The Medical Device Industry in Mexico

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1 The Medical Device Industry in Mexico Business Intelligence Unit 2015

2 Index 1. Healthcare Providers 2. The Medical Device Industry in Mexico Industry Indicators in Mexico Production and Consumption Mexico's International Trade Foreign Direct Investment (FDI) Companies Supply Chain 3. Pharmaceuticals Industry Indicators in Mexico CostS The Pharmaceutical Industry in México Production and Consumption Mexico s International Trade Foreign Direct Investment (FDI) Companies

3 Healthcare Providers In 2014, The Mexican healthcare providers sector reached a value of US$79.3 billion. Its CAGR between 2010 and 2014 was 6.3%. It is expected that between 2014 and 2019 the Mexican healthcare providers sector will grow at a CAGR of 6.1%, reaching a value of US$101 billion in Outpatient care was the largest segment of the health care providers sector in 2014, accounting for 37% of the sector s total value. Healthcare providers by segment 2014 Healthcare providers sector projections CAGR % Segment 2014 (billions of US dollars) Outpatient care % % CAGR % CAGR % Collective services % Inpatienrt care % Medical goods % Long- Term care % Total % Source: Marketline

4 1. Medical devices Business Intelligence Unit 2015

5 Industry Indicators in Mexico Production 2014: US$15.2 billion Consumption 2014: US$11.9 billion Compound annual growth rate (CAGR) : 5.3% Economic units* recorded in 2015: 2,344, located mainly in Baja California, Chihuahua, Coahuila, Distrito Federal, Estado de México, Jalisco, Nuevo León, Sonora and Tamaulipas Number of exporting companies in 2014: 655 CAGR : 2.4% Total employees 2014: 148,266 people Main investor countries in 2014: US, Germany and Italy Exports 2014: US$7.7 billion Main exports: Medical, surgical, dental or veterinary instruments and devices; orthopedic articles; mechano-therapy appliances; surgical furniture; and apparatus based on the use of X-rays. Sources: Global Trade Atlas, Global Insight, INEGI and the Ministry of Economy

6 Source: INEGI, Global Trade Atlas and Global Insig Production and Consumption Production Production in the sector reached US$15.2 billion in 2014, and is expected to record a 5.3% CAGR in the period. The industry accounted for 1.7 of manufacturing GDP and 0.3% of total GDP. Medical devices production in Mexico (millions of US dollars) 12,161 13,443 14,188 14,339 15,220 Consumption Consumption in the sector reached US$11.9 billion in 2014, and is expected to record a 2.4% CAGR in the period. 9,841 Medical device consumption in Mexico (millions of US dollars) CAGR : 2.4% 11,912 10,303 10,304 10, Added value ---- Disposable was 20% / electronic devices was 36% Inputs from foreing countries---- Disposable 32.3% / electronic devices 91.7%

7 Mexico's International Trade In 2014, Mexico exported US$7.7 billion, ranking as: 9th 1st 1st Ninth largest exporter of medical devices worldwide Largest exporter in Latin America Main supplier to the US Mexico's international trade of medical devices (million USD) 7,699 6,886 5,798 6,072 6,343 5,064 5,138 4,560 4,048 2,159 2,183 2,448 2,489 2,782 3,032 3,188 3,473 3,745 3,954 2,377 2,616 2,649 3,016 3,040 3,155 3,413 1, Exports Imports Balance of Trade Source: Global Trade Atlas Mexico's main trade partner in the sector is the US, with 92.5% of its exports going to that country and 62.7% of its imports coming from In 2014, it. the main products exported from the sector were medical, surgical, dental and veterinary instruments and devices. 2nd 4th 4th 4th Main products exported by Mexico in 2014 Product Medical, surgical, dental and veterinary instruments and devices Exports (millions of us dollars) Second largest exporter globally of tubular needles for sutures. Fourth largest exporter globally of surgical furniture. Fourth largest exporter globally of syringes, catheters and similar instruments. % 5, % Orthopedic items and devices % Mechano-therapy, respiratory therapy and massage devices % Other % Total 7, % Source: Global Trade Atlas

8 Foreign Direct Investment (FDI) Foreign Direct Investment into the sector reached an accumulated amount of US$1,689 million for the period The main investor countries were U.S., Italy, Germany, Spain and Netherlands. In 2014, total flows of FDI into Mexico reached US$150 million. 1,494 FDI Share by investor country in 2014 January December 2014 (million usd) United States Italy Germany Spain Netherlands Sweden France Finland Brazil Cuba Source: Ministry of Economy

9 Foreign Direct Investment (FDI) Investment announcements in Mexico between 2010 and 2015/1: Companie s 17 Projects Expansion Projects 6 New investments Betting on Mexico... Country U.S. Iceland Canada New Zealand Capital Investment (millions of US dollars) No. of Companies Jobs 6,37 5 Main Destinations: Guadalajara, Tijuana, Nuevo Laredo and Matamoros. Germany Colombia Source: FDI Markets. 1/ Latest figures available: March 2015

10 Source: FDI Markets. Foreign Direct Investment (FDI) Date Company Country Investment announcements in Mexico between 2014 and 2015: Investment (Millions of US dollars) JOBS Project type (New investment or Expansion) Description Betting on Mexico... Mar- 15 Medline U.S. n.d. n.d. Expansion US- based Medline Industries has expanded its plant in Nuevo Laredo, Mexico. The company's second expansion at its facility, located at the Oradel Industrial Park, has an addiuonal 20,900 sq m and will allow the company to increase staff levels to 1,800. Sep- 14 Baxter U.S Expansion Jul- 14 CareFusion U.S New investment The Mexican division of Baxter will invest $30mn at its plant in Cuernavaca, Mexico. The facility will increase producuon capacity by 40% and is likely to generate new employment opportuniues in the region. CareFusion has invested $6mn to expand its faciliues in Tijuana, Mexico. The company will create 100 new jobs to increase its medical devices producuon from 1 to 1.5 million units daily to serve the US market. Jul- 14 B. Braun Melsungen AG Germany 3 68 Expansion Germany- based healthcare company B. Braun Melsungen will invest $3 mn to expand its plant in Santa Cruz AUzapán, Mexico. The company will build a 1,400 sq m logisucs complex and will triple the producuon space by installing a line to manufacture spine implants. The expansion is scheduled for compleuon in the first quarter of Jun- 14 Phase 2 Medical Manufacturing U.S New investment Phase 2 Medical Manufacturing, a contract medical device manufacturer, has opened a new producuon facility in Tijuana, Mexico. The 2,790 sq m facility has created 20 new jobs. Feb- 14 Pexco U.S. N.A. N.A. Expansion Pexco (medical plasucs processing) plans to expand its facility in Mexicali. The expansion is expected to be completed by August Feb- 14 Surgical SpecialUes Canada New investment Surgical SpecialUes, subsidiary of Angiotech PharmaceuUcals, plans to open a new manufacturing facility in Tijuana, for producing blades and sutures for surgical use. Feb- 14 Fisher & Paykel Healthcare New Zealand 3 74 Expansion Fisher & Paykel Healthcare(designer and manufacturer of respiratory care devices) will invest $3.3 mn to expand its manufacturing facility in Tijuana. Jan- 14 Mediimplantes Colombia New investment Mediimplantes (manufacture of spinal implants and surgical instruments) plans to establish a $1.6 mn facility in Guadalajara, scheduled to be operauonal in 2014.

11 Companies In 2014, 2,344 economic units* specialized in medical devices had operations in Mexico. The same year, approximately 655 companies reported exports. Baja California: Location of Mexico's main medical devices cluster. Accounts for 33% of the country's total exports in the sector. Has 189 economic units and over 80 companies that export medical devices. *Includes companies, plants, commercial and sales offices Source: INEGI and Ministry of Economy Source: ProMéxico with data from the Ministry of

12 Supply Chain Industrial Processes There are several companies that provide important processes for the medical devices manufacturing industry in Mexico, which are located mainly in Coahuila, Nuevo León, the State of Mexico, Chihuahua, Puebla, Tamaulipas, Durango and Mexico City. Electronics One area of the electronic industry takes care of the manufacturing, assembly and incorporation of electronic components into medical devices. Machining 310 companies die casting 50 companies Foundry 102 companies Mechanical Assemlies 221 companies Die-Cutting and Stamping 225 companies Leading global electronic manufacturing services providers (EMS) have operations in Mexico. Company Foxconn Flextronics Jabil CelesDca Country of origin Taiwan Singapore US Canada Presence in Mexico Chihuahua, Baja California and Tamaulipas Jalisco, Chihuahua and Aguascalientes Tamaulipas, Jalisco and Chihuahua Nuevo León and Tamaulipas Plastic injection Molding 114 companies Thermal Surface Treatments 160 companies Sanmina US Jalisco Plexus Brazil Baja California Wistron Taiwan Chihuahua Source: ProMéxico Source: ProMéxico

13 Costs Costs Mexico offers lower operation and labor costs for every level of specialization, as well as lower manufacturing costs for medical equipment, electronic devices and precision components, in comparison to countries that are representative of the industry. Mexican Offer Index of savings on medical device manufacturing costs 2013 Germany U.S. Australia Japan Italy France U.K. Netherlands Canada Mexico 0.2% 0.0% - 0.7% - 1.1% - 2.6% - 2.8% - 4.2% - 5.0% - 5.4% % Compared to the US, Mexico offers 18.9% savings on manufacturing costs for the medical device industry. Source: KPMG, Competitive Alternatives, 2014 Index of savings on precision component manufacturing costs 2013 Germany Italy U.S. Australia France Japan Netherlandas Canada U.K. Mexico 1.1% 0.5% 0.0% - 0.1% - 0.7% - 1.5% - 1.9% - 3.1% - 3.4% Compared to the US, Mexico offered 7.8% savings on manufacturing costs for precision components, making it a globally competitive country. Index of savings on electronic systems development and tesdng costs % Source: KPMG, Competitive Alternatives, 2014 U.S. Germany Japan Italy Australia France U.K. Canada Netherlands Mexico 0.0% - 4.6% - 6.4% - 6.7% % % % % % % Compared to the US, Mexico offered 39.3% savings on product testing. Source: KPMG, Competitive Alternatives, 2014

14 1. Pharmaceuticals Business Intelligence Unit 2015

15 Industry Indicators in México 2014 Production 2014 US$11,430 million CAGR % Consumption 2014 US$16,916 million Imports of the pharmaceutical industry US$4,939 million Foreign Direct Investment (FDI) US$3,172 million Main investor countries in the sector United States, Ireland and Spain CAGR % E x p o r t s o f t h e pharmaceutical industry US$1,847 million Companies in Mexico MSD, Boehringer Ingelheim, Schering Plough, Bayer, AstraZeneca, Pfizer and GlaxoSmithKline, among others. Total employees 59,386

16 he Pharmaceutical Industry in Mexico Mexico has become an attractive destination for investment in the pharmaceutical industry due to an improved regulatory framework and to the increase in quality certifications. 20 out of the 25 most important companies worldwide have presence in the country. Mexico is the second largest market in Latin America in the pharmaceutical industry and also an important producer of high-tech drugs.

17 Production and Consumption In 2014, Mexico s pharmaceutical sector produced US $11,430 million. It is expected a CAGR of 8.7% between 2015 and The industry accounted for 2.9 of manufacturing GDP and 0.48% of total GDP, and its added value was 54%. 41.6% of production inputs came from foreing countries. Pharmaceutical Production Forecast (Millions of US dollars) Consumption of pharmaceutical in Mexico reached a value of US$16.9 billion. It is expected to record a CAGR of 8.4 % for the next five years. Pharmaceutical Consumption Forecast (Millions of US dollars) 13,143 13,236 13,656 16,962 12,656 15,857 16,158 15,972 11,430 15, Source: INEGI Source: INEGI yglobal Insight

18 Mexico s International Trade In 2014, Mexico was the leading pharmaceutical exporter in Latin America, with total exports of US$1,847 million. País Main Export Destinations 2014 Millions of US dollars %Part % / United States Switzerland Panama Venezuela Colombia Ecuador Guatemala Brazil Canada France Otros Total 1,874 1,709 1, Main products exported by Mexico: Medicines containing alkaloids or their derivatives Antiserums Drugs containing antibiotics The same year, Mexico imported pharmaceutical products for a total of US $4,939 million. Mexico s main suppliers were United States, Germany and France. Main Suppliers 2014 Country Millions of US dollars % / United States 1,168 1,130 1, Germany France Puerto Rico Switzerland Italy Canada Ireland Belgium Spain Otros 1,175 1, Total 4,985 5,038 4, Source: Global Trade Atlas

19 Main markets of mexican exports of pharmaceutical industry 2014 (mdd) Venezuela 11% Colombia 6% Ecuador 4% Guatemala 4% Panama 11% Switzerland 12% United States 24% Others [PORCENTAJE] France 2% Canada 3% Others 19% Brazil 4% Source: Global Trade Atlas

20 Exports of pharmaceutical industry (mdd) 2,000 1,800 1,600 1,400 1,200 1,000 1,266 1,257 1,225 1,311 1,305 1,274 7% 1,461 15% 1,774 21% 1,874 6% 1,709 1,847 8% 25% 20% 15% 10% 5% % - 3% - 1% - 2% - 9% 0% - 5% - 10% % Source: Global Trade Atlas

21 Imports of pharmaceutical industry (mdd) 6, % 5,000 4,000 3,000 2,000 2,169 2, % 3, % 3, % 19.9% 4,063 3,881 4, % 4, % 4,985 5, % 4, % 20.0% 15.0% 10.0% 5.0% 1, % 1.1% - 2.0% 0.0% - 5.0% % Source: Global Trade Atlas

22 Source: Ministry of Economy *1 st Quarterr Foreign Direct Investment Between 2005 and 2014, the pharmaceutical sector received US$3,172 million of FDI. In 2014, the country received US$174 million of FDI. FDI by country (millions of US dollars) Country FDI United States 1,154 Luxembourg 370 Ireland 369 Germany 364 Spain 234 Others 681 Total 3,172

23 Foreign direct investment The industry requires greater investment in the subsector pharmochemicals, in order to provide inputs and active ingredients for the Mexican pharmaceutical industry. Mexico has become an attractive destination for investment in the pharmaceutical industry due to its wide market and the improved legal framework that protects intellectual property and opens new business niches such as generic drugs and biopharmaceuticals. Spanish companies like Almirall and Genome Systems are interested in investing in Mexico in order to expand its presence in emerging markets. Several companies such as Daiichi Sankyo Pharmaceutical Company and Chiesi have begun operations in Mexico in order to sell their products in the Mexican market and other countries in Latin America

24 Companies There are a total of 718 economic units* in Mexico that specialize in the pharmaceutical industry. Currently, the pharmaceutical sector generates approximately 59,386 jobs. The companies are located mainly in Mexico City, Jalisco, the State of Mexico, Puebla. Economic Units Main companies in Mexico by sales 2014 (Millions of US dollars) Company Country Sales in Mexico 2014 millions of US dollars Bayer de México Germany 1,430 Pfizer USA 876 MSD USA 789 Grupo Novartis México Switzerland 529 State # Economic units Distrito Federal 222 Jalisco 135 Estado México 72 Puebla 33 Morelos 31 Nuevo León 27 Veracruz 26 Querétaro 23 Guanajuato 19 Michoacán 19 Others 130 TOTAL 718 *Includes companies, plants and administrative and sales Source: DENUE, ANFAM and CNN Expansión

25 Companies The mexican pharmaceutical industry stands out because it counts with the presence of 20 out of the 25 largest companies worldwide, but also because its national companies are wellknown for their quality and experience.

26 Costs

27 Thank You Business Intelligence Unit Camino a Santa Teresa No Col. Jardines del Pedregal Del. Álvaro Obregón CP 01900, México, D.F. Tel.: +52 (55)

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