1. Healthcare equipment market A short review

2. 10 years later • 2005, I came back 10 years after I left Turkey • 1995 • Large public market – small private • Focus on: Military, Universities and large MOH • Government guarantees • High inflation and currency dynamics • Most if not all business in NLG or USD, LC based

3. 10 years later • 2005 • Less focus on a relatively smaller public market • Fast growing private market: universities, hospital chains, clinics • Intro of “Income Sharing“ models at public hospitals • Limited or no government guarantees • Reduced inflation and rather stable currency • More and more business in TL

4. Recently • 2009/2010 • Strong focus on public healthcare for all (SSK incorporated in MOH) • Reimbursement reductions, changes in the labor law, hospital and equipment permits and licenses, regulatory actions • First signs of PPP (public private partnerships) • New regulations – future private market uncertain - strong reduction of the public market – many institutions in trouble • Foreign investments in some of the bigger hospital chains • Increased cross border business • Income Sharing reaching saturation • Reduced inflation and rather stable currency • Majority of the business in TL

5. At present • 2011 • Growing public market via central bulk purchasing, new framework tenders, local tenders and PPP (…. elections in June) • Largest PPP funnel world-wide (28 projects) • Improved private market – foreign investors and financing are successful – investments and projects started again • A further reduction in the reimbursement rates, permits and licenses continue – Income Sharing projects in trouble) • Increased cross border business – ME, Russia, CEE and Africa – largely via construction companies • Stable single digit inflation and stable currency (although lost 6% in the first 5 month) • Majority of the business in TL

6. Highly diverse market place

7. Healthcare equipment market • Private market: • 400 + hospitals (no new licenses) • 20 Medical Universities • PFI’s (income sharing) • Numerous clinics (struggling) • Minimum reimbursement rates • Limited private customers • Dominating hospital chains • Cross border activities • Foreign investments • Public Market segment: • 1000 MOH hospitals • 60 Medical Universities • 50 MOD hospitals • Numerous clinics (low perception) • Healthcare for all policy • Some health Tourism • Limited private insurance • Largest PPP funnel in the world GDP Healthcare expenditure 15% compared to European countries (OECD)

8. Great growth potential High volumes Very competitive Solid base for the region

9. Questions to answer: • How would you: • Define your market • Find your potential growth segments • Define your enablers for each segment • Involve local insight • Balance short term versus long term objectives