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Saudi Arabia
Healthcare
© 2015 KFH Research Ltd.
All rights reserved.
“Opportunities Abound”
KFH Research Ltd
KDNPP15024/03/2015 (031903)
16 January 2015
Contents
Overview
3
Non-Communicable Diseases on the Rise
4
Healthcare Provision
7
Pharmaceutical & Biotechnology
8
Key Challenges
9
Porter’s 5 Forces Analysis on Saudi Arabia Healthcare
11
Conclusion and Outlook
13
Appendix 1: Chart Analysis – Saudi Arabia Healthcare Indicators
14
Appendix 2: Saudi Arabia Ongoing Healthcare Projects 15
Saudi Arabia Healthcare
“Opportunities Abound”
Saudi Arabia Healthcare
“Opportunities Abound”
Overview
The healthcare sector represents a huge and growing market in Saudi Arabia, where spending as a proportion of
the total national budget has more than doubled in recent years. The Saudi Ministry of Health has allocated
USD100bln to a five year healthcare programme, with the intention of drawing on international best-practice to
help provide top class, universal healthcare to its population. Saudi Arabia has the largest and one of the fastest
growing populations in the GCC. In 2011, the population in the country stood at 28.4million, with an overall CAGR
(2004- 2011) of 3.35% [Saudi Nationals: CAGR (2004-2011) 2.32%; Non-Saudi’s: CAGR (2004-2011) 5.54%].
Saudi Arabia: Projected Population
Source: Collier International 2013, KFHR
Males in Saudi Arabia constitute 55% of the total population, the majority of which belong to the 30-34 years of
age category. The population below the age of 34 years accounts for about 60% of the total population in the
country. The rapidly growing young population is one of the key factors driving demand for the healthcare
sectors. As the profile of the country’s population change, the need for healthcare services both in terms of
disease pattern, as well as type of healthcare services provided is also expected to change dramatically.
Saudi Arabia: Age-Gender Distribution of Population
Source: Ministry of Health, Colliers International 2013, KFHR
Demand for healthcare services in the Saudi Arabia will continue to rise, backed by rapid population growth, a
growing aging segment, and the prevalence of long-term non-communicable diseases. The rising demand in its
healthcare has forced the government to increase its budget allocation on healthcare from SAR30bln in 2008 to
SAR100bln in 2013. The cumulative investment has also increased to SAR73.7bln per annum (2009-2013)
compared to only SAR23.5bln (2005-2008). In 2013, Saudi Arabia’s healthcare spending as percentage of GDP
was estimated at 3.7%, one of the highest in the GCC countries. However, the country is still behind many
developed nations in the world.
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Healthcare Spending as a % of GDP
Source: UNDP2012, Colliers International 2013, KFHR
Healthcare Budget in Saudi Arabia (SAR billion)
Source: Ministry of Health 2010, Colliers International 2013, KFHR
The government is the major healthcare provider in the country, contributing approximately 75% of the total
healthcare spending. The government also had a 67% share in the total hospitals and 77% in the total hospital
beds in the country in 2006.
Non-Communicable Diseases on the Rise
The improvement in the healthcare system played a vital role in bringing the infant mortality rate in the country
(per 1,000 births) down to 7.9 in 2011 from 71 recorded in 1980. Life expectancy in Saudi Arabia averaged an
estimated 75.3 years in 2011 (as compared to 62 years in 1980). The increase in life expectancy is indicative of a
growing elderly society due to an improved healthcare system and also the increase in the requirement for
medical healthcare facilities.
Saudi Arabia: Life Expectancy at Birth, Infant Mortality, Fertility and Birth Rate
Source: World Bank, KFHR
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Saudi Arabia has made some significant health gains over the past two decades, including increases in life
expectancy and swift reductions in child mortality. However, despite the improvement shown by the health
indicators, the chronic non-communicable diseases are on rise and are now the major cause of death among the
elderly in Saudi Arabia. Overweight and obesity were highly prevalent in all GCC countries relative to the rest of
the world. In Saudi Arabia, 69% of the population are overweight, and 33% are obese.
Saudi Arabia: Adult Risk Factors
Source: WHO, KFHR
A strong economic growth, rapid urbanisation, lack of physical activity, unhealthy diets and increasing sedentary
lifestyles are among the many factors that have led to a high prevalence of chronic conditions in the country.
According to the World Health Organisation (WHO), in 2008, an alarming 68.8% females and 69.1% males were
overweight while 28.6% male and 39.1 female were obese in Saudi Arabia. The prevalence of diabetes was also
amongst the highest in the world with 23.8% of the total population (age 20-79) suffering from this disease in
2013, an increase from 16.7% in 2007. The WHO predicts that by 2030 there will be 2.5 million diabetes patients
in Saudi Arabia. A large population of the country was also suffering from other chronic conditions such as
asthma, hypertension and dementia.
Top 5 Countries for Prevalence (%) of Diabetes (20-79 years) 2013
Source: International Diabetes Federation Diabetes Atlas 2013, KFHR
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Regional Comparison for Diabetes (20-79 age group), 2010 and 2030
2010
Region
Population
(20-79)
(million)
No. of
people
with
diabetes
2030
Comparative
diabetes
prevalence
(%)
(million)
Population
(20-79)
(million)
2010/2030
No. of
people with
diabetes
Comparative
diabetes
prevalence
(million)
(%)
Increase in
the no. of
people with
diabetes
(%)
AFR
379
12.1
3.8
653
23.9
4.7
98.1
EUR
646
55.4
6.9
659
66.5
8.1
20.0
MENA
344
26.6
9.3
533
51.7
10.8
93.9
NAC
320
37.4
10.2
390
53.2
12.1
42.4
SACA
287
18.0
6.6
382
29.6
7.8
65.1
SEA
838
58.7
7.6
1,200
101.0
9.1
72.1
WP
1,531
76.7
4.7
1,772
112.8
5.7
47.0
TOTAL
4,345
284.8
6.4
5,589
438.7
7.7
54.0
Source: The Global Burden: IDF Diabetes Atlas, KFHR. Note: Africa (AFR), Europe (EUR), Middle East and North Africa (MENA),
North America and Caribbean (NAC), South & Central America (SACA), South East Asia (SEA), Western Pacific (WP).
It is estimated that approximately 285 million people, or 6.4%, in the age group 20-79 will have diabetes
worldwide in 2010. About 70% of these live in low-and middle-income countries. The worldwide estimate is
expected to increase to some 438 million, or 7.7% of the adult population, by 2030. The largest increases will
take place in the regions dominated by developing economies. Low levels of exercise, widespread consumption
of fatty and salty foods and a high level of obesity will take their toll on the standard of health. Cardiovascular
illnesses and diabetes are likely to remain key health problems.
Healthcare Facilities and Infrastructure
Source: Colliers International 2013, KFHR
The high population growth rate combined with high prevalence of chronic diseases has resulted in a shortage of
doctors, nurses, and beds in Saudi Arabia. Generally, the shortage is prevalent across all GCC countries,
however, Saudi Arabia has the lowest number of beds and nurses and doctors per population even within the
GCC. There are currently over 415 hospitals, both within the public and private sectors providing various
healthcare facilities and treatment throughout the country. Almost 60% hospitals in Saudi Arabia and nearly 60%
beds with an average of 138 beds per hospitals are owned by the Ministry of Health (MoH). Quasi-government
hospitals meanwhile account for only 9.4% of total hospitals with an average of 280 beds per hospital
(representing 18.8% of total beds). Approximately 30.6% of total hospitals are private with an average of 101
beds per hospitals which represents about 22.1% of total beds.
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Saudi Arabia: Hospital Type
Source: Colliers International 2013, KFHR
Healthcare Provision
Healthcare Recruitment
The doctor/patient ratio is 2.4 per 1,000 people, according to the health ministry, which is low in comparison with
most OECD countries. Although the government has invested in medical training, expatriate doctors and nurses
make up a large majority of the nurses and doctors working in the kingdom. According to the latest health
ministry data, 25.4% of physicians, including dentists, were Saudi nationals at the end of 2012 (up from 22.6% in
2010), but just over 55% of nurses were Saudi (compared with 40% in 2006). The healthcare sectors ability to
recruit is limited by "Saudiisation" quotas, which require firms to employ a certain proportion of Saudi nationals.
According to reports, plans are in place to fully nationalise the healthcare workforce by 2018. The supply of
trained Saudi healthcare workers will struggle to keep pace with the number of new hospitals being built. In an
effort to address shortages in the sector, the health ministry has reached personnel and equipment training
agreements with South Korea and the UK�s National Health Service. In addition, in February the health minister,
Abdullah Rabia, announced that the kingdom would look to recruit extra physicians from Bangladesh.
Hospital Beds and Doctors, International Comparison (2013)
per 1,000 population
12
10
8
6
4
2
0
Saudi Arabia
Brazil
China
Germany
India
Russia
US
Source: EIU, Espicom, KFHR
Hospitals and Clinics
Most public hospitals are run by the health ministry. Several other public sector institutions operate hospitals for
their employees, including the Ministry of Defence, the Ministry of the Interior, the National Guard, Saudi Aramco,
the Royal Commission for Jubail and Yanbu (Marafiq), Saudi Airlines and some universities. There were 435
hospitals at the end of 2012: 259 under the health ministry, 39 under other government agencies and 137 private
hospitals. Overcrowding is a major problem in urban areas, where population growth has outstripped the pace of
hospital construction. The government is currently pursuing an extremely ambitious hospital construction
programme, which will eventually increase the total number of hospitals operated by the health ministry to 354.
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The ministry is also seeking to build five "medical cities", spread across the country. The cities will focus on
specialist treatments, complicated surgeries and rare diseases. The rapid rate of hospital construction is causing
problems, however, in terms of both restrictions on manpower and bureaucratic constraints at the health ministry
(the latter of which is being addressed by bringing in outside project managers from abroad and by the setting up
of a data centre to allow the sharing of information between health centres and government agencies). There is a
well-established private hospital-management sector in Saudi Arabia, with around 140 facilities currently run by
the likes of Saudi German Hospital Group, Kingdom Holding and the Saad Group. However, it will prove difficult
to attract sufficient private investment into rural areas. Besides hospitals, there are also 2,109 smaller health
clinics across the country, with more than half of these including a dental surgery. In an effort to improve
cohesion in national health strategy, the Supreme Health Services Council was established in 2010 to coordinate healthcare policy.
Pharmaceutical and Biotechnology
The pharmaceutical market is worth an estimated USD5.35bln in 2013, compared with USD6.4bln in Egypt, for
example. Nevertheless, the Saudi pharmaceutical market remains the largest of the Gulf Arab states. It is
expected that the pharmaceutical market will expand by 6.3% a year to reach USD7.3bln in 2018, equivalent to
USD215 per head and faster than overall growth in health spending. Nevertheless, cost restraint, including in the
purchase of medicines, is likely to be encouraged by the recent setting up of a pharmacoeconomic and outcome
research centre, which will be charged with curbing public healthcare expenditure. Branded products are more
popular than generics, with a survey by Dubai-based Alpen Capital in 2013 finding that 52% of Saudis prefer to
buy Western branded drugs than those produced in the Middle East.
Sales of medical devices are set to increase, mainly led by international suppliers. In 2012 a new medical device
approval system was introduced, through which the Saudi regulator would not require companies with existing
registrations in the US, Europe and elsewhere to meet a host of new national criteria. It is believed that around
35% of pharmaceuticals (by value) are purchased by the government, with the health ministry the single largest
buyer in the country. The remaining 65% are bought by the private sector. Over-the-counter (OTC) medication
can only be purchased at licensed pharmacies. Up to 85% of total pharmaceutical sales come from abroad, of
which the private sector typically purchases around two-thirds.
Saudi Arabia’s Pharmaceutical Sales
7,000
USD Million
6,000
5,000
4,000
3,000
2,000
1,000
0
2009
2010
2011
2012
2013e
2014f
2015f
2016f
Source: EIU, KFHR
Pricing
In 2007 the government set up a public-sector company, the National Unified Procurement Company for Medical
Supplies (Nupco), to be the sole supplier of medicines and medical appliances to Saudi government institutions.
The kingdom�s existing medical import and distribution firms have complained that Nupco is driving them out of
business, as they cannot compete on scale. Price controls are an issue for exporters into Saudi Arabia. Since
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July 2009 setting local retail prices for all imported drugs has been the responsibility of the Saudi Food and Drug
Authority (SFDA). Among other methods, the SFDA benchmarks prices against international norms, and it has
set up an electronic database to assist in the process.
Generics
According to the SFDA, generics account for only 6% of the Saudi pharmaceutical market, with branded
medications (mostly comprising imports) making up 83% of the total and OTC medicines comprising the
remainder. Generics are mostly produced locally, and local firms concentrate on generic production, sometimes
exporting to other Middle Eastern countries. Spiralling healthcare costs are likely to push government
procurement towards cheaper generics over time. Saudi Arabia also has potential as a regional supply hub. In
late 2011 a UAE-based firm, Gulf Pharmaceutical Industries, announced a joint venture with a Saudi company,
Cigalah Group, which will include building a factory in the King Abdullah Economic City (KAEC) to produce
branded generic drugs.
Pharma and biotech supply dynamics
The local pharmaceutical industry supplies only around 15% of the market. Local firms mainly produce generic
products, but the government is seeking to encourage research and development in the country. Saudi Arabia
imported pharmaceuticals worth USD4.48bln in 2012, up by 16.9% y-o-y. Most imports come from Europe, but
there may be rising demand for low-cost generics from emerging markets owing to price competitiveness. Saudi
Arabia is also a modest but growing exporter of pharmaceuticals, with the value of exports rising from
USD235mln in 2010 to USD307mln in 2012. The leading local pharmaceutical firm is GlaxoSmithKline of the UK,
which operates a joint venture with the Banaja Saudi Import Company. The joint venture has a market share of
around 10%.
The largest Saudi-owned manufacturer is the Saudi Pharmaceutical Industries & Medical Appliances Corporation
(Spimaco). Spimaco accounts for 72% of private-sector drug sales in the domestic market. Domestic
pharmaceutical manufacturing is set to expand now that foreign pharmaceutical companies can manufacture
drugs in the country with 100% ownership. Sanofi was the first company in the kingdom to take advantage of this
reform, by building a factory in the KAEC to produce oral anti-diabetic and cardiovascular products. The KAEC,
north of Jeddah, has succeeded in attracting international pharmaceutical firms to participate in manufacturing
joint ventures. As well as Sanofi, this includes Shamla Pharmaceuticals Industries (a partnership that includes a
Saudi firm, Zimmo Trading) and, most recently, Pfizer.
The government is also looking to encourage investment in biotechnology. With that in mind, the Jeddah BioCity
complex (located in King Abdulaziz University) has been created. In addition, in December 2013 the King
Abdulaziz City for Science and Technology and US-based Life Technologies launched the Saudi Human
Genome Programme, designed to provide a genetic database for the Saudi population in order to trace and treat
diseases in the kingdom. It is also now possible for foreign firms to operate pharmacies in the country. A Dubaibased chain, Planet Pharmacy, has expanded into Saudi Arabia, trading under the name Zahrat al-Rawdah.
Despite Saudi Arabia’s success in attracting investment, the development of the domestic pharmaceutical
industry is constrained by weak copyright protection, extensive counterfeiting and a cumbersome approvals
process.
Key Challenges
While many steps have been undertaken by the MoH to reform the Saudi Arabia health care system, a number of
challenges remain. These relate to the health workforce, financing and expenditure, changing patterns of
diseases, accessibility to health care services, introducing the cooperative health insurance scheme, privatisation
of public hospitals, and utilisation of electronic health (e-health) strategies and the development of a national
system for health information.
© KFH Research Ltd
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Saudi Arabia Healthcare System: Key Challenges
Source: KFHR
The Saudi health care system is mainly challenged by the shortage of local health care professionals, such as
physicians, nurses and pharmacists. The majority of health personnel are expatriates and this leads to a high rate
of turnover and instability in the workforce. In 2012, according to the MOH the total health workforce in Saudi
Arabia, including all other sectors, was about 71,518; more than half of them (35,841) work in the MOH. Saudis
constitute 24.2% of this total workforce. Of these, 23.8% are physicians, while 36.2% are nurses.
Saudi Arabia: Total Health Workforce (2012)
Number of Health Workforce
40000
35000
30000
25000
20000
15000
10000
5000
0
MoH
Government
Saudi
Private
Non-Saudi
Source: Ministry of Health, Health Statistics Annual Book 2012, KFHR
160000
40
140000
35
120000
30
100000
25
80000
20
60000
15
40000
10
20000
5
0
% of Saudi
Number of workforce
Saudi Arabia: Total Number of Physicians and Nurses
0
2008
2009
2010
2011
2012
Physicians
Nurses
Physicians % of Saudi (RHS)
Nurses % of Saudi (RHS)
Source: Ministry of Health, Health Statistics Annual Book 2012, KFHR
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The change in disease patterns from communicable to non-communicable diseases in Saudi Arabia is another
challenge that needs more attention from the MOH. There has been an alarming increase in the prevalence of
chronic diseases, such as diabetes, hypertension, and heart diseases, cancer, genetic blood disorders and
childhood obesity. Treatment of chronic diseases is costly and may even be ineffective. For example, the annual
cost for treatment of diabetes mellitus in Saudi Arabia was estimated to be SAR7bln (USD1.87bln). Early
prevention is the most effective way to reduce the prevalence of chronic diseases and the costs and difficulties
associated with treatment in the later stages of disease. Any projected reforms in the health care system must
involve plans to address this change in emphasis.
Porter’s 5 Forces Analysis on Saudi Arabia Healthcare
We use Porter’s 5 forces industry analysis to determine the industry’s attractiveness based on a) Intensity of
competitive rivalry; nature & level of competition b) barriers to new entrants; high or low, c) substitution effect;
level of similarities in products & services, d) buyers’ bargaining power; ability of consumer to negotiate prices;
and e) suppliers’ bargain power; industry players’ ability to negotiate the suppliers of key inputs. Overall, Porter’s
five forces analysis shows that the Saudi Arabia Healthcare industry is an ‘attractive’ market with ample
growth opportunities, in the following areas i.e. geographical expansion, infrastructure development, medical
training and wider health insurance.
1. Rivalry Intensity – Low
We consider the following key factors to evaluate the intensity of competitive rivalry among the Kingdom’s
existing medical complexes:
• Pricing
• Brand name
• Medical facilities at the premises
• Geographical presence
We believe the pricing is a major concern for those customers who have mandatory health insurance or have no
private health insurance (mainly Saudi citizen; who have only government insurance if not working in private
sector). However, those customers having good health insurance coverage (whether Saudi citizen or non-Saudi
citizen) are more focusing on brand name and other facilities (including quality of physicians). Hence, we believe
the intensity of rivalry on prices is high on low-end medical complexes; whereas, the brand name & other facilities
are more important for high-end (who have high medical expenditure power). On the other hand, due to limited
presence of big high class medical facilities (mainly concentrated in three big cities in Saudi Arabia (i.e. Riyadh,
Dammam and Jeddah) the rivalry, at present, in high-end segment of sector is low. This could be capitalised by
the new players through expansions. Furthermore, the intensity of rivalry based on geographical presence is high
in small low-class medical facilities; since, the business of these small low-class medical facilities is mainly based
on ease of access. It should be noted that the focus on medical services is limited at low-class small medical
complexes; as people are using these facilities for the treatment of general diseases.
It is our view that the limited availability of high-class and low-class specialized hospitals limits the intensity of
rivalry. The rivalry on pricing is also not much effective on high-class (where the customers have good health
insurance policies) with limited supply of quality physicians & medical staff leaving the customers with limited
choices. We, therefore, can conclude that overall the industry has a low intensity of rivalry.
2. Threat to New Entrants – Medium to High
The entry barriers in Saudi Arabia’s healthcare industry vary depending on the nature of medical facilities.
Specialised, large-to-medium hospitals have medium to high entry barriers due to the following requirements: 1.
Highly specialised physicians and medical staff, 2. High capital investment (around SAR0.5bln on average) to
accommodate all facilities, and 3. Ideal location to optimise the coverage. Meanwhile, polyclinics & dispensaries
have low to medium entry barriers due to the following reasons: 1. Average doctors and medical staff are easily
© KFH Research Ltd
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available, 2. Less capital incentive, and 3. Easy to find location in nearby localities. It should be noted that the
approval for opening a new medical facility (whether specialised, general or small hospital) is not an easy task.
Moreover, creating & maintaining a reputation is also a big challenge in the medical healthcare field. Beside
these factors, the new regulation regarding ownership of hospital or medical complex by a local doctor increases
the barrier to entry. The major impact will be on the private and small medical facilities (i.e. mostly polyclinics).
Based on the above identified factors, we can conclude that the Saudi Arabia medical health care sector has a
medium to high entry barriers which makes the industry more attractive to existing players.
3. Substitution Effect – Low
The end services of the industry are unique in nature and have no substitutes; unless the local authority will allow
alternative medics to penetrate in the market. However, inside the sector, the following factors can make one
medical complex a substitute to the other:
• Quality of physicians - It should be noted that the quality physicians are scarce in the kingdom; hence, this
factor makes a real difference among the existing players. The limited number of physicians limits the impact of
substitution.
• Medical service differentiation - Medical services are almost similar to each other and vary slightly from one
medical complex to another. The main difference is perception & discounts due to insurance policies. However,
we can say (in case of general illness) that the polyclinics could be a good substitute of low-level hospitals; on
cost & benefit analysis. We, therefore, believe the substitution effect is high on low end; while on high end the
effect is limited.
• Proximity - Proximity is the main issue associated with large-to medium medical facilities rather than small &
low level medical complexes. Hence, this factor limits the substitution effect on wide scale.
• Wider health insurance policy - We believe health insurance policy in the kingdom is under evolution stage.
Hence, this limits the substitution effect on the sector, for the time being; where, the widening of health insurance
policy could accelerate the substituting effect.
• Nature of illness - Seriousness of disease limits the options for customers (patients).
Thus, the substitution effect inside the industry is low thus making the industry more attractive for existing players
to maximise their profitability.
4. Buyer’s Negotiation Power – Low
It should be noted that the nature of disease and bargaining power in the healthcare industry has an inverse
relationship i.e. higher the seriousness of the disease, the lower the bargaining power. Nevertheless (when the
seriousness of disease is low) the customers’ negotiation power varies according to the insurance policies.
Further, the limited availability of physicians also puts a limit to the buyers’ negotiation power. Hence, based on
the nature of the industry’s business we believe the buyer’s (i.e. patients) have low bargaining power. This makes
the industry attractive to existing players.
5. Suppliers’ Negotiation Power – Low to Medium
The sector’s suppliers can be categorised into the following two categories: 1. Recruitment agencies providing
physicians & medical staff and 2. Medical equipment & supplies manufacturers. The negotiation power of
recruitment agencies is higher because they recruit talent which is scarce in the kingdom. On the other hand, the
negotiation power of the manufacturer of medical supplies & equipment is low (except for highly sophisticated
machines) as the products are highly commoditised and the medical facilities have number of supply sources.
Overall, we believe the supplier power in the medical healthcare industry ranges from low to medium which
makes the industry attractive to existing players.
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Conclusion and Outlook
The Government of Saudi Arabia continues to allocate a large pool of funds towards the development of the
healthcare sector along with providing initiatives for the private sector operators to enter the healthcare market in
the Kingdom. The surge in population, which shows no sign of slowing down, further contributes towards strong
fundamentals for growth and the evident supply gap. Private hospitals will continue to play an even more
important and crucial role within the Kingdom. Emergence of lifestyle related diseases such as diabetes,
hypertension, obesity, heart (cardiovascular) and kidney (dialyses) has created new opportunities for growth and
the private sector is gradually expected to play the role of main providers for these segments. The delivery of
healthcare in the Kingdom and around the world continues to evolve as the needs of healthcare provider become
increasingly complex. Trends and industry changes requires investors and operators of healthcare facilities to
make challenging decisions. Despite improvements in healthcare systems across the Kingdom, the healthcare
sector still offers significant opportunities for investors / operators. We believe that due to strong growth
fundamentals coupled with the increasing population and regulatory changes the sector is expected to
experience robust growth in the foreseeable future.
Healthcare Expenditure – Global and GCC Positioning
Source: World Health Organization – Word health statistics 2012
Healthcare Medical Services Sector - Global & GCC Positioning
Source: World Health Organization – Word health statistics 2012
© KFH Research Ltd
13
Saudi Arabia Healthcare
“Opportunities Abound”
Appendix 1: Chart Analysis: Saudi Arabia Healthcare Indicators
Saudi Arabia: Total Manpower in MOH Health
Centres by Nationality
Saudi Arabia: Number of Hospitals by Type (2010)
35000
Private
31%
30000
25000
20000
15000
Ministry of
Health
60%
10000
5000
0
MoH
Government
Saudi
Quasi
Government
9%
Private
Non-Saudi
Saudi Arabia: Total Health Expenditure (THE) %
Gross Domestic Product (GDP)
Saudi Arabia: Total Number of Hospitals and Beds
in all Health Sectors
440
62000
4
430
60000
Number of Hospitals
4.5
3.5
3
%
2.5
2
1.5
420
54000
390
52000
370
0.5
50000
2008
0
2004
2005
2006
2007
2008
2009
2010
2009
2010
Number of Hospitals
2011
Saudi Arabia: Life Expectancy at Birth (years)
2011
2012
Numbe of Beds (RHS)
Saudi Arabia: Mortality Rate, Infant (per 1,000 birth)
50
76
74
72
70
68
66
64
Per 1,000 birth
Years
56000
400
380
1
40
30
20
10
0
2004 2005 2006 2007 2008 2009 2010 2011 2012
2004 2005 2006 2007 2008 2009 2010 2011
World
World
Saudi Arabia
Saudi Arabia: Total Fertility Rate
Saudi Arabia
Saudi Arabia: Birth Rate
3.5
25
Per 1000 people
3
Birth per women
58000
410
Number of Beds
Number of Health Workforce
40000
2.5
2
1.5
1
0.5
20
15
10
5
0
2004 2005 2006 2007 2008 2009 2010 2011
0
2004
2005
2006
World
2007
2008
Saudi Arabia
2009
2010
2011
World
Saudi Arabia
Sources: Ministry of Health: Health Statistical Annual Book 2012, World Bank, WHO, KFHR
© KFH Research Ltd
14
Saudi Arabia Healthcare
“Opportunities Abound”
Appendix 2: Saudi Arabia Ongoing Healthcare Projects
Saudi Arabia: On-going Healthcare Projects
Project Name
Saudi MOH - King Abdullah Medical City
Saudi Arabia MHE - Qassim University - University Hospital
Saudi Arabia MOH - Al Sharaie Hospital
Project Type
Standalone
Standalone
Standalone
KFSHRC - King Faisal Specialist Hospital and Research Center Expansion
Standalone
900,000,000
Saudi Arabia MOH - King Faisal Medical City
Saudi Arabia MOH - Yanbu General Hospital Dialysis Center
Saudi Arabia MOH - Al Iman Medical Tower
Saudi Arabia MOH - Jazan Specialized Hospital
Master
Standalone
Standalone
Standalone
1,000,000,000
4,900,000
59,000,000
192,000,000
Saudi Arabia MOH - Primary Health Care Centers in Asir - Group 1
Standalone
12,600,000
Saudi Arabia MOH - Primary Health Care Centers in Asir - Group 2
Standalone
11,300,000
Saudi MOH - King Khalid Medical City
Saudi Arabia MOH - Al Jumum Hospital
Saudi Arabia MOH - Khamis Mushayt Hospital
Al Mouwasat - Al Mouwasat Riyadh Hospital
Saudi Arabia MOH - King Faisal Medical City - Phase 1
Saudi arabia MOH - Al Mahani General Hospital
Saudi Arabia MOH - Ar'ar Dialysis Center
Saudi Arabia MOH - Al Darb Hospital in Jazan
Saudi Arabia MOH - Rijal Almaa Hospital
Saudi Arabia MOH - Baqeeq General Hospital
Saudi Arabia MOH - Hail Maternity and Children Hospital
Saudi Arabia MOH - Tabuk Maternity and Children Medical Tower
Saudi Arabia MOH - Hail Specialized Hospital
Saudi Arabia MOHE - Rabigh General Hospital Phase 1
Saudi Arabia MOH - Hail Center Dialysis
Saudi Arabia MOH - Al Laith and Al Mekhwat Hospitals
Saudi Arabia MOH - Regional Laboratory, Blood Bank and Poisons Center in Al Jawf
Saudi Arabia MOH - Regional Laboratory, Blood Bank and Poisons Center in Jazan
NGHA - KSU Children Hospital
Saudi Arabia MOH - King Fahed Hospital - Kidney Center Expansion
Saudi Arabia MOH - Hail Hospital
Saudi Arabia MOHE - Tabuk University Hospital - Phase 1
Saudi Arabia MOH - King Abdullah Center For Tumor and Liver Diseases
Standalone
Standalone
Standalone
Standalone
Package
Standalone
Standalone
Standalone
Standalone
Standalone
Standalone
Standalone
Standalone
Standalone
Standalone
Standalone
Standalone
Standalone
Standalone
Standalone
Standalone
Standalone
Standalone
1,200,000,000
60,000,000
67,000,000
43,000,000
171,000,000
10,200,000
4,000,000
49,400,000
54,000,000
40,000,000
105,000,000
104,000,000
160,000,000
107,200,000
4,300,000
46,000,000
15,300,000
15,400,000
32,000,000
12,456,000
75,000,000
107,000,000
242,000,000
Saudi Arabia MoH - King Fahad Medical City - 6 Residential Towers
Standalone
120,000,000
Saudi Arabia MOH - Al Majardah Health Care Center
Saudi Arabia MOH - Aseer Specialized Hospital
Saudi Arabia MOH - Maternity and Children Medical Tower
Saudi Arabia MOH - Prince Salman Medical Tower
Saudi Arabia MOH - Sakaka Maternity and Women Hospital
Saudi Arabia MOHE - Al Baha University Hospital - Phase 1
Saudi Arabia MOH - Tabuk 13 Health Care Centers
Standalone
Standalone
Standalone
Standalone
Standalone
Standalone
Standalone
1,600,000
171,000,000
101,000,000
42,000,000
67,000,000
109,000,000
14,127,000
Saudi Arabia MOH - 5 Health Care Centers in the Northern Region
Standalone
5,000,000
Saudi Arabia MOH - 9 Primary Health Care Centers
Standalone
9,300,000
Saudi Arabia MOH - Regional Laboratory, Blood Bank and Poisons Center in Aseer
Saudi MOHE - Damam University Hospital
Standalone
Standalone
15,300,000
133,000,000
Saudi Arabia MOH - Health Care Centers in Medina - Group 1
Standalone
7,100,000
Saudi Arabia MOH - Health Care Centers in Medina - Group 2
Standalone
6,100,000
Standalone
317,000,000
Package
Standalone
Standalone
Standalone
Standalone
Standalone
Master
Package
Package
154,654,920
107,000,000
88,441,841
157,000,000
111,000,000
3,425,339
1,300,000,000
373,300,000
250,000,000
Saudi Arabia MOH - National Center for Neuroscience, Comprehensive Cancer Center, Heart Center
Laboratories Buildings
Saudi Arabia MOH - Prince Mohammad Bin Abdulaziz Medical City - Phase 1
Saudi Arabia MOHE - Al Hudud Ash Shamaliyah University Hospital - Phase 1
Saudi Arabia MOH - Jazan Maternity and Women Hospital
Saudi Arabia MOH - King Saud Surgical Medical Tower
Saudi Arabia MOH - Al Miqat Hospital
Saudi Arabia MOH - 3 Health Care Centers - Phase 4
Saudi Arabia MoH - King Fahad Medical City Expansion
Saudi Arabia MoH - King Fahad Medical City Expansion - Cancer Center / Proton Therapy
Saudi Arabia MoH - King Fahad Medical City Expansion - Cardiac Center
Project Value (USD
5,333,200,000
133,000,000
149,327,304
Facility Type
Medical city
Hospital
Hospital
Hospital and
research center
Medical City
Dialysis Center
Hospital
Hospital
Health Care
Centers
Health Care
Centers
Medical City
Hospital
Hospital
Hospital
Hospital
Hospital
Dialysis Center
Hospital
Hospital
Hospital
Hospital
Hospital
Hospital
Hospital
Center Dialysis
Hospitals
Healthcare Center
Healthcare Center
Hospital
Kidney Center
Hospital
Hospital
Hospital
Residential
towers
Health Center
Hospital
Hospital
Hospital
Hospital
Hospital
Health Center
Health Care
Centers
Health Care
Centers
Healthcare Center
Hospital
Health Care
Center
Health Care
Center
Completion Date
2015
2016
2016
Building, Bridge
Q4 2015
Hospital
Hospital
Hospital
Hospital
Hospital
Q4 2015
Q4 2015
Q4 2016
Q4 2016
Sep 2014
Sep 2015
Sep 2015
Sep 2015
Sep 2015
Saudi Arabia MoH - King Fahad Medical City Expansion - Central Services Building
Package
Saudi Arabia MoH - King Fahad Medical City Expansion - Cochlear Implant Center
Package
Saudi Arabia MoH - King Fahad Medical City Expansion - Neuroscience Center
Package
Cancer center
Cardiac Center
Healthcare
80,000,000
building
Healthcare
41,062,000
building
293,304,000 Healthcare center
Saudi Arabia MoH - King Fahad Medical City Expansion - Research Laboratory and Consultant Offices
Package
213,308,000 Clinics and offices
2017
2021
Apr 2014
Apr 2015
Apr 2015
Aug 2014
Aug 2014
Aug 2017
Dec 2014
Dec 2015
Feb 2014
Feb 2015
Jan 2014
Jan 2014
Jan 2016
Jan 2016
Jun 2015
Jun 2015
Jun 2015
Jun 2016
Jun 2017
Mar 2014
May 2014
May 2015
May 2015
Q1 2014
Q1 2014
Q1 2015
Q1 2016
Q2 2014
Q2 2014
Q2 2015
Q2 2015
Q2 2015
Q2 2015
Q2 2015
Q2 2015
Q3 2015
Q4 2014
Q4 2014
Q4 2014
Q4 2014
Q4 2015
Q4 2015
Sep 2015
Sep 2015
Sep 2015
Sep 2015
Source: Zawya, KFHR
© KFH Research Ltd
15
Contents
Overview
3
Non-Communicable Diseases on the Rise
4
Healthcare Provision
7
Pharmaceutical & Biotechnology
8
Key Challenges
9
Porter’s 5 Forces Analysis on Saudi Arabia Healthcare
11
Conclusion and Outlook
13
Appendix 1: Chart Analysis – Saudi Arabia Healthcare Indicators
14
Appendix 2: Saudi Arabia Ongoing Healthcare Projects 15
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Saudi Arabia
Healthcare
© 2015 KFH Research Ltd.
All rights reserved.
“Opportunities Abound”
KFH Research Ltd
KDNPP15024/03/2015 (031903)
16 January 2015