Ranking at the very top of all European countries, Germany’s healthcare market is a true heavyweight in terms of market volume and number of medtech manufacturers, healthcare providers and patients. It is a highly competitive market that is characterised by exacting regulatory requirements and high safety standards, yet also exciting business opportunities – particularly in the digital health segment. In this blog article, we will give you an overview of Germany’s consumer demographics, market conditions and latest trends and explain why it is important to partner up with a professional language provider that offers professional translation services.

Population

If you ask Germans about their health, you get a rather optimistic answer: 65.2% rate their state of health to be good or excellent. Only 8.3% think their health status is rather poor or very poor. In this respect, men aged 50 and over tend to be particularly pessimistic. However, life expectancy among the German population has increased considerably since the end of the 19th century, rising to 78.5 years and 83.4 years for men and women, respectively. But when compared to other countries worldwide, Germany is falling behind: people are getting even older in more than 20 other countries, including Austria, Switzerland and France.

Many Germans suffer from the typical lifestyle diseases that are common in many parts of the industrialised world. At the top of the list: conditions affecting the musculoskeletal system, such as back pain, closely followed by mental disorders, including burnout, depression and anxiety disorders. Metabolic disorders (e.g. diabetes) and cardiovascular diseases (high blood pressure, heart attacks, etc.) are also common. In 2017, the German Federal Statistical Office reported that around 53% of the adult population was overweight and 16% severely overweight (obese). This is of particular concern because it is assumed that the risk of metabolic and cardiovascular diseases rises with increasing obesity.

Yet there are also positive observations to be made: smoking rates has continued to decline in recent years, reaching 18.9% in 2021.

Health market

The health market makes up the largest sector in all industrialised nations. Relevant drivers include innovations in the field of medical technology, demographic changes including increasing life expectancy (“Silver Economy”) and the associated rise in medical conditions and increased need for preventive measures.

With a high demand for health services and products, and its advanced healthcare infrastructure and strict regulations, Germany is taking the lead among other European countries. It offers basic care to all its citizens and promotes the development of innovative high-tech products as well as new treatment and examination methods.

Looking back on a long tradition of developing innovative medicines, German pharmaceutical companies are among the world’s leaders in the research and development of new therapeutics. With highly trained specialists and a reliable infrastructure, Germany also boasts excellent conditions for service providers and companies in the healthcare industry.

These conditions also ensure long-term demand independent of economic cycles, stabilising the economy and serving as an employment driver for the German economy as a whole. In 2021, the gross value added in the health economy’s core area amounted to 391.8 billion euros, which corresponds to 12.1% of the country’s overall GDP. And the sector is growing – by 3.8% annually over the last ten years.

In addition to the primary healthcare market, which includes standard outpatient and inpatient care and is largely covered by health insurance (statutory or private), the segment called the secondary healthcare market has also become more and more important in recent years. It includes medicines that are available over the counter, dietary supplements, individual health services, functional food, the fitness and wellness sector as well as health-promoting exercise and leisure activities. With health awareness on the rise in Germany, the willingness to pay for these “self-pay” products and services is also increasing.

Trends

In Germany, demographic change is shifting the focus on prevention. The affluent and powerful group of “silver consumers” offers ample opportunity for sales and growth in many areas. In particular, products and services that help prevent bodily ailments and support active ageing continue to be in high demand, regardless of the economic situation.

Not least since the Covid pandemic, mental health has also become a major topic. All areas – from prevention, self-care and wellbeing to promoting health through food supplements, naturopathic medicine, pharmaceutical products and treatments – are experiencing strong growth. While in the early days of industrialisation, a person might have been considered healthy if he or she was fit to work, today the focus is on a holistic concept of overall well-being. Working and pursuing a successful career are still important, yet people’s emphasis is shifting towards a wholesome work-life balance, and they increasingly prioritise their private lives and leisure time.

In addition to optimised working conditions and more ergonomic workplaces, for example through occupational health management (“New Work”), a holistic lifestyle that incorporates sustainable consumption and a vegan diet have also become very popular.

Health apps and tracking applications have also been picking up steam. Germans use them to fulfil their growing desire for self-optimisation: to track their sleep rhythm, caloric intake, daily steps and much more. In Germany, doctors can also prescribe health apps as part of treatment, allowing patients to get coverage from their health insurance provider. This constitutes a pioneering concept in Europe and provides app developers from other countries with an attractive opportunity to market their product in Germany.

Legal and regulatory conditions

The healthcare market is largely regulated by the state. Research and development as well as approval and marketing are subject to very strict rules that ensure the high quality and safety of medical products and services. In Germany, the regulatory body supervising these activities is the Federal Institute for Drugs and Medical Devices (BfArM). The focus of this independent higher federal authority is on granting marketing authorisations for medicinal products on the basis of the German Medicinal Products Act (AMG) and the monitoring of drug safety, also known as pharmacovigilance. It is also responsible for recording and assessing the risks associated with medical devices. This category of products includes surgical instruments, imaging equipment or hearing aids as well as other products such as apps that serve a medical purpose.

The competent authority for the evaluation and authorisation of vaccines, sera, monoclonal antibodies and other special substance classes is the Paul Ehrlich Institute (PEI).

In terms of legal requirements, one of the most important piece of legislation is the Law on the Advertisement of Therapeutic Services and Products (HWG). It provides the legal framework for advertising medical devices, medicinal products and medical services. The aim of this law is to ban misleading advertising to prevent people from being harmed by inappropriate self-medication or misguided decisions when using medical devices. Advertisements that target the lay population is also subject to very specific restrictions.

EU-wide and global market conditions

In the EU, health-related policies are the responsibility of the individual Member States, but EU-wide directives and regulations provide a framework that must be transposed into national legislation. A much-cited example is the Regulation (EU) 2017/745 on Medical Devices, also known as the MDR, which defines the requirements for all medical devices distributed in the European single market. A prerequisite for marketing a product in this territory is a declaration of conformity.

For medicinal products, marketing authorisation can be granted at individual state level (in Germany, by the BfArM) according to local legislation or via the “centralised procedure” coordinated by EMA, enabling manufacturers to obtain approval in all member states of the European Economic Area (EU, Iceland and Norway) with a single application and a single evaluation.

Internationalisation

Internationalisation allows German hospitals and clinics to increase their competitiveness and position themselves as attractive service providers for patients from abroad. The exchange with other countries, including the translation of scientific publications and training materials, enables German healthcare professionals and healthcare facilities to learn from the experiences and best practices in other countries, thus improving the overall quality of treatment.

Translations may also be required at all stages of the life cycle of medical devices, medicines, food supplements and general health and lifestyle products. Here, the translated texts must always be geared to the target audience (government authorities, HCP audience, laypersons) and meet the specific requirements of the type of text and communication channel. This means that professional translators not only need to be masters of their language, but they also require years of experience and extensive subject matter expertise.

For clinical trials, for example, the Clinical Trials Regulation No. 536/2014 (EU-CTR) requires lay language summaries to be published in all languages of the Member States on the common EUDAMED server.

Documents that need to be submitted for regulatory approval are also of critical importance. It is essential to work with specialised translators who are familiar with the regulatory process and medical terminology. After all, errors may result in delayed approval or launch of the product and, in the worst case scenario, endanger patient safety.

When consumers and patients are addressed directly, such as on educational websites or in brochures, social media posts or blogs, the translation must be informative, avoid unnecessary jargon and often present the product in a favourable way without sounding overly promotional. In addition to direct translations, it can also make sense to commission specialist marketing translators to create a new localised version based on a detailed briefing – a service called “transcreation”.

The most important language for the German market is German, of course, which is spoken by the vast majority of the population (85%) as their mother tongue. In addition to English as the world’s lingua franca, other relevant languages in Germany include Russian (with up to three million native speakers), Turkish (with more than two million native speakers) as well as Polish, Kurdish, Italian, Greek, Arabic, Dutch, Serbian, Croatian, Spanish and Romanian. Depending on the target group, other languages may be important as well, such as other EU languages or minority languages.

Summary

The health market in Germany offers excellent opportunities and a high potential for growth, especially in the area of prevention, active ageing and silver economy. Germans tend to be mindful about their health, fitness and overall wellbeing and have a strong desire for safety. Given Germany’s past, the population also tends to be anxious about state-controlled surveillance, which is why market access has been lagging behind for digital applications and telehealth products. These concerns, however, will likely subside over time, and health app adoption will pick up steam, also due to enhanced coverage by health insurance providers.

For all documents and texts used in any area of the healthcare market, it is crucial to work with highly qualified professional translators with extensive knowledge of the medical field. They ensure that safety is not jeopardised by translation errors, and they prevent liability risks. Strong, faultless and effective communication also underlines a company’s commitment to quality and promotes trust in the brand among healthcare professionals, patients and consumers – which may prove to be a key success factor in the highly sensitive healthcare market.

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