Healthcare Industry 2020 - Facts and Figures for Baden-Württemberg - MEDTECH PHARMA BIOTECH - Gesundheitsindustrie BW
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Inhaltsverzeichnis 4 Foreword 5 Baden-Württemberg – an outstanding location for the Healthcare Industry 12 Medical Technology Sector 20 Pharmaceutical Industry and Biotechnology 21 Pharmaceutical industry 23 Medical biotechnology 32 Research in Baden-Württemberg 34 Company Foundation and Financing in Baden-Württemberg 36 Clusters and Networks 38 Database and Methods 39 Sources 42 Imprint Stuttgart
Foreword Baden-Württemberg – an outstanding location Prof. Dr. Ralf Kindervater, for the Healthcare CEO BIOPRO Baden-Württemberg GmbH Industry What will the healthcare system of the future look like? or smart implants. It has gained a prominent place in How can we meet the challenges of demographic develop- the media and in the public eye due to the coronavirus ment, increasing cost pressure and the shortage of skilled pandemic. The current, very positive perception should workers? What influence will digitalisation and artificial be used to underline once again the importance of the intelligence have, and what space will they occupy? BIO- Healthcare Industry and the healthcare sector in general. PRO Baden-Württemberg, which acts as a contact for the state’s Healthcare Industry – comprising medical technol- The Healthcare Industry operates in a highly regulated ogy, pharmaceutical industry and biotechnology – is an market that is increasingly coming under pressure from organisation dedicated to these exciting issues. large non-industry (IT) companies and global compe- Baden-Württemberg is a leading tition. At the same time, digital transformation, robot- exporter and the most important The new Healthcare Industry 2020 - Facts and Figures for ics and personalised medicine are set to revolutionise location for the industrial healthcare Baden-Württemberg report once again proves the impor- healthcare. Interdisciplinarity and networking among sector in Germany1 tance of these sectors that play a key role in the economy all players are indispensable in this process. BIOPRO and employment. The Healthcare Industry drives inno- Baden-Württemberg GmbH, as a wholly-owned affiliate 5 University hospitals vation in healthcare, in areas such as the development of the Baden-Württemberg government, makes a valua- of personalised therapies, companion diagnostics, bio- ble contribution to this process. 44 Research institutions und pharmaceuticals, novel cell therapies and biocompatible universities 181 Companies founded in the Healthcare Industry since 2010 BIOPRO Baden-Württemberg GmbH BIOPRO Baden-Württemberg GmbH’s goals are to team players across industry boundaries, bring industry and sci- 1,104 Companies in the Healthcare Industry ence together, provide information on regulatory requirements and generate new impulses for the location. BIOPRO offers interdisciplinary topic analyses and trend-based market analyses, innovative event concepts, initiates collabora- tions between companies and research institutions, and offers start-up support and organises events on current-inter- 17.8 Billion euros gross value added1 est topics. BIOPRO is the contact partner for the Healthcare Industry in Baden-Württemberg. 95,750 Employees 25.2 Billon euros turnover 4 | Healthcare industry 2020 Healthcare industry 2020 | 5
The Healthcare Industry at a Glance What will the healthcare system of the fu- rials and supplies for manufacturing processes have not ture look like? been available. As a result, the dependency of Europe- The development of a sustainable healthcare system that an supply chains on the Asian market is being discussed is patient-oriented and guarantees high-quality treatment within the industry and there is a debate about the ex- is a declared goal of current efforts to promote health tent to which countermeasures can be taken. The medi- in Germany. The Healthcare Industry is working across cal technology sector, which would have been pushed to industry boundaries on the holistic treatment of patients its absolute limits due to the switch to the new Medical MEDICAL TECHNOLOGY through the use of innovative technologies and the devel- Device Regulation (MDR) in April 2020, was granted a opment of smart treatment concepts. In addition to new one-year delay for the application of the regulation. The 851 52.092 13,79 therapy concepts, smart technologies can use artificial MDR will become fully applicable on 26th May 2021.This Companies Employees Billion euros taxable intelligence to optimise the search for active pharmaceu- gives companies more time to develop additional com- turnover tical ingredients, increase adherence to therapy, shorten petence and implement the MDR-compliant certification PHARMACEUTICAL INDUSTRY hospital stays and improve patient care through robotics. process. The MDR Fast-Track Support BW programme, which is financed with funds from the Baden-Württem- 90 25.069 7,24 Healthcare Industry - proven in the crisis berg Ministry of Economic Affairs, Labour and Housing, Companies Employees Billion euros taxable turnover During the coronavirus pandemic, the Healthcare In- offers assistance to the state’s micro and small companies BIOTECHNOLOGY dustry has shown how creative and agile it is. Within a in implementing the MDR (chapter: Medical Technology short period of time, more than 190 vaccine projects have Sector, page 18). 184 18.589 4,19 been launched to date. CureVac AG, the start-up compa- Companies Employees Billion euros taxable ny Prime Vector Technologies and BioCopy GmbH from Focus on medical needs with future tech- turnover Baden-Württemberg are among those involved in these nologies and use of intelligent data 2 projects . The medical technology sector reacted just as Although the crisis and the increased regulatory require- creatively, converting production processes to the manu- ments are a major test for the Healthcare Industry, they facture of personal protective equipment at an early stage may also offer companies the opportunity to rethink and seeking new ways to develop respiratory equipment. their business models, invest in smart processes, start Diagnostics manufacturers, including Spindiag GmbH, collaborating with other companies and become much Trenzyme GmbH and Mediagnost GmbH, have been in- more aware of new possibilities. Developments in the volved in developing test procedures for the detection field of digitalisation and artificial intelligence, the uti- of viral RNA or SARS-CoV-2-specific antibodies. At the lisation of real-world data as well as preventive and per- same time, the coronavirus pandemic has been driving sonalised medicine are particular drivers of innovation. digitalisation in the healthcare sector and will, among Cooperation and cross-sector networks will thus contin- other things, advance the field of eHealth. However, the ue to become increasingly important in the future and pandemic has also plunged many healthcare companies reduce sectoral thinking. With the patient as starting into crisis, as orders have fallen away or key raw mate- point, developments in the healthcare sector will in fu- 6 | Healthcare industry 2020 Healthcare industry 2020 | 7
Forum health region Baden-Württemberg ture be determined more by patients’ needs and less by of 65.5 percent for Germany as a whole5. In general, the Health at the forefront – science, business ics. To this end, the Baden-Württemberg government rigid structures. The data obtained in the real treatment Healthcare Industry has proven itself to be an innovative and healthcare thinking together. is providing 50 million euros in funding for implement- environment will therefore be key to providing valuable and relatively independent driver of economic growth. ing innovative projects from the Forum Health Region information for new products and processes. With the launch of the Forum Health Region Baden-Württemberg for 2020 and 2021. The spectrum of The innovation ecosystem in Baden-Würt- Baden-Württemberg in July 2018, the Baden-Württem- Forum projects ranges from personalised medicine and An important economic factor for temberg berg government inaugurated a strategic process in which new approaches in the field of patient care to combating Baden-Württemberg The Healthcare Industry in Baden-Württemberg is stakeholders from science, industry and patient care are multidrug-resistant hospital germs. Key selection criteria In addition to the major challenges facing the healthcare strongly represented with 1,104 companies that research, given a platform for joint exchange and multidisciplinary for the funded projects include ensuring that the benefit system, such as rising cost pressure and the shortage of develop and/or manufacture in the state. In terms of networking. Experts from the healthcare sector have en- to patients is a central element, and that the projects are skilled workers, the increasing number of multimorbid, the number of companies or employees, the state is the tered into strategic dialogue with the ministries involved, interdisciplinary and pursue new research and treatment chronically ill patients and the public’s heightened health 1 no. Healthcare Industry location in Germany . 181 5/6/7 working in three thematic blocks and tackling individu- approaches. awareness has huge potential for increased sales and high health-related start-ups were founded in Baden-Würt- al topics in working groups. The aim is to break down employment. This is also reflected in the gross value add- temberg between 2010 and 9/2020, most of them in the sectoral thinking, develop the healthcare location to the Elements of a joint strategy for Baden-Württemberg ed of the Healthcare Industry in Baden-Württemberg, high-tech segment. Together with the state’s university highest possible level and promote innovation that ben- The development of an overall strategy is aimed at which amounted to around 17.8 billion euros in 2018. In hospitals, research institutions and networks, a lively in- efits patients. strengthening Baden-Württemberg as an outstanding 2018, more than one million people were employed in novation ecosystem has been created here. One of the healthcare location in the long term and defining the the healthcare sector in Baden-Württemberg . 1 focal points of the CyberValley as a digitalisation hub, for The Baden-Württemberg Ministry of Science, Research necessary structural framework conditions at EU, feder- example, is the Healthcare Industry. The Forum Health and the Arts is responsible for the “science and research” al and state level. The spokesperson groups of the three Investment in research and development (R&D) is need- Region Baden-Württemberg is a state supported effort to thematic block, the Baden-Württemberg Ministry of Eco- thematic blocks have done the initial groundwork and ed in order to generate innovation. Baden-Württemberg further develop the Healthcare Industry and help it po- nomic Affairs, Labour and Housing for the “business-re- formulated strategy papers with recommendations for is well positioned in this area as shown by the figures sition itself as a model location (chapter: The Healthcare lated research, innovations, value creation and employ- action for their respective thematic block. As an overall on R&D intensity collected in an EU-wide compari- Industry at a Glance, page 9). ment in the healthcare sector” thematic block, and the strategy continues to be developed, findings and experi- son by the Baden-Württemberg Statistics Office. Here, Baden-Württemberg Ministry of Social Affairs and Inte- ence from the coronavirus pandemic will also be incor- Baden-Württemberg comes out top across all sectors as gration is in charge of the “healthcare structures” themat- porated in order to be structurally better prepared for the most innovative region in terms of invested nominal ic block. For each thematic block there is a three-member future pandemics. Regulations that safeguard the supply gross domestic product (GDP) in R&D (5.6 percent of spokesperson group consisting of experts representing of crisis-relevant drugs or medical products even in crisis 3 nominal GDP) . As regards the number of patent appli- the areas of science, economy and healthcare. The overall situations are also being worked on as elements of an cations, Baden-Württemberg also takes first place with coordination of the Forum Health Region Baden-Würt- overall strategy. Equally necessary are efficient network- 15,230 applications in 2019, followed by Bavaria and temberg is the responsibility of the Baden-Württemberg ing structures in the research field, aimed at gaining new 4 North Rhine-Westphalia . Baden-Württemberg’s health- State Ministry. BIOPRO Baden-Württemberg GmbH is in insights for further strategic action through studies and care sector is the leading exporter with an export con- charge of the administration for the Forum. research results. tribution of 38.2 billion euros, 94.7 percent of which is accounted for by the Healthcare Industry1. The high level The healthcare sector is to be strengthened and further of demand from abroad is evidenced by the export ratio developed through joint work on future-oriented top- 8 | Healthcare industry 2020 Healthcare industry 2020 | 9
MINISTERIUM FÜR WISSENSCHAFT, FORSCHUNG UND KUNST Stakeholders institutes and universities, health insurance companies, MINISTRY OF SCIENCE, RESEARCH AND THE ARTS The Forum Health Region Baden-Württemberg thrives clusters and associations, companies in the Healthcare In- 1. Digitalisation on the active participation of stakeholders from all areas dustry (biotechnology, pharmaceutical and medical tech- 2. Strengthening translation of Baden-Württemberg as a healthcare location who wish nology companies) as well as from the health trade and to help shape the strategic process. Around 480 actors are health service sectors. 3. Further development of academic education already registered (as of June 2020). The broad spectrum with regard to a sustainable healthcare system of participants includes experts from inpatient and outpa- Anyone interested in participating can get in touch via tient care, such as hospitals and nursing homes, research the Forum’s website. MINISTERIUM FÜR WIRTSCHAFT, ARBEIT UND WOHNUNGSBAU MINISTY OF ECONOMIC AFFAIRS, LABOUR AND HOUSING 1. Digitalisation and artificial intelligence 2. Business-oriented research and innovations for targeted translation into application 3. Economic potential of personalised medicine 4. Potential of industry, services and trade in the healthcare sector 5. Company foundation, start-ups and new business models 6. Skilled labour and employment in the healthcare sector 7. Regulatory framework Information and contact 8. Internationalisation Forum Health Region Baden-Württemberg MINISTERIUM FÜR SOZIALES UND INTEGRATION office at BIOPRO Baden-Württemberg GmbH MINISTRY OF SOCIAL AFFAIRS AND INTEGRATION 1. Digitalisation and artificial intelligence (inter alia, electronic E-mail: forum.gsbw@bio-pro.de patient records, patient protection, data usability, new Phone: +49 (0) 711 21 81 85 31 treatment options) www.forum-gesundheitsstandort-bw.de 2. Personalised medicine (medical treatment and care) 3. Pharmaceutical and medical device safety 4. Care and technology in the care sector 5. Medical rehabilitation 6. Prevention / health promotion 10 | Healthcare industry 2020 Healthcare industry 2020 | 11
Medical Technology Sector Medical technology comprises a heterogeneous spectrum turnover are the Tuttlingen area and the Rhine-Neckar MEDICAL TECHNOLOGY of medical technology products with a medical purpose, region, which is also the headquarter of Roche Diagnos- 851 52,092 13.79 intended for use on humans. These include dressing ma- tics GmbH. Companies Employees Billion euros turnover terials and surgical instruments as well as implants, X-ray equipment and medical software. The certification of A characteristic feature of medical technology in medical devices is currently subject to the German Medi- Baden-Württemberg is the high number of micro and cal Devices Act, which will be mandatory replaced by the small enterprises, which together make up more than 80 MDR in May 2021. percent of the region’s companies. This is where experts and traditionalists in the field of materials development In 2018, the 851 medical technology companies achieved and refinement as well as production techniques come Mannheim/ a taxable turnover of 13.79 billion euros with 52,092 together, along with developers and users of high-tech, 84 Heidelberg employees subject to social security contributions. This novel biomaterials and artificial intelligence. This diversi- Heilbronn/Franken makes Baden-Württemberg the no. 1 location for medical ty of companies and entrepreneurship and the close links technology in Germany. with centres of excellence, universities and university hospitals in Baden-Württemberg enable new develop- 12 Shaping the future with tradition, diversity ments to emerge across value chains and sectors. Karlsruhe and know-how Within the Healthcare Industry, medical technology Pooling know-how, using networks and 103 Aalen/Heidenheim companies represent by far the largest group in terms of promoting the entrepreneurial spirit 61 number of companies, turnover and number of employ- In the period between 2010 and 9/2020, 98 medical tech- Stuttgart 15 ees. The strong small- and medium-sized companies in nology companies were founded in Baden-Württemberg, 44 the medical technology industry are concentrated around 18 of which were established between 1/2018 and 9/2020. Pforzheim/ Freudenstadt Tuttlingen/Villingen-Schwenningen, in the Freiburg/Of- The regions with a high number of start-ups over the last fenburg/Lörrach area and around Stuttgart and Reutlin- ten years are Mannheim/Heidelberg with 21 start-ups 73 gen/Tübingen. Among the regions with the highest and Schwarzwald-Baar-Heuberg with 20 start-ups. These Reutlingen/Tübingen 27 Ulm/Biberach 286 50 % 32 % 14 % 4% Freiburg/ Tuttlingen/ Offenburg/ Villingen- Lörrach Medical technology companies in Baden-Württemberg in 2018 by employment size class Schwenningen Konstanz/Oberschwaben 2% 9% 18 % 71 % 100 46 Turnover of medical technology companies in Baden-Württemberg in 2018 by employment size class < 10 10 - 49 50 - 249 ≥ 250 12 | Healthcare industry 2020 Healthcare industry 2020 | 13
Medical technology companies founded in Baden-Württemberg between 1/2018 and 9/2020 Company Location Field of activity Derma Intelligence GmbH Mannheim eHealth evid UG Mannheim eHealth Dental products, therapeutic systems and Freiburger Medizintechnik GmbH Freiburg devices Tätigkeitsfelder Contract production, dental products, I.C. Lercher Solutions GmbH Stockach endoscopy start-ups are involved across all fields of activity, with the Fields of activity of medical technology companies in imm Innovative Medical Baden-Württemberg (companies may have several Mannheim Surgical instruments 2018 eHealth sector showing considerable growth in recent fields of activity) Mannheim GmbH years. Half of all start-ups between 1/2018 and 9/2020 are implacit GmbH Mannheim eHealth, software Surgical instruments Kamedi GmbH Eggenstein-Leopoldshafen eHealth, therapeutic systems and devices active in this segment. Therapeutic systems and devices LUNA cybernetics GmbH Weingarten Exoprostheses Implants and exoprostheses MR Shim GmbH Reutlingen Diagnostics Endoscopy The spirit of innovation and entrepreneurship in ReHub GmbH Reutlingen eHealth, therapeutic systems and devices Dental products Baden-Württemberg must continue to be strengthened Hygiene, protection and sterilisation Consumables WiMedical UG Singen and driven forward through intensive networking and co- equipment Healthcare-IT, eHealth and telemedicine operation in order to counter the pressure from global or 3a-diagnostics GmbH Frickenhausen Diagnostics Patient and point-of-care diagnostics Hygiene, sterilisataion, AIRAmed GmbH Tübingen eHealth, software non-industry competitors. protection equipment Becure GmbH Mannheim eHealth, therapeutic systems and devices 2019 Doctor’s practice and hospital equipment Hellstern medical GmbH Wannweil Doctor’s practice and hospital equipment The Medical Device Regulation and other In vitro diagnostics Living Brain GmbH Heidelberg eHealth, software Imaging methods challenges Thericon GmbH Mannheim Imaging methods, endoscopy Optical and laser systems The MDR corrigendum of December 2019 extended 2020 Anaesthesia and respiration Midaia GmbH Heidelberg eHealth the transition period for manufacturers of class Ir (class Gründungen 0 5 10 15 20 25 30 35 40 I, reusable) products. On 23rd April 2020, the Europe- Percentage of companies an Commission’s proposal to delay the application date active in the respective field of activity by one year from 26th May 2020 to 26th May 2021 for manufacturers of in vitro medical devices was approved The EU regulation on In Vitro Diagnostic Medical Devic- Medical technology companies founded in Medical technology moving towards the Baden-Württemberg between 2010 und 2019 by the European Parliament and Council. The decision es (IVDR) will be mandatory from 26th May 2022 after digital era 14 was partly due to concerns over the coronavirus pandem- a five-year transition period. Here too, manufacturers of The digitalisation of healthcare is changing the require- 12 ic. Although this gives the industry a breathing space, it in vitro diagnostic devices (IVD) will face major hurdles ments for modern medical technology. The Digital Care 10 Medizintechnik-Index number of companies must continue to make every effort to meet the increased when implementing the regulation and are advised to ap- Act and the Digital Health Applications Ordinance are 8 regulatory requirements for medical devices. ply and implement it at an early stage. 6 aimed at making the industry more dynamic and legisla- 4 tors want digital health applications to enter the medical Medical Technology Index for Baden-Württemberg: turnover In addition, the coronavirus pandemic is putting pressure 2 device market much faster. The first two “health apps on development from 2007 to 2018 in million euros on supply chains, orders are dropping below average and 0 prescription” were added to the list of digital health ap- 80 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 many manufacturers have had to announce short-time plications by the Federal Institute for Drugs and Medical 70 working. According to BVMed’s Autumn 2020 Survey, Devices (BfArM) in October 20209. After the Kranken- 60 50 companies are expecting a 4.9 percent drop in sales (com- basic documents, information events and individual ex- hauszukunftsgesetz (Hospital Future Act) passed in the 40 pared to the previous year: sales up 3.3 percent) . 8 pert consultation days (see page 18). The MDR & IVDR Bundestag in September 2020, the German federal gov- 30 Fast-track Support BW, which has so far focused on MDR, ernment is also making investment funds of 3 billion eu- 20 The MDR & IVDR Fast-track Support BW programme will be extended to IVD producers and will be available ros available for the digitalisation of hospitals10. 10 offers the medical technology companies in Baden-Würt- in an adapted format from 2021. More information will 0 temberg practical support for implementing the MDR shortly be available on the https://mdr-ivdr.bio-pro.de 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 and IVDR, including, for example, help with preparing website. 14 | Healthcare industry 2020 Healthcare industry 2020 | 15
Selected investments, acquisitions as well as collaborations and licensing agreements made by Baden-Württemberg medical technology companies in the period from 1/2018 to 9/2020 Investments Company Location Field of activity Investment volume Type of financing Investors monikit UG Stuttgart Epilepsy diagnostics EUR 1.86 million Project financing Life Science Inkubator GmbH 2018 SpinDiag GmbH Freiburg im Breisgau Point-of-care screening system EUR 3 million 2. financing round, Series A Business Angels from Baden-Württemberg Santo Venture Capital, LBBW Venture CorTec GmbH Freiburg im Breisgau Neuroprothetics EUR 13 million Financing round Capital 2019 Curetis N.V. Holzgerlingen Molecular diagnostics products EUR 6.5 million Financing EIB, Yorkville Expansion of Series A funding WBG Pflegeheime and a new investor as SpinDiag GmbH Freiburg im Breisgau Point-of-care screening system EUR 4 million round well as existing investors Curetis Holzgerlingen Molelcular diagnostics products EUR 20 million Convertible loan Issuance of Curetics N.V. convertible notes SpinDiag GmbH Freiburg im Breisgau Point-of-care screening system EUR 6 million Project funding Baden-Württemberg government Existing investors as well as Think.Health SpinDiag GmbH Freiburg im Breisgau Point-of-care screening system EUR 16.3 million Series B financing round Ventures 2020 WEFA Inotec GmbH, High-Tech Gründerfonds, Mittelständische Technology for the functionalisation of stimOS GmbH Konstanz - Series A financing Beteiligungsgesellschaft Baden- implant materials Württemberg, founding shareholder Schaffarczyk Acquisitions Company Location Field of activity Buyer EIT Emerging Implant Tuttlingen Spinal cord implants Johnson & Johnson Medical GmbH, Norderstedt Technologies GmbH 2018 GEHRING CUT AG Matzingen, Schweiz Surgical instruments KLINGEL medical metal GmbH, Pforzheim Hain Lifescience GmbH Nehren Molecular diagnostics Bruker Corporation, Billerica, MA, USA Bächler Feintech AG Hölstein, Schweiz Surgical instruments KLINGEL medical metal GmbH, Pforzheim 2019 FREI AG Kirchzarten Medical training devices and therapy beds Zimmer MedizinSysteme GmbH, Neu-Ulm Curetis Weil im Schönbuch Diagnostics Fusion: OpGen, Gaithersburg, Maryland, USA 2020 Stuckenbrock Medizintechnik Tuttlingen Surgical instruments KLS Martin Group, Tuttlingen GmbH Cooperations and licensing agreements Company Location Partner company Category Beijing Clear Biotech Co., Ltd., Beijing, 2018 Curetis N.V. Holzgerlingen Strategic cooperation China 16 | Healthcare industry 2020 Healthcare industry 2020 | 17
MDR Fast-Track Support BW The MDR came into force in May 2017 and will become In summer 2019, the Baden-Württemberg Ministry of Eco- aimed at saving time and resources for the companies af- holders was initiated so that first meetings can be started fully effective on 26th May 2021. In addition to a harmo- nomic Affairs, Labour and Housing made funds available fected. This includes jointly preparing basic documents in due time. nised legal framework for the marketing of medical devic- for a MDR Fast-Track Support BW programme to help for certification, developing guidelines on specific issues es, the European Union’s main objective is to ensure the the medical technology sector in Baden-Württemberg and sharing newly acquired information at events. In ad- In addition to topic-specific information events, compa- safety of these products for users. This results in new re- implement the MDR. The aim of this MDR Fast-Track dition, access to clinical trial centres will be facilitated nies can raise specific questions with experts at regular quirements for the industry, which pose major challenges Support BW is to offer practical, user-oriented support to help companies that are required to conduct clinical online consultation days. for micro and small companies in particular, but also for services for implementing the MDR by the end of 2021. trials due to MDR. BIOPRO Baden-Württemberg GmbH some medium-sized companies. The programme consists of five measures (see box below) is coordinating the MDR Fast-Track Support BW. The information and orientation aids obtained and com- piled as part of MDR Fast-Track Support BW as well as Interim status and outlook useful contributions by third parties are pooled and made Eighteen basic documents were completed last year. available via the MDR & IVDR Guide BW (https://mdr- Nine further product groups are currently being worked ivdr.bio-pro.de). on, and consortia are in the process of being formed for Product Group-Specific Shared Documents twelve product groups. The completed basic documents Company consortia are developing basic documents for individual medical device groups, which can be used as can also be purchased by companies outside Baden-Würt- a basis for creating individual certification documents. temberg and have already been shared over 300 times within and outside the consortia. MDR Expert Talks BW In the expert rounds, quality management and regulatory affairs specialists and service providers discuss A first expert panel on clinical evaluation identified a MDR-relevant issues and develop guidelines on the various topics. considerable need for information. To this end, a series of virtual events, “A focus on clinical trials”, provided prac- Clinical Study Guide BW tical information on how to carry out successful clinical The creation of a central information hub with a guide function will facilitate access to clinical trial centres and evaluations for existing products and innovations. Fur- provide information on the subject. ther expert panels are currently being set up. MDR Roundtables In order to facilitate access to clinical study centers and The Roundtables provide the opportunity for an informal exchange between relevant stakeholders such as noti- to provide support for the many questions regarding fied bodies, supervisory authorities, business associations and service providers in order to minimise uncertainty clinical trials, various aspects of this topic are discussed All information on MDR Fast-Track Support BW is in the interpretation of the new regulation. with experts, manufacturers and study center contacts. available at Afterwards, information is made available in the form of https://mdr-ivdr.bio-pro.de/mdr-soforthilfe MDR Fast-Track Support Events a Clinical Study Guide BW. These are events where the results and findings of the MDR Fast-track support BW programme as well as rele- Please feel free to send us your suggestions or vant topics relating to MDR will be presented in the form of information sessions. MDR-relevant topics were identified for the MDR questions for Expert Talks or Roundtables. Roundtables and the exchange with the different stake- E-mail: mdr-sh@bio-pro.de 18 | Healthcare industry 2020 Healthcare industry 2020 | 19
Pharmaceutical Industry and Biotechnology Pharmaceutical industry Fighting the coronavirus pandemic with Location-loyal medium-sized and large com- PHARMACEUTICAL INDUSTRY creativity and know-how panies 90 25.069 7,24 The coronavirus pandemic and the development of ap- The pharmaceutical industry in Baden-Württemberg is Companies Employees Billion euros turnover propriate vaccines and therapies against SARS-CoV-2 are loyal to its location. The number of companies based in the defining issues of 2020. The development of new the state has remained stable for many years and current- BIOTECHNOLOGIE drugs and vaccines usually takes 10 to 20 years. However, ly comprises 90 companies that research, develop and/ the Robert Koch Institute indicates that the first vaccines or manufacture here. In 2018, they achieved a taxable 184 18.589 4,19 against SARS-CoV-2 can be expected to be approved turnover of 7.24 billion euros with 25,069 employees sub- Companies Employees Billion euros turnover 11 in sufficient quantities as early as 2021 . The fully se- ject to social security contributions. The sector reinvests quenced genome of the novel coronavirus has been avail- more than 14 percent of its turnover in research and de- Mannheim/ able since mid-January 2020. Since then, collaborations velopment projects, making it the sector with the high- Heidelberg have developed across national borders, resulting in over est proportion of internal expenditure on research and 8 63 12 190 vaccine development projects . Pharmaceutical and development in relation to turnover13. Five pharmaceuti- Heilbronn/Franken medical biotechnology companies are responsible for the cal companies were founded in Baden-Württemberg be- 1 2 development of these therapies and vaccines. tween 2010 and 9/2020. These include ZentriForce Phar- ma Research GmbH in Heidelberg, which offers contract Karlsruhe In Baden-Württemberg, a large number of pharmaceu- research and analysis for the pharmaceutical industry tical and biotechnology companies and research insti- (founded 04/2019). 16 13 12 Aalen/Heidenheim tutes are working on new therapies and vaccines against 2 SARS-CoV-2, including CureVac AG, Atriva Therapeu- Today, due to the major hurdles involved in drug reg- 16 Stuttgart 4 3 tics GmbH and the start-up Prime Vector Technologies istration as well as the high capital expenditure, phar- GmbH. Companies in Baden-Württemberg, such as Pfiz- maceutical companies that combine production, regis- Pforzheim/ Freudenstadt er Manufacturing Deutschland GmbH in Freiburg and tration, marketing, research and development are rarely TEVA GmbH in Ulm, are also involved in securing the established. The biotechnology sector is proving to be an 5 29 supply of crisis-relevant drugs. innovative partner and provider of ideas here, contribut- Reutlingen/Tübingen 8 Ulm/Biberach 22 % 32 % 22 % 23 % Freiburg/ Tuttlingen/ Offenburg/ Villingen- 12 Lörrach Companies in the pharmaceutical industry in Baden-Württemberg in 2018 by employment size classes Schwenningen Konstanz/Oberschwaben 3 % 4 % 18 % 75 % 22 10 9 39 Turnover of the pharmaceutical industry in Baden-Württemberg in 2018 by employment size classes < 10 10 - 49 50 - 249 ≥ 250 20 | Healthcare industry 2020 Healthcare industry 2020 | 21
Tätigkeitsfelder Medical biotechnology Fields of activity of the pharmaceutical industry in lead to far fewer side effects. Pfizer’s Healthcare Hub was On course for growth with biotechnology coronavirus pandemic. Company founders are struggling Baden-Württemberg (campanies may have several fields of activty) founded in Freiburg in March 2018. In its search for digi- The attractiveness of the state is also shown by the fact with liquidity bottlenecks and the absence of financing Phytopharmaceuticals tal patient solutions, Pfizer’s Healthcare Hub seeks prox- that, in addition to pharmaceutical companies, a large rounds. The Baden-Württemberg Ministry of Economic Homeopathy imity to life sciences start-ups and spin-offs and focuses number of medical biotechnology companies enrich the Affairs, Labour and Housing has reacted to this situation Classical pharmaceuticals on flexible interaction models. Using simulation software overall offer in Baden-Württemberg. While the pharma- and is now promoting early-stage financing by expand- Contract research/development from the Karlsruhe-based start-up GoSilico GmbH, for ceutical industry provides implementation and produc- ing the Start-up BW Pre-Seed programme and through Contract production example, drugs can be brought to market faster and more tion process know-how, among other things, the mostly the newly established Start-up BW Pro-Tect support pro- Generic drugs cost-effectively because downstream (purification) pro- smaller, agile biotech companies or start-ups drive inno- gramme (chapter: Company Foundation and Financing, 0 10 20 30 cesses can be digitally simulated and scaled. vation in the sector. page 34)14. Percentage of companies by field of activity To survive against global competition, agile cooperation Baden-Württemberg is home to 184 medical/red biotech- The Mannheim/Heidelberg (29 start-ups since 2010), ing to a diversification of risk through complex financing and networks are valuable instruments for staying one nology companies that research, develop and/or manufac- Karlsruhe (15 start-ups since 2010) and Reutlingen/ models, cooperation and licensing agreements. step ahead of the competition. Baden-Württemberg offers ture here. In 2018, they generated a taxable turnover of Tübingen (13 start-ups since 2010) regions are particularly a large number of cooperation partners from industry and 4.19 billion euros with 18,589 employees subject to social strong as far as the foundation of new companies is con- In addition to a large number of owner-managed com- science. Research and technology parks and incubators security contributions. cerned. The Rhine-Neckar region plans the first Europe- panies and micro and small enterprises, Baden-Württem- also offer interesting concepts and space to set up offices an BioLabs life sciences start-up incubator in Heidelberg, berg is also home to a number of subsidiaries of mul- and research laboratories and to establish low-threshold Coronavirus start-up support and expansion a sign that it is planning to expand and secure this leading tinational corporations. The companies’ portfolios range contact between big pharma and start-ups. of start-up centres position in the future15. from generics to phytopharmaceuticals and homeopathic Over 78 medical biotechnology companies have been drugs, which enrich the traditional drug manufacturing founded in Baden-Württemberg since 2010. This rep- A leader in biopharmaceutical production market with valuable therapy options. resents 40 percent of all biotechnology companies in Germany is no. 1 in Europe and no. 2 behind the USA Baden-Württemberg. 17 companies were founded in the regarding the manufacture of biopharmaceuticals16. The Using the potential of new technologies period between 1/2018 and 9/2020. The fact that the num- region in the area around Laupheim, Ulm and Biber- and initiating agile cooperation ber of start-ups in the first half of 2020 is relatively low ach is particularly well known for developing and man- The development of new drugs is costly, lengthy and compared to previous years can be largely ascribed to the ufacturing biopharmaceuticals in Baden-Württemberg. high-risk. At the same time, the pharmaceutical market is highly regulated and global value chains are complex. 53 % 24 % 20 % 4% Although the challenges facing the pharmaceutical indus- try will continue to increase under the influence of glob- al developments, the possibilities are almost unlimited. Biotechnology companies in Baden-Württemberg in 2018 by employment size class Digitalisation continues to gain momentum, and access 1 %4 % 9 % 86 % to data from the real world, therefore the user world, can drive development ever more precisely towards tailored forms of therapy for sub-populations of patients that Turnover of biotechnology companies in Baden-Württemberg in 2018 by employment size class < 10 10 - 49 50 - 249 ≥ 250 22 | Healthcare industry 2020 Healthcare industry 2020 | 23
Tätigkeitsfelder Biotechnology companies founded in Baden-Württemberg between 1/2018 bis 9/2020 About half the turnover of biotechnology companies in Fields of activity of biotechnology companies in Baden-Württemberg (companies may have several Company Location Field of activity Baden-Württemberg is generated here. Boehringer In- fields of activity) gelheim is currently investing 230 million euros in the analytics Aquarray GmbH Eggenstein-Leopoldshafen Analytics construction of a new development centre in Biberach to consumables and devices AVA Therapeutics GmbH Denzlingen Therapeutics meet the growing demand for biopharmaceuticals. This therapeutics candidum GmbH Stuttgart Bioinformatics, service Biologicals Development Centre is scheduled for com- contract research/-development custom production 2018 pletion at the end of 2020. Rentschler Biopharma SE and CeCaVa GmbH & Co. KG Tübingen Therapeutics bioinformatics Vetter Pharma-Fertigung GmbH & Co. KG announced a Navitect Bio GmbH Heidelberg Diagnostics, service strategic cooperation in a press release in July 2020 aimed 0 10 20 30 40 Percentage of companies by at making new therapies available to patients even faster pantaBio AG Stuttgart Software field of activity in future (chapter: Pharmaceutical Industry, page 30/31). PixelBiotech GmbH Schriesheim Analytics, service Rentschler Biopharma SE is also involved in producing a The development of new therapies is risky and very cost- potential coronavirus vaccine . 17 ly. Many previously promising developments fail in later AaviGen GmbH Heidelberg Therapeutics phases of development and consume a great deal of re- Contract research and development, ARAXA Biosciences GmbH Heidelberg The industry’s expertise must continue to focus on new sources. Translational medicine, i.e. the early translation therapeutics technologies and developing new and innovative forms of research results into clinical practice, will help to pre- AUCTEQ Biosystems GmbH Mannheim Consumables and devices of therapy, while production processes must be mapped vent this from happening. Medical biotechnology, which Intavis Peptide Services GmbH & Co. KG Tübingen Contract production, service 2019 safely, smartly and effectively. In the field of gene and is dependent on external funding, stands to benefit from cell therapies, Sartorius Stedim Cellca GmbH has already the intensive exchange between clinics and research and Klar2O GmbH Bruchsal Analytics, therapeutics commissioned and invested 30 million euros in a new of- the early translation of research results into therapy op- n.able GmbH Eggenstein-Leopoldshafen Analytics, devices fice and laboratory building with over 100 employees in tions. the Ulm Science Park. CellGenix GmbH announced the Opto Biolabs UG Freiburg im Breisgau Consumables and devices expansion of its production facilities in October 2020 in The Tübingen-based biotech companies CureVac AG Prime Vector Technologies GmbH Tübingen Therapeutics Gründungen response to steadily increasing demand for materials for and Immatics Biotechnologies GmbH were founded in Axxelera UG Karlsruhe Bioinformatics gene and cell therapies. 2000 as spin-offs from the Department of Immunology 2020 at the University of Tübingen under the leadership of Fast Forward Discoveries GmbH Mannheim Consumables and devices Foundation of biotechnology companies in Prof. H.-G. Rammensee. Translational immunology is at Baden-Württemberg between 2010 and 2019 the centre of his research. Both companies made a re- 14 markable start on the Nasdaq technology stock exchange 12 - Immatics in July 2020 and CureVac in August 2020. 10 number of companies 8 6 4 2 0 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 24 | Healthcare industry 2020 Healthcare industry 2020 | 25
Selected investments, acquisitions, cooperation and licensing agreements as well as stock market launches of biotechnology companies in Baden-Württemberg between 1/2018 and 9/2020 Investments Company Location Field of activity Type of financing Investment volume Investors Meneldor, High-Tech Gründerfonds and Atriva Therapeutics GmbH Tübingen Antiviral therapy Series A financing EUR 1.25 million company founders High-Tech Gründerfonds and two private Cytena GmbH Freiburg im Breisgau Cell separation systems Series A financing EUR 3 million investors 2019 Heidelberg Pharma AG Ladenburg Cancer therapy Milestone payment Link Health Co. Individual simulation solutions for HQS Quantum Simulations High-Tech Gründerfonds, Unternehmertum Karlsruhe conventional computers and quantum Seed financing EU 2.3 million GmbH Venture Capital Partners und btov Partners computers Development and production of Federal Republic of Germany by way of CureVac AG Tübingen Growth financing EUR 300 million mRNA-based vaccines KfW Development and production of European Investment Bank and European CureVac AG Tübingen Loan EUR 75 million mRNA-based vaccines Commission 2020 Development and production of Qatar Investment Authority (QIA) and other CureVac AG Tübingen Private financing round USD 126 million mRNA-based vaccines investors Boehringer Ingelheim Venture Fund HepaRegeniX GmbH Tübingen Liver disease therapy Series B financing EUR 11 million GmbH, Novo Holdings A/S, High-Tech Gründerfonds, Coparion and Ascenion Acquisitions Company Location Field of activity Buyer Value 2018 Dispendix GmbH Stuttgart Liquid handling systems CELLINK AB, Gothenborg, Sweden EUR 5 million 2019 cytena GmbH Freiburg im Breisgau Cell separation systems BioCopy GmbH, Freiburg im Breisgau EUR 30.25 million Biametrics GmbH Tübingen Label-free biosensor technology BioCopy GmbH, Freiburg im Breisgau - 2020 Immatics Biotechnologies Fusion: Arya Sciences Acquisition Corp. (Houston) with Immatics Tübingen Cancer immunotherapies - GmbH Biotechnologies and name change to Immatics N.V. Cooperations and licensing agreements Company Location Partner company Category Financing amount Genentech Inc., San Francisco, California, Affimed will use its ROCK platform in order to discover interesting Affimed GmbH Heidelberg In total USD 5 billion USA immunotherapics for Genentech/Roche Expedeon AG Quanterix Corporation, Lexington, Heidelberg Supply and licensing agreement for proprietary immunoassay technology (früher: SYGNIS AG) Massachussets, USA 2018 Heidelberg Pharma Heidelberg Magenta Therapeutics, Cambridge, USA Resarch agreement for the development of antibody drug candidates USD max. 334 million Research GmbH Immatics Biotechnologies Research and licensing partnership for the development of new next- Tübingen Genmab A/S, Copenhagen, Denmark USD max. 3 billion GmbH generation cancer immunotherapies 26 | Healthcare industry 2020 Healthcare industry 2020 | 27
Cooperation and licensing agreements Company Location Partner company Category Financing amount Immatics Biotechnologies Celgene Corporation, Summit, New Jersey, Tübingen Strategic cooperation Approximately EUR 1.45 billion GmbH USA Heidelberg Pharma Research Heidelberg Magenta Therapeutics, Cambridge, USA Development and marketing rights USD 34 million GmbH Heidelberg Pharma Research Ladenburg Emergence Therapeutics AG, Duisburg Licensing and development agreement - GmbH Schepens Eye Research Institute of 2019 CureVac AG Tübingen Massachusetts of the Harvard Medical Exclusive research cooperation - School, Boston, USA Coalition for Epidemic Preparedness CureVac AG Tübingen Partnership agreement USD 34 million Innovations Yale University, New Haven, Connecticut, CureVac AG Tübingen Research cooperation - USA CureVac AG Tübingen Genmab A/S, Copenhagen, Denmark Strategic development partnership - Coalition for Epidemic Preparedness CEPI provides CureVac with funds for the development of a vaccine CureVac AG Tübingen Up to USD 8.3 million Innovations (CEPI), Oslo against coronavirus nCoV-2019 GSK makes equity investment of EUR 150 GlaxoSmithKline (GSK), Brentford, CureVac AG Tübingen Strategic cooperation agreement million in CureVac and one-off payment of Middlesex, UK EUR 120 million 2020 Immatics Biotechnologies Strategic collaboration to develop T-cell therapeutics for the treatment of EUR 45 million (possibly further milestone Tübingen GlaxoSmithKline, Brentford, Middlesex, UK GmbH solid tumours payments) Rentschler Biopharma SE Laupheim (und Milford, USA) Genmab A/S, Copenhagen, Denmark Strategic cooperation - Velabs Therapeutics GmbH Heidelberg Alytas Therapeutics, Jena Licensing agreement - Stock market launch Company CureVac AG 2020 Immatics N.V. 28 | Healthcare industry 2020 Healthcare industry 2020 | 29
Dr. Frank Mathias, CEO Rentschler Biopharma SE Strategic Collaboration between Peter Sölkner, Managing Director Vetter Rentschler Biopharma and Vetter Pharma-Fertigung GmbH & Co. KG Doing it the Swabian way: drug production. The resulting trust is extremely valuable mized workflows for a more efficient “time-to-market”. Under “normal” circumstances it is easy to overlook the joining forces to bring novel therapies to when it comes to their alliance, and the close proximity of Rentschler Biopharma and Vetter are proud to break new larger context of one’s actions. The pandemic has made patients faster our company headquarters, in Baden-Wuerttemberg, is a ground in Baden-Wuerttemberg with this alliance and are our industry all the more significant and shown what it major contributing factor. Our corporate cultures are simi- seeking to help turn the region into a global healthcare can contribute to people’s well-being. Fast and safe access The COVID-19 pandemic has caused setbacks for most lar, we have similar roots and we speak the same language. hub and create attractive opportunities for companies, to essential vaccines and medicines is a goal that can be global industries. With one major exception: the phar- employees and entrepreneurs. achieved through cooperation and alliances. maceutical industry. The industry has rarely been more Equally important is the fact that Baden-Wuerttemberg active in the development of vaccines and therapeutic is increasingly establishing itself as a central, internation- Optimised product path drugs. New collaborations, fundraising and IPOs, clinical al hub for biopharmaceutical development and produc- The biopharmaceutical market is developing rapidly with trials and regulatory approvals have happened at an un- tion through other world-class companies. In addition, the emergence of new, highly innovative therapies for a precedented pace - all with the aim of ensuring the fastest renowned universities such as Heidelberg, Tubingen and wide range of indications. To meet the dynamic demands possible public access to vaccines and medication. Ulm, as well as a whole range of small- and medium-sized of the market, we rely on collaboration with other com- biotech companies, are generating exciting therapies for panies that complement our core competencies. Forming Even before the COVID-19 pandemic, Rentschler Bio- the future along with excellent employment opportuni- technology alliances and integrating the skills of other pharma and Vetter, both headquartered in the heart of ties for skilled professionals. Another decisive factor is a specialists into our business processes is an important Baden-Wuerttemberg, foresaw the need to accelerate the good mix of auditors, lawyers, architects and engineers part of our global strategy. production of new therapeutics. Our two companies took with experience and expertise in this sector and the ac- action and entered into a strategic collaboration, aimed tive presence of BIOPRO Baden-Wuerttemberg GmbH. Both Rentschler Biopharma and Vetter are committed to at reducing complexity along the biopharmaceutical value The Baden-Wuerttemberg region is very well positioned long-term and sustainable value creation. It is part of our chain. The desired goal of the collaboration is to support to promote an environment for highly specialized biop- culture to see clients as partners and to see our services as our clients by aligning manufacturing approaches - from harmaceutical manufacturing in the heart of Europe. an extension of our clients’ activities. We consult our cli- the first steps in biopharmaceutical drug production to ents right from the early stages of new drug development the aseptic filling and packaging for market distribution. Joining forces and enter into strategic alliances to ensure the best offer- Both our companies have a long history of success in our The COVID-19 pandemic has underlined the urgent ings and processes for our clients. This flexibility enables respective fields. We are now leveraging this experience to need to reduce drug manufacturing time. This requires us to adapt optimally to the needs of the market. create long-term added value for our clients by optimizing even closer coordination between Rentschler Biopharma’s process development, product manufacturing and supply manufacturing of complex drug substances, and Vetter’s Last year, nobody would have imagined that the world chains, that enable our clients to bring their products to aseptic filling and packaging of drugs. The basis of our today would face unprecedented challenges due to the Information and contact patients more easily and faster. collaborative work will therefore be the development of COVID-19 pandemic. Companies must be open to col- Rentschler Biopharma SE new complementary processes from these two areas of bi- laboration if they are to emerge unscathed or indeed E-Mail: info@rentschler-biopharma.com An important hub opharmaceutical contract manufacturing, that will in turn stronger from these very different conditions and be able www.rentschler-biopharma.com Over the past decades, Vetter and Rentschler Biopharma, accelerate the overall process. to meet the needs of doctors and patients. Beyond this, both of which are family-run companies, have maintained regional cooperation can also contribute to a dynamic, ro- Vetter Pharma-Fertigung GmbH & Co. KG a good relationship based on mutual respect. We often By combining our strengths in a strategic collaboration, bust environment for the biotech sector in Baden-Wuert- E-Mail: info@vetter-pharma.com work with the same clients, albeit on different aspects of we can offer clients a manufacturing chain with opti- temberg. www.vetter-pharma.com 30 | Healthcare industry 2020 Healthcare industry 2020 | 31
Research in Baden-Württemberg Prof. Dr. Oliver G. Opitz, Head of the Coordination Center for Telemedicine Baden-Württemberg Translation in Medicine The Healthcare Industry in Baden-Württemberg is en- lishing NCT-Südwest in September 2020, as part of the Unfortunately, the terms innovation and translation are “sandbox” implementation in the form of living labs and riched by a diverse and effective academic research German Federal Ministry of Education and Research’s often misused, not only in medicine. Innovation de- testbeds is needed. The cost-benefit assessment is often landscape. Healthcare research is carried out at eight 18 National Decade against Cancer . Baden-Württemberg is scribes the placement of new technologies on the mar- completely overlooked. Why, for example, should a hos- universities, 15 universities of applied sciences, 21 represented in the German Consortium for Translation- ket, thus rendering them available to the general public. pital CEO make advance payments for investment costs non-university research institutions and five university al Cancer Research (DKTK) in three ways: by the focus Too often, however, innovation is used to describe ei- that will only allow him to make savings through new hospitals. Baden-Württemberg is also well positioned in on cancer immunotherapy in Tübingen, the epigenetics ther ideation (the generation of ideas) or testing. The (digital) processes years later? This is why many innova- the field of top-level translational - patient-related - re- expertise in Freiburg and the German Cancer Research same applies to translation, the process of implementa- tions - or rather ideas - from academia and start-ups in search. In addition to the National Centre for Tumour Center (DKFZ) in Heidelberg. The aim of the DKTK tion starting from ideation. However, many - if not most the healthcare sector are difficult to “sell”. And yet, the Diseases (NCT) in Heidelberg, a consortium of the Uni- is to strengthen translational cancer research in the long - new ideas never go beyond the pilot phase to reach healthcare sector is currently facing immense challenges: versity Hospitals in Ulm and Tübingen and the Robert term. the open market, i.e. the healthcare system. The term shortage of expert medical staff is an increasing problem, Bosch Hospital in Stuttgart was granted funds for estab- translation is therefore often used for preliminary stages the demographic change is exacerbating the problem for such as minimally viable products or clinical trials. The both healthcare providers and patients, and the num- indicator should rather be the sustainable rate of pilot ber of complex chronic conditions is constantly raising, Mannheim projects that make it into the market. making medical treatment more expensive. Here, trans- University lational catalysts can help to overcome barriers and gaps Heidelberg University of Applied Sciences The translation process - in the sense of implementation to improve the efficiency of the value chain. This means University Hospital - consists of at least four essential steps of a translational promoting new processes and health care solutions using Heilbronn Non-university research institution value chain: (1) demand, (2) novelty value, (3) stakehold- digitization in the healthcare system, explicitly from pre- Karlsruhe er involvement and (4) cost-benefit assessment. But why vention and healthcare in the regional context to special- Pforzheim do so few health innovations reach the public? Why are ised applications in academic medicine. they so rarely implemented on the market? In most cases, Stuttgart Aalen the value chain breaks off too early and is not geared to Esslingen Denkendorf needs. The implementation process is complex, various Nürtingen stakeholders are involved and the framework constantly Tübingen changes. The healthcare market is not a standard mar- Reutlingen Ulm Offenburg ket, and innovations that would introduce system-wide Albstadt- time- and cost savings are difficult to implement, as costs Sigmaringen and benefits do not occur at the same time or the same place. In addition, stakeholders as framework conditions Furtwangen Villingen- are changing with increased digitization. Freiburg Schwenningen Biberach Steps (3) and (4) are often considered too late, too lit- Information and contact tle or not at all, despite being critical to success. Stake- Telemedicine Coordination Office Baden-Württemberg Ravensburg Konstanz Weingarten holder involvement often works on a random basis or is E-mail: info@telemedbw.de based on existing cooperations. Here a flexible and open www.telemedbw.de 32 | Healthcare industry 2020 Healthcare industry 2020 | 33
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