The healthcare industry in Morocco is a growing sector that is full of opportunities for future investment. The government remains the primary healthcare provider since 70% of the population goes to public hospitals. There are five University Hospital Centers in Rabat, Casablanca, Fez, Oujda, and Marrakech, and six military hospitals in Agadir, Meknes, Marrakech, and Rabat. In addition, there are 148 hospitals in the public sector, with six new health centers under construction; and another 28 currently being rehabilitated and equipped, for a total of 65.1 million dirhams (MAD) in investment. The private sector healthcare market is growing rapidly with more than 356 private clinics and 7,518 physician specialists in Morocco.
The government spends around 5% of the gross domestic product (GDP) on the healthcare sector; the budget allocated to the healthcare sector this year is 14.70 billion MAD. This budget is expected to reach MAD 16.33 billion in the near future. The healthcare system is comprised of AMO (Mandatory Health Insurance), which is divided into “La CNSS” (private) that reimburses up to 70% and “La CNOPS” (public), which reimburses up to 80%. Additionally, Le Régime d’assistance médicale (RAMED) is a healthcare system based on the principle of social assistance and national solidarity in favor of low-income individuals. There is also a separate healthcare system that is solely dedicated to the military.
Moroccans base business on trust and mutual respect. United States (U.S.) companies should be patient as procedures tend to take more time in Morocco. Also, U.S. firms should work closely with a locally-based agent or distributor, who will have essential knowledge of key contacts, customs regulations, new laws that come into force, and specific opportunities in the market. U.S. firms should also fully understand the regulatory environment and procedures before jumping into the market to avoid problems. Morocco’s American Chamber of Commerce (Amcham) can organize collegial and informal meetings in Casablanca with other Amcham members to gain insight into the evolving market and learn how to best position product sales.
The U.S. Commercial Service is also available in Morocco to provide counseling to determine the best market entry strategy for a U.S. company/product/service, including joint venture partners, resellers, agents, and distributors.
Current Market Trends
The medical device market is estimated at $236 million, with $181 million comprised of imports. Medical device imports supply approximately 90% of the market. As the local medical device manufacturing industry remains at an embryonic stage, most sectors of the market rely on imports. Medical equipment prospects are increasing in both the public and private sector. The import of refurbished equipment is no longer allowed for public or private entities. A new law was submitted banning the purchase of second-hand or refurbished medical devices and equipment in 2015 and came into force in February 2017. This is expected to improve the quality of medical equipment and offer higher quality medical care to patients treated throughout Morocco.
Estimated Investment Budget - 2018
Details for this chart can be found in the link below.
In addition to these, the below segments arise as the best prospects:
Magnetic resonance imaging and ultra-sonic scanning equipment
Cancer Treatment equipment
Healthcare spending (including investment)
… as percent of GDP
… of which spent on inpatient services (including long-term care)
… of which spent on pharmaceuticals/consumables
… of which spent on investments
… of which spent on outpatient services
Hospitals, Procedures, Healthcare Professionals UN:
Number of hospitals
139 (source : http://www.service-public.ma )
Number of hospital beds
… available beds per capita
…of which in general hospitals
…of which in specialized clinics and rehabilitation centers
Number of surgical procedures
…of which [top procedure]
…of which [second highest procedure]
…of which surgeons
…of which internists
…of which pediatricians
Life expectancy men/women
76.15 years (for both)
21.853 deaths/1,000 live births
Percent of population older than 65
4.78 deaths/1,000 population
…caused by [highest disease burden]
…caused by [second highest]
Prevalence of [fastest growing disease burden]
Currently Morocco does not manufacture medical equipment. The local production is limited to medical disposables. The U.S., Germany, and France are the main suppliers. Recently, Italian products have been well received and accepted by the local population thanks to their good quality and attractive price. There is also an increasing demand for Turkish, Chinese, and Korean equipment.
Public hospitals represent 85% of the demand and private clinics 15%. The Moroccan government’s plan to build five CHU by 2018 has been delayed, with only construction in Tangier recently inaugurated. The project continues to create opportunity for U.S. companies to partner with Moroccan companies and export medical equipment. Morocco is also planning to develop emergency and mobile hospital units, which could be a good opportunity for U.S. firms. While there is domestic competition, disposables are good prospects for U.S. firms. Other best prospects include; specialty medical devices, magnetic resonance imaging and ultra-sonic scanning equipment, x-ray equipment, emergency aid equipment, monitoring and electro-diagnostic equipment, computerized tomography equipment, and ICT (E-medicine, equipment and related software).
In May 2018, the government of Morocco approved the “2025 National Healthcare Plan” with a budget of $ 2.4 billion. The plan will follow a roadmap centered on improving the health sector in six stages: quality of services, equal access to these services, solidarity and interdependence, continuity and proximity, performance and efficiency, then responsibility and accountability.
To proceed with the registration of medical equipment, the MOH (Ministry of Health) requires the following:
Authorization of the manufacturer to permit a local company to register and market the products.
EC Certificate, FDA Certificate or FSC (Free Sales Certificate).
ISO 13485 certificate or equivalent.
EC Declaration of Conformity of Equipment with components and accessories.
Labels or nameplates photos (equipment and its accessories), signed & stamped.
Technical file: Product Data, Maintenance Manual, Technical Specifications, Qualifications, Tests of controls, Final Test Report, Flow Chart, Manufacturing Processes Description.
PDF color catalog (original).
The average time to obtain a certificate of registration is six months.
The CNSS (Caisse Nationale de la Securite Sociale, or National Social Security Fund) runs the AMO (Assurance Maladie Obligatoire, compulsory health insurance) for private sector employees and pensioners. This system, which came into force on August 18th, 2005, was introduced in 2002 by Law No. 65.00, which establishes the Medical Coverage Code. Membership is mandatory for private companies and for all employees.
The AMO guarantees the reimbursement of part of the care costs, with the other part being borne by the insured.
The current care basket covers the following services:
Preventive and curative care related to the priority program of the State;
Care related to pregnancy and childbirth;
Care related to medical and surgical hospitalization;
Medical biology tests;
Radiology and medical imaging;
Medicines within the list of reimbursable medicines;
Medical devices and implants required for different medical procedures;
Medical prosthetic or orthotic appliances accepted for reimbursement;
Medical spectacle according to the frequency defined by regulation (Law-65-00-AMO);
Facial orthodontics for children.
The reimbursement rate is set at 70% and can be 90% for serious and debilitating diseases requiring long-term or particularly expensive care when the related services are provided in public institutions. The reimbursement of dental prosthesis is made up to a ceiling of 3000 MAD every 2 years. In parallel, the private insurance companies have different offers that vary from one company to another and from one client to another.
Unfortunately, nearly 80% of employed workers do not benefit from any medical coverage, according to the new survey of the Office of the High Commission for Planning (HCP). This is 8.29 million employed persons (77.5%) at the national level. This population is predominantly established in the countryside (4.44 million people), while 3.84 million workers in cities are concerned by this problem. In addition, at the national level, more than half of employees (58.1%) are without medical coverage. Rural areas are more affected in terms of proportion (77.6%). In the urban environment, more than half of the workers are concerned (51%).
The main languages spoken in Morocco are French and Moroccan Arabic, which presents a challenge for English-speaking companies. Another potential problem for U.S. firms is that Morocco is seen as a relatively small market for medical equipment, and there are many regulations that can hinder trade. Also, some customs procedures are not uniformly applied. Bribery, corruption, and requests for payoffs are an issue that U.S. investors may be confronted with (when foreign bribery prevents them from competing fairly based on price, quality or service). In addition to these barriers, Morocco has tariffs placed on some medical equipment imports:
Free of custom duties if the product is 100% made in the country of importation
10% of custom duties are applied if the products are manufactured in Morocco in order to protect the Moroccan industry.
2.5% tariff rate if less than 100% of the product is made in the country of importation
1. Who is responsible for regulating the healthcare sector in Morocco?
The Ministry of Health, based in Rabat, regulates the healthcare sector in Morocco. Codes and processes are set by a particular section, and all registrations happen within the ministry. The current Minister of Health is Mr. Anas Doukkali, who took over in January 2018.
2. Are regulations subject to change on a regular basis?
With the arrival of every new minister, the first thing they look at is the regulations and sometimes changes may occur every 4 to 8 years. For the time being, no change in laws has taken place.
3. Are there any U.S. companies in the healthcare sector in the marketplace?
There are many and in different sub-sectors: medical devices, consumables and pharmaceutical products. Also, many companies choose to select a local partner instead of investing and opening their own offices.
U.S. Commercial Service Contact Information
Name: Halima Berrami
Position: Commercial Specialist
Phone: +212 5 22 64 20 81