This paper seeks to explore the potential opportunities which Singapore can explore to fulfill its key economic objectives amidst global and regional developments within the life science industry and in the process develop Singapore-domiciled companies into viable players on the global stage.

1. Developing a Globally Competitive
Singaporean Life Science Industry

2. 1
Foreword
As Singapore embarks on her next phase of economic and industrial development, capturing more
value from the billions invested in publicly funded life science R&D has come into focus, demonstrated
with a recent shift of funding from basic research towards translational research. Notably in
Singapore’s Research, Innovation and Enterprise (RIE) 2020 plan, health and biomedical sciences
remains a key strategic economic and industrial pillar as the country seeks to support biomedical
innovation and better and sustainable healthcare outcomes for the local population.
This paper seeks to explore the potential opportunities which Singapore can explore to fulfill its key
economic objectives amidst global and regional developments within the life science industry. With
complementary industrial support initiatives and harnessing the natural advantages of intellectual
property protection and human capital capabilities, Singapore-based companies can be developed
into viable players on the global stage.
This paper contains the views of the author and is produced as a public service and without industry
or government funding. Citations listed within this paper are gratefully acknowledged.
XQ Lin
CEO
Esco Group and Esco Ventures
Esco Group Esco Ventures
21 Changi South Street 1 Singapore 486777 71 Ayer Rajah Crescent #07-26, Singapore 139951
http://www.escoglobal.com/ http://www.escoventures.com/
© 2017 Esco Group and its affiliates. With the exception of citations, all reproduction rights, quotations, broadcasting,
publications reserved. No part of this publication may be reproduced or transmitted in any form or by any means without
express written consent of Esco Group.

3. 2
Introduction
The desire for Singapore to capture more value from the billions which the country has invested in
publicly funded life science R&D is a pragmatic one.
Indeed, Singapore has now gained an outsized standing in the global scientific community despite her
relatively small size. However, this standing has yet to translate into expected downstream value
capture for her economy, especially in the startup/SME segment. This is in spite of the budding
emergence of promising home-grown life science companies with a few success stories and a healthy
number of out-licenses of Singapore-owned IP.
1. CrunchBase (Accessed Nov 2017), WIPO Statistical Database (Accessed Nov 2017).
With the rise of China, Singapore's role as an unrivalled Asian hub is changing rapidly. Many
multinationals will choose to locate their Asian headquarters in one of the Chinese metropolises.
While Singapore can continue to count on being the economic capital of Southeast Asia, developing a
homegrown ecosystem of life science SMEs/startups, some of which can eventually become
competitive players on the global stage, should feature on the national agenda.
The life science industry is a highly globalised, evergreen and knowledge intensive industry which
impacts humanity on a broad scale, spanning wide and deep across several industrial horizontals and
verticals to deliver a multitude of products and services. Though consolidation is occurring within
some segments of the life science industry, many opportunities for disruption still exists, allowing
startups and SMEs to thrive, especially those which aim to address unmet needs.
The narrative on current global medical issues persists; the globally aging population, combining with
an increasing affluent population and with it related chronic diseases, results in untenable cost burden
to healthcare systems. While most of these diseases continue to be treated with incremental
innovations, the unmet medical need of curing these diseases, including a plethora of as yet
untreatable debilitating and fatal diseases, still exist. These are enormous problems with great societal
and personal impact, which will pay great dividends for businesses that bring technological solutions
to bear, including Singaporean enterprises. After all, primary to building great businesses is to solve
problems for the society.
To further develop a homegrown life science industry which is globally competitive, an updated
industrial roadmap is needed, one which should account the current state of the global life sciences
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5 1
PCTs Published Companies with Known PE/VC
Series Rounds
IPO Companies
2012-2016: PCTs, Known PE/VC Series Rounds, IPOs by
Singapore Registered Life Science Companies
Global Rank: 21
Aslan
Aslan, Endomaster,
Prime BioLogics,
CellResearch, Tessa

4. 3
industry. To identify the niches which Singapore companies can fill and potentially developed into the
next billion-dollar enterprise, we should consider the broader landscape spanning across categories
such as drug, device, diagnostic, life science tools and healthcare IT categories, the dynamics of major
healthcare systems such as the US and China, and the nature of large and emerging enterprises in
both of these markets. Such an industrial roadmap could also shape our investment strategy and
specifically our grant policies towards publicly funded life science R&D. This will help sharpen our focus
on generating relevant IPs which can be licensed to homegrown life science startups and SMEs for
further development and commercialisation, leading to the development of leading global companies
anchored in Singapore.
Healthcare Markets in Focus for Singapore
The US market is the largest healthcare market in the world. While medical devices and diagnostics
have struggled with reimbursement, the US market significantly rewards novel pharmaceutical
innovation, even if some of these novel therapeutic drugs treat rare or orphaned diseases that may
only benefit less than tens of thousands of patients per year.
2. PhRMA (2016) - Rare diseases by the numbers

5. 4
3. IQVIA (2017): Lifetime Trends in Biopharmaceutical Innovation
The Chinese market is the fastest growing large healthcare market globally, driven by the dualities of
foreign direct investment and domestic companies fostered by supportive industrial policy and a
multi-staged economic plan. As Chinese patients are used to paying out of pocket for innovative
treatments and diagnostics, innovative medical devices and diagnostics face less reimbursement
challenges in the Chinese market. China now has the most dynamic SME and startup life sciences
sector in Asia, benefitting from a large and fast growing domestic market and supported by a wide
availability of various debt and equity instruments, including venture capital (VC). Despite mainly
being fast followers, Chinese life science companies are rapidly developing into innovators, narrowing
the technological gap between their regional counterparts from Japan, South Korea and Singapore.
With one of the fastest growing middle-class population in the world, Southeast Asia (ASEAN) could
also be an interesting market for Singaporean life science enterprises from a patient affordability and
access standpoint. However, the ASEAN markets are highly heterogenous with different levels of
economic development, regulatory and reimbursement frameworks. Hence, they are unlikely to be a
low-hanging fruit for organic development of the next billion-dollar Singaporean life science company.
For example, private equity (PE) firms such as Quadria Capital and TVM Capital are still mainly
concentrated on healthcare services roll-up plays.
Singapore: Key Developments within the Life Science Industry
For the Research, Innovation and Enterprise (RIE) 2015 plan, the Singapore government has
earmarked SGD 16.1B to continue support of research, innovation and enterprise activities, of which
SGD 3.7B has been dedicated to enhancing existing biomedical R&D infrastructure. This has now
increased to SGD 19B for RIE2020, of which health and biomedical sciences has been identified as 1 of
the 4 main strategic technology domains. Similarly, several proof-of-concept grant schemes, such as
those previously available from A*Star and more recently the National Research Foundation, were
made available to the local life science companies seeking to develop innovative products,
biotherapeutics inclusive. However, the challenges and lack of success stories from Singapore's early
investments in biotechnology firms (biotechs) and novel drug assets have contributed to a sense of
foreboding that have etched themselves into institutional psyche. This has resulted in the current
policy for supporting medical devices and diagnostics startups as opposed to biotechs. However, an
Share of US New Active Substances (NAS) by Average Sales in the First 5 Years

6. 5
analysis of current VC investments, exits and market trends reveals that investments in biotechs, while
perceived as riskier, generate higher returns than investments in medical devices and diagnostics.
Plausible reasons for these include frequent exits to large public companies before product regulatory
approval, typically after achieving human proof of concept or up to Phase II trials, whereas
development of medical devices and diagnostics typically require some commercial traction before
exit. To aid in the successful development of a successful domestic biotech industry, re-evaluating and
consideration of additional supportive policies would be of paramount importance.
4. BMO Capital Markets (2016): M&A Database
Filling in the Gaps: Early-Stage Drug Discovery
Since the decoding of the human genome, we are living in an age of unprecedented biological
discovery, and many of these insights can be translated into novel therapeutics addressing unmet
medical needs. Notwithstanding the unpredictable failures such as the beta-amyloid late-stage
therapeutic targets for Parkinson’s and Alzheimer’s disease, startups can enjoy a level playing ground
versus big pharma in drug discovery and development. Compounding to this is the partial retreat of
big pharma from direct early-stage drug discovery and development, which has increasingly been
outsourced to VC-funded startups with recent success exit stories. Given our relative strengths in
terms of human resource, IP development and growing VC capital access, Singapore is well-positioned
to capitalize on this market gap for early-stage drug discovery.
Strategic Therapeutic Niches
It might be too prescriptive to define specific therapeutic areas of focus. However, as Singapore does
not have the benefit of a large domestic market and is geographically distant from the established life
science industrial hubs, it would be more prudent for Singapore to focus its resources on an export-
based model for niche therapeutic areas with a global critical mass to increase our chance of success.
Particularly, ophthalmology serves as one such therapeutic area where we could synergise with our
strengths.

7. 6
Patentable Clinical Diagnostics
While having to reconsider the polices and investment strategies within the domestic biotech space,
the Singapore industrial policy should also continue to support domesticmedical device and diagnostic
enterprises. However, policies should be further refined and tailored towards enterprises which will
be competitive in major markets where reimbursement hurdles are lower such as China, or
technologies which have the potential to demonstrate a significant value to the payor in the US and
thus access to reimbursement. Particularly, the discovery and clinical validation of novel diagnostic
biomarkers and methods requires the careful curation of large biological/patient sample banks.
Prospectively collecting such samples is very expensive in the US. Singaporean companies could
leverage on local and regional hospitals to assemble large curated sample banks at a fraction of the
cost. Caucasian samples are also accessible from Australia which provides generous R&D incentives
supported at both state and federal level. As such, patent protection of such novel diagnostic content
could be achieved and become a potential play for Singaporean companies within the diagnostics
industry. Despite the recent changes in the patentability of diagnostics methods in the US, there are
clear pathways which we can navigate to achieve success in patent protection.
Speed to Market: Life-Science Tools
Another segment which Singapore could develop homegrown, globally competitive enterprises is in
life sciences tools. Multinational life sciences tools companies have a significant manufacturing
footprint in Singapore. Life sciences tools do not have to undergo clinical trials and regulatory approval,
resulting in a lower lead time to market. Some life sciences tools eventually transition to becoming
diagnostic platforms. However, there are few life sciences tools segments which can give rise to billion-
dollar companies. This is also a segment which is somewhat under-invested in by VCs within the US
and EU markets.
Healthcare ICT: A Misfit for Export?
Combining the rapid-growth triumvirate of an IT-savvy nation, digital innovation as a national
development and the recent influx of private equity and venture capital funding available for
information and communications technologies (ICT) opportunities, it is no wonder that several
healthcare ICT/digital health companies and startups have established themselves in Singapore.
However, such companies typically do not fit with the "deep-tech" mould that the government
currently advocates. Without IP protection and a limited domestic market, Singaporean companies
would be limited in protecting themselves from competition when exporting and adapting such
solutions to large markets such as the US, China and Europe. Furthermore, such businesses aim to
solve specific pain points which are relevant within a particular healthcare system. Therefore, a
solution developed to address the pain points within the Singapore healthcare system may not
translate to the Chinese or US healthcare systems. Thus, such business models can be harder to defend
against competition and are also harder to scale across borders into large global markets without
substantial “glocalisation” of the underlying product or service. Within the foreseeable future, it is
unlikely that such locally developed companies can to become the next billion-dollar businesses from
Singapore. However, there may be exceptions to this, such as digital health companies which have
proprietary hardware and/or business models which efficiently address the different stakeholders
needs and create network effects.

8. 7
Bio-Entrepreneurs as Creators & Cultivators in Singapore
Beyond the above analyses for the various segments in the life sciences industry and the different
major markets, there is also the pressing challenge of how to cultivate more "bio-entrepreneurs"
which can form and lead multi-disciplinary teams needed to translate cutting-edge scientific
discoveries into actual products. In this regard, Singapore has numerous young scientific talents which
can be cultivated. However, a bottoms-up approach should be taken to develop and nurture this talent.
Esco Ventures has hired and provided training on technology scouting and venture creation to young
and promising post-doctoral researchers within the life science “deep-tech” space.
Conclusion
In summary, Singapore desires more value capture from its investments in public life science R&D. A
globally competitive domestic life science industry can be one of the drivers of Singapore's economic
growth for the next few decades. An updated industrial roadmap is needed to chart the course of
Singapore's budding life sciences industry. Certainly, that is no substitute for groundswell involvement
from the private sector, especially early-stage life science VCs driving venture creation and bringing
both technologies and multi-disciplinary talent together to address the unmet medical needs.

9. 8
About the Author
XQ Lin
Life Sciences Entrepreneur, CEO, Investor
Life sciences entrepreneur with a track record of developing and scaling businesses starting from
concept, global operational experience and early stage investment acumen.
 Financially independent from 13 and founded first business at 17 (re-engineered family business
into a life sciences tools company and grew enterprise value at 25%+ CAGR for 10+ years)
 Successfully established and managed life science lab tools product development program
(including Esco's world leading biosafety cabinet product line)
 Introduced the Esco brand and products to more than 100 countries by establishing a global
distribution network and subsidiaries in US, UK, Japan, China, India and other countries.
 Successfully developed and commercialized over a dozen life sciences tools and medtech product
lines in the US, EU and China
 Developed and implemented China localization and growth strategy, resulting in 60% revenues
growth over a 1-year period. Grew lab tools product portfolio and established Medical IVF tools
business unit
 Life sciences startup investments and venture creation focused on large unmet needs
 Co-founder and Chairman of Carmentix Pte Ltd, a precision medicine company developing a novel
test to predict and enable prevention against preterm birth in asymptomatic women