Mission Statement

U.S. Healthcare Technologies Trade Mission

Italy, Greece and Cyprus

May 28-June 3, 2008

Mission Description:

The United States Department of Commerce, International Trade Administration, U.S. Commercial Service (CS), Office of Global Trade Programs, in coordination with the Global Healthcare Team and Commercial Service Milan, Rome and Athens, and U.S. Embassy Cyprus, is organizing a Healthcare Technologies Trade Mission, May 28-June 3, 2008, to Bologna, Italy and Athens, Greece. As a first-time initiative, agents and distributors from Cyprus will also be invited to meet with U.S. mission participants in Athens, as part of the mission.

The Italy leg of the mission will consist of participation in Exposanitá, the premier Italian medical trade fair www.senaf.it Exposanitá is the second largest EU medical trade show, after Medica in Dusseldorf, Germany, and is held every two years at the Bologna fairgrounds. In 2006, Exposanitá hosted 1,017 exhibitors and attracted 28,000 visitors. Healthcare mission participants will have individual turnkey booths in a well-defined U.S. pavilion. In addition to exposure provided by exhibiting in the fair, these U.S. companies will have a schedule of one-on-one appointments in their booths set up by the U.S. Commercial Service in Italy.

The trade mission will target a broad range of healthcare products and services, including products in the burgeoning IT-healthcare sector. The goal of the mission will be to match participating U.S. companies with qualified agents, distributors, representatives, licensees, and joint venture partners, and where appropriate, arrange for appointments with government officials in these markets. Consumers in Italy, Greece, and Cyprus have a strong affinity for U.S. products.

Commercial Setting

Italy:

The Italian medical equipment market is valued at approximately US$4 billion. Close to 70 percent of medical devices and diagnostics used in Italy are imported, with approximately 45 percent of these products coming from the United States. Other major market suppliers are EU countries and Japan.

Italy is a mature market for medical equipment, and its high per capita income and sophisticated healthcare system translate into demand for a broad range of cutting-edge medical equipment. Italians are educated consumers and expect state-of-the-art medical treatment, which ensures continuous demand for innovative medical equipment and products.

Government policy and the provision of public health services also stimulate demand for medical equipment. Italy has a government-funded healthcare system, making the government (at all levels) the primary purchaser of medical equipment. Public hospitals account for approximately 75 percent of sales of medical equipment, while 25 percent of sales are made to the private sector. As the costs of maintaining a public healthcare system increase, public hospital administrators and medical staff are directed to choose the best product available, at the lowest possible cost.

U.S. medical equipment is traditionally well received in Italy due to its perceived high quality. Opportunities are particularly strong for state-of-the-art and innovative medical equipment, and products that can result in significant improvement in clinical outcomes. In particularly high demand are products that lead to faster patient recovery and reduce hospital and rehabilitation costs.

Additionally, IT-healthcare products are in demand in Italy. Products that improve the delivery of services by reducing medical errors and adverse medical events, and increase patient safety and satisfaction, such as health information management systems, and patient administration and clinical information systems, are all experiencing growth.

U.S. medical equipment receives duty-free treatment in Italy, but must conform to EU standards and carry the CE mark , a manufacturer’s assurance that the product meets all relevant EU health and safety directives. Representatives in Italy can assist U.S. companies with meeting these standards if they have not already done so.

Greece:

The total Greek market for medical equipment is estimated at US$750 million. Imports comprise 95 percent of the market - about 40 percent from the United States and the balance mainly from other European Union (EU) countries. Innovative medical equipment and products from the United States enjoy an excellent reputation in Greece and are considered to be of superior quality and technology. There is a steady growth of imports from the United States in this sector, a trend expected to continue, with imports growing at an estimated average annual rate of 10-15 percent.

Greece has a government-funded healthcare system, and government policy and the provision of public health services are key drivers in the demand for medical equipment. The public sector accounts for 70 percent of total medical purchases in Greece, mainly by public hospitals.

A broad range of U.S. medical products have strong potential in Greece; the most promising sub-sectors include surgical equipment and supplies, electromedical equipment, IT-healthcare systems and telemedicine technology. There is particularly strong demand for IT-healthcare products that increase patient safety, ameliorate the delivery of healthcare services through reduction of medical errors, and improve health information management.

The Ministry of Health launched the eHealth Roadmap in June of 2006 as part of the National Strategy for Quality and Safety of Healthcare Services in the Knowledge Society. Based on the critical review of the National 2002-2006 Information/Communications Technology Action Plan, it includes re-orientation, where appropriate, to accelerate national progress, incorporate new polices and align with the European eHealth Action Plan. The strategy is to establish the National Health Information Systems (NHIS), i.e., a national system for organizing health related information. The major objective of the NHIS is to implement the Electronic Patient Record system. The central IT infrastructure of the NHIS, IASYSS, provides the national interoperability framework intended to enable Greek health organizations to seamlessly access and share health-related information. The National Integrated Shared Care Record, together with the protocols agreed upon by the public and private health care organizations and services, are key elements of the IASYSS strategy. Implementation of the eHealth Roadmap is divided into three phases over the next 10 years.

The Greek Social Insurance Institute (IKA), responsible for both public healthcare and social security services, has already implemented the first phase of automated patient scheduling, supported by its IT and Telecommunications network developed in 2003. Additionally, several e-services are already available to Greek citizens through the Institute’s website for social security.

The 3rd C.S.F. (Community Support Framework) is being developed through an EU grant, which aims to improve the standard of living of European citizens in various fields, including the healthcare sector. Between 2000 and 2006, approximately US$1.35 billion of EU funds were spent for improving healthcare delivery in Greece. Emphasis has been on the development of Regional Healthcare Centers throughout the country, along with the government’s proposed policy for the restructuring of the entire healthcare system.

To export to Greece successfully, it is crucial that all U.S. medical equipment conform to EU standards and carry the CE Mark. Representatives in Greece can assist U.S. companies with meeting these standards if they have not already done so, enabling them to gain access to Europe’s entire market. There are no formal restrictions or non-tariff barriers affecting imports of medical and hospital equipment to Greece. While duties are applied to parts for medical products and disposables, U.S. medical equipment receives duty-free treatment.

Cyprus:

The Cyprus medical equipment market (a combination of medical devices, medical disposables, and medical equipment) is valued at approximately US$100 million. All products (100%) are imported, with 90% imported from the EU and about 10% from the U.S. and other markets. However, many U.S. companies manufacture and sell their equipment in the EU and are therefore listed as EU imports.

The Government of Cyprus provides free or largely subsidized medical services to most residents. All other Cypriots have access to medical services at unsubsidized prices, but most have private health insurance. Since the Government funds the provision of public health services to a large number of the population, it is also the primary buyer of medical equipment (55-60% of total medical equipment imports).

Private medical services are also prevalent in Cyprus. Individuals who choose to use private sector services must pay their own costs, except in cases where the costs are covered by their trade union or employer insurance funds, which can provide either full or partial coverage.

Purchases for the public healthcare system are made through the Ministry of Health, and the most decisive factor is low cost. The Government is now in the process of switching to a National Health Insurance Scheme (NHIS) that will cover all citizens through both the public and the private sector. To implement this strategy, the Government created the semi-governmental Health Insurance Organization (HIO). The costs of implementation are estimated at over US$1 billion.

One of the fastest growing sectors is IT-healthcare, especially now with the formation of the NHIS. The number one buyer for this sector is currently the HIO, which is in discussions with a few well-known companies (including U.S. firms) for the following (information listed below provided by the HIO):

• Development, implementation, and integration of IT systems for Health Payer Organizations.
• Operation and support of IT infrastructure and applications provided as an outsourced service.
• Operation of processes for Healthcare Claims Management and Call Centers.
• Service provision of the Healthcare industry in the area of information management based on the development and implementation of an Electronic Patient Record.

The Ministry of Health has also made it a priority to automate its systems and provide better services through increased productivity, make the move towards paperless and filmless hospitals through an Electronic Health Record system, introduce a smart medical card, provide remote medical services – internet, telemedicine, and robotics – and provide access to external and internal data banks.

Cyprus has a developing health system and a maturing market for medical equipment. Demand for cutting-edge medical equipment and IT-healthcare services is rapidly growing and diversifying. Cypriots are increasingly requiring high-tech medical services and consider U.S. technology to be of very high quality. All U.S. medical equipment must conform to EU standards and carry the CE mark.

There are currently two projects in development that will upgrade the healthcare sector on the island for both Cypriots and foreigners alike. Both projects have U.S. involvement. The first project’s plan is to create a state-of-the-art international hospital that will attract clients from all parts of the region and offer several specialties currently unavailable in Cyprus. In accordance with the Government of Cyprus’ emphasis on health tourism as a strategic growth sector, the second project is a health resort that will consist of a medical clinic, an assisted-living community center, an organic farm, a five-star hotel, and a luxury residential development of almost 2000 units.

The healthcare sector is extremely promising in Cyprus, with considerable potential for U.S. suppliers of medical equipment and investors interested in projects that will upgrade the health services provided on the island.

Mission Goals:

The trade mission’s goal is to provide market entry or increased sales in the mission markets for U.S. healthcare firms and/or IT firms with healthcare-related products or services, as well as first-hand market information and access to potential business partners.

Mission Scenario:

The delegation will spend four days in Bologna and two days in Athens. In cooperation with U.S. Embassy Cyprus, Cypriot distributors, agents and other appropriate business partners will be invited to meet with the mission participants in Athens.

The Italy leg of the mission will consist of participation in Exposanitá, Italy’s premier medical trade fair. The show will run from Wednesday, May 28, to Saturday, May 31, 2008.

In Italy, the U.S. Commercial Service will:

• Arrange all the logistics for participation in Exposanitá.

• Provide a market briefing highlighting opportunities in the Italian healthcare technologies sector.
• Schedule one-on-one appointments with potential business partners at the show for each participant.
• Provide interpreter assistance as needed.

In Greece, the U.S. Commercial Service will:

• Provide a market briefing highlighting opportunities in the healthcare technologies sector.
• Schedule one-on-one appointments in a central Athens hotel with potential Greek business partners, and from Cyprus where appropriate, for each participant.
• Arrange a hospitality event to introduce participants to key business and industry officials.
• Provide interpreters as needed.
• Provide hotel/airport transfers for the mission participants.

Proposed Timetable:

Tuesday, May 27, 2008

Arrive in Bologna

Wednesday, May 28, 2008

Market Briefing in Bologna
Trade Fair and Business Appointments in Bologna

Thursday, May 29, 2008

Trade Fair and Business Appointments in Bologna

Friday, May 30, 2008

Trade Fair and Business Appointments in Bologna

Saturday, May 31, 2008

Trade Fair and Business Appointments in Bologna
Conclusion of Trade Show

Sunday, June 1, 2008

Travel to Athens

Monday, June 2, 2008

Breakfast Market Briefing in Athens
Business Appointments in Athens
Evening Reception

Tuesday, June 3, 2008

Business Appointments in Athens
Conclusion of Mission

Criteria for Participation:

• Relevance of the company’s business line to the mission scope and goals.
• Potential for business in the selected markets.
• Timeliness of the company’s completed application, participation agreement, and payment of the mission participation fee.
• Provision of adequate information on the company’s products and/or services and communication of the company’s primary objectives to facilitate appropriate matching with potential business partners.
• Certification that the company’s products and/or services are manufactured or produced in the United States or if manufactured/produced outside of the United States, the product/service must be marketed under the name of a U.S. firm and have U.S. content representing at least 51 percent of the value of the finished good or service.

Any partisan political activities of an applicant, including political contributions, will be entirely irrelevant to the selection process.

The mission will be recruited by an international trade specialist on the Healthcare Team with assistance from CS Milan, CS Rome and CS Athens, and will be promoted through the following venues: Export Assistance Centers and the Healthcare Team; USCS Trade Events List on www.export.gov; industry newsletters; the Federal Register; relevant trade publications; relevant trade associations; announcements to past Commerce trade mission participants and to various in-house and purchased industry lists; and the Commerce Department trade missions calendar: www.ita.doc.gov/doctm/tmcal.html

Recruitment will begin immediately and will close approximately six weeks prior to the mission. The trade mission participation fee will be U.S. $4,500 per company. The participation fee does not include the cost of travel and lodging. Participation is open to the first 10 qualified U.S. companies. Applications received after the recruitment deadline will be considered only if space and scheduling constraints permit.

Contact Information:

Tembi Secrist, Project Manager
U.S. Commercial Service
Seattle U.S. Export Assistance Center/Healthcare Team
2601 Fourth Avenue
Suite 320
Seattle, Washington 98121