After four decades of development, the medical device industry is now a national leader in Dominican manufacturing and export. With 27 firms, 18,000 jobs, and USD750 million in investment, the industry's USD1.23 billion in exports accounts for 25% of all free zone exports.

The Dominican Republic has gained a lot of experience from its rich history with the US Food and Drug Administration (FDA). It has also maintained a positive reputation in the realm of medical equipment manufacturing for over two decades. In the past 10 years, the Dominican Republic has become a destination for preventive medicine, orthopedics, cosmetic surgical procedures, weight loss surgery, cardiology, organ transplant, oncology, eye surgery, and dental procedures. Each of these has boosted the medical equipment market, both through domestic production and an important 86% import base from the US.

The production of medical devices in free zones started 40 years ago with a company called Surges and is now one of the foundations of the free zone industry. Within this, the sector is the second largest in terms of joint cumulative investment, with a total of USD754 million, surpassed only by clothing and textiles. This investment is comprised of 27 medical device and pharmaceutical companies that altogether have created 17,937 jobs.

In total, 98% of all Dominican production is exported through the Free Trade Zone (FTZ) program. Import statistics reflect large quantities of parts for medical equipment, which are then reassembled in the FTZs for re-export. Exports for medical devices and pharmaceuticals have followed an upward trend: in 2013, total exports reached USD1.23 billion, or 24.5% of all free zone exports. According to the National Free Zones Council (CNZFE), exports to the US and Canada registered visible growth of 9% and 4.3% that year, respectively, while exports for the EU saw a 20% increase.

The Dominican Republic's manufacturing and export systems have made the country one of the industry's leader with highly qualified labor at competitive costs, modern infrastructure, and a strategic location with preferential access to markets not only in the region but also the EU and the US. It is one of the main suppliers of dental floss, pacemakers, and several disposable items used by hospitals around the US, as well as sera, bed sheets, and medical gowns, among many others.

In terms of medical tools, the Dominican Republic is currently America's third-largest exporter and its fifth-largest supplier; the industry generated USD1.28 billion in exports during 2014 alone and exports have soared 1,390% in the past two years.

According to experts, the key to succeeding in the Dominican market for medical equipment is having a local distributor that provides after-sales and leasing services, supports guarantees, and maintains inventories for parts and supplies. Exporting directly to private hospitals is extremely difficult and procurement practices in public hospitals indicate that a local company must do all purchases. These importers and distributors usually have sales agents who distribute the products to small retailers throughout the country. Local distributors also conduct promotional activities to encourage physicians and nurses to use and recommend their products.