1. InforMedix Marketing Research, Inc. 20141 Emerging Markets and the Role of Market Research Steven Fuller InforMedix Marketing Research, Inc. 2014

2. Worldwide Experience About 30% of our work is conducted outside the US. About 30% of our work is conducted outside the US. Contacts and expertise are in place in … Contacts and expertise are in place in … Europe (UK, Germany, France, Italy, Spain, Nordics, etc.)Europe (UK, Germany, France, Italy, Spain, Nordics, etc.) Latin AmericaLatin America Mexico Mexico Brazil Brazil Argentina Argentina Chile Chile InforMedix Marketing Research, Inc. 2014 2 AsiaAsia Japan Japan China China India India Singapore Singapore

3. What is an “Emerging Market”? An emerging market economy (EME) is defined as an economy with low to middle per capita income. The term was coined in 1981 by Antoine W. Van Agtmael of the International Finance Corporation of the World Bank. EMEs are characterized as transitional, meaning they are in the process of moving from a closed economy to an open market economy while building accountability within the system. InforMedix Marketing Research, Inc. 2014 3 Reem HeakalReem Heakal, August 11, 2009

4. What is an “Emerging Market”? Emerging markets, also known as emerging economies or developing countries, are nations that are investing in more productive capacity. They are moving away from their traditional economies that have relied on agriculture and the export of raw materials. InforMedix Marketing Research, Inc. 2014 4 Kimberly Amadeo, President, WorldMoneyWatch.comWorldMoneyWatch.com

5. What is an “Emerging Market”? This term is used loosely to describe countries that are exhibiting increasing growth in purchasing and usage of a product of interest – and are crossing over from a point where the market is too small or too difficult to work in, to one where conducting business there yields a new and attractive marketplace. “Emergence” among markets for medical products, supplies and services is normally associated with growth in affluence of the population, increasing stability of government structures, and policies and attitudes that promote better healthcare than in the past. InforMedix Marketing Research, Inc. 2014 5 Steve Fuller InforMedix Marketing Research

6. EME Characteristics 1. 1.Lower-than-average per capita income 2. 2.Rapid change to a more industrialized economy U.S., Germany, U.K., Japan: 1-2% Turkey, Russia, Mexico and South Africa: 3-4% Brazil: 4.5% China, India: 8% 3. 3.Economic & political risk / volatility Higher-than-average return for investors InforMedix Marketing Research, Inc. 2014 6

7. Examples …. BRIC Brazil, Russia, India, China MSCI Index Brazil, Chile, China, Colombia, Czech Republic, Egypt, Hungary, India, Indonesia, Malaysia, Mexico, Morocco, Peru, Philippines, Poland, Russia, South Africa, South Korea, Taiwan, Thailand, Turkey Others (HBS) Argentina, Hong Kong, Jordan, Kuwait, Saudi Arabia, Singapore, UAE, Vietnam CIVETS Colombia, Indonesia, Vietnam, Egypt, Turkey, South Africa PINE Philippines, Indonesia, Nigeria, Ethiopia Fragile Five Brazil, India, Indonesia, South Africa, Turkey InforMedix Marketing Research, Inc. 2014 7

8. How are these locations different from “developed markets”? Patient age, Disease mixHealthcare infrastructureInsurance? Who pays for healthcare?Role of governmentDecision-makers (diagnostics and treatment)Role of local manufacturers and distributorsSpend level on healthcareetc. InforMedix Marketing Research, Inc. 2014 8

9. How is medical technology adopted in Emerging Markets? 1. Direct movement of products from developed markets High-endUsed/refurbedLow-end product InforMedix Marketing Research, Inc. 2014 9 In Vivo: The Business and Medicine Report 2012

10. How is medical technology adopted in Emerging Markets? 2. Low-cost copies by in-country manufacturers Low-cost supply chainLow-cost materials Low-cost labor (mfg. and distribution) Limited regulation & validation InforMedix Marketing Research, Inc. 2014 10

11. How is medical technology adopted in Emerging Markets? 3. Market-specific innovation By multi-nationalsBy locals InforMedix Marketing Research, Inc. 2014 11

12. Multinationals vs. Locals Multinationals vs. Locals Medical Device Growth in Emerging Markets (McKinsey & Co.) InforMedix Marketing Research, Inc. 2014 12

13. Market Research Market Research Available Information Sources Off-the Shelf Reports Individuals with Local Expertise Your distributors InforMedix Marketing Research, Inc. 2014 13

14. Market Research Market Research Formalized Custom Investigations Learn specifically about opportunities for your own particular product or service areas Reduce the risk of acting on information that comes from a limited viewpoint More information flows to professional market researchers Apples-to-apples comparisons between several targeted markets InforMedix Marketing Research, Inc. 2014 14

15. Learn About “the Local System” Who Does What in this Medical Marketplace? The Role of Company Sales Representatives The Role of Distributors The Role of Hospital / Facility Administration and Purchasing The Role of the Government and its Agencies Where Does the Money Flow? Patient payments, Insurance, Government subsidies Payment for Disposables and Services Payment for Capital Goods Purchase / Lease / Rental Contract InforMedix Marketing Research, Inc. 2014 15

16. Learn About the Medical Device Marketplace What Kinds of Facilities Will Be Our Customers? Hospitals Physicians Non-Hospital Care Sites Other Types of Customers How Does Product Evaluation and Purchasing Work? Purchasing Methods and Decision Makers How to Engage with a New Customer Site Vendor Selection Factors Product Selection Factors Pricing “Tiers” and Budget Approvals InforMedix Marketing Research, Inc. 2014 16

17. Learn About Unmet Needs What are the Unmet Needs in this New Market? Current Patient Evaluation and Pathways of Care Competitive Products and Services in Use Key Challenges, Costs, Inefficiencies with current products Medical Risks, Reasons for Morbidity and Mortality with current products InforMedix Marketing Research, Inc. 2014 17

18. Learn What Makes Prospects into Customers What Else Can We Do to Facilitate Use and Purchasing of Our Products/Services? Multiproduct Contracting Ancillary Support Services from Vendors Local Manufacturing Is there a better way? What Else Do I Need to Know About Doing Business Here? Regulatory Environment Relevant Cultural Issues Attitudes Toward Foreign (e.g. US) Based Vendors InforMedix Marketing Research, Inc. 2014 18

19. InforMedix Experience, Qualitative Research China China In-facility interviews with purchasers and surgeonsIn-facility interviews with purchasers and surgeons India India In-office interviews with surgeonsIn-office interviews with surgeons Mexico Mexico In facility & in-office with purchasers and surgeonsIn facility & in-office with purchasers and surgeons Brazil Brazil In facility & in-office with purchasers and surgeons In facility & in-office with purchasers and surgeons InforMedix Marketing Research, Inc. 2014 19 Market Research in Worldwide Emerging Healthcare Markets: Understanding Your Company’s Opportunity Steven J. Fuller, InforMedix Marketing Research, Inc.

20. Market Research Challenges in Emerging Healthcare Markets What is the goal? What is the goal? To participate as the market grows?  screen for typical customersTo participate as the market grows?  screen for typical customers To serve the undeveloped parts of the healthcare system?  screen for unserved customersTo serve the undeveloped parts of the healthcare system?  screen for unserved customers InforMedix Marketing Research, Inc. 2014 20

21. Market Research Challenges in Emerging Healthcare Markets Is there a bias for or against “outsiders”? Is there a bias for or against “outsiders”? Who should moderate?Who should moderate? How should assistants be trained?How should assistants be trained? InforMedix Marketing Research, Inc. 2014 21

22. Market Research Challenges in Emerging Healthcare Markets How good is the market research infrastructure? How good is the market research infrastructure? PlanningPlanning ScreeningScreening SchedulingScheduling FacilitiesFacilities InforMedix Marketing Research, Inc. 2014 22

23. Market Research Challenges in Emerging Healthcare Markets Are we communicating? Are we communicating? LanguageLanguage TerminologyTerminology Product descriptions & usageProduct descriptions & usage Should we assume they know what we mean?Should we assume they know what we mean? InforMedix Marketing Research, Inc. 2014 23

24. InforMedix Marketing Research, Inc. 201424 Emerging Markets and the Role of Market Research Steven Fuller InforMedix Marketing Research, Inc. 2014