Singapore has one of Asia’s fastest growing biopharma industries, increasing more than 23 percent annually between 2000 and 2006. Healthcare spending is forecast to increase from roughly $6.4 billion in 2015 to more than $9.2 billion in 2020. With newly introduced universal care through MediShield Life, investments to upgrade research infrastructure and the planned openings of new health centres, Singapore’s healthcare sector is poised for continuous and rapid growth.
There is tremendous opportunity for pharmaceutical and biotech manufacturers in Singapore, but opportunity breeds competition, with more than 50 biopharma companies having R&D or corporate operations there. For that reason it is essential that pharmaceutical companies effectively communicate their value stories to payers and distinguish their products as being worthy of reimbursement and access in an increasingly crowded market.
Singapore’s Payer Stakeholders
Singapore’s citizens have universal healthcare coverage through a variety of public and private providers. For private insurers premiums are payed entirely out of pocket, but public insurers offer lower government subsidised rates at the cost of not reimbursing some treatments. Ultimately, 60 percent of healthcare costs for patients come out of pocket as opposed to pure public subsidies. This multi-pronged approach delivers affordable healthcare through the following providers and funds:
- Direct Government subsidies on certain medicines.
- MediShield Life – The basic health insurance plan administered by the Central Provident Fund (CPF) of Singapore. MediShield Life provides universal coverage for Singaporean citizens. MediShield offers options with higher claim limits for hospital bills and some outpatient treatments in exchange for higher premiums.
Private Integrated Shield Plans – In addition to MediShield Life, there are plans provided by private insurers that often have more expansive coverage.
- Medisave – Every citizen contributes four to 10.5 percent of his or her monthly salary to a Medisave account (percentage varies with the individual’s age and yearly income). The monthly contribution goes toward future personal healthcare expenses or those of an immediate family member.
- Medifund – Medifund provides a safety net for people who do not have any money to pay off their medical bills, even after tapping every other resource available.
Ministry of Health (MOH)
Regulation of the healthcare industry comes under the purview of the MOH. The Ministry of Health is also the chief authority for determining what medicines, medical devices, and surgeries will be reimbursed by MediShield and by how much healthcare services will be subsidised. Aside from subsidising healthcare services and governing reimbursement strategy, the MOH distributes grants to innovators whose products in development offer improved efficacy over existing options. This grant process can serve as an initial point of access for innovative products whose price would otherwise disqualify them for reimbursement.
Group Procurement Office and Group Purchasing Office
These agencies support SingHealth and the National Healthcare Group (NHG), two of the largest government hospital systems, in the bulk purchase of required drugs, medical and surgical equipment and other critical healthcare supplies. Because there is no government regulation of prices in Singapore, the collective purchasing power of these hospital networks is the key factor in keeping prices low.
- Private hospitals have more leeway in the purchase and dispensation of medications and devices.
Important Points to Keep in Mind
Depending on the risk classification of a drug, the target turn-around time for product registration can take anywhere between 30 and 310 working days. Drugs that have been approved in foreign markets can be placed in an abridged evaluation process.
- Private providers often procure drugs at a much higher cost than their peers in the public sector, due to less collective bulk purchasing powers. At the same time, private hospitals and practices are more willing to administer high cost products that the public system considers inefficient.
- Drugs that are listed under the “Standard Drugs List” or “Medication Assistance Fund” are either heavily subsidised or priced at no more than $1.00 per week. The standard drug list is modeled after the WHO essential drug list, but with modifications to suit local disease profiles and practice. It is reviewed on an annual basis by the Drug Advisory Committee.
Implications for Industry
Singapore can be an excellent point of entry to the Asian healthcare market due to the well-established existing healthcare infrastructure and the free-trade agreements between Singapore and its neighbors. This eases the process of achieving regulatory approval and expanding a product’s access into the rest of Asia.
The Health Sciences Authority (HSA) strictly monitors safety and efficacy of products as well as modifies buying practices to ensure that drug prices remain relatively affordable for the general population. The marketing and promotion of innovative products is also tightly controlled. For these reasons, local experience is critical to developing a credible value story for products entering the healthcare market in Singapore. Being able to negotiate approval and access with the HSA and MediShield Life, as well as understanding the nuances of post-launch product support and marketing is the key to taking advantage of the opportunities present in the market. GLOBALHealthPR® has the experience and creativity to navigate the best possible route to market access success in Singapore.
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