Medical & Healthcare Equipment Industry in Hong Kong
10 March 2017
Hong Kong’s medical and healthcare equipment industry mainly targets the household consumer market. In 2016, Hong Kong’s total exports of medical and healthcare equipment increased by 8%.
According to the United Nations, the world population reached 7.5 billion in 2017. There were more than 960 million people aged 60 or above, accounting for 13% of the world’s total population. By 2050, there will be 2.1 billion people who are aged 60 or above, accounting for 22% of the world’s total population.
An aging population and increased health consciousness are factors boosting demand for home healthcare equipment such as commode chairs, pill alarm boxes and positioning aids, as well as medical equipment for patients suffering from cardiopulmonary disease, diabetes and neurological disorder. According to the latest figures from the World Health Organisation, the total global expenditure for health is around US$6.5 trillion a year.
Technology plays a major role in household medical products and services. Innovations such as mobile microminiature and remote surgery techniques, DNA-based diagnostics, tissue-engineered organs and advanced information technologies provide solutions to some of the most persistent and debilitating healthcare problems and create demand for new medical and healthcare devices.
The medical and healthcare equipment industry has two distinct markets: the household consumer and professional or institutional (hospitals and clinics). Most medical and healthcare equipment companies in Hong Kong are engaged in OEM business, such as producing massagers and blood pressure monitors for household consumer use; and rubber moulding, plastics/resins for institutional use. With increased competitiveness in price and product development, the Chinese mainland is increasingly putting pressure on Hong Kong local companies, inducing them to strive for product and company re-positioning. Many Hong Kong-based companies also provide engineering design services in order to enhance their competitive edge.
To lower production costs, many Hong Kong manufacturers have relocated their production facilities to the Chinese mainland, and most of them are engaged in the manufacturing of mechano-therapy appliances/massage apparatus. However, quality control, marketing, research and development, design, as well as material and equipment procurement continue to be conducted in Hong Kong.
Products with better growth prospects for Hong Kong manufacturers include home-based equipment, hygiene sterilised supplies, equipment for less-invasive procedures, orthopaedic tools and devices, devices and supplies for high health-risk diseases and injuries and telemedicine etc.
Performance of Hong Kong’s Exports of Medical and Healthcare Equipment
In 2016, Hong Kong’s total exports of medical and healthcare equipment increased by 8%. Exports to the Chinese mainland, the largest market for Hong Kong’s medical and healthcare equipment increased by 4%. Meanwhile, exports to the US and the EU, respectively, increased by 30% and 5%.
Among different product categories, Hong Kong’s exports of miscellaneous electro-diagnostic apparatus (including apparatus for functional exploratory examination or for checking physiological parameters) slightly increased by 3%. Meanwhile, exports of syringes/needles for medical/surgical increased by 18%.
Outsourcing has been growing in popularity among overseas manufacturers of medical and healthcare equipment in recent years. Hong Kong companies are in good position to act as contract manufacturers or sourcing partners given their edge in quality assurance and intellectual property (IP) protection. Though the cost of regulatory compliance is relatively higher in Hong Kong than the mainland, this helps to differentiate Hong Kong companies from other low-cost competitors. It also reinforces the role of Hong Kong companies as a partner providing high-quality products and services.
Medical equipment is mainly sold directly to hospitals and clinics, while healthcare equipment is mostly distributed to department stores, chain stores and supermarkets via local or overseas trading companies. Well-established suppliers, such as Osim and OTO, have set up their own specialty shops.
Many of Hong Kong’s medical and healthcare goods are exported under OEM arrangements with supplied product specifications and designs. Hong Kong manufacturers are highly regarded for their handling of customers’ intellectual property (IP) and sensitive technology. In recent years, Hong Kong manufacturers have become increasingly involved in product design and development, engineering, modelling, tooling and quality control. In order to differentiate themselves from low-end products, many Hong Kong manufacturers apply for different international certifications for their products.
Apart from producing for OEM customers, some Hong Kong manufacturers also have in-house R&D departments to develop models produced under their own brand names. For these original brand products, Hong Kong manufacturers would sell to overseas importers and distributors, who would also act as agents to provide an after-sales services. It is advised that manufacturers/distributors take out insurance or make other arrangements to minimise the risk of product liability claims.
To further explore overseas market opportunities, medical and healthcare equipment manufacturers and exporters are encouraged to join the trade fair missions and exhibitions organised by the Hong Kong Trade Development Council (HKTDC). HKTDC also organises from time to time study or matchmaking missions for Hong Kong manufacturers to visit specific markets for establishing new business connections.
Demographic trends have an important impact on the medical and healthcare equipment industry. According to the United Nations, the older population is, and will remain, predominately female. Globally, women outlive men by 5 years on average in 2010-2015. Life expectancy at birth was 73 years for females compared to 68 years for males. Globally, life expectancy is projected to 77 years in 2045-2050. These trends have resulted in an increasing demand for medical and healthcare products designed for the ageing population.
The total global expenditure for health is now more than US$6.5 trillion a year, according to the World Health Organization, and health expenditure as a percentage of GDP has been increasing among all major economies, including the Chinese mainland. The increasing share of medical services or healthcare in household expenditures in some developing countries can be translated into more opportunities for Hong Kong exporters of medical and healthcare products. Meanwhile, growth of public health expenditure in the more industrialised countries is slowing down which, however, creates opportunities for home medical equipment targeted at patients undergoing recuperation and therapy processes.
Since the implementation of the third phase of the Mainland and Hong Kong Closer Economic Partnership Arrangement (CEPA III) in January 2006, all products of Hong Kong origin can be imported into the mainland at zero tariffs. According to the stipulated procedures, products that have no existing CEPA rules of origin will enjoy tariff-free treatment upon applications by local manufacturers and upon the CEPA rules of origins being agreed and met. For more information about country of origin, please refer to the Trade and Industry Department’s CEPA web page.
General Trade Measures Affecting Exports of Medical and Healthcare Equipment
Equipment for medical purposes faces stringent regulations in overseas markets. In the US, the Food and Drug Administration (FDA) is responsible for ensuring that medical devices comply with the safety and effectiveness requirements stipulated in the Federal Food, Drug and Cosmetic Act. The US regulations cover various aspects of design, clinical evaluation, manufacturing, packaging, labelling and post-market surveillance of medical devices.
In the EU, medical devices are covered by three main directives. These set out the requirements for the performance and safety of medical devices and the procedures for checking product compliance. A product is required to have a CE mark to show full compliance with relevant directives. The CE mark enables the product to be marketed in any EU member country.
The Japanese government has revised the Pharmaceutical Affairs Law (PAL), and it had come into force in November 2014. Manufacturers, repairers and distributors are required to obtain a business licence for Marketing Authorisation Holders (MAH). If the manufacturing facilities are located outside of Japan, these foreign manufacturing facilities are required to obtain Foreign Manufacturer Accreditation instead of a Manufacturer Licence.
To market medical devices in Japan, the MAH must register the device through the following procedures:
Pre-market Submission – Class I Medical Devices
To register and market General Medical Devices (Class I devices), the MAH only needs to file a Pre-Market Submission to the Pharmaceuticals and Medical Devices Agency (PMDA), with no assessment by the PMDA.
Pre-market Certification – Class II Medical Devices
To register and market a Specified Controlled Medical Device, the MAH needs to file a Pre-Market Certification application with a Registered Certification Body (RCB) to obtain certification. This procedure is quite similar to the European CE marking using a Notified Body. Each Specified Controlled Medical Device must apply internationally harmonised standards as is the case with CE marking.
Pre-market Approval – Class II, III & IV Medical Devices
To register and market a Highly Controlled Medical Device the MAH needs to file a Pre-market Approval Application with the PMDA to obtain approval. Class II devices that are not Specified Controlled Devices are also subject to Pre-market Approval.
On the Chinese mainland, under the Regulations on the Administration and Supervision of Medical Appliances, for medical appliances imported for the first time, the import enterprise must submit samples and all necessary product information, such as instruction manuals, quality standards and examination methods, together with certification issued by the exporting country (or region) for their production and sale to the China Food and Drug Administration (CFDA) for examination, approval and registration. It is only after obtaining the import registration certificate that the enterprise may proceed to customs to complete import formalities.
Application procedures for import registration certificate:
As a result of the aging population, treatments for cardiopulmonary disease, diabetes and neurological disorders will see rapid growth, such as orthopaedic devices and pharmaceuticals that can help aging baby boomers stay active. In addition, increased consciousness in personal health and fitness in developed countries is boosting demand for home-based or self-care equipment such as pill alarm boxes, positioning aids, shower chairs, electric wheelchairs, canes, crutches and patient lifts. This equipment facilitates the prevention, detection and management of illness.
Modern technology plays major role in the medical and healthcare equipment industry. Innovations such as microminiature and remote surgery techniques, DNA-based diagnostics, tissue-engineered organs, 3D printing for cranial implants and advanced information technologies provide solutions to some of the most persistent and debilitating healthcare problems, and create demand for medical equipment utilising these new technologies. In addition, Bluetooth technology has also given rise to new medical devices such as a patient-worn pulse oximetry and a portable patient monitor. Technology has also led to telemedical services and less-invasive procedures.
 Since offshore trade has not been captured by ordinary trade figures, these numbers do not necessarily reflect the export business managed by Hong Kong companies.
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