According to market estimates, the Chilean market for laboratory equipment will generate over USD 100 million in imports in 2011, while importations of reagents will reach close to USD 90 million (CIF). Local production is minimal, so the market is dominated by imports.
There are approximately 1,200 clinical laboratories in Chile, with 900 of these private and 300 public. According to Mr. Leonardo Rubio, President of ALACLIN (the Chilean Clinical Laboratories Association), the rate at which small private clinical laboratories is closing is alarming and that a total of 800 private laboratories will be in business by the end of 2011.
According to Mr. Rubio, this trend is related to a general globalization process. “In Chile, health insurance companies are monopolizing the market, and have won the clients’ loyalty by providing 100% coverage for certain tests, which is deceptive because the cost of these tests is covered by high monthly insurance premiums. In order to take advantage of the service, the clients go to the large private medical centers and not to the small laboratories. Health insurance companies have also removed some small laboratories from their reimbursement agreements and consequently force their clients to go to the large health centers. If any of the health insurance clients go to any of the small laboratories, then they are not reimbursed by the insurance provider to the same extent”.
One of the very important factors that sometimes makes the survival of the small laboratories very difficult is the frequent change in technology of laboratory equipment, and large multinational corporations (MNCs) buying out smaller laboratories, which is becoming more common, and as a result smaller independent firms are gradually fading out.
Small laboratories are only able to compete in this system by lowering their prices to the minimum level, finding ways of cutting costs, and meeting the same quality and infrastructure standards as the large medical centers.
Nevertheless the situation is different in cities other than the capital Santiago, because the large health centers have not regionalized to the same degree and the small laboratories still dominate the market. These small labs will have to meet the same standards currently met by the large medical centers in the Santiago, so they will have to carry out significant investments in the near future in equipment and reagents to defend market share against the regionalization of the large medical centers. This is a good opportunity for U.S. suppliers.
In 2010, the U.S. was the country of origin of 32% of the total laboratory equipment and 35% of the total reagents imports.
According to ALACLIN, 20 years ago, there were nearly 1,000 clinical labs in Chile, present in all regions and divided as 30% public and 70% private. Today’s total number of labs is about 1,200, but nevertheless, given the high rate of private labs closing it is expected that by the end of 2011 no more than 800 will remain.
Today, the main challenge is regarding the quality of the labs in Chile, says Leonardo Rubio, President of ALACLIN. That is why in 2003, Chile was the first country in Latin America to use the ISO 15189 norm as a benchmark for the Chilean norm NCh 2547 for clinical labs. With this norm, Chilean labs are working with a new mentality, reorganizing their operating procedures according to international standards, so the results given to the patients are more trustworthy.
Also, since 2005 the Health Superintendence, MINSAL, obligates Chilean clinical labs to fulfill “voluntary” quality standards. Even though voluntary, those labs that do not comply are left out of the system.
There are 10 standards, the most important being:
• Patients have the right to receive a timely and uninterrupted service
• Patients should not be discriminated by social status, type of disease or beliefs
• The Laboratories must have a quality management system
• Personnel must have the adequate training and aptitude to deliver a quality service
In fact there is a new position at clinical laboratories called the “Quality Director/Manager”, who is in charge of all quality management issues, and there are many professionals obtaining a Quality Management Certificate.