Swiss Medtech Report.
CONTENT
3 INTRODUCTION
6 INvENTION
From the laboratory to the marketplace Patents – sound basis for negotiation Creating a culture of innovation
10 PRODUCT DEvElOPMENT
Ingredients for a successful product creation process Medtech design – bring life to the innovation process!
14 MaNUfaCTURINg
Manufacturing – precision is our specialty Additive manufacturing – the magic formula for success
18 MaRkETINg & MaRkET aCCESS
From product sellers to solution providers The market counts
2 2 REgUlaTION & HEalTHCaRE
Navigating the regulatory jungle Between quality demands and cost pressures
2 6 fUNDINg & fINaNCINg
3 0 faCTS & fIgURES
The Swiss medical technology industry Swiss Industry Guide
INTRODUCTION
Switzerland, like many other industrialized countries, is facing big challenges in healthcare. Under the current economic and demographic framework Switzerland must guarantee that its population have access to an optimal healthcare system both now and in the future. Even in Switzerland the rapid increase in healthcare expenditures requires measures for sustainable funding of medical care. Due to a careful financial and expenditure policy and stable economic growth, Switzerland has until now been able to secure enough funding to ensure that its whole population has access to one of the leading international health systems. In the next few years, however, Switzerland will hardly be able to escape the economic turbulence endemic in the rest of Europe and in the long term, the resulting demographic changes which will occur as a result. With both economic and demographic changes unfolding, a higher level of strain on the health system can be expected. In this changing environment it is essential to improve the overall efficiency of the health system which can be achieved in part through medical technology. Efficient cutting edge medical technologies offer patients and doctors new solutions
which increase the standard of care, reduce costs and increase domestic exports. Based on its industrial heritage particularly from the watch and machine industry, Switzerland has acquired decades of knowledge in the areas of precision mechanics and materials and electronics. Combined with the high standard of university research and medical training, the inventive talent and entrepreneurship of often family-managed businesses has burgeoned an attractive environment for both the Swiss medical technology industry and foreign investors. A tight network of training, research institutes, suppliers, manufacturers, distributors, specialized service providers and leading hospitals ensure that innovative solutions are found which help to significantly increase efficiency in healthcare. Therefore, I am confident that we will succeed in overcoming the challenges we will face in future years. A strong Swiss medical technology industry can contribute to ensuring access to healthcare services for a growing percentage of the Swiss and global population. Federal Councillor Johann N. Schneider-Ammann, Director of the Federal Department of Economic Affairs
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INTRODUCTION
The Commission for Technology and Innovation (CTI) is the federal agency responsible for encouraging innovation through the provision of funding, consulting and networks. It also works to ensure that scientific research contributes to economic growth. CTI supports innovation within the Swiss economy for the Swiss economy.
In addition every year 10 to 20 medtech start-up companies are enrolled in the CTI Start-up and Entrepreneurship program. These activities are further complemented by the CTI Voucher program, introduced in July 2011 at the initiative of the Federal Council. As part of this pilot project vouchers were issued in 2011 to five medtech companies.
CTI offers companies a wide range of continuing education and training options as well as coaching. It also provides funding for R&D projects conducted by companies and higher education institutions working as partners. In addition, CTI networks and platforms enable optimal knowledge and technology transfer. CTI support accelerates the process of transforming research findings into marketable products and services. It also helps companies to improve their innovation capacities, achieve greater added value and create new, high-value jobs.
In late 2011, the Federal Council launched a special innovation program: CHF 100 million in additional funding granted to CTI to counteract the effects of the strong franc. This was also a great success for the medtech sector. 35 additional projects could be realized starting January 1, 2012, with federal support totalling CHF 15 million and industrial matching funds of more than CHF 20 million. Every year CTI hosts its Medtech Event, which brings together the knowledge and expertise of the Swiss medtech sector and provides a platform for connecting people.
In order to support innovation and competiveness in the Swiss medtech sector and to stimulate the transfer of knowledge between centers of higher education, medtech firms, start-ups and SMEs the CTI Medtech initiative was launched in 1997.
It is our pleasure to support and take part in this Swiss Medtech Report, which introduces you to one of the most innovative sectors in the Swiss economy.
Today CTI Medtech is acting as part of the CTI Life Sciences program and has been supporting up to 35 medtech projects annually. These are characterized by significant investments of the collaborating economic partners.
Lutz Nolte Head CTI Medtech Contact: life.sciences@kti.admin.ch
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INNOvaTIONs FORIMTECH SA is a leading developer of new generation intra-operative probes using novel particle detection techniques. FORIMTECH’s probes are used by surgeons during an operation to quickly locate cancer tumors, metastases or sentinel lymph nodes labelled with radiopharmaceuticals and remove them with minimal impact to surrounding healthy tissues. The primary advantages of FORIMTECH’s products are cost, precision, compactness, ease-of-use and disposability.
FORIMTECH SA Gold Sponsor of the Swiss Medtech Report 2012 5
Invention
Product Development
Manufacturing
Marketing & Market Access
Regulation & Healthcare
Funding & Financing
Facts & Figures
From the laboratory to the marketplace Though Switzerland is a small country it produces a high volume of cutting edge research and innovative medical therapies. By building active collaborations across multiple disciplines the Swiss medtech industry exploits its intellectual resources to produce maximum innovation potential. C O R E s T R E N GT H s Many groundbreaking innovations happen at the interface between engineering, medicine and biology. To make optimal use of synergies, the ETHZ founded the Department Health Sciences and Technology (D-HEST) in January 2012 to combine teaching and research in health sciences and medical engineering. Natural scientists and engineers work together in food and nutrition science, medical engineering, movement and sports sciences and neurosciences. The focal area ‘Technology and Knowledge for Health’ will be promoted during 2012–2016 with the transfer of these topics to hospitals being the final goal. B R a I N M E E T s T E C H N O LO GY At the EPFL in the Laboratory of Cognitive Neuroscience, a multidisciplinary team of biologists, psychologists, medical doctors, physicists, engineers and computer scientists, are investigating the functional and neural mechanisms of body perception, corporeal awareness and self-consciousness. They combine psychophysical and cognitive paradigms with state-of-theart neuroimaging techniques. The goals are to develop neuroscientific models of body perception, corporeal awareness and self-consciousness by linking complex phenomenological experience of body and self to brain mechanisms of multisensory corporeal perception.
The Blue Brain Project, a co-operation with IBM, where researchers reconstructed the brain piece by piece to build a complete virtual brain in a supercomputer, achieved worldwide recognition. After five years of work, the team can create realistic models of processes within the human brain. At IBM Research Zurich, scientists pursue exploratory and applied research to pave the way for future innovations in IT. They collaboratively work on 6
projects to tackle some of the bigger challenges on our planet. The experimental biosciences team applies their expertise in micro and nanotechnologies to solve problems in biology, medicine and life sciences. For instance the team has developed a flexible, non-contact microfluidic probe made from silicon which serves as a unique tool to help researchers and pathologists in investigating critical tissue samples accurately for disease diagnostics and drug discovery. The eight-millimeter-wide, diamond-shaped probe delivers an antibody in a highly specific area of a tissue. A few picoliters – one trillionth of a liter – of liquid containing antibodies is sufficient for each analysis spot. The CSEM is at the interface between research and industry. Specialized in micro and nanotechnology, system engineering, microelectronics and communication technologies, its scientists and engineers transfer custom-made innovative solutions to industry. Transfer examples are portable human vital signs monitoring systems, point-of-care systems for multi-parameter biochemical monitoring or miniaturized sensing, processing and packaging, and wireless communication technologies to serve the needs of a non-invasive and mobile healthcare service. Product concepts for disabled people, such as artificial retinas, hearing aids and ambient assisted living-related smart sensors, are increasing in demand. Future trends are the integration of human vital signs monitors and biochemical data for mobile health services, as well as implantable devices with neurostimulation. Emphasis is placed on mental and neurological disease monitoring and artificial organs, such as the artificial kidney, developed within the European project Nephron. C LO s E T O C U s T O M E R s Besides education and training, listening closely to SMEs and deliv-
ering the solutions they need to run their business more efficiently is the task of the Universities of Applied Sciences. The R&D projects depend on intensive cooperation between physicians, engineers and computer scientists and create the framework for many interdisciplinary works for bachelors or masters degree students. A good example is the Institute for Human Centered Engineering, HUCE, whose research groups combine new technologies in close cooperation with industry and hospitals to create innovative products such as a complete recording
system that measures ECG signals from inside the esophagus close to the heart. To support both the cooperation with the private sector and the commercialization of research results, the Swiss universities set up the Swiss Technology Transfer Association, or SWITT. In Switzerland which is a country poor in natural resources, it has become clear that intellectual advancements and teamwork create the success of the Swiss medtech industry.
Patents – sound basis for negotiation Medical technology developments present patent agents with a challenge as they differ from other technical domains. The particularities have to be known and taken into account when drafting a patent application, rather than dealing with them later in a legal wrangle. E s s E N T I a L D I F F E R E N C E s Medical technology was named the ‘top technical field’ in 2011 with 9,351 European patent applications filed, and Switzerland ranking third in Europe in terms of absolute number of filings. This year, however, there is a decrease of 5.9% of granted patents published compared with the previous year. Just because an invention is technically and creatively possible does not necessarily mean that it is patentable. The development has to be new and satisfy a long-term need or overcome a prejudice of the experts in the field. It has to be suitable for commercial application, offer an economic or ecologic solution or stand out from the grey average with an excellent concept and an innovative approach. Candidates for a patent are for instance devices for surgery, diagnosis and therapy. Excluded from patentability are medical treatments, diagnosis and therapies for the human or animal body. A patent is a ‘negative protection’ in the sense that it prevents others from using our invention for commercial purposes, for instance for manufacturing or selling products with the same or similar features. The claims – written statements – are part of the patent application and define what the invention is and what it can do. P R O T E C T I v E s H I E L D ? It’s true that a patent
can give protection against plagiarism and the theft of ideas by competitors making it a useful tool for technologies sales over the longer term. However, in a rapidly changing technological environment where an invention becomes obsolete within 1 or 2 years, when it is difficult to copy or when the patent is vulnerable, it should consider whether a patent is the best solution. Today, the Asian markets are the focus of much intellectual property (IP) attention. “For the Asiatic regions, obtaining a patent is
extremely important,” states Dr. Peter Felder, European Patent Attorney with expertise in medical device technology. “The life of a patent is 20 years, calculated from the date of its filing. Therefore, the patent protection should not be neglected with the argument that Asian manufacturers disregard protection rights. In China IP rights, for instance, can also be enforced. We detect a positive trend in this area.” More importantly, the number of patent applications filed by Chinese companies in China shows an enormous increase. “To operate successfully in the Chinese market, a proactive patent strategy is indispensable,” comments Felder, who also lectures at the University of Zurich on the subject of protection of intellectual property. “Such a patent strategy includes not only the registration of property rights, but also the monitoring and – if necessary – the intervention against patent applications of competitors.” C L E v E R I D E a s If the Swiss medical technology industry wants to be a leading global player in the future, it needs efficient structures to transfer the newest research results into pioneering products and services to achieve maximum market success. Such an institution is Unitectra, the technology transfer organization of the Universities of Basel, Berne and Zurich. They support scientists in their collaboration with private industry and other public or private research institutions. As a non-profit company they offer researchers a helping hand in the protection and management of intellectual property and other related services. Only with a continuous flow of fresh and unconventional ideas can successful concepts for the future be created, and the high quality be constantly improved. 7
Creating a culture of innovation Switzerland is a country poor in natural resources but rich in intellectual assets. Dependent on the export of intelligent and sophisticated technologies, Switzerland has become one of the major global players in the creation of solution-driven products and techniques in the medical technologies sector. s M a L L – s M a R T – s W I T Z E R L a N D Be canny and flexible and adapt yourself quickly to a changing environment. This philosophy has been the motto for Swiss industry since 1541, when the influential French theologian and pastor Jean Calvin demonized the wearing of jewelry. In response to this change the highly skilled Swiss goldsmiths and jewelers rolled up their sleeves and concentrated their expert knowledge on watch-making. By the end of the century their precise, reliable and highquality watches were famous all across Europe.
Today about 51,000 people put their knowledge and commitment into high quality, precision, and reliability in the medical technology sector. With roughly 880 medical technology manufacturing and supply companies contributing, Switzerland maintains the highest density of medtech enterprises per capita in the world. In the fields of implants, hearing aids, diagnostics, laboratory instruments, and systems for minimally invasive surgery and surgical navigation, Swiss companies continue to provide cutting edge technologies which drive global innovation. The recipe for Switzerland’s success is in part due to the high level of expertise and skills endemic in the industry. Supported by a blooming medtech infrastructure which links and supports industry players across the whole value chain, Swiss medtech companies have access to the industry partners and resources they need in order to grow. In manufacturing for instance, novel developments and high precision, high-quality design are supported by integration into the value chain network through collaborations with research institutions and universities, strong connections to quality-driven Swiss suppliers, and orchestrated access to purchasers. By working as a team, industry players can have fast feedback from customers, accelerate new research concepts and integrate corresponding changes to efficiently improve product design, sales, and business activities.
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F E D E R a L F U N D I N G To promote and support innovation, two public funding programs exist. The Swiss National Science Foundation (SNFS) is the major funding body for scientific research in Switzerland. Established and funded by the Swiss federal government, SNFS provides grant money to all scientific disciplines ranging from philosophy and biology to nanotechnology and medicine. Since 2001, SNFS has supported the second major funding body for technology in Switzerland, the National Centers of Competence in Research (NCCR). NCCR sponsor programs with a technology innovation focus such as the “CO-ME – Computer Aided and Image Guided Medical Interventions” project. CO-ME is focused on improving surgical navigation and imaging technologies through funding research which leads to less invasive surgery techniques, increased accuracy of a technique, advanced simulation tools for preoperational planning, and novel therapeutic approaches. CO-ME researchers work closely with surgeons and medical practitioners to fine tune instruments and bring them rapidly to market. To date, the NCCR have generated three medical technology centers at ETH Zurich and at the Universities of Berne and Basel, to continue the collaboration after the conclusion of the NCCR. s U P P O R T The Commission for Technology and
Innovation (CTI) is the Swiss Confederation’s innovation promotion agency. CTI supports marketoriented R&D projects and entrepreneurship, as well as development funding for start-up companies. In 1997, the CTI launched its medtech initiative which grants funding to collaboration projects between the universities and industry. Since CTI’s initiation 340 medtech projects have been funded and every year 10–20 medtech start-ups have enrolled in our program.
CENDREs+MéTaUx sa Cendres+Métaux, a midsized company located in Biel, produces micromechanical components from high-quality materials characterized by a high level of purity, homogeneity and Swiss precision. Since its foundation in 1885, Cendres+Métaux has built up considerable know-how in the processing of small parts made from titanium, precious metal alloys or high-performance polymers. In August 2011, the company’s most current product development, a novel bone-anchored port for hemodialysis, was nominated for the CTI Medtech Award, one of the most significant awards in the industry.
Cendres+Métaux SA Gold Sponsor of the Swiss Medtech Report 2012 9
Invention
Product Development p
Manufacturing
Marketing & Market Access
Regulation & Healthcare
Funding & Financing
Facts & Figures
Ingredients for a successful product creation process Modern Switzerland still boasts the spirit of the 16th century watchmakers through the nurturing and continued growth of its highquality, high-precision medical technologies sector. With innovation and cutting edge technologies as the cornerstone for its competitive edge, Swiss medtech will likely remain one of the global leaders in medtech. C O N T R aC T I N G Across the globe medical technology companies are encountering challenges of increasing intensity. New emerging technologies, increasing specialization and high interfaculty, continuously changing regulations, and growing competition, all contribute to the industry’s high-impact and high-risk business climate. Staying at the cutting edge of medical technology calls for innovative, unconventional ideas with a multidisciplinary approach. Managing these current challenges individually is virtually impossible which is why successful companies seek expert help with cooperation networks of independent engineering contractors, medical and regulatory consultants, ergonomists, industrial designers, technology providers, and manufacturing partners in order to develop products and processes which satisfy actual customer needs.
Young, dynamic start-up companies rarely have the infrastructure or the personal resources to build up the development capabilities and quality management processes required to realize an innovative medical product in a timely manner. Medtech or pharmaceutical companies who sell diagnostic or therapeutic products where a medical device is an instrument for selling the drug or reagent must find a contract partner to develop the device as the device is not part of their core business. Characteristic of medical technology is the particularly long engineering, development, and clinical testing/ validation times which for a new generation product can take 3 to 7 years or even longer. As such, partnering with another company who can provide expertise can reduce cost and increase efficiency. s I N G L E s O U R C E Another difficulty often en-
countered is having enough specialists at hand dur10
ing each phase of product development as the creative minds you need in the beginning of a process are not always the experts required in the final phase. It is virtually impossible that one single person has all the talents necessary to implement innovation which include the roles of researchers, engineers, business and finance expertise, and an entrepreneurial spirit. In order to overcome these deficits, a medtech company can take advantage of the cross-sectional and interdisciplinary knowledge of an independent consultancy in order to increase its innovation capabilities for new developments. Such solution providers understand how the right ingredients come together to create a marketable innovation cocktail through the creation of a development team with project managers, creative innovators and expert engineers who are able to implement visionary ideas swiftly and successfully. Experience has shown that investment in an expert team quickly pays off. Important for the success of a product is the implementation of precision, quality and innovation in the development process. Today, medical regulations require stringent project management which requires companies to produce detailed information on their development processes and demonstrate proof of design control, traceability, and risk management. The best way to stay on target is through a step by step procedure based on specialization and networked, interdisciplinary thinking. In the design and engineering phase, an experienced engineering team on board from the very start can save a lot of money and time by avoiding design short-falls and adapting the medical device design for manufacturability and optimal assembly. An adequate product housing developed by a dedicated industrial design firm additionally serves as a business card and re-
flects the product language and corporate spirit of a company. The next strategically valuable step is to test the design with a prototype of the device which can considerably reduce the time-to-market. In short, the development stages which bring a device from the initial prototype to the manufacturing stages include concept, design and testing. Last is the manufacturing of a pilot series and finally, when all the bugs have been worked out, the device enters production. sUCCEssFUL
PRODUCT
s T R aT E GY
The subsequent validation of the processes, tools, and clinical assessment involved in a device help ensure that the development process obtains the desired results in the production process. A manufacturing company can expect the full support of the engineering partner for a seamless transfer from the development to the production phase. Throughout the whole development and completion process the responsible experts will continually inspect the product quality. It’s a tricky task to find the right product development strategy as it varies accordingly to the defined project and the applied technology. Whatever the type of strategy that is applied, however, there are
six sticking points which must be considered: 1. the time to market, as the gap between product development and market launch has to be as short as possible, 2. the cost of goods and manufacturing, as the product will be developed according to its lowest cost or its highest value, 3. the low development cost, or developing the product at its minimal cost, 4. product performance, technology and innovation, as the product has to comply with the strictest requirements both in terms of its function and its effectiveness, 5. quality, reliability and robustness, which satisfies customer needs, and 6. service, responsiveness and flexibility, which support good customer service practices. Medical technology is a unique industry in that no other industrial domain is as strictly regulated. Due to eventual use of a device on humans it goes without saying that safety and reliability must have the highest priority. Innovation requires creativity but comes with risk. Often the best products and solutions appear where a development team is given free rein to creative ideas at a very early stage in development with minimal ideological, bureaucratic, hierarchal, and administrative blocks or simply the fear of new things.
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Medtech design – bring life to the innovation process! In medical technology, product design sensibilities are heightened. Generally patients are stressed by medical procedures and unfamiliar instruments. To make their experience as pleasant as possible, the design of a medical product should be considered from the beginning of the development process. T R a N s L aT I N G
IDEas
INTO
DEsIGN
Emotion is the magic word of Britta Pukall and Therese Naef, the creative spirits at Milani Design & Consulting AG. From the beginning, when Francesco Milani created the unique white-blue product language for the Dräger Company, design for medical equipment has been a favorite focus. Today, medical technology and investment goods make up about 60% of the agency’s portfolio. For owner-manager Britta, medical technology is a challenge: “We create very simple solutions for complex tasks.” With this in mind, the Milani group does not focus on one single product, but tries to understand the client company in its entirety, to work out and to visualize its personality. “The exciting thing is not to modify the shape, but to evolve the idea behind it, to tell a story,” Naef notes. “That way, the company becomes understandable and tangible.” The company Meyer-Hayoz Design Engineering AG stands for strategic and market-oriented solutions in complex design processes in medical technology and high-tech industry. This is ensured by the target-oriented deployment of the five core competences of the enterprise: design strategy, industrial design, user interface design, temporary architecture, and communication design.
In a world which is becoming more virtual in so many areas, tangible design qualities which are advantageously based on design synergies and which integrate the corporate culture aspect as an ambassador are the best investment for building up and cementing sustainable confidence in a brand. As such, a strategic value design approach is of crucial importance for economic success. When companies consult Erdmann Design, they do not ask to make a developed idea more attractive to costumers but instead want to create ideas that better meet consumer needs. This is a strategy that leads to dramatically new forms of value. “We involve individuals from three environments in design thinking,” states Raimund Erdmann. “Market environment research as the playground for new product innovations, professional environment research where ideas are tried out, mistakes are made and the knowledge gained is quickly fed into a design solution, and social environment research, where we grasp ideas from different user groups with specific needs.” Being invited to imagine the future and to feed information and ideas into the design process allows Erdmann Design to craft new solutions. By integrating design thinking into the corporate culture of a company, employees become part of the innovation process and bring life to it on a daily basis.
Institutions which might be of interest to you
Creaholic
Helbling Technik Bern AG
2503 Biel www.creaholic.com
3097 Liebefeld-Bern www.helbling.ch
Empa
HELVETING AG
8600 Dübendorf www.empa.ch
6331 Hünenberg www.helveting.com
Forimtech SA
Meyer-Hayoz Design Engineering AG
1208 Genève www.forimtech.ch
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www.meyer-hayoz.com
Erdmann Design AG
Noser Engineering AG
5200 Brugg www.erdmann.ch
6039 Root www.noser.com
Gsell Medical Plastics AG
Sonceboz SA
5630 Muri AG www.gsell.ch
2605 Sonceboz www.sonceboz.com
sURFaCE TECHNOLOGY KKS Ultraschall AG was founded in 1982 with the vision to develop and manufacture ultrasonic generators and transducer systems. The continuous development over 30 years led to a company which is developing and producing innovative cleaning and surface treatment equipment for the medical industry. Today KKS also operates a Medical Surface Center where several thousands of surgical implants and instruments get treated daily.
KKS Ultraschall AG Gold Sponsor of the Swiss Medtech Report 2012 13
Invention
Product Development
Manufacturing
Marketing & Market Access
Regulation & Healthcare
Funding & Financing
Facts & Figures
Manufacturing – precision is our specialty Switzerland’s open economy is highly competitive and is known across the globe for producing a number of high-quality products. The success of its medical technologies sector relies on a highly skilled workforce and its dedication to precision. Realizing productivity gains helps the industry to counterbalance the effects of the global financial crisis in major Swiss export markets O U T D O I N G T H E C O M P E T I T I O N In 2010,
the World Economic Forum in Davos ranked Switzerland as the most competitive country in the world and the most innovative country in Europe. Switzerland offers one of the most stable economies in the world which is in part based on its highly qualified work force. A skilled labor force helps the Swiss medtech manufacturers maintain a competitive edge and acts as a magnet for foreign investment. Despite the high cost of living and high wages, companies often relocate their international or European headquarters to Switzerland and build up major plants or research & development activities. Switzerland is in the top ten list for medical manufacturing companies and is home to many medtech giants such as the US-based Johnson&Johnson Medical, Zimmer, Medtronic, Stryker and B. Braun. The reason for the success of the medtech industry in Switzerland is multi-faced and was recently investigated by the Swiss Medical Technology Industry (SMTI) survey. One of the primary findings of the SMTI was that much of the medtech industry’s success was due to access to a highly skilled workforce.
Switzerland’s highly educated work force stems from the demanding professional and university education in the dual education system which combines apprenticeship in a company with vocational education at a University of Applied Sciences, leading to advanced education in medical technology, mechanics, precision machining and general engineering expertise. The excellent engineering schools and the variability in education and training result in a group of young trainees who are motivated, full of curiosity and ready to break new ground. This outcome is reflected in the number of patent applica14
tions and a growing number of medtech start-up companies every year. N E T WO R K I N G – a P R E C I O U s a s s E T
Thanks to Switzerland’s dual education system, young engineers establish a network with other universities, users and physicians very early in their career and learn to understand consumer needs. Many of them take a job in the medtech company they got to know while working on their master or doctoral thesis. Medtech companies are also well networked with healthcare facilities and hospitals which perform top level research and play an active part in technological developments. Expertise in materials and processing techniques coupled with a high degree of automation know-how shape the success of the manufacturing sector. Another contributor to industry success as a whole is the cutting edge suppliers sector which is largely composed of small and medium-sized companies. For many manufacturers, including foreign companies, the stable economic and political environment, the skilled work force and the possibility to introduce and register a new product at a rapid pace make Switzerland an attractive place to grow a business. The high degree of integration along the value chain is a characteristic feature of Swiss medtech manufacturing.
L E T ’ s M Ov E U P a G E a R Despite its success in recent years, however, Switzerland has not been immune to the global financial crises and endured heavy exchange losses in 2011, which is why the year was marked by declining investments. New strategies to handle the decline have become a primary focus of the industry in recent months as manufacturing costs and high wage costs are not expected to decline. More than ever Swiss companies are
focused on achieving a high level of excellence and product quality to ensure market competitiveness and achieve high added value. To accomplish this, the transfer of knowledge between science and industry has to be intensified and the tried and tested dual education system strengthened. Medtech manufacturing companies have to achieve more competences in regulatory systems, engage themselves even more in environmentally sound production and top quality, and cooperate closely with clinics for patient-centered product development. A key feature of a successful future will be efficient management of manufacturing which focuses on
bolstering activities that create value and reduce waste. Products that demonstrate value from the point of view of the end customer must remain the aim, with the steps of the value stream for every product family assessed, and activities which do not create value eradicated. Industry survival will also mean the application of reliable and cost-effective technologies and processes which guarantee a high quality, ensure an efficient and smooth product flow, and maintain a culture of continuous improvement. In short, Swiss medtech companies are shifting into the role of what the market now urgently wants – total solution providers.
Additive Manufacturing – the magic formula for success Additive Manufacturing (AM) offers enormous potential, particularly where a greater freedom is essential for new, innovative designs. With higher complexity of the design and higher individuality of the product, the produced volumes are getting smaller which is where the economic efficiency of AM increases. N Ov E L a P P R OaC H E s Swiss manufacturers
are currently facing an extraordinary challenge; confronting the global economy and the growing competition from emerging countries, they have to introduce ever more complex and tailor-made products onto the market very rapidly to satisfy customer demands. In the last few years, different technologies known as additive manufacturing AM (formerly rapid manufacturing) have been introduced, specially aimed at shortening the design and production cycle where limited quantities of precision components are required. The advantages with this technique are obvious as AM makes the costly and time-consuming process of tool-making unnecessary by creating parts directly from computer-generated 3D CAD models. Designers enjoy more freedom in their creations and can implement changes flexibly at any time without leaving behind obsolete parts. There is no waste in production, no increase in cost or a time delay because of expensive and time-consuming tool changes.
Ta I LO R E D T O R E Q U I R E M E N T s AM makes sense where the output of conventional methods is unsatisfactory. Due to the fact that AM operates flexibly and with minimal tools it is especially suited for user-specific, custom-designed products. Ideal applications are instruments with complex internal structures with integrated drainage ducts or complicated tube geometries otherwise
very difficult to produce with traditional methods. In the hearing aid industry, AM triggered a revolution as the in-the-ear hearing aids have to be tailor-made for each customer and produced in low part quantities. Even so, success did not happen overnight but rather gradually as manufacturers searched for better ways to make the hearing aid shells as innovative as possible and adapted the process to their needs. Selective Laser Sintering (SLS) is a technique in which parts are built layer by layer and has become a commercial success in medical technology. The basic material consists of powder with particles of about 50 µm in size. After deposition of the successive powder layers, a CO2 laser beam scans the surface and selectively melts the powder particles together. At the Institute for Rapid Product Development (IRPD) at Inspire AG in St. Gallen, engineers help to prepare for complex skull surgeries by using SLS to create accurate models of a patient’s skull derived from CT and MRI data, which serve to plan and perform a ‘dry-run’ of the surgical procedure. With SLS, standard implants are made custom and immediately available during the operations. In another area additive printing methods have appeared is in tissue engineering. Although still in its developmental stage, very promising initial steps are 15
being made at the ZHAW Wädenswil with the organomimetic skin model production based on a novel bioprinting technology. N E C E s s I T Y D R I v E s I N v E N T I O N Incorporating novel technologies is not only a choice, but also a necessity. For instance, nowadays many surgeons rely on AM models of bones or tissue to develop strategies for their operations. When designing a new device it can be difficult to explain or even to visualize a design from a 3D drawing. But when a client can hold a physical object they will quickly grasp the essentials of the idea and AM only needs a few hours to produce this effect. Few things rival the experience of handing over a new device to engineers and designers so that they can feel if the shape is to their liking, if joints can easily be attached and if the device is really user-friendly. AM offers a fast way for a manufacturer to communicate a new device to both patients and doctors and receive instant feedback concerning functionality, appearance and color before a single device is built.
Prototyping processes like milling or vacuum forming also have great potential. Sophisticated 5-axis automation systems are developed exclusively for the efficient handling and milling of dental blanks. With the blank milled in the absolute center of the machine, an optimal cutting force is ensured, while high-performance servo and torque motors guarantee dynamics and speed.
It’s most telling that a company like Medtronics Sofamor Danek, world leader in spinal and cranial medical technologies, has in-house access to a FDM (fused deposition modeling) machine, which is not only appreciated by their medical technologists, but also cuts down on miscommunication. FUTURE C O M P E T I T I v E N E s s Additive technologies are developing consistently from pure prototyping methods to cost-effective production methods. At the international level, topics like AM are now strongly recommended for total quality management purposes. “It is not only the medtech branch, but also patients who benefit from AM,” states Ralf Schindel, director of the IRPD. “Patientspecific models for pre-surgical planning and drill templates assure that knee implants are aligned correctly and make an intervention quicker and safer, reducing the risk of infection.”
AM offers great potential for the direct manufacturing of patient-specific implants on the basis of CT and MRI data. This fabrication technology makes nearly every product design possible. A pioneer in this field is the University of Missouri-Colombia, as Ralf Schindel comments: “For a number of years, the researchers have been creating blood vessels consisting of endothelium, muscle and fibroblast cells with ‘organ printing’, an additive process. Therefore: think additive!”
Institutions which might be of interest to you
MedTec
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Andres AG
KKS Ultraschall AG
4573 Lohn-Ammannsegg www.andresag.ch
6422 Steinen www.kks-ultraschall.ch
Borer Chemie AG
MEDMIX SYSTEMS AG
4528 Zuchwil www.borer.ch
6343 Rotkreuz www.medmix.ch
Cendres+Métaux SA
MULTIVAC Export AG
2501 Biel/Bienne www.cmsa.ch
6331 Hünenberg www.multivac.com
ERAM AG
RIWISA AG
4123 Allschwil www.eram.ch
5607 Hägglingen www.riwisa.ch
Ivers-Lee MedTec AG
Wandfluh Produktions AG
3400 Burgdorf www.ilmedtec.com
3714 Frutigen www.wandfluh.ch
ZIEMER GROUP Founded in 1998 in the heart of the Swiss watchmaking valley of Bienne, the Ziemer Group has rapidly become a leader in high-precision ophthalmic femtolaser surgery and diagnostic devices. In 2011, Frank Ziemer, founder and CEO of the company, was awarded “Swiss Entrepreneur of the Year.� Famous products are the FEMTO LDV providing the well-known Z-LASIK treatment, the GALILEI imaging devices, the AMADEUS II microkeratome and the PASCAL Dynamic Contour Tonometer.
Ziemer Ophthalmic Systems AG Gold Sponsor of the Swiss Medtech Report 2012 17
Invention
Product Development
Manufacturing
Marketing & Market Access
Regulation & Healthcare
Funding & Financing
Facts & Figures
From product sellers to solution providers Six medtech production companies operating in Switzerland discuss their marketing organizations and strategies. Despite growing price pressures, they continue to focus on personal advice, a high degree of professional competence and product quality. Extra and bundled services are increasingly important. And more communication is taking place electronically. Highest demands for quality and safety along with mounting cost and competition pressures, the medtech industry is in a state of upheaval. So marketing and sales become more important. On that, Smith & Nephew, Covidien, Zimmer, Ziemer Ophthalmic Systems AG, Seca and B. Braun (Medical) all agree. Whether a global conglomerate or a Swiss small-tomidsize company, the six manufacturers surveyed cover the classic range from market research to distribution. As always, field sales activities are of primary importance. Here, there has been a clear shift away from pure product sales to target-segment-specific communication focusing clearly on added value for the customer. Above all, personalized support on site is increasing. Thus physicians and surgeons are accompanied in the operating room in their use of medtech products. Just as important are the training and advice that are also included in the provider’s service bundle. Precision work, in-depth knowledge and a high level of motivation on the part of the professional personnel are decisive elements for success. COU NTRY- s PEC I FIC I M PLE M E NTaTION
Smith & Nephew, a British marketer of orthopedic, endoscopic and wound care products, Zimmer, a US manufacturer primarily of orthopedic implants, and Covidien, an international manufacturer of medical and pharmaceutical products with group headquarters in Ireland, maintain marketing and sales units worldwide. The three companies carry out market research mainly in their key markets, while customer service and product management are locally performed. For Covidien and Zimmer, Switzerland holds a strong position in trade and sales. The latter company serves the EMEA sales region from its European headquarters and pro18
duction site in Winterthur. Each of the three manages its global marketing strategy from its Anglo-Saxon parent company, but the implementation is country-specific and the products, customer events and training sessions are adapted to the various local customs and practices, cultures and languages. Seca, a supplier of medical scales and measuring systems, is also transferring its marketing activities from its home base in Hamburg to, among other places, Switzerland. Ziemer, the specialist in femtosecond laser devices and diagnostics for ophthalmology, manages its worldwide marketing and sales from its headquarters in Port. B. Braun, located in Lucerne, has one marketing department for each sales division in medical consumer goods. B E T W E E N P U s H a N D P U L L All those sur-
veyed emphasize a healthy marketing mix, consisting of “product, price, place and promotion”. They alternate between push and pull approaches – depending on the product’s life cycle, sales are promoted and priced accordingly. For certain innovations, the market must first be sensitized and developed (push). At the same time, customers’ needs must be elicited via market research or direct contact (including after-sales) and the products adapted accordingly (pull). The six companies all pursue a competitive strategy so that the manufacturers and distributors of more exclusive products are differentiated from their competitors through the use of varied forms, materials and innovative technologies. Part of the profiling concept is to take over the market leadership in an area, to be the “original” or, like Seca with its bioimpedance analysis, to specialize in new areas of medicine. There is a tendency towards standing out
from the competition by supplying additional services, but it is taboo to do so through lower prices. Even in the commodity sector, it is the practice – but only to a limited extent – to adopt a “me-too” approach, differentiating solely on price. Covidien, with many products that are no more than three years old, maintains its innovation cycle at a high level. B U N D L E D s E R v I C E s For implants, the market prospects are in decline. Internationally, a bitter price war is raging. At Smith & Nephew, prices are currently far below the respective country’s consumer price index. The continuing erosion of profit margins is also forcing the other market participants to revise their cost structures. Yet, despite increasing pressures, the companies surveyed are determined to maintain their quality standards whilst not cutting service levels. Instead of granting discounts that cut to the bone, the companies are putting together attractive packages and bundling together more and more services under the same conditions. For example, Seca offers hospitals their own hotline and maintenance services. B. Braun is creating more benefit for customers with its tailor-made product systems such as anesthesia sets and scientifically conducted courses. Ziemer Ophthalmic Systems AG equips the device platform to meet the needs of eye clinics, providing additional functions or applications on a modular basis and offering a variety of financing models. INCREasING
PROCEss
E F F I C I E N CY
Those surveyed are adapting their sales to the adjusted purchasing strategies and case-based rates (SwissDRG) that result mainly from new hospital financing. Fixed costs are highly dependent on volumes, which in Switzerland are comparatively small. The general feeling is that even the emerging purchasing consortiums do not change the quantities ordered, and at the most produce advantages or savings because of the efficiencies of shorter transport distances. Thanks to a 90% vertical integration in manufacturing, B. Braun itself can optimize manufacturing costs. But for companies that have exhausted their product efficiency savings, processes in the hospitals can be improved. Together with the partners there, logistical and holistic solutions can be developed, for example in supply chain management, just-in-time delivery of items, or a reduction in operation times and hospital stays. INTEGRaTED COMMUNICaTION The companies surveyed pursue an integrated communications approach using all available channels. Personal cus-
tomer contact through a company’s own field sales force or through the trade is the most important distribution channel. In addition, Seca keeps itself in the public eye with strong advertising, uses posters and newspaper ads, and publishes technical reports. B. Braun addresses its target audience, among other ways, with sales folders and direct mail. Since 2010 Ziemer Ophthalmic Systems AG has been intensifying its marketing and also provides clinics and doctors with kits for the devices complete with PR tools and training documents. P R O M O T I O N R E s T R I C T I O N s But marketing has its limits. Medical devices that are dispensed only by prescription and may be used solely by professionals can only be promoted to them. Thus it is not allowed, for example, to publicize implants alongside a company logo. Instead, the products are promoted discreetly or indirectly, informational events and open houses are held, and appropriately worded brochures are distributed to patients.
In general, PR measures with scientific expertise are the preferred option. Electronic channels and new media are increasingly being used here. So each company has a well-constructed website. B. Braun exchanges knowledge with customers over the web and uses apps to familiarize users with product innovations. Some companies also have blogs targeted to patient issues. Social media such as Twitter and Facebook, for example, help Zimmer to keep customers informed about trade shows. sTRICT
COMPLIaNCE
CONDITIONs
Sponsoring activities, too, must be evidence-oriented. Training and continuing education for healthcare professionals are used just for information’s sake. All the companies surveyed stated that they adopt ever stricter compliance regulations for the granting of subsidies. The minimum standards for internal guidelines in Switzerland are the ethics principles of the industry’s “Code of Business Conduct”. aWa R E N E s s T R a I N I N G A change in marketing strategy is called for, not solely because of the difficult economic and regulatory climate. Also in light of the instances of harmful products, which all lead to a need to restore the battered image of the medtech areas concerned, and for that – as with the implant awareness campaign in Switzerland – some targeted training needs to be carried out. But irrespective of isolated crises, there is a call for the entire industry to publicize itself through an active communication approach.
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The market counts The Swiss medtech industry is characterized by its short access process and its market-friendly reimbursement practice. Medtech companies achieve more than half their sales with products that are no more than three years old. For a new medical device to be sold in the Swiss market quickly, it still does not have to undergo a time-consuming official approval process like the one for drugs. Rather, a declaration by the manufacture of the product’s conformity with the applicable standards must be submitted, and the medical device must be labeled in accordance with CE regulations. For certain non-hazardous medical devices (in Class I), the review of conformity may be undertaken by the manufacturer itself. For those with a higher risk potential, it must call in an external, government-certified and recognized conformity assessment body (also called a Notified Body). Under the Bilateral Treaties 1, Switzerland has agreed with the EU on the reciprocal recognition of their conformity assessment bodies. Thus the 5 Notified Bodies recognized by the Swiss accreditation body SAS and the 76 internationally accredited Notified Bodies of signatory states may be used. The standards applicable in Switzerland are to be found mainly in Federal Law 1 on Drugs and Medical devices (Therapeutic Products Act – “Heilmittelgesetz”), in the Swiss Regulation on Medical Devices (Medizinprodukteverordnung) and in the Regulation on Clinical Trials with Therapeutic Products. F R E E LY N E G O T I aT E D P R I C E s In contrast to the reimbursement for drugs or medications by the compulsory health insurance (OKP), there is in principle no approved list for medical devices. Nor are the prices set by the government, but instead freely negotiated in a market that is upstream of the healthcare market. Therefore, service providers
such as hospitals and physicians can in principle decide for themselves which products they will use, and pass the cost on to the health insurers as part of their services to the patient. EFFECTIvE, ExPEDIENT aND ECONOM I Ca L The insurers are obliged to reimburse
the services described in the Health Insurance Act (Krankenversicherungs-Gesetz) such as examinations conducted in hospitals, treatment or care services (cf. Art. 25 ff. Health Insurance Act). These must be effective, expedient and economical, i.e. the so-called “EEE” criteria must be fulfilled (Art. 32 Par. 1 Health Insurance Act), which is, in principle, assumed. In this system, health insurers generally do not pay for medical devices as a separate item, but rather as part of prices that are negotiated among service providers (doctors, hospitals, etc.). TARMED – the price schedule for individual medical services – covers the outpatient sector. For acute somatic services provided in an inpatient setting, the diagnosis-related case-based rates pursuant to the SwissDRG have applied since the beginning of 2012. This means that costs are no longer reimbursed, but rather clearly defined medical services. E xC E P T I O N s The exception to the reimbursement practice is materials and items (such as bandages, measuring devices, stoma supplies, incontinence, hearing, and vision aids) used by the insured person at a doctor’s prescription but without the aid of professionals (Art. 55 Health Insurance Regulation). For these there is a positive list of materials and items (MiGeL), with reimbursable product groups. MiGeL lays down a maximum reimbursement amount that the compulsory insurance must pay for each product.
Institutions which might be of interest to you
buchs&sachsse Innovations-Kommunikation
buchs&sachsse
ISS AG
4153 Reinach www.buchs-sachsse.ch
2562 Port www.iss-ag.ch
Creapole SA
Straumann Holding AG
2800 Délemont www.creapole.ch
4052 Basel www.straumann.com
DePuy Synthes
Ziemer AG
www.depuysynthes.com
2562 Port www.ziemergroup.com
Hocoma 8604 Volketswil www.hocoma.com
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sWIss MaDE Switzerland is the world’s second largest per capita consumer of healthcare. From advanced diagnostics and implantables to low-tech consumables, many of the products and materials used in the Swiss healthcare industry are also manufactured in Switzerland. A growing internal healthcare market helps Swiss medtech companies initiate business activities in a competitive local environment while preparing for the eventual next steps of growth through global export. Interest and demand in new technologies drive market growth and push innovation.
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Invention
Product Development
Manufacturing
Marketing & Market Access
Regulation & Healthcare
Funding & Financing
Facts & Figures
Navigating the regulatory jungle The Swiss medtech market is traditionally characterized by fast time to market. With increasing regulatory and safety requirements, however, this is changing. Swissmedic, the supervisory authority, addresses this fact by providing information, training and recommendations and consulting firms such as ISS support companies in the efficient management of authorization procedures and quality controls. On its passage through the development, manufacturing and delivery chain, a medical device has to meet countless requirementst to protect patients and users. For marketing authorization alone, there are numerous provisions on the tolerability of materials (biocompatibility), functionality, quality and sterility to be complied with. For example, cleanroom requirements for assembly or the safety of packaging for items such as syringes are subject to validation by specific tests. Sticking on a Band-Aid is not associated with the same risks as the use of walkers or even a cardiac pacemaker. When a medical device is scrutinized in terms of compliance for marketing purposes, it is subject to requirements, the stringency of which is dependent on its risk class. The potential risk is also a factor which determines how it is tested in humans. For example, clinical trials with implants must fulfill the highest scientific and ethical criteria, as well as statutory requirements in terms of patient information and insurance coverage for injuries. 10,0 0 0 PaG E s O F D O C U M E N TaT I O N
Whether for the development, composition or functionality of a product and for liability reasons as well, all relevant information must be meticulously documented in manuals and regularly updated. Depending on the risk class up to 10,000 pages may be required for technical and clinical documentation. In addition, manufacturers of products on the market are obliged to maintain a system for product surveillance. In this system, information on safety, quality, stability and performance of medical devices in actual use must be collected and evaluated. Here traceability is becoming ever more critical. It serves as proof of quality and allows for the efficient recall of products. Serious adverse events and measures taken to correct them must be reported by manufacturers and 22
users to Swissmedic, the Swiss authorization and regulatory authority for therapeutic products, and/or coordinated with it. Some 1,800 reports on medical devices are registered annually, i.e. nearly twice as many as in 2005. The largest increase was recorded between 2009 and 2010, resulting from the revision of the Swiss Regulation on Medical Devices (Medizinprodukteverordnung). Through implementation of the changes to European law, this entailed, among other things, the reclassification of a few surgicalinvasive products from Risk Class IIa to Class III. Besides erroneous classifications, the most frequent causes of undesirable events are labeling and packaging problems, incorrect product descriptions and software errors. Once the corrections carried out, they are published by Swissmedic, which also issues safety alerts on its own, for example if a manufacturer is faced with bankruptcy. CONsCIENTIOUs
M a N U FaC T U R E R s
“In principle, the manufacturers take their responsibilities seriously. The surveillance system works, and the SIRIS implant register provides another valuable instrument for quality control,” says Karoline Mathys, a member of Swissmedic’s Management Board. Hans-Jörg Riedwyl, CEO of Integrated Scientific Services (ISS) AG, also stresses that Swiss medtech companies have a strong tradition of quality and safety consciousness with respect to patients. For this reason, he cannot imagine cases of fraud, such as that of the PIP implants in France. I N N OvaTI O N - F R I E N D LY s W IT Z E R L a N D
“With a time to authorization of only a few months – in contrast to Japan where it takes up to two years – Switzerland offers an environment that is conducive to innovation. It often serves as a test market for international companies before they enter other countries,” says Ulrich Hofer, head of Regulatory Affairs & Science at ISS. Despite years of effort to achieve the global harmonization of laws covering
medical devices, there are still very different regulatory systems and hurdles to overcome. In the USA the federal government’s Food and Drug Administration, the FDA, controls the market and developing medtech countries, such as Brazil or China, barricade themselves against foreign companies by tightening conditions for authorization. “As a result of increasing global integration and the development of new technologies, such as in the nano range, changes in the regulatory environment are accelerating,” according to Riedwyl. Following incidents with defective products, regulations are being strengthened worldwide, entailing a corresponding increase in administrative expenses. From the validation of the production process to the conformity certificate for authorization the costs per product run from four to six figures. R E G U L aT O R Y a F Fa I R s a R E T O P P R I O R I T Y “In view of the growing complexity of the
requirements, a good knowledge of the laws and directives is needed,” emphasizes Mathys. It is here that Swissmedic provides information, training and regular recommendations. In order for a company to make its way through the thicket of important regulations, the subject should be part of the business strategy from the start and should be handled
by management. A start-up must bear this in mind even before the development of its first product, and must train employees to deal with it. Larger companies recruit a regulatory affairs officer and quality manager or form their own departments. On the other hand, small and midsized companies will, for financial reasons or due to a lack of medical knowledge, have to seek other solutions. This is all the more so since, as with pharmaceutical products, any review of efficacy requires ever increasing clinical know-how. sTR EaMLINED Q Ua L I T Y M a N aG E M E N T Companies like ISS can provide support
in the form of specialized advice and software to small and midsized companies and so help them build a streamlined quality management structure for rapid market entry. “ISO Standard 13485 for the design and manufacture of medical devices already offers an efficient basis for certification,” says Hofer. Given well-prepared documentation, the process for entry into as many markets as possible can be reduced significantly. In addition, thanks to the know-how provided by specialists, classification into a higher risk class, or recalls of a medical device can be prevented, which represents a great cost saving to the company concerned.
Between quality demands and cost pressures Switzerland, with its healthcare system, its number of hospitals and physicians, but also its use of medical technology, is a world leader. High-value services have always had top priority. But with increasing cost pressures, solutions are being sought to increase quality and efficiency, an area in which medtech users and manufacturers must work together closely. Today Switzerland has more than 310 hospitals, of which at least 130 are for acute care, more than 180 specialized clinics and more than 1,500 care facilities. In addition, medical devices are sold via 10,000 doctors’ practices and laboratories, as well as over 1,700 pharmacies. The hospital sector is the biggest customer, buying goods and services to the tune of approx. CHF 6.8 billion annually. Of this, a large part consists of medical technology. Among the medical consumables used are bandages, syringes and surgical instruments, as well as implants, which comprise about a third of the total. Aside from this, hospitals on the scale of the Hirslanden Group use thousands of devices and systems, primarily in diagnostic imaging.
H I G H D E N s I T Y O F Ca R E I N s W I T Z E R L a N D Healthcare in Switzerland is at a very high
level. In the OECD list, Switzerland occupies fourth place, with over 40 hospitals per million inhabitants. It shares second place with Germany when it comes to limiting the length of hospital stays. It also holds fourth place in the number of practicing physicians, and is number one in number of nursing personnel. The high density of care comes at a price. According to forecasts by KOF, the Swiss Economic Institute (ETH-Konjunkturforschungsstelle), dated November 2011 the Swiss healthcare system will cost CHF 1.7 to 2 billion more than in the previous year. According to the OECD, healthcare costs, at 11.4 percent of gross domestic product, are two percent over the 23
OECD average, and per-capita expenditures of USD 5,270 put the country in third place, behind the US and Norway. The use of medical technology is another indication of the above-average level of care and expenditure in Switzerland’s healthcare market. The availability of diagnostic technologies has grown tremendously over the last years. With over 30 computerized tomography (CT) and 18 magnetic resonance imaging (MRI) devices per million inhabitants, as well as the number of hip and knee operations, the country leads the world. H I G H -T E C H D E v I C E s Thanks to rapid advances in many fields, such as telemedicine, surgeons can now follow every step of an operation on a screen, and have push button control of all devices. With the aid of cameras, endoscopes and more flexible instruments, complex procedures can be carried out in a minimally invasive and precise manner. At the same time, the requirements for product stability, robustness and maneuverability continue to increase.
In view of mounting healthcare costs and at the latest with the introduction of the new hospital financing at the beginning of 2012, with case-based rates (SwissDRG), innovation has become crucial to success in terms of increased efficiency. As part of cost– benefit analyses, each innovation is reviewed for its economic benefit. Will automation produce the desired result? How often will that clever robot be used? “Today, the right tool must be standing by in the operating room, and the price has to be right as well,” says Fritz Schiesser, head of Logistics and Purchasing at the Hirslanden Group. The goal is to assure the availability of products and at the same time to optimize process flows and procurement costs. s U P P LY C H a I N M a N aG E M E N T Already in 1999, the Hirslanden Group comprising 14 private hospitals began centralizing its ordering and purchasing services. Logistics and strategic purchasing were transferred to management, and thus achieved a higher position in the organization. Another innovation was to place orders for all 14 centers through one purchasing office. In addition,
24
Hirslanden invested in technical equipment. Central management of master data was used as the basis for electronic processes, e-procurement with various supply-chain solutions was set into motion, barcode-scanning for internal ordering procedures and a system for electronic billing were established. “For further collaboration with suppliers, one of the essential requirements is to have systems capable of being integrated into the hospital procurement system,” stresses Schiesser. Already 40 of the 50 partners have introduced the international standard for electronic data interchange. Another important prerequisite is the labeling of products with bar and matrix codes, in order to make them readable and identifiable. Ta I LO R - M a D E P R O D U C T s E T s According to Schiesser, medtech companies are responding to the high demands and are reliable partners. There is a particular need for modular systems and product sets tailored to a hospital’s needs, for example with materials specific for an operation. The greatest challenge today is to keep prices to a minimum, whilst maintaining the same (at least) level of quality, something which requires flexibility as well as support from suppliers. Even given the case-based rates of the SwissDRG, logistics head Schiesser hopes to cut costs by 40 percent by the end of 2012. The key suppliers have already made innovative proposals to this end. For usability reasons, as well as liability, Hirslanden will stay on the one hand with its existing partnerships and on the other hand with domestic products. Not least of the reasons for this is “not to compromise the high quality of Swiss healthcare.”
In the management of instruments and devices, too, the Group calculates precisely what is more efficient – repair and maintenance or repeated reconditioning or replacement of items? In addition, Hirslanden plans to concentrate its logistics even further and to consolidate its hospital warehousing. By having manufacturers deliver to one location, it could benefit from quantity discounts and achieve greater efficiency. “One thing is certain. In order to successfully address the challenges of the future, all those involved along the value-creation chain must work more closely together,” stresses Schiesser.
sUPPORT Financing of young technologies and life science companies in Switzerland is a coordinated activity supported by multiple institutions and funding pools. From start-up funding through grants to the listing of a company on SIX Swiss Exchange, the fiscal infrastructure in Switzerland provides accessibility to funding opportunities which support and strengthen a company along every step of its life cycle.
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Invention
Product Development
Manufacturing
Marketing & Market Access
Regulation & Healthcare
Funding & Financing g
Facts & Figures
Funding and financing Switzerland is a European entry point for foreign investors and plays an important role in the funding and financing of innovation, notably in high-tech industries such as the medical technology industry. With over 10,000 new founded companies each year, Switzerland’s attractiveness as a place to do business, its strengths as a financial center and its thriving medical technology industry are all consequences of the collaborative activities between industry, academia, and the financial sector. From the very beginning, a Swiss company’s development is linked to and supported by academic and industrial partners. Many companies in Switzerland emerge from innovative technologies created from academic projects in institutions such as the ETH Zürich and the EPFL in Lausanne and are nurtured into young enterprises through both public and private development and funding programs. Easy access to funding resources, innovative and competitive financial products, and the availability of highly qualified staff all contribute towards lucrative business activities and Switzerland’s strengths as a financial center. The Swiss financial center maintains a global network and progressive capital market which aids the development of both the country as a whole and its medical technology sector. Because Switzerland is closely networked and internationally oriented, it has become an attractive financial center for both domestic and foreign companies seeking capital. B U s I N E s s - D E v E LO P M E N T L I F E CYC L E
Medical technology companies have varying capital needs based on the timeline to profitability as they progress through various stages of development. As such, the stages of the business development life cycle must be filled with appropriate and adequate forms of capital. Medical technology companies whose early developmental stages are typically longer than those of firms outside the life sciences
26
sector require more equity or risk capital to make it through the critical phases of early business. E a R LY s TaG E F I N a N C I N G A company in the pre-marketing phase of any product development is generally looking for seed capital. During this stage the company has a new product or technology with positive market potential though often limited financial resources and business expertise to boost R&D activities and to commercialize the product. Overall, seed money amounts to ~ 30 million Swiss francs per year or less than 0.1% of the Swiss GDP. Switzerland’s financial industry offers several possibilities to get funding during the seed stage such as grants through the Swiss National Science Foundation (SNSF) for basic research, and early stage funding through universities and the two Swiss Federal Institutes of Technology via their specific start-up and entrepreneur consulting departments. These departments maintain strong relationships to a multitude of investors, industry associations, government agencies and state-funded economic development programs such as the CTI Invest Private-Public-Partnership. Swiss companies can also find seed money through the globally growing pool of business angels who provide specific industry know-how, a network of industry contacts, and pure capital financing. Various foundations play a similar role in supporting research projects with outstanding pioneering potential.
The start-up financing phase funds companies in their initial development stage and market ing efforts. The major players in funding start-ups are venture capital firms specialized in managing risk or providing capital. The Swiss venture capital scene is represented by two leading financing platforms for Swiss high-tech start-ups: the CTI Invest and the SECA chapter “Seed Money & Venture Capital”. These private platforms organize match-making events and coordinate relationships between venture capital firms and companies in the start-up phase. The European Innovation Scoreboard (EIS) indicates that 0.2% of the Swiss GDP is invested in early-stage venture capital which is significantly higher than that of its geographic neighbors: Germany (0.06%), France (0.11%), Italy (0.03%), EU27 (0.12%). Additionally, the Swiss Confederation supports venture capital companies and private investors by reducing their direct federal tax burden, waiving stamp duty and offering assistance in securing cheaper bank loans by granting debt guarantees via assigned cooperatives. In conjunction with this almost every Swiss bank offers at least one financing instrument for start-up companies in the form of loans with no or minimal interest, or various consulting services aimed at corporate finance activities. While recently developed seeding and funding concepts like crowd funding or hybrid models are still in the early stages in Switzerland, a huge funding potential remains unused and will develop in the future. L aT E s TaG E F I N a N C I N G The expansion stage is typically characterized by the extension of the production capacity, further product devel-
opments and by an increase of marketing activities to boost sales. Similar to the early stage financing phase, late stage financing is also supported by venture capital investors in addition to smaller private equity funds. Switzerland offers a very dynamic private equity industry with many funds focused on investments in the life sciences and medical technology sectors. Approximately 0.3% of Swiss GDP is invested by the private equity industry. E x I T s TaG E F I N a N C I N G Financing of the
expansion step in the company’s life cycle usually requires investment by a larger and more diversified investor group such as larger institutions and sometimes private investors or a strategic buyer. The purchasing of a company often means a liquidity event for the venture capital and private equity investors. This liquidity event or exit can be an initial public offering or trade sale to a strategic buyer. In this event, the SIX Swiss Exchange offers an attractive listings product and allows for an inclusion in its main benchmark index, irrespective of the company’s place of incorporation and/or asset and revenue base. The life sciences sector on SIX Swiss Exchange accounts for about one-third of the total market capitalization and even as much as 40% of the overall European sector market capitalization. Specialized life sciences sector indices (SXI Life Sciences and SXI Bio and Medtech indices) allow for higher visibility of companies and support a fair valuation of listed companies. The maximum weighting of any given stock in this sector index is limited to 10%, which allows for greater visibility of small and medium-sized companies.
Profit
sTaGEs OF THE BUsINEss DEvELOPMENT LIFE CYCLE
Early stage
Late stage / exit stage
Financing stage
Seed
Startup
First stage
Phase
Product development
Formation of an enterprise
Market launch
Expansion stage Second stage
Third stage
Extension of the production capacity, new distribution channels & diversification
Bridge/ buy-outs
Bridge financing take-overs
Time State-funded research and development
Mezzanine capital
Business angels
IPO
Venture capital, alternative funding concepts
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Overall, the Swiss financial center creates an attractive bonus for domestic and foreign companies seeking capital: it is compact, closely networked, the local banks have strong financing and placing power, and it facilitates a unique and fast regula-
tion process when considering a listing. In addition, Switzerland comprises an international investor base with roughly CHF 4 trillion of assets available for investment.
PERFORMaNCE COMPaRIsON OF INTERNaTIONaL LIFE sCIENCEs INDICEs (Total return index on monthly basis, CHF-adjusted)
SXI LIFE S CI E NCE S
A M E X HE ALTH C A RE
D J S TOXX 600 H EA LTH C A RE
340% 300% 260% 220%
140% 100%
12 Se p
11 Se p
10 Se p
09 Se p
08 Se p
07 Se p
06 Se p
05 Se p
04 Se p
Se p
Se p
02
03
60%
Source: Bloomberg, SIX Swiss Exchange
180%
PRIvaTE EQUITY INvEsTMENTs IN sWIss COMPaNIEs 245 250
200
214
215
2008
2009
222
186
150
50
0
2007
Transaction Volume (EURm)
2010
2011
Number of transactions
Ernst&Young (www.ey.com) and SIX Swiss Exchange (www.six-swiss-exchange.com) are the authors of this chapter.
28
Source: seco.admin.ch and EVCA Yearbook 2012
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HOTsPOT Switzerland boasts one of the highest concentrations of medtech companies in the world. Employing 51,000 people, the industry embodies 2.1 percent of the Swiss GDP. Medtech industries in Germany, the UK, the US and even Europe as a whole still fall second to the Swiss medtech industry’s employment percentage, medtech exports, and percent contribution to GDP. With continued growth in the sector, the Swiss medtech industry is expected to keep its reputation as a global hotspot for medtech production and innovation.
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Invention
Product Development
Manufacturing
Marketing & Market Access
Regulation & Healthcare
Funding & Financing
g Facts & Figures
The Swiss medical technology industry Switzerland is among the global hotspots for medical technology Compared to its size Switzerland shows a high degree of industrial specialization in medical technology. Its open and export dependent economy makes it one of the dominant players on the global medtech
market. Not only in relation to its size but also in absolute numbers, Switzerland is regarded as one of the leading locations for the development, manufacturing and practical use of medical technology.
Approximately 1,600 companies in Switzerland are part of the medical technology industry. Making up this number are 480 suppliers to medtech manufacturers, 400 medtech manufacturers, 340 distributors, and 400 specialized service providers to the medtech industry. The split of suppliers by competence shows how the two main roots of the Swiss medtech industry evolved from watchmaking and machine engineering and manufacturing. 26% of suppliers are supplying components/systems, 9% are specialized in providing surface treatment, 22% are specialized in metal processing, and 12% in manufacturing specialized machines/automated devices for the medtech industry. Swiss medtech manufacturers cover a broad field of medtech products, technologies and competences. Leading in numbers are companies manufacturing implants which is one of the most technologically demanding fields within medtech (15% of medtech manufacturers produce dental implants, 10% inactive implants). Specialist’s know-how and cutting edge research done at Swiss universities additionally fuel the launch of new products in this field. 51,000 employees are working for the medtech industry with an annual growth rate of more than 1.5% seen over the last two years making it one of the fastest growing industrial activities in Switzerland. The Swiss medtech industry is growing significantly faster than the overall Swiss economy.
* forecast
30
Estimated growth of turnover in the Swiss medtech industry 6% 10% 6%
Source: Data from the Swiss Medical Technology Industry 2012 survey, Swiss Economic Growth Data from SECO 2012
2008 2010 2012*
Overall Swiss economic growth rate 5.0% 3.6% 1.4%
The relative share of the medtech industry in contributions to employment, GDP and exports is higher in Switzerland than in other globally important medtech manufacturing nations like the US and Germany. % of GDP (gross domestic product) Switzerland Germany UK EU
% of total employment Switzerland Germany
2.1 0.8 0.4 0.6
USA
0.7
1.1 0.4
UK EU
0.2 0.2
USA
0.2
% of total export value Switzerland Germany UK EU
5.5 1.1 1.8 n.a.
USA
2.9
Constant investment into R&D and the launch of cutting edge innovative medical devices is one of the competitive advantages of Switzerland. On average, Swiss medtech manufacturers invest 13% of their turnover on R&D – a figure that has remained stable for several years (2008: 12%, 2010: 12%). For research into novel technologies and the development of new products, 59% of Swiss medtech manufacturers collaborate with the ten universities and the two Federal Institutes of Technology (ETHZ/EPFL). Through these academic collaborations companies are able to stand at the forefront of R&D. Client and user collaborations make up the next largest subset of partnerships (55%), followed by collaborations with suppliers. Investment into R&D and active collaboration leads to the young product portfolio of Swiss medtech companies. On average, half of the products are less than three years old which demonstrate the constant effort to secure and expand their market position with new innovations.
NEW
sEvERaL REGIONs WITHIN sWITZERLaND HavE a HIGH DENsITY OF MEDTECH Number of
Manufacturers
Suppliers
1-2
1-2
3-4
3-4
5-6
5-6
>6
>6
Basel
Zurich
Zug Lucerne
Source: Data from the Swiss Medical Technology Industry 2012 survey
Berne
Lausanne
Geneva
Lugano
0
25
50 km
ALPGIS AG, 09.08.2012
Foreign medtech and life science companies looking to invest in Switzerland are supported by local economic promotion agencies like the GREATER GENEVA BERNE area or the Greater Zurich Area which offer a broad range of services to interested investors
ranging from setting-up a legal Swiss entity to finding the right location. Existing medtech companies can benefit in some of the Swiss cantons from financial contributions for attending international trade shows as well as other services. 31
Swiss Industry Guide Swiss members of Medical Cluster and FASMED MaNUFaCTURERs OF BRaNDED PRODUCTs WITH PRODUCTION IN sWITZERLaND D–L
Abbott AG www.abbott.ch
Degonda Rehab SA www.turbo-twist.ch
Accuratus AG www.accuratus.ch
Degradable Solutions AG www.degradable.ch
Adoptics AG www.adoptics.ch
Dräger Medical Schweiz AG www.draeger.com
Aïmago SA www.aimago.com
Edwards Lifesciences AG www.edwards.com
Alcon Switzerland SA www.alconlabs.com
Embru-Werke AG www.embru.ch
allshape AG www.allshape.ch
epimedical (Switzerland) AG www.epimedical.ch
Antia Therapeutics AG
Exactech International Operations AG www.exac.com
ANTON MEYER & CO LTD www.meyco.ch
FUJIFILM (Switzerland) AG www.fujifilm.ch
Ardo medical AG www.ardo.ch
Geistlich Pharma AG www.geistlich.ch
ATEC INGENIEURBÜRO AG www.swisstrac.ch
Gomina AG www.gomina.ch
B. Braun Medical AG www.bbraun.ch
Gribi AG www.gribi.ch
Baitella AG www.baitella.com
Haag-Streit Holding AG www.haag-streit.ch
Balgrist Tec AG www.balgrist-tec.ch
Hader SA www.hader-swiss.com
Bernafon AG www.bernafon.ch
Hocoma AG www.hocoma.com
Bien-Air Dental SA www.bienair.com
Hoga Roll AG www.hogaroll.ch
Biodenta Swiss AG www.biodenta.com
Hutman Diagnostics AG www.hutmandiagnostics.com
Biotronik Schweiz AG www.biotronik.com
ILS Services Switzerland Ltd www.integralife.eu
Borer Chemie AG www.borer.ch
Imetric 3D GmbH www.imetric.com
Carbagas AG www.carbagas.ch
Ing. Büro M. Kyburz AG www.kyburz-classic.ch
CAScination AG www.cascination.ch
IVF HARTMANN AG www.ivf.hartmann.info
Cendres + Métaux SA www.cmsa.ch
Johnson & Johnson AG www.jnj.ch
Chrisofix AG www.chrisofix.ch
Küschall AG www.kueschall.ch
Closemo AG www.closomat.ch
LEVO AG www.levo.ch
CODAN Medical AG www.codan.ch
Lima Switzerland SA www.lima-switzerland.ch
CRAMMTEC GmbH www.crammtec.ch
LINK Implants AG www.link-implants.ch
CSL Behring AG www.cslbehring.ch
Lysoform www.lysoform.ch
32
Source: Swiss members of Medical Cluster and FASMED (July 2012)
a–C
Source: Swiss members of Medical Cluster and FASMED (July 2012)
MaNUFaCTURERs OF BRaNDED PRODUCTs WITH PRODUCTION IN sWITZERLaND M–s
s–Z
M3AT www.m3at.com
Samarit Medizintechnik AG www.samarit.com
Manufactures D‘Outils Dumont SA www.outils-dumont.ch
SANITAS www.bottaweb.ch
Mathys AG Bettlach www.mathysmedical.com
Schaerer Medical AG www.schaerermedical.ch
Max Jung AG www.maxjung.ch
Schiller AG www.schiller.ch
Max Stäubli AG www.maxstaeubli.ch
Schülke & Mayr AG www.schuelke.com
Medacta International SA www.medacta.ch
SciCan Medtech AG www.scican.com
Medartis AG www.medartis.com
Seca AG www.seca.com
Medela AG www.medela.ch
Sectra Medical Systems GmbH www.sectra.com
Médilec SA www.medilec.ch
SENECTOVIA Schmidlin AG www.senectovia.ch
Medtronic (Schweiz) AG www.medtronic.ch
SKS Rehab AG www.sks-rehab.ch
Meridian AG www.meridian.ch
Smith & Nephew AG www.smith-nephew.ch
Naviswiss AG www.naviswiss.eu
SpineWelding AG www.wwtechnology.ch
Nobel Biocare Management AG www.nobelbiocare.com
SQ Products AG www.sqproducts.ch
Nouvag AG www.nouvag.com
StereoTools SA www.stereotools.com
Oertli Instrumente AG www.oertli-instruments.com
Steris AG www.steris.com
Orbiswiss AG www.orbiswiss.com
Straumann Holding AG www.straumann.com
orthopunkt ag www.orthopunkt.ch
Swiss Dental Specialties GmbH www.swissdentalspecialties.ch
Ortho-Team AG www.ortho-team.ch
Synthes GmbH www.depuysynthes.com
Orthotop – Technische Orthopädie www.orthotop.ch
team.sacon gmbh www.team-sacon.ch
PanGas Healthcare www.pangas-healthcare.ch
Thommen Medical AG www.thommenmedical.ch
Pantec Biosolutions AG www.pantec-biosolutions.com
Topol AG www.topol.ch
PB Swiss Tools GmbH www.pbswisstools.com
Ulrich AG www.ulrich-swiss.ch
Pnn Medical SA www.pnnmedical.ch
Wernli AG www.weroswiss.com
Reha Technology AG www.rehatechnology.com
Ypsomed AG www.ypsomed.com
Roche Diagnostics International AG www.roche.ch
Ziemer Group AG www.ziemergroup.com
Safrima AG www.safrima.ch
Zimmer Schweiz GmbH www.zimmer-orthopedics.ch
SALZMANN AG www.salzmann-group.ch
33
sUPPLIERs F–L
Agie Charmilles www.gfac.com
forteq Nidau AG www.forteq-group.com
Aloxyd AG www.aloxyd.ch
Fraisa SA www.fraisa.com
AMAX Automation AG www.amax.ch
GEHRING CUT AG www.gehringcut.com
AMG Studen SA www.amg-studen.ch
GEMÜ GmbH www.gemue.ch
Amsonic AG www.amsonic.com
Grossenbacher Systeme AG www.gesys.ch
Andres AG Präzisionsdrehteile www.andresag.com
Gsell Medical Plastics AG www.gsell.ch
Azurea Technologies Bévilard SA www.azurea.ch
Gut Metallumformung AG www.metallumformung.ch
Bamotec AG www.bamotec.ch
Hagmann Maschinenbau AG www.hagmann-machines.com
Blaser Swisslube AG www.blaser.com
HAKAMA AG www.hakama.ch
Bumotec SA www.bumotec.ch
Häni + Co AG www.hanitec.ch
Buser Oberflächentechnik AG www.buser-ot.ch
Härterei Gerster AG www.gerster.ch
BWT Aqua AG www.bwt-aqua.ch
HARTING AG www.harting-mitronics.ch
Cellpack AG Kunststofftechnik kunststofftechnik.cellpack.com
Hemmann Schleiftechnik GmbH www.hemmann-schleiftechnik.ch
c-mill technologie AG www.c-mill.ch
Hempel Special Metals AG www.hempel-metals.com
Composites Busch SA www.compositesbusch.ch
HERA AG Kunststofftechnologie www.heratech.ch
createch ag www.createch.ch
hn+m gmbh www.hn-m.ch
DECTRIS Ltd. www.dectris.com
Hoffmann + Krippner Schweiz GmbH www.tastatur.ch
Diener AG Precision Machining www.diener-ag.com
Hoffmann Neopac AG www.hoffmannneopac.ch
ECR AG www.ecrag.ch
icotec ag www.icotec.ch
Enics AG www.enics.com
Iftest AG www.iftest.ch
Eram AG www.eram.ch
innotool & greminger ag www.innotool-greminger.ch
Ernst Roser AG www.roser.ch
Insys Industriesysteme AG www.insys.ch
espisa ag www.espisa.ch
Ionbond Switzerland www.ionbond.com
Estoppey-Reber SA www.estoppey.ch
Ivers-Lee MedTec AG www.ilmedtec.com
EuropTec Polymer AG www.europtec.com
Jossi Orthopedics AG www.jossi-orthopedics.ch
F + L Bachmann AG www.flb.ch
KKS Ultraschall AG www.kks-ultraschall.ch
Faulhaber Minimotor SA www.faulhaber.com
Klöckner Pentaplast Schweiz AG www.kpfilms.com
Femron AG www.femron.ch
Komax Systems LCF SA www.komaxmedtech.com
Fischer Söhne AG www.fischersoehne.ch
Lamineries Matthey SA www.matthey.ch
FLUBE AG www.flube.ch
Lanz-Anliker AG www.lanz-anliker.com 34
Source: Swiss members of Medical Cluster and FASMED (July 2012)
a–F
Source: Swiss members of Medical Cluster and FASMED (July 2012)
sUPPLIERs L–P
P–s
Lastec AG www.lastec.ch
ProWaTech AG www.prowatech.ch
LAUENER & Cie SA www.lauener.ch
regenHU Ltd. www.regenhu.com
Leitner AG www.leitner-ag.ch
Riwisa AG www.riwisa.ch
Marposs AG www.marposs.ch
ROFIN-LASAG AG www.lasag.com
Mawatec AG www.mawatec.ch
Rolla Microgear AG www.microgear.ch
maxon motor ag www.maxonmotor.com
Rösler Schweiz AG www.rosler.ch
Mécaplast SA www.mecaplast.ch
roth medical ag www.rothmed.ch
Medipack AG www.medipack.ch
Rotomed AG www.rotomed.ch
MEDMIX SYSTEMS AG www.medmix.ch
Ruetschi Technology AG www.ruetschi.com
MEISTER + Cie AG www.meister-ag.ch
Rychiger AG www.rychiger.com
Metallux SA www.metallux.ch
Safrima AG www.safrima.ch
Metallveredlung Kopp AG www.kopp-metallveredlung.ch
Samaplast AG www.samaplast.ch
Metoxit AG www.metoxit.ch
Sandmaster AG www.sandmaster.ch
MICHEL ITC AG www.michelitc.ch
Saphirwerk Industrieprodukte AG www.saphirwerk.com
Micro Crystal AG www.microcrystal.ch
Schwarz AG Feinblechtechnik www.schwarzag.ch
Micro Systems Technologies Management AG www.mst.com
SDI Surgical Device International GmbH www.sdigmbh.ch
Microdul AG www.microdul.com
Signer Titanium AG www.signer-titanium.com
Mikron Group www.mikron.com
Sintron-Polymec AG www.sintron-polymec.ch
Moser Mechanik AG www.moser-mechanik.ch
SMC Mould Innovation AG www.smc-mould.ch
Moser-Baer AG www.mobatec.ch
Sonceboz SA www.sonceboz.com
Motorex AG Langenthal www.motorex.com
Stainless Suisse SA www.stainless.eu
MPS Micro Precision Systems AG www.mpsag.com
Stettler Sapphire AG www.stettler-saphir.ch
Multivac Export AG www.multivac.ch
Stoppani AG www.stoppani.com
Mythentec AG www.mythentec.com
Sulzer Mixpac AG www.sulzerchemtech.com
NOVOPLAST AG www.novoplast.com
SuSoS AG www.susos.com
Oerlikon Heberlein Temco Wattwil AG www.heberlein-ceramics.com
SWAN Isotopen AG www.swantec.ch
Paoluzzo AG www.paoluzzo.ch
Swisstronics Contract Manufacturing AG www.swisstronics.ch
Patric inox SA www.patric-inox.ch
Synair AG www.synair.ch
Précipart SA www.precipart.ch
SYNBONE AG www.synbone.ch
Preciswiss AG www.preciswiss.com
Synergy Health Däniken AG www.synergyhealthplc.com 35
sUPPLIERs s–U
v–Z
Systems Assembling SA www.sysa.ch
Valtronic Technologies (Suisse) SA www.valtronic.com
Teuscher Kunststoff-Technik AG www.teuscher-ag.ch
Volpi AG www.volpi.ch
ThyssenKrupp Materials Schweiz AG www.thyssenkrupp.ch
W. Hänni Q-Oberflächenveredelungen AG www.w-haenni.ch
Tornos S.A. www.tornos.ch
WANDFLUH Produktions AG www.wandfluh.com
Turck duotec S.A. www.turck-duotec.com
Waterjet Holding AG www.waterjet-group.com
UCM AG www.ucm-ag.com
Ypsotec AG www.ypsotec.com
Utilis AG www.utilis.com
ZMT Zurich MedTech AG www.zurichmedtech.com
sERvICEs & CONsULTING B–E
adbodmer ag www.adbodmer.ch
Burckhardt+Partner AG www.burckhardtpartner.ch
ADS GmbH www.ads-gmbh.ch
BV Holding AG / BVgroup www.bvgroup.ch
AFC Air Flow Consulting AG www.afc.ch
bytics ag www.bytics.ch
Aligned AG www.aligned.ch
CADFEM (Suisse) AG www.cadfem.ch
Altran AG www.altran.ch
Carag AG www.carag.com
Anagram Consultants AG www.anagram.ch
CAS Clean-Air-Service AG www.cas.ch
ANS Architekten und Planer SIA AG www.ans-architekten.ch
Casalini Werbeagentur AG www.casalini.ch
aRc management SA www.arc-sa.ch
Chemgineering Business Design AG www.chemgineering.com
archimed medical communication ag www.archimed-communication.com
cobra software ag www.cobrasw.ch
Art of Technology AG www.aotag.ch
Cofely AG www.cofely.ch
Atefos AG www.atefos.ch
Confarma AG Schweiz www.confarma.ch
Atelier Roue Libre SA www.atelier-rouelibre.ch
confinis ag www.confinis.com
awtec AG für Technologie und Innovation www.awtec.ch
Creaholic SA www.creaholic.com
Axxos GmbH www.axxos.ch
CSA Engineering AG www.csa.ch
b-cube AG www.b-cube.ch
Damedics GmbH www.damedics.ch
Besser-leben-GmbH www.bl4.ch
DE BORD LTD. www.debord.ch
Bestminds GmbH www.bestminds.de
DetecMed SA www.detecmed.com
Binder Corporate Finance AG www.binder.ch
Die Ergonomen Usability AG www.ergonomen.ch
BioMedPartners AG www.biomedvc.com
e. gross consulting gmbh
Bogensberger Patent- & Markenbüro www.bpm.li
EMH Schweizerischer Ärzteverlag AG www.emh.ch
Brönnimann Heimsoft AG www.heimsoft.ch
Erdmann Design AG www.erdmann.ch
36
Source: Swiss members of Medical Cluster and FASMED (July 2012)
a–B
Source: Swiss members of Medical Cluster and FASMED (July 2012)
sERvICEs & CONsULTING E–M
M–s
Ernst & Young Ltd. www.ey.com
Medivation AG www.medivation.ch
Exhibit & More AG www.exhibitandmore.ch
MedTech Composites GmbH www.medtechcomposites.ch
Flextronics International GmbH www.flextronics.com
Meister Executive Search AG www.meister-consulting.ch
FRIKART Engineering GmbH www.frikart.ch
MEM Media Foundation www.memmedia.ch
gasteiger-science GmbH www.gasteiger-science.com
Messe Luzern AG www.medtech-forum.ch
GEWA Stiftung für Berufliche Integration www.gewa.ch
METALING SUISSE GMBH www.metaling.de
Gimelli Engineering AG www.gimelli.ch
Meyer-Hayoz Design Engineering AG www.meyer-hayoz.com
Globomotion Ltd. Liab. Co. www.globo-motion.com
milani design & consulting AG www.milani.ch
GO! Express + Logistics (Schweiz) AG www.general-overnight.ch
MISO GmbH www.miso-gmbh.ch
Gribi Messtechnik AG www.gribimesstech.ch
mt engineering gmbh www.mt-engineering.ch
Helbling Technik Bern AG www.helbling.ch
Niutec AG www.niutec.ch
HELVETING Engineering AG www.helveting.ch
Noser Engineering AG www.noser.com
HMT Microelectronic AG www.hmt.ch
Nowak Engineering GmbH www.nowak-engineering.ch
IBM Schweiz AG www.ibm.ch
OGP AG www.ogpnet.ch
ICHI GmbH www.ichi.ch
Peter Schüpbach GmbH www.schupbachltd.com
IE Industrial Engineering Zürich AG www.ie-group.com
pinPlus ag www.pinplus.ch
inmedis GmbH www.inmedis.ch
Plaschko + Partner AG www.plaschkopartner.ch
Inspire AG www.inspire.ethz.ch
Plast Competence Center AG www.plastcc.ch
Integrated Scientific Services ISS AG www.iss-ag.ch
PostLogistics AG www.postlogistics.ch
Intersteri AG www.intersteri.ch
PROCESS PRODUCT DESIGN AG www.process.ch
Invision Private Equity AG www.invision.ch
Prodym Solutions SA www.prodym.com
konplan systemhaus ag www.konplan.ch
Qualis-Laboratorium AG www.qualis-laboratorium.ch
Leancom GmbH www.leancom.ch
Reha-Consult GmbH www.reha-consult.ch
legal & medical partner gmbh www.legalmedical-partner.ch
RFZ Engineering AG www.rfz-engineering.ch
Lutz Medical Engineering www.lutzmedicalengineering.ch
RMS Foundation www.rms-foundation.ch
MAJESTY Software GmbH www.majesty.ch
Rolitec AG www.rolitec.ch
MathWorks GmbH www.mathworks.ch
Ruffner Engineering www.ruffner-engineering.com
MDS Medical Device Solutions AG www.mds-ag.ch
Schwabe AG www.schwabe.ch
Mediatum Schweiz GmbH www.mediatum.com
SDN AG easyLEARN www.sdnag.com
meditec Consulting GmbH www.meditec-consulting.ch
Sedax AG www.sedax.ch 37
sERvICEs & CONsULTING s
T–Z
sermaX AG www.sermax.ch
TEK Innovative Solutions www.teksolutions.ch
SigmaRC GmbH www.sigma-rc.com
Tribecraft AG www.tribecraft.ch
Sleep & Health SA www.sleep-health.ch
units IM-Technology AG www.units.ch
Sobek Executive Search & Consulting AG www.sobek-consulting.ch
Vogel Business Media AG www.vogel-media.ch
spine surgical GmbH www.spinesurgical.ch
Wassmann AG www.wassmannag.ch
Swiss TS Technical Services AG www.swissts.ch
Werax Service AG www.werax.ch
SWISSCONSULT Executive Search HealthCare www.swissconsult.org
you-can export development gmbh www.you-can.biz
swisselect ag bern www.swisselect.ch
Zühlke Engineering AG www.zuehlke.com
DIsTRIBUTION & saLEs B–E
3M (Schweiz) AG www.3m.com/ch
Biomet Orthopaedics Switzerland GmbH www.biometorthopaedics.ch
A. Riegger AG / ERKA CH www.riegger-medizintechnik.ch
Boston Scientific AG www.bostonscientific.ch
ADMEDICS Advanced Medical Solutions AG www.admedics.com
Brütsch/Rüegger Werkzeuge AG www.brw.ch
Advance AG www.advance-omron.ch
CMS+ logistique santé www.cms-plus.ch
aegis medical technologies gmbh www.aegismedtec.com
Cochlear AG www.cochlear.com
Aichele Medico AG www.aichele-medico.ch
Coloplast AG www.coloplast.ch
AMO Switzerland GmbH www.amo-inc.com
ConvaTec (Switzerland) GmbH www.convatec.ch
Anandic Medical Systems AG www.anandic.com
Cook (Switzerland) AG www.cook.ch
Anklin AG www.anklin.ch
Cosanum AG www.cosanum.ch
Apotheke Dr. Portmann AG www.portmann.ch
Covidien Switzerland Ltd. www.covidien.com
Arthrex Swiss AG www.arthrex.ch
Desopharmex AG www.desopharmex.ch
Astra Tech SA www.astratech.ch
Diamex AG www.diamex.ch
Auforum AG www.auforum.ch
DIHAWAG www.dihawag.ch
Bard Medica SA www.bard.com
Diversey Europe B.V., Utrecht www.diversey.com
Bauerfeind AG www.bauerfeind.ch
Dolder AG www.dolder.com
Bayer (Schweiz) AG www.bayer.ch
Domed GmbH www.domed.ch
Becton Dickinson AG www.bd.com
Dürr Dental Schweiz AG www.duerr-dental.ch
Bigla AG www.bigla-care.ch
Dynavita GmbH www.dynavita.ch
Bimeda AG www.bimeda.ch
EchoWorld www.echoworld.ch
Binder Rehab AG www.binderrehab.ch
Ecolab (Schweiz) GmbH www.ecolab.ch
38
Source: Swiss members of Medical Cluster and FASMED (July 2012)
a–B
Source: Swiss members of Medical Cluster and FASMED (July 2012)
DIsTRIBUTION & saLEs E–H
H–N
Eizo Nanao AG www.eizo.ch
HomeCare-Medical GmbH www.homecare-medical.ch
Endotell AG www.endotell.ch
Hospitec AG www.hospitec.ch
ERBE Swiss AG www.erbe-swiss.ch
ICU Scandinavia Schweiz GmbH www.icu.ch
Favoterm AG www.favoterm.ch
Invacare AG www.invacare.ch
Fresenius Medical Care (Schweiz) AG www.fmc-ag.com
Jomes – Reha www.jomes.ch
G. Weinmann AG www.weinmann.de
KCI Medical GmbH www.kci-medical.ch
Galenica AG www.galenica.com
Laubscher & Co AG www.laubscher.ch
Galexis AG www.galexis.com
Leuag AG www.leuag.ch
Galmag AG www.galmag.ch
Liberty Medical (Switzerland) AG www.hollister.ch
Gambro Hospal (Schweiz) AG www.gambro.com
Lukas Jenni GmbH www.lukas-jenni.ch
GE Medical Systems (Schweiz) AG www.gehealthcare.com
Maquet AG www.maquet.ch
Gelbart AG www.gelbart.ch
Marcel Blanc & Cie SA www.marcel-blanc.ch
Gibraltar Trading GmbH – Division MedHealth www.medhealth.ch
MaxiMed Sàrl www.maximed.ch
Ginova medical ag www.ginovamed.ch
MCM Medsys AG www.mcm-medsys.ch
Gloor Rehabilitation & Co. AG www.gloorrehab.ch
Medical Systems Solution GmbH www.medicalss.net
Granger Médical SA www.granger-medical.ch
Medical Vision AG www.medicalvision.ch
Grauba AG www.grauba.ch
Medicare AG www.medicareag.ch
Hausmann Spitalbedarf AG www.hausmann.ch
Medicor Medical Supplies GmbH www.medicor.ch
HealthWatch Swiss AG www.healthwatchswiss.eu
Medidor AG www.sissel.ch
Heiland Schweiz AG www.heiland.ch
medi-lan ag www.medi-lan.ch
heimelig betten AG www.heimelig.ch
medilas ag www.medilas.ch
Heinz Stampfli AG www.heinzstampfli.ch
Mediq Suisse AG www.mediqsuisse.ch
Hélios Handicap Sàrl www.helioshandicap.ch
Méditec SA www.meditec.ch
Hermap AG www.hermap.ch
Mediwar AG www.mediwar.ch
Hilfsmittel-Markt GmbH www.hilfsmittelmarkt.ch
MedPlast SA www.medplast.ch
Hilfsmittelstelle Bern www.hilfsmittelstelle.ch
MF Réhabilitation Sàrl www.mfrehab.ch
Hilfsmittelstelle Burgdorf www.hms-burgdorf.ch
Miracor Sales & Marketing GmbH www.miracormedical.com
Hitachi Medical Systems Europe Holding AG www.hitachi-medical-systems.ch
Mölnlycke Health Care AG www.molnlycke.com
hock’n roll ag www.hocknroll.ch
MVB Handels AG
Hologic Suisse S.A. www.hologic.com
Naropa Reha AG www.naropa-reha.ch 39
DIsTRIBUTION & saLEs R–T
NL Neolab SA www.neolab.ch
ResMed Schweiz AG www.resmed.ch
NOSAG AG www.nosag.ch
Roll-Star 86 Sagl www.roll-star.ch
Novimed AG www.novimed.ch
RS-Hilfsmittel GmbH www.rsgmbh.ch
Novo Nordisk Pharma AG www.novonordisk.ch
Sanaclean AG www.sanaclean.ch
Novomed GmbH www.novomed.ch
Sanitätsgeschäft Beck AG www.sanbeck.ch
Nufer Medical AG www.nufer-medical.ch
Sanitätshaus Sanbor AG www.buchli.ch
Olympus Schweiz AG www.olympus.ch
Santé-Confort
Omniprax AG www.omniprax.ch
SCA Hygiene Products AG www.sca.com
Ortho plus GmbH www.orthoplus.ch
Siemens Schweiz AG www.siemens.ch
Orthoconcept SA www.orthoconcept.ch
Six Sigma Tools AG www.sixsigmatools.ch
Otto Bock Suisse AG www.ottobock.ch
Sodimed SA www.sodimed.ch
Paradigm Spine Switzerland AG www.paradigmspine.de
Sonotech Haltiner & Pitteloud www.sonotech.ch
Permobil AG www.permobil.com
SORIN Group International SA www.sorin.com
Philips AG Healthcare www.philips.ch/healthcare
SRS SA www.srs-handilift.ch
Plus Surgical AG www.plussurgical.com
St. Jude Medical (Schweiz) AG www.sjm.com
Polymed Medical Center AG www.polymed.ch
Strack AG www.strack.ch
PromediTec Sàrl www.promeditec.ch
Stryker Osteonics SA www.stryker.ch
Promefa AG www.promefa.ch
Sunrise Medical AG www.sunrisemedical.ch
PROreha www.proreha.ch
Synmedic AG www.synmedic.ch
RAUMEDIC AG www.raumedic.com
Systagenix Wound Management LLC www.systagenix.com
RegioMed www.regiomed-be.ch
Teleflex Medical AG www.teleflex.com
Reha Med AG www.rehamed.ch
TeMeCo Services AG www.temeco.ch
Reha mobil GmbH www.rehamobil.ch
Teomed AG www.teomed.ch
REHABIL AG www.rehabil.ch
Terumo Deutschland GmbH www.terumo-europe.com
Rehabilitations-Systeme AG www.rehasys.ch
Theo Frey AG www.theo-frey.ch
Rehadis GmbH www.rehadis.ch
Theramed AG www.theramed.ch
Reha-Hilfen AG www.reha-hilfen.ch
Tornier AG www.tornier.ch
Reha-Huus GmbH www.rehahuus.ch
Toshiba Medical Systems AG www.toshiba-medical.ch
Rehatec AG www.rehatec.ch
Treier Endoscopie AG www.treier.com
Reha-Technik Alex Hofer www.rehatechnikhofer.ch
trendreha ag www.trendreha.ch
40
Source: Swiss members of Medical Cluster and FASMED (July 2012)
N–R
DIsTRIBUTION & saLEs v
W–Z
Valteo SA www.valteo.ch
Weita AG www.weita.ch
Vermeiren (Schweiz) AG www.vermeiren.ch
ZweiPlus Medical GmbH www.2plusmedical.com
Vygon Schweiz GmbH www.vygon.com
REsEaRCH & EDUCaTION a–G
I–Z
AO Foundation www.aofoundation.org
Inselspital – Universitätsspital Bern www.insel.ch
Berner Fachhochschule – Technik und Informatik Institut für Medizinal- und Analysetechnologie www.ti.bfh.ch/medizintechnik www.fhnw.ch/ima EMPA www.empa.ch
Sonnenhof AG Bern www.sonnenhof.ch
Fachhochschule Nordwestschweiz www.fhnw.ch
Universität Bern www.unibe.ch
Gesundheitszentrum Schönberg Gunten AG www.schoenberg.ch
NON-PROFIT a–M
M–Z
Aargau Services Standortförderung www.aargauservices.com
Medtech Switzerland www.medtech-switzerland.com
FASMED www.fasmed.ch
OSEC www.osec.ch
Fondation SEREI www.serei.ch
OTC Foundation www.otcfoundation.org
Gewerkschaftsbund der Stadt Bern & Umgebung Standortförderung des Kantons Zürich www.gkb-gsb.ch www.standort.zh.ch IPQ Institut für praxisorientierte Qualifizierung www.ipq.ch
UK Trade & Investment, British Embassy Berne www.ukti.gov.uk/invest
IWAZ www.iwaz.ch
Wirtschaftsförderung Kanton Bern www.wfb.ch
Medical Cluster www.medical-cluster.ch
Wirtschaftsförderung Kanton Solothurn www.standortsolothurn.ch
Source: Swiss members of Medical Cluster and FASMED (July 2012)
INDIvIDUaLs Fred-Rainer Grohmann
Marcel Scacchi
Alfred Kammer www.kk-cc.ch
Margit Widmann
sUPPORTING PaRTNERs OF THE sWIss MEDTECH REPORT 2012 G R E AT E R G E N E VA B E R N E a r e a www.ggba-switzerland.ch
Ko m m i s s i o n f ü r Te c h n o l o g i e & I n n ova t i o n www.kti.admin.ch
Greater Zurich Area www.greaterzuricharea.ch
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IMPRINT
sTEERING COMMITTEE Patrick Dümmler (Medtech Switzerland) Peter Biedermann (Medical Cluster) Melchior Buchs (Fasmed)
PROJECT MaNaGEMENT Patrick Dümmler (Medtech Switzerland) Jonas Frey (Medtech Switzerland) Patrizia Fischer
TExT Heinrich Christen Kathrin Cuomo-Sachsse Marco Estermann Elsbeth Heinzelmann Kevin Meile Christian Ryf
LaYOUT Dominique Durtschi (Medical Cluster)
PHOTOs Peter Mosimann
PRINT Schwabe AG
sELECTED LITERaTURE The Swiss Medical Technology Industry 2012 – In The Wake Of The Storm Authors: Dr. Patrick Dümmler and Beatus Hofrichter Publisher: Medical Cluster Partners: Medical Cluster, Medtech Switzerland, IMS Consulting Group, Commission for Technology & Innovation CTI
FRONT PaGE Mathys has been developing, producing and distributing products for joint replacement since 1958. The Swiss family company sets its values on highest quality and ground-breaking innovations – like the with vitamin E stabilized highly cross-linked polyethylene or the recently developed short hip stem.
PHOTOs WITH KIND PERMIssION OF Schiller AG (page 21) forteq Nidau AG (page 25) B. Braun Medical AG (page 29) © Medtech Switzerland, 2012
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