Driver:By 2020, the number of chronic disease deaths in APAC will increase by 20% to 25 million.Chronic disease: Top 4 causes of chronic disease death: cardiovascular disease, cancer, diabetes, respiratory disease, By 2020, the cancer incidence is projected to increase to 7.1 million diagnoses per year with lung, breast, & colon cancers diagnosed most often. By 2030, 214.0 million people in APAC will have diabetes, due to unhealthy diet, sedentary lifestyles, and increased urbanization Pandemic and epidemic diseases such as tuberculosis, severe acute respiratory syndrome (SARS) and H1N1 (swine flu), according to WHO, accounted for 15% of the 37 million deaths worldwide in 2009, wherein more than one third was from Asia Pacific. Private expenditure is increasing in China and India, private spending accounted for 49.9% and 67.2% of the total health care expenditure in 2009 respectively. This causes pharmaceutical and devices company to offer value added products. In Vietnam and Indonesia, a high proportion of out-of-pocket payments is seen 90.2% and 73.2% respectively, due to very low / negligible penetration of medical insurance. Restraint:Per capita healthcare expenditure is far below global average (lowest is Vietnam and Indonesia )Shortage of professionals, The density of health care workers in APAC is 6.8 per 1,000 population, when compared to 18.9 in Europe and 24.8 in the USA in 2010. the number of doctors per 1,000 people in Indonesia, Vietnam and Thailand is less than 1, as compared to developed nations such as South Korea, Taiwan and Singapore, which have between 1.5 and 2 doctors per 1,000 people.Access to healthcare and distribution limited in emerging markets.
Drivers: Increased long term use of multiple and specialized drugs for the aging population: especially oncology products. Enhanced health awareness and purchasing power boosting over-the-counter purchaseGovernment support for generics/bio-similars; China’s government, under the 12th five-year plan (2011-15) has put emphasis on r&D and has decided to include biotechnology in its list of key strategic sectors this would result in investment in new drug research rise strongly in the next five years. Increased disease incidence boosted by availability and usage of new diagnostic toolsRestraints Patent expiry of major pharmaceutical products In Japan which is the largest market in Asia (most of which is patented products) will suffer because of patent expiry (Actos, Seroquel, Aricept, Diovan, Plavix, Abilify, Alimta, Spiriva will lose patent between 2011-2015) [IMS] Cost control measures by various governments: (India: Potential expansion of drug price controls from 74 to all 354 drugs on the essential medicines list; China: 12% drug price cut; Japan: 5.75% across the board price cut, Changes to the average overseas price calculation aimed at reducing launch prices) [IMAP] In markets with strong local manufacturing, government tenders favor local manufacturers eg. China, India, Indonesia
DriversCardiology market growing at 12.6 % in APAC and is estimated to reach $18 billion in 2015. Asia’s share of the cardiovascular device market comprises about 30 percent of the global market value. China leads APAC in cardio market, where CVD kills 2.6 million people in China, or 300 people on average every hour. Number of surgeries in hospitals across APAC is estimated at 3.0 bil in 2011 and growing at 12.0%. India and China conducted most number of surgeries in 2011, with 2.2 mil and 1.8 mil procedures respectively. Demand of minimally invasive surgeries (MIS) is growing. Japan and S.Korea lead APAC with 1.8mil and 1.1mil MIS procedures respectively in 2011. Demand for MIS increasing in Singapore, Malaysia, Australia and Thailand, driving devices market. RestraintsRegulatory and reimbursement issues for technology based pricing approval of devices remains as a hurdle to cross. National insurance covers only the basic devices. In Australia, S. korea, Japan and Taiwan stringent regulation hinders medical devices growth. Public hospitals in APAC practicing lowest price bidding leads to price war between companies and causes exit of existing and entry of new players. In 2011, there were 95,824 public hospitals and clinics in APAC, of which 60.5% belong to China, followed by 19.6 % in India.Inadequate training or certification for allied healthcare staff in countries like Vietnam and Indonesia hinders the devices market.
DriversIncreased demand in health screening due to awareness of people and preventive care culture growing strong in Asia, influenced by internet. Corporate initiatives for medical check ups also encourages X-rays and ultrasounds.Customized Asian medical imaging products to cater specific population will further gain popularity and boost the market. Philips launched Suresign VM3 to target the Indian market. R & D in medical imaging allows technological advancement - Molecular Imaging, Drug therapy combined with Ultrasound. - Collaboration with universities to conduct research to extend the use of molecular imaging for radiotherapy and Collaboration with RXI Pharmaceuticals to explore innovative ways to use ultrasound to “trigger drug therapy delivery” for cancer and cardio patients are some of the examples to note.RestraintsMarket of refurbished equipments growing at 9.0% by 2015. India emerges as the highest refurbished market in APAC. Multi modality or system interoperability challenges emerge as a restraint for medical imaging market as the equipments depend on technology to function efficiently. In countries like Indonesia, Vietnam and Philippines, the ability to overcome interoperability issues are low, thus restraints the market.
RestraintsMulti modality or system interoperability challenges emerge as a restraint for HIT. In countries like Indonesia, Vietnam and Philippines, the ability to overcome interoperability issues are low, thus restraints the market. Too many small vendors offering HIT solution hindering turn key projects.
Aging & growing Population – Asia’s population expected to expand to 4.5 billion by 2050 (60% of world’s populationRise in chronic disease – cancer, cardiovascular and diabetes accounts for more than 50% of mortality in most Asian countriesMedical Tourism – Asian medical tourism market expected to reach USD 4.4 billion by 2012Rising middle and affluent income population – 4.8 million Asian households with income above USD 50,000 p.a. & is expected to grow by 3 to 5% for SEA and 5 to 7% for China and India Restraint:Manpower shortage – Density of health care workers in South and Southeast Asia is 4.3 per 1,000 population, compared to 24.8 in the Americas in 2010)Access disparity between urban & rural regions – Despite government efforts in healthcare reforms, countries in Asia (e.g. Laos, Sri Lanka, and Nepal) hosts more than 80% of population in rural areas, posing challenge for effective healthcare distribution
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Asia Pacific Healthcare Outlook 2012-2015
Asia Pacific Healthcare Outlook 2012- 2015 What comes next…. Rhenu Bhuller Vice President, HC
Global vs. APAC: The New FrontierIn 2011, APAC is estimated to be 28.5% of global market Global & APAC Healthcare Revenues US$ Bn, 2011-2015 1800.0 1600.0 CAGR Market Drivers 4.3% 1400.0 • By 2020, Chronic disease deaths in APAC will grow at 20%. 1200.0 • 15% of the 37 million deaths worldwide is 1060.7 1000.0 1017.5 related to Pandemic and epidemic diseases, 978.1 1/3 of such was from APAC. 928.8 800.0 895.6 • Private expenditures is increasing in China and India, private spending accounted for 600.0 49.9% and 67.2% respectively in 2009. CAGR 400.0 12.1% 491.7 562.1 200.0 356.5 396.4 440.1 Market Restraints 0.0 2011 2012 2013 2014 2015 • Per capita healthcare expenditure is far APAC Rest of the World below global average (lowest is Vietnam and ($ Billion) ($ Billion) Indonesia). • Shortage of healthcare professionals. Health• By 2015, APAC could represent 34.6% of global market care workers in APAC is 6.8 per 1,000 population, compared to 18.9 in Europe and 28.5 % APAC Share 34.6% 24.8 in the Americas in 2010. • Access to healthcare and distribution limited in emerging markets.
Pharma market will grow at almost triple the rate compared with the rest of the world, accounting for 1/3rd of total by 2015 Pharmaceuticals & Biotechnology, US$ Bn, 2011-20151,200.0 Market Drivers CAGR 3.8%1,000.0 • Increased long term use of multiple and specialized drugs for the aging population. • Enhanced health awareness and purchasing 800.0 power boosting over-the-counter purchase. 738.5 707.4 • Government support for generics/bio- 677.6 600.0 649.0 similars. 636.0 • Increased disease incidence boosted by availability and usage of new diagnostic 400.0 CAGR tools. 11.5% 200.0 346.1 389.4 252.1 278.4 309.4 0.0 Market Restraints 2011 2012 2013 2014 2015 APAC Rest of the World • Patent expiry of major pharmaceutical ($ Billion) ($ Billion) products. • Cost control measures by various governments. 28.4% APAC Market Share 34.5% • In markets with strong local manufacturing, government tenders favor local manufacturers.
APAC Medical Devices Local Asian companies spur growth through low cost products Medical Devices Revenues, US$ Bn, 2011-2015400.0 Market Drivers350.0 CAGR 5.1% • By 2015, Cardiology market is expected to300.0 reach $18 billion. • Surgical procedures are growing at 12.0 %.250.0 208.69 • Japan and South Korea lead MIS in 201.19 APAC, demand for MIS increasing in200.0 200.10 185.07 Singapore, Malaysia, Australia and 170.92 Thailand, driving devices market.150.0 • Local Asian companies of Japan, China, Korea CAGR and Taiwan offering cost effective products.100.0 14.0% 140.0 50.0 104.1 116.2 82.8 94.1 0.0 2011 2012 2013 2014 2015 Market Restraints APAC Rest of the World ($ Billion) ($ Billion) • Technology based pricing approval remains a hurdle. 26.3 APAC Market Share 36.6 • Public hospitals practice- lowest price bidding, leads to price war. • Inadequate training or certification for allied healthcare staff.
Medical Imaging A technological challenge, new vs refurbished … Medical Imaging Revenues, US$ Bn, 2011-201545.0 CAGR40.0 4.3% Market Drivers35.0 • Increased demand for health screening.30.0 • Reverse innovation of customized Asian 28.49 medical imaging products to cater for25.0 27.54 26.19 different culture and population. 25.0020.0 24.04 • R & D in medical imaging allows technological advancement - Molecular15.0 Imaging, Drug therapy combined with CAGR Ultrasound.10.0 11.2% 12.2 13.4 5.0 8.8 9.8 11.0 0.0 Market Restraints 2011 2012 2013 2014 2015 • APAC Refurbished market for imaging APAC Rest of the World equipments is expected to reach 9% growth ($ Billion) ($ Billion) by 2015. • System interoperability hinders new systems 26.7 APAC Market Share 32.0 adoption in hospitals.
Healthcare Information TechnologyAPAC HIT growing at global pace of 9.0% Healthcare IT Revenues, US$ Bn, 2011-201545.040.0 CAGR Market Drivers35.0 9.2% • Quality, regulatory and performance30.0 application growing at 11.0% CAGR.25.0 31.96 • Patient and Revenue cycle management 31.00 related application will drive HIT with 10.3%20.0 27.01 25.29 CAGR. 22.5015.0 • Departmental Systems market size is expected to be $ 875 million in 2011, growing10.0 CAGR at 7.1%. 9.7% 5.0 8.2 5.7 6.2 6.8 7.5 0.0 2011 2012 2013 2014 2015 APAC Rest of the World Market Restraints ($ Billion) ($ Billion) • System interoperability hinders market growth. APAC Market Share • Too many small vendors offering HIT 20.2 20.5 solutions.
Healthcare Delivery Market:Rising middle income, medical tourism create impact APAC Healthcare Delivery Market Size US$ Bn, 2011-2015 Market Drivers Market Restraints 500 CAGR 8.0% 450 420 400 390 362 • Aging & growing • Manpower shortage 350 334 Population 309 300 • Access disparity between • Rise in chronic disease urban & rural regions 250 • Medical Tourism • Inability to meet demand of 200 • Rising middle and healthcare services in smaller 150 affluent income cities and rural areas population 100 50 - 2011 2012 2013 2014 2015 Note: All figures are rounded; the base year is 2009. Source: Frost & Sullivan• International accreditations (e.g. JCI) likely to become the prerequisite for hospitals targeting to participate in medical tourism. Stringent operational and stringent accreditation requirements likely to escalate the clinical and operational quality standards, thus increasing market competitiveness
Healthcare Delivery 2015… Delivery of health at home Consolidation of retail healthcare service model Integration of primary and secondary healthcare facilities. Establishment of electronic medical records integrating primary and secondary healthcare Satellite based hospital model using advanced medical technologies for increasing accessibility in rural areas Healthcare as a service industry Influx of non-traditional healthcare institutions investments New models of Holistic healthcare hubs integrating tertiary care, wellness, aged care and clinical R&D Increasing funding opportunity for medical tourism through expanded international medical insurance Differentiation of hospital models through specialty or holistic health platforms
The Future of Healthcare . . . .Linking Stakeholders From Different Industries Assisted Lifestyle Retirement Homes Medical Spa Healthy Villages Preventive Wellness Wellness Villages Medical Wellness Healthcare Cosmetic Surgery Nutritional Primary Alternative Corporate Wellness Community Secondary Spa Fitness Tertiary Beauty Courses Nutritional Supportive Industries Education Hospitality
Where to place your bets: 2012- 2015 Japan S.Korea China Thailand Hospital services India Taiwan Malaysia Vietnam Monitoring and Singapore Indonesia diagnostics Mobile Philippines Australia Healthcare Digital Imaging Distribution, manufacturing OTC, Traditional pharmaceuticals, bra Healthcare Specialty based hospitals nded generics Growth manpower vs. Holistic wellness hospitals Medical Primary and Diagnostic devices, biotech Tier2 and Tier3 stand alone centers Healthcare Service Center development New materials, biotechnol ogy INNOVATION SUPER LEADERSHIP TRIGGER GROWTH Time Source: Frost & Sullivan.
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