Why the Benelux can be a powerful base for scaling across Europe

Europe is one market. But it does not speak with one voice.

For life sciences companies looking to scale across Europe, the opportunity is substantial.

More than 440 million people. A common European regulatory framework for many medicines. Highly developed healthcare systems. Strong scientific institutions. Sophisticated clinicians. Significant demand for healthcare innovation.

It is tempting to think of Europe as one market.

It is not.

The European Union has 24 official languages, while healthcare organisation, pricing, reimbursement, stakeholder influence, clinical practice and adoption remain strongly shaped by national and regional contexts.

A European marketing authorisation can provide access to the market from a regulatory perspective, but pricing and reimbursement decisions remain largely national or regional.

So scaling in Europe is not simply about repeating the same launch in another language.

It is about operating successfully across different healthcare systems, stakeholder environments and decision-making cultures without losing the core of the strategy.

Language is more than translation

One of the easiest mistakes in European expansion is to assume that because people speak English, language is no longer an issue.

Research into multinational organisations suggests otherwise.

Studies have shown that language diversity can influence communication, participation, knowledge sharing, sensemaking and trust within international organisations and teams.

That matters in life sciences.

T

he question is not only whether a payer, clinician or hospital executive understands the words being used.

The question is whether the underlying meaning travels with them.

A value proposition may be interpreted differently across healthcare systems.

A discussion that feels appropriately direct in one country may require a different approach elsewhere.

The relative influence of clinicians, pharmacists, payers, hospital management, professional societies and patient organisations can also vary significantly.

Translation can change the words.

Local experience helps translate the context.

Culture matters — without reducing countries to stereotypes

Culture should be approached carefully.

Europe cannot be usefully divided into simplistic national stereotypes, and individual behaviour should never be predicted purely from nationality.

But cultural distance is not irrelevant.

Research in international business shows that cultural differences can affect international expansion, communication, trust formation and organisational performance.

For companies expanding across Europe, the practical lesson is not to memorise lists of “Dutch”, “German” or “French” behaviours.

It is to recognise that every company has its own communication style, assumptions and decision-making habits — and that these may not produce the same response in every European market.

A strong European partner helps identify those differences before they become commercial problems.

Why the Benelux is an interesting place to start

This is where the Benelux offers an unusual perspective.

The region is geographically compact, but it already requires organisations to work across different languages, cultures, healthcare systems and decision-making environments.

The Netherlands, Belgium and Luxembourg have a long history of cross-border cooperation. The Benelux Union itself has described the region as a “laboratory for Europe”, where cross-border solutions can be developed and tested.

That description is particularly relevant to life sciences.

Within a relatively small area, companies already encounter Dutch-, French-, German- and Luxembourgish-speaking environments.

Healthcare organisation differs.

Reimbursement structures differ.

Stakeholder dynamics differ.

Even within neighbouring markets, assumptions cannot simply be copied from one country to another.

This creates an important habit:

Never assume that what works across one border will automatically work across the next.

The Netherlands adds another dimension

The Netherlands is structurally international.

According to the OECD, the combined value of Dutch imports and exports represented 159% of GDP in 2024, compared with an OECD average of 106%. Around 70% of Dutch exports went to other EU countries.

That matters because working internationally is not an occasional activity in the Dutch economy.

It is part of its structure.

The Netherlands also hosts the European Medicines Agency in Amsterdam.

That should not be exaggerated: geographic proximity to EMA does not create privileged regulatory access.

But it does contribute to a broader life sciences environment in which European regulatory science, international companies and cross-border healthcare discussions are highly visible.

Combined with Belgium’s multilingual environment and Luxembourg’s cross-border character, the Benelux becomes an interesting starting point for companies preparing to scale across Europe.

But a Benelux partner should never pretend to “know Europe”

This may be the most important point.

A Dutch or Benelux consultancy cannot credibly claim to understand every local stakeholder dynamic in France, Germany, Italy, Spain, Poland or any other European market.

Europe requires local expertise.

The value of a strong Benelux partner is therefore not that it removes the need for country expertise.

It is that it can help organise and connect it.

A strong partner can distinguish between the elements of a European strategy that should remain consistent and those that need local adaptation.

It can recognise when an English-language answer is technically correct but locally incomplete.

It can challenge the assumption that a successful Dutch reimbursement argument will automatically work in Belgium or Germany.

And it can bring the appropriate local expertise into the process before strategic decisions become difficult or expensive to change.

Europe needs both consistency and localisation

European expansion therefore requires balance.

Too much centralisation and local reality is missed.

Too much localisation and the European strategy becomes fragmented.

The objective is not to create a completely different launch strategy for every country.

Nor is it to impose one global plan on very different healthcare systems.

The objective is to determine deliberately what should remain European, what can be regional and what must be local.

That is particularly important in life sciences, where a seemingly small difference in comparator choice, clinical practice, HTA expectations, hospital financing or stakeholder influence can have a significant effect on access and adoption.

A bridge, not a replacement

This is ultimately why the Benelux can be a powerful base for companies scaling into Europe.

Not because the Netherlands, Belgium or Luxembourg represent Europe as a whole.

They do not.

But because working in this region teaches an important European lesson very quickly:

Proximity does not mean similarity.

Countries separated by an hour’s drive may speak another language, finance healthcare differently, organise decision making differently and respond differently to exactly the same proposition.

A good Benelux partner therefore should not say:

“We understand Europe for you.”

It should say:

“We know how to navigate differences, recognise when local expertise is required and connect those local realities into one coherent European strategy.”

At Health Devotion, that is how we look at European expansion.

Our role is not to replace the expertise of the company entering Europe.

Nor is it to replace local specialists in individual countries.

It is to connect them.

To preserve the strength of the global strategy while challenging assumptions against local reality.

To create one direction without pretending that Europe is one market.

And to help build the local understanding and relationships that allow strong science and innovation to become clinically and commercially relevant in Europe.

For companies scaling into Europe, that distinction can make a significant difference.

Sources

European Union — Multilingualism and official languages

European Medicines Agency — European marketing authorisation, pricing and reimbursement

OECD — Economic Survey of the Netherlands 2025

Benelux Union — Benelux cooperation and cross-border integration

Beugelsdijk et al. — Cultural distance and firm internationalisation, Journal of Management

Tenzer et al. — Language barriers, trust and communication in multinational organisations

Tenzer, Pudelko & Zellmer-Bruhn — Language and multinational teams, Journal of World Business