LifeScience/Healthcare SAUDI ARABIA

An Expert's View about Healthcare in Saudi Arabia

Posted on: 4 Oct 2010

Saudi Arabia is largest market for medical equipment and healthcare products in the Gulf and Middle East where good opportunities exist and where UK companies can succeed.

HEALTHCARE ? SAUDI ARABIA Sector Report LifeScience/Healthcare SAUDI ARABIA Produced by: Syed Zaman, Trade & Investment Officer, Riyadh Last revised June 2009 "The Overseas Market Introduction Service ("OMIS") is provided by the Commercial Departments of Diplomatic Service Posts overseas as part of the joint trade development operation, UK Trade & Investment, of the Foreign and Commonwealth Office (" the FCO") and the Department for Business, Innovation and Skills (?BIS?). Whereas every effort has been made to ensure that information provided through OMIS is accurate, these Commercial Departments, UK Trade & Investment, the FCO and BIS accept no liability for any errors, omissions or misleading statements in such information and accept no responsibility as to the standing of any firm, company or individual mentioned." HEALTHCARE ? SAUDI ARABIA Table of Contents OVERVIEW 3 CHARACTERISTICS OF MARKET 4 OPPORTUNITIES 6 KEY METHODS OF DOING BUSINESS 7 PUBLICATIONS 8 EVENTS 8 CONTACT LISTS 9 Page 2 of 10 HEALTHCARE ? SAUDI ARABIA OVERVIEW The Kingdom of Saudi Arabia is a market where good opportunities exist and where rd UK companies can succeed. The Kingdom is the UK's 23 largest export market worth £1.6 billion (£1=SR7.00 approx). It is one of the UK's largest trading partners in the Middle East and our largest export market in the region. The UK is th Saudi Arabia's joint 4 largest investor. Healthcare in Saudi Arabia continues to be a thriving sector as the government continues to finance health services for a rapidly growing population of 24 million, which is growing by more than 3 percent per annum. It is the largest market for medical equipment and healthcare products in the Gulf and Middle East. Saudi healthcare market is classified into three broad segments i.e. Ministry of Health, non-MOH (military, National Guard, security forces, university hospitals etc) and private. Each of these segments bears their own distinctive characteristics. For realistic & effective strategy developments each of these segments should be considered as separate markets. The Ministry of Health (MOH) is the largest buyer representing around 60 percent of the market for such products. It is also the major buyer on all GCC healthcare equipment and supplies tenders issued. Second only to the industrial sector, the Saudi healthcare sector is the largest job provider, employing more than 35,000 personnel both Saudis and foreigners. The average ratio of physicians to population is about 17 per 10,000. The Saudi government's capital health spending for 2009 will be on construction of new health centres, 86 new hospitals with a capacity of 11,750 beds and further development of the Saudi Red Crescent. Although the price of oil, which contributes significantly to the country?s GDP, has been low, the Saudi government is continuing to invest heavily in health infrastructure development, which in 2009, was second only to education & manpower in terms of budget allocation for capital expenditure. Healthcare in Saudi Arabia, traditionally provided by the Ministry of Health (MOH), is now increasingly being shared with other public and private agencies. According to the latest available figures (2007), the total number of hospitals in the Saudi health sector stood at 384. MOH 225 (31,420 beds), private sector 123 (11,271 beds) and other Government agencies accounted for 36 (10,828 beds). The MOH also operates around 1925 primary healthcare centres and 19 dental centres, 2 tuberculosis centres and 12 rehabilitation centres. The private sector operates a further 1837 polyclinics and dispensaries 70 percent of which are located in Jeddah and Riyadh. The hospitals and clinics of various government agencies provide free healthcare services to Saudis and some expatriates. Some of the best hospitals in Saudi Arabia are owned and operated by the public sector. Other Government agencies operate separate hospitals for their employees, such as the Ministry of Defence & Aviation (MODA), the National Guard, Ministry of Interior, King Faisal Specialist Hospital and Research Centre (KFSH) and large corporations such as Saudi Aramco. In view of the excellent healthcare facilities available locally the number of medical cases being referred abroad for treatment by the MOH has dropped. The MOH and Page 3 of 10 HEALTHCARE ? SAUDI ARABIA Saudi Aramco only refer such patient's abroad that cannot be treated in-Kingdom. The US, Germany and the UK are the usual countries of referral. The government is working on expanding the health insurance sector, which in 2009, is valued at around SR5 billion (US$1.3 billion). This is expected to increase by a further SR2 billion (US$533 million) in the short term with new regulations introduced in January 2009 that will further expand the insurance scheme to Saudi nationals working in small and medium enterprises in the private sector. The large private sector companies already provide health insurance for their employers. In 2007, the Saudi government established the National Company for Unified Purchase of Medicines and Medical Appliances, to act as the sole supplier of medicines and medical appliances to government health institutions. The company was set up to bring down the prices of medical devices and pharmaceuticals by preventing overcharging. The company is in its planning phase and developing coordination with other stake holders like SGH executive Board and hospitals. The SFDA have been given the task of developing and enforcing a regulatory system for medical devices. This will include establishing licensing procedures for manufacturers and suppliers. In what is a first step in developing a regulatory framework for medical devices, the SFDA in 2007 started the Medical Devices National Registry (MDNR), which is a voluntary web-based project involving the registration of manufacturers, agents and suppliers in the country. From July 2009 all regulatory responsibilities were handed over to SFDA for pharmaceutuicals, medical devices and food. The local medical training programmes have not kept up with the growing demand for physicians and other para-medical staff. The Kingdom?s health services are therefore heavily dependent on expatriates, which provide around 80 percent of physicians/ nurses. Recent surveys suggest there has been an increase in Saudi nationals being employed in the health sector with physicians accounting for 20 percent and nurses 27 percent. The rapidly increasing demand for health services has created renewed concerns for the government. So as to lessen the burden on their budget, some MOH & non- MOH government hospitals have started business centres, where private patients, irrespective of their entitlements can get treatment by paying for such services. With the expansion of healthcare insurance coverage the government is studying the possibility of leasing out government hospitals to private sector in the future, as almost all the population by that time will be covered by insurance. The Government is considering plans to ask Saudi hospitals to adhere to quality standards by implementing quality improvement at hospitals and some Canadian and US companies are in touch with the Saudi MOH on implementation and training of evaluators for inspecting the hospitals and providing accreditation. CHARACTERISTICS OF MARKET The Saudi Ministry of Health (MOH) which is the main provider of healthcare services has on an average been spending 5.5%-6.5% of the country's annual budget on healthcare & related activities. Imported pharmaceuticals account for around 90 percent of the market with little manufacturing being undertaken locally. Market analysts estimate the import of Page 4 of 10 HEALTHCARE ? SAUDI ARABIA medicines has gone up from £800 million in 2004 to £900 million in 2005. The forecast is that imports will continue to go up to £1 billion in 2006 and around £1.1 billion in 2007. The pharmaceuticals manufacturing industry continues to expand moderately with seven local manufacturers producing a range of generic pharmaceuticals and co- marketing with multi-national companies. They supply around 10 percent of the total medicines market. The balance is imported from the US and Europe but for the last few years generic brands are being imported from the neighbouring Gulf countries, Egypt, Jordan and India. The MOH remains the single largest customer for pharmaceutical products in the Kingdom with annual purchases of approximately £136 million with the balance being purchased by non-MOH government hospitals, private hospitals and pharmacies. German & US companies lead in the export of large medical equipment to the Kingdom whilst the small to medium size equipment is supplied mostly by the US, Germany, UK, Japan and other European suppliers. Inspite of strong lobbying against the move by local representatives of manufacturers of pharmaceuticals, Saudi regulatory authorities have started to fix the CIF prices and retail prices in Saudi Rivals from 1 Feb 2009. Previously the CIF prices were registered in the currency of origin and adjusted according to the exchange rate fluctuation. With the current policy the manufacturer could loose or gain depending on the exchange rate fluctuation. The change is an attempt by the government to stabilise medicine prices in the Kingdom and avoid price fluctuations in the market. By adopting these procedures, the Ministry intends to stabilise 60 percent of prices of medicines registered in Saudi Arabia. According to the new directive, all medicines in Saudi Arabia which were registered more than five years ago will be reduced by one percent per year after the specified date. However, the prices of imported medicines which are ?important and have no alternatives? will not be reduced. Local representatives are considering moving this issue in the courts but the Saudi MOH has decided to move ahead on this. On the medical disposable market, inspite of local production imports dominate the market and there is an increasing market. Most medical disposable items are sourced from the Far East due to cheaper prices and there is a general feeling in the market that locally manufactured disposable items are of inferior quality. In view of an ever-increasing market for such items, there is potential for a new manufacturer that can tie up with a strong foreign partner with technical expertise. The total dental equipment and supplies (consumables) market is estimated at £47 million with an approx. growth rate of 7-8 percent. Dental supplies (consumables) is estimated at £27.9 million whilst the balance of £28 million is for equipment. The total number of dentists working in the Kingdom is estimated to be 4,300. The MOH has over the last two years been making regular purchases of dental equipment and supplies. Contrary to market beliefs that the private sector would be more lucrative, Government purchases have been more due to additional funds being available because of higher oil revenues. The demand for healthcare services is therefore increasing rapidly, mainly due to high growth rate of the population in Saudi Arabia and the introduction of a compulsory medical insurance scheme for expatriates. Page 5 of 10 HEALTHCARE ? SAUDI ARABIA OPPORTUNITIES Opportunities for UK companies are in the fields of medical equipment, medical disposable, dental equipment, surgical implants e.g. orthopaedics, spine, neurosurgery, pharmaceuticals, biopharmaceuticals, diagnostic products, hospital operation and management and medical training. Apart from Jeddah BioPharma who were expected to start producing vaccines by 2007, there is currently no biotechnology manufacturing in Saudi Arabia and it is worthwhile to evaluate the potential of setting up such facilities. Given the existing production capacity available with some manufacturers of pharmaceuticals there could also be potential for manufacturing of semi-bulk pharmaceuticals. SPIMACO is setting up a manufacturing facility in Riyadh for pharmaceutical raw materials. Both public and private sectors have announced plans to construct new hospitals and expand existing healthcare facilities. An ambitious healthcare development plan th has been chalked out under the 8 Development Plan (2005-2009) which has set up the following targets: ? Open 300 health care centres by the MOH in all regions of the Kingdom ? Open 54 new hospitals with a total bed capacity of 6,200 beds in the government sector ? Open 8 medical colleges in different regions of the Kingdom ? A target number of government hospitals to be transferred to the private sector ? 20 new diabetic centres to be established in different parts of the Kingdom both at existing hospitals and at new hospitals to be built The MOH also plans to lay the foundation stone soon for the £1.42 million King Abdullah Medical City in Makkah. This project will comprise a 500-bed hospital, a 300 bed children's & maternity hospital, a blood pressure & diabetes centre, a medical college, dialysis & oncology centre and a Haj research centre. Another £1.42 million Health City project for Asir has been recently announced. According to the MOH, this project will contain a 200-bed mental hospital with a centre to treat drug addicts, a health science college and a diabetes centre in the first phase of the project. The private sector is also taking a serious interest in healthcare. Most existing hospitals have either started building new hospitals or are expanding and upgrading their existing facilities. The Jeddah based Saudi German Hospital Group intends to expand their Jeddah hospital and build four hospitals in the coming years. The Bakhsh Hospitals Group plans to build one, Al Hammadi Hospital, two; Dr Sulaiman Al Habib Clinic, two; Saudi British Hospital two; Al Salama Hospital in Jeddah one, and Jareer Investment Group, one. Saudi Arabia has also established an efficient network of facilities to treat and rehabilitate the mentally and physically handicapped. The Ministry of Health and the Ministry of Labor and Social Affairs have established a network of rehabilitation centres for the handicapped. These facilities fall into two categories. The first offers services for medical, physical and mental treatment and rehabilitation of patients and is operated or supervised by the Ministry of Health. There are currently 18 such centres. The second group of centres focuses on the social rehabilitation of the handicapped and is run by the Ministry of Labor and Social Affairs. There are presently 14 centres throughout the country that teach the mentally and physically impaired social, educational and vocational skills designed to help them enter Page 6 of 10 HEALTHCARE ? SAUDI ARABIA society as independent, productive individuals. There are also 24 special education institutes for the blind and the deaf in Saudi Arabia and three centres for handicapped children. The special needs (handicapped) market is a largely untapped market and offers great potential to those overseas suppliers who are willing to invest in providing training on their products. UKTI Inward Missions representing Saudi companies to events such as NAIDEX has managed to introduce a number of UK suppliers to this largely untapped and growing market. The 345 hospitals, 1824 health-care centres and almost 2000 private clinics & dispensaries present innumerable opportunities in medical equipment and supplies, hospital operation & management, cleaning, catering, laundry services, infrastructure development and refurbishment as the size of the market considerably expands. Government hospitals are increasingly looking for specialist companies to operate and manage their hospitals. There is also a demand by investors to tie up with overseas hospitals to form JV's and the UK hospitals are held in high esteem. Private investment in the health services remains very attractive, especially in the major cities given that bed dependency ratio in these regions exceed the national average. The outlook for the health sector on the whole therefore looks very promising and to quote one analyst, "the sky is the limit for investment in the healthcare sector". There are more than 107 dental facilities at Government hospitals including specialised dental hospitals and around 320 private dental clinics. The private dental clinics are increasing with the growing awareness of oral hygiene. In Sept 2006 a joint Ministry of Health & Ministry of Education national oral care preventive program was launched to cover 250,000 first graders at Saudi schools. Sales of adult mouthcare reached £2.7 million in 2005, up by 7%. In addition to some others the British Centres for Excellence in Dentistry, London has set up a specialised clinic in Riyadh in collaboration with the Saudi British Hospital. These clinics are creating opportunities for suppliers of cosmetics, consumables, tools and dental equipment. The Kingdom has been spending generously in the field of medical training and plans to further improve medical education to ensure medical students are kept abreast of the latest developments. According to the latest available figures, there are now almost 4721 male and female students attending the Kingdom's medical colleges, a figure that is set to soar. The government and some private hospitals have announced plans for opening new medical colleges and universities. The ones to be established by he private sector will require Government approval. The Gulf Co-operation Health Ministers? Council, headquartered in Riyadh, issues unified public tenders every two years for pharmaceuticals, disposable products, sundry items and hospital chemicals. KEY METHODS OF DOING BUSINESS Each business segment has its own operational characteristics. The most common way of doing business in Saudi Arabia for suppliers of healthcare products is to appoint a commercial agent for a commission or a distributor who stocks products and supplies directly to the end users. For tenders business and for business with the Government the local agent/distributor is an important link for Page 7 of 10 HEALTHCARE ? SAUDI ARABIA constant follow up on projects and tenders, updating on market trends something that cannot be done by overseas suppliers until and unless they have their own direct presence. Saudi Arabia continues to offer good prospects to UK exporters in the healthcare sector. Marketing a good product, with professionalism, persistence and with due regard to price and after sales service can produce considerable sales even for niche products. UK exporters should know that face-to-face dialogue is an important aspect of doing business in Saudi Arabia. For high involvement products e.g. medical equipment, surgical implants etc. it is important that the UK manufacturer compliments the activities of its distributor by direct interaction with the end users to understand its needs and fulfil their ongoing training and development requirements. A Company focussing on continuous training and development of its end users is looked at favourably in this market. It is also very important for new companies to orient themselves on the social and cultural factors, which may affect the commercial aspects of the business PUBLICATIONS Middle East Medical is a monthly magazine printed in Bahrain at Dar Akhbar Al Khaleej (Tel.: +973 17293131). They have offices in Dubai (Tel.: +9714 3371366) and London (Tel: 0973 17293131), The Saudi Medical Journal ( is being published since 1979. It covers the modules and quality of the medical profession together with the clinical approaches to medical problems being confronted in the Middle East. Middle East Health ( is the Gulf region?s dedicated magazine for the Healthcare sector. It is published in Dubai. Middle East Health claims to reach 65,000 decision-makers in the healthcare industry. Arab Health World (AHW) ( is printed in Lebanon and serves the healthcare, laboratory, pharmaceutical and nutrition sectors in the Middle East and North Africa (MENA) region. The magazine is said to have a circulation of over 8,500 leading decision-makers engaged in the above-mentioned sectors. It is published bi-monthly in a bi-lingual format (English-Arabic). EVENTS The best sales promotion method for the Healthcare industry in Saudi Arabia is through the two major trade shows dealing with medical equipment and healthcare products. Saudi Medicare in Riyadh and Saudi Healthcare in Jeddah are held every two years. However, the major healthcare attraction is the Arab Health show held yearly in Dubai. This attracts the serious medical equipment and healthcare companies from Saudi Arabia. The UK has over the years continued to send a strong contingent to this show and a number of them have now started business relationship with Saudi companies as a result of their participation in this event. Page 8 of 10 HEALTHCARE ? SAUDI ARABIA Most leading companies distribute their trade literature for awareness and promotion of their new products through their distributors in Saudi Arabia. Some send these by e-mail whilst others send these through the mail. Additionally, UK companies seeking to promote their products and services may wish to participate in a UKTI sponsored Outward Mission. For further details please contact Saudi Desk, UKTI, London 0207 215 4834. For a general list of events in Saudi Arabia and the UK, please refer to the Saudi Arabia Calendar of Events on the Saudi country pages of the UKTI website or request by e-mail from CONTACT LISTS UKTI contact in London: Robert Kipps Head of Unit ? Healthcare Sector, ISG Kingsgate House, Victoria Street London SW1R 6SW Tel: 020 7215 4805 Fax: 020 7215 4259 Email: Other UKTI contacts in Saudi Arabia: Syed K Zaman British Embassy, Riyadh Tel: 00966 1 488-0088 ext 2252 Fax: 00966 1 488-2373 Email: Abdul Muqtadar British Consulate General Jeddah Tel 009662 622-5550 ext 2214 Fax 009662 622-6249 Email: Mumtaz Abdulla British Trade Office Al Khobar Tel 009663 882-5300 ext 2007 Fax 009663 882-5384 Email: List of Saudi government Contacts: Council of Saudi Chambers of Commerce P.O. Box 16683 Riyadh 11474 Tel.: 00 966 1 405-3200 Fax: 00 966 1 402-4747 Page 9 of 10 HEALTHCARE ? SAUDI ARABIA Chamber of Commerce & Industry Secretary General PO Box 596 Riyadh 11421 Tel: 00 966 1 404-0044/ 402-2700 Fax: 00 966 1 402-1103 Email: Dr. Manar M. Al-Moneef LifeScience Head Knowledge Base Sector Saudi Arabian General Investment Authority (SAGIA) PO BOX 5927 Riyadh 11432 Tel: +966 1 203-5050 Fax: +966 1 263-2894 Email: Page 10 of 10
Posted: 04 October 2010