Analysis
State health systems: opportunities in global markets
Julie Bächtold, with contributions from the Swiss Business Hubs
Aug 27, 2026
Public healthcare systems are a key distribution channel for biotech-pharma and medtech companies in many markets.
How this access works and what initial steps are available are shown in the expandable country profiles from 15 markets: Germany, France, India, Indonesia, Canada, Malaysia, Mexico, Singapore, Spain, South Africa, South Korea, Thailand, Turkey, United Kingdom, Vietnam.
What many public health systems have in common
Public procurement is a significant channel for medtech and biotech pharma products worldwide. The scope and healthcare systems may differ, but there are some constants. In many markets, public procurement is a key route to hospitals, health programs and government-funded systems, especially for drugs, vaccines, diagnostics, medical technology and selected digital solutions. Market access usually starts long before a tender. Without regulatory approval, product registration and, depending on the market, health technology assessment, reimbursement or listing, the public procurement channel remains closed.
Source: Swiss Business Hubs estimates
Public procurement is rarely fully centrally organized. While national authorities usually set the regulatory and political framework, the actual purchasing decisions are often made at the level of regions, provinces, health clusters, hospital groups, or individual institutions. Therefore, anyone who wants to enter the market must not only know the rules, but also understand where decisions are actually prepared and made.
It also often shows how important local presence or an experienced local partner is in practice – and in certain markets or for certain types of tenders, even mandatory. While a local partner is not always legally required, they are often crucial in practice. They facilitate registration, access to tenders, cooperation with procurement agencies, and the establishment of service and sales structures.
Public procurement in the healthcare sector is therefore not a uniform distribution channel, but a complex market access pathway. Companies that successfully combine regulatory, clinical, commercial, and operational requirements and consistently align their strategy with the institutional realities of the respective market are the ones that succeed.
What distinguishes the individual markets
Alongside these commonalities, there is a diversity of logics that govern how public health systems operate. For example, France is one of the markets where large central procurement organizations set the tone and pool procurement volumes worth billions. The United Kingdom’s public health market is heavily organized around the NHS, which has a major influence on the procurement, introduction, and use of many products. Canada, on the other hand, combines central price negotiations with a highly provincial access model: negotiations are conducted centrally, but decisions are made locally. In Vietnam, access to the public health market is not only shaped nationally, but also by provinces, public hospitals, and their procurement committees.
There are also differences in Europe. Spain has a national health system with a shared framework but substantial regional responsibility: 17 autonomous communities organize and manage their regional health services. Germany stands out for its contrast: public procurement plays a relatively limited role for pharmaceuticals, but a much larger role for medical technology. Turkey combines public procurement in certain cases with industrial policy objectives – for example, when local production or technology transfer can be made a condition for strategic products.
Asia also has its own national peculiarities. Indonesia stands out because a large part of the state’s health procurement is done through an electronic catalog, which effectively serves as a gateway to the public market. Singapore also relies on a highly centralized structure, but organizes it through clearly defined health clusters and specialized procurement agencies. Thailand has an innovation registry, which can facilitate access to public institutions for innovative products. In South Korea, the real hurdle for many suppliers is not the tender itself, but rather getting onto the health insurance system.
Other markets show how public access and commercial reality can overlap. In Mexico, new technologies often enter the market first through private hospitals and laboratories before they are adopted in the public sector. Malaysia demonstrates how access to public facilities remains closely tied to regulatory registration and local distribution partners. In India, local presence and registration on government platforms are also important. South Africa, on the other hand, shows how closely public procurement can be linked to supply policy: HIV, tuberculosis, and primary care programs largely determine which products are in demand in the public system.
Country profiles
Region Americas
In the drop-down country profiles, you will find information on which products and services are particularly relevant for public procurement in the health sector, which important stakeholders influence them, and which initial steps have proven successful for suppliers.
Canada
Relevant products
Vaccines are the largest category of publicly procured products in Canada. In addition, hospital pharmaceuticals and selected medtech and diagnostic solutions play an important role, particularly biologics, oncology products, intravenous hospital pharmaceuticals, and biosimilars.
Key stakeholders
Canada’s public procurement system is decentralized. Regulatory frameworks are set at the federal level, and there is a central bargaining structure, the pan-Canadian Pharmaceutical Alliance (pCPA), which negotiates prices on behalf of all provinces. However, actual procurement decisions are made by the provinces and territories. Access to the public market is therefore largely determined by provincial reimbursement and product lists, such as the Ontario Drug Benefit or RAMQ in Quebec.
First steps
In Canada, Swiss biotech, pharma and medtech companies benefit from a stable regulatory environment, a well-funded public health system, and close bilateral relations under the free trade agreement between the EFTA and Canada.
Without Health Canada approval, the market remains closed, followed by further steps depending on the product, such as health technology assessment, price negotiations, and listing at the provincial or hospital level. For medtech products in classes II to IV, MDSAP certification is relevant. Depending on the product, this process can take 2–4 years.
A local partner is not legally required, but in practice it is often very helpful, especially with access to purchasing organizations and provincial structures.
Contact S-GE for market information, positioning and access to potential business partners: Swiss Business Hub Canada
Mexico
Relevant products
The public sector is the main procurement channel for many specialized medicines in Mexico, especially innovative patented drugs, such as those used in oncology and for rare diseases, as well as biologics, biosimilars, vaccines, novel therapies, and generics (in large volumes for institutional supply).
In medical technology, public procurement is particularly important for hospital equipment and institutional diagnostics. This includes medical devices and instruments for the hospital sector, in vitro and molecular diagnostics, imaging systems, point-of-care diagnostics, as well as digital pathology and AI-driven diagnostics.
Key stakeholders
The central regulatory gatekeeper is COFEPRIS. Procurement in the pharmaceutical sector is dominated by large public institutions such as IMSS, ISSSTE, IMSS-Bienestar and the National Institutes of Health, often through bundled tenders with high volumes. Drug and therapy committees that decide on inclusion in institutional reimbursement and product lists, as well as bodies that assess medical benefit and cost-effectiveness, are also important.
In medical technology, public hospitals and the National Institutes of Health are central. For several IVD categories, InDRE is also relevant. In addition, there are biomedical engineering departments that shape technical specifications and maintenance requirements, as well as specialists, opinion leaders and specialized distribution partners.
First steps
For pharmaceutical and biotech products, inclusion in institutional product and reimbursement lists is crucial after registration, as without them access to institutional sales is practically blocked. Therefore, communication with the relevant bodies, assessment agencies and medical opinion leaders should begin early and clearly before tenders are issued.
For medical technology, technical validations and total cost of ownership considerations including maintenance and consumables are important. In addition, a local distribution partner is usually indispensable in practice. He not only takes over the distribution, but also provides technical support, training, customer service, supply of consumables and support in clinical and institutional evaluations. It is often sensible to start with a gradual entry via private hospitals and clinical laboratories, which can serve as reference sites and provide local performance data. Only when local evidence, service capacities and reference installations are available, is participation in public tenders sensible.
Formal basic requirements in both areas include a Mexican legal representative or registration holder, as well as supplier registration with the purchasing institutions.
Contact S-GE for market information, market positioning and access to potential business partners: Swiss Business Hub Mexico
APAC Region
India
Relevant products
Public procurement plays a relatively limited role in India’s health sector as a whole. But it is very important for public health institutions that serve a large part of the population. This includes vaccines and products for government health programs, diagnostics and in-vitro diagnostics, laboratory and imaging technology, hospital equipment, consumables, and digital health systems. Maintenance, calibration, installation, logistics, and training services can also be subject to public tenders.
Key stakeholders
Key actors at the national level include the Ministry of Health and Family Welfare (MoHFW), the Central Drugs Standard Control Organization (CDSCO) as India’s national drug and medical device regulator, and central procurement agencies such as the Central Medical Services Society (CMSS). The Government e-Marketplace (GeM) is a national portal for the procurement of commonly used goods and services by central and state government entities; however, it is not the only procurement channel.
For the public health systems, the state ministries of health and medical education, the state health departments, the structures of the National Health Mission, the state drug control authorities or food and drug administrations, and state procurement agencies are of particular importance. At the federal level, large public hospitals such as the All India Institute of Medical Sciences (AIIMS) are of particular importance; at the state level, state medical colleges, teaching hospitals, and other public health facilities also play an important role. In addition, state insurance systems and procurement or tender boards have an influence on tenders and contracts.
First steps
Depending on the product category, starting exporting to India should begin with a regulatory classification. For pharmaceuticals, medical devices and in-vitro diagnostics, the relevant licensing, import and registration requirements must be checked. Exporting to India usually begins with the appointment of an Indian agent or importer and the acquisition of the necessary approvals from the national regulatory authority. At the same time, it is important to build a local distribution and service network, as market penetration and participation in public tenders are difficult to achieve without a local presence.
Companies should register early on the government procurement platform GeM as well as on the respective portals of individual procurement agencies and states. GeM offers e-bidding, reverse auctions, and demand aggregation, among other things. It is also important to carefully review the specific pre-qualification requirements, tender conditions, and local content requirements. Local content requirements, supplier classification, and potential preferences for products manufactured in India can vary depending on the procurement agency, product, and tender.
Contact S-GE for market information, market positioning and access to potential business partners: Swiss Business Hub India
Indonesia
Relevant products
Public procurement plays a relatively limited role across India’s healthcare sector overall; however, it is highly significant for government-run healthcare institutions that serve a substantial share of the population. This is particularly the case for vaccines and products used in government health programs. Diagnostics and in-vitro diagnostics, laboratory and imaging technology, hospital equipment, consumables and digital health systems are also important. Maintenance, calibration, installation, logistics and training services may also form part of public tenders.
Key stakeholders
Key stakeholders at the federal level include the Ministry of Health and Family Welfare (MoHFW), the Central Drugs Standard Control Organisation (CDSCO), as India’s national regulator for medicines and medical devices, and central procurement agencies such as the Central Medical Services Society (CMSS).
The Government e-Marketplace (GeM) is a national portal for the procurement of commonly used goods and services by central and state government entities; however, it is not the only procurement channel.
For the State Health Systems, the health and medical education ministries of the individual states, the respective State Health Departments, National Health Mission structures, State Drug Controllers or Food and Drug Administrations, and state procurement corporations are particularly important. Large public hospitals such as the All India Institute of Medical Sciences (AIIMS) are particularly relevant at federal level; at state level, state medical colleges, teaching hospitals and other public healthcare facilities also play an important role.. In addition, state insurance systems and procurement or tender committees have a say in tenders and awards.
First steps
Depending on the product category, market entry should initially begin with a regulatory classification. For medicines, medical devices and in-vitro diagnostics, the applicable approval, import and licensing requirements must be assessed. Exporting to India usually begins with the appointment of an Indian agent or importer and the acquisition of the necessary approvals from the national regulatory authority. At the same time, it is important to build a local distribution and service network, as operational market development and participation in public procurement processes are difficult to implement without a local presence.
Companies should register early on the government procurement platform GeM as well as on relevant portals of individual procurement agencies and states. GeM offers, among other features, e-bidding, reverse auctions and demand aggregation. It is also important to carefully review the respective prequalification requirements, tender conditions and local value-added requirements. Requirements relating to local value addition, supplier classification and possible preferences for products manufactured in India may vary depending on the procurement agency, product and tender.
Contact S-GE for market information, positioning and access to potential business partners: Swiss Business Hub SEA
Malaysia
Relevant products
Public procurement is an important procurement channel for hospital medicines and medical technology in Malaysia, particularly diagnostics and laboratory equipment, medical consumables, and implants.
Key stakeholders
Key players include the Ministry of Health and its Pharmaceutical Services Program, the Medical Device Authority, and the NPRA drug authority for regulatory matters. In addition, there are the public hospitals and health facilities of the Ministry of Health, the defense and education ministries in the context of bundled procurement, and the relevant procurement and tender agencies.
First steps
Product registration with the relevant authority is a prerequisite for starting exporting to Malaysia. In practice, this is often done through a local partner or distributor. In addition, further requirements for operating licenses and distribution must be met for the supply of public health facilities. Public market opportunities can be identified primarily through tenders and procurement information from the Ministry of Health. An experienced local partner can significantly facilitate access to these procedures.
Contact S-GE for market information, positioning and access to potential business partners: Swiss Business Hub SEA
Singapore
Relevant products
The public sector is a key channel for the distribution of hospital-related products in Singapore, including hospital medicines, medical devices and equipment, hospital diagnostics and laboratory equipment, medical consumables, implants, and selected digital health solutions. Public hospitals provide the bulk of inpatient care, and public procurement is highly centralized.
Key stakeholders
The key players include the Ministry of Health, MOH Holdings and ALPS as the central procurement organization. In addition, there are the three public health clusters SingHealth, National Healthcare Group and NUHS, as well as the public hospitals and national specialist centers. The Health Sciences Authority is responsible for regulatory issues, and Synapxe plays an important role in digital health solutions.
First steps
For Swiss companies, regulatory approval and cooperation with local distribution partners who have good access to the public procurement sector are crucial. Existing approvals from other markets can facilitate or accelerate registration under certain conditions.
For sales to public institutions, companies should regularly monitor the government procurement platform GeBIZ as well as the relevant procurement channels of the public health clusters and ALPS. Those who wish to work with SingHealth must also register on the relevant electronic procurement platform for tenders and procurement processes.
Contact S-GE for market information, positioning and access to potential business partners: Swiss Business Hub SEA
South Korea
Relevant products
In South Korea’s healthcare system, public procurement is limited to specific segments, such as vaccines, infection control and emergency products. It also includes diagnostics and laboratory equipment for public health facilities, investment goods such as large medical equipment, equipment and consumables for national, regional and municipal hospitals, selected digital health solutions under public pilot projects, and specialized drugs or therapies procured through government programs.
Key stakeholders
The key stakeholders include the Ministry of Health and Welfare (MOHW), which oversees health policy and the National Health Insurance system, and the Ministry of Food and Drug Safety (MFDS), which is responsible for product approval, import licensing and quality requirements. The Health Insurance Review & Assessment Service (HIRA) plays a central role in reimbursement assessment, including clinical value and cost-effectiveness, while the National Health Insurance Service (NHIS) conducts price negotiations for new drugs.
For vaccines, public health programs and strategic reserves, the Korea Disease Control and Prevention Agency (KDCA) is important. The actual procurement process involves public tenders through the national e-procurement platform, Korea ON-line E-Procurement System (KONEPS) and the relevant awarding bodies. In addition, there are public hospitals at the national, regional and local levels and their purchasing and awarding bodies.
First steps
Starting to export to South Korea ideally begins with clarifying the regulatory and reimbursement access route. This is followed by finding a qualified Korean importer, licensee or distributor; alternatively, a Korean subsidiary may be an option. The necessary registration, licensing or certification steps then follow. Where reimbursement is required, the application should be prepared early.
To gain access to public procurement bodies, it is important to monitor the national tender platform regularly, complete any required supplier or bidder registration and meet the relevant requirements for Korean documentation, technical specifications, delivery, training and customer service. A strong local partner is usually the most practical way to do this. Local clinical support and initial reference projects to increase market acceptance are also advisable. Tender-specific eligibility, qualification and local service requirements should be assessed on a case-by-case basis.
Contact S-GE for market information, positioning and access to potential business partners: Swiss Business Hub Korea
Thailand
Relevant products
Public procurement is particularly important in Thailand for pharmaceuticals. Hospitals are the main distribution channel for medicines, especially prescription drugs, generics, patented medicines, vaccines, and products used in public health programs.
In medical technology, public procurement is particularly important for selected product categories. These include medical devices and equipment for hospitals, diagnostic solutions such as AI-driven X-ray systems for the thorax, dental implants, colostomy bags, prosthetic feet, and medical products listed in the Thai Innovation Registry.
Key stakeholders
The main actors include the Ministry of Public Health, the National Health Security Office, public hospitals and their tender committees, and the Thai Food and Drug Administration for product registration. Other actors include the Government Pharmaceutical Organization, the Health Intervention and Technology Assessment Program, the Social Security Office, and the relevant government procurement agencies under public procurement law. The national list of essential medicines also plays an important role, as does the Thai Innovation Registry for innovative products.
First steps
Start exporting to Thailand is usually done through a well-connected local distributor or authorized agent. Before marketing and before participating in public tenders, products must be registered with the Thai Food and Drug Administration (TFDA). Access to the public market is through tenders by public hospitals and government agencies in the e-procurement system. It is also important to engage early on with leading public hospitals, university hospitals and key opinion leaders to build clinical acceptance and facilitate future market access.
Where relevant, consideration should be given to inclusion in government-funded programs, especially for high-end medical devices. For innovative products, inclusion in the Thai Innovation Registry may also be beneficial, as it can facilitate procurement by public agencies.
Contact S-GE for market information, positioning and access to potential business partners: Swiss Business Hub SEA
Vietnam
Relevant products
Public procurement is particularly important in Vietnam for pharmaceuticals. The hospital market is the most important sales channel for medicines and is largely governed by tenders. Hospital medicines, vaccines, specialized therapies, diagnostics and laboratory equipment, and medical devices used in the hospital setting are particularly relevant. Digital health solutions can also play an important role, especially when they are procured by public hospitals or at the provincial level for IT and infrastructure modernization.
Key stakeholders
The main players include the Ministry of Health as the central national authority for health policy, regulation and the main procurement rules in public health care. In addition, there are public hospitals and health facilities as the main end-users of many pharmaceutical and medtech products, as well as hospital and procurement committees that often shape operational purchasing decisions.
Provincial health authorities also play an important role, as procurement can be organized at the provincial level and hospitals may be bound to the results of relevant tenders. Access to publicly funded healthcare structures is also central to the Vietnamese social security system, as it is a major payer and thus influences the financing and use of many products in public hospitals. Finally, local importers, distributors and registration partners are of particular importance, as foreign pharmaceutical companies are generally not allowed to distribute directly in Vietnam.
First steps
At the beginning of starting exporting to Vietnam, the question of which distribution channel a product should enter the market is paramount. Based on this, companies should select a suitable local partner for registration and distribution early on and prepare the product registration quickly.
For pharmaceuticals, it is particularly important to understand the logic of hospital tenders and to appreciate the benefits that can accrue to certain locally produced medicines of high quality in the public procurement process. For medical technology, a local registration holder and robust technical and regulatory documentation are key, especially in the context of a new procurement classification for medical devices.
Contact S-GE for market information, positioning and access to potential business partners: Swiss Business Hub SEA
EMEA Region
France
Relevant products
The public sector is a leading purchaser of high-value products for hospitals and healthcare institutions in France. These include imaging systems such as MRI and CT scanners, ultrasound systems, laboratory analytics, PCR and genomics platforms, IVD tests, orthopedic implants, cardiovascular products, surgical robotics, endoscopy, respiratory and monitoring systems, infusion pumps, hospital consumables, digital health and hospital IT solutions, and hospital pharmaceuticals such as oncology, monoclonal antibodies, cell and gene therapies, orphan drugs, vaccines and injectable biologics.
For medicines and innovative therapies, there are specific regulatory and financing requirements for access to publicly funded healthcare, depending on the product and indication. The relevant access and financing pathways may therefore differ from those for traditional hospital equipment.
Key stakeholders
France is one of the most concentrated hospital procurement markets in Europe. Public hospitals and central purchasing organizations play an important role. Hospital procurement is estimated at around EUR 35 billion for 2024. The largest buyers are UniHA, France’s leading hospital procurement group, Resah, the national procurement agency for healthcare, UGAP, the national public procurement authority, and the Groupements hospitaliers de territoire (GHT), which are French hospital groups at the territorial level. Within hospitals, procurement decisions are primarily made by purchasing departments, hospital pharmacists, clinicians, and biomedical engineers, depending on the product category.
First steps
Start exporting to France is usually done through an experienced local distributor or partner with access to hospitals and procurement centers. It makes sense to first identify leading reference hospitals, understand the relevant procurement channels, and prepare specifically for public tenders. Early engagement with clinical opinion leaders and research institutions can also help build credibility and support the introduction of new products.
Formally, depending on the product and procurement channel, the required product approvals or conformity certificates, as well as supplier registration, product registration with the relevant authorities, and, depending on the facility, additional listings or pre-qualifications are usually required. Since a large part of healthcare spending is publicly funded, commercial success often also depends on the reimbursement status. Local value-added requirements are limited, but in public procurement, partners with local service and market proximity may have an advantage.
Contact S-GE for market information, positioning and access to potential business partners: Swiss Business Hub France
Germany
Relevant products
In the German healthcare market, public procurement plays a relatively limited role for biotech and pharmaceuticals in general, but a much larger role for medical technology. It is particularly relevant for medical consumables and protective equipment such as disinfectants, disposable gloves, masks, protective gowns, and ventilators. In addition, it includes imaging systems such as CT, MRI, and X-ray machines, laboratory and diagnostic solutions, surgical and therapeutic equipment such as operating tables, anesthesia machines, dialysis machines, heart-lung machines, and infusion pumps, as well as medical consumables such as implants, stents, wound care products, and protective clothing.
Key stakeholders
The most important actors include hospitals and clinics, including university hospitals, municipal clinics, and non-profit providers. Research institutions such as university medical centers, Max Planck Institutes, and Fraunhofer institutions are also important. Health authorities such as health offices, state health authorities, and the Robert Koch Institute are also important. At the federal level, institutions such as the Bundeswehr (German armed forces) and the Federal Institute for Drugs and Medical Devices also play a role.
First steps
The start exporting process can be achieved through different channels depending on the product category. These include a German distributor or importer, direct sales to hospitals and laboratories, cooperation with hospital groups and purchasing organizations, participation in public tenders, clinical reference projects with university hospitals, and cooperation or licensing models with established German or European companies.
There is no uniform national access. Companies must register on relevant tender platforms as well as in the supplier systems of hospitals, hospital groups and purchasing organizations. A German distributor or service partner is not always legally required, but in practice it is often an important factor for success – especially for complex products and solutions. There are no general requirements for local value creation, but related requirements for delivery capability, local service, response times, cybersecurity, sustainability and supply security can be decisive in tenders.
Contact S-GE for market information, positioning and access to potential business partners: Swiss Business Hub Germany
Spain
Relevant products
In Spain, public procurement is particularly relevant for hospital-related products and services. Potentially relevant categories include hospital medicines, biologics, biosimilars and vaccines, as well as diagnostics, in-vitro diagnostics, surgical equipment, patient-monitoring systems and other medical devices. The applicable route depends on the product, the level of government and the relevant procurement, reimbursement and clinical-adoption framework.
Key stakeholders
The main national players are the Ministry of Health, the Spanish Agency for Medicines and Medical Devices (AEMPS), the Interterritorial Council of the National Health System and INGESA. They shape the health policy framework, coordinate the interaction between the State and the regions and can also negotiate framework agreements in certain areas. At regional level, the 17 autonomous health services are the main procurement actors, as they manage their health budgets and organize a large part of public procurement. The public hospital networks are also involved in the operational organization of procurement.
First steps
Entering Spain requires an understanding of the division of responsibilities between national institutions, the autonomous communities and individual or cluster-level buyers. Swiss biotech, pharma and medtech companies need to meet the applicable EU and Spanish regulatory requirements and map the relevant procurement, reimbursement and clinical-adoption pathways before approaching buyers.
Cooperation with a local partner can help navigate decentralized public-hospital structures, tender documentation, after-sales requirements and logistics. It is not, however, a universal legal requirement; the appropriate model depends on the product, authorizations, tender and contracting authority. It is also crucial to understand the differences between national frameworks and regional implementation early on and to align market development accordingly.
Contact S-GE for market information, positioning and access to potential business partners: Swiss Business Hub Spain
South Africa
Relevant products
In South Africa, public procurement is concentrated in a few supply areas, particularly in pharmaceuticals. The focus is on medicines for infectious diseases, especially HIV and tuberculosis treatments, and generics for primary care, such as cardiovascular and central nervous system (CNS) conditions. At the same time, public procurement for non-communicable diseases is gaining importance, increasing demand for primary care diagnostics, point-of-care diagnostics, and solutions for managing chronic diseases.
In medical technology, public procurement is particularly relevant for diagnostics, as well as for consumables, basic surgical instruments, sterilization equipment, and primary care devices. Digital health solutions are also gaining importance, especially in the context of patient information systems, data infrastructure, and strengthening the primary care system.
Key stakeholders
At the national level, the Department of Health is a key player. It sets the list of essential medicines, manages the national pharmaceutical procurement and distribution system, and shapes the strategic programs for communicable and non-communicable diseases. The South African Ministry of Finance is also central. It shapes the legal and financial framework for public procurement, and contributes to the rules for tendering and evaluation of public tenders.
The Department of Trade, Industry and Competition also shapes the industrial policy framework for medical technology. The South African Health Products Regulatory Authority (SAPHRA) is responsible for regulatory approval, which is a prerequisite for participation in public tenders. The National Essential Medicines List Committee also plays an important gatekeeper role, deciding which medicines are included on the list of essential medicines.
After procurement at the national level, orders are placed in a decentralized but coordinated system through the nine provincial health authorities and district structures. For laboratory diagnostics, reagents, and related equipment, the National Health Laboratory Service is the main institutional purchaser. The decentralized chronic medicines dispensing program is also a key component of the supply chain for HIV and NCD patients.
First steps
Since only locally based representatives can apply for product registration, starting to export usually involves finding a qualified local distributor or registering a subsidiary. Pricing is subject to the Single Exit Price system, and access to the public market also depends on inclusion in the list of essential medicines and participation in tenders by the Ministry of Health. Medical technology is also subject to registration, depending on the risk class, and is also subject to the same local representative logic.
Contact S-GE for market information, positioning and access to potential business partners: Swiss Business Hub Southern Africa
Türkiye
Relevant products
Public procurement is particularly important in Türkiye in the hospital segment. Hospital medicines, including high-priced and specialized drugs, medical consumables, medical devices and equipment, diagnostics and laboratory equipment, imaging systems, and hospital-adjacent infrastructure technologies are particularly relevant. Vaccines and certain strategic or critical products are also heavily influenced by the public sector. Digital health solutions are particularly relevant where they are procured by the Ministry of Health or public hospital networks.
Key stakeholders
The main actors at the national level include the Ministry of Health and its Directorate General for Public Hospitals, the State Procurement Agency DMO with its central procurement market for health products, the procurement authority and the electronic procurement platform EKAP. The Turkish Medicines and Medical Devices Agency for licensing and product registration and the social security system, which decides on reimbursement and listing, are also central.
At the operational level, individual public hospitals, university hospitals and their purchasing units play an important role. In addition, there are tender and specialist committees in the hospitals as well as local distributors, which often have a significant influence on market access in practice.
First steps
In practice, starting to export to Türkiye usually involves an experienced Turkish importer or distributor who is familiar with the licensing, reimbursement and public tender procedures and can also cover local distribution and technical service. For medical devices, the relevant conformity requirements and registration in the Turkish product tracking system are important. For pharmaceuticals, market authorization by the relevant authority is required; where relevant, reimbursement and listing issues also apply.
To access the public market, it is important to regularly monitor tenders on EKAP and procurement opportunities through the DMO. Depending on the procedure, pre-registration and product-specific certifications may be required. For the procurement of products classified as strategic, requirements for local production or technology transfer may be a condition.
Contact S-GE for market information, positioning and access to potential business partners: Swiss Business Hub Türkiye
United Kingdom
Relevant products
Public procurement is the main channel for prescription drugs, medtech and clinical solutions. This is especially true for hospital medicines – including high-cost drugs and advanced therapies such as cell and gene therapies or CAR-T treatments – vaccines and other products for publicly funded prevention programs, diagnostics solutions such as genomics and precision diagnostics, imaging systems, lab equipment and AI-driven diagnostics, surgical robotics, hospital equipment and clinical consumables, and digital health solutions such as clinical software, healthcare IT, decision-support tools, remote monitoring, connected care and hospital-at-home technologies.
Key stakeholders
These include NHS Trusts and NHS Foundation Trusts as key end-users, particularly for hospital-based products, medical technology, diagnostics, equipment and many digital health solutions. Integrated Care Boards (ICBs) are also playing an increasingly important role. There are also central procurement channels via the NHS Supply Chain and national framework operators, which are a key access point, especially for Medtech providers.
At a system level, the Department of Health and Social Care (DHSC) and NHS England shape the policy, commercial and structural context. NICE also has a significant influence on market access, although it does not procure itself, through its appraisals, evidence frameworks and health economic assessments. At an operational level, procurement teams, operational managers, tender panels and regional procurement hubs are also important.
First steps
Entry into the British market requires a clear route-to-market strategy, as procurement takes place at both national and regional and local levels. In parallel, the regulatory and formal requirements must be met, including the appointment of a “UK Responsible Person” for Swiss manufacturers without their own subsidiary in the United Kingdom.
Commercially critical are a robust evidence and value proposition, targeted messaging to relevant buyer groups, and the development of relationships with clinical users and procurement teams. Companies should also expect long sales cycles and pursue pilot projects only if a realistic path to future procurement is visible.
Contact S-GE for market information, positioning and access to potential business partners: Swiss Business Hub UK
This is how you plan access to the public health market
The public health market follows its own rules. Product quality, price and distribution are not the only factors that matter. The factors that determine access to the market vary significantly from country to country. Those who understand the system logic early on can prioritize markets more effectively, involve the right partners and prepare for start exporting much better. S-GE supports Swiss companies in this regard with market information, identification of relevant stakeholders and access to potential business partners. Schedule a free and non-binding appointment with our specialists and discuss your individual project.
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