Distribution Application Survey

Kindly complete the distribution application survey to allow CorNeat to evaluate your approach. Please try to respond to all questions. Thank you!

Contact Details:

Company Name

Contact Person Name

Company Address

Contact Person Position

E-mail

Distribution Country Profile:

Distribution Country Name:

Cornea transplantation/implantation in this country:

Total annual number of cornea transplant/implant surgeries:

Annual number of penetrating keratoplasty (donor cornea transplantation) surgeries out of total annual cornea surgeries:

Annual number of artificial cornea (KPro) implantations:

Patients in need of full cornea transplantation/ implantation (waiting list):

Reimbursement level for penetrating keratoplasty in the public health system?

Price of penetrating keratoplasty in private clinics (US$)?

Price of cornea tissue for transplantation (US$):

Price of currently available KPro (US$):

What is your recommended customer sale price for the CorNeat KPro in your country (US$)?

Glaucoma surgery in this country:

Total annual number of glaucoma surgeries:

Annual number of glaucoma drainage devices implantation surgeries (shunts, not MIGS):

Which grafts are currently used to cover the shunt in surgery?

Price of currently available grafts (US$):

What is your recommended customer sale price for the CorNeat EverPatch in your country (US$)?

General country information:

What is the time period to complete registration of ophthalmic implants like CorNeat Vision’s products in your country (assuming either FDA or CE approvals are in place)?

What is the time period to obtain reimbursement clearance for ophthalmic implants like CorNeat Vision’s products in your country (assuming either FDA or CE approvals are in place)?

Distributor company profile:

Distributor company sales per year:

<$500,000

$500,000-$1,000,000

$1,000,000-$3,000,000

>$3,000,000

Please specify numbers of your company personnel in sales:

Please specify number of your company personnel in marketing:

Please specify numbers of your company personnel in operations:

Please specify numbers of your company personnel in the regulatory dept:

Please specify numbers of your company personnel in administration:

Please specify numbers of your company personnel in other departments:

How many ophthalmologists are on your company's regular distribution/visit list?

Please specify how many are in the following subspecialities:

Anterior Segment Surgery:

Cataracts & Refractive Surgery:

Cornea & Exteral Disease:

Glaucoma:

Please name leading KOLs (Key Opinion Leaders) relevant to CorNeat Vision’s products with whom you have ongoing contact:

Other producers/brands/products represented by you in your region/territory (company name(s), product types):

Does your company regularly register the products distributed by you in your country’s medical devices registration?

What are your primary methods of customer contact?

Do you exhibit at medical meetings/congresses? If so, please specify which:

Do you organize surgeon workshops/training wet labs? If so, please specify how many annually:

How do you advertise the products you distribute?

Please specify the relevant characteristics of the ophthalmic market in your country:

How does your company handle complaints or safety issues related to your distributed products?

Do you have a CRM system? If so, which:

What is your suggested market launch scheme for the CorNeat KPro & your company's ability to execute it?

What is your suggested market launch scheme for the CorNeat EverPatch & your company's ability to execute it?

What are your company's relative advantages over other distributors, in distributing CorNeat Vision's products?

Thank you for your time!

Looking forward to future cooperation,

CorNeat Vision