The Netherlands. Europe s most attractive and innovative biopharmaceutical industry environment

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1 The Netherlands Europe s most attractive and innovative biopharmaceutical industry environment

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3 TABLE OF CONTENTS Foreword 5 Management Summary 1 THE NETHERLANDS 9 Strategic location 12 Superior infrastructure 13 Living in the Netherlands 17 Competitive economy 27 Entrepreneurial spirit 29 Thriving sectors 30 2 INDUSTRY CLIMATE 35 International business climate 36 Competitive fiscal climate 37 Supportive R&D incentives 39 Innovation-oriented schemes 40 Sustainability-oriented schemes 41 Further financial support 42 Human capital 45 3 BIOPHARMACEUTICAL SECTOR 53 Vibrant and booming Life Sciences & Health sector 55 Attractive biopharmaceutical sector 61 Employment 63 Turnover and investments 64 Export and import 65 Biotechnology companies in the Netherlands 66 Mergers and deals 69 Medicine development 71 Intellectual property protection of new ideas 72 Clinical trials 74 Digitalisation in healthcare 76 Public-private partnerships 77 References 80 Colophon 86 3

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5 FOREWORD Welcome to the Netherlands, the new home of the European Medicines Agency! World-class research institutes, a highly educated workforce, an excellent healthcare system, and an innovation-friendly government, combined with a central location make the Netherlands the ultimate R&D innovation hub in Europe and the ideal base for your biopharmaceutical operations. 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 strengthen our international competitive position while striving for sustainability. The Top Sector Life Sciences and Health is one of the priority sectors in which the Ministry actively participates to create an attractive business climate, foster R&D collaboration and provides optimum conditions for businesses to innovate and grow. Innovation, entrepreneurship and partnership are second nature to the Dutch. It is connected to our centuries-old battle against the water a way of life that has produced innovative and smart solutions, like our famous dikes, as well as a cooperative mindset. Our country is one of the main gateways to Europe. Thanks to our first-rate infrastructure, we offer excellent and efficient connections to Europe's 500 million consumers. Our world-class airport, top-ranked maritime ports and high-speed road, rail and broadband networks are second to none. are already conducting their R&D activities in the Netherlands. Others, including Amgen, Teva and MSD are taking advantage of our strategic location for their distribution activities. The Netherlands is also home to many promising start-ups and scale-ups such as Galapagos, Genmab, Pharming and uniqure. The relocation of EMA to Amsterdam in March 2019 will give a boost to the biopharmaceutical sector and put the Netherlands firmly on the map internationally. At the same time it will create huge opportunities for biopharmaceutical companies and service providers. The Ministry has joined forces with other organisations in PharmInvestHolland, to strengthen the Dutch biopharmaceutical sector and create the most attractive and innovative biopharmaceutical industry environment in Europe. 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 as a base for your pharmaceutical operations. Yours sincerely, 5 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. Leading pharmaceutical companies like Janssen, AstraZeneca and Synthon Eric Wiebes Minister of Economic Affairs and Climate Policy

6 MANAGEMENT SUMMARY Discover Europe s most attractive and innovative biopharmaceutical industry environment. 6 With an unrivalled concentration of biopharmaceutical companies, world-class universities and a long history of strategic partnerships between science, industry and government, the Netherlands is a perfect location for biopharmaceutical innovation in Europe. Many ground-breaking companies have already established themselves in the Netherlands. The EMA will soon follow in their footsteps and relocate to Amsterdam. This confirms once more that the Netherlands is the perfect home for biopharmaceutical companies all around the globe. Attractive location for your company The Netherlands is a thriving and prosperous country, providing an attractive place to live and locate your company. With a radius of only 120 miles, the country has a competitive international business climate which is reflected by its status as the sixth largest EU economy, a major global exporter and importer of goods and a Forbes ranking as the third best country for doing business. The strategic location of the Netherlands, situated between the three largest economies in Europe (Germany, the United Kingdom and France), makes the country the perfect gateway to Europe. Its superior infrastructure guarantees quick and easy access to European markets while ensuring that markets around the world are within efficient reach. In addition, the country is a data & ICT hub with an excellent information technology infrastructure. And its ranking as the sixth happiest place on earth in the World Happiness Report further demonstrates that the Netherlands is an attractive place to live. Appealing industry climate The Netherlands has an appealing business climate with plenty of room for innovation. It has a competitive and stable tax regime, attractive incentives that support R&D, and outstanding research and education institutions. In addition, the country is highly regarded for its well-educated, multilingual and dynamic workforce. Most concentrated biopharmaceutical ecosystem The Netherlands is home to one of the most concentrated Life Science & Health clusters in the world. It has over 2,900 innovative R&D Life sciences companies, including 420 biopharmaceutical companies. These 420 companies employ over 65,000 people. Scientific research in the Netherlands is internationally ranked as one of the best. This is demonstrated by the high quality of Dutch research universities and university medical centres, its high citation impact score and the position of its universities in international rankings. The country has a rich tradition of public-private cooperation, which has been further stimulated by multiple government-initiated programs. The government actively stimulates private cash investments in public-private R&D partnerships by topping up these investments. Most innovative biopharmaceutical environment Public and private partners in the Dutch biopharmaceutical sector have joined forces with the ambition of becoming the world s most attractive and innovative biopharmaceutical country. We are dedicated to further improving our excellent R&D climate that will benefit patients. Together we can make this ambition become a reality, so come join us to further strengthen the sector! Read all about the advantages of setting up your business in the Netherlands in this bidbook.

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9 THE NETHERLANDS 9

10 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 10 Seat of government: The Hague Surface area: 33,800 km 2 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 km 2 : 509 (February 2018) Monetary unit: Euro Languages: Dutch, Frisian Source: Holland Compared, 2017

11 THE 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 borders with Belgium and Germany. While generally known for its tulips, bicycles and windmills, the country has plenty more to recommend it! The Netherlands is a wealthy, flourishing country and is one of the founding European Union member states. It receives high scores for safety, stability and social responsibility thanks to its first-rate educational system, excellent healthcare, multi-skilled multilingual workforce and high market efficiency. The Netherlands multicultural population enjoys an affordable, high standard of living. Its urban centres, where most people get around by bike, maintain an appealing community feel. Meanwhile, the Dutch countryside is rarely far from office complexes and metropolitan areas. Locals and expats alike enjoy the country s rich diversity of culture, entertainment, sports and other activities. Its international focus facilitates easy access to Europe, providing international organisations and companies with opportunities to succeed throughout the region. Its location at the centre of Europe s three largest economies (Germany, the United Kingdom and France) means the Netherlands is not only attractive and stable but also highly accessible. Its business infrastructure ranks among the best internationally. In short, the Netherlands is an ideal environment for international companies and organisations wishing to solidly position themselves in a variety of sectors, from research and development to marketing and sales, technology and logistics. United Kingdom The Netherlands France Germany 11

12 Strategic Location The Netherlands is a first-rate, strategic location for international businesses whose activities expand into Europe and other areas of the world. Known for its favourable location, this compact country guarantees quick and easy access to the European market. In fact, 95% of Europe s most lucrative consumer markets are located within 24 hours of Amsterdam and Rotterdam. 12 The Netherlands is also considered a strategic hub for distribution within Europe, thanks to its location and highly ranked airports (including Amsterdam Schiphol) and seaports (e.g. Rotterdam). It boasts the greatest number of distribution centres and the largest inland shipping fleet in Europe. In addition, the Netherlands is one of the most wired countries in the world where 98% of all households have access to the Internet. European Medicines Agency Amsterdam will host the European Medicines Agency (EMA) from March The EMA, a decentralised agency of the European Union (EU), ensures the safety, effectiveness and high quality of all medicines available on the EU market. It will relocate from London. The EMA assesses, supervises and monitors the scientific development of medicines in the EU and protects human and animal health in 28 EU Member States and the countries of the European Economic Area. In other words, it monitors a market that serves more than 500 million EU residents. The EMA is forced to relocate to the Netherlands because of the Brexit. The relocation will boost the attractive Dutch pharmaceutical sector even further. Not only will it put the Netherlands in the spotlight, it will also offer huge opportunities to attract new biopharmaceutical companies and service providers to the Netherlands. The Dutch government expects that with the arrival of the EMA in Amsterdam, the pharmaceutical industry and service sector will create thousands of new jobs. Moreover, specialised lawyers, patent experts and consultants will also relocate to Amsterdam in order to be close to the EMA. Insiders expect that the Dutch medicines research industry will also receive a significant boost. Norway 1,000 km 500 km Denmark Sweden The Netherlands Ireland United Kingdom Poland Germany Belgium Luxembourg France Austria Switzerland Italy Spain

13 Superior infrastructure The Netherlands ranks second in the world for overall logistics performance, thanks in part to its top-ranking seaports and airports, a comprehensive network of railways and motorways as well as the second highest quality broadband network in Europe. The country tops DHL s Global Connectedness Index due to its strategic location and international, business-orientated focus. Indeed, half of the Netherlands Gross Domestic Product (GDP) is derived internationally. It is no wonder the country is so attractive to global companies wishing to reach millions of customers in Europe and beyond. Airports Alongside Amsterdam s award-winning Schiphol Airport, the Netherlands has four regional airports offering international flights, making it one of the world s top air transport infrastructures. Schiphol, which has been voted the Best Airport in Europe for 25 consecutive years by the Business Traveller Awards, is also Europe s top airport for cargo and passenger transport. The airport is just 90 minutes from all major Dutch cities via the country s compact, state-of-the-art network of motorways and secondary roads. The regional Maastricht-Aachen Airport is considered the 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. 13

14 14 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 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 Rotterdam

15 The Netherlands: a key hub for distribution in Europe Digital hub The digital infrastructure in the Netherlands is among the best in Europe. Amsterdam hosts one of the four key data centre hot spots in Europe: AMS-IX, which is the biggest internet exchange point in the world. In recent years, AMS-IX has turned Amsterdam into a digital hub. In addition, the Dutch LTE mobile internet broadband scores highest with regard to coverage and fourth in speed on a European level. The Netherlands also has one of the highest penetrations of wired household broadband connections in the world: 98% of all households. It ranks fifth among 25 European countries. The average broadband speeds in the Netherlands are among the world s fastest and it is also one of the most cyber-secure countries. It also directly links continental Europe to North America. Eleven of the fifteen transatlantic cables run directly across the Netherlands. What s more is that, its ultra-modern, fully digital, advanced fibre-optic network serves a multitude of start-ups, data centres and multinationals, such as Microsoft, IBM, Google, Cisco and Oracle. Road & Rail Companies looking to locate logistics and distribution operations in Europe naturally consider the Netherlands, given its comprehensive, state-of-the-art network of roadways. The country has over 14,000 km (8,600 miles) of roads, including 2,235 km (1,389 miles) of highspeed motorways, and more than 12,000 transport companies. With the Netherlands handling 14% of Europe s international road transport, it forms a European hub for international road freight transportation. The country s rail system boasts 3,200 km (2,000 miles) of network rail, directly linked to inland container terminals and destinations throughout the EU, Scandinavia and the Middle East. The Netherlands also has three highspeed rail lines as well as the Betuweroute, a dedicated doubletrack freight railway from Rotterdam to Germany. This gives businesses quick, direct access to Europe s major logistics centres. EU-28 households with internet access at home Netherlands 98% Denmark Luxembourg Sweden United Kingdom Finland Germany Austria Estonia Ireland EU-28 France Belgium Malta Spain Czech Republic Hungary Poland Slovenia Slovakia Italy Cyprus Latvia Portugal Romania Croatia Lithuania Greece Bulgaria % Source: Statistics Netherlands,

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17 Living in the Netherlands Quality of life (2015) The Netherlands is known as a great place to live. With excellent housing facilities, a rich culture life, and an outstanding health care system, the Dutch are among the most happiest people in the world. Appealing place to live The Netherlands is a very appealing place not only to visit and do business, but also to live in. It features a wide array of conveniently located leisure and cultural activities and its historical cities are an architectural delight. Its many museums include the famous Van Gogh Museum and the Rijksmuseum in Amsterdam. The Netherlands ranks in the top 10 for quality of life and housing is relatively affordable according to IMD. For international residents, there are several international schools as well as increasing numbers of schools that teach in both Dutch and English (130 in 2015). The Commonwealth Fund ranks Dutch healthcare as the best in the world as regards quality, access, efficiency, funding and healthy lifestyle of the general population. And in 2017, the Swedish think-thank Health Consumer Powerhouse rated the Dutch healthcare system as outstanding (#1) among its European peers Switzerland Austria Norway New Zealand Canada Denmark Australia Netherlands Germany Sweden Source: IMD,2016

18 Human Development Index (2015) The Netherlands is ranked the fifth most prosperous country out of 188 listed in the United Nations Development Programme (UNDP) Human Development Index. Alongside GDP, UNDP considers other factors in determining prosperity, such as life expectancy, literacy levels and public health. In addition, the Netherlands took sixth place in the World Happiness report s ranking of happiness, based on factors such as caring, generosity, health and freedom. Compared to most major European countries, the country has a lower cost of living while still maintaining a high standard. 18 Norway Australia Switzerland Denmark Netherlands Germany Ireland United States Canada Source: United Nations Development Programme, 2015 New Zealand 10 Ranking of Hapiness Norway (7,537) 2 Denmark (7,522) 3 Iceland (7,504) 4 Switzerland (7,494) 5 Finland (7,469) 6 Netherlands (7,377) 7 Canada (7,316) 8 New Zealand (7,314) 9 Australia (7,284) 10 Sweden (7,284) Explained by: GDP per capita Explained by: social support Explained by: healthy life expectancy Explained by: freedom to make life choices Explained by: generosity Explained by: perceptions of corruption Dystopia (1.85) + residual 95% confidence interval Source: World Happiness Report 2017

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20 Netherlands Switzerland Denmark Norway Luxembourg Finland Germany Belgium Iceland France Austria Sweden Slovakia Portugal United Kingdom Slovenia Czech Republic Spain Estonia Serbia Italy FYR Macedonia Malta Ireland Montenegro Croatia Albania Latvia Poland Hungary Lithuania Greece Bulgaria Romania Cyprus Global Access to Healthcare Index Score out of Netherlands France Germany Australia United Kingdom Canada Cuba Italy Japan Spain United States 10 Healthcare in the Netherlands One of the good things about living in the Netherlands is its first-rate standard of healthcare. The Dutch healthcare system is based on the principles: access to care for all, a compulsory medical insurance and highquality healthcare services. Indeed, it ranks first on the list of 35 countries in the 2017 Euro Health Consumer Index, which is considered the industry standard, for providing the best healthcare services. Since 2005, the Netherlands is the only country to consistently hold a top-three ranking. The country also ranks number one on the Economist Intelligence Unit s Global Access to Healthcare Index, which measures countries worldwide on accessibility of healthcare and the overall healthcare system. Not only is healthcare in the Netherlands highly ranked and accessible, but also affordable. Health spending grew by an annual average of only 1% from , according to the OECD. 20 Source: The Economist Intelligence Unit, Global Access to Healthcare Index EHCI 2017 total scores Source: Euro Health Consumer Index 2017

21 Annual average growth rate in per capita health expenditure, real terms, 2003 to 2016 (or nearest year) in % Greece Portugal Italy Ireland Czech Republic Spain Denmark New Zealand Slovenia France United Kingdom Sweden Luxembourg Austria Finland Netherlands Belgium Iceland Canada Mexico OECS35 Turkey Japan Germany Norway Slovak Republic United States Israel Latvia Hungary Australia Switzerland Poland Estonia Korea Chile Source: OECD Health Statistics 2017

22 22 Dutch healthcare system The success of the healthcare system in the Netherlands is driven by the tenets of access to care for everyone, solidarity through compulsory medical insurance and high-quality services. The fact that the country is given top rankings for healthcare is partly due to this philosophy of cooperation and spirit of joint effort. Healthcare Healthcare providers Private individual/ Insured person Health Health insurer The same applies to the Dutch Life Sciences & Health sector, which is characterised by collaboration and knowledge-sharing among companies and research institutions, with full government support. Dutch healthcare products and services related to medical equipment, remote care and other areas are equally innovative, providing comprehensive smart solutions. The Dutch model, which leads to affordable and sustainable products and solutions, reflects its highly inter-disciplinary approach and resulting expertise throughout the healthcare chain. 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 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 coverage. Meanwhile, under the Long-term Care Act, residents are legally insured against the risk of long-term care. Although, the Dutch healthcare system is essentially a private system, the government maintains a controlling role in the system to protect the public interest. The overhaul has led to various improvements that benefit patients, including more focus on effectiveness and quality, partly through selective contracting. In addition, waiting lists now are shorter and red tape has been reduced. Patients have the freedom to switch healthcare insurers each year and can influence the policies of insurers and health providers.

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24 24 Dutch healthcare facts The Netherlands is very much aware of the rising costs of healthcare and the Ministry of Health, Welfare & Sport devotes a great deal of attention to keeping these costs in check so the country s healthcare system remains affordable and accessible. In 2016, healthcare spending in the Netherlands amounted to 96 billion euros, or 13.8% of the GDP. In 2015, there were 85 hospitals at 131 locations in the Netherlands, eight of which were university medical centres. In addition, there were 112 outpatient clinics. The sector employed approximately 1.1 million people in that year. The number of hospitals is declining because many hospitals are partnering up, with a shift towards specialised institutions. On the other hand, accessibility to healthcare is increasing thanks to its availability at more locations and homecare. Patient organisations play a crucial role in formulating healthcare policies in the Netherlands. The largest patient association is the umbrella organisation NPCF who acts as the representative for approximately 170 different patient associations. Jobs in the Dutch healthcare sector > 2,525 pharmacists > 2,852 midwives > 8,775 dentists > 8,865 GPs > 17,082 physiotherapists > 22,585 specialists > 400,000 nurses / carers / home helps Source: Dutch Ministry of Health, Welfare and Sports, 2016 Financing of health expenditure Health Insurance Act Long-term Care Act Government Own payments Additional insurance Other bln euro Source: Statistics Netherlands, 2017

25 Availability of medicines In 2016, the Netherlands had a medicine availability rate of 30. The rate of availability is measured by the number of medicines available to patients in European countries. For most countries this is when the product is placed on the reimbursement list. With an availability rate of 30, the Netherlands ranks 6 th among the EU countries. Furthermore, the Netherlands also provides quick patient access to medicines after marketing authorisation and ranks in the top 5 countries of Europe. On average, it takes 228 days for patients to obtain access to their medicines in the Netherlands. The average time between marketing authorisation and patient access is measured by the number of days between the date of EU marketing authorisation (or effective marketing authorization in non-eea countries) and the date of completing the post-marketing authorisation administrative processes. Rate of availability Serbia Latvia Lithuania Estonia Bulgaria Croatia Poland Spain Source: EFPIA, Patient W.A.I.T. Indicator 2017 Hungary Ireland Portugal Slovakia Slovenia Belgium France Norway Sweden Switzerland Netherlands Italy Austria Denmark United Kingdom Germany EMA Apporved Data N/A EMA approved 25

26 Average time between marketing authorisation and patient access 1, Average delay (days) Serbia Poland Portugal Lithuania Bulgaria France Slovenia Croatia Latvia Italy Estonia Belgium Ireland Slovakia Spain Austria Norway Sweden Denmark Netherlands Switzerland UK Germany 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 2017

27 Competitive economy The Dutch business climate is attractive and its economy competitive. Actually in 2017, the Netherlands ranked third on Forbes annual Best Country for Business list. The Netherlands also receives high marks for its favourable business climate from the World Economic Forum and IMD. It draws significant investor interest, including from a wide range of multinationals in various sectors. Businesses consider the Netherlands an attractive place to locate in Europe thanks not only to its competitive tax climate and stable business relations, but also to its international focus, its well-educated highly productive labour force, its sophisticated (IT-) infrastructure, its strategic location and its key role as a European transportation hub, as well as its good quality of life. The Netherlands has the sixth-largest economy in the European Union (17 th in the world), with a Gross Domestic Product (GDP) of 697 billion euros in That is impressive for a country whose surface area comes in at 134 th worldwide. It is also a major importer, ranking eighth and taking 3.1% of the global share of imports (504 billion US dollars in 2016). The Netherlands exports and imports a significant amount of commercial services, totalling 180 billion and 173 billion US dollars respectively in This puts the country in sixth place for exports and seventh place for imports of commercial services. Labour productivity in the Netherlands is among the highest worldwide, thanks to a highly educated workforce and solid economic structure. Dutch employees also have an international focus and the majority is multilingual. Overall, the country has a high level of labour participation among both highly educated and lower educated employees. In summary, the Netherlands is one of the European Union s wealthiest nations. GDP per capita of employed persons is 48,326 US dollars (The Conference Board, 2015), compared to the EU average of 37,829 US dollars. Global Competitiveness Index ( ) Switzerland 5.86 United States 5.85 Singapore 5.71 Netherlands 5.66 Germany 5.65 Hong Kong SAR 5.53 Sweden 5.52 United Kingdom 5.51 Japan 5.49 Finland Source: The Global Competitiveness Report 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 GDP in the EU (2016) GDP per hour, corrected for purchasing power parity (2016) GDP per capita (2015) 3,132,670 2,366,912 2,225,260 1,672,438 1,113, , , , , , ,101 65,122 61,041 56,065 48,326 48,091 47,221 46,702 46,574 37, Germany United Kingdom France Italy Spain Netherlands Sweden Poland Belgium Austria Ireland Belgium Singapore United States Netherlands France Germany Denmark Switzerland Sweden Luxembourg Ireland Switzerland United States Netherlands Austria Germany Sweden Denmark EU Millions of euros. Source: Eurostat, 2016 US dollars. Source: The Conference Board, 2017 US dollars, corrected for Purchasing Power Parity. Source: OECD, 2016 Top 10 importers of goods (2016) Top 10 exporters of goods (2016) ,249, ,588, ,060, , , , , , United States 404, ,118, ,453, ,340, , , , , , , , China 2 Germany 3 United Kingdom 4 Japan 5 France 6 Hong Kong 7 Netherlands 8 South Korea 9 Italy 10 Millions of US dollars Share in world imports (%) China 1 United States 2 Germany 3 Japan 4 Netherlands 5 Hong Kong 6 South Korea 7 France 8 Italy 9 United Kingdom 10 Millions of US dollars Share in world exports (%) Source: International Trade Organisation, 2017 Source: International Trade Organisation, 2017

29 Entrepreneurial 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 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. 29 The Netherlands also is an innovator in the field of ICT, thanks to its solid infrastructure, highlevel 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.

30 30 Thriving sectors As a nation of traders, the Netherlands has long benefitted from its spirit of entrepreneurship and innovation, enabling it to grow into one of the world s twenty largest economies in the world. Even during times of economic and social adversity, this spirit has helped the country prosper. In an effort to maintain its edge in the global marketplace, Dutch government policies focus on nine top sectors that are considered the driving forces of the economy. These sectors are: Agriculture & Food, Chemistry, Creative Industries, Energy, High-Tech Systems & Materials (HTSM), Horticulture & Starting Materials, Life Sciences & Health, Logistics and Water. In a joint effort, governments, companies, researchers and civil society organisations are working together to facilitate innovation and create a climate for continuous innovation. In addition to the benefits of cooperation, the sectors benefit from crossfertilisation in creating the best products and services using the best people. This also helps the sectors thrive internationally. The Netherlands: one of the world s twenty largest economies

31 The 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 WATER

32 32 Top Sector Chemistry With over 400 high-quality chemical companies across the supply chain, the Netherlands takes a leading position in the supply of chemical products and services in Europe. With exports valued at 7.8 billion euros, 19 of the top 25 global chemical companies have major operations in the Netherlands, including AkzoNobel and Shell. The Top Sector Chemistry is earmarked to play a key role in the shift to green and sustainable chemistry. Like other industries, the chemical sector is facing a shortage of raw materials. Current efforts are focused on increasing the (re)use of environmentally friendly and sustainable raw materials for the energy, transport, food and healthcare industries. Top Sector Life Sciences & Health The Netherlands excels in the area of life sciences and is home to 2,500 Life Sciences & Health companies and research organisations, 85 hospitals and 12 research universities. Its excellent healthcare system and infrastructure are further supported by its advanced technological know-how in patient monitoring and medical imaging. The key features of the Top Sector Life Sciences & Health are close cooperation between government, knowledge institutions, the industry and patient organisations. In the Netherlands, this is called the quadruple helix. The top sector covers not only health infrastructure, but medical technology, biopharmaceuticals and regenerative medicine as well. One of its goals is to improve health and the quality of life, address the problems of an ageing population and ensure care remains affordable and accessible. Dutch companies 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, Top sectors Life Sciences & Health Agriculture & Food High Tech Systems and Materials Water Horticulture and Starting Materials Creative Industries Chemistry Logistics Energy Source: Statistics Netherlands, 2017 % change Top Sector Logistics Traditionally an internationally trading nation, the Netherlands is an important global economic player. Given the growing importance of sustainability, the Logistics top sector must focus its efforts on reducing CO 2 emissions while ensuring better accessibility including through the country s main airport (Amsterdam Schiphol) and seaport (Rotterdam). To preserve the Netherlands competitive position, this sector also concentrates on international logistics and supply chain management.

33 Industry Clusters in the Netherlands Groningen Amsterdam Utrecht Enschede Leiden Den Haag Arnhem Rotterdam Delft Nijmegen Wageningen 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, 2016

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36 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.

37 Competitive fiscal climate International companies see the Netherlands as a great place to locate, thanks in part to its investment-friendly corporate income tax system. It has a competitive corporate tax rate of 20-25% as well as excellent incentives for innovation and R&D, and a cooperative tax authority. Dutch tax practices have met OECD standards for the past 30 years. This, combined with its cooperative tax authority and stable government, means businesses can be confident that future changes will not pose significant obstacles or disadvantages to foreign investors. Investment-friendly corporate tax system The Dutch tax system offers several competitive features for companies looking to relocate or expand their operations in Europe: A broad participation exemption of 100% from Dutch corporate income tax for all benefits related to qualifying shareholding. This measure is aimed at preventing double taxation. Advance tax ruling from the tax authorities as well as the option for an Advance Pricing Agreement (APA). These give companies certainty concerning their tax position in the future. A transfer pricing practice that is aligned with OECD Transfer Pricing Guidelines. An R&D tax credit for qualifying R&D wage costs and other related costs and investments (WBSO). Pro-active and practical customs authorities. A beneficial tax programme with a 30% personal tax income advantage for qualified foreign workers. Nearly 100 bilateral tax treaties to prevent double taxation and many companies enjoy lower withholding tax on dividends, interest and royalties (the latter often to 0%). An efficient fiscal unity regime that provides tax consolidation for domestic activities within a corporate group. There is no statutory withholding tax on outgoing interest and royalty payments. A tax relief programme for sustainable energy investments (EIA). No up-front payment of VAT upon importation: no actual payment of VAT. An Innovation Box to stimulate technical innovation, which means an effective corporate tax rate of 7% for qualifying profits. A relatively low statutory corporate income tax rate of 25%. Tax relief for environmentally friendly investments (MIA/Vamil). Tax authorities allow access to the tax inspector. 37 The Netherlands: excellent incentives for innovation and R&D

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39 Supportive R&D Incentives The Netherlands has several measures in place that promote research & development. These include general corporate and specific R&D tax incentives. These pro-innovation R&D tax measures not only cut R&D costs but also lower a company s taxable base. R&D Tax Credit (WBSO) The WBSO tax credit is an example of a scheme for businesses involved in developing technically new products and production processes as well as those performing scientific research in biotechnology, physics, chemistry, production technology and IT technology. Clinical trials are also included in this scheme. The WBSO provides a payroll tax deduction as well as compensation for other costs for companies involved in R&D. Selfemployed entrepreneurs can also qualify and are entitled to a fixed deduction of 12,623 euros, while start-up entrepreneurs can receive an additional deduction of 6,315 euros. Companies may be entitled to as much as a 32% reduction on the first 350,000 euros in R&D wage costs and other R&D-related expenses and 14% for costs over 350,000 euros. Public knowledge institutes are excluded from the scheme. Innovation Box Under the Innovation Box regime, companies can benefit from an effective tax rate of only 7% for R&D income from patented and unpatented intangible assets. This includes technological innovations created by the Dutch taxpayer and for which an R&D tax credit was received. The normal corporate income tax rate is 20% to 25%. Companies are not required to apply for the Innovation Box and the level of income allocated is restricted. This means that as more R&D activities are outsourced, fewer profits can be allocated to the intangible assets that result from those activities. There is a flat-rate regulation for SMEs, which can decide each year to apply 25% of their profit to the Innovation Box with a cap of 25,000 euros. The corporate income taxpayer claims the lower 7% rate on their return. The lower rate is, in fact, an exemption of 72% of the profits that can be allocated to the Innovation Box, giving an effective rate of approximately 7%. The effective rate applies to profits exceeding any development costs and losses made. Such losses and expenses are deductive at the normal tax rate of 25%. 39

40 Innovation-oriented schemes 40 Innovation Credit The Dutch Ministry of Economic Affairs & Climate Policy offers Innovation Credit in the form of a risk-bearing loan that companies can use in the (technical) development phase of a product, process or service that is considered technically new. Funding, which can also be applied to the development of medical products that require a clinical study, varies from 25% for large companies to 45% for SMEs. This can be applied to project costs capped at 10 million euros with a minimum project size of 150,000 euros. Any additional expenses must be financed from the company s own resources. Companies must repay the loan within ten years after the settlement date. This requirement may be waived if the project fails for technical reasons or a change in the commercial environment. During the development phase, interest is added to the loan. Generally at 7% for technical development projects and 10% for clinical development projects. Businesses can only apply for the credit if they lack sufficient resources to finance their project. Both SMEs and large companies, whose activities are based in the Netherlands can apply for a loan for their projects, which must have a maximum duration of four years. Applicants must have a systematic development approach and a detailed project plan. PPP Allowance Top Sector Life Sciences & Health supports innovative research carried out by publicprivate partnerships (PPPs) in the Dutch LSH sector. Stakeholders from research organisations, health foundations and companies (start-ups, SMEs and industry) are invited to jointly invest in R&D to perform groundbreaking innovations and to contribute to a strong and sustainable LSH sector that plays a major role in finding solutions for healthcare challenges around the world. With the PPP (Public-Private Partnership) Allowance, the Top Sector provides stakeholders, like research organisations, knowledge institutes, companies, and health foundations with a financial tool to carry out their innovative ideas. Partnerships are offered the opportunity to apply for a PPP Allowance twice a year and they can get funding for up to 75 % of the R&D costs provided that both the company and the research organization, make a substantial contribution in cash and/or in kind to jointly bear the costs and risks of the R&D project. The Top Sector Life Sciences & Health Health~Holland, matches every euro invested by private partners with up to 30 cents by the Dutch government. The Top Sector LSH currently finances nineteen projects in the field of biopharma with a PPP Allowance. Unraveling the genetic basis of ALS by large-scale genetic sequencing is currently one of the projects financed with a PPP Allowance. MIT Scheme The MIT (SME Innovation Stimulation) Scheme offers SME entrepreneurs the opportunity to get additional funding for innovative R&D activities within the Top Sector. The funding, partly national and regional instruments, can be used in several ways: knowledge vouchers, innovation consultancy projects, feasibility projects and R&D joint ventures. Knowledge vouchers: An SME entrepreneur can present a knowledge voucher to a centre of expertise for a scientific inquiry into a research question. Innovation consultancy projects: To get innovation advice and recommendations from a centre of expertise or independent consultancy, such as answering a research question or addressing a request for advice. Feasibility projects: To identify the potential technical and financial risks of a proposed innovation project. R&D joint venture: A collaboration with at least one other SME entrepreneur to innovate or develop a product, production process or service.

41 Sustainability-oriented schemes The MIA and Vamil schemes The Netherlands also provides tax relief programmes for sustainable energy and environmentally friendly investments, including the MIA and Vamil schemes. Any Dutch entrepreneur paying income or corporate tax can apply and the two schemes can usually be combined. Under the MIA scheme, they can deduct up to 36% of an environmentally friendly investment from their tax profit. However, the investment must be included on the Environment List. This list of approximately 270 investments is updated annually and is found on the MIA/Vamil website of the Netherlands Enterprise Agency (in Dutch only). In 2018, the minimum investment amount is 2,500 euros and the maximum is 25,000,000 euros. The Vamil scheme provides entrepreneurs with an advantage in liquidity and interest as they can decide when to write off 75% of their Environment List-related investment spending. For the 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 environmentally friendly way. They are particularly beneficial to businesses in the shipping, agricultural and industry sectors. EIA and SDE+ schemes Under the Energy Investment Allowance (EIA), the Dutch government provides a 54.5% deduction to companies that invest in energysaving installations, or that make use of sustainable energy. The deduction, which is made on the amount invested sum and comes on top of the usual depreciation, is deducted from their taxable profits in the year in which the goods are purchased. The allowance is applicable to new fixed assets within three months of purchase and must be included on the Energy List. Any investment grant for that asset must be deducted from the costs, with the exception of operating subsidies. In 2018, the investment must be at least 2,500 euros and the deduction applies to investments up to 121 million euros. Any energy advice and additional expenses to make an asset operational can also be included in the deduction. On average, the EIA gives a 13.5% tax advantage. Under the Sustainable Energy Production Scheme (SDE+), producers of sustainable electricity and heat or a combination of sustainable heat and electricity (CHP) or green gas, are compensated for the renewable energy generated. The scheme is aimed at companies, institutions and non-profit organisations whose projects are realised in the Netherlands; private producers of renewable energy are not eligible. Energy generated using biomass is controlled to ensure it adheres to the sustainability criteria. Renewable energy production may not be profitable because the cost to generate it can outstrip the market price. This unprofitable component is compensated under SDE+ for a set number of years, depending on the technology involved. The Netherlands provides tax relief programmes for sustainable energy 41

42 Further financial support 42 Other governmental incentives The Dutch government offers several other incentives to companies. One example is the Corporate Finance Guarantee Scheme (GO), in which capital providers are granted a 50% government guarantee to facilitate medium and large companies wishing to borrow large amounts of money. For SMEs there is the Growth Facility Scheme, under which the government provides a 50% guarantee for financiers providing venture capital to these enterprises. And employers can get a tax-free budget for benefits equal to 1.2% of their annual taxable wage under the Work-related Costs Scheme. For employees, there is a Travel Allowance scheme for commuting costs to and from a fixed workplace. Invest-NL There will be an additional, new government incentive called Invest-NL. This was announced by the Dutch government in The objective of this scheme is to stimulate investments in the Netherlands. Invest-NL will be a development and financing institute with a capital of 2.5 billion euros aimed at helping companies experiencing difficulties with raising capital. This could be because there is uncertainty about the relationship between risk and return or because of a long and uncertain return on investment. Invest-NL offers entrepreneurs support in risk capital, guarantees, export credit insurances and international financing programs. Moreover, Invest-NL will develop large-scale social projects in the Netherlands and abroad and co-finance where necessary. Public financing of R&D The Dutch government finances approximately one third of the annual national expenses on R&D. There are several ways in which R&D is publicly funded. In general terms, basic financing allows universities and institutions to allocate the funds themselves. There is also project or programme financing. Here, funds are provided for a specific time, budget and content. In most cases there is also a competitive element. Health research is funded, among others, by the Netherlands Organisation for Health Research and Development (ZonMW). This organisation also promotes the actual use of the knowledge this research produces. Recently, the National Science Agenda gave a big boost to the Dutch science policy, which was generated in The purpose of the Agenda was to connect existing research agendas, like the EU Horizon 2020 programme with questions out of the Dutch society. It is expected that the National Science Agenda will be an important building block for future research programmes at universities and institutions. While further developing the health agenda, alternative methods to test the clinical effectiveness of new medical interventions (including medicines) will also be investigated, as well as research into outcome measures at the level of the individual patient. In addition, attention will be paid to new approaches, such as customised and regenerative medicines. Venture capital and private equity The Netherlands not only has a highly appealing tax regime and incentive schemes but an abundance of venture capital companies that invest in the country s innovative enterprises as well. A total of 3.7 billion euros was invested in 365 companies in These funds included venture capital injections in fast-growing start-ups and private equity investments in mature companies. Venture capitalists in the Netherlands often focus on life sciences and ICT companies.

43 Venture capital investments Venture capital investments by sector 280, , , , , , , , , ,000 80,000 60,000 40,000 20, , , , , ,483 55, ,195 49,485 91,089 67,207 80,701 92, ,720 60, ,191 33, ,337 32,440 80,274 90, Seed Start-up Later stage venture Source: Nederlandse Vereniging van Participatiemaatschappijen (NVP) Private equity investments 6,000, ,000 5,000,000 4,500,000 4,000,000 3,500,000 3,000,000 2,500,000 2,000,000 1,500,000 1,000, ,000 5,091,955 2,050, ,597 1,498,958 2,634, ,899 1,886,357 2,348,342 2,499,496 2,826, Growth Rescue/Turnaround Replacement Capital Buyout 260, , , , , , , , ,000 80,000 60,000 40,000 20, ,686 44,649 27,715 64,776 23,414 12, ,594 25,326 28, ,469 7, ,714 28,943 60,552 16, ,013 49,166 6,691 15,438 62, , , ,948 18, , ,809 54,370 99, ,370 62,212 90, ,452 16,316 84, ,835 76,462 55, Agriculture Business products and services Chemicals and materials ICT Construction Consumer goods and services Energy and environment Financial and insurance activities Real estate Healthcare and biotechnology Transportation Other 43 Source: Nederlandse Vereniging van Participatiemaatschappijen (NVP) Source: Nederlandse Vereniging van Participatiemaatschappijen (NVP)

44 44 Local business support through ROMS Business investments in the Netherlands receive local support from regional development companies (ROMs). The country has a number of ROMs in several provinces, which provide venture capital, support foreign companies upon their establishment in the Netherlands, coordinate collaborations between companies and knowledge institutes and sometimes become shareholders in regional companies. ROMs invested a total of 40 million euros in 124 companies in They are mainly focused on fast-growing innovative businesses and they not only help entrepreneurs with their operations but also encourage them to locate in their region. Ontwikkelingsbedrijf Noord-Holland Noord (NHN) Amsterdam Economic Board Amsterdam Trade Innovation Quarter Regional development companies DEN HAAG ALKMAAR AMSTERDAM ALMERE UTRECHT GRONINGEN APELDOORN Investerings- en ontwikkelingsmaatschappij voor Noord-Nederland (NOM) Ontwikkelingsmaatschappij Flevoland bv (OMFL) Ontwikkelingsmaatschappij Oost NL Rotterdam Partners ROTTERDAM BREDA Utrecht Economic Board NV Ontwikkelingsmaatschappij Utrecht (OMU) NV Economische Impuls Zeeland MIDDELBURG Brabantse Ontwikkelings Maatschappij (BOM) NV Industriebank LIOF MAASTRICHT Source: Health~Holland, Knowledge and Innovation Agenda

45 Human capital The Netherlands is a highly appealing country for multinationals thanks, in part, to its highly qualified workforce and the country s educational system. Citation impact score World-class education system The Netherlands has an outstanding higher education system, aimed at producing a pool of highly knowledgeable and skilled graduates. The country has 14 universities, 13 of which are globally ranked (QS World University Rankings, 2018), and 37 universities of applied sciences as well as many training facilities. In 2016/2017, the Netherlands ranked 7 th on the QS Higher Education System Strength and 8 th on the Universitas21 Higher Education Systems main ranking. Dutch universities also receive high citation impact scores, with the Netherlands ranking among the top three worldwide. The same applies to international co-publications Switzerland Denmark All publications Netherlands United Kingdom Ireland Belgium Sweden International co-publications Norway United States Australia Finland Austria Canada Germany France China Korea Japan 45 Source: OCW, 2018

46 46

47 The Dutch education system produces an excellent pool of human capital and the number of students enrolled at (scientific) universities has seen a sharp growth in recent years. In 2017, there were 276,713 students enrolled in a Bachelor s or Master s programme, with over 33,000 in health programmes and over 41,000 doing technology studies. Another 445,000 were attending higher vocational education courses in Another reflection of the country s academic excellence is the number of PhD students, which has doubled over the past 25 years to 4,829 in 2015/2016. The largest proportion of doctorate candidates are in the Health & Wellbeing sector (1,679). Registered university students academic year 300, , , , , , , , , , , Source: VSNU/CBS, 1cHO2017; Prognosis 2025; Reference Forecast 2016, OCW

48 The Netherlands: world leading in terms of research achievements Knowledge Institutions 48 Universities There are fourteen universities in the Netherlands, including twelve research universities, four specialised in technology and engineering, and eight university medical centres. In addition, there are 37 universities of applied sciences. Universities of Technology There are four universities of technology in the Netherlands, three of which rank in the top 10 of the best 300 universities worldwide in working with the industry. Not only are there opportunities for high-quality education but also excellent jobs for knowledge workers. In addition, the country is world leading in terms of research achievements in science and engineering. The Netherlands is among the top three countries with the greatest scientific impact related to research and development in the area of technology and innovation as well as collaboration and technology partnerships.

49 University Medical Centres The Netherlands is home to eight university medical centres (UMCs), all of which have a wider range of responsibilities than regular hospitals. Patients with rare or complex diseases are generally referred to UMCs, which also serve as educational institutions and research centres. UMCs offer Bachelor s and Master s courses for medical students, training for physicians specialising in a particular medical field and both basic and advanced nursing courses. 49

50 50 Leiden University Medical Center

51 Productive and multilingual workforce The country is home to a highly educated, wellmotivated, and multilingual workforce, whose productivity exceeds that of most European countries. And it is highly regarded for its large pool of candidates with advanced degrees and acceptance of foreign ways of doing business. Not only are 90% of Dutch fluent in English, but many are multilingual, and the Netherlands ranks third out of 54 countries in the EF English Proficiency Index. A significant proportion of the population also speaks German and French. In addition, life-long learning is common compared with other EU member states. The Dutch are known for their pragmatism, including in the business arena, and labour disputes are relatively rare compared to other European countries. And the high labour productivity is helped by the solid employeremployee relations. Fast Track Permits The Netherlands immigration laws also help companies easily attract top talent internationally. Under the country s fast-track permit scheme for highly-skilled migrants (so-called knowledge workers ), employers are not required to apply for a work permit for such employees coming from outside the EU. Such knowledge workers and their families only need a provisional residence permit (MVV) and/or residence permit. There is a special tax ruling for these specialised knowledge workers, who must have an employment contract. The required monthly income (2018) to qualify as a highly-skilled knowledge worker is at least 4,404 euros gross (3,229 euros for those under age 30). The salary must be considered reasonable compared to other similar jobs in the sector. However, this requirement does not apply to employees of education or research institutes or scientific researchers and physicians training to become specialists. In addition, shareholder/ employees who own more than 25% of the company s shares are not included in this permit scheme as they are considered self-employed. Short-stay scheme The short-stay scheme for highly-skilled migrants allows these individuals to work in the Netherlands for up to 90 days on short-term projects or while providing consultation or training. Employers must first be approved as recognised sponsors and are required to apply for work permits. Still, the process is simpler than it is for other migrants and the Employee Insurance Agency UWV issues the permit within two weeks (compared to the usual five weeks). There is also less red tape involved and no requirement for labour market testing or verifying the validity of the vacancy. The gross monthly income requirements are the same as for the fast-track permit scheme and the employer must provide proof of salary payment. Language skills Netherlands 9.26 Switzerland 8.77 Belgium 8.21 Germany 6.95 Source: IMD World Talent Ranking, 2017 Ireland United Kingdom 4.14 France 51

52 52 30% ruling The Netherlands is not only attractive for multinationals and investors, but also for expats who can take advantage of a special tax regime, the so-called 30% ruling. Under the ruling, the employer may give foreign workers a tax-free allowance of up to a maximum of 30% of his or her gross salary that is subject to payroll tax for up to 96 months. The allowance, which is meant as compensation for the extra costs involved in living abroad, includes bonus payments and stock options but not pension payments. To qualify, the employee must have lived more than 150 km from the Netherlands for more than two-thirds of the two years prior to starting work. The ruling can be applied for eight years but after five years, the tax authorities may require the employer to prove the employee still meets the conditions. This eight-year period may be reduced if the expat has previously lived or worked in the Netherlands. The gross salary must be at least 37,296 euros (or 53,280 euros including the 30% reimbursement) or 28,350 euros (or 40,500 euros including reimbursement) for under-30s with a university degree (these minimums do not apply to scientific researchers, doctors in training or employees in the scientific education field). The ruling also requires that the employment contract detail the taxable and non-taxable portions of the employee s income. University of Groningen

53 3BIOPHARMACEUTICAL SECTOR 53

54 Notable Dutch scientists throughout the years The Netherlands has a rich history with impressive contributions to the world s medical science that date back to the late 1500s. Below are some examples of Dutch scientist and their contributions. 1 2 Hans and (son) Zacharias Jansen 1 ( ) invented the microscope around Andreas Vesalius 2 ( ), anatomist, physician and the author of one of the most influential books on human anatomy, De humani corporis fabrica ( On the Fabric of the Human Body ). Vesalius is often referred to as the founder of modern human anatomy Antoni van Leeuwenhoek 3 ( ) is known as the father of microbiology and is considered to be the first microbiologist. He is best known for his work on the improvement of the microscope and for his contributions towards the establishment of microbiology. Herman Boerhaave 4 ( ) is regarded as the founder of clinical teaching and of the modern academic hospital. He is often referred to as the father of physiology. Willem Einthoven 5 ( ), winner of the Nobel Prize in Medicine in 1924 for his invention of the electrocardiogram. 5 6 Willem Kolff 6 ( ), considered one of the most important physicians of the 20 th century, developed and applied the first functioning artificial kidney in 1943, and was involved in breakthrough development such as the heart-lung machine and artificial heart. Ben Feringa 7 (born in 1951), winner of the Nobel Prize in Chemistry in 2016, for the development of molecular machines and the research on Nano-medicine. 7 8 Bert Meijer 8 (born in 1955), recipient of Japan s highest award for chemistry scientists, the Nagoya Gold Medal of Organic Chemistry in Meijer joins an eminent group of 22 other recipients, including winners of Nobel Prizes, Franklin Medals and Wolf Prizes.

55 BIOPHARMACEUTICAL SECTOR With a large number of attractive aspects the Netherlands is already selected by several biopharmaceutical companies as their preferred location for R&D, manufacturing, distribution and logistics. There are more than 2,900 innovative R&D Life Sciences companies active in the Netherlands, including 420 biopharmaceutical companies, making the Netherlands one of the most concentrated Life Science & Health clusters in the world. 55 Vibrant and booming Life Sciences & Health sector The Netherlands is home to a vibrant, booming and concentrated Life Science & Health sector. The last ten years, the number of companies active in the Life Sciences sector has doubled and the country has one of the highest concentrations of LSH activity in the world, with more than 2,900 innovative R&D Life Sciences companies employing over 34,000 people within a 120 mile radius. The Life Sciences & Health sector in the Netherlands is characterized by the high per capita R&D output and the excellent expertise in several areas such as cancer research, cardiovascular diseases, infectious diseases, neurodegenerative diseases, clinical research, medical imaging in preventive healthcare and health care systems. The huge number of innovative small-medium companies ensure that the country is an attractive and interesting place for young talent.

56 The Life Sciences sector has doubled from Number of companies in 2005 and 2015 Companies per sector Professionial Services and Consulting 13.6% Public/Non-Profit Organization 10.8% Investor 2.1% Medical Technology 6.4% Pharma % Biotechnology - other 7.1% Supplier & Engineering 36.4% Micro (1-10 FTE) Small (11-50 FTE) Medium/Large (>50 FTE) Source: HollandBIO, Life Sciences Biotechnology/R&D services 12.5% Biotechnology - Therapeutics and Diagnostics 6.3% Media 0.2% HealthTech 2.4% Source: Dutch Life Science Database, 2018

57 Life Sciences & Health Clusters Today, the Netherlands maintains its position as leader in the Life Sciences and Health sector, thanks to the country s booming and vibrant local clusters that focus on Life Sciences and Health, organised into specialised science parks. Each science park contains a local ecosystem of companies (from small to mid-size to large), start-ups, a university and a university medical centre. Park authorities facilitate local companies and support cooperation. This makes it relatively easy in the Netherlands to work together and to develop joint solutions for emerging and urgent matters in the field of Life Sciences and Health. On the next page are some examples of science parks located in the Netherlands. Zernike 57

58 88 Businesses 58 Amsterdam Science Park The Amsterdam Science Park has one of the largest concentrations of exact sciences in Europe and offers excellent science and business opportunities for ICT, Life Sciences, High-tech, Physics and Chemistry. It is the perfect nerve centre for business, science and innovation, thanks to the location of the renowned Science Faculty of the University of Amsterdam, the Amsterdam University College, dozens of outstanding research institutes and 130 companies including both start-ups and multinationals. More than 10,000 scientists, entrepreneurs and students use the park every day. Furthermore, the park is home to the world s largest data transport hub, the AMS-IX. The Amsterdam Science Park is a joint development of the University of Amsterdam (UvA), City of Amsterdam and the Netherlands Organisation for Scientific Research (NWO). Utrecht Science Park The Utrecht Science Park is the biggest science park in the Netherlands with the highest concentration of knowledge institutes on a small surface area. The park is home to 88 businesses on a 300-hectare area east of Utrecht and focuses primarily on Life Sciences & Health and Sustainability. The internationally acclaimed Utrecht University is located at the Park and has boasted 12 Nobel laureates among its alumni. In 2010 and 2013 the Utrecht region was named the most competitive region in Europe (Joint Research Centre - European Commission). Furthermore, the local incubator (UtrechtInc) is one the 10 best incubators in Europe. 2,500 Student accommodations 24,800 Staff members per day 51,700 Students per day 322 Surface area in hectares Source: Utrecht Science Park

59 Zernike Leiden Bio Science Park The Leiden Bio Science Park is the perfect place for businesses in the field of biotechnology and pharmaceuticals. The park ranks in the top 5 science parks in Europe and is a fast-growing and well-known cluster in the Netherlands with 195 organizations and 18,300 employees. The Park is home to 106 biomedical companies, dozens of innovative bioscience start-ups and several research institutes, educational institutes and healthcare organizations. The combination of a large number of start-ups, several multinationals and renowned research institutes makes Leiden a significant international R&D hub. 23 providing business services dedicated to medicine development 106 biomedical (red) biotech companies, of which: 46 companies that provide medicine development services Pivot Park Newcomer Pivot Park, founded in 2012, is an initiative of the pharmaceutical company MSD in collaboration with the Province of Noord- Brabant, the municipality of Oss, the Ministry of Economic Affairs, the Ministry of Health, Welfare and Sport, and the Brabant Development Agency (BOM). Pivot Park is located in Oss, a city with a long history of drug development dating back nearly a century. Oss has played a significant role in today s medicines due to the former pharmaceutical company Organon that was active from Now, Pivot Park builds upon the impressive legacy of Organon and offers an outstanding R&D infrastructure where start-ups flourish, grow and contribute to a healthy society by developing new and innovative medicines in collaboration with other companies. The park is home to 50 companies, consisting of start-ups, consultancy companies and service providers. Zernike Campus Groningen One of the best-known and oldest campuses in the Netherlands is the Zernike Campus. This campus originated in the 1960s in the city of Groningen and focuses on energy, chemistry, life sciences and big data. The park is home to knowledge institutions, numerous companies and facilities such as Innolab Chemie Groningen, Zernike NanoLab Groningen, Energy Transition Centre EnTrance, Energy Academy Europe, Cube050 incubator and the Zernike Advanced Processing facility. More than 4,000 researchers and employees and a few hundred entrepreneurs are working on innovative solutions needed for the future. More than 35,000 students are preparing themselves at the park to become professionals at the University of Groningen and the Hanzehogeschool Groningen. For the approximately 150 companies, the high-tech facilities and the cooperation possibilities provide an excellent breeding ground for their products and services medtech companies 25 medicine development companies Source: Leiden Bio Science Park

60 60 Utrecht Science Park

61 Attractive biopharmaceutical sector The biopharmaceutical sector is a growing and attractive sector in the Netherlands, with 420 biopharmaceutical companies and the employment of approximately 65,000 people. The biopharmaceutical sector of the Netherlands is unique and outstanding due to the high concentration of university medical centres, research universities and the impressive number of biopharmaceutical companies, all within a 120 mile radius. This makes it highly common in the Netherlands to develop medicines together as a collaboration between research universities, university medical centres and biopharmaceutical companies. The Netherlands The world's most concentrated life sciences cluster 420 BIOPHARMACEUTICAL COMPANIES 8 UNIVERSITY MEDICAL CENTERS 61 The majority of the biopharmaceutical companies active in the Netherlands focus on medical biotechnology (54%). The remaining companies are active in the pharmaceutical products industry (38%) and pharmaceutical raw materials industry (7%). Most of the biopharmaceutical companies in the Netherlands are small to medium-sized enterprises. Only 20 biopharmaceutical companies can be considered as large companies. 12 UNIVERSITIES ENGAGED IN BIOMEDICAL RESEARCH... all within a 120 mile radius!

62 62 Number of biopharma companies in the Netherlands Distribution of companies developing medicinal products Proportion of small-to-medium versus large companies Pharmaceutical raw-materials industry 7% Large companies 20 Medical biotechnology 54% Small to medium Manufacture of pharmaceutical products 38% Source: PwC, Economische Footprint Nederlandse Geneesmiddelensector, 2017 Source: PwC, Economische Footprint Nederlandse Geneesmiddelensector, 2017 Source: PwC, Economische Footprint Nederlandse Geneesmiddelensector, 2017

63 Employment In the Netherlands, approximately 65,000 employees work in the medicine development sector with both direct and indirect employment. Most direct employment in the medicine development sector in the Netherlands involves the development and manufacturing of medicines (87%). The remaining direct employment concerns clinical research (12%) and the pharmaceutical raw materials industry (less than 2%). Total employment in the development of medicinal products (x 1,000) Distribution of employment in medicine development sector Pharmaceutical raw-material industry 1% Clinical research 12% Development and manufacture of medicines 87% Direct Indirect Source: PwC, Economische Footprint Nederlandse Geneesmiddelensector, 2017 Source: PwC, Economische Footprint Nederlandse Geneesmiddelensector, 2017

64 64 Total turnover and production value in millions of euros 40,000 35,000 30,000 25,000 20,000 15,000 10,000 5, ,592 33,937 35,782 33,075 30,512 26,789 32,135 28,723 33,169 29,352 Private investments in own R&D in millions of euros Turnover and investments In 2014 the pharmaceutical sector in the Netherlands had a turnover of more than 33 billion and a production value of more than 29 billion. The turnover is calculated by the total value of sales by a company (organisation, legal entity) in a certain period and the production value is calculated by the value of production-related sales. The turnover in the pharmaceutical sector in the Netherlands consists of the distribution of medical products (84%) and the manufacturing of pharmaceutical products (16%). In the Netherlands, annually approximately 380 million is invested in R&D activities. This amount consists of 250 million for internal R&D activities and 130 million for external R&D expenses. Turnover Production value Own R&D Source: PwC, Economische Footprint Nederlandse Geneesmiddelensector, 2017 Source: PwC, Economische Footprint Nederlandse Geneesmiddelensector, 2017 Distribution of turnover 16% 84% Distribution of medical articles Manufacture of pharmaceutical products Source: PwC, Economische Footprint Nederlandse Geneesmiddelensector, 2017

65 Export and import Pharmaceutical exports Pharmaceutical imports According to the European Federation of Pharmaceutical Industries and Associations (EFPIA), the Netherlands has a pharmaceutical export and import of respectively 27 billion and 19 billion. With these volumes, the Netherlands is ranked 7 th in Europe. EFPIA 2015 million Austria 8,472 Belgium 41,003 Bulgaria 819 Croatia 562 Cyprus 255 Czech Republic 2,148 Denmark 11,537 Estonia 64 Finland 852 France 27,857 Germany 68,706 Greece 1,018 Hungary 4,448 Ireland 30,231 Italy 19,052 Latvia 332 Lithuania 632 Luxembourg 300 Malta 241 Netherlands 27,434 Norway 705 Poland 2,841 Portugal 920 Romania 851 Russia 277 Slovakia 480 Slovenia 2,413 Spain 10,934 Sweden 7,600 Switzerland 58,127 Turkey 849 United Kingdom 33,343 Total 365,303 EFPIA 2015 million Austria 8,002 Belgium 34,694 Bulgaria 1,151 Croatia 803 Cyprus 222 Czech Republic 3,678 Denmark 3,592 Estonia 361 Finland 2,010 France 23,659 Germany 42,282 Greece 2,790 Hungary 3,647 Ireland 5,752 Italy 21,372 Latvia 510 Lithuania 964 Luxembourg 390 Malta 132 Netherlands 19,168 Norway 1,597 Poland 4,912 Portugal 2,360 Romania 2,614 Russia 6,873 Slovakia 1,660 Slovenia 1,059 Spain 13,826 Sweden 3,576 Switzerland 20,688 Turkey 4,165 United Kingdom 30,503 Total 269, Source: EFPIA, The Pharmaceutical Industry in Figures, 2017 Source: EFPIA, The Pharmaceutical Industry in Figures, 2017

66 Biotechnology companies in the Netherlands Biotechnology plays an important role in the Netherlands Life Sciences landscape. The Netherlands hosts many innovative biotechnology companies, from start-ups to small and medium-sized enterprises to large companies that are active in the field of health, nutrition or bio-based economy. Dutch scientists and entrepreneurs like Herbert Heyneker, Hubert Schoemaker, Rob Schilperoort, Henri Termeer, and more recently Hans van Eenennaam, have played an important role. Over the past decades, the Netherlands has developed new medicines, diagnostics, nutritional and industrial products that have contributed to society, sustainability and health. Galapagos, Genmab and Kiadis Pharma are some examples of biotech companies hosted by in the Netherlands. Most of the biotech companies located in the Netherlands are private or independent companies, 85.8%. Only 12.4% are subsidiary and 1.8% are publicly listed on the stock exchange. Most biotechnology companies in the Netherlands are active in diagnostics and analytical services, contract research, manufacturing and other services and suppliers. 66 Biotechnology companies by ownership status Publicly listed on stock exchange 1.8% Subsidiary 12.4% Key activities of biotechnology companies Veterinary 3.4% Therapeutics 12.6% Other Services and Suppliers 22.9% AgroBio 6.6% Bioinformatics and Bioelectronics 4.5% Contact Research and Manufacturing 13.2% Cosmetics 1.6% Diagnostics and Analytical Services Private / independent 16.7% 85.8% Industrial Biotechnology 1.1% Drug Delivery Genomics and Proteomics 3.0% 6.9% Environment Food and Nutraceuticals 1.2% Source: The Dutch Life Sciences Trend Analysis % Source: The Dutch Life Sciences Trend Analysis 2017

67 Companies in the Netherlands Big multinational pharmaceutical companies such as MSD (also known as Merck & Co.), Janssen pharmaceutical companies of J&J, Amgen and Astellas have chosen the Netherlands as their location for different operations, such as R&D, production, and logistics activities. Some have set up their European headquarters in the Netherlands or have invested in Dutch SME s. There are several industry associations, for example, the Innovative Medicines Association (innovative pharmaceutical industry), HollandBIO (biotechnology) and VNO-NCW (employers). 67

68 68 MSD is the largest and most versatile pharmaceutical company in the Netherlands. It contributes to the health of both humans and animals. For almost one hundred years MSD has been active in the Netherlands and has contributed to many developments in the area of fertility and birth control. It also discovered and (partly) developed several important medicines in the Netherlands, such as immune therapy for the treatment of cancer. In addition, MSD produces 100 different veterinary vaccines and medicines for animals, which contribute to disease prevention and health protection of 50 billion animals worldwide. Approximately 4,000 people work at MSD in the Netherlands. On a yearly basis 15o million is invested by MSD in the Netherlands and 9,5 billion is exported each year. From its locations in the Netherlands, MSD is able to develop, produce and distribute medicines and vaccines to 140 countries in the world. Besides its role in medicines and vaccines development, MSD also shows a huge societal responsibility with different projects such as MSD for Mothers and the Mectizan donation programme. Galápagos is a pharmaceutical research company founded in 1999 as a joint venture between Crucell and Tibotec. Its headquarters are located in Mechelen, Belgium, with branches in the Netherlands, France and Croatia. Galápagos develops medicines against diseases such as rheumatoid arthritis, inflammatory bowel disease and fibrosis, based on the discovery of novel targets. The company uses human primary cells and patient cells to discover which proteins ( targets ) play a key role in causing diseases, Galápagos applies a technology in which small molecules obstruct these targets, restore the balance and have a positive influence on the course of the disease. This technology targets the root cause of the disease rather than just treating the symptoms. Galápagos wants to make a lasting positive contribution to society with its therapies for diseases that still need effective treatment methods. The Galápagos group, including the subsidiary company Fidelta, has approximately 550 employees. Janssen, pharmaceutical companies of Johnson & Johnson, focuses on R&D, biotechnology and commercial activities. Janssen has branches in Leiden and Breda and, employs 2100 people in the Netherlands. Several biotech medicines and vaccines are developed and produced by Janssen in the Netherlands, such as the Ebola vaccine and Remicade. Janssen is currently working on a HIV vaccine. Approximately 900 employees of Janssen work on R&D in the Netherlands and 318 million is invested in R&D in the Netherlands (2016). Janssen is also very involved in social development programmes and sponsors several charities and anti-stigma programmes.

69 Mergers and deals Over the past years, several Dutch biopharmaceutical companies have attracted investments from larger pharmaceutical companies. Sometimes, this resulted in the acquisition of a Dutch company. Furthermore, several companies have had a successful Initial Public Offering (IPO) on Wall Street. Mergers and IPOs Acerta Pharma $ 7 bln Dezima Pharma $ 1.55 bln Below, an overview of the largest IPO s and mergers/acquisitions. Largest IPOs: 1. Galapagos: 279 mln (2015) 2. uniqure: $91.8 mln (2014) 3. Merus: 42.5 mln (2016) Largest mergers/acquisitions: 1. Dezima Pharma ($1.55 bln) 2. Acerta Pharma (max $7 bln) 3. WIL Research ($585 mln) Important partnerships (exl. royalties): 1. uniqure/bms ($254 mln) 2. Galapagos/Gilead ($725 mln) 3. Galapagos/Abbvie (~645 mln) uniqure $ 92 mln Sapiens $ 200 mln Prosensa $ 840 mln ProQr $ 112 mln uniqure $ 571 mln Galapagos $ 318 mln AM-Pharma $ 600 mln Galapagos $ 2.1 bln WIL Research $ 585 mln Merus $ 200 mln IPO, licence deal or private venture Merger / acquisition 69

70 Biotechnology financing in the Netherlands Financing value (Million USD) Number of Rounds H H H H H H H H H H H H2 Financing value Number of rounds Financing Value Number of rounds Source: The Dutch Life Sciences Trend Analysis 2017

71 Biotech products - breakdown by therapeutic area 100 Medicine development The Netherlands has a strong position in biopharmaceuticals, human and veterinary vaccines and regenerative medicine. In 2016, 181 biotech medicines were being developed in the Netherlands. The majority of these medicines were in the preclinical stage of trial (99). Seven medicines were already in Phase III. Most of the biotech products on the market are for cancer, infectious and parasitic diseases, and diseases of the nervous system Biotech medicines in development 99 Preclinical 37 Phase I 38 Phase II 7 Phase III 0 Neoplasms / cancer / oncology Other Infectious and parasitic diseases Diseases of the nervous systems Musculoskeletal sustem and connective tissue Cardiovascular Diseases of the eye Genitourinary system Diseases of the blood and blood-forming organs; immune disorders Digestive system Endocrine, nutritional and metabolic diseases Respiratory Skin and subcutaneous tissue Mental and behavioural disorders Congenital malformations, deformations and chromosomal abnormalities Symptoms, signs and abnormal clinical and laboratory findings Pregnancy, childbirth and the puerperium Diseases of the ear Conditions originating in the perinatal period Injury, poisoning and other consequences of external causes 71 Source: The Dutch Life Sciences Trend Analysis 2017 Source: The Dutch Life Sciences Trend Analysis 2017

72 Number of patents Biopharma and biotechnology in the Netherlands, Belgium and France 1, Intellectual property protection of new ideas In the Netherlands, the number of biotechnology patents is very high and has been increasing enormously. In 2015, there were more than 600 patents filed by Dutch inventors. This has grown considerably when compared to the number of patents in The Netherlands is even ranked 2 nd on patent applications for biotechnology in the world The Netherlands Belgium France Source: PwC, Economische Footprint Nederlandse Geneesmiddelensector, 2017 European Patent Office

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74 Active clinical trials Submitted clinical trials Clinical trials 74 1,200 1, Phase I Phase II Phase III Phase IV Other Phase I Phase II Phase III Phase IV Other The new European Clinical Trial regulation (ECTR) will come into effect in the Netherlands in Public and private stakeholders are working together in the Dutch Clinical Research Foundation (DCRF) to make sure the transition to the new system will run smoothly. The objective is to ensure that the Netherlands remains attractive for the developers of medicines and a perfect location to carry out clinical medical research. Every year, more than 900 clinical trials are conducted in the Netherlands, involving approximately 43,000 patients. A slight upward trend can be seen for the number of research projects with medicines that are submitted. Every year approximately 500 new clinical trials are submitted to the CCMO (The Central Committee on Research Involving Human Subjects) for approval, of which approximately 97% are approved. Source: PwC, Economische Footprint Nederlandse Geneesmiddelensector, 2017 Source: PwC, Economische Footprint Nederlandse Geneesmiddelensector, 2017

75 According to the Global Observatory on Health R&D, there are approximately 17,000 clinical and observational trials carried out annually in the Netherlands. The country carries out a high number of clinical trials in comparison to other countries in Europe, as shown in the graph below. The number of trials carried out in Belgium and Denmark is much lower in comparison to the Netherlands. Although Germany, France and the United Kingdom have higher absolute numbers of clinical trials, they execute relatively fewer clinical trials than the Netherlands if the size of their pharmaceutical sector is taken into account. Number of trials per year (clinical and observational trials) 30,000 25,000 20,000 15,000 10,000 5,000 0 Germany 26,285 United Kingdom 25,854 France 20,618 Netherlands 16,856 Belgium 10,589 Denmark 8, Source: PwC, Economische Footprint Nederlandse Geneesmiddelensector, 2017

76 Percentage of digitised patient data Digitalisation in healthcare Austria 86.7% Netherlands 86.9% Nordic Countries 84% Spain 80.4% Italy 79.2% Other 78.2% Europe-Wide 73.2% United Kingdom 67.1% Germany Switzerland 62.6% 64.2% Ireland 42% As stated earlier, the Netherlands holds a strong position in ICT. More than that, it is even one of Europe s leaders in the digitalisation of healthcare. This makes the Netherlands an extremely attractive country for the biopharmaceutical sector, since it provides enormous opportunities to improve medicine development. According to a survey carried out by HIMSS Europe, the Netherlands is close to the point to of completely eliminating paper-based medical records. The Netherlands has 87% of its patient related data in digital medical records. Source: HIMSS Analytics Annual European ehealth Survey, 2017

77 Public-private partnerships The Netherlands has gained international praise for its groundbreaking work in Public- Private Partnerships (PPP). Since innovation, entrepreneurship and partnership are in the Dutch DNA, a high number of PPPs are currently in place. While varying in size and scope, there are over 200 PPPs, in the Netherlands who are jointly trying to come up with solutions for societal problems. A PPP is a coalition between entrepreneurs, government, NGOs and knowledge institutions. Often, this joint collaboration is referred to as the quadruple helix. Through these diverse partnerships, not only are objectives and funds combined, but knowledge and expertise of different players are bundled which is particularly important in the biopharmaceutical sector because it brings opportunities to jointly develop medicines for complex diseases. The PPPs allow the Dutch a faster and quicker way to develop medicines and to achieve solutions to cure destructive diseases such as Alzheimer s, anti-microbial resistance and cancer. 77 The Life Sciences and Health sector has become increasingly reliant on PPPs to find solutions for present and future healthcare issues that cannot be solved by a single public or private organisation. Solutions required a wide variety of knowledge, expertise and resources which can be found at universities, in the industry, patient organisations and government.

78 Dutch PPPs have often made innovative discoveries. For example, recently the partnership between the company BioNovion and three Dutch scientific researchers. BioNovion, a former pharmaceutical company (that now works under the name Aduro Biotech) started with a collaborative project within the framework of TI Pharma (Now: Lygature) and investments from a venture capitalist and a regional development company. The company purchased the ownership of three potential cancer therapies that have been developed together with three Dutch professors: Jan Paul Medema of the AMC, Jannie Borst of the Netherlands Cancer Institute (NKI) and Steven de Jong of the UMC Groningen. As a result of this collaboration, one of the molecules has been administered to a patient for the first time in December It is expected that a molecule from a second project will be administered to patients before the summer of Below are some recent examples of Dutch public-private partnerships in field of Life Sciences and Health. 78 Oncode is a new independent world-class, innovative institute that unites, under a common strategy, more than five hundred of the Netherlands' most outstanding scientists, specialized in the field of fundamental oncological research (i.e. research on how cancer operates at a basic, molecular level). Oncode incorporates the knowledge and experience to identify and foster scientific discoveries that are potentially beneficial to patients. The institute helps to pave the path leading from such discoveries towards translational and clinical research and practical applications. Outsmarting cancer, Impacting lives. Health-RI connects existing Dutch Infrastructure programs in a public-private partnership. Health-RI builds a state-of-the-art infrastructure to support personalized medicine and health research in the Netherlands. The national infrastructure improves efficiency by offering shared services, allowing for optimal exchange and reuse of data, samples and images, and acting as the collective voice of the field for research infrastructure related topics. By optimally facilitating personalized medicine and health research, Health-RI will accelerate the development of personalized medicine and health solutions, creating major value for researchers, patients and citizens. RegMed XB (Regenerative Medicine Crossing Borders) is a virtual institute that uses regenerative medicine strategies to cure common chronic diseases. It comprises an intensive Flemish-Dutch public-private partnership between governments, health funds, doctors, scientists and specialized companies. In phase 1, the ambitious research focuses on curing patients with type 1 diabetes, kidney failure and osteoarthritis. Looking to the future, the research will also focus on other diseases. Regenerative Medicine holds the promise to cure many of what are now chronic patients, restoring health rather than protracting decline, bettering the lives of millions in the Netherlands and beyond and at the same time preventing lifelong, expensive care processes: Cure instead of Care

79 International research International research in the field of Life Sciences & Health is also essential for the development of health research programmes in the Netherlands. While Horizon 2020 is one of the most successful European research programmes, Dutch participants are involved in 49% of the initiatives in health research programmes. Dutch SMEs and scientific institutions are successful participants in projects driven by the Innovative Medicines Initiative (IMI). The driving force behind some of these projects is the Dutch not-for-profit organization Lygature. Another chief example is the collaborative public-private partnership European Lead Factory whose objective is to deliver innovative drug discovery starting points with a total budget of 196 mln. The European Lead Factory has founded the first European Compound Library, the first European Screening Centre and it offers free access to up to 500,000 novel compounds, which is a unique industry-standard uhts platform. 79

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86 Colophon 86 This document contains our bid to attract foreign biopharmaceutical companies to the Netherlands. The information contained in this publication has been compiled with great care by the partners of PharmInvestHolland and is accurate to the best of its knowledge at the time of production. PharmInvestHolland is a public-private initiative that focuses on: Enhancing the business and R&D climate for biopharmaceutical companies in the Netherlands Earlier availability of medicines for patients PharmInvestHolland is powered by: American Chamber Of Commerce Dutch Association Innovative Medicines Health~Holland HollandBIO Lygature Ministry of Economic Affairs and Climate Policy Netherlands Foreign Investment Agency VNO-NCW For more information on the possibilities for life sciences companies in the Netherlands, please visit com/industries/life-sciences-health/ or March 2018, PharmInvestHolland

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