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CountryFocus: Healthcare, Regulatory and Reimbursement Landscape - Germany

Summary

GlobalData, the industry analysis specialist, has released its latest report, “CountryFocus: Healthcare, Regulatory and Reimbursement Landscape - Germany”. The report is an essential source of information on and analysis of the healthcare, regulatory and reimbursement landscape in Germany. It identifies the key trends in the country’s healthcare market and provides insights into its demographic, regulatory, and reimbursement landscape and healthcare infrastructure. Most importantly, the report provides valuable insights into the trends and segmentation of its pharmaceutical and medical device markets. It uses data and information sourced from proprietary databases, secondary research, and in-house analysis by GlobalData’s team of industry experts.

Germany’s increasingly elderly population and its associated disease burden are key drivers of its pharmaceutical market. In 2013, the elderly accounted for 27.1% of the total population, expected to increase at Compound Annual Growth Rate (CAGR) of 1.2% to 29.5% in 2020.

In 2008, healthcare expenditure as percentage of Gross Domestic Product (GDP) amounted to 10.7%, which increased to an estimated 11.5% in 2013. In 2011, the government initiated a new plan - Arzneimittelmarkt-Neuordnungsgesetz (AMNOG) - to curb healthcare expenditure.

The pharmaceuticals market was worth $54.7 billion in 2008 and is projected to have reached a value of approximately $65 billion by 2020 at a CAGR of 1.4%. The German medical device market was valued at $18.9 billion in 2008 and is projected to grow at a CAGR of 5.1% to reach $34.4 billion in 2020. These positive growth trends can be primarily attributed to -
- The rising prevalence of chronic disease
- Universal health coverage
- Well established and centralized regulatory procedure

Scope

The report provides information on the healthcare, regulatory, and reimbursement landscape in Germany, and includes -
- An overview of the pharmaceuticals and medical device markets, consisting of market size, segmentation, and key drivers and barriers
- Profiles and SWOT analyses of the major players in the pharmaceutical market - Novartis, Pfizer, Teva Pharmaceutical, Sanofi and Roche - and profiles and SWOT analyses of the major players in the medical device market - Medtronic, Siemens Healthcare, F. Hoffmann-La Roche, Philips Healthcare and GE Abbott Laboratories
- Insightful review of the reimbursement and regulatory landscape, with analysis covering details of the country’s healthcare reimbursement process, regulatory agencies and the approval processes for new drugs and medical devices
- Detailed analysis of the political and economic environment, covering economic indicators, demographics, healthcare infrastructure and healthcare expenditure
- An overview of the opportunities for and challenges to growth in the healthcare market

Reasons to buy

This report will enhance your decision-making capability by enabling you to -
- Develop business strategies by understanding the trends shaping and driving Germany’s healthcare market
- Drive revenue by understanding the key trends, reimbursement and regulatory policies, pharmaceutical market segments, and companies likely to affect Germany’s healthcare market in the future
- Formulate effective sales and marketing strategies by understanding the competitive landscape and analyzing the performance of various competitors
- Organize your sales and marketing efforts by identifying the market categories and segments that present the best opportunities for consolidation, investment, and strategic partnerships
- Identify, understand, and capitalize on the opportunities and challenges in Germany’s healthcare market

Table Of Contents

CountryFocus: Healthcare, Regulatory and Reimbursement Landscape - Germany
1 Table of Contents
2 Introduction 20
2.1 GlobalData Report Guidance 20
3 Overview of Pharmaceutical and Medical Device Market 21
3.1 Pharmaceutical Market 21
3.1.1 Market Overview 21
3.1.2 Pharmaceutical Exports and Imports 24
3.1.3 Supply Channels 25
3.1.4 Market Segments 28
3.1.5 Major Therapeutic Areas 34
3.1.6 Major Players 38
3.2 Medical Device Market 80
3.2.1 Market Overview 80
3.2.2 Overview of Top Five Segments 83
3.2.3 Diagnostics Market 97
3.2.4 Major Players 98
3.3 Market Drivers and Barriers 134
3.3.1 Drivers 134
3.3.2 Barriers 136
4 Market Access 139
4.1 Reimbursement and Payer Landscape 139
4.1.1 Overview of Healthcare system 139
4.1.2 Reimbursement Process 140
4.1.3 Overview of Insurance Providers 145
4.1.4 Patient Share in Healthcare Spending 149
4.1.5 Price Trends in the Healthcare Sector 151
4.1.6 Pricing Policies 153
4.2 Regulatory Landscape 158
4.2.1 Overview of Regulatory Agencies 158
4.2.2 Market Authorization Procedure for Pharmaceutical Products 159
4.2.3 New Medical Device Approval Process 169
4.2.4 Licensing Process for Pharmaceutical and Medical Device Manufacturing 174
4.2.5 Exports and Imports 176
4.2.6 Intellectual Property Rights 176
4.2.7 Clinical Trial Regulations 182
4.2.8 Pharmaceutical Advertising Regulations 185
4.2.9 Pharmacy Regulations 186
4.2.10 Labeling and Packaging Regulations 186
5 Country Analysis 189
5.1 Political Environment 189
5.1.1 Political Structure 189
5.1.2 Analysis of Current Political Environment 191
5.1.3 Healthcare Policy Initiatives 193
5.2 Economic Landscape 196
5.3 Economic Indicators 199
5.3.1 Gross Domestic Product 199
5.3.2 Gross National Income 203
5.3.3 Inflation 205
5.3.4 Currency Exchange Rate 208
5.3.5 Foreign Direct Investment 209
5.3.6 Foreign Exchange Reserves 211
5.3.7 Trade Balance 212
5.3.8 Government Structural Balance 214
5.3.9 General Government Net Debt 216
5.3.10 Major Industries 218
5.4 Demographics 219
5.4.1 Population 219
5.4.2 Education and Literacy 237
5.4.3 Employment 239
5.4.4 Disease Burden 241
5.5 Healthcare Infrastructure 244
5.5.1 Healthcare Facilities 244
5.5.2 Healthcare Parameters 248
5.5.3 Environmental Health 252
5.5.4 Healthcare Personnel 255
5.6 Healthcare Expenditure 261
5.6.1 Overview 261
5.6.2 Major Components of Healthcare Spending 263
5.6.3 Public and Private Sector Share 264
5.6.4 Spending in Pharmaceutical Research and Development 265
5.7 Trade Associations 266
5.7.1 The Association of Research-based Pharmaceutical Companies 266
5.7.2 The Federation of Pharmaceutical Manufacture 266
5.7.3 The Federation of Pharmaceutical Industry 267
5.8 Trade Fairs 268
6 Opportunities and Challenges 269
6.1 Opportunities 269
6.2 Challenges 269
7 Appendix 271
7.1 Abbreviations 271
7.2 Bibliography 277
7.3 Research Methodology 296
7.3.1 Coverage 296
7.3.2 Secondary Research 297
7.3.3 Forecasts 297
7.3.4 Expert Panel 297
7.4 Disclaimer 298

1.1 List of Tables
Table 1: Pharmaceutical Market, Germany, Revenue ($bn), 2008-2013 22
Table 2: Pharmaceutical Market, Germany, Revenue Forecast ($bn), 2014-2020 23
Table 3: Pharmaceutical Market, Germany, Exports and Imports ($bn), 2008-2013 24
Table 4: Pharmaceutical Market, Germany, Wholesale Mark-up for Proprietary Medicinal Products, 2014 27
Table 5: Pharmaceutical Market, Germany, Pharmacy Mark-up for Proprietary Medicinal Products, 2014 28
Table 6: Pharmaceutical Market, Germany, Generic Pharmaceutical Market Share (%), 2008-2013 29
Table 7: Pharmaceutical Market, Germany Drugs Going Off-patent, Global, 2014-2015 30
Table 8: Pharmaceutical Market, Germany, Biological Drugs in Pipeline, 2008-2013 31
Table 9: Pharmaceutical Market, Germany, OTC Drug Market Revenue ($bn), 2008-2013 32
Table 10: Pharmaceutical Market, Germany, Major OTC Drug Classes, Revenue and Share, 2013 33
Table 11: Pharmaceutical Market, Germany, Major Disease Areas, Total Cost of Illness ($bn), 2008 35
Table 12: Pharmaceutical Market, Novartis, Global, Major Products, Revenue ($bn) and Annual Growth (%), 2013 39
Table 13: Pharmaceutical Market, Novartis, Global, Planned Filings, 2014-2018 40
Table 14: Pharmaceutical Market, Pfizer, Global, Major Products, Revenue ($bn) and Annual Growth (%), 2013 50
Table 15: Pharmaceutical Market, Pfizer, Global, Late-Stage Pipeline, 2014 51
Table 16: Pharmaceutical Market, Teva, Global Revenue of Major Products, 2013 59
Table 17: Pharmaceutical Market, Teva, Late-Stage Pipeline, 2013 59
Table 18: Pharmaceutical Market, Teva, Global, Major Products, 2013 61
Table 19: Pharmaceutical Market, Sanofi, Global, Major Products, 2013 66
Table 20: Pharmaceutical Market, Sanofi, Global, Late-stage Pipeline, 2014 67
Table 21: Pharmaceutical Market, F. Hoffmann-La Roche, Global, Major Products, Revenue ($m) and Annual Growth (%), 2013 72
Table 22: Pharmaceutical Market, F. Hoffmann-La Roche, Global, Late-stage Pipeline, 2013 73
Table 23: Medical Device Market, Germany, Revenue ($bn), 2008-2013 81
Table 24: Medical Device Market, Germany, Revenue Forecast ($bn), 2014-2020 82
Table 25: Medical Device Market, Germany, Revenue by Segment, 2013 83
Table 26: Medical Device Market, Germany, Cardiovascular Device Market ($m), 2008-2013 85
Table 27: Medical Device Market, Germany, Cardiovascular Device Market, Sales Trend for Major Players, 2012 86
Table 28: Medical Device Market, Germany, IVD Market ($m), 2008-2013 88
Table 29: Medical Device Market, Germany, IVD Market, Sales Trend for Major Players, 2012 89
Table 30: Medical Device Market, Germany, Orthopedic Device Market ($m), 2008-2013 90
Table 31: Medical Device Market, Germany, Orthopedic Device Market, Sales Trend for Major Players, 2012 91
Table 32: Medical Device Market, Germany, Wound Care Management Market ($m), 2008-2013 93
Table 33: Medical Device Market, Germany, Wound Care Management Market, Sales Trend for Major Players ($m), 2012 94
Table 34: Medical Device Market, Germany, Hospital Supplies Market ($m), 2008-2013 95
Table 35: Medical Device Market, Germany, Hospital Supplies Market, Sales Trend for Major Players ($m), 2012 96
Table 36: Medical Device Market, Germany, Diagnostics Market, Revenue ($bn), 2008-2013 97
Table 37: Medical Device Market, Germany, Diagnostic Market Revenue, Forecast ($bn), 2014-2020 98
Table 38: Medical Device Market, Germany, Major Medical Device Companies, Revenue, 2012 99
Table 39: Medical Device Market, Medtronic, Global, Major Products, 2013 101
Table 40: Medical Device Market, F. Hoffmann-La Roche, Global, Major Products, 2014 115
Table 41: Medical Device Market, Philips Healthcare, Global, Major Products, 2013 121
Table 42: Medical Device Market, Abbott, Global, Major Products, 2013 127
Table 43: Medical Device Market, Abbott, Global, Late-Stage Pipeline, 2014 127
Table 44: Market Access, Germany, Reimbursement Rates by Age, 2014 144
Table 45: Market Access, Germany, Number of SHI Providers, 2008-2013 146
Table 46: Healthcare Spending, Germany, Out-of-Pocket Expenditure (%), 2008-2013 150
Table 47: Healthcare Spending, Germany, Out-of-Pocket Expenditure (%), 2008-2013 151
Table 48: Market Access, Germany, Prescription Drug Prices, Annual Change (%), 2008-2013 152
Table 49: Market Access, Germany, Healthcare Price Index, Annual Change (%), 2008-2013 153
Table 50: Market Access, Germany, Early Assessment of Drugs, 2013 157
Table 51: Market Access, Germany, Patent Application Fees, 2014 177
Table 52: Market Access, Germany, Trademark Registration Fees, 2014 179
Table 53: Market Access, Germany, Voluntary Harmonization Procedure, 2014 184
Table 54: Economic Indicators, Germany, Gross Domestic Product per Capita ($), 2008-2013 200
Table 55: Economic Indicators, Germany, Gross Domestic Product per Capita ($) Forecast, 2014-2020 201
Table 56: Economic Indicators, Germany, Gross Domestic Product Annual Growth (%), 2008-2013 202
Table 57: Economic Indicators, Germany, Gross Domestic Product Annual Growth Forecast (%), 2014-2020 203
Table 58: Economic Indicators, Germany, Gross National Income per Capita ($), 2008-2013 204
Table 59: Economic Indicators, Germany, Average Consumer Price Index, 2008-2013 206
Table 60: Economic Indicators, Germany, Average Consumer Price Index Forecast, 2014-2020 206
Table 61: Economic Indicators, Germany, Average Consumer Price Annual Change (%), 2008-2013 207
Table 62: Economic Indicators, Germany, Currency Exchange Rate (€/$), 2008-2013 209
Table 63: Economic Indicators, Germany, Foreign Direct Investment ($bn), 2008-2013 210
Table 64: Economic Indicators, Germany, Foreign Exchange Reserves ($bn), 2008-2013 211
Table 65: Economic Indicators, Germany, Imports of Goods and Services ($bn), 2008-2013 213
Table 66: Economic Indicators, Germany, Exports of Goods and Services ($bn), 2008-2013 214
Table 67: Economic Indicators, Germany, Government Structural Balance ($bn), 2008-2013 215
Table 68: Economic Indicators, Germany, General Government Net Debt ($bn), 2008-2013 216
Table 69: Economic Indicators, Germany, General Government Net Debt ($bn) Forecast, 2014-2020 217
Table 70: Economic Indicators, Germany, Major Industries, Gross Value Added ($bn), 2013 219
Table 71: Demographics, Germany, Population (million), 2008-2013 220
Table 72: Demographics, Germany, Population (million) Forecast, 2014-2020 221
Table 73: Demographics, Germany, Population, Urban and Rural Population Share (%), 2008-2013 222
Table 74: Demographics, Germany, Population Distribution by Age Group (%), 2008-2013 224
Table 75: Demographics, Germany, Population Distribution by Age Group Forecast (%), 2014-2020 225
Table 76: Demographics, Germany, Births (per 1,000 Population), 2008-2013 226
Table 77: Demographics, Germany, Mortality (per 1,000 Population), 2008-2013 227
Table 78: Demographics, Germany, Major Causes of Mortality (‘000), 2013 229
Table 79: Demographics, Germany, Children ?5 Years, Mortality Rate (per 1,000 Live Births), 2008-2013 230
Table 80: Demographics, Germany, Major Causes of Male Mortality (‘000), 2013 231
Table 81: Demographics, Germany, Major Causes of Female Mortality (‘000), 2013 233
Table 82: Demographics, Germany, Immunization Rate (%), 2008-2013 234
Table 83: Demographics, Germany, Gender Ratio (Male/Female), 2008-2013 235
Table 84: Demographics, Germany, Life Expectancy at Birth (Years), 2006-2011 236
Table 85: Demographics, Germany, Highest Level of General Education Completed, Share (%), 2013 238
Table 86: Demographics, Germany, Vocational Qualification, Share (%), 2013 239
Table 87: Demographics, Germany, Unemployment Rate (%), 2008-2013 240
Table 88: Demographics, Germany, Most Frequently Diagnosed Diseases, Patients (‘000), 2012 242
Table 89: Demographics, Germany, Major Diseases, DALY (Per 100,000 Population), 2004 243
Table 90: Healthcare Infrastructure, Germany, Hospitals, 2008-2013 245
Table 91: Healthcare Infrastructure, Germany, Acute Care Hospitals (per 100,000 Population), 2008-2013 246
Table 92: Healthcare Infrastructure, Germany, Diagnostic Equipment# (Units per Million Population), 2008-2013 247
Table 93: Healthcare Infrastructure, Germany, Hospital Beds (per 1,000 Population), 2008-2013 249
Table 94: Healthcare Infrastructure, Germany, Acute Care Hospitals Beds (per 1,000 Population), 2008-2013 250
Table 95: Healthcare Infrastructure, Germany, Psychiatric Hospital Beds (per 1,000 Population), 2008-2013 251
Table 96: Healthcare Infrastructure, Germany, PM10 (µg/m3), 2008-2013 253
Table 97: Healthcare Infrastructure, Germany, CO2 (in million tons), 2008-2013 254
Table 98: Healthcare Infrastructure, Germany, Full-Time Healthcare Personnel (‘000), 2008-2013 256
Table 99: Healthcare Infrastructure, Germany, Physicians (per 1,000 Population), 2008-2013 258
Table 100: Healthcare Infrastructure, Germany, Dentists (per 1000 population), 2008-2013 259
Table 101: Healthcare Infrastructure, Germany, Pharmacist (Per 1,000 Population), 2008-2013 260
Table 102: Healthcare Infrastructure, Germany, Nurses (per 1,000 Population), 2008-2013 261
Table 103: Healthcare Infrastructure, Germany, Healthcare Expenditure (% of GDP), 2008-2013 262
Table 104: Healthcare Infrastructure, Germany, Healthcare Expenditure, Major Component Share (%), 2012 263
Table 105: Healthcare Infrastructure, Germany, Healthcare Expenditure, Public-Private Share (%), 2008-2013 264
Table 106: Healthcare Infrastructure, Germany, Research and Development Expenditure ($bn), 2008-2013 265
Table 107: Major Healthcare Trade Fairs, Germany, 2015 268

1.2 List of Figures
Figure 1: Pharmaceutical Market, Germany, Revenue ($bn), 2008-2013 22
Figure 2: Pharmaceutical Market, Germany, Revenue Forecast ($bn), 2014-2020 23
Figure 3: Pharmaceutical Market, Germany, Exports and Imports ($bn), 2008-2013 24
Figure 4: Pharmaceutical Market, Germany, Supply Channel, 2010 26
Figure 5: Pharmaceutical Market, Germany, Generic Pharmaceutical Market Share (%), 2008-2013 29
Figure 6: Pharmaceutical Market, Germany, Biological Drugs in Pipeline, 2008-2013 31
Figure 7: Pharmaceutical Market, Germany, OTC Drug Market Revenue ($bn), 2008-2013 32
Figure 8: Pharmaceutical Market, Germany, Major OTC Drug Classes, Revenue ($m), 2013 33
Figure 9: Pharmaceutical Market, Germany, Major Disease Areas, Total Cost of Illness ($bn), 2008 34
Figure 10: Medical Device Market, Germany, Revenue ($bn), 2008-2013 81
Figure 11: Medical Device Market, Germany, Revenue Forecast ($bn), 2014-2020 82
Figure 12: Medical Device Market, Germany, Revenue by Segment ($bn), 2013 83
Figure 13: Medical Device Market, Germany, Cardiovascular Device Market ($m), 2008-2013 85
Figure 14: Medical Device Market, Germany, Cardiovascular Device Market, Sales Trend for Major Players, 2008-2012 86
Figure 15: Medical Device Market, Germany, IVD Market ($m), 2008-2013 87
Figure 16: Medical Device Market, Germany, IVD Market, Sales Trend for Major Players, 2008-2012 88
Figure 17: Medical Device Market, Germany, Orthopedic Device Market ($m), 2008-2013 90
Figure 18: Medical Device Market, Germany, Orthopedic Device Market, Sales Trend for Major Players, 2008-2012 91
Figure 19: Medical Device Market, Germany, Wound Care Management Market ($m), 2008-2013 92
Figure 20: Medical Device Market, Germany, Wound Care Management Market, Sales Trend for Major Players ($m), 2008-2012 93
Figure 21: Medical Device Market, Germany, Hospital Supplies Market ($m), 2008-2013 95
Figure 22: Medical Device Market, Germany, Hospital Supplies Market, Sales Trend for Major Players ($m), 2008-2012 96
Figure 23: Medical Device Market, Germany, Diagnostics Market, Revenue ($bn), 2008-2013 97
Figure 24: Medical Device Market, Germany, Diagnostic Market Revenue, Forecast ($bn), 2014-2020 98
Figure 25: Medical Device Market, Germany, Major Medical Device Companies, Revenue ($m), 2012 99
Figure 26: Healthcare Market, Germany, Drivers and Barriers, 2014 138
Figure 27: Market Access, Germany, Roles of Regulatory Bodies, 2014 142
Figure 28: Market Access, Germany, Reimbursement Process, 2014 143
Figure 29: Market Access, Germany, Number of SHI Providers, 2008-2013 146
Figure 30: Healthcare Spending, Germany, Out-of-Pocket Expenditure (%), 2008-2013 149
Figure 31: Market Access, Germany, Prescription Drug Prices, Annual Change (%), 2008-2013 152
Figure 32: Market Access, Germany, Healthcare Price Index, Annual Change (%), 2008-2013 153
Figure 33: Market Access, Germany, AMNOG Reimbursement Process for Drugs, 2014 157
Figure 34: Market Access, Germany, Organizational Structure of BfArM, 2014 158
Figure 35: Market Access, Germany, Organizational Structure of PEI, 2014 159
Figure 36: Market Access, EU, Centralized Procedure for Market Authorization, Pre-Submission, 2012 162
Figure 37: Market Access, EU, Centralized Procedure, Market Authorization, Pre-Opinion Phase, 2012 163
Figure 38: Market Access, EU, Centralized Procedure, Market Authorization, Post-Opinion Phase, 2012 164
Figure 39: Market Access, EU, Decentralized Procedure, Market Authorization, 2012 166
Figure 40: Market Access, EU, Mutual Recognition Procedure, Market Authorization, 2012 167
Figure 41: Market Access, EU, Conformity Assessment of Class I Medical Devices, 2014 171
Figure 42: Market Access, EU, Conformity Assessment of Class IIa Medical Devices, 2014 172
Figure 43: Market Access, EU, Conformity Assessment of Class IIb Medical Devices, 2014 173
Figure 44: Market Access, EU, Conformity Assessment of Class III Medical Devices, 2014 174
Figure 45: Market Access, Germany, Patent Approval Process, 2014 178
Figure 46: Market Access, Germany, Trademark Approval Process, 2014 181
Figure 47: Economic Indicators, Germany, Gross Domestic Product Per Capita ($), 2008-2013 200
Figure 48: Economic Indicators, Germany, Gross Domestic Product per Capita ($) Forecast, 2014-2020 201
Figure 49: Economic Indicators, Germany, Gross Domestic Product Annual Growth (%), 2008-2013 202
Figure 50: Economic Indicators, Germany, Gross Domestic Product Annual Growth Forecast (%), 2014-2020 203
Figure 51: Economic Indicators, Germany, Gross National Income per Capita ($), 2008-2013 204
Figure 52: Economic Indicators, Germany, Average Consumer Price Index, 2008-2013 205
Figure 53: Economic Indicators, Germany, Average Consumer Price Index Forecast, 2014-2020 206
Figure 54: Economic Indicators, Germany, Average Consumer Price Annual Change (%), 2008-2013 207
Figure 55: Economic Indicators, Germany, Currency Exchange Rate (€/$), 2008-2013 209
Figure 56: Economic Indicators, Germany, Foreign Direct Investment ($bn), 2008-2013 210
Figure 57: Economic Indicators, Germany, Forex Reserve ($bn), 2008-2013 211
Figure 58: Economic Indicators, Germany, Imports of Goods and Services ($bn), 2008-2013 212
Figure 59: Economic Indicators, Germany, Exports of Goods and Services ($bn), 2008-2013 214
Figure 60: Economic Indicators, Germany, Government Structural Balance ($bn), 2008-2013 215
Figure 61: Economic Indicators, Germany, General Government Net Debt ($bn), 2008-2013 216
Figure 62: Economic Indicators, Germany, General Government Net Debt ($bn) Forecast, 2014-2020 217
Figure 63: Economic Indicators, Germany, Major Industries, Gross Value Added ($bn), 2013 218
Figure 64: Demographics, Germany, Population (million), 2008-2013 220
Figure 65: Demographics, Germany, Population (million) Forecast, 2014-2020 221
Figure 66: Demographics, Germany, Urban-Rural Population Share (%), 2008-2013 222
Figure 67: Demographics, Germany, Population Distribution by Age Group (%), 2008-2013 223
Figure 68: Demographics, Germany, Population Distribution by Age Group (%) Forecast, 2014-2020 224
Figure 69: Demographics, Germany, Births (per 1,000 Population), 2008-2013 226
Figure 70: Demographics, Germany, Mortality (per 1,000 Population), 2008-2013 227
Figure 71: Demographics, Germany, Major Causes of Mortality (‘000), 2013 228
Figure 72: Demographics, Germany, Children ?5 Years, Mortality Rate (per 1,000 Live Births), 2008-2013 230
Figure 73: Demographics, Germany, Major Causes of Male Mortality (‘000), 2013 231
Figure 74: Demographics, Germany, Major Causes of Female Mortality (‘000), 2013 232
Figure 75: Demographics, Germany, Immunization Rate (%), 2008-2013 234
Figure 76: Demographics, Germany, Gender Ratio (Male/Female), 2008-2013 235
Figure 77: Demographics, Germany, Life Expectancy at Birth (Years), 2006-2011 236
Figure 78: Demographics, Germany, Highest Level of General Education Completed, Share (%), 2013 238
Figure 79: Demographics, Germany, Vocational Qualification, Share (%), 2013 239
Figure 80: Demographics, Germany, Unemployment Rate (%), 2008-2013 240
Figure 81: Demographics, Germany, Most Frequently Diagnosed Diseases (‘000), 2012 241
Figure 82: Demographics, Germany, Major Diseases, DALY (Per 100,000 Population), 2004 243
Figure 83: Healthcare Infrastructure, Germany, Hospitals, 2008-2013 245
Figure 84: Healthcare Infrastructure, Germany, Acute Care Hospitals (per 100,000 Population), 2008-2013 246
Figure 85: Healthcare Infrastructure, Germany, Diagnostic Equipment# (Units per Million Population), 2008-2013 247
Figure 86: Healthcare Infrastructure, Germany, Hospital Beds (per 1,000 Population), 2008-2013 248
Figure 87: Healthcare Infrastructure, Germany, Acute Care Hospital Beds (per 1,000 Population), 2008-2013 250
Figure 88: Healthcare Infrastructure, Germany, Psychiatric Hospital Beds (per 1,000 Population), 2008-2013 251
Figure 89: Healthcare Infrastructure, Germany, PM10 (µg/m3), 2008-2013 253
Figure 90: Healthcare Infrastructure, Germany, CO2 (in Million Tons), 2008-2013 254
Figure 91: Healthcare Infrastructure, Germany, Full-Time Healthcare Personnel (‘000), 2008-2013 256
Figure 92: Healthcare Infrastructure, Germany, Physicians (per 1,000 Population), 2008-2013 257
Figure 93: Healthcare Infrastructure, Germany, Dentists (per 1,000 Population), 2008-2013 258
Figure 94: Healthcare Infrastructure, Germany, Pharmacist s (per 1,000 Population), 2008-2013 259
Figure 95: Healthcare Infrastructure, Germany, Nurses (per 1,000 Population), 2008-2013 260
Figure 96: Healthcare Infrastructure, Germany, Healthcare Expenditure (% of GDP), 2008-2013 262
Figure 97: Healthcare Infrastructure, Germany, Healthcare Expenditure, Major Component Share (%), 2012 263
Figure 98: Healthcare Infrastructure, Germany, Healthcare Expenditure, Public-Private Share (%), 2008-2013 264
Figure 99: Healthcare Infrastructure, Germany, Research and Development Expenditure ($bn), 2008-2013 265
Figure 100: Healthcare Market, Germany, Opportunities and Challenges, 2014 270

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