-mail: [email protected]: www.advanstar.com /

www.mdt2002.mdtevents.com

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APPENDIX 6 TRADE PRESS

INTERNATIONALMcKnight’s Long-Term Care NewsLanguage: EnglishPublisher: McKnight Medical Communications Co.Address: Two Northfield Plaza, Suite 300,

Northfield, IL 60093-1217, USATelephone: + 01 (0) 847 4413700Telefax: + 01 (0) 847 4413701E-mail: [email protected]: www.mcknightsonline.com

The Journal of the American Dental Association (JADA)Language: EnglishPublisher: ADA Publishing Inc.Address: 211 E. Chicago Ave., Chicago,

IL 60611, USATelephone: + 01 (0) 312 4402500Telefax: + 01 (0) 312 4402800E-mail: [email protected]: www.ada.org

GERMANYMade for ExportLanguage: EnglishPublisher: Made in EuropeAddress: Weissenburgerstrasse 28, D-63739

Afschaffenburg, GermanyTelephone: + 49 (0) 6021 391850Telefax: + 49 (0) 6021 3918525

THE NETHERLANDSNederlands TandartsenbladNetherlands Dentists’ MagazineLanguage: DutchPublisher: NMTAddress: P.O. Box 2000,

3430 CA Nieuwegein, The NetherlandsTelephone: + 31 (0) 30 6076251Telefax: + 31 (0) 30 6076301E-mail: [email protected]: www.nmt.nl

Nederlands Tijdschrift voor TandheelkundeNetherlands Magazine for Dental ScienceLanguage: DutchPublisher: Bohn Stafleu Van Loghum BVAddress: P.O. Box 246,

3990 GA Houten, The NetherlandsTelephone: + 31 (0) 30 6383838Telefax: + 31 (0) 30 6383839E-mail: [email protected]: www.bsl.nl

Tandarts PraktijkDentist PracticeLanguage: DutchPublisher: Bohn Stafleu Van Loghum BVTelephone: + 31 (0) 30 6383838Telefax: + 31 (0) 30 6383839E-mail: [email protected]: www.bsl.nl

TransmitterMagazine about medical and pharmaceutical productsLanguage: DutchPublisher: Axioma Address: P.O. Box 176,

3740 AD Baarn, The NetherlandsTelephone: + 31 (0) 35 5425363Telefax: + 31 (0) 35 5425820E-mail: [email protected]: www.axioma.nl

UNITED KINGDOMBritish Dental JournalLanguage: EnglishPublisher: British Dental AssociationAddress: 64 Wimpole Street,

London W1G 8YS, United KingdomTelephone: + 44 (0) 20 75355830Telefax: + 44 (0) 20 75355843E-mail: [email protected]: www.nature.com/bdj

British Medical JournalLanguage: EnglishPublisher: BMJ Publishing GroupAddress: BMA House, Tavistock Square,

London WC1H 9JR, United KingdomTelephone: + 44 (0) 20 73874499Telefax: + 44 (0) 20 73836661E-mail: [email protected]: www.bmjgroup.com

FDI WorldLanguage: EnglishPublisher: FDI World Dental Press Ltd.Address: 7 Carlisle Street,

London W1D 3BW, United KingdomTelephone: + 44 (0) 20 79357852Telefax: + 44 (0) 20 74860183E-mail: [email protected]: www.fdiworldental.org

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Journal of Medical Engeneering & TechnologyLanguage: EnglishPublisher: Taylor & Francis Ltd.Address: Rankine Road, Basingstoke,

Hants RJ24 8PR, United KingdomTelephone: + 44 (0) 1256 813002Telefax: + 44 (0) 1256 479438E-mail: [email protected]: www.tandf.co.uk

Medical Device TechnologyLanguage: EnglishPublisher: Advanstar CommunicationsAddress: Advanstar House, Park West, Sealand Road,

Chester CH1 4RN, United KingdomTelephone: + 44 (0) 1244 378888Telefax: + 44 (0) 1244 370011E-mail: [email protected]: www.advanstar.com

Pharmaceutical & Medical Device NewsLanguage: EnglishPublisher: Espicom Business IntelligenceAddress: Lincoln House, City Fields Business Park,

City Fields Way, Chichester, West Sussex,PO20 6FS, United Kingdom

Telephone: + 44 (0) 1243 533322Telefax: + 44 (0) 1243 533418E-mail: [email protected]: www.espicom.com

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APPENDIX 7 BUSSINESS SUPPORT ORGANISATIONS

INTERNATIONALInternational Trade Centre (ITC)Address: Palais des Nations,

1211 Geneva 10, SwitzerlandTelephone: + 41 (0) 22 7300111Fax: + 41 (0) 22 7334439E-mail: [email protected]: www.intracen.org

AUSTRIABundeskammer der gewerblichen WirtschaftAustrian Federal Economic ChamberAddress: Wiedner Hauptstrasse 63,

A-1045 Vienna, AustriaTelephone: + 43 (0) 1 50105Telefax: + 43 (0) 1 50105E-mail: [email protected]: www.wk.or.at

DENMARKDanish Import Promotion Office for Products fromDeveloping Countries (DIPO)Danish Import Promotion Office for Products fromDeveloping CountriesAddress: Danish Chamber of Commerce, Børsen,

DK-1217 Copenhagen, DenmarkTelephone: + 45 (0) 33 950500Telefax: + 45 (0) 33 120525E-mail: [email protected]: www.dipo.dk

FRANCECentre Français du Commerce Exterieur (C.F.C.E.)Address: 10, avenue d’Iéna, F-75116 Paris, FranceTelephone: + 33 (0) 1 40733000Telefax: + 33 (0) 1 40733979E-mail: [email protected]: www.cfce.fr

COLEACPAddress: 5, rue de la Corderie, Centra 342,

F-94586 Rungis Cedex, FranceTelephone: + 33 (0) 1 41800210Telefax: + 33 (0) 1 41800219E-mail: [email protected]: www.coleacp.org

GERMANYBfAI, Federal Office of Foreign Trade InformationAddress: Agrippastrasse 87-93,

D-50676 Köln, GermanyTelephone: + 49 (0) 221 2057-0Fax: + 49 (0) 221 2057-212E-mail: [email protected] Internet: www.bfai.com

ITALYInstituto Nazionale per il Commercio Estero (ICE)Italian Institute for Foreign TradeAddress: Via Liszt 21, P.O. Box 10057,

I-00144 Rome, ItalyTelephone: + 39 (0) 6 59921Telefax: + 39 (0) 6 59647438E-mail: [email protected]: www.ice.it

NORWAYNorad, Norwegian Agency for Development Co-operationAddress: Ruseløkkveien 26, P. O. Box 8034 Dep.,

0030 Oslo, NorwayTelephone: + 41 (0) 22 314400Fax: + 41 (0) 22 314403Internet: www.norad.no

SWEDENSIDA, Swedish International Development Agency Swedish International Development AgencyAddress: S-10525 Stockholm, SwedenTelephone: + 46 (0) 8 6985000Telefax: + 46 (0) 8 208864E-mail: [email protected]: www.sida.se

SWITZERLANDSIPPO, Swiss Import Promotion ProgrammeSwiss Import Promotion ProgrammeAddress: Stampfenbachstrasse 85,

P.O. Box 492, CH-8035 Zürich, SwitzerlandTelephone: + 41 (0) 1 3655200Telefax: + 41 (0) 1 3655202E-mail: [email protected]: www.sippo.ch

THE NETHERLANDSCBI, Centre for the Promotion of Imports fromdeveloping countriesCentre for the Promotion of Imports from developingcountriesAddress: P.O. Box 30009,

3001 DA Rotterdam, The Netherlands Telephone: + 31 (0) 10 2013434Fax: + 31 (0) 10 4114081E-mail: [email protected]: www.cbi.nl

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APPENDIX 8 OTHER USEFUL ADDRESSES

BELGIUMEuropean Commission, Medical Devices SectorEU publicationsAddress: 15, rue de la Science, Bureau 3-133,

B-1040 Brussels, BelgiumTelefax: + 32 (0) 2 2967013

(to be contacted by fax only)

GERMANYDeutsche Gesellschaft für Technische Zusammenarbeit (GTZ) German Agency for Technical CooperationAddress: Dag-Hammarskjöld-Weg 1-5,

D-65760 Eschborn, GermanyTelephone: + 49 (0) 6196 790Telefax: + 49 (0) 6196 791115E-mail: [email protected]: www.gtz.de

LUXEMBOURGBureau for Official EU publicationsEU publicationsAddress: 2, rue Mercier, L-2985 LuxembourgTelephone: + 35 (0) 2 292942718Telefax: + 35 (0) 2 292942758E-mail: [email protected]: www.eur-op.eu.int

THE NETHERLANDSCentraal Bureau voor de Statistiek (CBS)Central Bureau of StatisticsAddress: P.O. Box 4481,

6401 CZ Heerlen, The NetherlandsTelephone: + 31 (0) 45 5707070Telefax: + 31 (0) 45 5706268E-mail: [email protected]: www.cbs.nl

Centrale Dienst voor In- en Uitvoer (CDIU)(Central Licensing Office for Import and Export)Address: Engelse Kamp 2, P.O. Box 3003,

9700 RD Groningen, The NetherlandsTelephone: + 31 (0) 50 5239111Telefax: + 31 (0) 50 5260698

Chamber of Commerce and Industries for Rotterdam& the Lower Meuse(Provides information on registered business, businesspractices and import tariffs)Address: Beursplein 37, P.O. Box 30025,

3001 DA Rotterdam, The NetherlandsTelephone: + 31 (0) 10 4057777Telefax: + 31 (0) 10 4145754E-mail: [email protected]: www.rotterdam.kvk.nl

Directie Wetgeving Douane, Ministerie van FinanciënCustoms Policy and Legislation Directorate,Ministry of FinanceAddress: Korte Voorhout 7, P.O. Box 20201,

2500 EE The Hague, The NetherlandsTelephone: + 31 (0) 70 3427542Telefax: + 31 (0) 70 3427937E-mail: www.minfin.nl h Mail to the Ministry

of FinanceInternet: www.minfin.nl

Exportbevorderings- en Voorlichtingsdienst (EVD),Ministerie van Economische ZakenTrade Promotion and Information Department,Ministry of Economic AffairsAddress: P.O. Box 20105,

2500 EC The Hague, The NetherlandsTelephone: + 31 (0) 70 3798811Telefax: + 31 (0) 70 3797858E-mail: [email protected]: www.evd.nl

CBI/AccessGuideCBI’s database on European non-tariff trade barriersAddress: P.O. Box 30009,

3001 DA Rotterdam, The NetherlandsTelephone: + 31 (0) 10 2013434Telefax: + 31 (0) 10 4114081E-mail: [email protected]: www.cbi.nl/accessguide

The Ministry of Housing, Spatial Planning and theEnvironment (VROM)Provides information on environmental regulationsAddress: P.O. Box 20951,

2500 EZ The Hague, The NetherlandsTelephone: + 31 (0) 70 3393939Telefax: + 31 (0) 70 3391296E-mail: www.minvrom.nl h mailInternet: www.minvrom.nl

The Ministry of Public Health, Welfare and Sports (VWS)Provides information on safety and health regulationsAddress: P.O. Box 20350,

2500 EJ The Hague, The NetherlandsTelephone: + 31 (0) 70 3407890Telefax: + 31 (0) 70 3406251E-mail: n.a.Internet: www.minvws.nl

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APPENDIX 9 LIST OF DEVELOPING COUNTRIES

Please note that the OECD list of developing countries, as applied in this market survey, may include countries that are usuallynot considered as developing countries (e.g. South Korea).

Afghanistan Albania Algeria Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Azerbaijan Bahrain Bangladesh Barbados Belize Benin Bhutan Bolivia Bosnia & Herzegovina Botswana Brazil Burkina Faso Burundi Cambodia Cameroon Cape Verde Central African rep. Chad Chile China Colombia Comoros Congo Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Djibouti Dominica Dominican republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Ethiopia Fiji Gabon Gambia Georgia Ghana

Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras India Indonesia Iran Iraq Jamaica Jordan Kazakstan Kenya Kiribati Korea, Rep. of Kyrghyz Rep.LaosLebanon Lesotho Liberia Macedonia Madagascar Malawi MalaysiaMaldives Mali Malta Marshall Islands Mauritania Mauritius Mayotte Mexico Micronesia, Fed. StatesMoldova Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Nicaragua Niger Nigeria Niue Oman Pakistan Palau Islands

Palestinian Admin. Areas Panama Papua New Guinea Paraguay Peru Philippines Rwanda São Tomé & Principe Saudi Arabia Senegal Seychelles Sierra Leone Slovenia Solomon Islands Somalia South Africa Sri Lanka St. Helena St. Kitts-Nevis St. Lucia St. Vincent and GrenadinesSudan Surinam Swaziland Syria Tajikistan Tanzania Thailand Timor Togo Tokelau Tonga Trinidad & Tobago Tunisia Turkey Turkmenistan Turks & Caicos Islands Tuvalu Uganda Uruguay Uzbekistan Vanuatu Venezuela Vietnam Wallis & Futuna Western SamoaYemen Yugoslavia, Fed. Rep. Zaire Zambia Zimbabwe

Note: Eurostat figures do not include figures of Cook Islands, Niue, St. Kitts-Nevis, Timor and Tokelau

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APPENDIX 10 LIST OF NETHERLANDS IMPORTERS AND KEY EU IMPORTERS

BELGIUM Flen Pharma NVAddress: Drie Eikenstraat 661,

B 2560, Antwerp, BelgiumTelephone: + 32 (0) 3 3842248Telefax: + 32 (0) 3 3842790E-mail: [email protected]: www.flenpharma.com

Home Care Corporation / HCCAddress: Balgerhoeke 26, B-9900 Eeklo, BelgiumTelephone: + 32 (0) 9 3784095Telefax: + 32 (0) 9 3784418

Hospithera S.A.Address: Emile Feronstraat 70,

B-1060 Sint-Gillis, BelgiumTelephone: + 32 (0) 2 5350211Telefax: + 32 (0) 2 5350610E-mail: [email protected]: www.hospithera.be

Ontex Belgium NVAddress: Genthof 5, B-9255 Buggenhout, BelgiumTelephone: + 32 (0) 52 399499Telefax: + 32 (0) 52 330784E-mail: [email protected]: www.ontex.be

Sanicalor Medical S.A. NVAddress: Grondelsstraat 152,

B-1070, Anderlecht, BelgiumTelephone: + 32 (0) 2 5210105Telefax: + 32 (0) 2 5213400E-mail: [email protected]

GERMANYAlbert Barthelmess GmbH.Address: Pallaswiesenstrasse 150,

D-64293 Darmstadt, GermanyTelephone: + 49 (0) 6151 897216Telefax: + 49 (0) 6151 897417

Behrend GmbH.Address: Bahnhofstrasse 13,

D-30916 Isernhagen, GermanyTelephone: + 49 (0) 511 9724520Telefax: + 49 (0) 511 9724550E-mail: [email protected]: www.willy-behrend.de

Deutsch-Ordens HospitalwerkAddress: Im Freihaven 14, D-47138 Duisburg, GermanyTelephone: + 44 (0) 203 8008820Telefax: + 44 (0) 203 8008821

Helm AGAddress: Nordkanalstrasse 28,

D-20097 Hamburg, GermanyTelephone: + 49 (0) 40 2375-0Telefax: + 49 (0) 40 23751845E-mail: [email protected]: www.helmag.com

Paul Hartmann AGAddress: Postfach 1420,

D-89504 Heidenheim, GermanyTelephone: + 49 (0) 73 21360Telefax: + 49 (0) 73 21363636E-mail: [email protected]: www.hartmann-online.de

Trusetal Verbandstoffwerk GmbH.Address: Industriestrasse 1, D-33758 Schloß

Holte-Stuckenbrock, GermanyTelephone: + 44 (0) 5207 927946Telefax: + 44 (0) 5207 4483E-mail: [email protected]: www.walker-aid.de

FRANCECooperation Pharmaceutique FrancaiseAddress: Place Lucien-Auvert,

77020, Melun Cedex, FranceTelephone: + 33 (0) 1 64872048Telefax: + 33 (0) 1 64872074

EDECAddress: Z.I. 76, Avenue Du Midi, P.O. Box 77,

63802, Cournon Cedex, FranceTelephone: + 33 (0) 473 692808Telefax: + 33 (0) 473 692850E-mail: [email protected] (president)

LappsAddress: 29 rue de Verdun, 34000, Montpellier, FranceTelephone: + 33 (0) 467 069669Telefax: + 33 (0) 467 920229

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Specialized Medical SuppliesAddress: P.O. Box 2332,

38033 Grenoble cedex 2, FranceTelephone: + 33 (0) 4 76864322Telefax: + 33 (0) 4 76171982E-mail: [email protected]

Sterima SA.Address: P.O. Box 37, Z.I. Artois Flandres, FranceTelephone: + 33 (0) 321 693200Telefax: + 33 (0) 321 373007

THE NETHERLANDSAdquipment Medical BVDistributor medical disposables and devicesAddress: Rontgenweg 13,

3208 KG Spijkenisse, The NetherlandsTelephone: + 31 (0) 181 612151Telefax: + 31 (0) 181 612184E-mail: [email protected]: www.adquipment.nl

AllegianceManufacturer and importer of medical disposablesAddress: Gerritsenweg 5,

7202 BP Zutphen, The NetherlandsTelephone: + 31 (0) 575 596500Telefax: + 31 (0) 575 513145E-mail: [email protected]: www.allegiance.nl

Alvab BVMedical devicesAddress: De Bloemendaal 23,

5221 EB Den Bosch, The NetherlandsTelephone: + 31 (0) 73 6312625Telefax: + 31 (0) 73 6312508E-mail: [email protected]: www.sigvaris.com

Auco Nederland BeroepskledingHospital LinenAddress: Ambachtsweg 7,

5627 BZ Eindhoven, The NetherlandsTelephone: + 31 (0) 40 2429445Telefax: + 31 (0) 40 2482465E-mail: www.auco.nl ? infoInternet: www.auco.nl

B & L Systems BVMedical devicesAddress: Industrieweg 66-68,

3606 AS Maarssen, The NetherlandsTelephone: + 31 (0) 346 550556Telefax: + 31 (0) 346 554619

Berg’s Handelsmij. BV, Jos tenHospital suppliesAddress: P.O. Box 1419,

3430 BK Nieuwegein, The NetherlandsTelephone: + 31 (0) 30 2888424Telefax: + 31 (0) 30 2897504

Blycolin Groep BVHospital linenAddress: P.O. Box 288,

5300 AG Zaltbommel, The NetherlandsTelephone: + 31 (0) 418 541800Telefax: + 31 (0) 418 541850E-mail: www.blycolin.nl ? info Internet: www.blycolin.nl

Chemie-Pack Nederland BVPharmaceuticalsAddress: P.O. Box 29,

4780 AA Moerdijk, The NetherlandsTelephone: + 31 (0) 168 356666Telefax: + 31 (0) 168 356667E-mail: [email protected]: www.chemiepack.nl

Chemodis BVMedical oils for physiotherapyAddress: P.O. Box 28,

2180 AA Hillegom, The NetherlandsTelephone: + 31 (0) 252 515233Telefax: + 31 (0) 252 515941E-mail: [email protected]: www.chemodis.nl

Contimeta BVMedical equipmentAddress: Savannahweg 15, P.O. Box 40200,

3504 AA Utrecht, The NetherlandsTelephone: + 31 (0) 30 2484848Telefax: + 31 (0) 30 2410633E-mail: [email protected]: www.contimeta.nl

Danica Nederland BVGeneral medical equipmentAddress: Hamersveldseweg 135, P.O. Box 471,

3830 AM Leusden, The NetherlandsTelephone: + 31 (0) 33 4345060Telefax: + 31 (0) 33 4325050E-mail: [email protected]: www.danica.nl

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Delft Instruments BVLaboratory and revalidation equipmentAddress: Rontgenweg 1, P.O. Box 103,

2600 AC Delft, The NetherlandsTelephone: + 31 (0) 15 2601200Telefax: + 31 (0) 15 2601222E-mail: [email protected]: www.delftinstruments.nl

Dépex BVHospital and education materialAddress: Dorpsstraat 85,

3732 HH De Bilt, The NetherlandsTelephone: + 31 (0) 30 2219900Telefax: + 31 (0) 30 2204895E-mail: [email protected]: www.depex.nl

Van Dijk en ZonenHospital linenAddress: P.O. Box 27,

5580 AA Waalre, The NetherlandsTelephone: + 31 (0) 40 2231300Telefax: + 31 (0) 40 2231323

DK BVHospital clothingAddress: Binnenhaven 38,

7547 BH Enschede, The NetherlandsTelephone: + 31 (0) 53 4300400Telefax: + 31 (0) 53 4312391

Dutchmed BVMedical equipmentAddress: P.O. Box 2050,

4200 BB Gorinchern, The NetherlandsTelephone: + 31 (0) 183 669820Telefax: + 31 (0) 183 636260

Economic Holland BVMedical and revalidation equipmentAddress: Venenweg 16,

1161 AK Zwanenburg, The NetherlandsTelephone: + 31 (0) 20 4977771Telefax: + 31 (0) 20 4977491E-mail: [email protected]: www.economic-holland.nl

EHCO-KLM Kleding NVHospital linenAddress: Strootsweg 16,

7547 RX Enschede, The NetherlandsTelephone: + 31 (0) 53 4800300Telefax: + 31 (0) 53 4800301E-mail: [email protected]: www.ehco-klm.nl

Ek Orthopaedie Bandages BVOrthopaedic bandagesAddress: 1e Middellandstraat 26D,

3014 BE Rotterdam, The NetherlandsTelephone: + 31 (0) 10 4360036Telefax: + 31 (0) 10 4363408E-mail: [email protected]

Elbo TechnicsMedical equipment and instrumentsAddress: Bieslookstraat 25,

9731 LR Groningen, The NetherlandsTelephone: + 31 (0) 50 5410744Telefax: + 31 (0) 50 5412656

Emdamed BVMedical disposablesAddress: Goudstraat 36,

2718 RC Zoetermeer, The NetherlandsTelephone: + 31 (0) 79 3614051Telefax: + 31 (0) 79 3613181

Emro Medical BVMedical disposablesAddress: P.O. Box 77,

1420 AB Uithoorn, The NetherlandsTelephone: + 31 (0) 297 540703Telefax: + 31 (0) 297 540166E-mail: [email protected]

Enting Instruments & SystemsMedical instrumentsAddress: Vijftig Bunderweg 1,

4849 PD Dorst, The NetherlandsTelephone: + 31 (0) 161 411369Telefax: + 31 (0) 161 412636

Hartmann BV, PaulMedical disposables and bandagesAddress: Sperwestraat 90,

6541 SH Nijmegen, The NetherlandsTelephone: + 31 (0) 24 3723610Telefax: + 31 (0) 24 3778284E-mail: [email protected]: www.hartmann-online.de

Havena BVMedical kits and contentsAddress: Bedrijvenweg 20D,

2351 BC Leiderdorp, The NetherlandsTelephone: + 31 (0) 71 5893410Telefax: + 31 (0) 71 5896829

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Hensen Bedrijfskleding BVHospital linenAddress: Paarlaarsteeg 1,

2011 TA Haarlem, The NetherlandsTelephone: + 31 (0) 23 5319587Telefax: + 31 (0) 23 5315477E-mail: [email protected]: www.hensen-haarlem.com

Hoek Loos BVMedical gases and disposablesAddress: P.O. Box 78,

3100 AB, Schiedam, The NetherlandsTelephone: + 31 (0) 10 2461616Telefax: + 31 (0) 10 2461600E-mail: [email protected]: www.hoekloos.nl

Hospimed International BVDisposables for X-ray diagnosticsAddress: P.O. Box 90,

7720 AB Dalfsen, The NetherlandsTelephone: + 31 (0) 529 434411Telefax: + 31 (0) 529 434422E-mail: [email protected]

Hokatex Gezondheidszorg BVHospital linenAddress: P.O. Box 128,

1800 AC Alkmaar, The NetherlandsTelephone: + 31 (0) 72 5672400Telefax: + 31 (0) 72 5613104E-mail: [email protected]: www.rentokil-hokatex.nl

Stichting IDAInternational Dispensary AssociationAddress: P.O. Box 37098,

1030 AB, Amsterdam, The NetherlandsTelephone: + 31 (0) 20 4033051Telefax: + 31 (0) 20 4031854E-mail: ida [email protected]

Inpakindustrie Koopman BVPacking medical productsAddress: H. ter Kuiterstraat 20,

7547 BD Enschede, The NetherlandsTelephone: + 31 (0) 53 4312053Telefax: + 31 (0) 53 4329704

International Procurement Agency BVGeneral hospital suppliesAddress: P.O. Box 190,

1400 AD Bussum, The NetherlandsTelephone: + 31 (0) 35 6915077Telefax: + 31 (0) 35 6936016

InterPharm Intramuraal BVMedical devicesAddress: Parallelweg 151,

5223 AR Den Bosch, The NetherlandsTelephone: + 31 (0) 73 6282302Telefax: + 31 (0) 73 6282366E-mail: [email protected]: www.interpharm.nl

Jovident International BVImport & export of dental productsAddress: Brussellaan 2B,

5628 TC Eindhoven, The NetherlandsTelephone: + 31 (0) 40 2413485Telefax: + 31 (0) 40 2422775E-mail: [email protected]: www.indent.nl/jovident/

Knap Medical BVMedical instrumentsAddress: Satijnbloem 49,

3068 JP Rotterdam, The NetherlandsTelephone: + 31 (0) 10 2201818Telefax: + 31 (0) 10 2200116E-mail: [email protected]: www.knapmedical.nl

Kommer Biopharm BVVeterinary medical productsAddress: Handelsweg 28,

1851 NX Heiloo, The NetherlandsTelephone: + 31 (0) 72 5332836Telefax: + 31 (0) 72 5338691

De Koningh BVPrecision equipmentAddress: P.O. Box 5023,

6802 EA Arnhem, The NetherlandsTelephone: + 31 (0) 26 3849000Telefax: + 31 (0) 26 3849099E-mail: [email protected]: www.dekoningh.nl

Kortman Intradal BVPharmaceuticals and cosmetic productsAddress: Brabantsestraat 17,

3812 PJ, Amersfoort, The NetherlandsTelephone: + 31 (0) 33 4697600Telefax: + 31 (0) 33 4697666

Krijnen Medical BVGeneral medical equipmentAddress: P.O. Box 10, 4145 ZG Beesd, The NetherlandsTelephone: + 31 (0) 345 682604Telefax: + 31 (0) 345 681504E-mail: [email protected]

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Lameris Industries BVComplete hospital outfitting and disposables programmeAddress: Nieuweweg 224,

3905 LT Veenendaal, The NetherlandsTelephone: + 31 (0) 318 547111Telefax: + 31 (0) 318 547195E-mail: [email protected]: www.lameris.com

Leenarts Medibanda BVHospital productsAddress: Wijcker Brugstraat 12,

6221 EC Maastricht, The NetherlandsTelephone: + 31 (0) 43 3210349Telefax: + 31 (0) 43 3257115Internet: www.medi.nl/leen/

Lode Medical Technology BVMedical and surgical instrumentsAddress: ZernikePark 16,

9747 AN Groningen, The NetherlandsTelephone: + 31 (0) 50 5712811Telefax: + 31 (0) 50 5716746E-mail: [email protected]: www.lode.nl

Lohmann en Rauscher BVSwabs and bandagesAddress: P.O. Box 10117,

1301 AC Almere, The NetherlandsTelephone: + 31 (0) 36 5463020Telefax: + 31 (0) 36 5463021Internet: www.lohmannenrauscher.nl

Lopital Nederland BVGeneral hospital suppliesAddress: P.O. Box 56,

5061 AB Oisterwijk, The NetherlandsTelephone: + 31 (0) 13 5239300Telefax: + 31 (0) 13 5239301E-mail: [email protected]: www.lopital.nl

Lubberts Instruments BVSurgical instruments distributorAddress: P.O. Box 300,

5480 AH Schijndel, The NetherlandsTelephone: + 31 (0) 73 5476655Telefax: + 31 (0) 73 5478495E-mail: [email protected]: www.lubberts.nl

Mainit BVImporter and distributor of hospital productsAddress: Venenweg 19,

1161 AK Zwanenburg, The NetherlandsTelephone: + 31 (0) 20 4976252Telefax: + 31 (0) 20 4976826

Medasto BVImporters, manufacturers of medical equipmentAddress: P.O. Box 21,

3440 AA Woerden, The NetherlandsTelephone: + 31 (0) 348 420420Telefax: + 31 (0) 348 415996E-mail: [email protected]: www.medasto.nl

Medeco BVAddress: P.O. Box 1555,

3260 BB, Oud-Beijerland, The NetherlandsTelelephone: + 31 (0) 186 634400Telefax: + 31 (0) 186 616893E-mail: [email protected]: www.medeco.nl

Medical Export GroupExporter and importer of medical equipmentAddress: P.O. Box 598,

4200 AN Gorinchem, The NetherlandsTelephone: + 31 (0) 183 634266Telefax: + 31 (0) 183 634650

Medicor Nederland BVMedical productsAddress: P.O. Box 2026,

1400 DA Bussum, The NetherlandsTelephone: + 31 (0) 35 6949094Telefax: + 31 (0) 35 6949168E-mail: [email protected]: www.medicor.nl

Medin StaalMedical equipmentAddress: P.O. Box 5026,

2000 GA Haarlem, The NetherlandsTelephone: + 31 (0) 23 5319034Telefax: + 31 (0) 23 5314392

MediscoreGeneral medical equipmentAddress: H. de Jongstraat 6,

3067 AB Rotterdam, The NetherlandsTelephone: + 31 (0) 10 4209155Telefax: + 31 (0) 10 4560242

Medisize BVMedical specialtiesAddress: P.O. Box 366,

2180 AJ Hillegom, The NetherlandsTelephone: + 31 (0) 252 576888Telefax: + 31 (0) 252 519825E-mail: [email protected]: www.medisize.nl

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Metemij BVGeneral hospital productsAddress: P.O. Box 149,

1110 AC Diemen, The NetherlandsTelephone: + 31 (0) 20 6952111Telefax: + 31 (0) 20 6907016

Microtechniek BVMedical instrumentsAddress: Van Lijndenweg 9-11,

1948 ND Beverwijk, The NetherlandsTelephone: + 31 (0) 251 229222Telefax: + 31 (0) 251 210008E-mail: [email protected]: www.microtechniek.nl

Miele Nederland BVMedical equipment and instrumentsAddress: P.O. Box 166,

4130 ED Vianen, The NetherlandsTelephone: + 31 (0) 347 378911Telefax: + 31 (0) 347 378290E-mail: www.miele.nl ? e-mailInternet: www.miele.nl

Nipak BVPlastic hollow ware (trays)Address: 3e Industrieweg 11B,

3411 MD Lopik, The NetherlandsTelephone: + 31 (0) 348 553644Telefax: + 31 (0) 348-553144E-mail: [email protected]: www.nipak.nl

NPBI International BVBlood transfusion and general infusion fluids and systemsAddress: P.O. Box 2280,

1180 EG Amstelveen, The NetherlandsTelephone: + 31 (0) 20 6473861Telefax: + 31 (0) 20 6476072E-mail: [email protected]: www.npbi.nl

Omnilabo International BVMedical disposablesAddress: P.O. Box 3939,

4800 DX Breda, The NetherlandsTelephone: + 31 (0) 76 5795795Telefax: + 31 (0) 76 5876236E-mail: [email protected]: www.omnilabo.nl

Van Oostveen Medical BVMedical disposables and instrumentsAddress: Herenweg 269,

3648 CH Wilnis, The NetherlandsTelephone: + 31 (0) 297 282101Telefax: + 31 (0) 297 288316

OPG Groep NVPharmaceuticals, medical disposables, swabs and bandages,The NetherlandsAddress: P.O. Box 2066, 3500 GB UtrechtTelephone: + 31 (0) 30 2821911Telefax: + 31 (0) 30 2826650E-mail: [email protected]: www.opggroep.com

Ophtec BVOptical instrumentsAddress: Schweitzerlaan 15,

9728 NR Groningen, The NetherlandsTelephone: + 31 (0) 50 5251944Telefax: + 31 (0) 50 5254386E-mail: [email protected]: www.ophtec.nl

Orthofex BVPedicure and manicure instrumentsAddress: Hamburgerstraat 2-8,

3512 NR Utrecht, The NetherlandsTelephone: + 31 (0) 30 2313592Telefax: + 31 (0) 30 2334652

Otto Bock Benelux BVOrthopedic suppliesAddress: P.O. Box 133,

5690 AC Son en Breugel, The NetherlandsTelephone: + 31 (0) 499 488413Telefax: + 31 (0) 499 461523E-mail: [email protected]: www.ottobock.de

Resprecare Medical BVRespiration equipment and disposablesAddress: P.O. Box 84175,

2508 AD Den Haag, The NetherlandsTelephone: + 31 (0) 70 3586263Telefax: + 31 (0) 70 3584333E-mail: [email protected]: www.resprecare-medical.nl

Sarstedt BVMedical disposablesAddress: P.O. Box 24,

4870 AA Etten-Leur, The NetherlandsTelephone: + 31 (0) 76 5017550Telefax: + 31 (0) 76 5017626

SchimmelLatex glovesAddress: Industrieweg 23A,

7903 AH Hoogeveen, The NetherlandsTelephone: + 31 (0) 528 273926Telefax: + 31 (0) 528 279191

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Schinkel Medical BVSurgical instrumentsAddress: Industrieweg 14,

3433 NL Nieuwegein, The NetherlandsTelephone: + 31 (0) 30 6060330Telefax: + 31 (0) 30 6062047E-mail: [email protected]: www.schinkelmedical.nl

Scholten Medische GroothandelGeneral hospital suppliesAddress: P.O. Box 18,

4190 CA Geldermalsen, The NetherlandsTelephone: + 31 (0) 345 571041Telefax: + 31 (0) 345 576057E-mail: [email protected]: www.scholten-medisch.nl

Sensor Partners BVMedical measurement instrumentsAddress: P.O. Box 270,

5150 AG Drunen, The NetherlandsTelephone: + 31 (0) 416 378239Telefax: + 31 (0) 416 377439E-mail: [email protected]: www.sensor.nl

Spruyt Hillen BVMedical disposablesAddress: P.O. Box 2416,

3500 GK Utrecht, The NetherlandsTelephone: + 31 (0) 30 2814411Telefax: + 31 (0) 30 2870330E-mail: [email protected]: www.opg.nl

Stöpler Instrumenten & Apparaten BVGeneral hospital equipmentAddress: P.O. Box 2445,

3500 GK Utrecht, The NetherlandsTelephone: + 31 (0) 30 2644911Telefax: + 31 (0) 30 2613766E-mail: [email protected]: www.stopler.simed.com

Straten Medische Techniek, J. vanGeneral medical suppliesAddress: P.O. Box 440,

3430 AK Nieuwegein, The NetherlandsTelephone: + 31 (0) 30 6023830Telefax: + 31 (0) 30 6023831E-mail: [email protected]: www.vanstraten-medical.com

Strijker BVMedical instrumentsAddress: P.O. Box 8747,

5605 LS, Eindhoven, The NetherlandsTelephone: + 31 (0) 40 2922522Telefax: + 31 (0) 40 2922555

Tackenberg Medische Instrumenten BVMedical instruments and disposablesAddress: Fatimastraat 37,

4834 XT Breda, The NetherlandsTelephone: + 31 (0) 76 5654440Telefax: + 31 (0) 76 5607184

Tarmedi BVOrthopaedic equipmentAddress: P.O. Box 12, 3700 AA Zeist, The NetherlandsTelephone: + 31 (0) 30 6914117Telefax: + 31 (0) 30 6916448E-mail: [email protected]: www.tarmedi.nl

TD Medical BVGeneral medical instruments and disposablesAddress: Dillenburgstraat 11A,

5652 AM Eindhoven, The NetherlandsTelephone: + 31 (0) 40 2525445Telefax: + 31 (0) 40 2550455E-mail: [email protected]

Technex BVMedical equipmentAddress: Industrieweg 35,

1521 NE Wormerveer, The NetherlandsTelephone: + 31 (0) 75 6474567Telefax: + 31 (0) 75 6213663E-mail: [email protected]: www.technex.nl

Technomed Engineering BVMedical instruments and disposablesAddress: P.O. Box 239,

6190 AE Beek, The NetherlandsTelephone: + 31 (0) 46 4370371Telefax: + 31 (0) 46 4379697E-mail: [email protected]: www.technomed.nl

Tefa Portanje BVLaboratory and measuring equipmentAddress: P.O. Box 275,

3440 AG Woerden, The NetherlandsTelephone: + 31 (0) 348 495700Telefax: + 31 (0) 348 495799E-mail: [email protected]: www.tefa-portanje.nl

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Tektronix Holland BVMedical equipment/OscilloscopesAddress: P.O. Box 406,

2130 AK Hoofddorp, The NetherlandsTelephone: + 31 (0) 23 5695555Telefax: + 31 (0) 23 5695500E-mail: [email protected]: www.tektronix.nl

Temid Raadgevende Ingenieurs BVTesting of medical equipmentAddress: P.O. Bos 344,

1700 AH Heerhugowaard, The NetherlandsTelephone: + 31 (0) 72 5750512Telefax: + 31 (0) 72 5744035E-mail: [email protected]: www.temid.nl

Uni-Instrumenten BVGeneral hospital suppliesAddress: P.O. Box 9820,

3506 GV Utrecht, The NetherlandsTelephone: + 31 (0) 30 2623352Telefax: + 31 (0) 30 2624884E-mail: [email protected]

Urotex Medical BVUrological equipment and devicesAddress: P.O. Box 64,

3910 AB Rhenen, The NetherlandsTelephone: + 31 (0) 317 613842Telefax: + 31 (0) 317 616074E-mail: [email protected]

Utermöhlen Koninklijke NVSwabs and bandagesAddress: P.O. Box 3,

8470 AA Wolvega, The NetherlandsTelephone: + 31 (0) 561 693366Telefax: + 31 (0) 561 617625E-mail: [email protected]: www.utermohlen.nl

Vacutech BVMedical equipment and instrumentsAddress: P.O. Box 3061,

2280 GB Rijswijk, The NetherlandsTelephone: + 31 (0) 70 3990390Telefax: + 31 (0) 70 3950692E-mail: [email protected]: www.vacutech.nl

Vandeputte Medical BVDistributor medical disposables and devicesAddress: P.O. Box 1533,

3430 BM Nieuwegein, The NetherlandsTelephone: + 31 (0) 30 6005151Telefax: + 31 (0) 30 6000427E-mail: [email protected]: www.spirometrie.net/vandeputte/home.html

Van Veen Textiel BVHospital linenAddress: P.O. Box 33,

2410 AA Bodegraven, The NetherlandsTelephone: + 31 (0) 172 619251Telefax: + 31 (0) 172 612631E-mail: info@vanveentextielInternet: www.vanveentextiel.nl

Welzorg Revalidation equipmentAddress: Heathrowstraat 5,

1043 CE Amsterdam, The NetherlandsTelephone: + 31 (0) 20 5840751Telefax: + 31 (0) 20 5840180E-mail: [email protected]: www.welzorg.nl

UNITED KINGDOMAnglia Vale MedicalMedical suppliesAddress: Premier House, Southgate Way,

Orton Southgate, Peterborough,Cambridgeshire PE2 6YG, United Kingdom

Telephone: + 44 (0) 1733 230700Telefax: + 44 (0) 1733 230900

Huntleigh Hygeia PlcMedical suppliesAddress: Snaygill Ind Est, Keighley Road, Skipton,

North Yorkshire BD23 2QR, United KingdomTelephone: + 44 (0) 1756 706010Telefax: n.a.

Intermark Medical Innovation LimitedMedical specialty productsAddress: The Coach House, 34 Southborough Road,

Bromley, Kent BR1 2EB, United KingdomTelephone: + 44 (0) 20 84673355Telefax: + 44 (0) 20 84673364E-mail: [email protected]: www.intermarkmedical.com

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Seward LimitedMedical, surgical and laboratory equipment and suppliesAddress: 98 Great North Road, London N2 0GN,

United KingdomTelephone: + 44 (0) 20 83654100Telefax: + 44 (0) 20 83653999E-mail: [email protected] Internet: www.seward.co.uk

Smith & Nephew PlcOrthopaedics, endoscopy, advanced wound managementand rehabilitation productsAddress: Heron House, 15 Adam Street,

London WC2N 6LA, United KingdomTelephone: + 44 (0) 20 74017646Telefax: + 44 (0) 20 79303353E-mail: [email protected]: www.smith-nephew.com

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APPENDIX 11 USEFUL INTERNET SITES

Price informationhttp:\\www.esurg.comVirtual market place for medical, surgical and pharmaceuticalsupplies.

http:\\www.medmarket.comBusiness-to-business medical supply store.

http:\\www.devicelink.com Source for medical device manufacturing products andservices.

Magazines and journalshttp://www.hsj.co.ukWeekly magazine dealing with healthcare policy andmanagement issues.

http://www.biz-lib.com/ZEBWMM.htmlThe world medical fact file.

http://www.medicaldevices.com/Medical data institute.

Standards and regulationshttp://www.ear.nlEuropean authorised representative legal experts for enteringthe EU market.

http://europa.eu.int/eur-lex/en/lif/dat/1993/ en_393L0042.htmlFull text of the EU marking Directive 93/42EEC.

http://www.mdss.comMedical Device Safety Service.

http://www.wssn.netWorld Standard Service is a network of standardsorganisations.

http://www.cenorm.beInternet site of the European Committee for Standardisation.

European importerswww.europages.comContact details and information on the activities of importers.

CBI puts you in touch with the markets of Europe

CBI, the Centre for the Promotion of Imports from developing countries, is an agencyof the Netherlands Ministry of Foreign Affairs. Since its establishment in 1971, CBIoperates within the policy framework set by the Minister for Development Co-operation.Its mission is to contribute to the economic independence of developing countries.To fulfil this mission, CBI aims at strengthening the competitiveness of companies inthose countries on international markets, primarily the West-European market, byimproving conditions in enterprises and business support organisations. CBI considerssocial values and compliance with the most relevant environmental requirements to bean integral part of its policy and activities

CBI offers various programmes and services to its target groups:

Market information – CBI News Bulletin (6 times annually);– CBI guide “Exporting to the European Union”;– Market surveys and strategic marketing guides covering the EU including

The Netherlands;– Quick scans on environmental, social and health issues;– Manuals on subjects such as technical and environmental regulations, trade fair

participation, Fashion Forecast etc.;– CBI’s extensive Web site at www.cbi.nl providing general information about CBI,

details about CBI programmes, CBI publications (downloadable free-of-charge)and the GreenBuss database on European trade-related environmental policy andtechnology;

– CBI’ s Trade Documentation Centre offering supply-related information to importers,such as exporters’ directories, country and sector information, periodicals fromdeveloping countries, and - to visiting exporters - demand-related information such asmarket information, trade magazines, address books of European companies etc.

Matching servicesCBI’s computerized exporters’ and importers’ databases, containing around3,500 regularly updated company profiles, are instrumental in providing buyersand suppliers with relevant company data on potential trade partners.

Export promotion programmes (EPP)Step-by-step approach providing intensive assistance to selected exporters in developingcountries in order to obtain a firm and lasting position on the EU market. Made tomeasure, demand- driven and flexibility are combined with fixed elements such as:– pre-selection of candidates based on written documentation;– technical assistance during company visits and distance guidance by CBI branch

experts;– export marketing training (for instance through the EXPRO seminars);– market entry (for instance via participation in European trade fairs);– market consolidation by way of follow-up support, further technical assistance

and/or repeat market entry activities.

Human resources development– BSO MARKET INTEL: five-day seminar in Rotterdam for relevant

middle management staff of BSO’s, aiming at supporting BSO’s inestablishing or improving a Market Information Service (MIS);

– CAPITA: two-week seminar in Rotterdam for specific industry &trade associations. Aims to provide –through their associations-specific industries or sectors in developing countries with tools toengage in business relations with importers and/or manufacturersin the EU;

– BSO-FAME: two-week seminar in Rotterdam for project managersof BSOs focusing on practical knowledge and applicable tools inexport promotion to international markets in general and theEuropean market in particular;

– IntFair: two-week seminar in Rotterdam for BSO staff members onthe organization of collective participation in European trade fairs;

– Expro: seven-day seminar in Rotterdam on export marketing andmanagement for selected exporters participating in a CBI exportpromotion programme;

– Workshops in developing countries: 2-4 days for BSOs and/orexporters, focussing on general export marketing andmanagement, a specific product sector or on specific subjects.

Multilateral co-operationCBI co-operates with the International Trade Centre (ITC/WTO) toglobalize trade promotion and with other European import promotionorganizations to increase efficiency and effectiveness by combiningefforts.

Please write to us in English, the working language of the CBI.

Centre for the Promotion of Imports from developing countriesCentrum tot Bevordering van de Import uit de ontwikkelingslanden

Mailing address:CBIP.O. Box 300093001 DA RotterdamPhone +31 (0) 10 201 34 34Fax +31 (0) 10 411 40 81E-mail [email protected] www.cbi.nl

Office and showroom:WTC-Beursbuilding, 5th Floor37 Beursplein, Rotterdam, The Netherlands.

No part of this publication may be sold, reproduced in any form or by any means without the prior permission of CBI

Mailing address: P.O. Box 30009, 3001 DA Rotterdam, The NetherlandsPhone: +31 10 201 34 34 Fax: +31 10 411 40 81E-mail: [email protected] Internet: http://www.cbi.nl

Office and showroom: WTC-Beursbuilding, 5th floor37 Beursplein, Rotterdam, The Netherlands

CENTRE FOR THE PROMOTION OF IMPORTS FROM DEVELOPING COUNTRIES

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