Having stepped up recently as Global Head of DKSH’s Business Unit Healthcare, I was asked by US magazine Pharmaceutical Commerce for my views on the South East Asian pharmaceutical market. What are the trends and what makes the region so special?
With an annual growth rate of 9.1% between 2016 and 2021 in Asian markets, pharmaceutical companies in South East Asia still enjoy high growth in the region and probably some of the highest worldwide. Yet high dependence on out-of-pocket expenses in South East Asia results in a low adoption of high-priced treatments, compared to reasonably well-financed reimbursed markets. While the middle class is growing quickly, many treatments are simply not yet affordable for many patients.
Meanwhile, governments in several South East Asian countries are faced with a challenge: how to contain the increasing healthcare costs. In markets such as Vietnam, we see a trend towards reference pricing and generic substitution for large therapeutic categories. This, in turn, leads to price pressure and the need for pharma companies in Asia to prioritize; in terms of markets, channels and products. Commercial outsourcing to companies like DKSH is a proven way for companies to expand market or channel coverage, and drive sales growth of products.
This year, ASEAN celebrates its 50th anniversary. This long-term collaboration is intensified with the recent establishment of the ASEAN Economic Community (AEC). This has led to a certain level of standardization, yet at the same time, regulatory differences between countries remain.
The move towards a single registration process and other efforts will harmonize the market somewhat, however, each country within the region maintains the right to retain its own regulatory system with varied requirements and registration systems. This means that, for example, medicinal products (new chemical entities and new combination of APIs that have been circulated) that have been marketed for less than five years in their country of origin (or reference country) need to undergo local clinical trials in Vietnam. This is a unique rule that does not apply to other markets in the ASEAN region where local clinical trials are not required, even if medicinal products are marketed for less than five years.
To further complicate matters, regulations in emerging markets are changing rapidly and labeling requirements vary across countries. Furthermore, health authorities often struggle with having limited resources, leading to long review timelines for product registration.
In many Asian markets, the decision on which treatment to provide is still largely with the doctor, as opposed to the USA, where doctors have very strict prescription guidelines, often dictated by insurance companies and Pharmacy Benefit Managers. In addition, across Asia, pharmacies act as a trusted partner of patients. In some cases, patients never even visit a doctor, relying on their pharmacist as their primary healthcare practitioner and adviser.
Different from the USA, direct-to-consumer marketing is not permitted in Asia. The direct contact between the sales force and healthcare prescribers is therefore extra important. Most of this is in person; telesales and telemarketing are relatively new and underutilized methods, which DKSH has adopted to increase reach and frequency of contact, particularly with pharmacies. Results show that pharmacies that receive a combination of direct contact by sales reps and a tele sales follow up, have a higher impact on both top and bottom line performance.
I have 24 years of experience in the healthcare sector, working across four continents. I started my career in the USA, spent a few years in Europe and Africa, but have worked in Asia for 15 years.
The USA is a fluid market, but healthcare costs are putting high pressure on government budgets. There is a major discussion on the value of healthcare. Asia, on the other hand, is a continent with a fast-growing population with an increased willingness to pay for quality. This brings plenty of opportunities for healthcare companies and creates a vibrant business environment.
Unlike highly developed markets, where plenty of data insights are available, healthcare leaders in Asia need to rely more on intuition and experience. They must be clever and agile in understanding patients’ motivation to buy out-of-pocket. Often this requires making decisions without having all data at hand. This is challenging but also an opportunity for leaders to make an impact. You can find yourself with much more responsibility and accountability in your hands than in a western environment, where there are many more specialized roles.
Recently, we asked our specialists one simple question: what gets you up every morning? We want to truly understand what drives them, what their purpose is. Personally, I get energy from making an impact on the people inside and outside of the company. I am passionate about building winning teams and solving client problems by listening well.
In addition, I believe that in terms of healthcare access, Asia has been relatively underserved. Many Asians still don’t have access to the most innovative products. My mission is to bring these products to Asia, always in a compliant and ethical way.
Giving people access to high-quality healthcare is close to my heart. With my Asian roots, I am proud to work in a company in Asia for the benefit of Asians, together with a team of committed people. My experience working in different cultures and ability to build bridges between people helps me achieve that mission and continue our strategy for sustainable, profitable growth.
How do you see the development of the South East Asian healthcare market? And what gets you up every morning?
This is an excerpt of an article published in the July/August edition of Pharmaceutical Commerce.
For the past two years, Bijay Singh has successfully been leading the Business Development function, a substantial growth driver of Business Unit Healthcare at DKSH. Since July 1, 2017, he is heading Business Unit Healthcare.