Medical Equipment Overview

An Expert's View about Medical, Health and Cosmetics Products in Uruguay

Posted on: 28 Nov 2011

Summary

Uruguay imports almost all its medical equipment. Major market opportunities are for new, technologically advanced supplies and equipment, particularly in the areas of non-invasive procedures, ultrasound, magnetic resonance imaging and CT scans. All products must be registered with the Ministry of Public Health by a duly approved and registered local representative. The Commercial Service in Uruguay can assist U.S. firms with finding their local business partner.

Background

The demographic portrait of Uruguay ensures that the demand for medical supplies and equipment is relatively steady, and this trend is projected to continue. Compared to other Latin American countries, Uruguay has an aging society; 13 percent of the population is 65 years and over and the average life expectancy is 72 for males and 79 for females. The average age is 33 years. Uruguay’s historical total expenditures on health are on average 8 to 9 percent of GDP.

Uruguay is one of the countries with the highest number of doctors per capita, with over 14,640 physicians in a population of 3.3 million. It has a high degree of urbanization, with 94 percent of the population living in urban areas.

Cardiovascular problems are the most common cause of death amongst the population over 45 years old, with malignant tumors as the second leading source of mortality.

Practically all medical equipment is imported. There is only one local company which manufactures pacemakers, but with imported parts, and used equipment is generally refurbished locally. However, imports of refurbished medical equipment are authorized.

In 2005 the Government of Uruguay started to implement a major health care system reform. The pillar of this reform was the law dated January 2008 which created the Integrated National Health System (INHS). The System was designed to identify a basic package of comprehensive health services to be offered by public and private health care providers alike. An important component of the health reform focuses on strengthening the MPH’s ability to carry out the essential public health functions: regulation and stewardship; health promotion and prevention; and epidemiological surveillance and monitoring.

The former President of Uruguay, Tabare Vazquez, a practicing oncologist even during his tenure, was particularly focused on improving medical attention. The current administration of President Jose Mujica, who holds office until 2015, continues along the same path. The ruling left-of-center Broad Front coalition considers the previous health care model unfair and inequitable. Since 2005 the Government of Uruguay has sought to: expand coverage to a greater percentage of the population; promote health and equity; and improve quality of life. The current health system has focused on access to medical attention in rural areas; has included coverage for mental, sexual and reproductive health; and has provided attention to teenagers and addictions among other areas.

Market Overview

The Uruguayan health sector includes both public and private sub-sectors. The public sub-sector consists of the Ministry of Health, the country's main healthcare provider. As per the latest data available [2009] the Ministry runs 300 outpatient clinics, 22 health centers, and 62 hospitals. Approximately 39 percent of the population is served by the public sector and 53 percent by the private sector; the remainder are also served by other services (military, police and insurance) and a very minor percentage of the population has no coverage.

Private care is organized through Collective Medical Care Institutions (CMCIs), which are non-profit organizations offering comprehensive medical care through a prepayment system. Private institutions include private hospitals, partial health insurance, private clinics, and highly specialized medical institutions. There are currently 39 CMCIs with 1.8 million members, 12 of these institutions in Montevideo and 28 in the Interior of the country.

The public sector accounts for almost 60 percent of the beds, and it is the only sector that provides hospital beds for chronic patients.

On average, the private sector represents over 70 percent of health expenditures. Health sector funding is a complex mix between public and private sources. Multiple funding comes from taxes, central government funds, sales, own sources, user contributions, and state transfers.

Market Access

Approximately 35 percent of Uruguay's total medical equipment imports are for the public sector and 65 percent are for the private sector.

Customs duties and other taxes for medical equipment range from 0 to 23 percent. The only products that require special processing are those associated with orthodontics, on which a 5 percent Professional and University Orthodontics tax is applied. All medical products have to be registered and approved by the Ministry of Public Health. The Ministry's Division of Control is responsible for all registrations. With prior authorization from the MPH, orthopedic prosthesis as well as other items for handicapped patients or institutions may be exonerated from tariff duties.

Medical equipment registration includes the following procedures:

• Applicants: Only companies duly registered and authorized by the Ministry of Public Health (MPH) can register products at the General Directorate of Health, GDH (Division of Health Products and Division of Pharmaceuticals). Foreign companies must have a local representative.

• Requests: Approval requests must be submitted with a sworn statement. Approved products are assigned approval certificates with individual identification numbers. The MPH must be notified of imports within ten working days of the product's arrival. If products are not imported, approval certificates must be returned within 90 days from the date of issue.

• Language: All documents must be presented in Spanish (one copy of original documents plus one copy of translated documents)

• Validity: Five years.

• Ownership: The owner of the registration is the company/individual that is registered at the Ministry of Public Health.

• Costs: Need to check with MPH each time. Costs depend on the category of the equipment and are based on an indexed unit in local currency.

The registration process takes approximately 90 days. However, distributors have advised that delays can occur up to a year.

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Posted: 28 November 2011