United States

The United States is the largest economy in the world and the Netherlands is its fifth-largest European trading partner. When looking at the LSH sector, the United States and the Netherland are also close trading partners. From the Netherlands there is a strong interest in eHealth solutions, as well as solutions to help support the growing elderly population and the increasing prevalence of noncommunicable diseases.

Key indicators

Largest healthcare market in the world
The United States is the largest market in the world when it comes to healthcare, biotech, medical devices and the pharmaceutical industry. In 2018, the US spent US$ 3,6 trillion on medical costs, making it one of the biggest healthcare markets in the world. This offers many opportunities for solutions to improve its health system. In the past few years, the American healthcare system has gone through many developments and experienced great reform, as witnessed with the implementation of the Patient Protection and Affordable Care Act.

Challenges within the United States
The health issues that the United States are facing are similar to that of the Netherlands: an ageing population and unhealthy lifestyles are leading to an increase in non-communicable diseases. This growing pressure on healthcare providers is emphasized even more due to the growing shortage of personnel and the fact that almost 46 million Americans (15% of the population) live in rural areas, making access to care an additional hurdle to overcome. In urban areas on the other hand, there are public health concerns about the effects of pollution, the speed in which viruses spread in dense populations and the lack of adequate nutrition and physical activity.

Because the U.S. health system is a mix of public and private healthcare, it is considered quite open for entrepreneurs and businesses to enter the market. Private insurance, the dominant form of coverage, is primarily provided by employers. The uninsured rate, 8.5% of the population, is down from 16% in 2010. Public and private insurers set their own benefit packages and cost-sharing structures, within federal and state regulations.

Focus of the future
In the upcoming years it is expected that consumer demand will rapidly change the way healthcare is currently delivered in the U.S. The digital health services industry is growing fast and more technology and consumer-focused companies are entering the healthcare market. As to pharmaceutical and bio-tech, massive investments are in the field of personalized medicine and DNA research. The Covid-19 crisis also pushed the agenda for the U.S. to be less reliant on external production of essential medicines and medical technology. A result is the U.S. government’s massive investment in the development and production capabilities of a vaccine in the U.S..

In brief, the U.S. remains a leader in research & development, innovation and standardization. Combined with the size of the market and the challenges in the U.S. healthcare system is facing, the United States is a highly promising market for Dutch companies that want to distribute, scale or innovate their products or services.

From the perspective of the Netherlands the following market trends are of interest:

Research and innovation and trade

The digital transformation of health and care
North America is still the biggest digital health market in the world. The growth of the region is mainly due to increasing number of older citizens along with rising prevalence of chronic diseases across the region. The market is still expanding rapidly, with more  consumer-focused companies entering the healthcare market and scale-ups expanding there activities across the US.

Growth of the market for accessible medical technology
The medical device market in the US is expected to grow at a rate of 5.0% in the coming years. Personal medical devices (e.g. PPE, thermometers, pulse oximeter) grew very fast during the COVID-19 pandemic. The market for medical devices used in elective procedures is expected to bounce back in 2021 after a decline during the pandemic. A lot of attantion is paid to invasice procedures and the use of robitoca in a clinical setting.

Biopharmaceutical development / personalized medicine
The US market for biopharmaceuticals and personalized medicines is one of the largest markets of the global market and is expected to remain in a leading position. At present, the US market accounts for around half of the global market in terms of production. Thanks to the strong science infrastructure and the financial eco-system, advanced products come to the market at short intervals, giving patient populations new medicines and enhanced products. 


Med-tech & Pharma
The Netherlands has a significant presence of large U.S. MedTech and pharma companies, such as Medtronic, Boston Scientic, Johnson & Johnson, MSD, Pfizer, Alnylam, Styker and Amgen. Overall U.S. companies are positive about the Netherlands as a business location and appreciate the efforts to foster the Netherlands as one large LSH hub, with the European Medicines Agency (EMA) in close proximity.

Connecting & Collaboration
The Netherlands offers a geostrategic location for US companies looking to build their business across Europe. Furthermore the Netherlands offers a thriving business climate, political and economic stability with a population highly proficient in the English Language. Many U.S. companies were previously interested in the UK as a location, due to Brexit the Netherlands offers a strong alternative location with access to EU markets. 

In the United States the Netherland Foreign Investment Agency (NFIA) has six locations; Atlanta, Boston, Chicago, New York City, San Francisco and Washington.  These offices provide the first point of contact to support and promote investment opportunities for U.S. companies looking to connect with the Netherlands LSH eco-system.

Two representatives of our US NFIA network are based in the New York and Boston area connecting with the strongest Life Science eco-system in the U.S. to identify new opportunities for collaboration and connect these networks with our eco-system in the Netherlands.
Together with the Invest in Holland Life Sciences & Health team they will focus on supporting companies that will contribute to the societal challenges and solutions of the future and strengthen the Life Sciences & Health ecosystem in the Netherlands.

The Invest in Holland LSH team is a collaborative team of the NFIA, regional development agencies, several large cities and Holland International Distribution Council.

Financial opportunities & Entrepreneurship
U.S. firms in general have more funds available (due to the large presence of venture capitals) and a more entrepreneurial mindset to become a global company. Most of the growth is expected in cell and gene therapy and vaccines-related activities. A good example is the new EU production facility of Kite Pharma in Hoofddorp and the activities of Janssen vaccines. New EU Medical Device Regulation will slow down investments in European markets in the short-term. Focus is initially on existing MedTech companies and new digital health initiatives.

Regional priorities

In size, numbers and capital, the United States is so big that a sole nation focus risks missing opportunities. The East Coast (NY and Massachusetts) is known for its expertise and innovation in biotech, pharma, and medical devices, combined with strong opportunities for investors. The West Coast (San Diego and San Francisco Bay Area, California) is a priority region for its expertise on digital health, and the strong presence of new tech companies. Texas houses the largest healthcare center in the world, the Texas Medical Center in Houston, and has a very interesting position regarding telemedicine given the vast distances between cities and towns. North Carolina has a strong drug development and logistics scene, while the region around Chicago brings opportunities regarding medical device manufacturing. Georgia houses the Center for Disease Control and Prevention (CDC) and is regarded a key area in the global health field. Florida, given its population and location, has a strong focus on healthy ageing and also sport-related activities.

In short, next to national health priorities, each region has its specific focus. These regional priorities will focus the actions taken within those regions and build up expertise for the whole network. Below an overview of the selected regional priorities.


Overview milestones & flagships

  • G2G (MoU, state visits)
  • Trade (PIBs, Market study E-health (2019)
  • Innovate (joint R&D projects, specific bilateral calls)
  • Invest (significant investments in the Dutch LSH sector)

Collective Trade Activities to the USA


  • Economic Mission to Chicago, Illinois and Boston, Massachusetts
  • Dutch delegation present at BIO International Convention in Philadelphia


  • Dutch delegation present at BIO International Convention in San Francisco


  • Digital Health Mission to San Francisco
  • Netherlands Pavilion at the RSNA
  • Dutch delegation present at BIO International Convention in San Diego


  • Publication of Market Report on Texas
  • Dutch delegation present at BIO International Convention in Boston


  • Economic Mission to Texas with Secretary General Erik Gerritsen
  • Economic Mission to Boston Massachusetts with MP Mark Rutte and MoH Bruno Bruins
  • Memorandum of Understanding (MoU) between Dutch Ministry of Economic Affairs and Climate Policy and the Massachusetts Office of International Trade and Investment: Netherlands Transatlantic Life Sciences Partnership
  • Dutch delegation present at BIO International Convention in Philadelphia


  • Economic Mission to Texas with MP Mark Rutte and MoH Bruno Bruins (cancelled)
  • Dutch delegation (Focco Vijselaar and Clémence Ross-van Dorp) present at the BIO International Convention (digital)


  • Health~Holland Digital Meet-up and Reconnect session United States
  • Publication of the Market Study California
  • Life Sciences and Health trade mission to San Francisco and Los Angeles (postponed)


  • Health~Holland Digital Round Tables | California

The way forward

For the Dutch Life Sciences & Health sector the United States of America is a high priority country. In the course of 2022 a Roadmap Multiannual Integral Program will be finalised, coordinated by Health~Holland, in close cooperation with the public and private sector, Netherlands Enterprise Agency, the Dutch economic network in the USA, and the Ministries of Health, Welfare and Sport, Foreign Affairs and Economic Affairs and Climate Policy.

This Roadmap builds on a number of ongoing initiatives in the USA and provides for an integrated approach for the coming years. It aims to strengthen the Dutch Life Sciences & Health (LSH) sector through coordinated cooperation between industry, knowledge institutions, economic network the USA and Dutch government, with less fragmentation and more focus. This roadmap integrates programming and activities on trade, foreign investments into the Netherlands and collaboration in R&D and innovation. The international partnership and program of cooperation between Massachussets and the Netherlands is an excellent example.

Preferred actions

Preferred actions Expertise/Capacity/Finance

Develop specific expertise on FDA and registration processes.

RVO, EZ, LSH-network US


Strengthen regional focus and have market scans done in all resorts with LSH-representation.

RVO, LSH-network US


Organize multi-regional digital mission on the national priorities

BZ, EZ, VWS, RVO, Health~Holland, TFHC, HollandBIO, LSH-network US

Increase K2K and G2G cooperation on national and specific regional priorities (e.g. public health, healthy ageing, sport).

EZ, RVO, VWS, LSH-network US



Implement actions MoU Massachusetts – Netherlands, such as bilateral (virtual) conferences, inviting Venture Capitals from Massachusetts to the Netherlands and annual biotech awards in honor of Henri Termeer.

EZ, HollandBIO, Innovation-Attaché network, Invest in Holland / NFIA, VIG, Henri Termeer Foundation, Health~Holland.


Formulate multi-year programming for LSH-activities within the US.

BZ, EZ, NFIA, RVO, Health~Holland, TFHC, HollandBIO, NLIB, LSH-network US

Program of Cooperation between the Netherlands and Massachusetts

International dialogue, exchange, and development are crucial to accelerate the development of new life sciences and health solutions that benefits patients and citizens worldwide. For this reason, the Netherlands and Massachusetts have entered a partnership to focus on building a healthier world, together.

This partnership is implemented through a Program of Cooperation, fostering the flow of talent, ideas, business, and investments between the two ecosystems by supporting increased collaboration and partnerships among all stakeholders including private sector, students, researchers, and governments.

Activities and Awards

Activities - Each year, parties will aim to achieve:

  • Visit of Massachusetts LSH ecosystem leaders to the Netherlands: 
    At least 1 delegation of companies / researchers / government visits the other ecosystem.
  • Emerging technologies in Health mission:
    Missions to connect innovators from both ecosystems. Last year a Biotech scaleup mission to Boston took place. This program aimed to support Dutch innovators that are ready to expand to the US. Find more information about this mission in 2021 here.
  • Roundtable on reimbursement systems
  • Workshop on regulatory developments:
    Yearly workshop on clinical development & medical device regulations (EMA)
    Focused workshop, with the exact focus to be determined on the most actual and relevant needs of the sector.
  • Soft Land support: 
    Soft-land programs for companies that are wanting to scale


  • Henri Termeer Transatlantic Connections Award
    The Henri A. Termeer Transatlantic Connections Award was established in 2021. With support from the Termeer Foundation and Health~Holland, the Award recognises and honors two emerging life science entrepreneurs, one in Massachusetts and one in the Netherlands, who are leading innovative biomedical research activities, and whose programmes have the potential to strengthen transatlantic relations between the two life science regions. 

    The 2022 Henri Termeer Transatlantic Connections Award honorees were: Kasper Roet, CEO and co-founder of, QurAlis Corporation; and Koenraad Wiedhaup, CEO and founder of Leyden Labs.

    The 2021 Henri Termeer Transatlantic Connections Award honorees were: Eline van Beest, CEO, Hybridize Therapeutics; and Joshua Cohen and Justin Klee, co-Founders and co-CEOs of Amylyx Pharmaceuticals.


This Program of Cooperation is a Public-Private partnership. It’s made possible by the efforts of several parties that contribute their time and resources to strengthen transatlantic collaboration.

Project Lead

  • Health~Holland
  • Massachusetts Life Sciences Center

Government Sponsors

  • The Netherlands Ministry of Economic Affairs and Climate Policy
  • The Massachusetts Office of International Trade and Investment


  • The Termeer Foundation
  • MassBio
  • HollandBIO

Get in touch

Want to learn more about the Program of Cooperation or get involved, please reach out to:

Laura duran or Jannica Swieringa



In 2019, during an official economic mission from the Netherlands to Boston led by Prime Minister Mark Rutte and former Minister Bruno Bruins for Medical Care of the Ministry of Health, Welfare and Sport, representatives from public investment agencies, the life sciences industry and other organizations convened to discuss an international partnership. As a result of this discussion, the Massachusetts Office of International Trade and Investment and their Dutch counterpart, the Dutch Ministry of Economic Affairs and Climate Policy have signed a Memorandum of Understanding (MoU). This MoU will formed the foundation of the Program of Cooperation

Focco Vijselaar, Director-General Enterprise and Innovation at Ministry of Economic Affairs and Climate Policy:‘The Netherlands and Massachusetts have successful life sciences communities. By joining forces in this partnership, they can both be strengthened.’

Mark Sullivan, Executive Director of Massachusetts Office of International Trade and Investment: ‘By signing this MoU we underline the great opportunities that lie ahead of two formidable life sciences ecosystems, here in Massachusetts as well as in the Netherlands. This international partnership will help create economic development and investment in the sector.’

John Maraganore, co-chair of The Henri A. Termeer Tribute Committee, Board Member of BIO and former CEO of Alnylam Pharmaceuticals, Inc.: ‘This MoU is a great demonstration of the international leadership of Massachusetts in life sciences, as well as the fast-growing development 
of the Netherlands as an environment that champions a vibrant ecosystem for life sciences and health innovation. As a company headquartered in Cambridge,Massachusettsand with strategic and growing European operations in the Netherlands, we are strongly convinced that the collaboration potential between innovators in these two leading life sciences hubs is immense, and patients are waiting for the fruits of our work.’

Hans Schikan, Top Team member of Health-Holland: ‘Working together is part of the Dutch DNA. By collaborating with the best, we can identify innovative solutions that matter.’

Robert K. Coughlin, former President and CEO, MassBio: ‘Disease has no borders, and neither should the research and development have borders when it comes to creating new therapies and cures. We are looking forward to embarking on this international partnership with the Netherlands and sharing the talent, resources, and capabilities of Massachusetts’ innovation ecosystem so we can all more efficiently bring new tomorrows to patients around the globe.’

Annemiek Verkamman, Managing Director at HollandBIO, the Dutch biotech industry association: ‘This transatlantic partnership provides a solid basis for increased collaboration between both our vibrant life sciences communities. We are looking forward to helping create opportunities for innovation and investments and fostering mutual understanding of our life sciences ecosystems.’




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