Mainz country presentation Greece

							Distributor Meeting

          October 13-16, 2011
             GREECE
      Paris Hatzianastasiadis
Market Situation in Greece:
1. The medical market in Greece is 70% Public Sector and 30% Private Sector.
   In the plastic surgery market, reconstructions are made in the public and aesthetic
   operations in the private. In the public sector, it was McGhan who for years ruled
   the market until its acquisition from Allergan. Mentor also had a significant market
   share being a multinational company. In the private, McGhan was still holding the
   majority of the market followed by Mentor. Due to McGhan’s (Allergan’s) absence
   during the acquisition, market shares changed and now Mentor has 55% of the
   market.
2. Under the difficult economic situation of the country, many changes have taken
   place and many more are expected to follow:
   Social changes:
    Aggressive measures applied by the Government affecting the income of the
      population. The Official Labor Association claims that the income decrease is
      35 to 40%, thus affecting the purchasing power of the people.
    Unemployment has increased dramatically, as in 2009 it was 8,9% and in May
      2011 it was 15,9% - official information - but many sources claim that actual
      unemployment is about 20%. At the moment, we are obliged to fire 30.000
      public servants in order to be consequent to our commitments with Europe.
Market Situation in Greece/con’t
 Political & Financial changes:
  Activation of IMF mechanism.
  The Ministry of Health is forced to decrease expenditures by 40-50% and the
   Administrators of the Hospitals and Clinics have limited budgets.
  Private sector has also been affected from the financial crisis and due to lack of
   cash flow in the market, customers demand credit & delay payments.
     -   Shift of about 30% of patients from the private to the public sector.
 Healthcare Sector:
  Public sector’s payments have not been settled since many years. Government
   has provided government bonds to fulfill it’s obligation towards suppliers (at zero
   coupon) for years 2007-2009. These will expire in years 2011, 2012, 2013
   accordingly per year.
  Invoices for years 2010 and 2011 were supposed to be paid in 60 days, but up
   to date only invoices from 2011 have started slowly to be settled.
  Several companies ceased their operation, i.e. Health Care Solutions and
   Covidien who appointed a distributor which has recently let go quite a number of
   their sales personnel.
OVERVIEW GREECE
• POPULATION
  10.8 millions acc. the 2011 census
  (2001 census 11.3 millions)
• PLASTIC SURGEONS
   283 surgeons, according to the official data of
  the Hellenic Society of Plastic Reconstructive &
  Aesthetic Surgery
• ACTIVE SURGEONS (breast surgery)
  ~ 180 / there is no official data available.
OVERVIEW GREECE
There is no official data available
• RECONSTRUCTIONS
   about 2.400 per year
• AUGMENTATIONS
  Before the financial crisis, aesthetic augmentations covered a large
  amount of total breast operations. Now, economic conditions are so
  unstable and Greek people so insecure that their spending behavior
  has changed dramatically. It remains to be seen how the financial
  situation will affect Plastic Aesthetic surgery.
• Number of Anatomical gels sold (all companies)
  N.A. (about 20% of total implants)
• Number of Round gels sold (all companies)
  N.A. (about 80% of total implants)
Historical Sales
    GREECE
SALES History_GREECE
 160,000.00


 140,000.00


 120,000.00


 100,000.00


  80,000.00


  60,000.00


  40,000.00


  20,000.00


       0.00
              2008   2009   2010   2011(JAN -     2011
                                     AUG)       estimate
Market Share_GREECE

                   3%   3%
              4%
         5%

    5%
                                   MENTOR
                                   ALLERGAN

                                   POLYTECH
                                   EUROSILICONE
                             55%
                                   ARION

  25%                              NAGOR
                                   OTHER
SWOT Analysis_GREECE
OPPORTUNITIES
1. Focus in MPS implants which we have almost exclusively (Silimed).
2. Follow up on the results of running protocol conducted in the University
   of Athens under the title “Comparative study on the capsular
   contracture of textured implants”. The participating companies are
   Allergan, Mentor, Eurosilicone and Polytech. MPS Polytech implants
   are also evaluated.
3. Use Dr. Sterodimas as a key surgeon to promote MPS in congresses,
   scientific meetings etc.
4. There are tenders in which we have submitted offers and are waiting
   for their development.
SWOT Analysis_GREECE
THREATS
1. Financial situation of the country.
    – Pricing has become a very important criterion for both Public and Private sector.
    – Number of patients doing cosmetic surgery has decreased and will decrease even
      more due to latest aggressive measures taken by the Government (reduction in
      salaries, layoffs, increased taxes etc).
2. Competition’s low pricing.
3. MPS implants are still not widely accepted from plastic surgeons in
   Greece.
4. There are Greek doctors who are importing directly from abroad to
   minimize costs.
5. Increase of smaller less costly/invasive operations.
6. Medical Tourism: new trend in which patients travel to nearby
   countries that offer economic packages for aesthetic operations.
What are the key strategies you are using
to develop your market?
• Immediate & dedicated customer service, tailored to doctors‘ needs
• Excellent after sales service
• Special price offer to volume purchases
   – Achievement of longer customer commitment
   – Better customer conversion rate
   • Sales Management Structure
   – Restructure of sales force (3 sales people)
   • Competitive payment terms
   • Emphasis on the promotion of MPS (Replicon) and its warranty
     program.
   – Naturally aesthetic result while reducing/eliminating the possibility of rotation and
     misplacement.
What were your successes in 2010?
Won a Contract for MPS products:
– Our target was a very important public hospital for breast reconstructions.
– 7 tenders were procurred from 2001 up to 2010 for plastic reconstructive
   surgery. We participated in all of them.
– The specifications were photographic (Mentor & McGhan) and our products
   were not accepted during the technical evaluations.
– They were asking for FDA approval which both multinationals have.
– We took legal action each time in regards to the photographic specifications
   as well as the FDA requirement, with no success, at excessive cost. We did
   however manage to cancel several tenders but the new ones had the same
   specifications.
– In the last tender, we managed to change the specifications at least for the
   MPS implants and finally got a contract and started cooperation with the
   hospital.
What did you do that did not work in 2010?
• We assigned the sales management responsibility for plastic surgery
  to our sales manager, with whom we eventually terminated the
  collaboration and hence valuable time was lost.
What innovations would you support
Polytech focusing on?
• Becker type expander
• Consideration upon the wrinkling effect of our breast implants.
• Support in terms of patient size determination
   (competition offers solutions to facilitate patients to visualize the final result)
What other technologies would fit our
product portfolio?
• A 3D-imaging software program at a very low price in
  order for surgeons to accomodate it in their
  appointments. i.e. e-sterix
Thank you for your
attention!