The Netherlands Europe's most attractive and innovative biopharmaceutical industry environment - Health Holland
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The Netherlands Europe’s most attractive and innovative biopharmaceutical industry environment
2
TABLE OF CONTENTS
Foreword 5 3 BIOPHARMACEUTICAL SECTOR 53
Vibrant and booming Life Sciences & Health sector 55
Management Summary
Attractive biopharmaceutical sector 61
1 THE NETHERLANDS 9
Employment
Turnover and investments
63
64
Strategic location 12 Export and import 65
Superior infrastructure 13 Biotechnology companies in the Netherlands 66
Living in the Netherlands 17 Mergers and deals 69
Competitive economy 27 Medicine development 71
Entrepreneurial spirit 29 Intellectual property – protection of new ideas 72 3
Thriving sectors 30 Clinical trials 74
2
Digitalisation in healthcare 76
INDUSTRY CLIMATE 35 Public-private partnerships 77
International business climate 36
References 80
Competitive fiscal climate 37
Supportive R&D incentives 39
Colophon 86
Innovation-oriented schemes 40
Sustainability-oriented schemes 41
Further financial support 42
Human capital 45
4
FOREWORD
Welcome to the Netherlands, the new home of the European Medicines Agency!
World-class research institutes, a highly educated workforce, are already conducting their R&D activities
in the Netherlands. Others, including
an excellent healthcare system, and an innovation-friendly
Amgen, Teva and MSD are taking advantage
government, combined with a central location make the of our strategic location for their
distribution activities. The Netherlands is
Netherlands the ultimate R&D innovation hub in Europe and
also home to many promising start-ups and
the ideal base for your biopharmaceutical operations. scale-ups such as Galapagos, Genmab,
Pharming and uniQure.
At the Ministry of Economic Affairs and Climate Policy, we are proud of
the Netherlands’ spirit of innovation and enterprise and we work hard to The relocation of EMA to Amsterdam
strengthen our international competitive position while striving for in March 2019 will give a boost to the 5
sustainability. The Top Sector Life Sciences and Health is one of the priority biopharmaceutical sector and put the
sectors in which the Ministry actively participates to create an attractive Netherlands firmly on the map
business climate, foster R&D collaboration and provides optimum internationally. At the same time it will create huge opportunities for
conditions for businesses to innovate and grow. biopharmaceutical companies and service providers. The Ministry has
joined forces with other organisations in PharmInvestHolland, to strengthen
Innovation, entrepreneurship and partnership are second nature to the the Dutch biopharmaceutical sector and create the most attractive and
Dutch. It is connected to our centuries-old battle against the water – a way innovative biopharmaceutical industry environment in Europe.
of life that has produced innovative and smart solutions, like our famous
dikes, as well as a cooperative mindset. I am pleased to present this bid book, illustrating all that the Netherlands
can offer your company. I hope it will lead you to consider the Netherlands
Our country is one of the main gateways to Europe. Thanks to our first-rate as a base for your pharmaceutical operations.
infrastructure, we offer excellent and efficient connections to Europe's
500 million consumers. Our world-class airport, top-ranked maritime ports Yours sincerely,
and high-speed road, rail and broadband networks are second to none.
We’re especially proud of the pharmaceutical sector, which plays an
important role in our economy and acts as a breeding ground for new talent. Eric Wiebes
Leading pharmaceutical companies like Janssen, AstraZeneca and Synthon Minister of Economic Affairs and Climate Policy
MANAGEMENT SUMMARY
Discover Europe’s most attractive and innovative biopharmaceutical industry environment.
With an unrivalled concentration of biopharmaceutical Appealing industry climate
companies, world-class universities and a long history of The Netherlands has an appealing business climate with plenty of room for
strategic partnerships between science, industry and innovation. It has a competitive and stable tax regime, attractive incentives
government, the Netherlands is a perfect location for that support R&D, and outstanding research and education institutions.
biopharmaceutical innovation in Europe. Many ground-breaking In addition, the country is highly regarded for its well-educated, multilingual
companies have already established themselves in the and dynamic workforce.
Netherlands. The EMA will soon follow in their footsteps and
relocate to Amsterdam. This confirms once more that the Most concentrated biopharmaceutical ecosystem
Netherlands is the perfect home for biopharmaceutical The Netherlands is home to one of the most concentrated Life Science &
companies all around the globe. Health clusters in the world. It has over 2,900 innovative R&D Life sciences
6 companies, including 420 biopharmaceutical companies. These 420
Attractive location for your company companies employ over 65,000 people. Scientific research in the Netherlands
The Netherlands is a thriving and prosperous country, providing an attractive is internationally ranked as one of the best. This is demonstrated by the high
place to live and locate your company. With a radius of only 120 miles, the quality of Dutch research universities and university medical centres, its high
country has a competitive international business climate which is reflected citation impact score and the position of its universities in international
by its status as the sixth largest EU economy, a major global exporter and rankings. The country has a rich tradition of public-private cooperation, which
importer of goods and a Forbes ranking as the third best country for doing has been further stimulated by multiple government-initiated programs.
business. The government actively stimulates private cash investments in public-private
R&D partnerships by topping up these investments.
The strategic location of the Netherlands, situated between the three largest
economies in Europe (Germany, the United Kingdom and France), makes the Most innovative biopharmaceutical environment
country the perfect gateway to Europe. Its superior infrastructure guarantees Public and private partners in the Dutch biopharmaceutical sector have joined
quick and easy access to European markets while ensuring that markets forces with the ambition of becoming the world’s most attractive and
around the world are within efficient reach. In addition, the country is a data innovative biopharmaceutical country. We are dedicated to further improving
& ICT hub with an excellent information technology infrastructure. And its our excellent R&D climate that will benefit patients. Together we can make this
ranking as the sixth happiest place on earth in the World Happiness Report ambition become a reality, so come join us to further strengthen the sector!
further demonstrates that the Netherlands is an attractive place to live.
Read all about the advantages of setting up your business in the
Netherlands in this bidbook.
7
8
9 THE NETHERLANDS
About the
Netherlands
Official name:
Kingdom of the Netherlands
Form of government:
A constitutional monarchy and a
parliamentary democracy
Head of state:
His Majesty King Willem-Alexander, King of
the Netherlands, Prince of Orange-Nassau
Capital:
Amsterdam
Seat of government:
10 The Hague
Surface area:
33,800 km2
Location:
In Western Europe, bordering the North Sea
to the west, Belgium to the south and
Germany to the east
Number of inhabitants:
17,200,126 (February 2018)
Number of inhabitants per km2:
509 (February 2018)
Monetary unit:
Euro
Languages:
Dutch, Frisian
Source: Holland Compared, 2017THE NETHERLANDS
With its strategic location, highly educated multilingual workforce, top notch
healthcare system and excellent international business climate, the Netherlands
is one of the world’s best locations for foreign companies. What is more,
compared to most European countries, the Netherlands always ranks very
high in matters such as happiness, health, quality of life and freedom.
Located in the heart of Europe, the Netherlands expats alike enjoy the country’s rich diversity of
The Netherlands
11
United
borders with Belgium and Germany. While culture, entertainment, sports and other Kingdom
generally known for its tulips, bicycles and activities. Germany
windmills, the country has plenty more to
recommend it! Its international focus facilitates easy access to
Europe, providing international organisations
The Netherlands is a wealthy, flourishing and companies with opportunities to succeed
France
country and is one of the founding European throughout the region. Its location at the centre
Union member states. It receives high scores for of Europe’s three largest economies (Germany,
safety, stability and social responsibility thanks the United Kingdom and France) means the
to its first-rate educational system, excellent Netherlands is not only attractive and stable but
healthcare, multi-skilled multilingual workforce also highly accessible. Its business infrastructure
and high market efficiency. The Netherlands’ ranks among the best internationally.
multicultural population enjoys an affordable,
high standard of living. Its urban centres, where In short, the Netherlands is an ideal environment
most people get around by bike, maintain an for international companies and organisations
appealing community feel. Meanwhile, the wishing to solidly position themselves in a variety
Dutch countryside is rarely far from office of sectors, from research and development to
complexes and metropolitan areas. Locals and marketing and sales, technology and logistics.Strategic Location
The Netherlands is a first-rate, strategic location the European Economic Area. In other words,
for international businesses whose activities it monitors a market that serves more than
expand into Europe and other areas of the world. 500 million EU residents.
Known for its favourable location, this compact
country guarantees quick and easy access to the The EMA is forced to relocate to the
European market. In fact, 95% of Europe’s most Netherlands because of the Brexit. The
lucrative consumer markets are located within relocation will boost the attractive Dutch
24 hours of Amsterdam and Rotterdam. pharmaceutical sector even further. Not only
will it put the Netherlands in the spotlight, it
The Netherlands is also considered a strategic will also offer huge opportunities to attract
hub for distribution within Europe, thanks to its new biopharmaceutical companies and
12 location and highly ranked airports (including
Amsterdam Schiphol) and seaports (e.g.
service providers to the Netherlands. The
Dutch government expects that with the
Norway
Rotterdam). It boasts the greatest number of arrival of the EMA in Amsterdam, the
1,000 km
distribution centres and the largest inland pharmaceutical industry and service sector
shipping fleet in Europe. In addition, the will create thousands of new jobs. Moreover,
Netherlands is one of the most wired countries specialised lawyers, patent experts and Denmark Sweden
in the world where 98% of all households have consultants will also relocate to Amsterdam 500 km
access to the Internet. in order to be close to the EMA. Insiders
The Netherlands
expect that the Dutch medicines research
European Medicines Agency industry will also receive a significant boost. Ireland United
Kingdom Poland
Amsterdam will host the European Medicines
Germany
Agency (EMA) from March 2019. The EMA, a Belgium
Luxembourg
decentralised agency of the European Union
(EU), ensures the safety, effectiveness and high
Austria
quality of all medicines available on the EU France
Switzerland
market. It will relocate from London.
The EMA assesses, supervises and monitors the Italy
scientific development of medicines in the EU
and protects human and animal health in
28 EU Member States and the countries of
SpainSuperior infrastructure
The Netherlands ranks second in the world Airports
for overall logistics performance, thanks in Alongside Amsterdam’s award-winning
part to its top-ranking seaports and airports, Schiphol Airport, the Netherlands has four
a comprehensive network of railways and regional airports offering international flights,
motorways as well as the second highest making it one of the world’s top air transport
quality broadband network in Europe. infrastructures. Schiphol, which has been voted
the “Best Airport in Europe” for 25 consecutive
The country tops DHL’s Global Connectedness years by the Business Traveller Awards, is also
Index due to its strategic location and Europe’s top airport for cargo and passenger
international, business-orientated focus. transport. The airport is just 90 minutes from
Indeed, half of the Netherlands’ Gross Domestic all major Dutch cities via the country’s
Product (GDP) is derived internationally. It is no
wonder the country is so attractive to global
compact, state-of-the-art network of
motorways and secondary roads. The regional 13
companies wishing to reach millions of Maastricht-Aachen Airport is considered the
customers in Europe and beyond. fastest air cargo handler in Europe. Maastricht-
Aachen airport is located in the tri-border
region with Germany and Belgium. After an
aircraft has landed, it takes only 45 minutes to
unload the aircraft and get the first trucks on
their way to some of the most concentrated
industrial and population centres of Europe.
The Netherlands’ strategic location and
world-class airports, give businesses a major
advantage in serving millions of consumers
throughout Europe, the Middle East and Africa.Ports
Dutch ports handle 54% of all trade shipping in
Western Europe, transporting over 500 million
metric tonnes annually. The country’s port
infrastructure receives top ranking globally.
Home to three deep-water ports, thousands of
kilometres of rivers and a sophisticated network
of canals, cargo from the Port of Rotterdam –
Europe’s largest and most important harbour –
can reach Western Europe’s major industrial and
economic centres in less than a day. This gives
companies unparalleled access to the European
market. The Port of Amsterdam (fourth largest
14 in Europe) offers additional logistics and
distribution benefits. Furthermore, the ports of
Groningen and Zeeland serve the north and
south of the country.
Port of RotterdamThe Netherlands: a key hub EU-28 households with internet access at home
for distribution in Europe Netherlands
Denmark
Luxembourg
98%
Sweden
United Kingdom
Finland
Germany
Digital hub Road & Rail
Austria
The digital infrastructure in the Netherlands is Companies looking to locate logistics and
Estonia
among the best in Europe. Amsterdam hosts one distribution operations in Europe naturally
Ireland
of the four key data centre hot spots in Europe: consider the Netherlands, given its
EU-28
AMS-IX, which is the biggest internet exchange comprehensive, state-of-the-art network of
France
point in the world. In recent years, AMS-IX has roadways. The country has over 14,000 km
15
Belgium
turned Amsterdam into a digital hub. In addition, (8,600 miles) of roads, including 2,235 km
Malta
the Dutch LTE mobile internet broadband scores (1,389 miles) of highspeed motorways, and
Spain
highest with regard to coverage and fourth in more than 12,000 transport companies.
Czech Republic
speed on a European level. With the Netherlands handling 14% of
Hungary
Europe’s international road transport, it forms
Poland
The Netherlands also has one of the highest a European hub for international road freight
Slovenia
penetrations of wired household broadband transportation.
Slovakia
connections in the world: 98% of all households.
Italy
It ranks fifth among 25 European countries. The The country’s rail system boasts 3,200 km
Cyprus
average broadband speeds in the Netherlands (2,000 miles) of network rail, directly linked to
Latvia
are among the world’s fastest and it is also one of inland container terminals and destinations
Portugal
the most cyber-secure countries. It also directly throughout the EU, Scandinavia and the Middle
Romania
links continental Europe to North America. East. The Netherlands also has three high-
Croatia
Eleven of the fifteen transatlantic cables run speed rail lines as well as the Betuweroute, a
Lithuania
directly across the Netherlands. What’s more is dedicated doubletrack freight railway from
Greece
that, its ultra-modern, fully digital, advanced Rotterdam to Germany. This gives businesses
Bulgaria
fibre-optic network serves a multitude of quick, direct access to Europe’s major logistics
0 10 20 30 40 50 60 70 80 90 100%
start-ups, data centres and multinationals, such centres.
2017 2015
as Microsoft, IBM, Google, Cisco and Oracle.
Source: Statistics Netherlands, 2018CHAPTER 1: THE NETHERLANDS 16
Living in the Netherlands Quality of life (2015)
9.73
The Netherlands is known as a great place to The Netherlands ranks in the top 10 for quality
9.57
9.51
9.38
9.36
9.31
live. With excellent housing facilities, a rich of life and housing is relatively affordable
9.24
9.25
9.21
9.17
culture life, and an outstanding health care according to IMD. For international residents,
system, the Dutch are among the most there are several international schools as well
happiest people in the world. as increasing numbers of schools that teach
in both Dutch and English (130 in 2015).
Appealing place to live The Commonwealth Fund ranks Dutch
The Netherlands is a very appealing place not healthcare as the best in the world as regards
only to visit and do business, but also to live in. quality, access, efficiency, funding and healthy
It features a wide array of conveniently located lifestyle of the general population. And in
leisure and cultural activities and its historical 2017, the Swedish think-thank Health
cities are an architectural delight. Its many Consumer Powerhouse rated the Dutch
17
New Zealand
Netherlands
Switzerland
museums include the famous Van Gogh healthcare system as ‘outstanding’ (#1)
Denmark
Germany
Australia
Norway
Sweden
Canada
Austria
Museum and the Rijksmuseum in Amsterdam. among its European peers.
1 2 3 4 5 6 7 8 9 10
Source: IMD,2016Human Development Index (2015)
0.944
0.935
The Netherlands is ranked the fifth most the Netherlands took sixth place in the World
0.930 prosperous country out of 188 listed in the Happiness report’s ranking of happiness, based
0.923
0.922
United Nations Development Programme on factors such as caring, generosity, health and
0.916
0.916
0.915
(UNDP) Human Development Index. Alongside freedom. Compared to most major European
0.913
0.913
GDP, UNDP considers other factors in countries, the country has a lower cost of living
determining ‘prosperity’, such as life expectancy, while still maintaining a high standard.
literacy levels and public health. In addition,
United States
New Zealand
Netherlands
Switzerland
Denmark
Germany
Australia
Norway
Canada
Ireland
1 2 3 4 5 6 7 8 9 10
18 Source: United Nations Development Programme, 2015
Ranking of Hapiness 2014-2016
1 Norway (7,537) Explained by: GDP per capita
2 Denmark (7,522) Explained by: social support
3 Iceland (7,504) Explained by: healthy life expectancy
4 Switzerland (7,494) Explained by: freedom to make life choices
5 Finland (7,469) Explained by: generosity
6 Netherlands (7,377) Explained by: perceptions of corruption
7 Canada (7,316) Dystopia (1.85) + residual
8 New Zealand (7,314) 95% confidence interval
9 Australia (7,284)
10 Sweden (7,284)
0 1 2 3 4 5 6 7 8
Source: World Happiness Report 201719
Global Access to Healthcare Index
Score out of 10
Healthcare in the Netherlands Since 2005, the Netherlands is the only country
9.1
9.0
9.0
8.8
8.8
8.6
8.5
8.4
8.4
8.3
8.3
One of the good things about living in the to consistently hold a top-three ranking.
Netherlands is its first-rate standard of The country also ranks number one on the
healthcare. The Dutch healthcare system is Economist Intelligence Unit’s Global Access to
based on the principles: access to care for all, Healthcare Index, which measures countries
a compulsory medical insurance and high- worldwide on accessibility of healthcare and
quality healthcare services. Indeed, it ranks the overall healthcare system. Not only is
first on the list of 35 countries in the 2017 healthcare in the Netherlands highly ranked
United Kingdom
Euro Health Consumer Index, which is and accessible, but also affordable. Health
United States
Netherlands
considered the industry standard, for providing spending grew by an annual average of only 1%
Germany
Australia
Canada
France
Japan
Spain the best healthcare services. from 2009-2016, according to the OECD.
Cuba
Italy
1 2 2 4 4 6 7 8 8 10 10
20 Source: The Economist Intelligence Unit, Global Access to
Healthcare Index
EHCI 2017 total scores
924
898
864
850
850
846
830
836
832
816
825
807
749
747
735
726
726
695
691
673
673
649
642
630
623
620
596
587
584
584
574
569
548
439
0
United Kingdom
FYR Macedonia
Czech Republic
Netherlands
Montenegro
Luxembourg
Switzerland
Denmark
Lithuania
Germany
Romania
Hungary
Portugal
Slovenia
Bulgaria
Slovakia
Belgium
Norway
Sweden
Albania
Croatia
Estonia
Finland
Austria
Iceland
Greece
Cyprus
Ireland
Poland
France
Serbia
Latvia
Malta
Spain
Italy
Source: Euro Health Consumer Index 2017Greece 5.4
-5.0
Portugal 2.2
-1.3
2003-2009
Italy 1.6
-0.3
Ireland 6.9
0.1
Czech Republic 4.9
2009-2016
0.1
Spain 3.4
Source: OECD Health Statistics 2017
0.3
Denmark 3.4
0.3
New Zealand 4.5
0.6
Slovenia 3.2
0.7
France 1.6
0.9
United Kingdom 3.9
0.9
Sweden 1.8
0.9
Luxembourg 1.8
0.9
Austria 2.1
1.0
Finland 3.4
1.0
Netherlands 3.2
1.0
Belgium 2.7
1.0
Iceland 0.4
1.0
Canada 3.1
1.1
Mexico 1.3
1.1
OECS35 3.6
1.4
Turkey 4.6
1.7
Japan 2.9
1.8
Germany 2.2
1.8
Norway 2.1
1.8
Slovak Republic 12.2
1.9
Annual average growth rate in per capita health expenditure, real terms, 2003 to 2016 (or nearest year) in %
United States 2.5
2.1
Israel 2.3
2.2
Latvia 6.5
2.4
Hungary -0.4
2.7
Australia 2.7
2.7
Switzerland 1.4
2.8
Poland 6.6
3.1
Estonia 5.6
3.6
Korea 8.5
5.7
Chile 5.5
5.9
21Dutch healthcare system The same applies to the Dutch Life Sciences & Although, the Dutch healthcare system is
The success of the healthcare system in the Health sector, which is characterised by essentially a private system, the government
Netherlands is driven by the tenets of access to collaboration and knowledge-sharing among maintains a controlling role in the system to
care for everyone, solidarity through compulsory companies and research institutions, with full protect the public interest. The overhaul has
medical insurance and high-quality services. government support. Dutch healthcare led to various improvements that benefit
The fact that the country is given top rankings products and services related to medical patients, including more focus on effectiveness
for healthcare is partly due to this philosophy equipment, remote care and other areas are and quality, partly through selective
of cooperation and spirit of joint effort. equally innovative, providing comprehensive contracting. In addition, waiting lists now are
‘smart solutions’. The Dutch model, which leads shorter and red tape has been reduced.
to affordable and sustainable products and Patients have the freedom to switch healthcare
solutions, reflects its highly inter-disciplinary insurers each year and can influence the
approach and resulting expertise throughout policies of insurers and health providers.
Private individual/
Private individual/
Insured person
the healthcare chain.
22 Insured person
The healthcare system currently in place in the
Netherlands is the result of various changes in
recent years, which took the supply-driven
system and made it demand-driven. The new
Health Insurance Act, which entitles all Dutch
residents to a comprehensive basic health
insurance package, went into effect in 2006.
This means that all legal residents are required
to take out health insurance from among the
24 competitive private (mainly non-profit)
health insurers. The package includes essential
medical care and residents have the option to
take out supplementary dental and other
Healthcare Health coverage. Meanwhile, under the Long-term
Healthcare Health Care Act, residents are legally insured against
providers
providers
insurer
insurer the risk of long-term care.23
Dutch healthcare facts The sector employed approximately 1.1 million Jobs in the Dutch healthcare sector
The Netherlands is very much aware of the people in that year. The number of hospitals
rising costs of healthcare and the Ministry of is declining because many hospitals are > 2,525 pharmacists
Health, Welfare & Sport devotes a great deal partnering up, with a shift towards specialised
> 2,852 midwives
of attention to keeping these costs in check institutions. On the other hand, accessibility
so the country’s healthcare system remains to healthcare is increasing thanks to its > 8,775 dentists
affordable and accessible. In 2016, healthcare availability at more locations and homecare.
> 8,865 GPs
spending in the Netherlands amounted to
96 billion euros, or 13.8% of the GDP. Patient organisations play a crucial role in > 17,082 physiotherapists
formulating healthcare policies in the
> 22,585 specialists
In 2015, there were 85 hospitals at 131 Netherlands. The largest patient association
locations in the Netherlands, eight of which is the umbrella organisation NPCF who acts > 400,000 nurses / carers / home helps
were university medical centres. In addition, as the representative for approximately
24
Source: Dutch Ministry of Health, Welfare and Sports, 2016
there were 112 outpatient clinics. 170 different patient associations.
Financing of health expenditure
Health Insurance Act
Long-term Care Act
Government
Own payments
Additional insurance
Other
0 10 20 30 40 50
2016 2015 bln euro
Source: Statistics Netherlands, 2017Availability of medicines Rate of availability
In 2016, the Netherlands had a medicine
availability rate of 30. The rate of availability 160
is measured by the number of medicines 140
available to patients in European countries.
For most countries this is when the product is 120
placed on the reimbursement list. With an
47
100
availability rate of 30, the Netherlands ranks 6 th
37
23
37
33
34
among the EU countries. 80
26
30
18
17
15
12
60
16
Furthermore, the Netherlands also provides
6
53
9
40
9
45
9
43
44
quick patient access to medicines after
35
7
24
38
42
27
40
15 7
23
28
19
3
16 6
27
19
24
5
marketing authorisation and ranks in the
20
7 3
22
13
25
20
14 3 4
9
top 5 countries of Europe. On average, it takes
7 10
19
18
19
23
21
25
28
30
31
29
28
31
37
36
37
38
43
37
39
39
42
46
228 days for patients to obtain access to their 0
medicines in the Netherlands. The average
United Kingdom
EMA Apporved
time between marketing authorisation and
Netherlands
Switzerland
Denmark
Lithuania
Germany
patient access is measured by the number
Hungary
Portugal
Slovenia
Bulgaria
Slovakia
Belgium
Norway
Sweden
Croatia
Estonia
Austria
Ireland
Poland
France
Serbia
Latvia
Spain
of days between the date of EU marketing
Italy
authorisation (or effective marketing
authorization in non-EEA countries) and the
date of completing the post-marketing Source: EFPIA, Patient W.A.I.T. Indicator 2017 2014 2015 2016 Data N/A – EMA approved
authorisation administrative processes.Average time between marketing authorisation and patient access
979
1,000
800
Average delay (days)
632
606
563
600 535
500
490
479
467
438
436
411
396
379
329
329
400
291
281
269
228
123
200
111
106
0-
26
Netherlands
Switzerland
Denmark
Lithuania
Germany
Portugal
Slovenia
Bulgaria
Slovakia
Belgium
Norway
Sweden
Croatia
Estonia
Austria
Ireland
Poland
France
Serbia
Latvia
Spain
Italy
UK
For most countries patient access equates to granting of access to the reimbursement list, except for hospital
products in DK, FI, NO, SE where some products are not covered by the general reimbursement scheme and so the
zero-delay is artificially declining the median and average.
In France, some innovative products without competitors can be made available prior to market authorisation under
the system of Temporary Authorisations. As these are not taken into account in the analysis, the average for France is
higher than in reality.
Source: EFPIA, Patient W.A.I.T. Indicator 2017Competitive economy
The Dutch business climate is attractive and It is also a major importer, ranking eighth and Global Competitiveness Index (2017-2018)
its economy competitive. Actually in 2017, the taking 3.1% of the global share of imports (504
Netherlands ranked third on Forbes’ annual Best billion US dollars in 2016). The Netherlands
5.86
5.85
5.71
5.66
5.65
5.53
5.51
5.49
5.52
5.49
Country for Business list. The Netherlands also exports and imports a significant amount of
receives high marks for its favourable business commercial services, totalling 180 billion and
climate from the World Economic Forum and 173 billion US dollars respectively in 2015.
IMD. It draws significant investor interest, This puts the country in sixth place for exports
including from a wide range of multinationals and seventh place for imports of commercial
in various sectors. Businesses consider the services.
Netherlands an attractive place to locate in
Europe thanks not only to its competitive tax Labour productivity in the Netherlands is among
United Kingdom
Hong Kong SAR
climate and stable business relations, but also to the highest worldwide, thanks to a highly
27
United States
Netherlands
Switzerland
Singapore
its international focus, its well-educated highly educated workforce and solid economic
Germany
Sweden
Finland
Japan
productive labour force, its sophisticated (IT-) structure. Dutch employees also have an
infrastructure, its strategic location and its key international focus and the majority is
1 2 3 4 5 6 7 8 9 10
role as a European transportation hub, as well multilingual. Overall, the country has a high
as its good quality of life. level of labour participation among both highly Source: The Global Competitiveness Report 2017-2018
educated and lower educated employees.
The Netherlands has the sixth-largest economy In summary, the Netherlands is one of the
in the European Union (17th in the world), with a European Union’s wealthiest nations. GDP per
Gross Domestic Product (GDP) of 697 billion capita of employed persons is 48,326 US dollars
euros in 2016. That is impressive for a country (The Conference Board, 2015), compared to the
whose surface area comes in at 134th worldwide. EU average of 37,829 US dollars.
Furthermore, the Netherlands takes fifth place
worldwide when it comes to export, making
it a major player in world trade. In 2016, the
Netherlands exported just under 570 billion US
dollars in goods, accounting for some 3.6% of
total global exports.28
2,249,661
1
Germany
1
United States 3,132,670
14.0
1,588,696
2
2
China United Kingdom 2,366,912
9.9
1,060,672
3
3
Germany France 2,225,260
6.6
635,570
4
4
United Kingdom Italy 1,672,438
4.0
606,924
5
5
GDP in the EU (2016)
Japan Spain 1,113,851
3.8
560,555
6
6
France Netherlands 697,219
Millions of euros. Source: Eurostat, 2016
3.5
547.124
7
7
Hong Kong Sweden 462,417
Source: International Trade Organisation, 2017
3.4
Top 10 importers of goods (2016)
504,185
8
8
Netherlands Poland 424,269
3.1
406,060
9
9
South Korea Belgium 421,611
2.5
404,578
Italy
10
2.5
10
1 Austria 349,493
Ireland 76
2
Belgium 69
3
Singapore 68
Millions of US dollars
4
United States 67
Share in world imports (%)
power parity (2016)
5
Netherlands 66.4
6
France 65.7
2,118,981
1
China
13.4
7
Germany 65
US dollars. Source: The Conference Board, 2017
1,453,167
2
United States
9.2
8
Denmark 63.4
1,340,752
3
Germany
8.5
9
GDP per hour, corrected for purchasing
Switzerland 63.2
644,932
4
Japan
4.1
Sweden 62
10
5
Netherlands 569,384
3.6
516,588
6
Hong Kong
3.3
1
Luxembourg 102,101
495,466
7
South Korea
Source: International Trade Organisation, 2017
3.1
2
Top 10 exporters of goods (2016)
Ireland 65,122
488,885
8
France
3.1
3
Switzerland 61,041
461,529
9
Italy
2.9
4
United States 56,065
415,856
United Kingdom
10
2.6
5
Netherlands 48,326
GDP per capita (2015)
6
Austria 48,091
7
Germany 47,221
8
Sweden 46,702
9
Denmark 46,574
Millions of US dollars
Share in world exports (%)
EU-28 37,829
10
US dollars, corrected for Purchasing Power Parity. Source: OECD, 2016Entrepreneurial spirit The Netherlands is historically famous for being a nation of entrepreneurs. This is reflected in the fact that nearly 12% of Dutch workers are self-employed. To this day, the government encourages start-ups as a way of boosting economic vitality as well as competition and innovation among existing businesses. Many leading multinationals also got their start in the Netherlands, including Philips, Unilever, ASML and Booking.com. And there are numerous smaller international companies with Dutch roots, including G-Star and eBuddy. There is a lot of creative talent in the Netherlands as 29 evidenced by its top-five spot on the Global Innovation Index. It earned its number three ranking thanks to its test market, open culture and flexible consumers. The Netherlands also is an innovator in the field of ICT, thanks to its solid infrastructure, high- level security and advanced research. The country, moreover, is a major player in internet traffic, with around one-third of Europe’s traffic with the US routed via the Amsterdam Internet Exchange. Meanwhile, The Hague Security Delta, among other centres of expertise, reflects the Netherlands’ concern for cyber security. Foreign investors are taking advantage of the opportunities the country has to offer and one-fourth are ICT-related.
Thriving sectors
As a nation of traders, the Netherlands has long Materials (HTSM), Horticulture & Starting
benefitted from its spirit of entrepreneurship Materials, Life Sciences & Health, Logistics and
and innovation, enabling it to grow into one of Water. In a joint effort, governments,
the world’s twenty largest economies in the companies, researchers and civil society
world. Even during times of economic and social organisations are working together to facilitate
adversity, this spirit has helped the country innovation and create a climate for continuous
prosper. In an effort to maintain its edge in the innovation. In addition to the benefits of
global marketplace, Dutch government policies cooperation, the sectors benefit from cross-
focus on nine top sectors that are considered fertilisation in creating the best products and
the driving forces of the economy. These sectors services using the best people. This also helps
30 are: Agriculture & Food, Chemistry, Creative
Industries, Energy, High-Tech Systems &
the sectors thrive internationally.
The Netherlands: one of the
world’s twenty largest economiesThe Netherlands’ nine top sectors for innovation:
AGRICULTURE & FOOD CHEMISTRY CREATIVE INDUSTRIES
31
ENERGY HIGH TECH SYSTEMS AND MATERIALS (HTSM) HORTICULTURE AND STARTING MATERIALS
LIFE SCIENCES AND HEALTH LOGISTICS WATERTop Sector Chemistry Current efforts are focused on increasing the Top Sector Life Sciences & Health are close
With over 400 high-quality chemical companies (re)use of environmentally friendly and cooperation between government, knowledge
across the supply chain, the Netherlands takes sustainable raw materials for the energy, institutions, the industry and patient
a leading position in the supply of chemical transport, food and healthcare industries. organisations. In the Netherlands, this is called
products and services in Europe. With exports the “quadruple helix”. The top sector covers
valued at 7.8 billion euros, 19 of the top Top Sector Life Sciences & Health not only health infrastructure, but medical
25 global chemical companies have major The Netherlands excels in the area of life technology, biopharmaceuticals and
operations in the Netherlands, including sciences and is home to 2,500 Life Sciences & regenerative medicine as well.
AkzoNobel and Shell. Health companies and research organisations,
85 hospitals and 12 research universities. Its One of its goals is to improve health and the
The Top Sector Chemistry is earmarked to play excellent healthcare system and infrastructure quality of life, address the problems of an
a key role in the shift to green and sustainable are further supported by its advanced ageing population and ensure care remains
chemistry. Like other industries, the chemical technological know-how in patient monitoring affordable and accessible. Dutch companies
32 sector is facing a shortage of raw materials. and medical imaging. The key features of the and universities are contributing to major
innovations in the international biomedical and
healthcare fields. This sector grew 25% from
2010 to 2016, outpacing the other top sectors.
Development in value added by top sector, 2010-2016
Top Sector Logistics
Traditionally an internationally trading nation,
Top sectors
the Netherlands is an important global
economic player. Given the growing
Life Sciences & Health
importance of sustainability, the Logistics top
Agriculture & Food
sector must focus its efforts on reducing CO2
High Tech Systems and Materials
emissions while ensuring better accessibility
Water
– including through the country’s main airport
Horticulture and Starting Materials
(Amsterdam Schiphol) and seaport
Creative Industries
(Rotterdam). To preserve the Netherlands’
Chemistry
competitive position, this sector also
Logistics
concentrates on international logistics and
Energy
supply chain management.
-25 -20 -15 -10 -5 0 5 10 15 20 25 30
Source: Statistics Netherlands, 2017 % change 2010-2016Industry Clusters in the Netherlands
Groningen
€ Amsterdam
€ Utrecht
Enschede
Leiden
Arnhem
Den Haag
Wageningen
Delft
Rotterdam
Nijmegen 33
Eindhoven Maastricht & Chemelot
Creative Hub & Advertising Automotive Chemicals Mathematics (CTIT)
Software, Multimedia & Gaming Cyber Security Materials Hardware Manufacturing
Life Sciences Telecom Computer Science Engineering
€ Finance Healthy Aging Nanotech (MESA +) Health & Food
Based on: Invest in Holland, 201634
35 INDUSTRY CLIMATE
INDUSTRY CLIMATE
The Netherlands is home to an attractive business climate with a wide-ranging scope
for innovation. It is known for its competitive and stable tax regime, attractive R&D
incentives, excellent research facilities and top-rated educational institutions that
produce a well-educated and multilingual workforce with a high level of productivity.
36
International business climate
The Netherlands has a highly attractive
international business environment and is
home to over 8,000 foreign companies. Their
decision to locate in the Netherlands is based
on several factors. The country’s workforce is
highly productive and has a strong work ethic.
In addition, the Netherlands has several
superior (technical) universities as well as an
excellent business infrastructure. And the
corporate sector enjoys an open relationship
with government, knowledge institutes and
other companies and institutions. As a matter
of fact, many companies in the Netherlands
often attribute their success to this
environment of mutual transparency.Competitive fiscal climate
International companies see the Netherlands • A broad participation exemption of 100% from royalties (the latter often to 0%).
as a great place to locate, thanks in part to its Dutch corporate income tax for all benefits • An efficient fiscal unity regime that provides
investment-friendly corporate income tax related to qualifying shareholding. This measure tax consolidation for domestic activities
system. It has a competitive corporate tax rate is aimed at preventing double taxation. within a corporate group.
of 20-25% as well as excellent incentives for • Advance tax ruling from the tax authorities • There is no statutory withholding tax on
innovation and R&D, and a cooperative tax as well as the option for an Advance Pricing outgoing interest and royalty payments.
authority. Dutch tax practices have met OECD Agreement (APA). These give companies certainty • A tax relief programme for sustainable energy
standards for the past 30 years. This, combined concerning their tax position in the future. investments (EIA).
with its cooperative tax authority and stable • A transfer pricing practice that is aligned with • No up-front payment of VAT upon importation:
government, means businesses can be OECD Transfer Pricing Guidelines. no actual payment of VAT.
confident that future changes will not pose • An R&D tax credit for qualifying R&D wage costs • An ‘Innovation Box’ to stimulate technical
significant obstacles or disadvantages to
foreign investors.
and other related costs and investments (WBSO).
• Pro-active and practical customs authorities.
innovation, which means an effective
corporate tax rate of 7% for qualifying profits. 37
• A beneficial tax programme with a 30% personal • A relatively low statutory corporate income tax
Investment-friendly corporate tax tax income advantage for qualified foreign rate of 25%.
system workers. • Tax relief for environmentally friendly
The Dutch tax system offers several • Nearly 100 bilateral tax treaties to prevent investments (MIA/Vamil).
competitive features for companies looking to double taxation and many companies enjoy • Tax authorities allow access to the tax
relocate or expand their operations in Europe: lower withholding tax on dividends, interest and inspector.
The Netherlands: excellent incentives
for innovation and R&D38
Supportive R&D Incentives
The Netherlands has several measures in place Innovation Box
that promote research & development. These Under the Innovation Box regime, companies
include general corporate and specific R&D can benefit from an effective tax rate of only
tax incentives. These pro-innovation R&D tax 7% for R&D income from patented and
measures not only cut R&D costs but also lower unpatented intangible assets. This includes
a company’s taxable base. technological innovations created by the Dutch
taxpayer and for which an R&D tax credit was
R&D Tax Credit (WBSO) received. The normal corporate income tax rate
The WBSO tax credit is an example of a is 20% to 25%. Companies are not required to
scheme for businesses involved in developing apply for the Innovation Box and the level of
technically new products and production income allocated is restricted. This means that
processes as well as those performing
scientific research in biotechnology, physics,
as more R&D activities are outsourced, fewer
profits can be allocated to the intangible assets 39
chemistry, production technology and IT that result from those activities. There is a
technology. Clinical trials are also included in flat-rate regulation for SMEs, which can decide
this scheme. The WBSO provides a payroll tax each year to apply 25% of their profit to the
deduction as well as compensation for other Innovation Box with a cap of 25,000 euros.
costs for companies involved in R&D. Self- The corporate income taxpayer claims the
employed entrepreneurs can also qualify and lower 7% rate on their return. The lower rate is,
are entitled to a fixed deduction of 12,623 in fact, an exemption of 72% of the profits that
euros, while start-up entrepreneurs can receive can be allocated to the Innovation Box, giving
an additional deduction of 6,315 euros. an effective rate of approximately 7%.
Companies may be entitled to as much as a The effective rate applies to profits exceeding
32% reduction on the first 350,000 euros in R&D any development costs and losses made. Such
wage costs and other R&D-related expenses losses and expenses are deductive at the
and 14% for costs over 350,000 euros. Public normal tax rate of 25%.
knowledge institutes are excluded from the
scheme.Innovation-oriented schemes
Innovation Credit PPP Allowance sequencing is currently one of the projects
The Dutch Ministry of Economic Affairs & Climate Top Sector Life Sciences & Health supports financed with a PPP Allowance.
Policy offers Innovation Credit in the form of a innovative research carried out by public-
risk-bearing loan that companies can use in the private partnerships (PPPs) in the Dutch LSH MIT Scheme
(technical) development phase of a product, sector. Stakeholders from research The MIT (SME Innovation Stimulation) Scheme
process or service that is considered ‘technically organisations, health foundations and offers SME entrepreneurs the opportunity to get
new’. Funding, which can also be applied to the companies (start-ups, SMEs and industry) are additional funding for innovative R&D activities
development of medical products that require a invited to jointly invest in R&D to perform within the Top Sector. The funding, partly national
clinical study, varies from 25% for large companies groundbreaking innovations and to contribute and regional instruments, can be used in several
to 45% for SMEs. This can be applied to project to a strong and sustainable LSH sector that ways: knowledge vouchers, innovation consultancy
costs capped at 10 million euros with a minimum plays a major role in finding solutions for projects, feasibility projects and R&D joint
40 project size of 150,000 euros. Any additional
expenses must be financed from the company’s
healthcare challenges around the world. With
the PPP (Public-Private Partnership) Allowance,
ventures.
own resources. the Top Sector provides stakeholders, like Knowledge vouchers: An SME entrepreneur can
research organisations, knowledge institutes, present a knowledge voucher to a centre of
Companies must repay the loan within ten years companies, and health foundations with a expertise for a scientific inquiry into a research
after the settlement date. This requirement may financial tool to carry out their innovative question.
be waived if the project fails for technical reasons ideas. Partnerships are offered the opportunity
or a change in the commercial environment. to apply for a PPP Allowance twice a year and Innovation consultancy projects: To get
During the development phase, interest is they can get funding for up to 75 % of the R&D innovation advice and recommendations
added to the loan. Generally at 7% for technical costs provided that both the company and the from a centre of expertise or independent
development projects and 10% for clinical research organization, make a substantial consultancy, such as answering a research
development projects. Businesses can only contribution in cash and/or in kind to jointly question or addressing a request for advice.
apply for the credit if they lack sufficient bear the costs and risks of the R&D project.
resources to finance their project. Both SMEs The Top Sector Life Sciences & Health Feasibility projects: To identify the potential
and large companies, whose activities are ‘Health~Holland’, matches every euro invested technical and financial risks of a proposed
based in the Netherlands can apply for a loan by private partners with up to 30 cents by the innovation project.
for their projects, which must have a maximum Dutch government. The Top Sector LSH
duration of four years. Applicants must have currently finances nineteen projects in the field R&D joint venture: A collaboration with at least
a systematic development approach and a of biopharma with a PPP Allowance. Unraveling one other SME entrepreneur to innovate or
detailed project plan. the genetic basis of ALS by large-scale genetic develop a product, production process or service.Sustainability-oriented schemes
The MIA and Vamil schemes EIA and SDE+ schemes Under the Sustainable Energy Production
The Netherlands also provides tax relief Under the Energy Investment Allowance (EIA), Scheme (SDE+), producers of sustainable
programmes for sustainable energy and the Dutch government provides a 54.5% electricity and heat or a combination of
environmentally friendly investments, including deduction to companies that invest in energy- sustainable heat and electricity (CHP) or green
the MIA and Vamil schemes. Any Dutch saving installations, or that make use of gas, are compensated for the renewable energy
entrepreneur paying income or corporate tax sustainable energy. The deduction, which is generated. The scheme is aimed at companies,
can apply and the two schemes can usually be made on the amount invested sum and comes institutions and non-profit organisations
combined. Under the MIA scheme, they can on top of the usual depreciation, is deducted whose projects are realised in the Netherlands;
deduct up to 36% of an environmentally friendly from their taxable profits in the year in which private producers of renewable energy are
investment from their tax profit. However, the the goods are purchased. The allowance is not eligible. Energy generated using biomass
investment must be included on the Environment applicable to new fixed assets within three is controlled to ensure it adheres to the
List. This list of approximately 270 investments is
updated annually and is found on the MIA/Vamil
months of purchase and must be included on
the Energy List. Any investment grant for that
sustainability criteria. Renewable energy
production may not be profitable because the 41
website of the Netherlands Enterprise Agency asset must be deducted from the costs, with cost to generate it can outstrip the market
(in Dutch only). In 2018, the minimum investment the exception of operating subsidies. In 2018, price. This unprofitable component is
amount is 2,500 euros and the maximum is the investment must be at least 2,500 euros compensated under SDE+ for a set number of
25,000,000 euros. and the deduction applies to investments up years, depending on the technology involved.
to 121 million euros. Any energy advice and
The Vamil scheme provides entrepreneurs with additional expenses to make an asset
an advantage in liquidity and interest as they can operational can also be included in the
decide when to write off 75% of their Environment deduction. On average, the EIA gives a 13.5% tax
List-related investment spending. For the advantage.
remaining 25%, they can apply the regular
investment rebate procedure. The schemes
encourage companies investing in building/
operating a manufacturing plant to do so in an
The Netherlands provides
environmentally friendly way. They are particularly
beneficial to businesses in the shipping,
agricultural and industry sectors.
tax relief programmes for
sustainable energyFurther financial support
Other governmental incentives This could be because there is uncertainty Agenda was to connect existing research
The Dutch government offers several other about the relationship between risk and return agendas, like the EU Horizon 2020 programme
incentives to companies. One example is the or because of a long and uncertain return on with questions out of the Dutch society. It is
Corporate Finance Guarantee Scheme (GO), in investment. Invest-NL offers entrepreneurs expected that the National Science Agenda
which capital providers are granted a 50% support in risk capital, guarantees, export will be an important building block for future
government guarantee to facilitate medium credit insurances and international financing research programmes at universities and
and large companies wishing to borrow large programs. Moreover, Invest-NL will develop institutions. While further developing the
amounts of money. For SMEs there is the large-scale social projects in the Netherlands health agenda, alternative methods to test
Growth Facility Scheme, under which the and abroad and co-finance where necessary. the clinical effectiveness of new medical
government provides a 50% guarantee for interventions (including medicines) will also be
financiers providing venture capital to these Public financing of R&D investigated, as well as research into outcome
42 enterprises. And employers can get a tax-free
budget for benefits equal to 1.2% of their
The Dutch government finances approximately
one third of the annual national expenses on
measures at the level of the individual patient.
In addition, attention will be paid to new
annual taxable wage under the Work-related R&D. There are several ways in which R&D is approaches, such as customised and
Costs Scheme. For employees, there is a Travel publicly funded. In general terms, basic regenerative medicines.
Allowance scheme for commuting costs to and financing allows universities and institutions to
from a fixed workplace. allocate the funds themselves. There is also Venture capital and private equity
project or programme financing. Here, funds The Netherlands not only has a highly
Invest-NL are provided for a specific time, budget and appealing tax regime and incentive schemes
There will be an additional, new government content. In most cases there is also a but an abundance of venture capital
incentive called Invest-NL. This was announced competitive element. Health research is funded, companies that invest in the country’s
by the Dutch government in 2017. The objective among others, by the Netherlands Organisation innovative enterprises as well. A total of
of this scheme is to stimulate investments in for Health Research and Development (ZonMW). 3.7 billion euros was invested in 365 companies
the Netherlands. Invest-NL will be a This organisation also promotes the actual use in 2016. These funds included venture capital
development and financing institute with a of the knowledge this research produces. injections in fast-growing start-ups and private
capital of 2.5 billion euros aimed at helping equity investments in mature companies.
companies experiencing difficulties with Recently, the National Science Agenda gave a Venture capitalists in the Netherlands often
raising capital. big boost to the Dutch science policy, which focus on life sciences and ICT companies.
was generated in 2016. The purpose of theVenture capital investments Venture capital investments by sector
280,000 ’000 € ’000 €
260,000
23,414
240,000 260,000
220,000
200,000
240,000
180,000
33,475
107,682
126,780
160,000
60,372
32,440
140,000 220,000
55,060
49,485
120,000
67,207
90,944
92,819
100,000
64,776
200,000
80,000
60,000
130,545
40,000 180,000
124,720
139,684
80,274
149,191
121,337
101,483
102,195
91,089
80,701
20,000
27,715
106,469
0
160,000
’07 ’08 ’09 ’10 ’11 ’12 ’13 ’14 ’15 ’16
Seed Start-up Later stage venture
43
55,914
Source: Nederlandse Vereniging van Participatiemaatschappijen (NVP) 140,000
28,853
44,649
Private equity investments
120,000
90,722
60,552
6,000,000 ’000 €
99,094
25,326
62,940
5.500,000
100,000
5,000,000
84,445
6,691 15,438
4,500,000 Agriculture
28,943
Business products and services
112,270
4,000,000 80,000
16,316
3,500,000 Chemicals and materials
111,912
3,000,000 ICT
60,000
18,066
2,500,000 Construction
2,000,000 Consumer goods and services
76,462
1,500,000 40,000 Energy and environment
62,212
2,826,704
2,499,496
54,370
2,634,598
276,597
2,348,342
2,050,978
5,091,955
1,498,958
42,714
1,886,357
Financial and insurance activities
12,013 49,166
39,452
1,000,000
987,899
12,060 90,686
7,305 80,594
25,948
Real estate
21,835
500,000
37,176
19,370
16,809
20,000
16,060
0 Healthcare and biotechnology
’07 ’08 ’09 ’10 ’11 ’12 ’13 ’14 ’15 ’16 0 Transportation
Growth Rescue/Turnaround Replacement Capital Buyout ’07 ’08 ’09 ’10 ’11 ’12 ’13 ’14 ’15 ’16 Other
Source: Nederlandse Vereniging van Participatiemaatschappijen (NVP) Source: Nederlandse Vereniging van Participatiemaatschappijen (NVP)You can also read
