Healthcare, Regulatory and Reimbursement Landscape - Mexico
Publisher Name » GlobalData
Published Date » 2012-08-15
No. Of Pages » 191
Industry analysis specialist GlobalData has released its new report, Healthcare, Regulatory and Reimbursement Landscape - Mexico. An essential source of information and analysis on the Mexican healthcare, regulatory and reimbursement landscape, this report identifies the key trends in the Mexican healthcare market, as well as providing insights on the demographic, regulatory, and reimbursement landscape, and the healthcare infrastructure of Mexico.
Most importantly, the report provides valuable insights on the trends and segmentation of the pharmaceutical and medical devices market. This report is built using data and information sourced from proprietary databases, secondary research and in-house analysis by GlobalDatas team of industry experts.
The population of Mexico in 2010 was approximately 112 million and was the 11th most populated country in the world, and is increasing due to the countrys high birth rate and increase in life expectancy.
The pharmaceutical market in Mexico was estimated at $11.4 billion in 2010 and is expected to reach approximately $22.5 billion by 2020 at a projected CAGR of 7%. The medical device market size was approximately $3 billion in 2010 and is expected to reach approximately $4.9 billion by 2020 at a projected CAGR of 5.2%.
The positive trend in the Mexican healthcare market can be attributed primarily to -
- Increasing elderly population
- Government initiatives for the prevention and management of chronic diseases
- The North American Free Trade Agreement, which guarantees its members the protection of intellectual property rights
- An improved and updated regulatory environment
Scope
The report provides information on the healthcare, regulatory and reimbursement landscape of Mexico. Its scope includes -
- Overview of the Mexican pharmaceutical and medical devices market including the market size, market segmentation, key drivers and barriers for the market.
- Profile and SWOT analysis of the major players in the pharmaceutical and medical devices market. Key players covered for the pharmaceutical market are Pfizer, Sanofi and Genomma Lab. Key players covered for the medical devices market are F. Hoffmann-la Roche, Siemens Healthcare and Fresenius Medical.
- Insightful review on the reimbursement and regulatory landscape. Analysis includes details of the healthcare reimbursement process, regulatory agencies and market authorization process for new drug and medical devices for Mexico.
- A detailed analysis of the political and economic environment of Mexico including economic indicators, demographics, healthcare infrastructure and healthcare expenditure.
- An overview of the opportunities and challenges for growth that exist in the Mexican healthcare market.
Reasons to buy
The report will enhance your decision-making capability. It will allow you to -
- Develop business strategies by understanding the trends shaping and driving the healthcare market of Mexico.
- Drive revenues by understanding the key trends, reimbursement and regulatory policies, pharmaceutical and medical devices market segments and companies likely to impact the Mexican healthcare market in future.
- Formulate effective sales and marketing strategies by understanding the competitive landscape and by analyzing the performance of various competitors.
- Organize your sales and marketing efforts by identifying the market categories and segments that present maximum opportunities for consolidations, investments and strategic partnerships.
- Identify, understand and capitalize on the opportunities and challenges in the Mexican healthcare market.
Table Of Contents
1 Table of Contents 5
1.1 List of Tables 7
1.2 List of Figures 9
2 Introduction 11
2.1 Report Guidance 11
2.1 Report Guidance 11
3 Overview of the Pharmaceutical and Medical Device Market 12
3.1 Pharmaceutical Market 12
3.1.1 Market Overview 12
3.1.2 Supply Channels 15
3.1.3 Market Segments 15
3.1.4 Major Disease Areas 18
3.1.5 Major Players 19
3.2 Medical Device Market 42
3.2.1 Market Overview 42
3.2.2 Overview of Top Five Segments 45
3.2.3 Major Players 56
3.3 Market Drivers and Barriers 78
3.3.1 Drivers 78
3.3.2 Barriers 78
3.1 Pharmaceutical Market 12
3.1.1 Market Overview 12
3.1.2 Supply Channels 15
3.1.3 Market Segments 15
3.1.4 Major Disease Areas 18
3.1.5 Major Players 19
3.2 Medical Device Market 42
3.2.1 Market Overview 42
3.2.2 Overview of Top Five Segments 45
3.2.3 Major Players 56
3.3 Market Drivers and Barriers 78
3.3.1 Drivers 78
3.3.2 Barriers 78
4 Market Access 80
4.1 Reimbursement and Payer Landscape 80
4.1.1 Healthcare System Overview 80
4.1.2 Reimbursement Process 81
4.1.3 Overview of Insurance Providers 84
4.1.4 Patients Share in Healthcare Spending 85
4.1.5 Price Trend in Healthcare Services 86
4.1.6 Pricing Policies 87
4.2 Regulatory Landscape 88
4.2.1 Overview of Regulatory Agencies 88
4.2.2 Marketing Authorization Procedure for Pharmaceutical Products 88
4.2.3 New Medical Device Approval Process 91
4.2.4 Licensing Process for Pharmaceutical and Medical Device Manufacturing 93
4.2.5 Licensing Process for Pharmaceutical Exports and Imports 95
4.2.6 Intellectual Property Rights 96
4.2.7 Clinical Trial Regulations 101
4.2.8 Pharmaceutical Advertising Regulations 103
4.2.9 Pharmacy Regulations 104
4.2.10 Labeling and Packaging Regulations 105
5 Country Analysis 106
5.1 Political Environment 106
5.1.1 Political Structure 106
5.1.2 Analysis of the Current Political Environment 107
5.1.3 Healthcare Policy Initiatives 108
5.2 Economic Landscape 109
5.3 Economic Indicators 112
5.3.1 Gross Domestic Product 112
5.3.2 Gross National Income 116
5.3.3 Inflation 117
5.3.4 Currency Exchange Rate 121
5.3.5 Foreign Direct Investment 122
5.3.6 Foreign Exchange Reserves 123
5.3.7 Trade Balance 124
5.3.8 Government Net Debt 126
5.3.9 External Debt 128
5.3.10 Major Industries 129
5.4 Demography 130
5.4.1 Population 130
5.4.2 Education and Literacy 145
5.4.3 Employment 146
5.4.4 Disease Burden 148
5.5 Healthcare Infrastructure 150
5.5.1 Healthcare Facilities 150
5.5.2 Healthcare Parameters 161
5.5.3 Environmental Health 163
5.5.4 Healthcare Personnel 169
5.6 Healthcare Expenditure 170
5.6.1 Overview 170
5.6.2 Major Components of Healthcare Spending 171
5.6.3 Share of Public and Private Sectors 172
5.6.4 Spending in Healthcare R&D 173
5.7 Trade Associations 174
5.7.1 Mexican Association of Pharmaceutical Research 174
5.7.2 National Association of Pharmaceutical Manufacturers 174
5.7.3 Mexican Association of Pharmaceutical Laboratories 174
5.7.4 National Chamber of the Pharmaceutical Industry 174
5.8 Trade Fairs 175
4.1 Reimbursement and Payer Landscape 80
4.1.1 Healthcare System Overview 80
4.1.2 Reimbursement Process 81
4.1.3 Overview of Insurance Providers 84
4.1.4 Patients Share in Healthcare Spending 85
4.1.5 Price Trend in Healthcare Services 86
4.1.6 Pricing Policies 87
4.2 Regulatory Landscape 88
4.2.1 Overview of Regulatory Agencies 88
4.2.2 Marketing Authorization Procedure for Pharmaceutical Products 88
4.2.3 New Medical Device Approval Process 91
4.2.4 Licensing Process for Pharmaceutical and Medical Device Manufacturing 93
4.2.5 Licensing Process for Pharmaceutical Exports and Imports 95
4.2.6 Intellectual Property Rights 96
4.2.7 Clinical Trial Regulations 101
4.2.8 Pharmaceutical Advertising Regulations 103
4.2.9 Pharmacy Regulations 104
4.2.10 Labeling and Packaging Regulations 105
5 Country Analysis 106
5.1 Political Environment 106
5.1.1 Political Structure 106
5.1.2 Analysis of the Current Political Environment 107
5.1.3 Healthcare Policy Initiatives 108
5.2 Economic Landscape 109
5.3 Economic Indicators 112
5.3.1 Gross Domestic Product 112
5.3.2 Gross National Income 116
5.3.3 Inflation 117
5.3.4 Currency Exchange Rate 121
5.3.5 Foreign Direct Investment 122
5.3.6 Foreign Exchange Reserves 123
5.3.7 Trade Balance 124
5.3.8 Government Net Debt 126
5.3.9 External Debt 128
5.3.10 Major Industries 129
5.4 Demography 130
5.4.1 Population 130
5.4.2 Education and Literacy 145
5.4.3 Employment 146
5.4.4 Disease Burden 148
5.5 Healthcare Infrastructure 150
5.5.1 Healthcare Facilities 150
5.5.2 Healthcare Parameters 161
5.5.3 Environmental Health 163
5.5.4 Healthcare Personnel 169
5.6 Healthcare Expenditure 170
5.6.1 Overview 170
5.6.2 Major Components of Healthcare Spending 171
5.6.3 Share of Public and Private Sectors 172
5.6.4 Spending in Healthcare R&D 173
5.7 Trade Associations 174
5.7.1 Mexican Association of Pharmaceutical Research 174
5.7.2 National Association of Pharmaceutical Manufacturers 174
5.7.3 Mexican Association of Pharmaceutical Laboratories 174
5.7.4 National Chamber of the Pharmaceutical Industry 174
5.8 Trade Fairs 175
6 Opportunities and Challenges 176
6.1 Opportunities 176
6.2 Challenges 176
6.1 Opportunities 176
6.2 Challenges 176
7 Appendix 178
7.1 Abbreviations 178
7.2 Bibliography 181
7.3 Methodology 189
7.3.1 Coverage 190
7.3.2 Secondary Research 190
7.3.3 Forecasting 190
7.3.4 Primary Research 190
7.3.5 Expert Panel Validation 191
7.4 Contact Us 191
7.5 Disclaimer 191
7.1 Abbreviations 178
7.2 Bibliography 181
7.3 Methodology 189
7.3.1 Coverage 190
7.3.2 Secondary Research 190
7.3.3 Forecasting 190
7.3.4 Primary Research 190
7.3.5 Expert Panel Validation 191
7.4 Contact Us 191
7.5 Disclaimer 191
List of Tables
Table 1: Pharmaceutical Market, Mexico, Revenue ($bn), 20052010 13
Table 2: Pharmaceutical Market, Mexico, Forecast ($bn), 20112020 14
Table 3: Drugs Going Off-Patent, Revenues ($bn), Global, 20112015 16
Table 4: Major Products, Genomma Lab Internacional, SAB de CV, 2011 20
Table 5: Major Products, Pfizer, Global, Revenue ($m), 2011 23
Table 6: Late Stage Pipeline, Pfizer, 2012 24
Table 7: Major Products, Sanofi, Global, Revenue ($m), 2011 28
Table 8: Late Stage Pipeline, Sanofi, 2012 29
Table 9: Major Products, GlaxoSmithKline, Global, Revenue ($m), 2011 34
Table 10: Late Stage Pipeline, GlaxoSmithKline, 2012 34
Table 11: Major Products, Liomont, 2012 40
Table 12: Medical Device Market ($bn), Mexico, 20062011 43
Table 13: Medical Device Market ($bn), Mexico, Forecast, 20122020 44
Table 14: Medical Device Market, Mexico, Segments, Revenue ($m), 2011 45
Table 15: Ophthalmic Devices Market ($m), Mexico, 20062011 46
Table 16: Sales Trends for Major Players*, Ophthalmic Devices, Mexico, 2010 47
Table 17: Nephrology and Urology Devices Market ($m), Mexico, 20062011 48
Table 18: Sales Trends for Major Players*, Nephrology and Urology Devices, Mexico, 2010 49
Table 19: Orthopedic Devices Market ($m), Mexico, 20062011 50
Table 20: Sales Trends for Major Players*, Orthopedic Devices, Mexico, 2010 51
Table 21: In Vitro Diagnostics Market ($m), Mexico, 20062011 52
Table 22: Sales Trends for Major Players*, In Vitro Diagnostic Devices, Mexico, 2010 53
Table 23: Diagnostic Imaging Market ($m), Mexico, 20062011 54
Table 24: Sales Trends for Major Players*, Diagnostic Imaging Market, Mexico, 2010 55
Table 25: Major Medical Device Companies, Mexico, Revenue ($m), 2010 56
Table 26: Major Products, Fresenius Medical, 2012 57
Table 27: Major Products, Roche, Global, Revenue ($m), 2010 63
Table 28: Late Stage Pipeline, F. Hoffmann-La Roche Ltd., 2012 64
Table 29: Major Products, Siemens, Global, Revenue ($m), 2010 67
Table 30: Major Products, Baxter International, Global, Revenue ($m), 2010 74
Table 31: Healthcare Spending, Mexico, Patient's Share (%), 20052010 85
Table 32: Price Trend in Healthcare Sector (%), Mexico, 20052010 86
Table 33: Regulatory Fee Structure, Pharmaceutical Products, Mexico, 2012 91
Table 34: Regulatory Review Time, Pharmaceutical Products, Mexico, 2012 91
Table 35: Medical Device Approval Timelines, Mexico, 2011 92
Table 36: Regulatory Fee Structure, Medical Devices, Mexico, 2012 92
Table 37: GDP Per Capita ($), Mexico, 20052010 112
Table 38: GDP Per Capita ($), Mexico, Forecast, 20112020 113
Table 39: GDP, Mexico, Annual Growth (%), 20052010 114
Table 40: GDP, Mexico, Annual Growth (%), Forecast, 20112020 115
Table 41: GNI Per Capita ($), Mexico, 20052010 116
Table 42: Average Consumer Price Index, Mexico, 20052010 117
Table 43: Average Consumer Price Index, Mexico, Forecast, 20112020 118
Table 44: Average Consumer Price, Mexico, Annual Change (%), 20052010 119
Table 45: Average Consumer Price, Mexico, Annual Change (%), Forecast, 20112020 120
Table 46: Currency Exchange Rate ($/MXN), Mexico, 20052010 121
Table 47: Foreign Direct Investment ($bn), Mexico, 20052010 122
Table 48: Foreign Exchange Reserves ($bn), Mexico, 20052010 123
Table 49: Imports of Goods and Services ($bn), Mexico, 20052010 124
Table 50: Exports of Goods and Services ($bn), Mexico, 20052010 125
Table 51: General Government Net Debt ($bn), Mexico, 20052010 126
Table 52: General Government Net Debt ($bn), Mexico, Forecast, 20112020 127
Table 53: External Debt ($bn), Mexico, 20052010 128
Table 54: Major Industries, Mexico, Gross Output ($bn), 2009 129
Table 55: Population (m), Mexico, 20052010 130
Table 56: Population (m), Mexico, Forecast, 20112020 131
Table 57: Urban and Rural Population, Mexico, Share (%), 20052010 132
Table 58: Age Groups, Mexico, Population Distribution (%), 20052010 134
Table 59: Age Groups, Mexico, Population Distribution (%), Forecast, 20112020 135
Table 60: Births (Per 1,000 Population), Mexico, 20052010 135
Table 61: Mortality (Per 1,000 Population), Mexico, 20052010 136
Table 62: Major Causes of Mortality (000s), Mexico, 2008 137
Table 63: Children <5 Years Age, Mexico, Mortality (Per 1,000 Live Births), 20052010 138
Table 64: Maternal Mortality (Per 100,000 Live Births), Mexico, 2005-2010 139
Table 65: Immunization Rate (%), Mexico, 20052010 140
Table 66: Major Causes of Male Mortality (000s), Mexico, 2008 141
Table 67: Major Causes of Female Mortality (000s), Mexico, 2008 142
Table 68: Gender Ratio (M/F), Mexico, 20052010 143
Table 69: Life Expectancy at Birth (Years), Mexico, 20052010 144
Table 70: Levels of Education, Mexico, Students Enrollment (000s), 2010 146
Table 71: Unemployment Rate (%), Mexico, 20052010 146
Table 72: Employees, Mexico, Segment Share (%), 2011 147
Table 73: Major Diseases, Mexico, Hospital Discharges (000s), 2009 149
Table 74: Major Diseases, Mexico, DALY (Per 100,000 Population), 2004 150
Table 75: Hospitals, Mexico, 20052010 152
Table 76: Public and Private Hospitals, Mexico, 20052010 153
Table 77: Hospital by Standard of Care, Mexico, Share (%), 2010 155
Table 78: Public Hospital by Bed Size, Mexico, 20052010 156
Table 79: Private Hospital by Bed Size, Mexico, 20052010 157
Table 80: Public Hospitals without Coverage Plan, Mexico, 20052010 158
Table 81: Public Hospitals with Coverage Plan, Mexico, 20052010 159
Table 82: Diagnostic Facilities, Mexico, Diagnostic Devices (Per 100,000 Population), 20052010 160
Table 83: Diagnostic Centers, Mexico, 20052010 160
Table 84: Hospital Beds (Per 1,000 Population), Mexico, 20052010 161
Table 85: Physicians (Per 1,000 Population), Mexico, 20052010 162
Table 86: Environmentally Attributable Deaths (Per 100,000 Population), Mexico, 2004 163
Table 87: PM10 (microgram per cubic meter), Mexico, 20052010 164
Table 88: CO2 Emissions (Million Tons), Mexico, 20052010 166
Table 89: Sewerage, Mexico, Population Connected (%), 20052010 167
Table 90: Waste Generation (Million Tons), Mexico, 20052010 168
Table 91: Healthcare Personnel (Per 1,000 Population), Mexico, 20052010 169
Table 92: Healthcare Expenditure (% of the GDP), Mexico, 20052010 170
Table 93: Public Healthcare Expenditure, Mexico, Share of Major Components (%), 2010 171
Table 94: Healthcare Expenditure, Mexico, PublicPrivate Share (%), 20052010 172
Table 95: Public Healthcare R&D Expenditure ($m), Mexico, 20052010 173
Table 96: Major Healthcare Trade Fairs, Mexico, 20122013 175
List of Figures
List of FiguresFigure 1: Pharmaceutical Market, Mexico, Revenue ($bn), 20052010 13
Figure 2: Pharmaceutical Market, Mexico, Forecast ($bn), 20112020 14
Figure 3: Medical Device Market ($bn), Mexico, 20062011 43
Figure 4: Medical Device Market ($bn), Mexico, Forecast, 20122020 44
Figure 5: Medical Device Market, Mexico, Segments, Revenue ($m), 2011 45
Figure 6: Ophthalmic Devices Market ($m), Mexico, 20062011 46
Figure 7: Sales Trends for Major Players*, Ophthalmic Devices, Mexico, 20062010 47
Figure 8: Nephrology and Urology Devices Market ($m), Mexico, 20062011 48
Figure 9: Sales Trends for Major Players*, Nephrology and Urology Devices, Mexico, 20062010 49
Figure 10: Orthopedic Devices Market ($m), Mexico, 20062011 50
Figure 11: Sales Trends for Major Players*, Orthopedic Devices, Mexico, 20062010 51
Figure 12: In Vitro Diagnostics Market ($m), Mexico, 20062011 52
Figure 13: Sales Trends for Major Players*, In Vitro Diagnostic Devices, Mexico, 20062010 53
Figure 14: Diagnostic Imaging Market ($m), Mexico, 20062011 54
Figure 15: Sales Trends for Major Players*, Diagnostic Imaging Market, Mexico, 20062010 55
Figure 16: Major Medical Device Companies, Mexico, Revenue ($m), 2010 56
Figure 17: Drivers and Barriers, Healthcare Market, Mexico, 2012 79
Figure 18: Addition of Drug in Basic Formulary, Mexico, 2012 83
Figure 19: Healthcare Spending, Mexico, Patient's Share (%), 20052010 85
Figure 20: Price Trend in Healthcare Sector (%), Mexico, 20052010 86
Figure 21: Marketing Authorization Procedure, Mexico, 2012 90
Figure 22: Licensing Process for Manufacturing, Mexico, 2012 94
Figure 23: Patent Approval Process, Mexico, 2012 98
Figure 24: Trademark Approval Process, Mexico, 2012 100
Figure 25: Clinical Trial Regulation Process, Mexico, 2012 102
Figure 26: GDP Per Capita ($), Mexico, 20052010 112
Figure 27: GDP Per Capita ($), Mexico, Forecast, 20112020 113
Figure 28: GDP, Mexico, Annual Growth (%), 20052010 114
Figure 29: GDP, Mexico, Annual Growth (%), Forecast, 20112020 115
Figure 30: GNI Per Capita ($), Mexico, 20052010 116
Figure 31: Average Consumer Price Index, Mexico, 20052010 117
Figure 32: Average Consumer Price Index, Mexico, Forecast, 20112020 118
Figure 33: Average Consumer Price, Mexico, Annual Change (%), 20052010 119
Figure 34: Average Consumer Price, Mexico, Annual Change (%), Forecast, 20112020 120
Figure 35: Currency Exchange Rate ($/MXN), Mexico, 20052010 121
Figure 36: Foreign Direct Investment ($bn), Mexico, 20052010 122
Figure 37: Foreign Exchange Reserves ($bn), Mexico, 20052010 123
Figure 38: Imports of Goods and Services ($bn), Mexico, 20052010 124
Figure 39: Exports of Goods and Services ($bn), Mexico, 20052010 125
Figure 40: General Government Net Debt ($bn), Mexico, 20052010 126
Figure 41: General Government Net Debt ($bn), Mexico, Forecast, 20112020 127
Figure 42: External Debt ($bn), Mexico, 20052010 128
Figure 43: Major Industries, Mexico, Gross Output ($bn), 2009 129
Figure 44: Population (m), Mexico, 20052010 130
Figure 45: Population (m), Mexico, Forecast, 20112020 131
Figure 46: Urban and Rural Population, Mexico, Share (%), 20052010 132
Figure 47: Age Groups, Mexico, Population Distribution (%), 20052010 133
Figure 48: Age Groups, Mexico, Population Distribution (%), Forecast, 20112020 134
Figure 49: Births (Per 1,000 Population), Mexico, 20052010 135
Figure 50: Mortality (Per 1,000 Population), Mexico, 20052010 136
Figure 51: Major Causes of Mortality (000s), Mexico, 2008 137
Figure 52: Children <5 Years Age, Mexico, Mortality (Per 1,000 Live Births), 20052010 138
Figure 53: Maternal Mortality (Per 100,000 Live Births), Mexico, 2005-2010 139
Figure 54: Immunization Rate (%), Mexico, 20052010 140
Figure 55: Major Causes of Male Mortality (000s), Mexico, 2008 141
Figure 56: Major Causes of Female Mortality (000s), Mexico, 2008 142
Figure 57: Gender Ratio (M/F), Mexico, 20052010 143
Figure 58: Life Expectancy at Birth (Years), Mexico, 20052010 144
Figure 59: Levels of Education, Mexico, Students Enrollment (000s), 2010 145
Figure 60: Unemployment Rate (%), Mexico, 20052010 146
Figure 61: Employees, Mexico, Segment Share (%), 2011 147
Figure 62: Major Diseases, Mexico, Hospital Discharges (000s), 2009 148
Figure 63: Major Diseases, Mexico, DALY (Per 100,000 Population), 2004 149
Figure 64: Hospitals, Mexico, 20052010 152
Figure 65: Public and Private Hospitals, Mexico, 20052010 153
Figure 66: Hospital by Standard of Care, Mexico, Share (%), 2010 154
Figure 67: Public Hospital by Bed Size, Mexico, 20052010 155
Figure 68: Private Hospital by Bed Size, Mexico, 20052010 156
Figure 69: Public Hospitals without Coverage Plan, Mexico, 20052010 157
Figure 70: Public Hospitals with Coverage Plan, Mexico, 20052010 158
Figure 71: Diagnostic Facilities, Mexico, Diagnostic Devices (Per 100,000 Population), 20052010 159
Figure 72: Diagnostic Centers, Mexico, 20052010 160
Figure 73: Hospital Beds (Per 1,000 Population), Mexico, 20052010 161
Figure 74: Physicians (Per 1,000 Population), Mexico, 20052010 162
Figure 75: Environmentally Attributable Deaths (Per 100,000 Population), Mexico, 2004 163
Figure 76: PM10 (microgram per cubic meter), Mexico, 20052010 164
Figure 77: CO2 Emissions (Million Tons), Mexico, 20052010 166
Figure 78: Sewerage, Mexico, Population Connected (%), 20052010 167
Figure 79: Waste Generation (Million Tons), Mexico, 20052010 168
Figure 80: Healthcare Personnel (Per 1,000 Population), Mexico, 20052010 169
Figure 81: Healthcare Expenditure (% of the GDP), Mexico, 20052010 170
Figure 82: Public Healthcare Expenditure, Mexico, Share of Major Components (%), 2010 171
Figure 83: Healthcare Expenditure, Mexico, PublicPrivate Share (%), 20052010 172
Figure 84: Public Healthcare R&D Expenditure ($m), Mexico, 20052010 173
Figure 85: Opportunities and Challenges, Healthcare Market, Mexico, 2011 177
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