Import dependent and still maintaining good growth levels, the markets of South East Asia offer enterprising companies good opportunities. However, they must meet the challenges of widely differing operating environments.
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Why invest in South East Asia?
Like all other sectors, the medical device markets in South East Asia have been impacted by the downturn of the world economy. Most of these countries, which rely heavily on exports as a significant portion of their respective GDP - South Korea and Singapore being prime examples - saw cuts in demand for manufactured goods and most have seen dips in overall GDP for 2009. Economic conditions, however, have started to gradually improve in these markets and GDP growth rates were strong between 2010 and 2012.
The economy aside, what factors are affecting medical device growth?
Fundamentally, the eight countries covered in this collection share a similar characteristic. These medical device markets have, on average, been growing at more attractive rates compared to the more developed, mature medical device markets in Western Europe, for example.
Broadly speaking, the high growth rates for this region have been spearheaded by a number of similar and distinct factors. All countries in this report collection have experienced strong medical devices import growth and steadily rising health expenditure. Medical devices imports, as we have seen in the last economic crisis in 1997, could possibly be affected in the short term, but like before, these countries are expected to bounce back.
The demand for medical devices prior to the current downturn was largely driven by the expansion of the respective healthcare sectors in the region, and government budget cuts for capital infrastructure may temper growth in the short term. But healthcare development and provision is an increasing political and social priority for nearly all these countries, even the poorer ones like Indonesia, Thailand and Philippines and the prospects for medical devices remains strong.
Other factors driving or impeding the market’s growth rate are also taken into account. For example, government cost containment strategies and tariff and non-tariff barriers to trade for medical devices. New dynamics are also affecting the market, such as Vietnam’s expansion of health insurance to all citizens by 2014 or the opening up of the notoriously difficult but lucrative South Korean market via Free Trade Agreements (FTA) with the USA and the EU.
Highlights from the Region
The Social Insurance Providers Board (BJPS) Law, which becomes effective on 1st January 2014, aims to provide universal healthcare coverage for all Indonesians. The programme, to be managed by State-owned PT Askes, will entitle the entire population to free treatments and medicines for major illnesses at public healthcare facilities, the cost for which will be borne by the government. Public funding for healthcare is low, estimated at around US$10.7 billion in 2011, and the country continues to rely on international aid. Despite the present administration placing more emphasis on healthcare, funding, insufficient numbers of health professionals and bureaucratic problems are hampering development. There is a marked disparity in the standard of healthcare between rural and urban areas. The capital city Jakarta enjoys relatively good levels of primary care as well as a range of modern private specialist facilities, while healthcare coverage in remote regions tends to be insufficient.
Malaysia's major natural resource is rubber, and the country's medical device exports are dominated by latex products such as surgical gloves. The share of this sub-category has slowly started to diminish with the steady growth of diagnostic imaging exports in recent years, particularly electrocardiographs and other electrodiagnostic apparatus. In the five years from 2007-11, imports rose at a CAGR of 13.2%. Imports are expected to continue growing at a strong rate, in line with rising health expenditure growth, and the country's heavy reliance on imports to meet its healthcare needs. Malaysia's first set of regulations for medical devices, the Medical Devices Act 2012 (Act 737), was approved in March 2012. Effective November 2012, it became mandatory for all medical devices to be registered with the Medical Devices Authority (MDA). The regulations are aligned with the guidelines drawn up by the ASEAN Harmonisation Working Party (AHWP) and the Global Harmonisation Task Force (GHTF).
South Korea ranks as one of the world’s leading economies, with a population approaching 50 million and overall GDP listed among the top 15 in the world. As a result, much of the population expects a high level of medical care. South Korea has the highest healthcare expenditure of all the ‘Asian Tigers’, with an estimated 59% funded by the public sector. Almost every citizen is covered by the country’s public health insurance system. The government has been forced to implement cost-cutting measures in recent years, owing to a large deficit faced by the healthcare system. Healthcare costs continue to rise, with the country’s rapidly aging population adding upward pressure to total spending. In the first half of 2009 for example, senior citizens accounted for 31.7% of costs covered by the National Health Insurance Corporation (NHIC).