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Emerging Markets for In Vitro Diagnostics (IVD in Brazil, Russia, India,
China and Other Nations)
June 1, 2011
There is much discussion about emerging markets in in vitro diagnostics, especially the
BRIC nations - Brazil, Russia, India and China. Which companies have been successful
in these markets and how have they accomplished it? What kind of realistic growth can
marketers expect by selling products in these areas? This report is intended to provide
an overview of trends and developments in the in IVD industry as it applies to emerging
markets and the BRIC countries in particular.
A Realistic Look at the Market for IVD in New, Emerging Markets
A good number of reports on the BRIC and emerging markets have been published.
Most of these focus on quantitative data such as number of labs, hospitals, product
registration regulations, and import taxes and conditions. Too many of them perhaps
present merely a growth scenario without presenting the challenges the nations face
and the challenges the countries face entering the market. This report provides much of
this information because it provides an objective overview of the market for in vitro
diagnostics in selected countries. This report also explores the opportunities that
specific developing countries offer to IVD companies.
Kalorama also attempts to add some realistic aspects of working in a foreign country
that are more qualitative in nature. Thus the report explores some of the cultural
aspects of how the market for clinical diagnostics may evolve in a selection of emerging
markets including the BRIC countries.
Useful Information for Business Planning
The discussion of each of the BRIC markets begins with a short introduction to the
country and follows with a SWOT analysis of the market for IVDs. The SWOT analysis
provides positive and negative aspects of market conditions. The author has decided to
include positive and negative aspects of certain factors in the same SWOT category.
The factors are classed positive or negative according to the strength of current market

2. conditions. This is done to make the analysis comprehensive and easier to read. The
report covers data trends and issues, including:
Healthcare trends and metrics in each country
Physician Office Testing (POL) in BRIC Countries
Disease Trends ( Diabetes, Cancer, Allergy, Emerging Viruses )
Lab Systems in BRIC Countries
SWOT Analysis for Each BRIC Nation, Including:
o Strengths - factors that make the country attractive for IVD companies
o Weaknesses that form barriers to entry and success such as health
insurance coverage, regulatory affairs and distribution issues
o Country Elements that Provide Testing Opportunities
o Threats - a look at the competition and incumbents
Key Companies Operating in Each Country
Research and High Technology in BRIC countries
Other Trends (Insurance, Medical Tourism, Recession Effects )
Market and economic trends are discussed from the point of view of their present and
potential impact and there is a focus on the mix of economics, healthcare and
diagnostics that may evolve in these countries.
Beyond BRIC
With all the attention directed at the BRIC countries, there is a tendency to think that
they are the only prospects for IVD market growth and development. The fact is that
some of the same trends - growing middle class, mix of infectious and non-
communicable diseases and government supported healthcare - are prevalent in many
countries in E. Europe and Africa. We provide as an example three non-BRIC nations:
Turkey, Poland and Nigeria, where IVD may flourish in the future.
From Kalorama Information, a Respected Source for IVD Market Analysis
Authored by Shara Rosen, R.T. MBA, the author of The Worldwide Market for In Vitro
Diagnostics, in seven editions, This report explores some of the quantitative and
qualitative aspects of emerging markets but leaves conclusions up to the readers, who
can best judge how their individual company culture and strategic aspirations fit with
prospects in emerging countries. The information contained here provides an overview
of the general economic and infrastructure information related to emerging markets. The
information presented in this report is derived from publicly available information
sources such as company, government, and medical organization reports. The analysis
is based on the author's industry knowledge combined with literature searches and
interviews with industry professionals and experts in in vitro diagnostics.
Additional Information

3. IVD Sales in BRIC Nations Growing Fast, But Not Without Challenges
The growing economies of the so-called 'BRIC Nations'--Brazil, Russia, India and
China--will see increased demand for healthcare services led by testing. Healthcare
market research publisher Kalorama Information notes that this is good news for
diagnostic companies. According to its report, Emerging Markets for In Vitro Diagnostics
(IVD in Brazil, Russia, India, China and Other Nations), IVD sales in BRIC nations are
expected to grow from $2.9 billion in 2009 to $5 billion in 2014, which represents a
CAGR of 12%.
This rate of growth for diagnostic instrumentation, product and reagent sales is double
the six percent growth rate projected for worldwide IVD sales. Kalorama suggests that
this growth is partially occurring because as the economies of these nations grow, they
can treat a broader set of diseases than the infectious disease treatments often
provided by large donor organizations, and treat patients that are not properly serviced
now.
"It is now recognized that it's the low- and middle-income countries that face the
greatest burden of chronic diseases such as diabetes, heart disease and cancer," said
Shara Rosen, R.T. MBA, author of the report. "As markets in industrialized countries
begin to mature, IVD companies are casting their nets in developing countries, where
rising incomes and standards of living have sparked a new health consciousness and a
growing demand for quality medical care."
According to Kalorama, the IVD market in BRIC countries is dominated by established
players such as Roche, Abbott, Siemens, Beckman Coulter, and Becton Dickinson.
However, domestic players such as Transasia, JMitra, Horiba, Kehua, Mindray and
others have taken the distribution of IVD products from urban areas to the rural areas in
their respective markets. Incumbent companies--international and local alike--tend to
provide a host of routine tests. It is expected that as IVD demand in developing
countries increases, there will be opportunities for rapid tests and advanced tests that
are now emerging as healthcare systems become more sophisticated.
Despite the strong growth rate, the report stresses that opportunities for diagnostic
companies in BRIC nations will take some time to develop. The report also takes note of
financial and infrastructure challenges that will present obstacles to companies
marketing in the BRIC nations and other emerging markets. Economic growth for
instance, would not make every citizen of the BRIC countries a customer.
"Economic growth does not always mean that the new found resources will be shared
by all socioeconomic groups in the country," said Rosen. "The reality is that although
there are many wealthy people who can afford the type of healthcare services that are
available in the U.S. and in Europe, there are many more people who barely earn
enough to feed themselves and their families."

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TABLE OF CONTENTS
There is much discussion about emerging markets in in vitro diagnostics, especially the
BRIC nations - Brazil, Russia, India and China. Which companies have been successful
in these markets and how have they accomplished it? What kind of realistic growth can
marketers expect by selling products in these areas? This report is intended to provide
an overview of trends and developments in the in IVD industry as it applies to emerging
markets and the BRIC countries in particular.
A Realistic Look at the Market for IVD in New, Emerging Markets
A good number of reports on the BRIC and emerging markets have been published.
Most of these focus on quantitative data such as number of labs, hospitals, product
registration regulations, and import taxes and conditions. Too many of them perhaps
present merely a growth scenario without presenting the challenges the nations face

6. and the challenges the countries face entering the market. This report provides much of
this information because it provides an objective overview of the market for in vitro
diagnostics in selected countries. This report also explores the opportunities that
specific developing countries offer to IVD companies.
Kalorama also attempts to add some realistic aspects of working in a foreign country
that are more qualitative in nature. Thus the report explores some of the cultural
aspects of how the market for clinical diagnostics may evolve in a selection of emerging
markets including the BRIC countries.
Useful Information for Business Planning
The discussion of each of the BRIC markets begins with a short introduction to the
country and follows with a SWOT analysis of the market for IVDs. The SWOT analysis
provides positive and negative aspects of market conditions. The author has decided to
include positive and negative aspects of certain factors in the same SWOT category.
The factors are classed positive or negative according to the strength of current market
conditions. This is done to make the analysis comprehensive and easier to read. The
report covers data trends and issues, including:
Healthcare trends and metrics in each country
Physician Office Testing (POL) in BRIC Countries
Disease Trends ( Diabetes, Cancer, Allergy, Emerging Viruses )
Lab Systems in BRIC Countries
SWOT Analysis for Each BRIC Nation, Including:
o Strengths - factors that make the country attractive for IVD companies
o Weaknesses that form barriers to entry and success such as health
insurance coverage, regulatory affairs and distribution issues
o Country Elements that Provide Testing Opportunities
o Threats - a look at the competition and incumbents
Key Companies Operating in Each Country
Research and High Technology in BRIC countries
Other Trends (Insurance, Medical Tourism, Recession Effects )
Market and economic trends are discussed from the point of view of their present and
potential impact and there is a focus on the mix of economics, healthcare and
diagnostics that may evolve in these countries.
Beyond BRIC
With all the attention directed at the BRIC countries, there is a tendency to think that
they are the only prospects for IVD market growth and development. The fact is that
some of the same trends - growing middle class, mix of infectious and non-
communicable diseases and government supported healthcare - are prevalent in many
countries in E. Europe and Africa. We provide as an example three non-BRIC nations:

7. Turkey, Poland and Nigeria, where IVD may flourish in the future.
From Kalorama Information, a Respected Source for IVD Market Analysis
Authored by Shara Rosen, R.T. MBA, the author of The Worldwide Market for In Vitro
Diagnostics, in seven editions, This report explores some of the quantitative and
qualitative aspects of emerging markets but leaves conclusions up to the readers, who
can best judge how their individual company culture and strategic aspirations fit with
prospects in emerging countries. The information contained here provides an overview
of the general economic and infrastructure information related to emerging markets. The
information presented in this report is derived from publicly available information
sources such as company, government, and medical organization reports. The analysis
is based on the author's industry knowledge combined with literature searches and
interviews with industry professionals and experts in in vitro diagnostics.
TABLE OF CONTENTS
CHAPTER ONE: EXECUTIVE SUMMARY
Scope and Methodology
Emerging Market Trends
World Demand for Diagnostics
CHAPTER TWO: INTRODUCTION
Background
Population Trends and Disease Demographics
Disease Trends
o Diabetes
o Cancer
o Allergy
o Emerging Viruses
Market Segment Opportunities
o Physician Office Testing (POL)
o Lab Systems
o Research and High Technology
Insurance Trends
Medical Tourism
Recession Effects
CHAPTER THREE: OVERVIEW AND BRIC COMPARISON
Background
The BRIC Metrics
o Available Market
o Culture of Paying for Healthcare
o Capacity to Serve

8. IVD Spending
China and India - The BRIC Engines
CHAPTER FOUR: CHINA: MARKET TRENDS/DEMAND ANALYSIS
Introduction
Strengths - Factors That Make the Country Attractive
Weaknesses - Factors That Offer Barriers to Market Success and Entry
o Insurance
o Regulatory Affairs
o Distribution Issues
Opportunities - Elements That Provide Opportunity
Threats - competition and incumbent players
o The Market
o International IVD Companies
o Bayer Diabetes Care
o Biohit Oy
o Cogenics (now part of Danaher)
o Eiken Chemical Co., Ltc
o Fenwal, Inc.
o IRIS International, Inc.
o Luminex Corporation
o MedMira
o m-u-t AG
o PerkinElmer
o Phadia AB
o QIAGEN N.V.
o Quest Diagnostics
o Quintiles
o Roche Diagnostics
o SuperNova Diagnostics, Inc.
o China-based Companies
o Autobio Group
o Beijing Genome Institute (BGI)
o Bio-Asia Diagnostics
o CapitalBio Corporation
o Caretium Medical Instruments
o Chemtron Biotech Co. Ltd
o China Health Labs & Diagnostics Ltd.
o China Medical Technologies
o China Sky One Medical, Inc.
o Hai Kang Life Corporation
o Mindray Medical International Limited
o Motic
o ProGenTech Limited
o Runbio Biotech Co. Ltd.

9. o Shanghai Kehua Bio-Engineering
o Vita Genomics
CHAPTER FIVE: INDIA: MARKET TRENDS/DEMAND ANALYSIS
Introduction
Strengths - factors that make the country attractive
o No Centralized Decision Makers
o Insurance
o Regulatory Affairs
o Distribution Issues
Opportunities - elements that provide opportunity
Threats - competition and incumbent players
o The Market
o International IVD Companies
o Biomagnetics Diagnostics Corp.
o DiaGenic
o Novartis Diagnostics
o PerkinElmer
o Phadia AB
o QIAGEN N.V.
o Quest Diagnostics
o Quintiles
o Radient Pharmaceuticals Corp.
o India-Based Companies
o 3B BlackBio India Biotech
o Agappe Diagnostics
o AGD Biomedicals Pvt. Ltd.
o Avesthagen Limited
o Diagnova
o J.Mitra & Co. Pvt Ltd
o ROBONIK INDIA PVT LTD
o Span Diagnostics Ltd.
o Transasia Bio-Medicals Ltd.
o Trivitron Group
o The Tulip Group
o Vimta Labs
CHAPTER SIX: BRAZIL: MARKET TRENDS/DEMAND ANALYSIS
Introduction
Strengths - factors that make the country attractive
Weaknesses - factors that offer barriers to market success and entry
o Insurance
o Regulatory Affairs
o Distribution

10. Opportunities - elements that provide opportunity
Threats - competition and incumbent players
o The Market
o International IVD Companies
o Agendia B.V.
o AnaSpec, Inc.
o Axela Inc.
o Chembio Diagnostics Inc.
o Fluidigm Corporation
o Genomic Health, Inc.
o Hemagen Diagnostics, Inc
o Phadia AB
o Brazil-based Companies
o Bio-Manguinhos/FioCruz
o BIOTÉCNICA Indústria e Comércio Ltda
o CELM - Companhia Equipadora De Laboratorios Modernos
o Doles Reagentes
o Ebram Productos Laboratorias
o Gold Analisa
o Hemogram Indústria e Comercio de Produtos Hospitalares
o Katal Biotechnologica/Interteck
o Laborlab
o Wama Diagnostica
CHAPTER SEVEN: RUSSIA: MARKET TRENDS/DEMAND ANALYSIS
Introduction
Strengths - Factors that make the Country Attractive
Weaknesses - Factors that Offer Barriers to Market Success and Entry
o Insurance
o Regulatory Affairs
o Distribution Issues
Opportunities - Elements That Provide Opportunity
Threats - Competition and Incumbent Players
o The Market
o International IVD Companies
o Arrayit Corp.
o Biohit Oy
o Russia-based Strength
o Alkor Bio
o Biola
o Dialat Ltd.
o Evrogen JSC
o InterLabService Ltd. (ILS)
o Olveks Diagnostikum
o Technomedica

11. o Vital Diagnostics SPb
o Xema-Medica Co., Ltd.
CHAPTER EIGHT: NATIONS OTHER THAN BRIC
Introduction
Turkey
Poland
Nigeria
CHAPTER NINE: CONCLUSION
Introduction
Insurance
Intellectual Property Protection
Regulatory Affairs & Distribution
Market Opportunities
TABLE OF EXHIBITS
CHAPTER ONE: EXECUTIVE SUMMARY
Figure 1-1 IVD Market in BRIC Nations
Table 1-1: In Vitro Diagnostic Reagent, BRIC countries 2009-2014, $ million
Table 1-2: Market Conditions in Developing Countries
Table 1-3: Worldwide In Vitro Diagnostic Reagent Sales by Country/Region
2009-2014,
CHAPTER TWO: INTRODUCTION
Table 2-1: Selected Disease Statistics, Worldwide, 2008
Table 2-2: Elderly Support Ratio in Selected Countries (2050)
Table 2-3: Overview of Physician Office Labs by Country
Table 2-4: Labs in the BRIC Countries
Table 2-5: Medical Cost Increases, Worldwide, 2006-2008
CHAPTER THREE: OVERVIEW AND BRIC COMPARISON
Table 3-1: Available Market Data, 2009
Table 3-2: Healthcare Expenditure History
Table 3-3: Healthcare Infrastructure Capacity
Table 3-4: IVD Expenditure per person, 2009
Table 3-5: BRIC IVD sales, 2009-2014
Table 3-6: Infrastructure data for major markets, 2005-2006
CHAPTER FOUR: CHINA: MARKET TRENDS/DEMAND ANALYSIS

12. Table 4-1: Selected Disease Prevention Programs
Table 4-2: Selected Preventative Medicine Opportunities
Table 4-3: IVD Market Segmentation, China 2009, percent dollar sales
Table 4-4: Company Market Share Data, 2009
Table 4-5: Selected IVD Manufacturers in China
CHAPTER FIVE: INDIA: MARKET TRENDS/DEMAND ANALYSIS
Table 5-1: Key Drivers for Healthcare in India
Table 5-2: IVD Market Segmentation, India 2009, percent dollar sales
Table 5-3: Company Market Share Data, 2009
CHAPTER SIX: BRAZIL: MARKET TRENDS/DEMAND ANALYSIS
Table 6-1: Brief History of Brazil’s Health Reform (1988-2009)
Table 6-2: IVD Market Segmentation, Brazil 2009 (Chemistry, Immunoassays,
Hematology/Coag, Molecular, Other)
Table 6-3: Company Market Share Data, 2009
CHAPTER SEVEN: RUSSIA: MARKET TRENDS/DEMAND ANALYSIS
Table 7-1: Market Share of Imported Products, by country 2009
CHAPTER EIGHT: NATIONS OTHER THAN BRIC
Table 8-1:Country Metrics: Turkey, Poland, Nigeria
Table 8-2: Major Private Networks in Poland
CHAPTER NINE: CONCLUSION
Table 9-1: Selected Advanced IVDs in Demand
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