Healthcare Resource Guide: Chile

Chile Statistics

Summary

Market Entry

Current Market Trends

Main Competitors

Current Demand

Registration Process

Reimbursement

Barriers

Trade Events

CS Contacts

Market Size

Capital: Santiago

Population: 18.1 million

GDP: US$ 277 billion

Currency: Chilean peso

Language: Spanish

Summary

The country’s annual healthcare expenditure amounts to approximately 7.3% of Chile’s GDP. President Pinera’s administration took office in March 11, 2018. His announcements for the healthcare sector include: reform of the private healthcare insurance (ISAPRES) system; reform of the Primary Attention System; modernization of FONASA, the public-sector healthcare insurance system; and amendments to the “Ley Farmacos II” currently being discussed in Congress.

Chile’s Universal Access to Healthcare government program, ex “Plan AUGE”, currently known as “GES” (Garantias Explicitas en Salud) started in 2005 and consists of government-subsidized healthcare coverage for, as of now, 80 diseases considered to be high-incidence. In the private sector, however, the expenditure has doubled in the last 10 years. Private clinics have increased their number of outpatient centers and number of beds, mainly due to three factors: a) increase in the number of attentions, b) an aging Chilean population, and c) state-of-the-art technology available for diagnosis and treatment.

FONASA, the government-run healthcare insurance system, covers 69% of the population; of the remaining 31%, approximately 5% lacks any type of insurance, 3% has insurance under the Ministry of Defense (for armed forces and police), and 23% (bordering on 2.6 million people) pay into the private sector insurance system provided by ISAPRES. There are 12 ISAPRES currently operating in the Chilean market.

In terms of regulation, pharmaceuticals have mandatory registration at the Institute of Public Health. Currently, medical devices that need authorization include contraceptives, gloves, needles, and syringes. However, there is a law currently being discussed in Congress - Ley Farmacos II - that may impose additional regulations to pharmaceuticals and medical devices.                                          

Market Entry

U.S. medical equipment and devices are well regarded in Chile. A strategy that has proven successful is to appoint a qualified agent or distributor. Chilean distributors in the medical sector are usually knowledgeable, experienced, and have a good network of sales people throughout the country. Reliable after sales support is a priority in this market. Local distributors/representatives should be experienced in selling to the public sector through the government portal: www.mercadopublico.cl

The metric system of weights and measures is standard in Chile. The electric power supply is 220V 50Hz. Since the implementation of the U.S.-Chile Free Trade Agreement, in 2004, medical devices/equipment, and pharmaceuticals enter Chile duty-free, provided a U.S. certificate of origin is presented to Chilean Customs. Imports to Chile from foreign countries, as well as domestic products, are subject to Chile’s 19% VAT (Value Added Tax).

Currently, mandatory registration at the Institute of Public Health is required for all pharmaceuticals and quality testing authorization contraceptives, gloves, needles, and syringes.

There are 1,002 clinical laboratories along Chile, 303 are government-owned through municipalities or health centers and the rest are privately owned. In Santiago, there are 312 laboratories and 22 blood centers, which account for 31% of the private centers that assist 40% of the population.

There is no local production of laboratory equipment other than some refrigerators, cold chambers and blood banks, so the market size is estimated on imports. In 2017 the US had a 28% market share for laboratory equipment followed by Germany with an 11% share. In the case of reagents, the market share was 37% for United States followed by 24% for Germany.

Miniaturization and automation are boosting the growth of new lines of equipment in the industry. Customers are now seeking space-saving options to cut costs. Mobility is also another focus; therefore, portable laboratory instruments are hitting the market. Regarding reagents, the focus is on PCR.

Public sector opportunities are published as tenders at the government portal www.mercadopublico.cl Foreign companies may register on this portal as foreign suppliers; however, it is often more effective to appoint a local representative with experience in selling to the public sector and the use of the government portal. Local reps generally have good contacts in the public and private sector and a network of sales people throughout the country. Selling to the public sector may be a challenge, as suppliers complain that payment terms are often not met. In April 2018, local media reported that the public hospitals debt amounted to US$ 320 million.

Current Market Trends

U.S. state-of-the-art medical technology has a good market potential in Chile, especially in the private sector as the Chilean private healthcare system is well regarded in the region. Private hospitals receive foreign patients for treatment on a regular basis. Some of these private hospitals have Joint Commission accreditation, and therefore maintain high standards as a permanent goal. Many Chilean physicians have U.S. post-graduate degrees and maintain regular contact with important U.S. healthcare institutions.

Main Competitors

In 2017, medical device imports amounted to US$ 692 million with the following market share: The United States has approximately 39%, followed by Germany with 23%, and China with 10%. Price is an extremely important factor, especially in the public sector where limited funds cover a large segment of the population. The private sector is also price sensitive but is far more likely to consider recognized brands that have good quality and after-sales reputation.

Current Demand

The following list of equipment is currently in demand in Chile: autoclaves, surgical tables, non-disposable and disposable surgical instruments, cardiology equipment including pacemakers, monitors (low and medium complexity), central monitors, ventilators, aspiration pumps, imaging equipment, trauma equipment, anesthesia instruments and appliances, hospital furniture.

The following equipment/devices continue to have market potential: surgical tables, surgical lamps and flash lights, disposable and non-disposable surgical instruments, central monitors, trauma equipment, emergency equipment, and hospital furniture.

Since the implementation of the U.S. Chile Free Trade Agreement, in 2004, medical devices with U.S. Certificate of Origin enter Chile duty free. However, a 19% Value Added Tax is levied over the CIF value of the merchandise. Sub-Sector best prospects include modern senior home care equipment products and assistive devices, modern orthotics, modern orthopedic devices, trauma equipment, central monitors, incubators, surgical tables, disposable and non-disposable surgical instruments. 

Registration Process

In general, there is no health-required registration imposed on medical devices except for contraceptives, gloves, needles, and syringes, which do need an authorization/quality control assessment to certify its safety. X-Ray equipment or nuclear medicine equipment does need special authorization from other government agencies. Pharmaceuticals do have mandatory registration that is granted by the Institute of Public Health.

Reimbursement

Employees under contract are mandated by law to designate 7% of their monthly net wages to healthcare. However, free-lance workers are not obliged to do so. Contracted workers must choose between public and private healthcare to which they use their 7%.

In the public sector, the workers are classified into three different categories depending on the contribution, which means that there are workers who will pay for healthcare services and others who will not. Currently in Chile the minimum monthly wage is approximately US$ 425. Therefore, workers who earn less than this monthly amount do not pay. Wages above the minimum monthly wage must pay around 10% of the healthcare service, depending on the contribution.

The private sector, on the other hand, is different. Private healthcare insurance is called ISAPRES. The insurance is held by a contract that is renewed on an annual basis. For a new contract with a company, a healthcare declaration of all diseases must be provided. In some cases, an insurance company may decide to not include healthcare for previously diagnosed chronic diseases within the proposed plan. The contracted plan is paid on a monthly basis and the cost is calculated depending on the chosen benefits. In general, the healthcare service is paid according to the contracted plan and prior to any healthcare services provided. Insurance plans also have a limit on certain services they provide and once the annual limit is reached, the rest of the cost of healthcare must be paid out of pocket. 

Barriers

Chile has a favorable import climate. There are no known barriers to U.S. medical equipment, devices, pharmaceuticals, laboratory equipment, or diagnostic test.

Procurement & Tenders

Government procurement portal: www.mercadopublico.cl

Ministry of Health: www.minsal.cl

FONASA, National Health Fund: www.fonasa.cl

ISAPRE’s Association: www.isapre.cl

Health Superintendence: www.supersalud.gov.cl

Institute of Public Health: www.ispch.cl

Association of Private Clinics: www.clinicasdechile.cl

Trade Events

ExpoHospital

Chilean international trade fair for healthcare technology, devices, products, and services. Next Dates TBD.

  

FAQs

1. What are the main healthcare priorities for the current administration?

Reduce the number of patients in waiting list throughout the country, by creating a unified national registry with to establish a maximum waiting time. Implement a delay alert system that will give patients time to find an alternative solution. Create an easy access healthcare system for the elderly citizens.

2. What does the retail pharmaceutical sector look like in Chile?

There are three pharmacy chains that represent approximately 92% of the market. Farmacias Ahumada http://www.farmaciasahumada.cl/fasaonline/fasa/ owned by Walgreens Boots Alliance; Cruz Verde , http://www.cruzverde.cl/ owned by the Mexican group Femsa; and Salcobrand, https://salcobrand.cl/ owed by the local group BCI.

Statistics Snapshot

Market Size

Healthcare spending (including investment)

 

... as percent of GDP

7.8 % (2014)

Hospitals, Procedures, Healthcare Professionals UN:

Number of hospitals

363 (2015)

…Public

46%

…Private

54%

Number of hospital beds

38,496 (2015)

... available beds per capita

21 per 10,000 (2010)

Number of surgical procedures

5,540 per 100,000 (2012)

Physicians

1.03 physicians/1,000 population (2009)

Demographics

Population

17,650,114 (2016)

Life expectancy men/women

75.7 men

81.9 women

Infant mortality

6.7 deaths/1,000 live births

Percent of population older than 65

10.51%

...projection, 2030

20.2 million

Annual deaths

101,943

...caused by [highest disease burden]

Ischemic heart disease

...caused by [second highest]

Cerebrovascular disease

Prevalence of [fastest growing disease burden]

Chronic kidney disease

U.S. Commercial Service Contact Information

Name: Veronica Pinto

Position: Commercial Specialist

Email: veronica.pinto@trade.gov

Phone: (56-2) 2330-3369

Industries: Pharmaceuticals, medical devices/equipment, dental devices/equipment, biotechnology, and healthcare services.

Name: Claudia Melkonian

Position: Commercial Assistant

Email: claudia.melkonian@trade.gov

Phone: +54-11-5777-4519

Industries: Laboratory/testing equipment, veterinary equipment/products/ pharmaceuticals.


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