Healthcare Opportunities in the Dominican Republic
The Dominican government has shown deep interest in developing the National Health System in both private and public sectors, which has been demonstrated with the new legislation proposed by the president to the Congress to create a National Health Reform which could rise to new business opportunities for UK companies.
The Dominican health system comprises two sub sectors, the public sub sector (insurance and provider institutions of non-profits and for-profit services, governed by the General Health Law) and the private sub sector (non-profits and for-profit). The Ministry of Health provides leadership for the system and provides services to 75% of the population, most of who are uninsured (care is free but with no guarantee of access or quality). The private sector provides services mostly to the upper-economic segment of the population. Most of the doctors are bilingual and have received specialised training in the United States of America or European countries.
Types of insurance include worker-employer prepayment schemes (such as the Social Security Dominican Institute), prepaid private health insurance, self-managed insurance and private providers.
Standards of accreditation, regulations and good practices have been established for health facilities, laboratories and pharmaceutical companies, although regulatory processes are still needed to improve the quality of care, quality control and bio safety. In the last few years, the physical infrastructure of the health services network has improved and expanded, both in the public and private sectors with the introduction of new technologies.
The Dominican Republic is the home to various top medical technology companies, which have chosen the country as a base for developing, manufacturing and marketing a wide range of medical products, forming one of the largest clusters in Healthcare manufacturing in the Caribbean and the Central American region.
The medical device industry represents 6% of free zone exports (US$286 million) whose main destination is the United States. This industry generates approximately 9000 skilled workers, who are constantly renowned for their superior work ethic, allowing us to offer a wealth of human resources that meet the quality demands of the industry.
Also, this industry has played a key role in promoting and sustaining growth and development in this important sector, due to a significant and sophisticated network of experienced international companies (Baxter Healthcare, Abbot Laboratories), established in the Dominican Republic. These companies have encouraged and supported its development; investment totals well over US$260 million.
International Pharmaceutical Companies in the Dominican Republic
Other international companies in this market are: Astra-Zeneca, GlaxoSmithKline, Ayerst Maersk, Sanofi Aventis, Bristol Myers Squibb and Laaned.
All diagnostic medical equipment is imported. Some of the renowned brands present in this market are: Siemens, Philips, Terumo, Sony, Fuji, Boston Scientific, Cardiette, Sterus, Ziehm Imagining, MEK Intensive Care System, Hill-Rom, Fisher & Payken Healthcare, Quinton, Burdick.
A number of areas of specific interest have been identified by the Dominicans authorities:
Private hospital provision
Public hospital reform is the most challenging part of the overall Dominican healthcare reform. The vested interest embedded in the public hospital provision is a serious hurdle. Currently the national reform panel is finalizing a more detailed work-plan to endorse this policy in real practice. Each province is authorized and encouraged to implement a tailor-made policy and open its hospital market to regional demand.
Green design to build and/or renovate infrastructure and facility is inspiring understanding about modernizing hospitals.
Health screening and lifestyle management
This is an open market in the Dominican Republic. Both public hospitals and private sector are free to provide services. The competition is comparatively fair and each has unique selling points. Given the growing demand and huge population, the market share expands on an annual base. However high profile services with guaranteed medical quality for the educated middle class people in urban area still needs to improve. One reason is the lack of professionals in health clinics.
Private nursing home
Given the ageing population in the Dominican Republic in both developed south coastal and developing western regions, the Government has been promoting a consistence policy to encourage private companies to invest in this field.
Private health insurance
Financing is the major element that results in current ‘profit -driven’ practice in Dominican healthcare provision. The “so-called” public hospitals in Dominican Republic have never received sufficient financing to maintain daily operations. Currently, there are pilot projects for large state-owned health insurance companies to invest in hospitals. This takes place in individual regions but is not yet a national practice. However, we consider that UK private health insurance providers and broker companies should monitor the situation regularly.
Professional training in hospital management and clinical governance
It is the commitment from the central government to improve the management and governance skills for healthcare policy and decision makers. The capacity building is also to cope with the deepening of Dominican healthcare reform as some of the health authority staff themselves are becoming the hurdle to reform due to limited vision. There are many local players in this sector; most of them have various links with Health Authorities. However UK business could consider them as potential Dominican partners to jointly deliver programmes.
Professional training in Continuing Medical Education (CME)
The Dominican Ministry of Health focuses on professional training as the overall quality of services in clinical practicing is deteriorating. One reason is the fee-for-service financing system which causes health professionals to be profit driven instead of quality driven. Currently local recourses are available at some teaching hospital level across the country. Therefore, the advice is to personalise and localize UK healthcare training programmes before approaching potential Dominican partners.
Getting into the market
In most cases doing business in the Dominican Republic requires local representation in the form of an agent or distributor.
The appointment of a local partner/representative will only be the first step. Dominican Republic is a market in which family structures predominate in the business environment, and where personal relationships therefore are important. This requires an investment primarily of time and personal presence. Likewise, product training for the agent’s workforce is essential, as are regular updates on developments, modifications, competitor activity, etc. Therefore, regular visits to the market, especially during the early phase, are an important part of a successful interaction with the agent/distributor.
British companies wishing to approach the Dominican market are advised to undertake as much market research and planning as possible in the UK.
UK Trade & Investment (UKTI) team in the Dominican Republic can provide a range of services to British-based companies wishing to grow their business in the Dominican market. Our services include the provision of market information, validated lists of agents/potential partners, key market players or potential customers; establishing the interest of such contacts in working with the company; and arranging appointments. In addition, they can also organise events for you to meet contacts or promote a company and its products/services.
The country’s legal system also is an incentive for investment. In recent years, the Dominican economy has been supported by a continuous process of regulatory modernization, which has led to a variety of measures aimed at opening and commercially integrating the economy into the international markets. Having recognized that the Dominican market depends on international economic integration, the Dominican government has chosen to generate a legal foundation that allows for sustained economic stability and growth as well as freedom and security in the commercialization of goods and services to the economy’s different participants.
Additionally, the Dominican Republic has a widespread, developed and growing physical infrastructure adjusted to the requirements of a society focused on the production and commercialization of goods and services. The Dominican roadways are among the best in the region, connecting practically all areas of the country. The country has modern, broad, and efficient airport and port systems formed by eight international airports and a dozen significant seaports located close to key production centres. Also, the Dominican Republic’s modern telecommunications system is one of the country’s main competitive advantages.
As in any new market you will need to use your competitive advantages to the full extent, and it is important to know which ones will be the most effective in the Dominican Republic. You will need to research the market to identify the level of demand for your product and to decide whether you should address the market as a whole or via specific niches.
The Dominican Republic is a very competitive market and it is important to take a medium to long-term view.
When considering the Dominican Republic as an export market, the following points are important:
Leave your preconceptions at home.
Keep hold of your business sense as tightly as you would anywhere else.
Do your homework on the market and on potential partners.
Be patient, as some things may take longer to set up than you think (especially if they involve bureaucracy). Allow for this in your preparations.
Take a long-term approach, but do not stick rigidly to your plans. Things often change rapidly and unexpectedly in the Dominican Republic.
Obtain good quality independent legal and professional advice, particularly concerning intellectual property.
Do your research on local business culture.
Consult UK Trade & Investment team in Dominican Republic who can provide help in researching the Dominican market.
Once you have confirmed that there is a market for your product in the Dominican Republic you may want to use the information you have gathered as a basis for developing a formal Dominican strategy. This strategy should address questions such as the form of market entry (setting up a subsidiary, distributor or agency agreement, or joint venture), identification of customers, potential partners, geographical locations, sales structure, product delivery and payment channels, and after-sales setup.
Market intelligence is critical when doing business overseas, and UKTI can provide bespoke market research and support during overseas visits though our chargeable Overseas Market Introduction Service (OMIS).
To commission research or for general advice about the market, get in touch with our specialists in country – or contact your local international trade team.
Leonora Dipp, British Embassy Santo Domingo. Tel: +1 (809) 472 7054 or email: [email protected]
Claudia Fulgencio, British Embassy Santo Domingo. Tel: +1 (809)472 7111 x 2032 or email: [email protected]
UKTI runs a range of events for exporters, including seminars in the UK, trade missions to overseas markets and support for attendance at overseas trade shows.
Countries: Dominican Republic