A Global Economic Outlook for Medtech Leaders · Restructuring at Philips and Siemens is similarly motivated. Philips recently said it will create a separate legal entity combining

+ConCep Think Tank & Strategy Consultant

LIMEDex Index 2015 ConCep Think Tank +

Beatus Hofrichter, Dr. Patrick Dümmler, Dr. Sarah Moyle

THINKING AHEAD! 1st LIMEDex Index Report A Global Economic Outlook for Medtech Leaders

Published on March 6, 2015

, 2014

LIMEDex Index Report – Q1/ 2015 Results

Thinking ahead, ConCep+, March 2015 2

Table of Contents 1. LIMEDex – Outlook for 2016 ............................................................................................................................. 3 2. Global Market Access Outlook .......................................................................................................................... 5 3. Global Operations Outlook ................................................................................................................................ 7 4. Global Financial Outlook ................................................................................................................................... 9 5. Food for Thought ............................................................................................................................................. 11 6. Conclusions ..................................................................................................................................................... 12 7. Appendix .......................................................................................................................................................... 13

Publisher:

ConCeplus GmbH, Weggis, Switzerland

Authors: Beatus Hofrichter, Dr. Patrick Dümmler, Dr. Sarah Moyle

Editor: Valerie Thompson

If you are interested to participate in LIMEDex, please contact us by email [email protected] or call +41 79 254 0968 For your personal copy of the LIMEDex Index Report, please visit and register under www.conceplus.com/en/cc+extranet

© 2015. All rights reserved. This publication is an exclusive property of ConCeplus GmbH, Switzerland




1. LIMEDex – Outlook for 2016 The global healthcare sector is re-shaping itself more as hospital and insurer account activities are consolidated to increase bargaining power. In Japan, the second largest healthcare market world-wide, regulations are being revised to ease access to innovation, while the government is providing a stimulus to support homecare and an aging population. At the same time, ICT/ Internet companies are becoming more healthcare-application oriented. All this means that strategic sales and portfolio management are now more important than they once were. Market access will be fought for fiercely. The Medtech industry is responding by increasing its globalization efforts and consolidating. The world’s largest Medtech companies doubled revenues between 2006 and 2014. Much of their growth came as the result of strategic acquisitions, creating the “USD +25bn League” whose members now include J&J (USD 28bn), Fresenius (USD 27bn), and most recently Medtronic (USD 27bn). Mergers serve to focus and integrate complementary product portfolios, rather than to diversify. Restructuring at Philips and Siemens is similarly motivated. Philips recently said it will create a separate legal entity combining its Healthcare and Consumer Lifestyle businesses, while Siemens plans to spin off its healthcare business into a separately managed USD 17 billion company. It is also cutting 8’000 jobs or 2% of its workforce.

“Economic uncertainties are rising, but we follow our strategic plan closely and may move fast on rising opportunities.” – C-Level

“The market is still strong – one should not get distracted by the late FOREX corrections.” - Director-Level

”We seek advantages in excellent talent, high capacity to innovate, and brand strength.” – C-Level

The LIMEDex Index1 - The outlook is for growth

Figure 1.1: LIMEDex Index - Q1/ 2015

! LIMEDex is positive with little change since last quarter. A slight decline occurred in February due to currency shocks and FOREX volatility

! Single digit sales growth is expected as a result of uncertainty in core markets, with further downward pressure caused by economic outlook, EBIT projections, the effect of a lack of skilled resources, challenges to employee retention, low order levels, and project delivery capabilities

! LIMEDex exhibits a more cautious outlook than the NASDAQ Healthcare Index2

Figure 1.2: LIMEDex Index – Outlook development since Q4/ 2014

1 For details, see Appendix – The LIMEDex Sample 2 The NASDAQ HIX was 3.5 points on Feb 11th 2015 (see also: http://www.nasdaq.com/symbol/ixhc/stock-chart)

© 2015. ConCep+

2.6

LIMEDex Index

Score Past period (Dec-14) Actual period

LIMEDex Index is based on 27 KPIs, obtaining the LIMEDex Index. We derive three Sub-Indexes, namely the Market Access Outlook and Operational comprising 37.5% of the KPIs each, and Financial Outlooks comprising of 25% of the KPIs,

Financial Outlook

Operational Outlook

Market Access Outlook

10 -10 5 -5 0

-0.9 2.2

-2.1

5.5 6.0

-6.7

Source: CC+ Think Tank - LIMEDex Survey © 2015. ConCep+

Decline

Growth

! LIMEDex Index

+ NASDAQ Health Care Index

2.0 3.2 4.2

2.6

Nov-14 Dec-14 Jan-15 Feb-15



Market Access is an emerging challenge, affecting Financial Outlook ! It is perceived as highly

competitive, constrained by lower expected economic growth rates (e.g. China), and export/ import limitations (e.g. Russia)

! Market access will get harder as payers are under continued budget pressure

! In growth markets, however respondents expect improved access (1.9 pts)

Operations outlook is positive compared to November but down compared to January ! On the whole, there is confidence in

the ability to maintain control, further improve operational processes and gain efficiencies

The Financial Outlook was strongly influenced by the recent FOREX rate volatility ! Expectations on EBITs are

decreasing into a danger zone

Figure 1.3: LIMEDex Index – Mood shift on all three sub-indices Definition: Each sub-index provides a short-term prediction of Medtech leaders choosing between optimistic, unchanged or pessimistic in their outlook. Market access environment outlook represents 37.5% of LIMEDex KPIs, focusing on local/ international/ global commercial excellence (e.g. expectation in growth regions, channel network strength, and price point realization, etc.) Operations environment outlook represents 37.5% of LIMEDex KPIs focusing on operational excellence (e.g. business model strength, employee retention, and cross-functional excellence, etc.) Financial outlook is 25% of LIMEDex KPIs focusing on the performance excellence (e.g. revenue and EBIT development of COGS, investment sentiment, etc.)

Key LIMEDex Index expectations are …

! The Medtech industry’s LIMEDex outlook is positive at +2.6 pts for the coming 12 months ! Biggest impact affecting business in the coming 12 month is observed in Market Access outlook (-6.7pts) ! The Operations outlook is positive, but some KPIs indicate issues ahead e.g. ability to retain employees is weakening due

to slower economic growth rates ! The Financial outlook is negative (-0.9) and Medtech companies are expecting consolidation or restructuring measures

We foresee the following tendencies rising …

! Competition in established markets and segments is gaining in fierceness; expansion efforts are turning to non-traditional markets and channels

! Consolidation will affect companies with revenues between USD 0.5bn to 5bn who will be a target for even bigger companies seeking to complement their product portfolios

! Profitability is increasingly dependent on time-to-market and localized business models ! Shortfall of skilled resources for non-engineering capabilities (e.g. regulatory affairs, compliance, strategic marketing, and

launch management) is inevitable, undermining the competitiveness of SMEs ! Apps from outside the Medtech industry, mainly from ICT/Internet companies, are potentially disruptive. They will have an

effect on consumer behavior. The speed of change is not predictable, however the history of the consumer electronics sector suggests it can happen faster than incumbents expect

! Uncertainty is increasing. Medtech leaders are facing a time of greater uncertainty ahead

Source: CC+ Think Tank - LIMEDex Survey © 2015. ConCep+ Financial outlook for the next 12 months

Market outlook for the next 12 months

Operations outlook for the next 12 months

-0.2

-2.1

-3.6

-6.7

2.4

5.5

7.4

6.0

-0.1

2.2 2.6

-0.9

-10

0

10




2. Global Market Access Outlook

The outlook on revenue growth is positive (2.7%), as is the outlook for growth markets (1.9%). Asia and BRIC are the top growth regions, while North America is predicted to exhibit the least growth (despite its market size and recent positive US labor market news). However, the LIMEDex Market Access outlook declined by -4.6 base pts., to score currently at -6.7 pts, making this topic the greatest challenge for business in the coming 12 months. Most leaders believe that their traditional sales channels will alter with growing economic pressures and regulatory requirements. These views may influence mid- to long-term investment strategies. Despite the market access issues, Medtech industry players are confident about their ability to achieve good price-points around the world, except Europe. Downward pricing pressure is felt as a result of spending cuts by governments and fiscal policies. It is also to be noted that the survey results suggest that most Medtech companies are exposed to ageing product portfolio, which is not yet compensated for by new products and/or shortened time to peak sales.

“For successful Medtech firms the current question to answer is: “how to unlock the full market potential in

existing market vs. shifting investment into rising market” – C-Level

“The competence of serving growth markets i.e. BRIC successfully requires strong internal and local scale-up process capacities at the onset of the clinical trials and the product launch phase.” – C-Level

“Being the preferred supplier game is “On”; our goal is to be the winner in this game” – VP - Level

The average expected revenue growth for all companies is 2.8 % but there is a large variation in expectations depending on the size of the company

! Average projections for companies’ respective growth markets is 2%

! Large companies are most exposed to negative growth, particular in growth markets.

! We see Multi-nationals (MNE) having a market advantage

Global revenue growth expectation: ! Multi-Nationals: 2.4% ! Large: -0.7% ! Medium: 6.4% ! Small: 5.0% ! Micro: 6.3% … and in growth markets: ! Multi-Nationals: 2.3% ! Large: -0.5% ! Medium: 3.3% ! Small: 5.5% ! Micro: 9.7%

Figure 2.1: Revenue projections to expectation in growth markets in %

Overall Asia is the preferred growth market region in the next 12 months

! Companies are shying away from US and European markets due to price pressure and market access constraints

! These views may influence future investment strategies leading to the diversion of funds away from established markets.

Unlike manufacturers, suppliers still stand to gain in US and BRIC to better serve their customers

Figure 2.2: Global economic outlook per region


Expectation in Growth Markets in %

Re

ven

ue

gro

wth

pro

jec

tion

in %

Company Size


LIMEDex

Global Large Medium Small Micro Supplier

Asia 1 1 1 3 1 1 3

BRIC 2 2 2 1 2 2 1

LATAM 4 5 3 1 3 4 3

Europe 3 4 3 5 5 3 3

MEA 6 6 5 4 4 6 6

North America 5 3 5 5 6 5 1

1 = Top growth region vs. 6 = Least growth region

Company Size Company Type

Manu-facturer



Average market network/ access outlook is negative in the coming 12 month

! A decline is evident, regardless of company size, but SMEs are most affected

Biggest negative drivers3 are :

! Customer access strength ! Market share development ! Order entries Despite less optimism about order entry levels, survey respondents do not yet see an effect on inventory levels Figure 2.3: Average market network/ access strength affecting current sales and

distribution structure

Definition: Market access strength can be defined by the degree of customer retention, account penetration rate, degree of access to key decision makers beyond procurement and the order win rate.

Price point realization in most regions remains positive, averaging at +5 pts globally

! North America is leading for price point realization

! Asia and LATM are positive but with less potential than North America and Asia

! Price point realization in Europe is expected to decline

Home-market potential is positive and serves to counter-balance the negative outlook for Europe

Figure 2.4: Average entry price point realization per region

! Manufacturers foresee severe price pressure on their critical products

! On top of it, new products release will take longer to contribute to companies’ growth

! Innovation is not off-setting downward price pressure and cannot balance the weakened market access potentials of the given portfolio, which is aging

! The top- and bottom line impact of these two trends is becoming a financial double burden, magnifying any liquidity gaps

Figure 2.5: Mid-term portfolio strategy reflection

3 LIMEDex KPIs - Net changes in actual quarter in % – see page 15


0.0 -0.5

-8.7

-1.2

-10

-8

-6

-4

-2

0

2


27.3%21.2%

9.4% 9.4%

0.2%

*12.1%

*39.4%*50%

*40%

*30%

*20%

*10%

0%

10%

20%

30%

40%

North America

Home Market

Asia LATAM BRIC MEA Europe

0.0

21.7

33.7

15.5

0.0

-13.7

-4.0

-16.6 -20

-10

0

10

20

30

40



Perceived time-to-peak-sales ratio in the next 24 months

Pricing levels of critical products in next 24 months



3. Global Operations Outlook

The outlook on Operations reveals confidence in business models and the ability to defend market shares. Confidence is enhanced by the Medtech industry’s ongoing streamlining efforts. Players are confident despite the effect of increased regulatory requirements on costs, along with reduced reimbursements and lower prices for products from new entrants. Medtech companies expect to experience longer products approval timelines. Business model fine-tuning is particularly evident amongst smaller players. Expectations about order entries are negative (-29 pts) for the coming 12 months.

“Today, firms can be distinguished of being “Insiders or Outsiders” - they either have the capacities and expertise to compete and to comply on rising regulations.”- C- Level

“We anticipate a fierce “volume game” leading either to more automation or off-shoring of production, while maintaining an optimal COGS / Quality ratio.” – Manager - Level

“In zero growth markets, government will turn to significant cost-take-out programs while maintaining adequate healthcare quality provisions. This may affect our project investment rather negatively” – C-Level

Companies’ business models will be a key competitive factor in successfully managing growth and overcoming any market uncertainties ! Companies that are strengthening

their core-competences and apply a focused portfolio strategy believe they are safeguarded against current challenges

! Survey respondents remain confident about the efficacy of their business to achieve projected market share

Stronger alignment of core competences is for many firms an appropriate mid-term growth tactic

Figure 3.1: Strength of business model

The outlook on human resources is darkening, a result of an emerging “employees market”. Medtech leaders are less confident about their ability to maintain…. ! Competitive edge ! Key resources and talents This long-term trend is solidifying now; particularly regarding the lack of highly qualified non-engineering resources. (e.g. regulatory/ medical affairs, compliance, strategic marketing) Consolidation may provide extra capacity, but will not close the gaps entirely However, some companies under current FOREX pressures plan to implement HR cost optimization measures

Figure 3.2: Resource basis for growth


Absolute outlook impacting the current business models

Absolute outlook impacting market share

0.0

13.4 11.3

59.9

0.0

39.3

48.9

42.4

0

10

20

30

40

50

60

70



Perceived improved competitiveness through improved skills/ competences

Perceived improved employee retention

0.0

13.3 13.3

-85.5

0.0

-38.5

-77.5

-55.5

-100

-80

-60

-40

-20

0

20


Employee market



Project excellence is correlated to cross-functional productivity as a leading performance indicator ! Project excellency steadily declined

(including collaborations with 3rd parties)

! Hence, Cross-functional productivity is now negatively affected e.g. due to increasing regulatory requirements

This affects the overall project completion timelines, budget, and excellency. It will also lead to delays in ! Time-to-market (e.g. Launch dates) ! Time-to-peak sales

Short-term external expert support could alleviate the impact

Figure 3.3: Cross-functionality and project delivery excellence


Absolute perception of cross-functional productivity

Absolute perception of projects delivery excellence capabilities

0.0

65.4 72.2

47.7

0.0# $2.2#

$28.5#

$53.0#

-60

-40

-20

0

20

40

60

80




4. Global Financial Outlook

The Financials outlook declined by -3.1 base points, scoring currently -0.9 points. It is affected by several factors and market challenges. Foremost, companies perceive a decline of their EBIT margins (-4.5%) due to greater currency fluctuations (e.g. soaring USD, CHF, declining EUR, YEN and others), tighter market access and declining order entries. For instance, Swiss Medtech firms believe that a strong Swiss Franc will negatively affect their ability to compete, and are taking workforce counter-measures, and optimize sourcing or their location of some operations activities. The outlook on COGS is still positive (5 pts), but it is susceptible to recent macro-economic changes. There is a trend to operate with an “investment gap”, which could affect mid-to-long term competitiveness of companies.

“Consolidation may become inevitable, as price pressures and resource constrain SMEs in competing effectively against dominant players” – C- Level

“We do not keep any EBIT per se – we will rather reinvest any bottom-line gains into innovative projects” – Niche company” – C-Level

“The current net-drop effect of the EBIT expectation in Switzerland is severe, but rather a short term event – let’s revisit the net impact in the months to come.” – C-Level

Overall top-line growth is too weak to compensate for declining EBIT expectations (EBIT is -4.5% now compared to 0.9% in Q4/ 2014) ! This will call for OPEX measures to

improve EBIT, e.g. restructuring/ consolidation

! Tighter budgets lead to lesser investment/ project appetite (see Fig 4.3)

! The soaring US dollar affects price stability in BRIC and other export markets

In Switzerland, the strong Swiss Franc affected the business outlook severely ! Revenue projections declined by

4.4% to 2.68% in the last quarter ! EBIT growth lost 6.4% to -4.2% in

the last quarter ! All Swiss Medtech firms are

negatively affected: ! Large: (-6.7%) ! MNE s (-4.0%) ! SMEs (-1% to -2%)

Figure 4.1: Revenue vs. EBIT growth projections in Q1/ 2015 – Focus on Switzerland

The development of COGS is slightly affected (-7 pts) by the current outlook. Managers are paying attention to focus on ! Lowering sourcing costs of raw

materials and components ! Increasing efficiency of overhead

costs (capital, labor)

The current outlook sees a decline in expectations on Order entries; yet, management is confident that inventory levels are still adequate

Figure 4.2: Outlook on COGS in the coming 12 months


EBIT growth projection in %

Re

ven

ue

gro

wth

pro

jec

tion

in %



Perception of COGS development in the coming 12 months

0.0

31.1

12.0

5.0

0

10

20

30

40




Medtech leaders are negatively affected by the economic outlook and strongly averse to investment activities in the coming 12 months

! Large companies maintain a

negative viewpoint, while smaller companies remain more positive

! Most leaders focus on improving operations which is within a company’s control, e.g. ! shifting production capacity

closer to markets ! investing in automation ! upgrading/ trimming portfolios

This sentiment on spending curbs leads to a cementing the “status quo” of the core of business model, protecting markets and market shares, rather making new investments

Such cautious behavior creates an investment gap as “waiting on” or “no” decision taken might be the false mid-to long-term approach, while movers & shakers strike bold deals along their value chains, as recently observed of a leading company in the hearing devices segment

Figure 4.3: Global economic outlook vs. Investment sentiment

-6.7

-23.3

-27.9

0.0

-13.1

-61.5 -62.9 -70

-60

-50

-40

-30

-20

-10

0



Economic outlook of Medtech industry in the coming 12 months

Is it a good time to conduct strategic investments along the value chain?

Investment gap



5. Food for Thought

The long-term growth prediction is 4% CAGR

The Medtech industry is expected to grow steadily and in line with the recent World Bank prediction for the global GDP growth of a moderate 3% for 2015 and 3.3% for 20163. However, in order to be able to capture that growth, individual companies are looking beyond “Operations”. It is believed that MNEs will grow at least 4% in the next years reaching total revenue of USD ~380bn by 2018. The contribution from the Top 20 firms will grow beyond 70% by then, leading to a higher market concentration in the global Medtech industry.

Consolidation and growth contributors for MNEs are primarily found in: ! Expansion of offerings ! Commercial excellence to ensure

higher market access ! Geographic footprint expansion,

particularly into emerging markets ! Vertical/ forward integration along

the strategic focus of their value chains

! Outcome based marketing using proprietary data platforms to foster corporations’ market position and solidify market shares further, particularly in growth markets

Figure 4.1: Estimated consolidation in Medtech by end of 2018 Source: Annual reports of selected 90 listed global Medtech firms FY 2013

Sparking trends to come …

Many Medtech leaders believe their business environment will undergo a considerable change toward “Holistic, integrative healthcare solutions” in the coming decade. Here, the US-based ICT/ Internet sector is a dominant change agent, sparking multiple disruptive business models with global reach. Such solutions often create platforms to bundle processes and services efficiently, maximizing profitability, while providing novel autonomies to networked users. This trend is now reaching healthcare. Medtech leaders recognize the enormity of this adjacent sector push, and some seek early-mover advantages/ trend participation4.

! Patient empowerment will crystallize as eHealth protocols are implemented

! Medtech in collaboration with ICT players would be the ideal enabler to push “Internet of things” within healthcare

! Aspirational forward integration models will foster profitable healthcare collaboration establishing citizen/ hospital/ out-patient care platforms using e.g. “wearables”, “gamification”, or “monitoring” devices

! New frontier markets will no longer be a “White space” for Medtech companies

Figure 4.2: Medtech Industry trend topics (10 to 15 years outlook)

4 More than 270 Medtech companies participated at the Consumer Electronic Show in Las Vegas, in January 2015

Top 20

USD 348 bn

2013

68.4%

31.6%

Top 90

Next 70

USD 376 bn

2018

70.5%

29.5 %

CAGR+4.1%


Human resources 3%

eHealth/ empowered patients 27%

Internet of things 24%

Affordabiity of healthcare 12%

Innovative forward integration models 21%

Demographic changes 6%

New frontiers & markets 6%



6. Conclusions

Medtech leaders predict a continuous and positive revenue growth for the coming 12 months. The road ahead is stony for many companies in an ever-globalized market, primarily because of fierce international and adjacent competition, cost intensive regulatory requirements and price pressure from payers and providers. The rising FOREX volatility is posing again a major challenge. Many Medtech leaders are strongly concerned that the room to maneuver is tight as EBITs predictions slide into the negative.

Medtech companies have improved their tactical and operational performance in the past and have little margin left to react to any “market hiccup”. This became evident in the weeks following the currency disruption in January, particularly hard hit were exporting companies producing outside US or EU markets. These players have now to cope with a new volatility amongst lead-currencies. The sudden change of just one key variable revealed the “dormant” top-line issues of many companies. This event clearly exposed the need for companies to shift gears in managing tomorrows’ competitiveness differently. Often, past operational excellence programs were stretched beyond further yields, while strategic positioning, disruptive business model innovation, regulatory and reimbursement strategies, and market access were detrimentally neglected. Several KPIs of the LIMEDex suggest that measures to address a turn-around and take strategic actions should be taken by management now

Some high level recommendations …

On the surface, the current forecast and insight from Medtech peers indicates a stable but challenging business environment. Medtech leaders now face multiple tasks to steer clear of challenges with their teams. In order to heighten their market yields, companies can safeguard their business against the new uncertainties by:

! Protecting against any FOREX exposure movements ! Improving the portfolio strategy in order to meet your clients needs and objectives ! Understanding arising opportunities in non-traditional channels ! Aligning/ restructuring sales and distribution approaches to strengthen the impact of account network ! Addressing the rising “employee market” issue to maintain competitiveness ! Meeting the rising needs of local regulatory requirement avoiding any compliance issue and lastly, ! Overcoming the risk aversion



7. Appendix

Methodology & Acknowledgements

LIMEDex – a leading global Medtech Industry Index is developed and published quarterly by ConCeplus GmbH, Switzerland since 2015. LIMEDex is designed to identify and understand emerging trends and key themes, enabling Medtech industry peer insight. It is qualitative, capturing opinions on market access environment, operations environment, and financial outlook and the underlying challenges facing Medtech industry leaders and experts for the coming 12 months. LIMEDex is based on online surveys to determine expectations and attitudes, as well as selected interviews sharing interim results with survey participants to obtain first-hand their thinking on emerging trends during report writing, which represent “nowism - wisdom of the crowd”. The LIMEDex survey applies a standard set of 27 focused questions on key performance indicators during the current quarter. More than 30 global, regional, international and local Medtech leaders and industry experts participated at least once in these surveys. The respondents represent manufacturers, suppliers and service providers of leading companies of all sizes, including larger corporations, as well as acknowledged niche leaders.

The authors want to thank all the Medtech executives and experts for their engagement, contribution, and support with the LIMEDex Index surveys.

Last but not least, CC+ would like to thank all those who contributed to the writing of ‘1st LIMEDex Index Report – Thinking ahead’ (Q1/ 2015), particularly Dr. Sarah Moyle and Valerie Thompson.

The LIMEDex Samples

Authors

Mr. Beatus Hofrichter is Founder & Managing Director of ConCep+, an innovative Medtech&Healthcare value chain think tank and strategy consultant. He is a frequently invited speaker on the Medtech Industry, New Business Models, Business transformation, and innovative/ holistic Value Chain integrations. He has published numerous articles, the Swiss Medical Technology Industry (SMTI) survey since 2006 and the Global Medtech Report 2012, and co-develops a Hospital Management Report currently. Mr. Hofrichter has more than 15 years of consulting experience in the medical devices and pharmaceutical industries. He studied in London, UK, and holds a Master of International Management and Business Administration.

Dr. Patrick Dümmler is Partner at ConCep+. He has 10 years consulting and industry experience in the Medtech and life science industry. Formerly, he was the Managing Director of Medtech Switzerland and as part of this he led the WMTF Lucerne Conferences (2012 & 2013). He has published over 80 articles, books and numerous reports on the medical devices industry, and since 2006, has co-authored the Swiss Medical Technology Industry (SMTI) survey. Additionally, he wrote and published multiple country reports on the local Medtech industry and foreign direct investment opportunities in these markets. Dr. Patrick Dümmler studied Economics at the University of Zürich and completed his PhD at the ETH Zürich.

Dr. Sarah Moyle is Project Member of ConCep+. Formerly, she acted as Head of International Relations for Medtech Switzerland and is currently Manager Medical & Clinical affairs at a Swiss medtech company. With international experience in the Medtech and clinical areas, Dr. Moyle works both from an economic and medical background supported by 15 scientific and economic publications. Dr. Moyle studied neurophysiology at the University of Colorado at Boulder and received her doctorate from the University of Bern in Biomedical Science with a focus in cardiology.

HQ Countries Representation Participation by Company Size Participation by Industry Sectors Participation by Hierarchical Level

© ConCep+ 2015 n= 33 © ConCep+ 2015 n= 33 © ConCep+ 2015 n= 33 © ConCep+ 2015 n= 33

Micro 9%

Small 9%

Medium 18%

Large 30%

Big 34%


C-Level 33%

VP-Level 9%

Director 49%

Manager 9%

Switzerland 33%

Germany 43%

USA 12%

Brazil 6%

Denmark 3%

Brazil 4%

China 4%

Company Size

Company HQ

Locations

Manufacturer 82%

Supplier 9%

Service provider 3%

Academia 6%

Industry Sector

Hierarchy Level



LIMEDex Index Data in Q1 2015

LIMEDex Index - Net changes in actual quarter in %

LIMEDex KPIs - Net changes in actual quarter in %

LIMEDex Challenges - Net changes in actual quarter in %

LIMEDex

Global Large Medium Small Micro Supplier

Strategic Outlook -1.5 -4.2 -0.9 3.2 4.1 -1.9 0.4

Financial Outlook -3.4 -6.1 -5.0 4.8 11.8 -4.1 -2.2

Operational Outlook

-1.4 -5.0 -2.5 5.2 3.5 -2.2 1.7

Market Access Outlook

-3.1 -5.3 -2.4 3.0 6.3 -3.5 -1.0

Company TypeCompany Size

Manu-facturer


LIMEDex KPIs – Net changes in actual quarter in %

52%

52%

45%

27%

24%

24%

6%

5%

3%

3%

-3%

-6%

-9%

-9%

-12%

-12%

-15%

-21%

-22%

-24%

-24%

-26%

-31%

-42%

-57%

Cross functional effectiveness

New talents

Economic outlook

Export share

Access in growth markets

Invertory levels

Employee retention

Time to peak sales impact

Disruptive technology

Projects delivery excellence

COGS projection

Entry price point realization

Strategic investment timing

Business model

Access to finance

Skills & competences strength

Need for coll projects

Order entries

Market share development

Revenue projection

Source prices

Net Challenges

Customer access strength

EBIT projection

Challenges affect growth


LIMEDex KPIs – Current challenges in %

-15%

-39%

-39%

-55%

-70%

-70%

-72%

-79%

-79%

-82%

-88%

-94%

28%

Patent issues

Financing

Skilled resources

Innovation cycles

Globalization

Tenders

Consolidation

International competition

Cost pressure

Regulations

Market access

Price pressure

Others


Disclaimer

It is not permitted to modify or create derivative works of this report and presentation or to use it for commercial or other public purposes without the prior written permission of ConCeplus GmbH.

Based on experience publishing reports with insights from the national and international Medtech industry management since 2006, we developed LIMEDex – a leading global Medtech Industry Index, enabling executives to track and plot their strategic thinking against their peers on market access environment, operations environment, and financial outlook and the underlying challenges facing Medtech industry leaders and experts for the coming 12 months. The strategic and tactical usage of LIMEDex to optimize one’s business shall only be applied as a secondary opinion guidance.

In this respect the publication reflects and contains international Medtech industry leaders’ opinions and insights and is not intended to be comprehensive, nor to provide financial, investment, legal, tax or other professional advice or services at the date of the publication, and are subject to change without notice. Although the information used was taken from reliable and trusted sources, ConCep+ does not accept any responsibility for the accuracy or comprehensiveness of the details given. Therefore, this publication is not a substitute for personalized professional advice or services, and it should not be acted on or relied upon or used as a basis for any strategic decision, investment or other action that may affect you or your business. Before taking any such decision you may consult a suitably trusted source and/ or qualified professional service provider. Whilst reasonable effort has been made to ensure the accuracy of the information contained in this publication, this cannot be guaranteed and neither ConCeplus GmbH nor any of its Advisory Board members shall have any liability to any person or entity which relies on the information contained in this publication, including incidental or consequential damages or losses arising from errors or omissions related to this publication. Any such reliance is solely at the user’s risk.

ConCeplus GmbH + Lützelaustrasse 44 + CH-6353 Weggis/ + 0041 79 254 0968 + www.conceplus.com

We invite you to subscribe to this publication and selected breakout reports. Please contact us or see www.conceplus.com/en/cc+extranet for further information.

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A Global Economic Outlook for Medtech Leaders · Restructuring at Philips and Siemens is similarly motivated. Philips recently said it will create a separate legal entity combining