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Germany has one of the most advanced economies in the world. GDP is estimated at US$3.6trn in 2013, equal to around US$44,000 per capita, making the German economy the fourth largest, behind the USA, China and Japan. As one of the world's largest exporters, the German economy has been hard hit by the poor global economic climate

Economic growth is expected to remain modest with GDP now forecast to rise by 0.5% in 2013, having grown by an estimated 0.7% in 2012. However, this still makes Germany by far the strongest of the major euro economies, many of which are estimated to have seen negative growth in 2012.

At 11.0% of GDP, healthcare expenditure is at a high level but is increasingly constrained. The domestic market remains tight, with continued downward pressure on prices. Government funding of hospitals in recent years has remained static, therefore hospitals in the public sector are maintaining existing equipment rather than investing in new appliances. This has led to domestic producers becoming increasingly reliant on the export market.

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Germany has the third largest medical device market in the world, ranking behind the USA and Japan. In 2013, the German medical device market is estimated at US$25.6bn, equal to US$313 per capita.

Germany has a history of producing high quality medical equipment, with particular emphasis on diagnostic imaging, dental products and optical technologies. The country has a handful of large producers, headed by Siemens, B. Braun and Fresenius. Total production is estimated to be in the region of EUR20bn.

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Table of Contents

Espicom Industry View   9
Espicom Industry View      9
SWOT    12
Medical Device Market     12
Political     13
Economic    14
Business Environment     15
Industry Forecast     16
Medical Device Market Forecast    16
Table: Projected Medical Device Market, 2013-2018     18
Table: Detailed Medical Device Market By Product Area, 2008-2018 (US$mn)   19
Table: Detailed Medical Device Market By Product Area, 2008-2018 (US$ Per Capita)  23
Table: Detailed Medical Device Market By Product Area, 2008-2018 (% Of Total)     26
Table: Detailed Medical Device Market By Product Area, 2009-2018 (US$mn % Change)     29
Consumables Market Forecast    33
Table: Consumables Market, 2008-2018 (US$mn)  34
Table: Consumables Market, 2008-2018 (US$ Per Capita)    35
Table: Consumables Market, 2009-2018 (US$mn % Change)    36
Diagnostic Imaging Market Forecast     38
Electrodiagnostic Sector      39
Radiation Apparatus Sector     39
Imaging Parts & Accessories Sector     40
Table: Diagnostic Imaging Market, 2008-2018 (US$mn)     41
Table: Diagnostic Imaging Market, 2008-2018 (US$ Per Capita)   42
Table: Diagnostic Imaging Market, 2009-2018 (US$mn % Change)     43
Dental Products Market Forecast   45
Table: Dental Products Market, 2008-2018 (US$mn)     46
Table: Dental Products Market, 2008-2018 (US$ Per Capita)  47
Table: Dental Products Market, 2009-2018 (US$mn % Change)     48
Orthopaedics & Prosthetics Market Forecast  50
Table: Orthopaedics & Prosthetics Market, 2008-2018 (US$mn)   52
Table: Orthopaedics & Prosthetics Market, 2008-2018 (US$ Per Capita)   52
Table: Orthopaedics & Prosthetics Market, 2009-2018 (US$mn % Change)      53
Patient Aids Market Forecast     55
Table: Patient Aids Market, 2008-2018 (US$mn)    56
Table: Patient Aids Market, 2008-2018 (US$ Per Capita)   56
Table: Patient Aids Market, 2009-2018 (US$mn % Change)   57
Other Medical Devices Market Forecast    60
Table: Other Medical Devices Market, 2008-2018 (US$mn)   60
Table: Other Medical Devices Market, 2008-2018 (US$ Per Capita)  62
Table: Other Medical Devices Market, 2009-2018 (US$mn % Change)      63
Annual Medical Device Imports     66
Table: Medical Device Imports By Product Area , 2008-2012(US$000s)      69
Table: Medical Device Imports By Product Area, 2008-2012 (US$000s, % Change)  70
Table: Medical Device Imports By Product Area, 2008-2012 (Local Currency 000s)     71
Table: Medical Device Imports By Product Area, 2008-2012 (Local Currency 000s, % Change)      72
Table: Medical Device Imports By Product Area, 2008-2012 (% Distribution)      74
Table: Leading Medical Device Suppliers By Product Area, 2012 (US$ 000s)   76
Table: Leading Medical Device Suppliers By Product Area, 2012 (% Distribution)     77
Table: Top 20 Medical Device Suppliers, 2012 (US$000s)    78
Table: Detailed Medical Device Imports By Product Area, 2008-2012 (US$000s)  79
Table: Detailed Medical Device Import Trends By Product Area, 2012      82
Table: Detailed Leading Medical Device Suppliers By Product Area, 2012 (US$000s)  86
Monthly Medical Device Imports    89
Table: Monthly Medical Device Imports By Product Area, September 2010 - August 2013 (US$mn)     89
Annual Medical Device Exports     92
Table: Medical Device Exports By Product Area, 2008-2012 (US$000s)      95
Table: Medical Device Exports By Product Area, 2008-2012 (US$000s, % Change)  96
Table: Medical Device Exports By Product Area, 2008-2012 (Local Currency 000s)     97
Table: Medical Device Exports By Product Area, 2008-2012 (Local Currency 000s, % Change)      98
Table: Medical Device Exports By Product Area, 2008-2012 (% Distribution)   100
Table: Leading Medical Device Destinations By Product Area, 2012 (US$000s)  102
Table: Leading Medical Device Destinations By Product Area, 2012 (% Distribution)     103
Table: Top 20 Medical Device Destinations, 2012 (US$000s)  104
Table: Detailed Medical Device Exports By Product Area, 2008-2012 (US$000s)  105
Table: Detailed Medical Device Export Trends By Product Area, 2012   108
Table: Detailed Leading Medical Device Destinations By Product Area, 2012 (US$000s)     112
Table: Detailed Medical Device Balance Of Trade, 2008-2012 (US$000s)   115
Monthly Medical Device Exports     119
Table: Monthly Medical Device Imports By Product Area, September 2010 - August 2013 (US$mn)      119
Macroeconomic Forecasts  121
Table: Germany - Economic Activity   127
Industry Risk Reward Ratings      128
Industry Risk Reward Ratings   128
Table: Espicom Analysis Of The Medical Device Market, 2013     128
Market Overview     130
Medical Device Market Overview     130
Table: Medical Device Market, Key Ratios, 2013  131
Healthcare Overview     134
Healthcare System      134
Healthcare Reform      136
Health Insurance   140
Table: Health Insurance Spending By Service, 2010-2012 (EURbn)  143
Health Expenditure     145
Medical Technology     145
Table: Diagnostic Imaging Technology In Hospitals By Type, 2005-2011      147
Key Data     147
Table: Key Data, 2008-2013   147
Industry Trends And Developments   150
Industry Trends & Developments     150
Table: Top 20 Medical Device Export Destinations, H112/H113 (US$000s)      151
Table: Statutory Health Insurance Spending By Service, Q1-3 2012-2013 (EURbn)  152
Table: Most Frequent Inpatient Operations Performed In German Hospitals, 2009-2012  154
Table: Inpatient Operations, Diagnostic & Therapeutic Procedures By Type, 2008-2012  157
Table: Artificial Joint Replacement Procedures, 2005-2012   159
Regulatory Development  164
Medical Device Regulations     164
Table: German Medical Notified Bodies, 2011    165
Medical Device Pricing & Reimbursement   165
Reimbursement     165
Procurement    168
Competitive Landscape   169
Domestic Medical Device Production    169
Table: Medical Device Production by Broad Product Area, 2008-2012 (EURmn)  170
Table: Detailed Medical Device Production By Product Area, 2008-2012 (EURmn)     170
Table: Detailed Medical Device Production By Product Area, 2008-2012 (US$mn)  173
Table: Detailed Medical Device Production By Product Area, 2008-2012 (% Distribution)  177
Domestic Medical Device Manufacturing    181
National Medical Device Manufacturers     182
Table: B  Braun Turnover By Division & Type, 2010-2012  183
Table: B  Braun Turnover By Region, 2010-2012  183
Table: Biotronik Turnover By Type, 2009-2011  186
Table: Biotronik Turnover By Region, 2009-2011    186
Table: BSN Consolidated Revenues By Division, 2009-2011    188
Table: BSN Medical Consolidated Revenues By Region, 2009-2011  188
Table: Carl Zeiss Meditec Turnover By Division, FY2010-2013 (Ending September 30)     190
Table: Carl Zeiss Meditec Turnover By Region, FY2010-2013 (Ending September 30)     190
Table: Dräger Medical Turnover By Region, 2010-2012   191
Table: Fresenius Medical Care, Turnover By Segment, 2010-2012     194
Table: Fresenius Medical Care, Turnover By Region, 2010-2012      194
Table: Maquet, Turnover By Segment, 2009-2011    199
Table: Maquet, Turnover By Region, 2009-2011    199
Table: Maquet Cardiopulmonary, Turnover By Segment, 2009-2011     200
Table: Maquet Cardiopulmonary, Turnover By Region, 2009-2011     200
Table: Otto Bock Healthcare, Turnover By Division, 2009-2011   202
Table: Otto Bock Healthcare, Turnover By Region, 2009-2011     202
Table: Paul Hartmann, Turnover By Segment, 2010-2011    204
Table: Paul Hartmann, Turnover By Region, 2010-2011   204
Table: Richard Wolf, Turnover, 2009-2011  205
Table: Siemens Healthcare, Turnover By Region, FY2010-2013 (September 30)  208
Table: Waldemar Link, Turnover, 2009-2011  210
Table: World of Medicine, Turnover By Segment, 2010-2011  211
Table: World of Medicine, Turnover By Region, 2010-2011   212
Multinational Medical Device Manufacturers  213
Multinational Market Activity   218
Table: Multinational Market Activity, 2013  218
Medical Device Market Access     221
Distribution     221
Trade Associations      221
Trade Fairs     222
Methodology     224
Table: Used HS Trade Codes, 2013     225
Table: Rearranged HS Trade Codes, 2013    227