THE CORPORATE REPUTATION OF THE MEDICAL-DEVICE INDUSTRY IN THE PERSPECTIVE OF 582 PATIENT GROUPS WORLDWIDE (5TH EDITION)

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1 1 P a g e o f 9 THE CORPORATE REPUTATION OF THE MEDICAL-DEVICE INDUSTRY IN THE PERSPECTIVE OF 582 PATIENT GROUPS WORLDWIDE (5TH EDITION) Report published by PatientView Contact: Alex Wyke Tel: +44-(0) report@patient-view.com Website: Embargo date: 6AM GMT Tuesday, September 20th, 2016

2 2 P a g e o f 9 Press Release Publication date: Tuesday, September 20th, 2016 Results drawn from survey conducted: June-August Feedback from the patient groups surveyed: 582 patient groups, covering a wide range of specialties, from 62 countries. Industry analyses: compared with other healthcare sectors, assessed for a wide range of activities, and for different geographic areas. Company analysis: 33 medical-device companies analysed on 7 indicators of corporate reputation (one of the indicators, 'effectiveness of patient-group relations', is brand new for ). Companies are also compared within 12 different therapy/device areas. Over 150 patient-group comments, providing guidance to industry about how to be more patient centric. Three leading medical-device companies B. Braun, Coloplast, and ConvaTec tell their own story about their patient-centric strategies, and about their activities in the field of patient-group relations during Companies analysed: 3M Healthcare I Abbott Laboratories I Alcon I B. Braun Melsungen AG I Bausch + Lomb I Baxter International I BD (Becton, Dickinson and Company) I Biotronik International I Boston Scientific I Coloplast A/S I ConvaTec I Dansac I Fresenius Medical Care I GE Healthcare I Hartmann Group I Hitachi I Hollister I Invacare I Johnson & Johnson I Medtronic I Mölnlycke Health Care I Novo Nordisk A/S I Olympus Medical Business I Omron I Ortho Clinical Diagnostics I Philips Healthcare I Roche Diagnostics I Sanofi I Siemens Healthcare I Smith & Nephew I St Jude Medical I Stryker I Toshiba Medical Systems Corporation Report length: 124 pages. The medical-device industry s performance at corporate reputation is assessed by 3 types of measure: The 7 indicators of corporate reputation used to assess the 33 medical-device companies: 1. How the medical-device industry s corporate reputation compares with that of other healthcare industries. 2. How the medical-device industry s corporate reputation has changed over the past five years. 3. How good or bad the medical-device industry is at various activities of relevance to patients and patient groups. 1. Patient centricity. 2. Patient information. 3. Patient safety. 4. Useful products. 5. Transparency. 6. Integrity. 7. Effectiveness of patient-group relations (NEW for ).

3 3 P a g e o f 9 INDUSTRY-WIDE FINDINGS The 582 patient groups worldwide responding to the June-August 2016 survey on the Corporate Reputation of the Medical-Device Industry were more positive about the industry s corporate reputation than patient groups in any of the previous four annual surveys. The main reason for the increased approval from patient groups appears to be the industry s technological success. However, in some parts of the world, the industry is not held in such high regard. Product recalls, issues of patient safety, regulatory quarrels, as well as questionable corporate behaviour, are all raised as concerns by some respondent patient groups. THE POSITIVE FEEDBACK: The medical-device industry's corporate reputation stands, in , at its best since 2011 (when PatientView first began surveying to discover the industry's corporate reputation). 62% of the 582 patient groups responding to the Corporate Reputation of Medical-Device Companies survey stated that the industry, as a whole, had an Excellent or Good corporate reputation over the course of that year ranking the industry 2nd out of 8 healthcare sectors (ahead of private healthcare, notfor-profit and for-profit health insurers, biotech, generics, and pharma). Among patient groups, only retail pharmacy had a higher corporate reputation than medical devices in However, levels of approval for the medical-device industry varied across different countries/regions [see chart below]. The corporate reputation of the medical-device industry from the perspective of patient groups, % of respondent patient groups stating Excellent or Good How do you think your organisation s members (or the people you represent) would rate the corporate reputation of the medical-device industry in ? % of patient groups (from 13 regions of the world) respondent to the survey, stating Excellent or Good The main reason given by respondent patient groups for the positive feedback about the medical-device industry in was its ability to produce high-quality products of value to patients. As many as 75% of the 582 patient groups responding to the survey stated that the medical-device industry as a whole was Excellent or Good during the year at producing high-quality products.

4 4 P a g e o f 9 BUT... THE NEGATIVE FEEDBACK: As many as 78% of the 582 patient groups surveyed believed the industry Fair or Poor at instigating fair pricing policies. 77% of the 582 patient groups believed the industry Fair or Poor at being philanthropic. 65% of the 582 patient groups believed the industry Fair or Poor at having integrity. Again, the strength of feeling on these three issues varies worldwide. The percentage of patient groups from 13 different countries/regions stating that the medical-device industry is Fair or Poor at: having fair pricing policies at having integrity and at being philanthropic. % of patient groups within each country/region responding to the survey (numbers of respondent patient groups are in brackets) One of the 150 patient-group quotes in the report from a national, Portugal-based, public-health organisation Below are our demands in this field: All medical devices on the market must have a positive benefit/risk ratio, and bring therapeutic benefit to patients. Manufacturers should be required to produce more and better clinical data, and, whenever possible, conduct randomised controlled trials to demonstrate that a medical device is safe and effective before being placed on the market. Bring more clarity with regard to clinical evidence. Authorisation of a clinical investigation should be subject to the opinion of an independent ethics committee. All clinical investigations should be registered, and all results made public. A centralised pre-market assessment should be established for a limited number of high-risk devices, and be entrusted to a new medical-devices committee within the European Medicines Agency (EMA). Special precaution is needed for medical devices containing hazardous chemicals and nanoparticles. The functioning of notified bodies must be improved, with a view to promoting specialisation and excellence... [quote continues]."

5 5 P a g e o f 9 HOW CAN THE MEDICAL-DEVICE INDUSTRY IMPROVE ITS CORPORATE REPUTATION? Patient groups want the medical-device industry to be patient centred. They want new, useful products that are safe. And they also want these new medical devices to be made available at affordable prices. What do such requests mean in practice? The patient-group comments show that patients need: Greater personalization of healthcare products. Medical-device companies to be continuously innovative. And patient groups want to be involved in innovation from cocreation to post-marketing surveillance. Quote from a regional patient group, based in the United States, specialising in respiratory conditions Our genes are in test-tubes, working to solve the problem at the deepest levels.

6 6 P a g e o f 9 HOW COMPANIES PERFORMED ConvaTec, which manufactures ostomy and continence products, is ranked overall 1st out of 33 medical-device companies for corporate reputation by patient groups in The company ranked 5th out of 28 medical-device companies in the previous year, This is the first time that ConvaTec has been rated by respondent patient groups to have reached the overall top slot in the corporate-reputation league table of medical-device companies. Boston Scientific, which manufactures a wide range of medical devices (including those for women s and men s health), is ranked overall 2nd for corporate reputation by patient groups in Boston Scientific jumped to its 2nd place in from a position of 12th out of 28 medical-device companies in The company's biggest leap in corporate reputation, as rated by patient groups, is for the provision of high-quality products. Boston Scientific's results for corporate reputation among patient groups interestingly parallel the company's improving financial prospects. After a period of financial decline ended in 2013, Boston reversed its financial fortunes and shored up its R&D portfolio. A major priority for patient groups is for a medical-device company to produce useful, high-quality products. Rankings of the 33 medical-device companies in HIGHEST TO LOWEST Novo Nordisk, a manufacturer of insulin-delivery systems, is ranked overall 3rd for corporate reputation by patient groups in The company ranked 6th in Novo Nordisk s biggest increase in corporate reputation among patient groups was for patient safety. Coloplast, which (like ConvaTec) manufactures ostomy and continence products, has dominated the top position of this league table in previous surveys, and is now ranked overall 4th for corporate reputation by patient groups in The company continues to be 1st in in two of the seven indicators of corporate reputation: patient centricity, and the brand-new corporate-reputation indicator of patient-group relations.

7 7 P a g e o f 9 Hollister, another ostomy supplier (and included in this survey for the first time) is ranked overall 5th for corporate reputation by patient groups in One segment of the respondent patient groups the 19 patient groups specialising in gastrointestinal conditions and familiar with Hollister rated the company 1st for overall corporate reputation, when compared with other suppliers of ostomy products. About the companies that seem to do BEST in the corporate-reputation league table of medical-device companies CONTINENCE/OSTOMY MANUFACTURERS: During the five years that this survey has been undertaken, companies manufacturing continence and ostomy products have dominated the top tier of the corporate-reputation league table. In fact, in , continence/ostomy companies took 1st place for six of the seven indicators of corporate reputation mostly due to approbation received from cancer, gastrointestinal, and urological patient groups. Patients who use continence and ostomy products are grateful of the benefits brought by the devices. Not only do continence/ostomy products improve the quality of life by enabling independent living, they also reduce the stigma often felt by patients with these conditions. In addition, continence/ostomy manufacturers involve patients closely in product design, and, thus, are seen as more patient oriented than many other types of device manufacturer. B. Braun is a continence/ostomy manufacturer, but its

8 8 P a g e o f 9 product portfolio includes other therapy areas. B. Braun is ranked a respectable overall 12th out of 33 companies in , according to patient groups familiar with the company. This slightly lower positioning, compared with the other suppliers of continence/ostomy products, shows that patients and patient groups appear to value specialization in a medical-device company. About the companies that seem to do POOREST in the corporate-reputation league table of medicaldevice companies LARGE MEDICAL-IMAGING CONGLOMERATES: The medical-device divisions of large, well-known, industrial conglomerates, such as GE, Hitachi, Philips, Siemens, and Toshiba, consistently sit in the lower half of the corporate-reputation league table, as rated by patient groups. Their situation has hardly changed since PatientView first started conducting its corporate-reputation surveys back in The two medical-imaging companies with the best corporate reputations among patient groups in are GE Healthcare (up to 20th position overall from 28th in ), and Philips Healthcare, at 17th overall (Philips' higher positioning is partly due to the company's decision to dispose of its lighting business in 2014, and focus on healthcare). Three major factors drag down the corporate reputation of manufacturers of major diagnostic machinery: a lack of familiarity with them [brand awareness] among patients; a confusion about what the degree of the company's involvement in healthcare; and high-profile patient-safety issues. Profiles of the 582 patient groups participating in the survey % of total

9 9 P a g e o f 9 END OF PRESS RELEASE PatientView is a UK-based research organisation that consults closely with patient groups, and publishes their feedback on important healthcare issues