Identification of business opportunities for small and medium-sized Dutch companies in Minas Gerais Commissioned by the Netherlands Enterprise Agency 1 1 INDEX EXECUTIVE SUMMARY .............................................................................................................................. 6 1 Brazilian Health System Overview .................................................................................................... 8 1.1 Health expenditure in Brazil....................................................................................................... 9 1.2 Minas Gerais Brief Overview .................................................................................................... 10 2 Health Sector Value Chain in Minas Gerais .................................................................................... 12 2.1 The Healthcare value chain of Minas Gerais............................................................................ 12 3 Analysis of Stakeholders of Minas Gerais ....................................................................................... 16 3.1 The multiplicity of the biotechnological pole of Minas ........................................................... 16 3.1.1 Anbiotec ............................................................................................................................ 18 3.1.2 Biominas Brasil .................................................................................................................. 18 3.1.3 BiotechTown ..................................................................................................................... 19 3.1.4 CDTN - Nuclear Technology Development Center............................................................ 21 3.1.5 CTIT/UFMG - Technological Transfer and Innovation Coordination ................................ 21 3.1.6 Ezequiel Dias Foundation (Funed) .................................................................................... 23 3.1.7 FIEMG - Federation of Industries of the State of Minas Gerais........................................ 23 3.1.8 SENAI Institute for Chemical Technology ......................................................................... 25 3.1.9 Lab Bio - UFMG Bioengineering Laboratory ..................................................................... 25 4 Opening a healthcare company in Minas Gerais: regulatory aspects ............................................ 26 4.1 Steps to open a foreign company in Brazil............................................................................... 26 4.2 From Federal to Regional Level................................................................................................ 27 5 Regulatory aspects for the exercise of health services in Brazil..................................................... 29 5.1 State and Municipal Health Surveillance ................................................................................. 29 5.2 National Health Surveillance Agency - ANVISA ........................................................................ 29 5.3 Registration Routes in Brazil .................................................................................................... 30 Market Study - Identification of business opportunities for small and medium-sized Dutch companies in Minas Gerais, Biominas Brasil & NBSO Brazil Belo Horizonte, 2020. 2 5.4 Good Manufacturing Practices................................................................................................. 31 5.5 INMETRO certification requirements....................................................................................... 31 5.6 Summarizing the regulatory issue............................................................................................ 31 6 PEST Analysis of the health sector in Minas Gerais ........................................................................ 32 6.1 Political Factors ........................................................................................................................ 32 6.2 Economic Factors ..................................................................................................................... 33 6.3 Social Factors............................................................................................................................ 34 6.4 Technological Factors ............................................................................................................... 35 7 Market Entry Analysis: custom duties and import procedures ...................................................... 38 7.1 Imports of health products: tax charges .................................................................................. 38 7.2 Protocols to import health care products in Brazil .................................................................. 40 8 List of Life Sciences and Health companies from Minas Gerais for potential sales and/or distribution channels, aligned with the opportunities identified and the Supplier Analysis of Netherlands............................................................................................................................................. 43 8.1 Potential Brazilian companies importing Dutch products ....................................................... 45 8.1.1 List of companies – segment A – Public Health ................................................................ 49 8.1.2 List of companies – segment B – Hospital Build ............................................................... 61 8.1.3 List of companies – segment C – Medical Devices & Commodities ................................. 70 8.1.4 List of companies – segment D – Mobility & Vitality ...................................................... 131 8.1.5 List of companies – segment E – Product Development & High Tech............................ 143 8.1.6 List of companies – segment F – Pharma & Biotechnology............................................ 170 9 Challenges and opportunities analysis ......................................................................................... 179 9.1 Opportunities ......................................................................................................................... 180 9.1.1 Prevention treatment ..................................................................................................... 180 9.1.2 E-health ........................................................................................................................... 180 9.1.3 Ageing Population ........................................................................................................... 182 9.1.4 Long-Term Care (LTC)...................................................................................................... 185 Market Study - Identification of business opportunities for small and medium-sized Dutch companies in Minas Gerais, Biominas Brasil & NBSO Brazil Belo Horizonte, 2020. 3 9.2 Strengths ................................................................................................................................ 187 9.2.1 Foreign Investment authorization .................................................................................. 187 9.2.2 Private Hospitals ............................................................................................................. 189 9.2.3 Telehealth ....................................................................................................................... 190 9.3 Weaknesses ............................................................................................................................ 193 9.3.1 Foreign trade obstacles................................................................................................... 193 9.3.2 Tax issues ........................................................................................................................ 194 9.3.3 Rural Health .................................................................................................................... 194 9.4 Threats.................................................................................................................................... 196 9.4.1 Economic Crises .............................................................................................................. 196 9.4.2 Shortage of doctors......................................................................................................... 197 10 Potential synergies between Holland and Brazil .......................................................................... 198 10.1 An overview of the Dutch health system ............................................................................... 199 10.2 Aligning LSH's strategic planning with the opportunities in Minas Gerais ............................ 200 10.3 Digital Healthcare ................................................................................................................... 202 10.4 Binational technology opportunities ..................................................................................... 202 10.5 Financing opportunities for Dutch companies....................................................................... 203 10.6 The accelerated verticalization process in Minas Gerais ....................................................... 206 11 Conclusion and recommendations ............................................................................................... 209 REFERENCES .........................................................................................................................................