Post on 10-Apr-2018
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GLOBAL PLAYERS IN
HEALTH CARE: PART 2
MULTINATIONAL COMPANIES INHEALTH CARE
JANE LETHBRIDGE
PUBLIC SERVICES INTERNATIONAL
RESEARCH UNIT (PSIRU)
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MULTINATIONAL HEALTH
CARE COMPANIES Insurance ± ING/Aetna, Cigna
Health care services ± Afrox, Capio, HCA,
Parkway Holdings, UnitedHealth Diagnostic and laboratory services ± Quest
Diagnostics, Unilabs, Euromedic
Support/ facilities management services ±
Compass, ISS, Rentokil-Initial, Sodexho Vertically integrated services ± Adeslas,
BUPA, Medicover, Fresenius
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MULTINATIONAL HEALTH
CARE COMPANIES
1. AETNA INTERNATIONAL / ING
Taken over by ING, a global provider of
financial services in 2000 ING deals with banking, insurance and asset
management in 65 countries worldwide
Aetna Financial and International services are
being integrated into ING Europe, ING Americas, and ING Asia/Pacific
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MULTINATIONAL HEALTH
CARE COMPANIES1. AETNA INTERNATIONAL / ING
Europe is seen as ING¶s most important
region ING Europe plans to expand further with a
strong base in the Netherlands and Belgium
ING sees European social security systems
as weak due to increased costs and anageing population, which will provide new
opportunities for insurance providers
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MULTINATIONAL HEALTH
CARE COMPANIES2. AFROX HEALTH CARE LTD Southern Africa's leading provider of private
healthcare
Listed as AHealth in the healthcare sector onthe Johannesburg Stock Exchange
Formed in 1999 when the healthcareinterests of African Oxygen Limited (Afrox)
was merged and reverse listed into PresidentMedical Investments Limited (PresMed)
Afrox, one of South Africa's top 100companies, is the majority shareholder
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MULTINATIONAL HEALTH
CARE COMPANIES2. AFROX HEALTH CARE LTD Afrox Healthcare competes in both the
managed care and fee for service markets in
South Africa, Zimbabwe and Botswana Operates and has interests in 73 acute care
hospitals and some surgical centres with over
7000 hospital beds
Also active in long term chronic care,
emergency response and medical care
services network, occupational health care
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MULTINATIONAL HEALTH
CARE COMPANIES3. CAPIO Floated as an independent company on the Swedish
stock exchange in late 2000
Previously owned by financial investment group Bure Provides healthcare services in Scandinavia and
other European countries
Healthcare services: hospitals, outpatient healthcareand psychiatry; 73% sales
Diagnostic services: provision of laboratory andradiology services; 19%
Elderly care services: care services for the elderly.8%
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MULTINATIONAL HEALTH
CARE COMPANIES3. CAPIO
Capio is currently operating in Sweden, Norway,Denmark, the UK, Switzerland and Poland
Annual turnover SEK 3,300 million. Following the acquisition of the Community
Hospitals Group in the UK (now Capio UKdivision), Capio¶s operations outside Sweden
now generate more sales than operations withinSweden
September 2002 acquired French clinics -Clininvest
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MULTINATIONAL HEALTH
CARE COMPANIES3. CAPIO
150 operating units with 10,000 employees,
of which 2,000 are physicians.
Sees the public/private health care
relationship as a significant factor in the
future growth of the private health care sector
Has identified a growing role for the privatesector in delivering services to the public
health sector in Nordic countries and the UK
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MULTINATIONAL HEALTH
CARE COMPANIES
4. PARKWAY HOLDINGS
Based in Singapore
Owns and operates private hospitals, and
provides healthcare services in Singapore,Malaysia, Indonesia, Sri Lanka, India and until August 2001 in the UK
Also owns and manages medical clinics andradiology clinics; deals in medical supplies,
equipment and healthcare products; dentalclinics; provides clinical research centre; providescomprehensive diagnostic laboratory services;and investment holding and trading
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MULTINATIONAL HEALTH
CARE COMPANIES
4. PARKWAY HOLDINGS The Group¶s healthcare business is owned and
managed by the wholly owned subsidiary ParkwayGroup Healthcare Pte Ltd.
The Group also provides contract research servicesthrough subsidiary Gleneagles Clinical ResearchCentre Pte Ltd, which serves the research needs of physicians, multinational pharmaceutical companies,contract research firms and biotechnology companiesin Asia.
Apollo Gleneagles Hospitals is a recently agreed joint venture between Parkway Group and ApolloHospitals (India) hoping to attract patients from SE
Asia
Government hospitals are proving to be challenging
competitors in Singapore.
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MULTINATIONAL HEALTH
CARE COMPANIES5. QUEST DIAGNOSTICS
A laboratory testing business that provides
diagnostic tests to patients, doctors and healthcare institutions through a network of laboratories
Provides routine tests and esoteric tests
Manufactures diagnostic test kits for esoteric
testing Runs two clinical trials testing centres in the US
and the UK as well working in partnership with
two centres in Australia and South Africa
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MULTINATIONAL HEALTH
CARE COMPANIES5. QUEST DIAGNOSTICS
Owns one of the largest privately owned clinicallaboratories in the UK which was developed in
partnership with an NHS trust/ hospital Mexico - Quest owns three laboratories and provides
testing services throughout Mexico
Brazil ± a centre and aiming to set up additionallaboratory services in Brazil
Provides esoteric testing services to the NicholsInstitute, involved in clinical trials, which operateworldwide
29,000 people employed in 2001, the majority in theUnited States.
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MULTINATIONAL HEALTH
CARE COMPANIES5. QUEST DIAGNOSTICS
Recently established an alliance with RocheDiagnostics to develop gene based medical
testing Recent acquisitions and alliances show the
shared interests between the laboratory divisionsof pharmaceutical companies and diagnostictesting businesses
Growing demand for esoteric tests, includinggene testing, provides opportunities for expansion
Expensive tests to provide requiring hightechnology equipment and staff
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MULTINATIONAL HEALTH
CARE COMPANIES5. ISS A Danish company providing facilities services
including cleaning, catering, and services for
hospitals and older people¶s care homes Cleaning and maintenance - office cleaning for private and public sectors
Services for the health sector - targeted athospitals and other institutions within the health
sector Services for the food industry
Services for airports
259,739 employees worldwide
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MULTINATIONAL HEALTH
CARE COMPANIES5. ISS
Facility services represent 87% of sales in2000/1
Hospital services contribute 14% of sales Over 80% of hospital sales take place in Europe
The development of the facilities servicespackage is most developed in the UKSpecialisation of cleaning concepts is most
developed in Germany ISS has also lost several contracts with the public
sector in Denmark due to poor standards of delivery
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MULTINATIONAL HEALTH
CARE COMPANIES5. ISS
ISS has made a large number of acquisitions inthe last few years
In the health sector, it has acquired a number of older people¶s facilities and medical facilities butin some cases it has also divested of recentacquisitions in the health care sector
The CarePartner division, which delivers medical
facilities and older people¶s care in Denmark,Sweden, Norway and Finland is being reviewedin 2002 which suggests that ISS¶s overall role inhealth care provision is still unclear
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MULTINATIONAL HEALTH
CARE COMPANIES
6. SODEXHO
A French company ± delivers services ± cleaning, catering,to a range of sectors including the health care sector
Provides a range of services (often described as multi-service) to hospitals and to older people¶s care homes
These services may include, catering, cleaning,housekeeping, building maintenance and management of paramedical staff
Services delivered within the health care sector provide18% of revenue
313,469 employees worldwide with 45% of employees inEurope.
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MULTINATIONAL HEALTH
CARE COMPANIES
6. SODEXHO
Sodexho sees opportunities in globalmulti-site, multi-service contracts
Partnerships with public and privatesector organisations in order to deliver services
Involved in several Private FinanceInitiatives involving hospital building andmanagement
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MULTINATIONAL HEALTH
CARE COMPANIES
7. BUPA
International health and care specialist
Provides worldwide health insurance and care
services to nearly four million people and 40,000companies with members in over 180 countriesaround the world
Offices in Ireland, Hong Kong, Saudi Arabia,
Spain, Thailand, Singapore, Malaysia, Australia BUPA is a provident association with no
shareholders
Any profits are reinvested back into the company
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MULTINATIONAL HEALTH
CARE COMPANIES
7. BUPA
BUPA Hong Kong provides insurance for over 145,000people and over 1,500 companies
BUPA Middle East, established in 1997, is a joint venturepartnership between BUPA International and the Nazer Group, a leading Saudi Arabian company with interests inthe health care, computing, retail and electro-mechanicalengineering fields
BUPA owns the Spanish health care organisation Sanitas
Blue Cross joined with BUPA in 1996 to form BUPA BlueCross, the largest health insurer in Thailand
In 2001, BUPA recently bought primary healthcarebusinesses in Australia, Malaysia, Hong Kong andSingapore
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MULTINATIONAL HEALTH
CARE COMPANIES
8. FRESENIUS
Integrated kidney care company
Provides kidney dialysis equipment, productsand services
Fresenius AG has operations in Asia, Europe,Latin America, and North America
North America and Europe are the main
focus of sales with 57% and 32% respectively South America and Asia-Pacific account for
5% and 6% of sales
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MULTINATIONAL HEALTH
CARE COMPANIES
8. FRESENIUS
49,974 staff employed in 2000
52% of the labour force in North America and35% in Europe
4,000 employees joined Fresenius in 2000 as
the result of acquisitions
Fresenius Medicare (clinics) employs 71% of the labour force and has a 74% share of
sales
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MULTINATIONAL HEALTH
CARE COMPANIES
8. FRESENIUS
Renal care is a growing area of healthcareand part of a very competitive market
worldwide Growing evidence that companies, which
manufacture drugs and /or equipment for thetreatment of kidney diseases are also
involved in the provision of health care Multinational companies involved in renal
care have combined operations that includeGambro, Baxter
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CONCLUSION
Diverse nature of health care multinationalcompany expansions and contractions