Executive Summary
Market Entry
Current Market Trends
Main Competitors
Market Size
Current Demand
Registration Process
Reimbursement
Barriers
Procurement & Tenders
Government & Association Links
FAQs
U.S. Commercial Service Contact Information
Tab Options
Executive Summary
Market Entry
Current Market Trends
Main Competitors
Market Size
Current Demand
Registration Process
Reimbursement
Barriers
Procurement & Tenders
Government & Association Links
FAQs
U.S. Commercial Service Contact Information
Executive Summary
Cambodia has grown rapidly over the past two decades, having attained lower middle-income status in 2015, and averaging seven percent growth per year prior to the COVID-19 pandemic. After a three percent economic contraction in 2020, Cambodia’s economy is recovering steadily. With Cambodia’s rapid economic expansion, there has been increasing demand for medical services and products, and Cambodia’s growing middle class has driven demand for higher quality healthcare products, services, and preventative care. Against this backdrop, there are good opportunities for U.S. healthcare products including medical equipment, medical supplies, and medicines.
The Cambodian healthcare market is comprised of a wide variety of providers, including public health facilities, private clinics and hospitals, professional medical service providers, and pharmacies. Cambodia’s Strategic Health Plan 2016-2020 reported approximately 1,000 public healthcare facilities and 8,000 private healthcare providers across Cambodia.
The public sector plays a leading role in health promotion and prevention and for providing care for essential reproductive, maternal, neonatal, pediatric health, communicable diseases and non-communicable diseases (NCD). However, private practitioners remain popular for curative care. Over the counter (OTC) medicines are also very common in Cambodia. Many pharmaceuticals are available without a doctor’s prescription. In 2021, Cambodia had 3,312 registered pharmacies, 590 drug import/export companies and branches, and 15 medical manufacturing institutions.
The Royal Government of Cambodia’s (RGC) current expenditures increased in 2020-2021 in response to COVID-19, reaching $430 million USD in 2021, though it is expected to decrease to $335 million USD in 2022. The increased spending was used to purchase millions of vaccine doses, COVID treatment pills, and rapid test kits for domestic supplies. These purchases were in addition to millions of doses of COVID-19 vaccines and related medical supplies that Cambodia received via bilateral and multilateral donations. The RGC also procured COVID-related medical devices and equipment such as PPE, oxygen concentrators, ventilators, and lab equipment through the WHO and other multilateral donors.
Cambodia is building two hospitals for COVID-19 treatment and cancer treatment due to be completed by early 2023. Diagnostic devices and imaging equipment are among the items that will be in greatest demand in coming years
Market Entry
Cambodia allows 100 percent foreign ownership of businesses, allowing market entrants the ability to set up their own companies locally. However, many U.S. companies have found it advantageous to work with partners (agents or distributors) who have local networks as well as knowledge of the local market, rules, and regulations. A reputable local partner can be the key to maintaining relationships with local customers whose procurement decisions are influenced mostly by trust and may have built-in distribution networks.
Current Market Trends
The Ministry of Health (MoH) is Cambodia’s single largest purchaser of drugs, medical supplies, and medical equipment; however, the private sector provides a large proportion of healthcare services, ranging from consultation to treatment. Consistent with Cambodia’s rapidly growing economy and demand for medical services, several new private hospitals and clinics have opened throughout the country in the past few years, and more are expected in the future. These private facilities are most commonly built by private local and international doctors, as well as international franchises from Thailand, Vietnam, Singapore, and Japan.
Cambodia’s dental market is gaining increased interest from medical tourists from developed countries such as Japan, Australia, and the Middle East due to the relative low cost of care. Cambodia has about 300 dentists, as of 2018, and approximately 20 dental clinics in Phnom Penh operate in accordance with international standards, appropriate ISO certification, and western-trained staff.
There has also been tremendous growth in the consumption of pharmaceutical products, due in part to the COVID-19 pandemic. Local pharmaceutical importers are eager to import U.S.-made products, and Cambodian consumers are keen to receive what they perceive to be high-quality treatments offered by American medical products. For instance, the RGC spent about $2.5 million USD to purchase 4 million tablets of U.S.-made Molnupiravir for Covid-19 treatment.
2018
2019
2020
2021
Total imports ($million)
201
230
242
677
Annual % Growth
14%
5%
180%
Unit: USD millions( link )
Main Competitors
Similar to other markets, U.S. pharmaceuticals also face price competition in Cambodia. The majority of imported pharmaceuticals are from countries such as Thailand, Indonesia, Malaysia, Pakistan, and India – which have lower costs of production and can offer more affordable prices for household consumers.
The main competitors of U.S. medical device companies, on the other hand, are from Japan and European countries, primarily Germany. Consumable healthcare products from China are also very popular in the market due to their competitive prices.
Companies from Australia, New Zealand, U.K, Germany, the Czech Republic, Poland, Korea, and Japan also market health supplements in Cambodia.
Market Size Hospitals, Procedures, Healthcare Professionals UN:
Number of hospitals
…Public
34 National/Provincial Hospitals (2018)
…Private
54 (2016)
Number of hospital beds
…available beds
0.9/1000 population (2016)
Number of surgical procedures
706 (2012)
Physicians
0.1 9 cia.gov )
Dentists
497 dentists, dental assistants, and dental nurses (2018)
Demographics:
Population
16,713,015 (2022 est.)
Life expectancy men/women
68 years / 72 years
Infant mortality
29/1000
Percent of population older than 65
4.5% (2020 est.)
…projection, 2030
6%
Annual deaths at hospitals
0.72%
…caused by Communicable, maternal, perinatal and nutritional conditions
37%
…caused by Cardiovascular diseases
24%
Current Demand
Medical devices with significant sales potential in Cambodia include diagnostic devices and imaging equipment such as ultrasound machines, x-ray machines, and CT scanners. Cambodia’s Essential Medicine/Medical List can be found here. However, the challenge in this market is the high degree of competition from medical device companies from other countries in the region.
In 2018, there was a total of 22,328 products registered in Cambodia, 93% of which were imported. That number has now reached 26,640 in 2021. Cambodia’s main imports of U.S devices are therapeutic respiration apparatus and accessories for electro-diagnostic apparatus, which were valued at $4.4 million USD in 2020.
Maternal Care
The Cambodian government has made maternal health a priority in recent years, and now almost 90%of births are supervised by skilled birth attendants. Cambodia’s young adult population, where the median age a woman first gives birth is 22, also contributes to the high demand for maternal care services. Unfortunately, the supply of high-quality maternal care remains limited.
With rising incomes and the growing popularity of insurance, more Cambodians are willing to pay for safe and clean maternal facilities. Many high-income Cambodians travel to Thailand or Singapore to deliver babies. The main challenge in expanding the number of high-quality maternal care facilities in Cambodia is the lack of qualified personnel to fill the jobs.
Health Supplements
Over the last decade, Cambodians have become more knowledgeable about the importance of health care, driving an increase in the demand for health supplements and nutrition products as a means of preventive care. From 2008 to 2018, there were new 1,400 health supplements registered in the Cambodian market.
Two major U.S. supplement brands prominent in Cambodia are Unicity and Herbalife. One significant challenge that comes with selling supplements in Cambodia is parallel imports (U.S. products imported into Cambodia from neighboring countries such as Vietnam and Thailand) for tax evasion purposes.
Health and Life Insurance
There is a rising demand for health insurance by Cambodia’s growing middle class. Poorer populations are increasingly targeted by government and NGO healthcare insurance, such as National Social Security Fund (link ), and middle class and wealthier Cambodians more often purchase policies from international and local insurance companies. About 60 percent of Cambodia’s total health expenditure is comprised of out-of-pocket payments. Medical insurance premiums, on the other hand, increased by 26 percent from $21.6million in 2020 to $27.1 million USD in 2021. A list of insurance companies is available here .
Registration Process
Imported medicines and medical products must be registered at the MOH for laboratory testing. All imported pharmaceutical products are required to have at least 18 months validity before the expiry date, and medical devices are classified into four categories according to their levels of risk: low, fairly low, fairly high, and high.
Companies can register their imported products online via the MOH registration platform known as the Cambodia Pharmaceutical Online Registration System CamPORS . The documents required for registration include an application form, GMP or ISO certificates, a free sale certificate, a letter of authorization, and the product’s manual. Registration of some categories of medical devices also require registration certificates from the country of export, an analysis report from the manufacturer, and technical documents. The registration process should take three to six months; however, it can take longer based on documentation and MoH workload. Registration certificates are valid for three years from the date of issuance. Companies must re-apply for new registration certificates six months before the expiration date.
Reimbursement
There are no government controls or reimbursement systems for drugs in Cambodia.
Barriers
There are no specific barriers for foreign firms to import medical products into Cambodia. Three types of pharmaceutical products are restricted in Cambodia: narcotic drugs, psychotropic substances, and precursors. Medical importers need to send their products to the Ministry of Health for testing to determine if they fall under any specific restrictions.
Procurement & Tenders
Information about procurement and tenders in Cambodia can be found here:http://www.medicaltenders.com/medical_tenders_cambodia.htm
Local Associations
· Cambodian Medical Association: https://masean.net/our-member-association/cambodia
· Cambodian Medical Council: http://mcc.org.kh
· Reproductive Health Association of Cambodia https://www.ippf.org/about-us/member-associations/cambodia
Government Links
FAQs
How long does registration of medical products take in Cambodia? http://apps.export.gov/article?id=Cambodia-Local-Professional-Services
What are the rates of custom duties for medical products in Cambodia? http://www.customs.gov.kh/publication-and-resources/customs-tariff-of-cambodia-2017/
What is the practical market entry strategy you would recommend?
U.S. Commercial Service Contact Information
Name: Sina Try Tr yS@state.gov
