A New Entrance to Medical Device Market in Jordan

Introduction

Medical devices are vital in ensuring effective prevention, diagnosis, and treatment of various diseases. It is estimated that approximately 50,000 medical devices are utilized daily in administering medical care all over the world (World Health Organization, 2006). Increased research and development within the medical device market have led to the improvement of diagnosis and administration of treatment. The high rate of innovation insinuates that there is a high probability of market growth.

Scanning the business environment is one of the steps that entrepreneurs undertake to identify feasible business opportunities. Upon identification and successful determination of its viability, entrepreneurs are faced with a challenge on how to venture into a particular market.

Jordanian medical device market is characterized by minimal production of medical equipment and other medical device consumables. The low level of production makes the country to be increasingly dependent on the importation of these supplies. For example, during 2008, the country’s total imports of these products amounted to $ 129 million. Germany and United States were the main suppliers. The current total medical device market averages $186 million, which is equivalent to $29 of US per capita. It is expected that the market will expand by a margin of 8.1 percent annually to reach $ 275 million by 2015 (Espicom, 2010, para. 2-5). The provision of standard healthcare has been the goal of both public and private sectors in the country (Wagner, Dullaart, Bock & Zweck, 2006, p.1211). Venturing into the medical device market in Jordan presents a viable business opportunity for domestic entrepreneurs. Over the past decade, there has been an increment in demand for medical devices in Jordan. For example, for the period ranging from 2005 to 2008, the potential demand for medical devices increased from $20 million to $27 million (World Health Organization, 2006).

According to Art (2004, p.138), selecting a target market forms the basis of a firm succeeding in the market. Art asserts that selecting a target market is beneficial to both the customer and the business. To succeed in the market, the entrepreneur needs to conduct market research. Through market research, in the Jordanian medical device industry, the entrepreneur who is also the author of this paper identified a large market potential for PICC (Peripheral Inserted Central Lines) in Jordan. This arises from the fact that there are no local firms that manufacture these products in Jordan. PICC is a small, slender, and flexible tube that is used in attaining intravenous access in a patient. It is inserted through the peripheral vein, that is, the arm until it terminates in the chest area. Choice of PICC lines resulted from the identification of the ease with which clinicians and doctors can use it in administering internal treatments.

In supplying these products to the market, the entrepreneur targets institutional customers. The institutional customers identified include public and private hospitals that offer acute healthcare services.

Institutional customers form the largest percent of PICC lines consumers. The entrepreneur identified a high market potential for its PICC lines amongst the institutional customers due to the possibility of it being utilized in various medical operations. According to Sing, Rosemary, Diane, and Miriam (1994), physicians in hospitals increasingly utilize PICC lines in the process of administering various treatments such as chemotherapy and TPN nutrition. Hospitals also use the PICC lines in the process of conducting blood transfusions.

This chapter is organized into two sections. The first part gives an analysis of the various modes of entry available to the entrepreneur. The second part gives an illustration of the channels of distribution that the entrepreneur can use in marketing the PICC lines in the domestic market. The hypothesis to be tested is outlined.

Methods of Market entry

The decision to venture into business is motivated by the entrepreneur’s attitude and objectives about business (Mattsson & Wallenberg, 2003). In addition, the decision is dependent on the confidence and capacity of the entrepreneur to cope with changes in the business environment.

According to Google and Lowe (2008, p), the selection of an entry mode plays a significant role in the process of the firm exploiting market opportunities presented. According to Ray (n.d, p. 26), the choice of market entry mode is dependent on several factors. Some of these factors include:

• Intensity of competition
• Potential of value addition
• Degree of risk involved
• Probability of the firm acquiring a fast entry

Before venturing into business, there are several issues, which should be considered. Some of these issues relate to a method of market entry, selection of distribution channel, evaluation of key factors to consider when venturing into the market. There are various modes of entry, which entrepreneurs can consider. In addition, there are several advantages and disadvantages associated with the various modes of entry. As a result, the entrepreneur needs to undertake a comprehensive cost-benefit analysis. This means that there is no ideal mode of market entry. Different entrepreneurs may use different modes of entry in venturing into the same market. According to Bruce, Moore, and Birtwistle, the entry mode selected reflects the level of control desired to be attained by the entrepreneur, the intended degree of flexibility to effectively and efficiently counter market conditions. Selection of the method of entry is vital in introducing a new product to the market (Agarwal & Ramaswami, 1991, p. 1). According to Lama, Gonzalez, and Marco (2010), introducing a new medical device product in the market is challenging.

Some of the methods the market entry into the domestic market includes acquiring an existing firm, Distributer, use of agents, contract manufacturing, franchising, and purchasing an existing business (Bruce, Moore & Birtwistle, 2004, p. 16).

Acquiring an existing firm

This is a mode of entry, which is mostly characterized by taking control of a firm, which is already in existence in the market (Sherman & Hart, 2006). This mode of entry gives the entrepreneur venturing the market an opportunity to penetrate the market more easily. This arises from the fact that there is an already instituted management team making cash flow to be immediate. In addition, purchasing an already existing firm allows the entrepreneur to obtain market expertise (Fairburn & Kay, 1989).

For this mode of entry to be effective, the entrepreneur should ensure that the due legal process is followed (Wu & Zhao, 2007). In addition, the entrepreneurs should analyze the firm to determine its market prospects. To have control of the firm, it should be ensured that all the intellectual property rights are transferred. According to Steingold (2007), all the products that the firm being purchased has developed over the years are regarded as intellectual property. If the firm has developed a strong positive reputation, its products will succeed in the market. On the other hand, if the firm being acquired has a bad reputation, the firm may not succeed in the market.

Contract manufacture

A firm intending to venture into its domestic market may do so by entering into a contract with another manufacturing firm located in the foreign market. For example, in venturing into the Jordanian medical device market by introducing the PICC lines, the entrepreneur may decide to select a firm operating in the foreign medical device industry and enter into a manufacturing contract. Through the contract, the foreign manufacturing company commits itself to producing the other party’s products according to their specification. Through this strategy, the product can easily penetrate the market if it does not require adaptations for the market. This is advantageous in that the firm venturing into the market can concentrate on other issues such as marketing activities. If the new product being introduced becomes unsuccessful in the market, it is easy for the firm to exit the market since the minimal investment was conducted. Through contract manufacturing, it is more likely that the firm will be able to overcome market barriers. In addition, contract manufacturing enables a firm to penetrate the market in case political barriers are existing (Doole & Lowe, 2008).

Franchising

Domestic entrepreneurs can also consider incorporating a franchising business model. Edwards and Economy (2010) define a franchise as an agreement whereby a firm grants another business entity a right to market its products.

In addition, granting franchise is mainly incorporated by firms that have been successful over the years in their operation and have a proven business model. The new firm entering the market is required to use the franchisor’s trademark or carry its product. The franchisee pays a predetermined fee or royalties to the franchisor. This means that the assistance received by the entrepreneur comes at a cost. This mode of entry is widely used by firms in Western Europe and North America as an expansion strategy within the domestic market (Arnold, 2003).

In venturing into the Jordanian medical device market, the entrepreneur can consider franchising as an alternative mode of entry. One of the potential franchisors that the entrepreneur can consider includes the foreign Export Management Companies (EMCs) which distribute medical device products in Jordan because Jordan mainly relies on imported medical devices. By entering into a franchise relationship with EMCs, the entrepreneur will be able to procure and distribute PICC lines from these companies and distribute them in its domestic market.

Franchising presents several advantages and disadvantages to firms as explained below. For example, EMCs have a well-established business model. The new firm established will incorporate this model enabling it to be effective in its marketing process. The firm and its products will gain significant market exposures at a relatively lower cost compared to when they would have undertaken by themselves (Steven & Janet, 2009).

However, consideration of EMCs as a franchisor may be limited since some countries may lack EMCs appropriate to the firm venturing the market. This arises from the fact the existing export houses maybe specialize in a given customer type such as industrial, retail, or institutions. In addition, the firm may be dealing with particular products, which do not fit the firm’s category. This means that selection of franchising, as a market entry alternative is limited to the franchisor’s objectives. In addition, franchising limits the entrepreneur’s operational capacity for product diversification (Magretta, 2003). This arises from the fact that the firm is required to only deal with products of the franchisor.

Use of agents

An agent refers to a representative (either a company or individual) with a legal capacity to deal on behalf of another party in a target market (McMillan & Paulden, 1974). Upon conducting the due diligence in identifying the most appropriate agent, the distributing of the products is undertaken by experts in the local market (Raff, Ryan & Stahler, 2007). The use of agents is advantageous since they are conversant with the local market. In integrating the use of agents, the firm should consider entering into a contract with the agent.

There are several agents that a firm may decide to incorporate in its market entry strategy. Some of these agents include Export Management Companies (EMCs) and trading companies. EMCs refer to firms that specialize in marketing various products on behalf of an exporting company in the foreign market.

In such a case, the importing firm delegates selling activities to the agent. A significant proportion of domestic entrepreneurs who have ventured Jordanian medical device market have integrated the use of a local agent to conduct sales and distribution. It is a requirement that the agents selected must be of Jordanian origin. According to Farkouh (n.d, p. 1), the selected agents must be registered by the Ministry of Industry and Trade (MIT). In addition, they must have a valid import license for them to be able to make foreign currency payments.

Mode of entry within Jordanian medical device market

In venturing into the Jordanian medical device market, the entrepreneur will enter the market by becoming a distributor. The decision to incorporate this mode of entry resulted from the conduction of a comprehensive cost-benefit analysis of other modes of entry. The entrepreneur identified that incorporating franchising would result in inefficiency in its operation. This arises from the fact that the entrepreneur will be limited to operating by the stipulations of the franchisor. On the other hand, conflict of interest may arise between the firm and the agents or its contract manufacturers. Market entry through acquisition may be costly to the entrepreneur.

The firm will import PICC from the US and distribute them to Jordanian hospitals.

This will give the firm adequate control of the marketing process in the local market. This mode of entry is similar to firms within the UK medical device market. A significant proportion of medical devices supplied in the UK are imported. This means that most of the firms operating in this industry are distributors and not manufacturers. This arises from the fact that most domestic firms in the UK do not undertake the production of medical devices. This arises from the rapid change in demand for medical devices (Kopac, 2009).

To attain customer satisfaction, the entrepreneur will ensure that he specializes in this area. This strategy entails the entrepreneur obtaining a trading license from the government to legalize its operation. When considering this method of entry, the entrepreneur must conduct comprehensive market research. The research will be aimed at evaluating the barriers and stages of establishing a new firm. In addition, the entrepreneur should take time in developing strategies aimed at establishing an effective sales network. According to Lynch (2009), the network should be in line with the firm’s goals.

To effectively establish the firm, the entrepreneur will conduct a concrete market analysis. This will contribute to the development of a concrete business plan. The business plan will act as a map describing how the firm will conduct its business activities making the idea to be a reality. The business established will take the company form of business structure. This means that the firm will be separate from the entrepreneur. However, the entrepreneur as the owner of the firm will handle all activities related to importing the new medical device that it intends to introduce into the market.

The selection of this entry mode arrived through consideration of the need to secure a permanent and long-term position within the Jordanian market. In addition, the firm would be able to develop a highly competitive advantage in the distribution of PICC lines in Jordan. For the firm to be successful, the entrepreneur will become directly involved with importing the PICC lines. Becoming a domestic distributor is considered as being a more proactive approach even though establishing all the necessary logistics may be challenging initially, the method will give the entrepreneur more control over several issues such as marketing mix (Sorenson& Soensen, 2003). In addition, the entrepreneur will be able to attain relatively high feedback over the performance of the product that the firm deals with (Kapoor & Kansal, 2004). In summation, the distribution mode of entry will enable the firm to respond to market needs effectively culminating in customer satisfaction.

Customer feedback is paramount in business and is positively influenced by this mode of market entry. This arises from the choice of the channel of distribution.

As a result, the firm can access market information more effectively. The resultant effect is that the firm will be able to supply products by the local market demand leading to an increment in customer satisfaction (Delaney, 2010).

The selection of this mode of entry was also motivated by the realization of the fact that high-risk investment is usually associated with high returns. As a result, it was realized that significant returns might only be attained after 3 to 5 years (Neves, Zuurbier & Campomar, 2001). Despite the degree of sophistication and amount of energy required in ensuring that the firm survives the market challenges, it is efficient in attaining long-term growth and maximizing profits.

Channels of distribution to be used within Jordan

A firm’s distribution system is a key component in the process of the firm ensuring that it attains long-term success in its entrepreneurial ventures (Brettel, Engelen, Muller & Schilke, 2010). Inefficiency in bringing products close to consumers is one of the reasons why startups firms fail a few years after they are established. Channel choice is a vital decision about a firm’s distribution system (Taylor & Francis Group, 2010).

Upon venturing into the Jordanian medical device market, the entrepreneur needs to establish an effective distribution channel (Mentzer, Min, & Bobbitt, 2004). The channel of distribution selected should be appropriate to the firm. According to Osman and Westgerd (2008), it may be difficult to change distribution channel structures once established. This means that it is important for the entrepreneur to make an effective decision regarding the channel of distribution to use initially since ineffective decision results in poor performance. Osman and Westgerd (2008) assert that both industrial and consumer products should have a well-established distribution channel. Distribution channels are classified into two. These include direct and indirect methods of distribution.

The selection of the distribution channel should be a key consideration since it is a major investment by the firm. Upon deciding to use an intermediary, the selection of high-quality intermediaries is vital. Four phases should be incorporated in making a decision relating to the channel of distribution to use as outlined below.

• Choosing the intermediary
• Locating intermediary prospects
• Evaluating intermediary prospects
• Drawing intermediary profile

Locating the prospect intermediary in the market can be conducted by obtaining information from banks, government agencies, trade fairs, and trade publications (Osman & Westgerd, 2008). Drawing the intermediary profile entails evaluation of the needs and goals of the potential intermediaries. A comparison of the profile should then be conducted. If the two profiles conflict, such an intermediary is not a potential distribution channel to select. In evaluating the intermediary prospect, the firm can either utilize information provided by the intermediary’s existing customers or the bank. In addition, the firm can also obtain this information from independent bodies which research the operation of firms in various industries. An example of such a firm is Espcom. Evaluating the intermediary’s history would enable the firm to determine its effectiveness in distributing the products. Upon completing the evaluation process, an entrepreneur should physically meet with the entrepreneur. This is important in selecting the intermediary since the success of the firm’s product in the foreign market is directly related to the intermediary’s efforts (Osman & Westgerd, 2008).

The decision regarding distribution channel intensity should also be made. Distribution channel intensity refers to the total number to be considered as intermediaries in the channel of distribution. There are three main approaches to distribution channel intensity. These include intensive, selective, and exclusive distribution. Intensive distribution involves placing the firm’s products in a large number of outlets. In most cases, this strategy applies to consumer goods. On the other hand, selective distribution entails placing the products in just a few distribution channels and most cases, the firms are willing to carry the firm’s products. This strategy is in most cases used by already established firms and new firms seeking distributors. Through this channel of distribution, the firm is not required to waste its effort via involvement in a wide range of outlets. The selective distribution also gives the firm control of its products and at the same time gain relatively high market coverage (Osman & Westgerd, 2008). Exclusive distribution entails minimizing the number of intermediaries. In addition, exclusive distribution is incorporated if the firm intends to maintain control of the products’ marketing process.

Direct distribution

The method of distribution selected is dependent on the desired degree of control and the amount of investment required. In addition, the choice of distribution method is also dependent on the nature of services required to ensure effective distribution. For example, if the products being distributed are technical, the parties involved in the channel must be conversant with its operation. This will ensure that adequate product information is disseminated to the customers. According to Osman and Westgner (2008), the selection of producer-agent-retailer or wholesaler-consumer channel of distribution is instigated by the fact that minimal investment is required about time and money.

In marketing the medical device product in Jordan, the firm will use a direct distribution channel. This means that no other local or foreign intermediaries will be used. The selection of direct channels was considered by considering the nature of the product. In selecting the channel of distribution to use, the entrepreneur should make a decision on the type of product the firm deals with. This arises from the fact that the channel selected is directly related to the nature of the product. According to Satish and Kansal, technical products are usually distributed to the final consumers. In addition, the decision to use direct distribution was motivated by the need to develop positive publicity amongst the hospitals who will be the firm’s target customers. This arises from the fact that the firm will have direct contact with the customers. This means that the nature of the relationship between the firms will be business to business (Morris, Pitt & Honeycutt, 2001). This arises from the fact that the firm will market its products to organizations (hospitals). Organizations have a complex decision-making process. Through direct marketing, the firm will be able to understand the firm’s decision-making process. The resultant effect is that the firm will have a chance to influence the decision-making process thus persuading the firm to purchase the product from it.

The decision to incorporate direct distribution was made after evaluating the existing import regulation in Jordan about medical devices. The government through the Ministry of Finance has formulated comprehensive medical device import regulations. Through direct distribution, it will be possible for the firm to meet the market requirement. According to Farkouh (n.d, p. 1), the Jordanian Ministry of Health (MOH) is charged with the responsibility of overseeing all the laws and regulations related to the healthcare sector. As a result, the MOH has formulated a set of technical rules and regulations about all medical devices. The objective of these rules and specifications is to ensure that the medical products sold to Jordanian hospitals and other end users are by safety and quality requirements (Gad & McCord, 2008). Because Jordan relies on importing medical equipment, all the medical equipment procured within the private and public sector have to be tested by several departments such as the Royal Scientific Society, Royal Medical Services, or the Ministry of Health (Farkouh, n.d, p. 1). Direct distribution will enable the firm to conduct direct marketing more effectively and efficiently. This arises from the fact that the firm will be able to establish a strong relationship with its customers. According to Capon (2008), a direct channel enables entrepreneurs to effectively manage the contact established between the firm and its customers. The selection of a direct channel of distribution was instigated by the need to understand the domestic medical device needs of the customers. This arises from the fact that direct contact with customers gives suppliers a comprehensive insight into customer product needs (Capon, 2008). Growth in technology will enhance the firm’s direct marketing process. For example, it will be possible for the new firm to market the product to the target customers through the incorporation of media marketing, telephone marketing, electronic commerce that will be enhanced by internet developments and direct mail.

According to Doole and Lowe (2008), there has been an increment in the rate at which firms are incorporating direct marketing as a result of developments in information technology. This will culminate in the firm developing a strong relationship with the customers and hence customer loyalty. Attaining customer loyalty will enable the firm to retain a large customer base thus increasing its level of profit. This arises from the fact that customers will develop confidence in the firm’s products. According to Knox, Maklan, and Payne (2003), developing customer relationship is one of the ways through which a firm can attain long-term success. Over the past years, effective customer relationship has been considered as the lifeblood of every business. Currently, customers are being considered as life-support to the business.

Consideration of a direct channel of distribution was also instigated through the realization of rampant change in purchasing behavior amongst organizational customers (Doole & Lowe, 2008). Currently, a significant proportion of institutions are incorporating emerging technology in their purchasing process. This presents an opportunity for the firm to conduct direct marketing more effectively and efficiently. Even though direct distribution may be challenging, numerous benefits result. Some of the challenges that the firm will have to face include the need to install current information communication technologies. For example, the firm will have to install databases to aid in attaining reliable credit control and also to ensure secure payment systems.

Hypothesis

From the above review, the study will be aimed at approving or disapproving the following hypothesis.

• Providing post services are essential for new market entrance in the medical device sector in Jordan.

OR

• New entrance to medical device market in Jordan can be without proving post services to Hospitals

Summary

Venturing into the Jordanian medical device market presents a viable business opportunity for entrepreneurs. This arises from the fact that the Jordanian medical device market is not saturated. The numbers of domestic firms specializing in the production of medical devices are few. As a result, the market is characterized by minimal production of medical equipment and other medical device consumables. The low level of production makes the country to be increasingly dependent on the importation of these supplies. For example, during 2008, the country’s total imports of these products amounted to $ 129 million. Germany and United States were the main suppliers. The current total medical device market averages $186 million, which is equivalent to $29 of US per capita. It is expected that the market will expand by a margin of 8.1 percent annually to reach $ 275 million by 2015 (Espicom, 2010, para. 2-5). However, the success and effective performance of the new firm established is dependent on the mode of entry selected.

There are various modes of entry available for entrepreneurs to consider in venturing into the market. Different modes of entry may be used to venture into the same market. This means that the entrepreneur is at discretion to decide on the entry mode.

To ensure the success of the PICC lines in Jordan, the entrepreneur will ensure that the PICC distributed are of high quality. In addition, they will be effectively designed to ensure ease of insertion. Considering the sensitive nature of the PICC lines that the new firm intends to supply in Jordan, the entrepreneur considered direct exporting as the most appropriate method of entry into the Jordanian market. Selection of the method to use when distributing the product to the market is vital. This arises from the fact that the effectiveness of the distribution decision made plays a significant role in determining whether the product will succeed in the market. About product distribution, a direct method of distribution will be used. This will enable the firm to develop a strong relationship with its customers. In addition, direct distribution will enable the firm to meet the quality and safety standards instituted by the Jordanian Ministry of Health.

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