A Study of Potential Medical Tourists: Marketing Recommendations for Cyprus

1. A Study of Potential Medical Tourists: Marketing Recommendations for Cyprus Dr. Michael Guiry Senior Fellow Center for Medical Tourism Research (CMTR) University of the Incarnate Word (UIW) San Antonio, Texas, USA

2. Agenda • Describe the CMTR • Medical Tourism Model • CMTR Research on Potential U.S. Medical Tourists • Research on European Medical Tourism • Cyprus and the Medical Tourism Continuum • Marketing Recommendations

3. About Us • Center for Medical Tourism Research • First and leading academic-based research center in this industry (Medical & Retirement Tourism/Travel) • Non-profit organization • Motivated to spread the word and influence key stakeholders • Key members have years of healthcare and international business experience

4. Model for Understanding the Drivers of Medical Tourism Technology Globalization Medical Tourism Consumerism

5. Types of Medical Tourism

6. Potential U.S. Medical Tourists

7. PMT Sample Demographics • Avg. Age: 36.49 (36.7- U.S. Census Est. 2008) • Gender: Females 65.47% (50.7%- U.S. Census Est. 2008) • Education: HS- 12.4% / C- 33.9% / G- 18.8%(HS- 84.5% / C- 27.4% / G- 10.3%- U.S. Census Est. 2008) • Avg. Household Inc. (Gross): $101,815 Mean/$50,000 Median and Mode ($52,175- U.S. Census Est. 2008) • Race/Ethnicity: B- 8.6% / A- 7.8% / W- 39.7% / H- .3% / Other (Pref. Not)- 43.5%(B- 12.3% / A- 4.4% / W- 74.3% / H- 15.1%- U.S. Census Est. 2008) • Marital Status: M- 46.9% / NM- 39%(M- 50.2% / NM- 30.8%- U.S. Census Est. 2008)

8. Findings: If Medical Travel- What

9. Findings: Research • Internet was #1 by a wide margin

10. Expectations of Int’l Healthcare Facilities (Top 8 Answers) • Healthcare facility employees are knowledgeable. (Assurance) • Patients feel safe in their interactions with healthcare facility employees. (Assurance) • Healthcare facilities are accurate in their billing. (Reliability) • Healthcare facility employees get adequate support from their employers to do their jobs well. (Assurance) • Healthcare facility employees tell patients exactly when services will be performed. (Responsiveness) • Healthcare facilities provide their services at the time they promise to do so. (Reliability) • Healthcare facilities in other countries have up-to-date equipment. (Tangibles) • Healthcare facilities have their patients' best interests at heart. (Empathy)

11. Medical Tourism as Wish Fulfillment? • The use of medical tourism services will allow me to achieve more: • Freedom to act • Knowledge • Pleasurable life • Comfort in my life • Stimulating and adventurous life

12. Research on European Medical Tourism

13. A Study of Romania Findings of the study (of Europeans): • 80% of the foreign tourists have no idea what Romania can offer them • Most were only exposed to negative news about the country. • Conclusions: • They needed to find an element to differentiate Romania’s brand from other countries or • They must invent one.

14. Gallup/Eurobarometer Study of European Cross Border Care (2007) • 4% of Europeans received medical treatment in another EU Member State over the past 12 months • Slightly more than half of EU citizens are open to travel to another EU country to seek medical treatment (54%) • The most prominent reason to do so is a hypothesized unavailability of the necessary treatment in the domestic healthcare system

15. Gallup/Eurobarometer Study of European Cross Border Care (2007) • Motivating Factors: • Europeans hope to receive a treatment of better quality (generally, or through a specialist residing elsewhere in Europe) • The promise of quicker access to the necessary treatment • Different perspectives: • Quality is the major drive for health tourism to Western Europe • Lower prices are a major argument to travel for treatment to Central and South Eastern Europe

16. EU Society for Human Reproduction and Embryology Studies (1) • An online survey of over 300 patients last year found that 76% would consider going abroad • The vast majority of those who went (88%) were happy with their treatment

17. Cyprus and the Medical Tourism continuum

18. Cyprus’ Strengths & Weaknesses Strengths • Close proximity to over 110 million European Baby Boomers • Increasing perception of quality • Low cost infrastructure (personnel, legal, etc.) • Beautiful tourism destination Weaknesses • History of turmoil/political issues • Known more for recreational tourism • Lack of a Medical School or specialized institutions focused on health tourism or engaged in health tourism

19. Offer a Continuum of Services

20. Marketing Recommendations • Create and Market a Medical Tourism Brand and Brand Image • Use a Brand Personality framework (Aaker 1997) • 5 Dimensions • Sincerity, Excitement, Competence, Sophistication, and Ruggedness • Manage Customer Expectations • Avoid service quality gaps, i.e., difference between perceptions and expectations of service quality • Associate the Provision of Medical Tourism Services with Personal Values • Being a medical tourist is more than just a trip abroad for healthcare; for some it is a 'journey' or a 'wish fulfillment' effort 

21. Questions • Thank you! Contact Dr. David Vequist, Founder and Director of CMTR at vequist@uiwtx.edu Contact Dr. Michael Guiry at guiry@uiwtx.edu

22. EU Society for Human Reproduction and Embryology Studies (2) • Another study was carried out in six countries during the course of one month – • Belgium, the Czech Republic, Denmark, Slovenia, Spain and Switzerland (1,230 patients) • Greatest numbers were: Italy (31.8%), Germany (14.4%), the Netherlands (12.1%) and France (8.7%) • Most traveled to bypass legal restrictions • 34% of those from the UK said they went abroad because of difficulties of access to treatment. • The average age was over 37 but 63.5% of the British patients were over 40

23. Medical Tourism Country Investments (Potential) Investments in High Tech and Commercial Research (e.g., Pharma, Energy, etc.) Higher Higher Higher Investments in HC & Medical/Retirement Tourism Investments in Technology Manufacturing/ High-end Consumer/Commercial Products Intensity of the Regulatory Changes Required Investments in Service Outsourcing Intensity of the Current Competitive Environment ROI Investments in Basic Tourism Activities Investments in Low-end Consumer/Commercial Products Lower Lower Lower Estimates based on the CMTR

24. Cyprus: ROI and Investments • ROI described: • Job growth (great jobs too!) • Brings opportunities for new direct (and indirect) revenue streams • Fills a community need • Ask yourselves, based on the economic and environmental factors- “Will there be a time in the next 20-30 years when great healthcare will not be in demand?”

25. Recommendations • All- • Prepare to create and market a medical tourism brand! • Government- • Create a good business environment! • Tax incentives, tax holidays, prioritize infrastructure and regulatory improvements • Education- • Get universities involved! • Private Industry- • Prioritize investments in this area and invest! • Healthcare facilities and particularly retirement tourism-aligned developments

26. Don’t Believe Me? • IFC is: • the private sector arm of the World Bank • invests in private sector projects in developing countries • world’s largest multilateral investor in the private health sector