THE HEART of ASIA PACIFIC PAGE 21 SINGAPORE FEBRUARY 2017 Acknowledgements Pharmaboardroom Is Profoundly Grateful To…

PUBLISHED IN COLLABORATION WITH:

SINGAPORE’S PHARMACEUTICALS IN EMERGING ASIA - UNVEILING MICROSOFT’S DEVELOPMENTAL MODEL: THE SKY: BLAZING NEW LEADING THE DIGITAL HEALTHCARE STRATEGY FROM EXCEPTION TO TRAILS IN COLD-CHAIN CHARGE PAGE 53 EXCEPTIONAL LOGISTICS PAGE 50 PAGE 12 PAGE 34

THE HEART OF ASIA PACIFIC PAGE 21 SINGAPORE FEBRUARY 2017 Acknowledgements PharmaBoardroom is profoundly grateful to…

Fredrik Nyberg, CEO, Asia Pacific Medical Technology Association (APACMed)

Ho Weng Si, Director of Biomedical Sciences, EDB

Dr. Benjamin Seet, Executive Director, A*STAR BMRC

for their continuous support, enthusiasm and encouragement in the compilation of this report.

2 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com HEALTHCARE & LIFE SCIENCES REVIEW SINGAPORE Jack of all Trades - An Exclusive Interview with Takeda’s President of CONTENTS Emerging Markets — February 2017 Interview 40

2 ACKNOWLEDGEMENTS 4 FOREWORD 5 PREFACE 8 SNAPSHOT IN FIGURES The Heart of Asia 12 SINGAPORE’S DEVELOPMENT HISTORY Pacific FEATURE Fostering Knowledge and Innovation Cover story 14 SINGAPORE’S ECONOMIC STRATEGY 21 INTERVIEW Weng Si Ho, EDB 16 MEDTECH INTERVIEW Fredrik Nyberg, APACMed 18 LOCATION, INFRASTRUCTURE, TALENT FEATURE Becoming a Hub 21 THE HEART OF ASIA PACIFIC COVER STORY 22 The Best is yet to Come 26 Spearheading a New Model of Asian Healthcare 27 A Prescription for Performance 30 A Beacon of Light 31 Calibrating Collaboration Emerging Asia - leading the digital 34 Pharmaceuticals... in the Sky! charge 34 Connecting Data in the Logistics Community Featured 50 36 Managing Diversity 40 EXECUTIVE PROFILE INTERVIEW Giles Platford, Takeda 41 TAKEDA IN FIGURES Therapeutic Areas, Emerging Markets & Access to Medicine 42 PATIENT-CENTRICITY INTERVIEW Bob White, Medtronic The Healhcare & Life Sciences Review was produced by PharmaBoardroom. 44 3PL SPECIALIZATION INTERVIEW Sugantha Natarajan, DB Schenker Project Publisher: Mariuca Georgescu Senior Editor: Louis Haynes 46 CORPORATE COMPLIANCE INTERVIEW Editor: Patrick Burton Christopher Snook, Novartis Project Director: Jun Wakabayashi, Alexander Ackerman Project Coordinators: Lisa Diericks, Roxane Höck 48 AMINO-ACIDS INTERVIEW Peter Meinshausen Project Asssistant: Luis Sancho, Frances Doria & Dr. Stefan Randl, Evonik Graphic design: Miriam León 50 DIGITALIZATION IN SOUTHEAST ASIA For exclusive interviews and more info, please log onto FEATURE Innovative Solutions www.pharmaboardroom.com or write to [email protected]. 52 INNOVATIVE NETWORKING INTERVIEW Copyright: All rights reserved. No part of this publication maybe reproduced in any form or by any means, whether electronic, mechanical or otherwise including photo- Ong Wee Min, Marina Bay Sands copying, recording or any information storage or retrieval system without prior written 53 MICROSOFT’S HEALTHCARE PLAN FEATURE consent of Focus Reports. While every attempt is made to ensure the accuracy of the information contained in this report, neither Focus Reports nor the authors accept any An Emerging Digital Player liabilities forerrors and omissions. Opinions expressed in this report are not necessarily those of the authors. 54 VALUE-CENTRICITY INTERVIEW Elisabeth Staudinger, Siemens Healthineers

www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 3 STRAPFOREWORD IN HERE PLEASE Strap subhead in here please

In fast growing regions such as Asia, many countries are confronted with unmet healthcare needs and increasing accesibility to healthcare. Singapore has invested strongly in building up our biomedical sciences industry to date, and has built up a strong foundation. Today, Singapore is home to more than 50 biomedical sciences manufacturing plants, producing a wide range of products ranging from drugs to medical devices and equipment, with a combined manufacturing output of more than $26 billion in 2014. With over 30 leading biomedical sciences companies basing their regional headquarters here, Singapore is also a key base for companies to access the fast-growing Asia-Pacific markets. On the research front, business expenditure in R&D (BERD) in Biomedical & Related Sciences and Biomedical Engineering has increased more than four times from around S$140 million in 2002 to more than S$630 million in 2014. The employment of researchers has also grown more than three times from around 500 to 1500 in the same period. As a whole, the industry employs an estimate of over 25,000 people across manufacturing, R&D and commercial activities today. Looking ahead, heathcare models are shifting, particularly with aging populations and increasingly pervasive chronic diseases, ASEAN today is a US$2.5 trillion economy, with an expected GDP growth averaging 5% in the coming years. Collectively, it has a population of more than 650 million people and it is already the seventh largest economy in the world. These trends present key opportunities for governments, companies and institutions alike. Navigating the region’s complex markets and meeting the growing demand for healthcare solutions is critical for the development of the sector. With its pro-business environment, coneectivity to the region and strong talent pool, Singapore has been future- ready in responding to changing healthcare needs over the years. The Singapore Government is commmitted to developing the biomedical sicences sector in the years to come. I am confident that the industry in Singapore will continue to grow and play a critical role in addessing healthcare needs in the region and beyond. We will strive to ensure that our continued efforts will accelerate Singapore’s shift from beign a value adding economy to being a value creating one, to bring about sustainable development in the long run.

Weng Si Ho Director (Biomedical Sciences) Singapore Economic Development Board (EDB)

4 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com PREFACE

Preface

As a tiny city-state with limited land and nat- and maintain its status as the beating heart of ural resources, Singapore has had to carve out Asia-Pacific. its own niche as a global trade hub and gateway Through in-depth interviews with industry to the Asia-Pacific region to compete globally leaders in both the public and private sectors, since declaring independence in 1965. In terms as well as exclusive articles and detailed facts of healthcare and life sciences, the island now and figures, this report helps paint a picture of serves as a regional hub for myriad multina- how actors within Singapore are pivoting their tionals, stands at the forefront of cutting-edge operations to combat the problems of aging scientific research and development, and is populations and increasingly pervasive chronic globally renowned in several important levels diseases; the new realities of global healthcare. of the pharmaceutical supply chain, such as A country that has based much of its extraor- logistics. dinary growth over the last 50 years on inter- However, with a number of countries from national capital inflows is now focusing on emerging Asia now catching up to Singapore, building truly innovative homegrown compa- this report tackles how the Lion City is repo- nies and looks set to stay ahead of the curve for sitioning itself to fend off new challengers years to come.

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www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 7 SNAPSHOT IN FIGURES The Big Picture

SINGAPORE FACTS HOME TO OVER 40 PERCENT OF GLOBAL MNCS’ REGIONAL HEADQUARTERS Population: Area: >10,000 5,781,728 697 sq km (192nd globally) 41% 7,000 34% 5,700 5,000 Ethic groups: (2013 est.) GDP (PPP): Chinese 74.2% $486.9 billion 16% Malay 13.3% (2016 est.) OTHERS SEA G3 Indian 9.2% 9% Other 3.3% Source: CIA World Factbook Source: EDB, 2016

STAR PERFORMANCE REAL GDP PER PERSON, AT PPP* $’000

Singapore declares ASEAN formed with Goh Chok Tong Lee Hsien Loong becomes independence Singapore as one of the becomes prime prime minister founding members minister.

Primary Research, Innovation Singapore education made & Enterprise (RIE) plan Changi compulsory launched Airport opens

Goverment starts process of economic SINGAPORE 50 restructuring following two oil crises UNITED STATES 40 HONG KONG

30 JAPAN

20 MALAYSIA

10 CHINA INDONESIA 0 1960 1970 1980 1990 2000 2010 2015

*Purchasing-power parity Source: Penn World Table, University of Groningen; UN; The Economist

LEADING THE PACK FOR INVESTOR FRIENDLINESS

EASE OF DOING BUSINESS LABOUR FORCE INNOVATION INPUT 1 SINGAPORE 1 SINGAPORE 1 SINGAPORE

2 NEW ZEALAND 2 US 2 SWITZERLAND

3 HONG KONG 3 TAIWAN 3 FINLAND

4 DENMARK 4 SWITZERLAND 4 HONG KONG 5 REPUBLIC OF KOREA 5 BELGIUM 5 US Singapore was the top-ranked Asian country in the Global Innovation Index 2015. Source: EDB, 2016

8 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com SNAPSHOT IN FIGURES Health Profile

THE EVOLVING HEALTHCARE LANDSCAPE IN SINGAPORE

DEMAND FOR HEALTHCARE WORKERS Source: MOH, 2015 Average population Increase in demand for Increase Citizens aged 65 and above Citizens aged 80 and above healthcare workers

6 45 + 340K 900K + 70K 210K = 82% 2015 2030 2015 2030 2015 2030

CAPACITY OF AGE CARED SERVICES

Nursing home care beds increase by 1,000 more Twice 3,500 home pallitative care The number of centre more home 7,200 places based care places care places

SINGAPORE AS A MEDICAL TOURISM HUB

50% 4th 2 Cheaper than USA in Best healthcare Consecutive years for ‘Best medical/Wellness terms of medical cost infrastructure (2010) Tourism Destination’ award (2007,2008)

TOP 10 CAUSES OF DEATH PER YEAR (2014) HEALTHCARE EXPENDITURE - SINGAPORE COMPARED TO REST OF SE ASIA Deaths Source: WHO 2014; Worldlifeexpectancy.com INDONESIA 27 CORONARY HEART 4,228 19.71% DISEASE THAILAND 11,9 INFLUENZA AND 4,036 18.82% PHEUMONIA SINGAPORE 11,8

STROKE 2,079 9.69% PHILIPPINES 10,8

LUNG CANCERS 1,524 7.11% MALAYSIA 10,5

COLON-RECTUM VIETNAM 9,8 CANCERS 1,090 5.08%

MYANMAR 1,16 KIDNEY DISEASE 1,013 4.72%

CAMBODIA 0,756 LIVER CANCER 643 3.00%

LAO 0,406 BREAST CANCER 622 2.90% BRUNAI 0,357 DARUSSALAM LUNG DISEASE 603 2.81% Of the 10 ASEAN members, Singapore is by far the most developed and efficient healthcare provider and annually spends the most per STOMACH CANCER 510 2.38% capita on health.

Source: ASEAN, TforG 2015 SINGAPORE HEALTH RISK FACTORS PER 100,000 POPULATION Source: WHO 2014; Worldlifeexpectancy.com Rank Rank Rank TOTAL SMOKING MALE FEMALE 141/ OBESITY MALE FEMALE 81/ 139 ALCOHOL 82 PERCENT 28.0 5.0 LITERS 2.9 176 PERCENT 5.7 6.8 www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 9 SNAPSHOT IN FIGURES Pharmaceutical Industry

GENERICS PENETRATION IN SOUTHEAST ASIA SINGAPORE MANUFACTURING SECTOR BREAKDOWN

Source: Gabi, 2014 12.5% Generics market share (%) 11% 100 General Manufacturing Chemicals Industries 90 14.8% 80 Precision Engineerring 70

60 Biomedicals 17.8% Manufacturing 50

20 26.8% 17.2% Others Transport 10 Engineering 0 Singapore’s medical technology sector contributes about SG $4.3 billion and around 9000 jobs to the country’s economy. To put this into perspective, 10 percent of the world’s contact lenses, over 70 percent of microarrays, and roughly half of the world’s thermal cyclers and mass spectrometers are currently produced in Singapore. INDONESIA MALAYSIA PHILIPPINES SINGAPORE THAILAND Source: EDB, Emerging Strategy 2016

STILL MAKING STUFF MANUFACTURING, % OF GDP Source: Thomson Reuters JAPAN 35 SOUTH KOREA

30 SINGAPORE

5 HONG KONG

0 1975 1985 1995 2005 2013

ARE PHARMACEUTICALS HELPING REVIVE SINGAPORE’S FLAGGING EXPORT SECTOR?

SINGAPORE - ELECTRONICS & PHARMACEUTICAL NODX*, & OF TOTAL Electronics Pharmaceuticals *NODX: Non-oil domestic exports. 80

0 JAN SEP MAY JAN SEP MAY JAN SEP MAY JAN SEP MAY JAN SEP MAY JAN SEP MAY JAN SEP MAY JAN SEP MAY JAN

00 00 01 02 02 03 04 04 05 06 06 07 08 08 09 10 10 11 12 12 13 14 14 15 16 Bloomberg BMI, Source:

10 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com SNAPSHOT IN FIGURES Biosciences

BIOMEDICAL SCIENCES INDUSTRY

Source: EDB Singapore BIOPOLIS

KENT RIDGE CAMPUS TUAS BIOMEDICAL PARK

MEDTECH HUB SCIENCE OUTRAM BUSINESS PARK CAMPUS DISTRICT

BIOSCIENCES R&D EXPENDITURE & OUTPUT

1,600

25,000 1,400

1,200 20,000

1,000

15,000 800

600 10,000 Output (Millions S$) (Millions Output R&D Expendition (Millions S$) 400

5,000 200

0 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Public Research Pharma & Bio Product Private Education Goverment Institutes Output

In 2015, Singaporean pharma & bio product output accounted for roughly 3.7% of GDP Research and Science, Technology for Agency Singapore Source: www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 11 SINGAPORE’S DEVELOPMENT HISTORY Fostering Knowledge and Innovation

innovation and enterprise to take FROM Singapore to through its next stage of development. This is 18 percent EXCEPTION TO more than the previous plan, with spending close to one percent of EXCEPTIONAL the nation’s GDP. Under this plan, Singapore seeks to support and translate research, Preface: Since gaining independence in 1965, Singapore has invested build up the innovative capacity of heavily in moving beyond being a mere supplier of low cost labor like its companies to drive economic many of its Asian neighbors and pivoting into a more knowledge-based growth, and leverage science and and innovation-intensive economy. technology to address national challenges. Resources will be prior- itized in four key areas: advanced Chemicals, engineering, and Amgen inaugurated its USD 145 manufacturing and engineer- electronics have always served as million bio manufacturing plant ing (17%), health and biomedical key manufacturing segments, but two years ago. Chugai has pledged sciences (21%), services and digital only starting from 2000, with the USD 355 million through to 2021 economy, and urban solutions and implementation of the Biomedical to ramp up its R&D efforts, while sustainability. Sciences (BMS) Initiative, have the GSK is investing a further USD Essentially, RIE2020 aims to pharmaceutical and biotech realms 57 million to enhance its antibiot- smash research silos by getting become a strategic focus. With an ic manufacturing facility. Ferring interdisciplinary groups to work injection of more than USD five recently opened up its regional HQ together under broad groupings, billion, segmented into three phas- for APAC and plans on investing increase competition for funding es over the past 15 years, Singapore USD 7.5 million in R&D over the to get the best research, train peo- has strived to construct a self-sus- next five years. ple in the right areas and get the taining terrarium comprising com- With respect to Horizon 2020, best out of them. These efforts prehensive, end-to-end capabilities under the sixth science and tech- strive to fortify the country against for biomedical research, develop- nology plan for Singapore, Prime a backdrop of brethren ASEAN ment, and manufacturing. In many Minister Lee Hsien Loong has countries looking to replicate respects, the country has succeeded recently unveiled the RIE2020 Singapore’s development curve in becoming a simply irresistible Plan, which entails a government and allure, while buffering the platform for companies looking commitment of S$19 (USD 14) bil- country’s assets to shine through a to tap into lucrative Asian markets lion over 2016 to 2020 to research, post-modern era. and enhance their R&D productivity, with over 30 of the world’s top pharmaceutical biotechnology and medical technology companies now using Singapore as a regional center of excellence to host a variety of their core business activities. And the vitality of Singapore’s investment pipeline remains fruitful so far. On the biologics front AbbVie recently committed USD 320 million to construct its first manufacturing plant in Asia and

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www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 13 SINGAPORE’S ECONOMIC STRATEGY Weng Si Ho, EDB

ATTRACT, TRANSFORM, CREATE

Preface: The Singapore Economic Development Board (EDB) director of biomedical sciences, Weng Si Ho highlights three values: ‘attract,’ transform,’ and ‘create’ as the primary strategic focuses of the organization and explains how, ultimately, they serve WENG SI HO to help sustain Singapore’s future value proposition to Director of healthcare and life science companies Biomedical Sciences, EDB

HCLS: What items have been occupying the bulk of your agenda since assuming this role in January 2016? WENG SI HO (WSH): Singapore has done well to date, but now the question is how do we remain compet- This is especially relevant in the greater context of how itive and evolve alongside the industry’s own develop- healthcare is evolving. In the future, healthcare solu- ment? Healthcare models are shifting, particularly with tions might not only be delivered by just incumbent aging populations and increasingly pervasive chron- healthcare players—certain partnerships may need to ic diseases. In Singapore, it is about creating the right be taken into consideration. With the advent of digi- environment so that companies can benefit from the tal technologies effectively disrupting care models, we capabilities that we have built. Companies then adopt may start seeing the surge of more companies from, for and pivot to new healthcare models, in order to contin- example, IT or insurance entering the mix, alongside ue growing their businesses. traditional pharma, medtech, and nutrition companies Our overall strategic framework is Attract, to meet modern day healthcare challenges. Transform, and Create (ATC). “Attract” has us very much focused on growth, but by selectively attracting HCLS: Spanning all the sectors under EDB’s scope, the type of activities that align with Singapore’s priori- how do biomedical sciences align with the organiza- ties to ultimately ensure sustainable growth. tion’s primary interests? “Transform” focuses on working with the already WSH: We are one of the key sectors in Singapore, as established base of companies in Singapore to adopt we’re now the second largest contributor to manufac- the latest trends and technologies to stay competitive turing output. This is alongside the country’s other and remain sustainable in Singapore in the long-term. industry pillars including chemicals, electronics, and “Create” is our latest agenda, and is specifically tar- engineering. geted at cultivating new businesses from Singapore. Currently, about 3.5 to 4 percent of our GDP is cur- Startups are certainly one aspect of that objective, rently attributed to the biomedical sciences manufac- but of course it’s also about helping MNCs and large turing sector, amounting to roughly SGD 27 billion, local enterprises create new lines of business out of of which SGD 16 billion is coming from the pharma Singapore. Given the country’s capabilities in not only industry and SGD 11 billion from medtech. In terms biomedical sciences, but all the other complementary of manufacturing workforce, the biomedical sciences sectors as well, we hope the close integration and co-lo- employs more than 18,000 workers, with the medtech cation of industries can make some magic happen. 14 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com SINGAPORE’S ECONOMIC STRATEGY Weng Si Ho, EDB

IN SINGAPORE, IT IS ABOUT CREATING THE RIGHT ENVIRONMENT SO THAT COMPANIES CAN BENEFIT FROM THE CAPABILITIES THAT WE HAVE BUILT. COMPANIES THEN ADOPT AND PIVOT TO NEW HEALTHCARE MODELS, IN ORDER TO CONTINUE GROWING THEIR BUSINESSES.

The current phase will now focus on driving health outcomes for Singapore, not just economic ones. Together with the Ministry of Health (MoH), we have defined the top five therapeutic areas of national priority: diabetes, infectious diseases, cancer, sensory and neurological disorders, and cardiovascular diseases. sector typically requiring more people—>12,000 to HCLS: And where does EDB then come into play? pharma’s >6,000. WSH: Of course as a development agency, we focus on the economic outcomes. We work closely with the HCLS: Particularly invoking this concept of a “Fu- MoH to bridge public sector resources with indus- ture Ready Singapore,” what direction will Singapore’s try capabilities to drive the healthcare outcomes. It’s biomedical sciences landscape now take in relation to only by establishing that collective drive can we begin national priorities? achieving our goals on both fronts. WSH: Singapore is not a large country, so to remain As a case in point, the health minister recently competitive we need to always plan in a forward-think- declared war on diabetes, a pervasive problem in not ing manner. In addition, we do have the luxury of a only Singapore but across the entire region—60 per- stable government, leaving ample opportunities to cent of the world’s diabetics actually reside in Asia. In consistently pursue longer term objectives. This is start Singapore, it is predicted that one in three people will be in the latest Research, Innovation, and Enterprise Plan afflicted with this disease at some point in their lifetime. (RIE 2020)—the national budget for R&D, which is de- In response, we have organized different roundta- termined in five-year tranches. bles to bring together the unconventional industry For biomedical sciences specifically, the first phase partners together with government stakeholders and was launched in 2000 and focused on building the healthcare providers, to obtain a variety of perspectives foundation—putting in the core scientific capabilities, on the same challenge. It’s about bringing together all establishing the Biopolis, and establishing fundamen- encompassing stakeholders to collectively look at the tal pillars to build the landscape. patient journey, understand the points where interven- Phase two then was about moving into translation- tion can and should take place, and ultimately develop al and clinical research—effectively taking the science the business model to drive these solutions. Essentially, from bench to bedside. it’s about bringing together all relevant parties togeth- Phase three, which just culminated in 2015, focused er to brainstorm and discuss opportunities for collab- on integrating all these capabilities and forging indus- oration towards tangible outcomes that meet the needs try partnerships. of both patients and Singapore. www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 15 MEDTECH Fredrik Nyberg, APACMed

UNITING HEALTHCARE LEADERS

Preface: CEO of the Asia Pacific Medical Technology Association (APACMed), Fredrik Nyberg explains the rationale behind the creation of the first regional medical technology association; the industry challenges ahead, and the critical importance of bringing together all industry stakeholders to effectively advance the development of medical technology across Asia Pacific.

association, we have two equally important responsibilities: firstly, to add value, stay relevant and serve our member organizations. Secondly, to serve our patients and ensure that they have timely access to the most Fredrik Nyberg appropriate medical technologies and innovations. APACMED HCLS: What is the main strategy that the association is following in Asia Pacific in terms of the medical technology business? FN: Our mission is simple: we strive to improve the HCLS: Could you please introduce to our interna- standards of care for patients through innovative collab- tional readers the rationale behind APACMed’s estab- orations, to jointly shape the future of healthcare in Asia lishment, as well as the main responsibilities of the Pacific. It is a patient-centric mission that focuses on col- association? laborating in new, innovative ways with a diverse range FREDRIK NYBERG (FN): APACMed was estab- of stakeholders within a complex healthcare ecosystem. lished in late 2014 as a non-profit trade association We have defined three strategic pillars, which under- with the aim of unifying the medical technology indus- pin everything we do: access, innovation and collabora- try across Asia Pacific to raise standards of care for pa- tion. Firstly, “access” is centred on working closely with tients in the region. Our founding members are some regulators and policy makers to develop policies that of the world’s largest medical devices, equipment and improve patient access to high quality healthcare. in vitro diagnostics manufacturers. Secondly, “innovation” aims to promote cost-effective, The diversity across Asia Pacific, in terms of demo- value-based approaches to healthcare, to ensure product graphics, disease profiles, healthcare systems, and reg- portfolios meet regional needs. ulatory regimes presents big challenges. Our aim is to Finally, “collaboration” aims to provide an industry support our member companies in addressing these platform for knowledge exchange, to raise awareness, challenges. and to meet the demands of the markets in Asia Pacific. National, country-based industry associations have We have also recently identified the need for much great- existed in many part of the region for some time. But er collaboration among industry stakeholders to build until now, there had been no overarching medical tech- regulatory capacity, to enhance the pace and quality of nology association covering all of Asia Pacific, specifi- medical education and to accelerate the adoption of cally addressing regional issues and challenges. As an new innovative healthcare delivery models.

16 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com MEDTECH Fredrik Nyberg, APACMed

companies have multiple manufacturing plants and R&D centres in the region. A recent McKinsey study indicates that the Asia Pacific medical technology market will exceed the EU in size by 2020 to become the world’s second largest market after the U.S.

HCLS: How have regulators across the region per- ceived the creation of such association? FN: Regulators have been very welcoming. To ensure that patients have timely access to new, safe medical technology innovations, industry and regulators must work together. For example, in emerging markets where device regulations are new and evolving, the industry can play a key role in supporting regulatory capacity building and provide training on new HCLS: Why was APACMed established in Singapore technologies. and what is the strategic importance of the region to For compliance reasons, regulators nowadays often your members? prefer to deal with an industry body rather than work- FN: It is not a coincidence that we are headquartered in ing on a one-on-one basis with individual companies. Singapore, as most medical technology MNCs have their The regulatory environment in the region is com- Asia Pacific headquarters here. To date, over 30 medical plex, and there are several initiatives aimed at regula- technology companies have set up operations in Singapore tory harmonization or convergence. An independent to produce medical devices for both regional and global association such as APACMed is well placed to be the markets. But I should add that we also have members with voice of the industry and lead a constructive dialogue regional offices in Hong Kong, Shanghai and Tokyo. with regulators on these topics. We are already work- Asia Pacific is of major strategic significance to our ing actively with organizations such as AHWP (Asian member companies. Ten or fifteen years ago, the focus was Harmonization Working Party), APEC-RHSC (APEC almost exclusively on Japan and China. Today, the region Regulatory Harmonization Steering Committee) as a whole contributes to 15-20% of global sales for many and CIMDR (China International Medical Device of our members, and markets such as India, Indonesia Regulatory Forum). and Vietnam are getting much greater attention. This is also the region of the world that continues to HCLS: What trends in Asia Pacific must industry drive overall growth in our sector. Many of our member executives start taking into consideration now to ensure long-term, sustainable success in the future? FN: The megatrends of a rapidly ageing population, a growing middle class, and a rising chronic dis- IT IS NOT A COINCIDENCE THAT WE ARE ease burden are all driving demand for quality health- HEADQUARTERED IN SINGAPORE, AS care. Addressing this growing demand will require a MOST MEDICAL TECHNOLOGY MNCS different kind of innovative thinking on the part of HAVE THEIR ASIA PACIFIC HEADQUAR- all stakeholders. We will need to collaborate differ- TERS HERE. TO DATE, OVER 30 MEDICAL ently to solve our common health care challenges. TECHNOLOGY COMPANIES HAVE SET UP In addition, there are other trends that will drive growth and cannot be ignored: expanding universal OPERATIONS IN SINGAPORE TO PRODU- healthcare coverage; an increase in private healthcare CE MEDICAL DEVICES FOR BOTH REGIO- infrastructure; and the adoption of digital health NAL AND GLOBAL MARKETS. technologies to enable alternative delivery models. www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 17 LOCATION, INFRASTRUCTURE, TALENT Becoming a Hub

A RECIPE FOR SUCCESS

Preface: Singapore, though conscious of its limitations, has been able to leverage its key assets of location, infrastructure and local talent to become the business hub for the entire region, with pharma and biotech as key components in its success.

t is not a coincidence that connectivity to regional markets. friendly organizations such as more than 30 of the top Most notably, it has a robust intel- BioSingapore, SAPI and the dif- 100 biomedical compa- lectual property framework, ranked ferent country chambers that are nies globally have their fourth in the World Economic tailored to facilitating business regional headquarters in Forum’s Global Competitiveness processes, innovation acceleration I Singapore. It is well known Report 2015/2016, which bolsters and developing relations between that the nation offers a unique sit- the confidence of medical technol- the Singaporean and international uation that, despite the compar- ogy firms and investors.” business communities. atively small size of the market, The Singapore Economic In comparison to other regions makes it a great place to establish Development Board (EDB) is such as Europe and North America, a flagship office in Asia.The execu- working hard to create the condi- it is quite normal to see public-pri- tive director of the French Chamber tions necessary to attract foreign vate partnerships used in both of Commerce and Industry (FCCI) companies. Leading enterpris- Singapore and Asia to build up in Singapore, Carine Lespayandel, es that have already set up their biomedical industry expertise. says that “Singapore is indeed an regional headquarters, manu- Business interests and the govern- attractive investment destination, facturing sites, and R&D centers ment’s health objectives therefore especially for the biomedical sec- in Singapore include Sanofi, converge in order to meet upcom- tor, because it has sophisticated International SOS, BioMérieux, ing needs for services, support, infrastructure, a relevantly skilled and Servier. Singapore and solutions in integrated eco- workforce and great logistical also has several business systems. The president of SAPI

18 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com LOCATION, INFRASTRUCTURE, TALENT Becoming a Hub

(the Association of Pharmaceutical resources, so it was with purpose for Singapore to establish the Industries), Ti Hwei How, explains that the government original- proper setting, environment, and that “Singapore is the exam- ly focused on attracting foreign incentives. ple of how efficiency can be direct investment to develop the One of the government’s prior- improved when the government economy.” In order to attract for- ities is attempting to understand and the industry work together eign interest, it was imperative how science, technology and inno- collaboratively.” vation can help Singapore to be In order to maintain its leading more competitive in the future regional position, the Singaporean economy. Pharma and biotech government remains receptive to SINGAPORE IS THE remain a fundamental part of foreign investment, with a number EXAMPLE OF HOW the country’s biomedical strategy, of initiatives rolled out to make EFFICIENCY CAN BE now and moving forward, includ- Singapore a more competitive ing disruptive technologies such and attractive place to do busi- IMPROVED WHEN THE as genomics, imaging, and digital ness. The executive director of the GOVERNMENT AND THE monitoring, in which A*Star plan American Chamber of Commerce INDUSTRY WORK TO- to invest heavily. Indeed, the gov- in Singapore, Judith Fergin, elu- GETHER COLLABORATI- ernment plans to invest USD 14 cidates the inherent need to look VELY. billion into R&D over the next five for external resources, “Singapore years with USD three billion being is a small market with few natural TI HWEI HOW SAPI directed to biomedical research. www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 19 SIAC-010-T16 FR [email protected] 1 4/1/17 2:51 pm

STRAP IN HERE PLEASE Strap subhead in here please

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COVER STORY The Heart of Asia Pacific

Singapore THE HEART OF ASIA PACIFIC

The narrative of Singapore’s economic miracle will be boards, risk management teams, and families seeking all too familiar to many readers: a country that was nev- to relocate,” quips A.T. Kearney’s head of health prac- er meant to be, transforming itself from a sleepy fish- tice for Asia Pacific Keith Lostaglio. erman’s hollow into a thriving metropolis that is now Time and time again, Singapore has exceeded among the richest nations in the world in terms of GDP expectations and managed to stay relevant despite its per capita. With limited land and natural resources, relatively minuscule size. Currently serving as a regional this island city-state has managed to carve out its own hub for a horde of leading international healthcare and unique value proposition over the last 50 years as a life sciences companies, while simultaneously strad- leading global hub of trade, and a facilitator of access dling the frontier of scientific advancement and inno- for companies looking to unlock Asia’s untapped vation, Singapore’s position as the “Biopolis of Asia” is potential; “Singapore remains an extraordinarily logi- seemingly uncontested. cal place to lead operations for either Southeast Asia Yet, the most pressing question remains, how many or Asia Pacific: it’s quite frankly an easy sell to corporate times can one country reinvent itself before plateauing?

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THE BEST IS YET TO COME

“The harsh reality is that a lot of countries within the region are now catching up and developing their economies,” conveys Dr. Teoh Yee Leong, CEO of the Singapore Clinical Research Institute (SCRI). “In order for us to truly maintain our lead positioning, we have to be highly conscious of our limitations and contin- DR. BENJAMIN HO WENG SI DR. TEOH YEE SEET LEONG uously invest in our human, intellectual, and indus- Director of Biomedical Executive Director, Sciences, EDB CEO, Singapore Clinical trial capital, while forging networks with highly pop- A*STAR BMRC Research Institute ulated countries in Asia and mounting the forefront of scientific and clinical research within the region,” stresses Teoh. Under the sixth iteration of the science cementing it as Singapore’s 4th economic pillar, along- and technology plan, Prime Minister Lee Hsien Loong side chemicals, engineering, and electronics. recently unveiled the RIE2020 Plan, which entails a “Singapore has done well to date, but now the question government commitment of SGD 19 (USD 14) billion is how do we remain competitive and evolve alongside over the period 2016 to 2020 to research, innovation the industry’s own development? Healthcare mod- and enterprise, with at least 21 percent of that fund- els are shifting, particularly with aging populations ing dedicated to taking Singapore’s biomedical scienc- and increasingly pervasive chronic diseases. For us in es sector through its next stage of development. As it Singapore then, it’s about creating the right environ- currently stands, according to Singapore’s Economic ment so that companies can adopt and pivot to a new Development Board (EDB)—the lead government agen- healthcare model,” indicates EDB’s director of biomed- cy in charge of attracting multinational interests and ical sciences Ho Weng Si. responsible for much of the country’s success to date— In line with the agency’s latest strategic framework — the biomedical sciences sector now employs over 15,000 Attract, Transform, and Create (ATC) — pivoting to a people and contributes 3.5 to 4 percent of the nation’s new healthcare model is not only about attracting and GDP, amounting to roughly USD 19 billion and firmly applying the latest technologies to improve standards

THE NEXT LAP: BIOSCIENCES IN SINGAPORE 2025

SINGAPORE TAIWAN SOUTH KOREA

R&D intensity: GERD/GDP 2011 2.23% 2.30% 4.36%

Researchers in R&D / mil people 2011 6494 7480 5928

Bioscience patent applications (2012) 104 N/A 1,168

Scientific American 2015 #5 #25 #23 Worldview biotech rank

Source: A*STAR, Israel Advanced Technology Industries, Scientific American, World Intellectual Property Organization.

22 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com COVER STORY The Heart of Asia Pacific

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of care, but also strives to incorporate the participation AGING IN ASIA & ECONOMIC DISPARITY of non-conventional players. “In the future, healthcare POPULATION PERCENT OF GDP PER CAPITA CHANGE POPULATION 65+ solutions might not only be delivered by just incum- MARKET S$ 2 1 1 (Current U ) 2014 bent healthcare players… we may start seeing the surge 2015-2050 2015-2050 2015 - 7.35B 2015 - 8.3% of more companies from IT or insurance for example, Global US$ 10,595 entering the mix, alongside traditional pharma, med- 2050 - 9.73B 2050 - 16.0% tech, and nutrition companies to meet modern day 2015 - 4.39B 2015 - 7.5% Asia US$ 9,002 healthcare challenges,” predicts Ho. 2050 - 5.27B 2050 - 18.2% This notion of convergence and integration of indus- 2015 - 1.38B 2015 - 9.6% China US$ 7,594 tries has been one of the primary themes driving the 2050 - 1.35B 2050 - 27.6% nation’s R&D efforts. “In the past, approximately 75 2015 - 126.6M 2015 - 26.3% US$ 36,194 percent of our engagements were attributed to pharma Japan 2050 - 107.4M 2050 - 36.3% and biotech,” recounts Dr. Benjamin Seet, executive ASEAN director of A*STAR’s Biomedical Research Council. (Brunei, Cambodia, Indonesia, Laos, 2015 - 633.5M 2015 - 5.9% A*STAR, the chief government body tasked with coor- Malaysia, Myanmar, US$ 3,911 2050 - 792.1M 2050 - 15.6% dinating the nation’s research and development initia- the Philippines, Singapore, Thailand, tives, has experienced a material change in its research Vietnam) portfolio over the last 5 years, with that 75 percent 1United Nations, Department of Economic and Social Affairs, World Population now becoming 25 percent. Seet explains this structural Prospects, the 2015 revision PRINTFILE-Janssen_Pharma_Executive_FINAL.pdf 10/13/2016 9:17:59 AM2The World Bank, World Bank Open Data

At Janssen, we believe that healthier lives lead to happier lives. To help make that happen, we’re committed to investing in and strengthening the communities we touch.

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M Every person, family and community deserves high-quality healthcare. And through Y partnership, we can help make that a reality. CM

CY We are Janssen. We collaborate with the world for the health of everyone in it.

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Collaboration.

24 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com COVER STORY The Heart of Asia Pacific

change had two Meanwhile, the founder and CEO purposes, one of ASLAN Pharmaceuticals Dr. being to respond Carl Firth argues that Singapore to emerging must eventually grow out of its opportunities, reliance on international capital. and second to “Decision makers have long rec- diversify into ognized that any subsequent value CARL FIRTH adjacent sectors created from good science actual- ANAND DR. ONG SIEW THARMARATNAM HWA CEO, ASLAN such as medi- ly leaves Singapore when partner- Pharmaceuticals cal technolo- ing with overseas companies,” President Asia Pacific, Chairwoman, QuintilesIMS BioSingapore gies, food and exclaims Firth, going on further nutrition, and to suggest that the ability to build personal care. “I believe we have to truly innovative homegrown com- Singapore, especially given its rel- reinvent ourselves every five years. panies is the next critical step in atively young age, does not possess Looking at how to be relevant is a driving Singapore’s future value the same level of experience, depth continuous process that requires proposition. The chairwoman of of knowledge, or critical mass in looking for and anticipating signals BioSingapore Dr. Ong Siew Hwa, biotechnology that other terri- of change that will drive how con- however, provides a word of cau- tories such as the US or Europe sumers behave,” proclaims Seet. tion: “It is worth mentioning that might have. This may increase the PRINTFILE-Janssen_Pharma_Executive_FINAL.pdf 10/13/2016 9:17:59 AM

At Janssen, we believe that healthier lives lead to happier lives. To help make that happen, we’re committed to investing in and strengthening the communities we touch.

That starts with collaboration. First, we work with local partners to understand the most pressing needs. Then, we build on local innovation and resources to create lasting healthcare solutions. C

M Every person, family and community deserves high-quality healthcare. And through Y partnership, we can help make that a reality. CM

CY We are Janssen. We collaborate with the world for the health of everyone in it.

CMY

K Learn more at www.janssen.com

Collaboration.

www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 25 COVER STORY The Heart of Asia Pacific

difficulties in dealing with MNCs SPEARHEADING A that healthcare or financial institutions in order NEW MODEL OF ASIAN systems across to obtain investment.” HEALTHCARE the region are in Anand Tharmaratnam, no-way prepared QuintilesIMS’s president for One area where Singapore can to meet the Asia Pacific, contends that for still assume a technological and incredible scale Singapore to successfully com- thought leadership position is in of new demand mercialize homegrown innova- its responsiveness to the myriad of for healthcare. GARY PRUDEN tions, “there are some skills and issues afflicting the Southeast Asian Makatsaria con- Worldwide Chairman competencies that will need to be and Asia Pacific healthcare and life tends that, “sup- Medical Devices, Johnson & Johnson developed to get there. Singapore’s sciences space. “With roughly half of ply as currently capabilities are quite robust in the world’s population here in Asia configured will basic research, but the capacities Pacific, we see an increase in unmet not be able to needed to translate research into medical needs, which will continue keep up. It will something of commercial value to grow with aging populations and take hundreds are still developing.” He further the surge of chronic diseases,” says of years for details that, “Singapore will have Gary Pruden, worldwide chairman doctor-patient to import talent for guiding prod- of medical devices at Johnson & ratios in Asia to ucts and companies from the clinic Johnson. Indeed, demand for health- draw level with into the early commercial phase… care in Asia is massive and rising those in coun- VLADIMIR MAKATSARIA Steps must also be taken to ensure quickly; Johnson & Johnson Medical tries with the Company Group that there is sufficient capital avail- Devices’ company group chair- most advanced Chairman Asia Pacific, able as the startup ecosystem starts man for Asia Pacific Vladimir healthcare sys- Johnson & Johnson Medical Devices to mature.” Makatsaria – who also serves as tems. By 2020, Nevertheless, whether it’s an chairman of APACMed – explains the region will inward or outward focus, A*STAR’s “we spend more than eight times experience a Dr. Benjamin Seet remains resolute as much on healthcare for people shortage of in the country’s ambitions: “Going who are older than 65, and in Asia approximate- ahead, we will focus our efforts Pacific alone we have 320 million ly two million on identifying the disruptors and people that are aged 65 and over, a healthcare trend setters for each of these number that is set to double over practitioners.” industry sectors, determine what the next few years.” While many see For pharma KRIS STERKENS we can do that’s differentiated, and the scale of these unserved or under- and medical Company Group then invest deeply to build a level served patient populations as little device compa- Chairman Asia of expertise that’s competitive on a more than a sizeable and sustained nies, there are Pacific, Janssen global scale.” growth opportunity, the truth is significant market access issues making it difficult to reach these large patient populations. As Kris WITH ROUGHLY HALF OF THE WORLD’S POPULA- Sterkens, company group chair- TION HERE IN ASIA PACIFIC, WE SEE AN INCREASE man Asia Pacific for Janssen, points out, “Many of the governments in IN UNMET MEDICAL NEEDS, WHICH WILL CONTINUE this region don’t have the budgets TO GROW WITH AGING POPULATIONS AND THE to accommodate the substantial SURGE OF CHRONIC DISEASES premiums associated with some of the newer treatments for cancer, for GARY PRUDEN JOHNSON & JOHNSON example. Similarly, within metabolic

26 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com COVER STORY The Heart of Asia Pacific

diseases, the number of diabetic patients in India is 90 more patients and restore more million, and that number increases to 150 million when lives in Asia Pacific as a whole.” we add China, which is more than the rest of the world However, what is clear is that combined by far. Governments are well aware of how dif- driving the adoption of innovation ficult it is to enable widespread access to medicines for in terms of products and therapies all of these patients, placing more of a moral obligation can only do so much to help address on the industry to explore different options that will the huge imbalance between sup- help more patients.” ply and demand of healthcare in KEITH Moreover, medical practices in many countries still lag the biggest markets in Asia Pacific. LOSTAGLIO significantly behind best practices, in many cases lead- Keith Lostaglio, partner and head Partner & Head of Health Practice Asia ing to inefficient use of limited resources. Pruden argues of A.T. Kearney’s health practice Pacific, A.T. Kearney that, “Medtech across the region is underpenetrated in in Asia Pacific illustrates the issue, many categories,” highlighting that “MIS (minimally explaining that for countries “like invasive surgery) has a penetration rate of roughly 34 Thailand or Indonesia with the logistical challenges of percent globally – which is significantly lower in emerg- reaching all 16,000 islands, developing and implementing ing markets. Patients are often staying at a hospital for rational, relatively efficient systems and broadening cov- an extended period of time instead of going home in one erage beyond major cities will require the use of new tech- day.” As such, J&J sees “a lot of opportunity in partnering nologies, new ways of thinking and creative solutions. with governments in the region to increase training, edu- There is absolutely no way a multinational life science cation, and access to new technology to ultimately reach company can reach and communicate with physicians,

A Prescription for Performance

JAMES LIM US. Not only are many countries when approaching and conduc- — Executive in the region relatively resource ting business. I always tell my team Vice President constrained, but as Lim explains, that we’re not here just to deliver & President many “don’t possess the resour- products into the market, but to Greater Asia, ces or political capital to allocate advance the healthcare system for BD a significant portion of their GDP the people in the country, invoking to healthcare… China, for exam- the passion of our purpose to do ple, only spends seven percent, so. This entails more than selling, perhaps but true partnerships such as fa- “In order to truly succeed in heal- moving to eight percent in the cilitating worker safety sessions, thcare markets across Asia Paci- coming years, while Indonesia assisting hospitals with accredi- fic, companies need to make a spends only two to three percent.” tation, collaborating with gover- point of addressing localized un- As such, “what these countries nments to conduct phlebotomy met needs,” counsels BD’s presi- are looking for then is increasin- training, or overall improving upon dent for Greater Asia James Lim. gly innovative avenues to address the competencies of the local “This will invariably entail tailored healthcare challenges—achieving workforce.” He concludes, saying solutions to meet these needs, more outcomes with less spen- “this approach to business pro- beyond just provision of products ding— which has invariably impac- duces farreaching benefits across and pill-pushing.” ted the way decision makers go the value chain for everyone invol- about addressing patient needs.” ved, including patients, healthcare The needs for tailored or innovati- practitioners, governments, and ve solutions and products in many For the life sciences industry, this companies themselves—falling in contexts across the Asia Pacific re- means that it is essential that com- line with our ambition of beco- gion are often of a very different panies go the extra mile beyond ming the recognized partner of quality than the ‘unmet medical just selling a product. Lim exhorts choice and our mission of Advan- needs’ discussed in Europe or the “we don’t just look at products cing the World of Health.”

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a Western product and transplant- ing it in a market in Asia Pacific and expecting it to simply work… The way that technology plays itself out in each market is also very different, and it’s crucial that people appreciate these regional complexi- HIDEO ARASE BOB WHITE STEPHEN OOI JEAN-LUC BUTEL ties before diving into the nuances.” Director & Senior President Asia Senior Executive Advisor President, K8 Global Executive Officer, Terumo Pacific, Medtronic Zimmer Biomet’s senior exec- Asia Pacific, Corporation & Managing utive advisor for Asia Pacific Zimmer Biomet Director, Terumo Asia Holdings Stephen Ooi is a big believer in what he calls ‘frugal innovation.’ pharmacists, and patients across “Emerging markets innovate specific concerns of the popula- more difficult to access portions of because they have urgent needs tions that need the product and the region without an effective dig- for solutions. Some emerging build the product around these ital platform in place.” Meanwhile, market innovations need to be needs. Innovation needs a ground- Makatsaria argues that, “the first more focused on gaining value up approach.” It is in this context priority must be innovation — not rather than creating high prices. that Zimmer Biomet is “doing a just product innovation, but pro- This ‘frugal innovation’ can have lot more in bringing designers and cess, procedure, and organizational an enormous impact.” He also engineers from the Western world to innovation such that we can deliver critiques his peers, saying that see what is happening here in Asia better clinical value to patients at a “Western companies sometimes Pacific and they are truly amazed lower overall economic cost.” use what I believe is an incorrect by the developments in this region,” The challenge is that the usual approach when they take exist- enthuses Ooi. innovators from the multination- ing innovations and just reduce With need necessitating innova- al life science industry are not well the number of features. Instead tion in healthcare models across suited towards this task, or rather they should be addressing the Asia, it is clear that Singapore has their innovative goals are not necessarily well aligned with the chal- CLINICAL TRIALS IN SINGAPORE IN COMPARISON lenges that patients and healthcare practitioners in Asia most need Number of Ratio of innovative solutions for. Hideo COUNTRY Open Phase 1 Population/ Arase, director and senior execu- Studies Phase 1 Study tive officer of Terumo Corporation South Korea 1102 48,000 and managing director of Terumo Asia Holdings, explains that “the Western mentality and fruitful Taiwan 630 37,000 demand for high-end value and features simply does not align in Hong Kong 213 35,000 developing countries, particularly here in Asia, where many places Singapore 235 24,000 are struggling to even meet basic medical needs, let alone elicit funds China 1,833 764,000 for premium products.” Similarly, Medtronic’s president for Asia USA 21,285 15,000 Pacific Bob White admits that a common “misconception is taking Source: clinicaltrials.gov

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MAKING AN IMPACT ON HEALTHCARE-ASSOCIATED INFECTIONS. Across the world, BD works closely with healthcare MAKINGorganisations AN IMPACT to combat ON healthcare-associated HEALTHCARE-ASSOCIATED infections (HAIs). INFECTIONS. HAIs, or infections Across the acquired world, in BD healthcare works closely settings, with are thehealthcare most organisationsfrequent adverse to combat events healthcare-associated in healthcare delivery infectionsworldwide. 1(HAIs). In healthcare HAIs, or facilities, infections the acquired impact of in HAIs healthcare is signiﬁcant—ranging settings, are the most 1 frequentfrom needlessadverse eventspatient in su ering healthcare to strained delivery resources worldwide. and In related healthcare costs. facilities,Our broad the portfolio impact of solutionsHAIs is signiﬁcant—ranging and global frominsights needless combine patient products, su ering education, to strained screening, resources diagnosis and related and costs. surveillance, Our broad helping portfolio you minimise of solutions the risk and of globalHAIs, insightsdeliver combine improved products, patient outcomes education, and screening, control costs. diagnosis Discover and the di erencesurveillance, one helpingcompany you can minimise make. Discover the risk the of HAIs,new BD. deliver improved patient outcomes and control costs. Discover the di erence one company can make. Discover the new BD.

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Learn1 World more Health about Organisation. the Patient Di erence Safety: Healthcare-associated of One at Infections Fact Sheet. Accessed on August 5, 2016 at http://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdfbd.com/HAI-SG www.pharmaboardroom.com© 2016 BD. BD and the BD Logo are trademarks of Becton, Dickinson and Company. AMED321 BDIG-21479 Healthcare & Life Sciences Review: Singapore 29 1 World Health Organisation. Patient Safety: Healthcare-associated Infections Fact Sheet. Accessed on August 5, 2016 at http://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf © 2016 BD. BD and the BD Logo are trademarks of Becton, Dickinson and Company. AMED321 BDIG-21479 COVER STORY The Heart of Asia Pacific

an important role to play supporting the development of healthcare systems in other countries, particularly the nearby members of ASEAN. A.T. Kearney’s Lostaglio argues “Singapore and the life science ecosystem here should take the lead in developing broad health enablement across the region, which in part will mean strengthening Singapore’s role as a hub for R&D and innovation.” J&J’s Makatsaria elaborates TI HWEI HOW ALBERT LEE CHRISTOPHER SNOOK on Singapore’s suitability for this role, explaining that President, SAPI Chairman, MTIG Country President Singapore when Singapore’s innovative healthcare system and & Head of Group Country management, Novartis medical talent are “coupled with Singapore’s medical education capabilities and connectivity with the rest of the region, this translates into Singapore being a very A BEACON OF LIGHT important hub for training of doctors and surgeons from across the Asia Pacific region.” Since 2000, the government’s Biomedical Sciences Evidently the one takeaway for multinationals with (BMS) Initiative has set out to establish a self-sustain- global innovation platforms is that healthcare needs can ing biomedical ecosystem of end-to-end capabilities in only be met at a local level, and in turn, a personal level, research, development, and manufacturing—effectively according to Jean-Luc Butel, president of K8 Global and enabling Singapore to transcend the technology curve senior advisor to McKinsey. “Many companies certainly into a truly knowledge and innovation-intensive econ- see Asia as a market, as with the US or Europe, but do omy. Following an orthodox export-oriented industrial- they perceive Asia as a lever that will effectively define ization strategy, Singapore started on the road towards their future 10 years down the road?” he ponders. “Asia this ambitious goal by attracting FDI based manufac- is a huge continent and, as a result of many factors such turing and R&D investments. This strategy has yield- as the vast aging population and a huge emerging mid- ed much fruit, and today this ‘little red dot’ now serves dle class entering and demanding healthcare, it is going a myriad of roles for healthcare and life science enter- to play an important role in determining the healthcare prises. The president of the Singaporean Association of model of tomorrow. The sooner healthcare executives Pharmaceutical Industries (SAPI) How Ti Hwei believes come to terms with that, the sooner their companies will the country’s refined network of infrastructure and the perform better regionally and globally,” concludes Butel. fact that 6 out of the top 10 selling drugs are now being

Creating immediate and growing advantage A.T. Kearney is a leading global management consulting irm with oices in 40 countries. Since 1926, we have been trusted advisors to the world’s foremost organizations. A.T. Kearney is a partner-owned irm, committed to helping clients achieve immediate impact and growing advantage on their most mission-critical issues. www.atkearney.com

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produced in Singapore only yields positive signs for the manufacturing sector. “This gives confidence to the Calibrating Collaboration industry that not only can we maintain sustainable operations, but also keep up our pace of growth,” proclaims SUGANTHA As Asia Pacific NATARAJAN healthcare direc- How. Furthermore, “from an R&D point of view, we have — many highly trained scientists and clinicians that work tor, Sugantha Na- Director, tarajan outlines, with pharmaceutical companies to keep pushing the Healthcare, Asia Pacific, “DB Schenker has boundaries of science. DB Schenker been in Asia Pa- This open mindset is attracting some companies to Healthcare cific—the fastest even conduct their first-in-human clinical trials here.” growing region The chairman of the Medical Technology Industry for the company —for approxima- Group (MTIG) Albert Lee holds Singapore’s allure in a tely 55 years, active in 20 countries from Pakistan all similarly supportive light: “The country has done a lot in the way to New Zealand.” Moreover, according to trying to make it attractive for people, driving scientific Natarajan, “in certain countries we’re now by far the collaboration among public and private parties, which leading provider of Third-Party Logistics (3PL), and has clearly not only appealed to SMEs, but also large perhaps in the top three in others.” The recipe for suc- MNCs. The joint physical spaces at One North, coupled cess? “We hold a strong positioning in any country we operate in... because we work around the limitations with supportive policies and infrastructure has created and go beyond traditional 3PL by collaborating with a unique ecosystem where innovation can thrive,” he broader supply chain stakeholders.” For DB Schenker, summarizes. Novartis has long been one of Singapore’s collaborating with a broader range of stakeholders leading pharma investors, both in the manufacturing often means bringing in supply chain expertise from other industries, which Natarajan explains are “definitely ahead of healthcare in terms of the way supply chains are handled.” In the past such cross-industry sharing of best practices has been limited as “traditionally, healthcare has been very risk averse” and constrained by regulatory and quality concerns. However, today “companies are becoming more open to the ideas and best practices that can be brought from Delivering healthy other industries.” As such, DB Schenker is now working to find new ways to “best work with quality assu- supply chain solutions rance teams more collaboratively, and see where we can improve efficiencies of the supply chain.” Success for the healthcare in the Asia Pacific region has been driven by a wider range of partnership models, which recognize that and pharmaceutical “the needs and qualifications of every country [in the region] are completely different.” Natarajan shares the example that, “in Indonesia, you can become a industries be-all, end-all partner to the customer, contributing to all aspects of the business including regulatory, quality assurance, and government affairs… that’s what it Learn more takes to succeed in markets like Cambodia, Indonesia, about our products. and Vietnam.” On the other hand, with highly developed markets in Asia such as Singapore, Natarajan excitedly declares that it “is a completely different ballgame. Here we’re talking about how we can innovate, improve productivity, efficiency, where we can apply the Internet of Things, while also working with prominent government agencies such as the Econo- mic Development Board (EDB) to bring more value to the overall system.”

www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 31 COVER STORY The Heart of Asia Pacific

SINGAPORE IS AN EXCELLENT ENGI- NEERING AND MICROELECTRONICS HUB SO THE TECHNOLOGY IS OF THE BEST CALIBER HERE

MICHAEL TILLMANN VELA DIAGNOSTICS RAMAN SINGH MICHAEL THOMAS PAGE TILLMANN President of Emerging Vice President of Markets, Mundipharma CEO, Vela Diagnostics Contract Logistics and Healthcare Asia Pacific, However, the logic behind investments in manufacturing UPS remain relatively ambiguous as many neighboring countries such as Vietnam, Malaysia, and China boast signifi- and R&D spaces. Country president of Singapore and cantly lower-cost operating environments. Nevertheless, head of group country management Christopher Snook Mundipharma’s president of emerging markets Raman explains that today Novartis has “three manufacturing Singh recognized the value of Singapore’s pivot towards facilities currently in production… last year, we celebrat- high-value manufacturing such as injectables, biolog- ed the tenth anniversary of our contact lens manufac- ics, and vaccines. “This aligned perfectly with our ambi- turing while next year, our tableting facility will reach its tions to build one of the most advanced manufacturing tenth anniversary.” The group has also further strength- plants in the world, forgoing laborintensive processes ened their manufacturing presence in Singapore with a and employing cutting-edge technologies to give us the new “aseptic filling facility as part of the Alcon group… ability and flexibility to ship volumes in smaller quanti- and at the moment, we are building an extraordinary ties to anywhere in the world,” illustrates Singh. biologics facility in Tuas, which is currently undergoing On a similar note, established locally in 2011, Vela validation.” Diagnostics, despite a primarily European and American- On the R&D side, Snook explains that back in 2004 focused business, maintains Singapore as its global HQ, “the Novartis Institute for Tropical Diseases (NITD) housing both R&D and manufacturing under one roof. was established as a public-private partnership between “Singapore is an excellent engineering and microelec- Novartis and Singapore’s Economic Development tronics hub so the technology is of the best caliber here,” Board (EDB).” Although it was announced in October firmly underscores the company’s founder and CEO 2016 that Novartis would be moving the institute out Michael Tillmann. “At the early stage of the company, of Singapore, Snook enthuses that “in R&D terms, the it would have been very disruptive to have the manufac- work of NITD has proven extraordinary. In 12 years, sci- turing site away from the research site as it was necessary entists discovered two new antimalarial compounds that to transfer the know-how in scalable manufacturing siz- are now in clinical development and have the potential es. Especially for a small company, facilitating this tech to represent a real paradigm shift in the treatment of transfer on a consistent basis is difficult,” he admits. malaria. That in itself is impressive by any R&D assess- “Therefore, we are happy to have our manufacturing ment and we are delighted by the progress we have made hub in Singapore and we are willing to shoulder the there.” As such, Snook strongly stresses that the facili- slightly higher prices as it is ultimately to the benefit of ty’s closure does not reflect any negative judgement on the total output. The question is not rooted on the cost, Singapore’s R&D potential, and rather Novartis want- but on the strength of the manufacturing talent to bring ed to merge the NITD with their Biomedical Research the level of quality to scale up the costs. Establishing a Institute in Emeryville, California. With successful R&D benchmark base here is essential in order to be able to investments in Singapore like the NITD to point to, build a secondary (or even tertiary) manufacturing sites Singapore’s attractiveness as an R&D ecosystem has been in the years to come,” projects Tillmann. BD’s executive clearer for more recent investors such as Mundipharma - vice president and president of Greater Asia James Lim who recently decided to establish its first-ever consumer suggests that BD’s investments in Singapore have been health hub in the country. correlated with Singapore’s investments in human and

32 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com CAG5016_Cargo.pdf 1 21/12/2016 13:59

COVER STORY The Heart of Asia Pacific

MICHAEL TILLMANN VELA DIAGNOSTICS

www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 33

CAG5016_Cargo_CAPABILITIES_PharmExec TK CC Size: (W)203.2mm x (H)273.05mm_ISO39L JWT CC1607228 GP3B 21.12.2016 1 16-081 COVER STORY The Heart of Asia Pacific

intellectual capital: “The government has done a phe- the country. As such, Singapore has strong capabilities nomenal job in not only attracting top talent from all across the life sciences value chain from clinical research over the world, but also building up the capabilities and to manufacturing, commercialization, and distribution.” skills of its own population… [and] providing a work- It is with this narrative that Lim highlights that “DHL force that complements the whole spectrum from very is strongly present in Singapore to support this strategic basic labor to advanced innovation.” sector and globally recognized pharmaceutical cluster,” and explains that the company has “special processes and facilities, such as our DHL Global Forwarding Life Sciences Competence Centers, in place to cater to the PHARMACEUTICALS… IN THE SKY! demanding needs of our clients from the life sciences industry. Our Advanced Regional Center (ARC) (a SGD With the Singaporean government putting immense 160 million contract logistics facility run by our sister effort into developing a true pharmaceutical cluster in business division, DHL Supply Chain, which opened in the country replete with manufacturing and R&D, the April 2016) is a huge investment in this regard and con- city-state has simultaneously emerged as a major logis- tains the infrastructure and certifications required by life tics hub for the life sciences sector in the region. As sciences customers.” Leonora Lim, vice president life sciences and healthcare With the pharma industry’s mentality towards cost Asia Pacific for DHL customer solutions & innovation, and expenditures, which continue to evolve in light of explains “the Singaporean government has invested a lot persistent scrutiny of and downward pressure on prices to make healthcare and life sciences a strategic sector for around the world, many companies are doubling down

Connecting data in the logistics community

“From origin to destination an come much more digital and data does nothing to buck this trend. average product goes through driven,” such that information As Chin admits, today “data is roughly 26 touch points and se- and technologies have created currently largely confined to the venor eight different service pro- “opportunities to better manage airport-to-airport segment of viding entities,” explains UPS’s complex global supply chains… the supply chain… [and] in the Thomas Page. From a perspecti- the availability of data and the abi- air cargo industry data flows are ve of a pharma company, every lity to process large amounts of it still often disconnected between additional touch point bears enable better visibility and control different segments of the supply additional risk when shipping of the supply chain.” Page con- chain.” However, “we recognize high value sensitive products. As curs, saying that “we are a big be- this issue and are actively looking Changi Airport Group’s Phau Hui liever in data at UPS and we track for ways to address the challen- Hoon observes, “with the rising an enormous amount of metrics, ges,” says Chin, explaining that sophistication, sensitivity, and mostly for operational efficiency Singapore Airlines Cargo has an value of many innovative pharma purposes. We only see this increa- “IT subsidiary in Singapore ca- products, many pharmaceutical sing as it continues to be reques- lled Cargo Community Network companies are now taking an ac- ted by regulatory authorities and (CCN) that provides data services tive role in determining how their the customer.” for the air cargo industry, not just products are transported to ensu- to SIA Cargo and freight forwar- re that the number of touchpoints Despite the prevalence of dis- ders but also to some other airli- is minimized and thus, that the cussions regarding digitization nes. CCN is always on the lookout risk in the overall transport chain of business and the rise of big for ways to improve data sharing is minimized.” data, significant work remains to and integration.” As such, Chin be done in actually setting up expects “to see a lot more data Luckily, as the president of Sin- the needed systems and ensu- sharing and integration across the gapore Airlines Cargo Chin Yau ring they are properly intercon- various segments of the supply Seng explains “the world has be- nected – and the logistics sector chain” going forward.

34 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com COVER STORY The Heart of Asia Pacific

on their regional distribution oper- at Changi Airport Group, explains “DNATA, our ations in Singapore to improve effi- that, “we have seen pharmaceuticals other airport ciency – and DHL is far from the as a high potential niche for sever- ground han- only company working to capture al reasons. Global spending on cold dler, followed the associated growth. Thomas Page, chain pharma shipments is grow- with their UPS’s vice president of contract ing at between eight and nine per- investment in logistics and healthcare Asia Pacific cent per year, and over the next few their own cold explains that when “an additional years Asia will account for one of the chain facility LEONORA LIM location is added to the distribution largest shares of that global growth. in 2013,” adds Vice President, Life Sciences & hub, this reflects up to 29 percent Given our geographic location, con- Phau. Beyond Healthcare Asia more inventory, leading to obsoles- nectivity, infrastructure, and capa- infrastruc- Pacific, DHL Customer Solutions and cence and an enormous investment bilities and a whole range of other ture, Changi Innovations on the balance sheet under invento- factors, we feel [Changi Airport is] Airport Group ry. Companies are looking to pull well located to capture a significant has also spear- this inventory back to a regional hub portion of this growth in pharma- headed the effort to get companies with proximity to market and lower ceutical airfreight. As such we have working in the airport ecosystem labeling costs for optimal inventory made significant efforts to position certified to handle pharma prod- and flexibility. We are seeing this as a Changi as an optimal hub for these ucts. In this respect, the group has trend and one of the added benefits shipment volumes,” and efforts have selected the relatively new IATA- of Singapore as a hub.” The logic is proved successful as “pharma cargo CEIV Pharma certification, and much the same for packaging and volumes have grown at a CAGR of SATS once again was the first mover labelling operations, as “once the 13 percent from 2010 to 2015.” getting certified in 2014; Phau excit- product is labeled there is no longer Since “Changi Airport Group edly shares that “we are expecting the ability to be geographically flexi- itself is not a direct service provid- six different companies to get their ble with that inventory,” and “when er,” Phau clarifies that the airport’s IATACEIV Pharma certification the product is labeled in-country, “role was very much to work with in 2017.” The next step for the air- inventory is then sprinkled through- our stakeholders in the airport eco- port has been joining the recently out the region tying up working cap- system to raise awareness about the established Pharma. Aero commu- ital.” Running a physical or virtual potential the pharma industry rep- nity of IATA-CEIV Pharma certi- distribution center in Singapore via resented, and some of the necessary fied airports around the world, with a third party logistics provider can investments that would be needed the eventual goal of being able to allow companies to cover significant to capture that.” The first visible offer end-to-end services guaran- sections of Asia Pacific markets with success of this awareness initiative teed under the same quality stand- relatively low inventories on hand. arrived in 2010 when one of the ards. Phau states “Changi Airport At the heart of the Singapore logis- airport’s ground handlers, SATS, is proud to be a strategic member tics hub lies Changi International opened their Coolport facility. of the international Pharma.Aero Airport, which was voted the World’s Best Airport for the fourth time in a row in 2016 by the pas- senger oriented Skytrax survey, and also holds a wide range of air cargo focused awards, including the Asia Pacific Airport of the Year from Payload Asia, which it won for the third consecutive year in 2016. Phau Hui Hoon, assistant vice president Airside, Aircraft Taking-Off for cargo and logistics development Courtesy of: Changi Airport Group www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 35 COVER STORY The Heart of Asia Pacific

community alongside Miami enjoys direct flights to over 330 International Airport, Brussels cities, including 32 in China, 15 in Airport, Sharjah Airport in the India, and at least 13 in Indonesia UAE, Singapore Airlines Cargo – – a level of connectivity unparal- other members include Brussels leled by other airports in the region Airlines and Brinks Life Sciences.” according to Phau. Today Singapore’s position as PHAU HUI HOON the premier logistics hub for phar- CHIN YAU SENG Assistant Vice maceuticals in Asia is unassaila- President, President for Cargo ble. As explained by President of MANAGING DIVERSITY Singapore Airlines and Logistics Cargo development, Changi Singapore Airlines Cargo Chin Yau Airport Group Seng, “pharmaceutical companies With stagnating growth rates need to be able to have easy access in Western economies and their to even more locations to ensure that their products increasingly stringent pressures on controller healthcare reach their ultimate customers without compromising costs, Asia Pacific has often been viewed as the next fron- product integrity. That’s where direct air links are par- tier for unlocking much sought-after growth. “APAC is ticularly important… Singapore together with SIA Cargo estimated at 25 percent of the global economy and within are in a good position to fulfil those needs as we have 10 years it is expected to grow to 35 percent,” postulates a substantial global flight network with extensive cover- Martin Dewhurst, senior partner, co-convenor of the age of the Asia Pacific region.” Altogether, the city-state global pharmaceuticals and medical products practice

36 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com COVER STORY The Heart of Asia Pacific

at McKinsey & as a whole contributes to 15-20 Company. He percent of global sales for many of further out- our members, and markets such as lines that “there India, Indonesia and Vietnam are are two billion getting much greater attention,” people in just details Nyberg. this region and Moreover, today the innova- MARTIN the developing tive potential of many countries FREDRIK ALAN ONG DEWHURST NYBERG countries are in Asia is of increasing interest Executive Vice Senior Partner, Co- projected to to foreign service providers – no CEO, APACMed President Asia Pacific convenor of the Global and Global Head Pharmaceuticals and grow between longer can one view many of these of Medical Devices Medical Products and diagnostics, INC Practice, McKinsey & 6 - 10 percent economies as large, population Research Company compared to driven consumer markets. Alan 1 - 2 percent Ong, executive vice president Asia growth in the United States.” “That Pacific and global head of medi- After years of organizational focus being said,” continues Dewhurst, cal devices and diagnostics at INC on Japan as the advanced market “the region is entering a second épo- Research enthuses “like most CROs, in the region and the behemoth que that will throw up new challeng- we see the enormous potential of Chinese market, many Western comes for the pharma and life sciences Asia due to the population size and panies have found themselves rather industries. If the first era was defined the growing developments within tangled when attempting to access by great excitement and optimism, the region… A number of years ago traditionally undervalued markets the second will be all about respond- the attraction to Asia Pacific was across emerging Asia. “The inher- ing to unfolding scenarios and keep- access to this large population at a ently dynamic nature of the region ing alive the ambitions.” lower pricing point, with Japan as has come as a surprise to some peo- Indeed, while the tantalizing an exception… Now we are starting ple —dwindling growth rates, rap- appeal of lucrative, untapped Asian to see an increasing number of bio- idly rising inflation, and deepening markets still exerts a strong grip on tech companies from Korea, China, devaluation of major currencies by investors, the degree of diversity in and Taiwan, and they are developing as much as 40 to 80 percent over the terms of demographics, disease pro- their pipelines. We did not see this past couple of years has of course files, healthcare systems, and regula- just five years ago…” The growth been a challenge to navigate through tory regimes present big challenges potential such opportunities present from a business perspective,” muses according to Fredrik Nyberg, CEO is substantial, and Ong attests “this Takeda’s president of emerging mar- of APACMed — a non-profit trade region’s contribution to the over- kets Giles Platford. “Although, these association established in 2014 to all revenue of INC Research is only countries are extremely individual in unify the voice of Asia’s medical increasing and we expect this to con- nature, and lack the homogeneity of device industry. “10 or 15 years ago, tinue and grow. We are experiencing Europe, the sheer level of diversity the focus was almost exclusively on double-digit growth, with still more and complexities actually introduc- Japan and China. Today, the region potential for further growth.” es certain commonalities that you can leverage in terms of leadership styles and management capabilities,” advises Platford. APAC IS ESTIMATED AT 25 PERCENT OF THE Janssen’s company group chair- GLOBAL ECONOMY AND WITHIN 10 YEARS IT IS man of Asia Pacific Kris Sterkens EXPECTED TO GROW TO 35 PERCENT believes “succeeding in Asia Pacific entails first coming to terms with the sheer level of diversity that MARTIN DEWHURST MCKINSEY & COMPANY you’re dealing with. This region www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 37 COVER STORY The Heart of Asia Pacific

to accept the fact that culturally there are differences, while identifying the shared commonalities that we as a regional team can capi- talize on. We don’t have to reinvent the wheel in each market, as there are some strategies we can execute across all or most of the markets. Ultimately, it’s both a science and an art — constantly evaluating where exactly you can achieve com- monality and where you should Marina Bay Sands Property Overview Shot | Courtesy of: Marina Bay Sands embrace diversity.” Zimmer Biomet’s senior execu- exhibits considerably distinctive stakeholders choose to engage with tive advisor for Asia Pacific Stephen dynamics and regulatory frame- pharmaceutical companies. They Ooi is confident that the “key is not works compared to say the con- don’t want to only interact with viewing the market from purely the vergence of healthcare systems in reps anymore, or at least not all the company’s perspective. For exam- Europe.” “But no matter what mar- time, often opting instead for alter- ple, there are fewer regulators in ket you’re in,” he argues, “you’re native channels including digital emerging markets in comparison to starting to see an evolution of how platforms. However, you still want the number of regulators in more

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38 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com COVER STORY The Heart of Asia Pacific

developed markets to address Singapore has a clear role to play in facilitating and the huge amount of reviews and catalyzing such pan-Asian collaboration. After dec- approvals. At the same time, reg- ades of hard work and investment, the country has ulators in emerging markets also become an irresistable platform for multinational need training. That is why for us businesses to manage their regional operations. With as a corporation it is much more the immense challenge of bringing access to healthcare beneficial to take the approach to hundreds of millions of people across the region GILES where we ask ourselves: how can serving as a massive impetus to create new ways of pro- PLATFORD we make their jobs easier and help viding healthcare, many are looking towards the entre- President Emerging Markets, Takeda them to better understand our preneurs, scientists, and experienced innovative life technology?” science companies based in Singapore to help define At times, regional leadership the way forward. Ultimately, “Singapore is a fantastic and management may seem an pilot ground for influencing the best medical practices exercise in futility. However, the in the region,” says BD’s executive vice president and scope of challenges is such that president of Greater Asia James Lim. “With its prev- individual actors, be they govern- alent forward-thinking attitude, the country effec- ment institutions or companies, tively serves as an experimental basis for pioneering cannot hope to develop effective better technologies, processes, and solutions with the solutions in a timely manner. patient of the future in mind. Undoubtedly, Singapore ANNA MARIA As APACMed’s Frederik Nyberg will continue innovating higher up the value chain,” he BRAUN explains, “The megatrends of a optimistically concludes. President Asia rapidly aging population, a grow- Pacific, B. Braun ing middle class, and a rising chronic disease burden are all driving demand for quality healthcare. Addressing this growing demand will require a different kind of innovative thinking on the part of all stakeholders. We will need to collaborate differently to solve our common healthcare challenges.” Asia might be a diverse patchwork of unique circumstances, but to bring access to healthcare to the vast majority of patients in the region actors will need to Helping develop the find ways to effectively collaborate, coordinate, and sup- medicines people port one another across both organizational boundaries need is something and national borders. “In essence, the industry has a common overarching we take personally goal of driving innovation in the region and ensuring that access is available to a greater number of people over time,” pinpoints Anna Maria Braun, president of B. Braun Asia Pacific and vice chairman of APACMed. “I strongly believe that a joint platform which pro- motes unity and neutrality of interests will foster interaction and generate better results with stakeholders. Moreover, engaging with doctors and nurs- Find out how at es associations through organizations like APACMed www.incresearch.com can help elevate patient safety and actualize the industry’s vision to deliver healthcare in the best way possible,” stresses Braun. www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 39 EXECUTIVE PROFILE Giles Platford, Takeda

JACK OF ALL TRADES

Preface: Takeda’s President of Emerging Markets Business Unit, Giles Platford, speaks about his assignments across various global markets, his leadership philosophy, as well as the impressive international growth of the company. GILES PLATFORD TAKEDA

HCLS: Spanning all the countries you’ve worked in, have been a number of people throughout my career who which one has left the most lasting impression? Which of have inspired me and shaped my own thinking around your various assignments has helped you develop most leadership - most recently, our Global CEO, Christophe as a leader? Weber. He made a bold leap in globalizing Takeda, with GILES PLATFORD (GP): I have had the good for- it being a 235-year-old Japanese company. Currently, the tune to work in different countries across multiple conti- company boasts a presence in 70 countries, spearheaded nents alongside a wealth of cultures, which has provided by a truly international leadership team with innovative me with a better understanding of how to operate with a product launches on a global scale and a strong corporate level of empathy and agility in those very different envi- culture, especially regarding patient-centricity, ethics and ronments. I also had the great opportunity to learn from access to medicines. the various market archetypes and differing healthcare systems around the world, which offered me a broad per- HCLS: What do you identify as the biggest challenge spective on how to maneuver in a diverse and dynamic facing pharma leaders like you today? region, most importantly the need to hire strong and ca- GP: One of the biggest challenges in the industry today pable leaders who know the local market environment. is making sure we balance the need to build a sustainable R&D model, at the same time making the innova- HCLS: Who do you look up to as your role models? tive medicines we develop broadly accessible to patients, And how have they ultimately shaped your own leader- which is a particular challenge in emerging markets with ship style and management philosophy? evolving healthcare systems. GP: As a self-motivated individual, it is not a necessity Also, people development is always a critical aspect for me to work for an inspirational leader. However, there when it comes to attracting, retaining and nurturing the best talent. This is something we put a tremendous amount of focus on, and the recognition Takeda is ONE OF THE BIGGEST CHALLENGES IN receiving as a Top Employer across the emerging markets is something I feel very proud of. THE INDUSTRY TODAY IS MAKING SURE Front and center for most companies today is the WE BALANCE THE NEED TO BUILD A agenda of ethics and compliance. For over 235 years SUSTAINABLE R&D MODEL, AT THE SAME Takeda has consistently held integrity at its core, and TIME MAKING THE INNOVATIVE MEDICI- our decision-making model, which puts patients first, is NES WE DEVELOP BROADLY ACCESSIBLE gaining the trust of society, and reinforcing the reputa- TO PATIENTS, WHICH IS A PARTICULAR tion of the company. You can feel it alive in the organi- CHALLENGE IN EMERGING MARKETS zation and this becomes an important differentiator for WITH EVOLVING HEALTHCARE SYSTEMS. our stakeholders across EM.

40 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com TAKEDA IN FIGURES Therapeutic Areas, Emerging Markets, & Access to Medicine

TAKEDA’S EMERGING MARKETS STRATEGY

THERAPEUTIC AREAS EMERGING MARKETS

KEY THERAPEUTIC AREAS: FIVE GEOGRAPHIC AREAS:

ASIA-PACIFIC GREATER CHINA

GI ONCOLOGY

LATAM NEMEA (Latin America) (Near East, Middle East and Africa) DIABETES PLUS VACCINES

INNOVATIVE CORE BRANDS: Russia CIS ONCOLOGY: Ninlaro®, (Commonwealth of Independent States) Mepact® GI: Entyvio®, Dexilant® · Around 35 countries across 15 time zones · Emerging Markets represents 80% of the world's population, a region ® ® DIABETES: Nesina , Edarbi with significant unmet medical needs

ACCESS TO MEDICINES STRATEGY

TAKEDA’S ACCESS TO MEDICINES STRATEGY IS:

International, company- Focused on areas of highest Product focus: innovative Geographic focus: wide effort aimed at unmet medical need and potentially life-saving, life evolving healthcare improving access and going beyond medicines transfroming specialty systems where access health for patients to address the range of access medicines and vaccine challenges remain a barriers, where Takeda can candidates significant barrier to pa- have the greatest impact tients getting the treat- on patients’ lives ments they need

THE ACCESS TO MEDICINES STRATEGY RESPONDS TO THE CHALLENGES OF EVOLVING HEALTHCARE SYSTEMS THROUGH:

Patient Assistance Capacity Building R&D: Goal for pa- CSR: Extensive Expedited Programs: Giving to ‘Go Beyond’ tients to access new, prevention Access to more patient access Medicines: Via innovative, and diffe- programs focusing Vaccines to our innovative and partnerships in rentiated medicines, on vaccination potentially life-saving carefully selected regardless of where and maternal and medicines countries they live child health

www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 41 PATIENT-CENTRICITY Bob White, Medtronic

HCLS: What would you highlight as the most sa- TRANSFORMING lient trends impacting healthcare systems across the region today? TO TREAT BW: In Asia Pacific, the coexistence of both highly developed and emerging markets exemplifies the complexity of healthcare systems. There are developed markets like Japan, Australia, and Korea, and then there are emerging markets like India and Preface: Bob White, President Asia Pacific at Southeast Asia. This means that there are over 2 bil- Medtronic, on how transforming healthcare begins lion people that we are serving across these countries with the patient, particularly in Asia Pacific where in Asia Pacific, with over USD 1 trillion spent on there is a rapid evolution in social demographics and healthcare every year – of which USD 50 billion is on concurrent emergence of unmet needs. medical devices alone. In addition to rapidly aging populations and a burgeoning middle class, this region is facing a tsu- nami of non-communicable diseases, particularly when it comes to diabetes and cardiovascular disease. Consequently, you have got healthcare systems that need to fundamentally transform in order to address Bob White universal healthcare needs such as improving clinical MEDTRONIC outcomes, access, and cost-efficiency.

HCLS: I would venture to say that these three factors culminate in what the industry has fundamentalized HCLS: You oversee one of, if not the most, dynamic as value-based healthcare—a concept that Medtronic and fast-changing regions in the world today. How is has been a huge proponent of. What exactly does val- your time allocated between your various priorities? ue-based healthcare entail in your eyes, Bob? BOB WHITE (BW): According to a 2016 study by BW: Value-based healthcare means reaping bene- The Lancet, total global healthcare spend now exceeds fits beyond the face value of a product. We believe $7.8 trillion. Data from World Health Organization this means sharing in direct accountability for clin- also showed that an estimated 20 to 40 percent of ical outcomes. We have a seven step framework to resources spent globally on health are wasted every think about value-based healthcare very clearly; es- year. This means that many governments, healthcare sentially, it entails selecting the right disease, iden- systems, health insurance companies, and other or- tifying the right patient cohorts, understanding the ganizations need to adopt new approaches to decrease costs that are being spent today, as well as the respec- healthcare costs. These new approaches are moving tive clinical outcomes, and how we’re going to ulti- healthcare from a fragmented, volume-based system, mately measure our impact. This is very much evolv- where providers are paid for each episode of care, to ing from a fee-for-service model to a point where we a value-based framework that integrates patient care position value at the center of everyone in the care across a full continuum to improve outcomes and continuum. costs. This brings us to another strategic imperative That is the direction I see healthcare systems mov- we are focusing on – value-based healthcare where we ing towards. It will certainly take a while, and every seek to collaborate with the stakeholders to discov- country in this region moves at a different pace. But er and apply solutions that either drive operational it all comes back to the three universal healthcare efficiency within the healthcare system or augment needs we need to address: better clinical outcomes, the delivery of care through better patient care more access for people, and more efficient cost management. schemes.

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www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 43 3PL SPECIALIZATION Sugantha Natarajan, DB Schenker

driving DB Schenker to greater heights—moving from LEVERAGING good to great. Personally speaking, healthcare a sector that touches LOGISTICS all peoples’ lives in some way, shape, or form—knowing that alone brings me unparalleled levels of satisfaction. From a corporate standpoint, this is an industry that requires a lot of focus and specialization, and is a niche exhibiting widespread demand and sustainable growth. Preface: DB Schenker’s director of healthcare in Asia Healthcare is also rapidly growing worldwide, particu- Pacific, Sugantha Natarajan depicts the company’s larly here in Asia Pacific. Governments are increasingly presence across the region, while exclaiming the seeking ways to enable healthcare to their citizens and crucial need for localized solutions when it comes to overall improve their healthcare systems—be it a devel- specialized healthcare logistics across the different oping nation or a mature one. Consequently, you can’t countries under her watch. She also describes the afford to take any risks in this industry solely because company’s pivotal role in enhancing their clients’ value chains and elaborates on how industry players are able peoples’ lives are at stake—and that’s why, as a logistics to leverage logistics as a competitive differentiator. player, this is an industry you simply cannot avoid.

HCLS: How have client expectations and demands evolved alongside this level of dynamism? SN: Traditionally, healthcare has been very risk averse. But now companies within this industry are becom- Sugantha ing more open to ideas and best practices that can be Natarajan brought from other industries. DB SCHENKER More and more people from other industries are joining supply chain in the healthcare space. If you look at other industries, they’re definitely ahead of healthcare in terms of the way supply chains are handled. It wasn’t by HCLS: Could you start off by providing our readers choice that the healthcare industry stayed behind, but with some insight into DB Schenker’s history and pres- really on account of regulatory and quality issues. ence in the region? Currently, we try to determine how to best work with SUGANTHA NATARAJAN (SN): DB Schenker has quality assurance teams more collaboratively, and see been in Asia Pacific—the fastest growing region for the where we can improve efficiencies of the supply chain. company —for approximately 55 years, active in 20 coun- But sheer willingness to partner with third parties is tries from Pakistan all the way to New Zealand, with what’s now starting to truly set in, mainly because Cambodia and Myanmar as the most recent additions to our portfolio. Except for a few countries where we partner with exclusive agents, we’ve mostly established our own offices with comprehensive logistics network setup in each location.

HCLS: How does the healthcare vertical align with the global organization’s priorities, particularly in line with the ambitions set out in Vision 2020? SN: As a part of our vision for 2020, there have been two sectors nominated as focus verticals, one of which is healthcare. If nothing else, this displays the sheer importance that we place on healthcare when it comes to Shecnker DB of: courtesy Photos

44 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com 3PL SPECIALIZATION Sugantha Natarajan, DB Schenker

YOU CAN’T AFFORD TO TAKE ANY RISKS IN THIS INDUSTRY SOLELY BECAUSE PEOPLES’ LIVES ARE AT STAKE—AND THAT’S WHY, AS A LOGISTICS PLAYER, THIS IS AN INDUSTRY YOU SIMPLY CANNOT AVOID. healthcare is a cost-driven industry and competitive pressures are forcing players to see supply chains as a source of differentiation and efficiencies. Photos courtesy of: DB Shecnker

HCLS: How has DB Schenker needed to innovate to succeed in markets like Cambodia, Indonesia, and upon its service offering to respond these changing Vietnam. market conditions and shifts in mindset? Singapore, on the other hand, is a completely dif- SN: DB Schenker has recently partnered with a ferent ballgame. Here we’re talking about how we can German university to leverage big data as a medium to innovate, improve productivity, efficiency, where we can identify underlying trends, better anticipate our custom- apply the Internet of Things, while also working with ers’ needs, and ultimately optimize the type of services prominent government agencies such as the Economic we provide—both in terms of quality and efficiency. Development Board (EDB) to bring more value to the Whenever our customers have requirements, we aim overall system. to convert those requirements into a value chain, rath- In certain countries we’re now by far the leading pro- er than a supply chain. We work with them to under- vider of 3PL, and perhaps in the top three in others. But stand their problem statements—sometimes hosting regardless, we hold a strong positioning in any coun- intimate workshops to gain this insight. try we operate in—whether that’s China or Indonesia— From a solutions standpoint, we look at who their because we work around the limitations and go beyond customers and what their KPIs are. It’s more about traditional 3PL by collaborating with broader supply what’s driving them, and what even their customer chain stakeholders. requirements are; only after coming to these terms are we able to craft a tailored solution. HCLS: What is the significance of a small country like Singapore to DB Schenker as both a market and HCLS: Your oversight covers a vast range of coun- strategic hub? tries, varying largely in levels of income and wealth. SN: Size doesn’t matter—and Singapore is a classic How do you go about tailoring a strategy to effectively example of that. I see Singapore as not just a standalone accounts for this discrepancy? country, but as an integrator to the Asia Pacific mar- SN: Asia Pacific is not an easy market exactly for the ket. From a logistics standpoint, the nation serves as a inherent level of disparity between the rich and the pivotal gateway to the broader region—namely because poor, the developed and the developing. But the needs of its efficiency, established infrastructure, and high and qualifications of every country are completely caliber talent. Many companies establish and stabilize different. their operations here first, before venturing off into the In Indonesia, you can become a be-all, end-all partner frontier. Any other market would be tough otherwise. to the customer, contributing to all aspects of the busi- When it comes to domestic consumption, however, ness including regulatory, quality assurance, and gov- Singapore does not offer the same level of prospects as ernment affairs. It’s easy to only focus on traditional its neighbors, so the focus is really leveraging the coun- competencies such as warehousing, but that’s simply try as a springboard, now with most of our clients also not the approach that we’ve taken. That’s what it takes categorized as regional HQs. www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 45 CORPORATE COMPLIANCE Christopher Snook, Novartis

that their operations meet both internal and external PERFORMANCE requirements. Ultimately, this means we always default WITH to the more stringent standards. HCLS: With four manufacturing facilities in Singa- INTEGRITY pore, can you give us an overview of the role Singapore plays in Novartis’s regional and global supply chains? CS: Three manufacturing facilities are currently in production, while the fourth is in the process of vali- Preface: Christopher Snook discusses his dual role dation. Last year, we celebrated the tenth anniversary as Head of Group Country Management as well as of our contact lens manufacturing while next year, our Country President for Singapore, highlighting the tableting facility will reach its tenth anniversary. More importance of adhering to in-house as well as coun- recently opened an aseptic filling facility as part of the try-specific regulatory frameworks and the continued Alcon group. At the moment, we are building an ex- importance of Singapore to the global group. traordinary biologics facility in Tuas, which is currently undergoing validation. These facilities reflect a USD 1.2 billion investment - spent or committed – and a workforce of 1200 people, both of which are very significant by any standard. Right now, we are expanding our presence, putting in new production lines at the Alcon con- Christopher tact lens facility. We expect our new biologics produc- Snook tion facility to be operational in 2018, producing drug NOVARTIS substances for our worldwide portfolio of biologics. Furthermore, this manufacturing footprint opens up very interesting opportunities from a talent develop- HCLS: What are some of your highest priorities in ment point of view, as all four of these facilities are very your capacity as Head of Group Country Management? distinct in terms of the manufacturing environments. CHRISTOPHER SNOOK (CS): Over the last few This is why we launched an initiative called “Novartis years, Novartis has gone through quite a few organiza- TechOps Academy” in Singapore, a program in which tional changes and adjusting to these has been on the we rotate young talents around those four facilities. For top of my priority list. To give an example, we have con- people joining us to develop a career in technical opera- solidated a lot of our support function in our division tions, we are providing them with a very unique oppor- called Novartis Business Services. This transition period tunity to gain first-hand experience in four very differ- has lasted for approximately two and a half years and it ent manufacturing environments, both in pharma and has been a major focus for many of our offices around medical device manufacturing. In terms of attracting the world, not just at our headquarters in Basel. talent to Novartis, we are proud to be able to offer this Secondly, I have dedicated a great deal of my focus program which is second to none as a reason to come to to operational priorities which concern business devel- Novartis, and move beyond the usual competitive com- opment and growth. Performance with integrity is a pensation packages. key priority, as it relates to our strict approach towards compliance particularly with regards to promotional practices. My key responsibility is to ensure that our country presidents and country executive committees PERFORMANCE WITH INTEGRITY IS A KEY around the world understand what local regulatory PRIORITY, AS IT RELATES TO OUR STRICT environments do and do not require from Novartis, APPROACH TOWARDS COMPLIANCE how the local framework compares to Novartis’s inter- PARTICULARLY WITH REGARDS TO PRO- nal guidelines, policies and processes, and to ensure MOTIONAL PRACTICES

46 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com STRAP IN HERE PLEASE Strap subhead in here please

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ups.com/healthcare

CRAZY CHEMISTRY

Preface: Evonik, the creative industrial chemical company, recently announced that it will be investing EUR 500 million to build a second amino-acid synthesis facility in Singapore. Regional President Peter Mein- shausen discuses Singapore’s suitability for this investment, and Healthcare VP Dr. Stefan Randl shares some of the company’s ambitions for innovative collaboration with the Singapore biomedical cluster.

HCLS: What would you highlight as the main eco- investment in the region, with Indian and Chinese com- nomic development trends and dynamics in Southeast panies making significant investments in Southeast Asia over the last seven years? Asia as well as other global players. Australia and New PETER MEINSHAUSEN (PM): Evonik organ- Zealand are another major sources of investment in the izes its business around three global trends: Health region. This apart from practical management consider- & Nutrition, Resource Efficiency and Globalization. ations is one of the reasons why Evonik decided to man- For healthcare and nutrition specifically, we work to age Australia and New Zealand along with Southeast provide solutions that enable people to stay healthy. Asia – they are very much part of the Southeast Asia According to projections the global population will economic equation. reach 9 billion by 2050 and a significant portion of that population growth will occur in Asia. Feeding 9 HCLS: We understand Evonik has recently an- billion people and ensuring they receive proper nutri- nounced plans to invest more than half a billion euros tion such that they can live healthy lives will be a major in another amino acid plant for animal feed here in Sin- global challenge. Similarly, the steady development of gapore – could you tell us a bit about this investment Southeast Asia’s economies, and the rise of the middle and the importance of DL-methionine? class drives demand for healthcare products and ser- PM: Given the mentioned global challenge of feed- vices, as well as changes in diet including an increased ing a growing population, it’s clear that efficient food demand for quality meat. These are the challenges which and feed management is increasingly important. Thus, Evonik’s products help to address and solve. Evonik has for example developed portfolios of amino More specific to the region, interesting dynamics acids for both human applications as well as the animal exist just due to the geography of ASEAN being sand- nutrition field. For the efficient and healthy raising of wiched between the two massive economies, India and livestock to supply societies demand for a healthy diet China. This in combination with local policies designed including meat, the availability of amino acids play a to ensure connectivity among ASEAN members as well vital role in terms of cost, resource efficiency and the en- as with neighboring economies and trade zones, makes vironmental impact of raising livestock. ASEAN countries very attractive for outside investors as Among others, the amino acid DL-methionine plays they can ideally serve not only regional markets but also a vital role. Evonik as the market leader for this impor- both the Chinese and Indian markets from Southeast tant animal feed supplement, operates several dedicated Asia. As such, we see a convergence of foreign direct DL-Methionine production facilities worldwide. To also

48 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com AMINO-ACIDS Peter Meinshausen & Dr. Stefan Randl, Evonik

At the global level, Evonik has using our functional polymers, recently acquired certain fermen- i.e. EUDRAGIT® for pharma and tation biotechnologies geared EUDRAGUARD® for nutraceuti- towards amino acid production cals, which can control the release from the French company METEX. profile of oral drug and nutraceuti- As the leader in the amino acid field, cal products are particularly inter- acquiring these technologies which esting to local companies. These complement our current technology polymers can protect the actives platform, was a strategic decision to present in a tablet or capsule until further enhance our capabilities in it reaches the right part of the intes- this core business area. tine and accordingly maximize the bioavailability of the active com- HCLS: Looking at the pharma pounds. Our portfolio of generic industry in Southeast Asia, what APIs and excipients are of the high- would you highlight as some of est quality and relevant to any man- the interesting areas where Evonik ufacturer looking to produce high could have a particular impact? quality products. STEFAN RANDL (SR): In Recognizing the rapid pace of efficiently meet the rising demand healthcare, we serve the pharma change in dietary habits and high for meat in the Asia Pacific region, industry with a variety of business incidence of chronic conditions Evonik has completed its global pro- models, as well as the medical devic- such as diabetes across Southeast duction network and established a es sector, and finally the nutraceu- Asia, we see an increased need for significant DL-methionine manu- ticals or functional foods industry. health-minded nutrition and high- facturing capacity here in Singapore. For pharma in the Southeast Asia, er demand for nutraceuticals and Currently we have a capacity to pro- Australia and New Zealand region, functional foods. We are actively duce 150 000 tons of DL-methionine we see three main trends; growing working on developing our port- locally, and have recently announced local production, more R&D activ- folio of advanced food ingredients that Evonik will be investing anoth- ities being carried out by both local and already offer some interesting er 500 million euros to establish a companies and multinationals, and products with clinically proven second manufacturing facility of the steadily advancing regulatory and health benefits, such as Healthberry same magnitude. quality standards. All of these fac- and PentaQQ. We also offer a range tors play in our favor and as such of amino acids for human health PETER we are increasing our presence in under the brand REXIVA. MEINSHAUSEN the region in terms of sales capabil- It is well known that Singapore ities, technical support, and tech- has a highly developed industry Regional President, Evonik Southeast nical services – which can serve as with the highest R&D standards, Asia, Australia a stepping stone to bringing R&D and Evonik also supports R&D & New Zealand, activities to the region. To this end, and manufacturing ventures here Evonik we have recently opened a formula- with relevant products. Taking the tion laboratory in Bangkok to pro- Singaporean biopharma industry DR. STEFAN vide our clients assistance in formu- as an example, we have developed RANDL lating oral drug and nutraceutical a strong position in the supply of products. high purity amino acids and cell VP Sales & Services Asia, Evonik This way, we can be closer to culture ingredients used as inputs Healthcare our customers and better support in biotech manufacturing process- them in challenging development es, for both R&D and commercial projects. Formulation solutions applications. www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 49 DIGITALIZATION IN SOUTHEAST ASIA Innovative Solutions

EMERGING ASIA: LEADING THE DIGITAL CHARGE

Preface: Despite underdevelopment in many facets; Southeast Asia is actually at the forefront of a digital revolution in healthcare; with digital solutions helping bring about more efficient, cost-effective, and tailored patient care.

hen it comes to healthcare, deployment and increased benefits for patients. Perhaps Western societies are often then the emerging markets will instead become the lead- hailed as the frontrunners in ers, with the followers quickly shedding their ‘on prem- the digital age, exhibiting both ises’ technology,” postulates Forsythe. the highest rates of internet and With many of these countries struggling to meet W mobile penetration and elec- even the most basic medical needs, digital technologies tronic health records (EHR) adoption, according to a provide a viable pathway to circumventing hefty infra- recent paper published by PwC, The Digital Healthcare structure investments and pioneering new healthcare Leap. Developed countries such as the Netherlands, models to elevate care standards. Furthermore, imple- Denmark, the US, Germany, and of course Singapore— mentation is more seamless, with fewer sunk costs, giv- leading the pack for its Southeast Asian brethren—have en existing infrastructure and equipment, lower fixed largely transitioned away from paper-based healthcare costs from building overcapacity, weaker vested inter- solutions to comprehensive electronic record systems ests and less divided public opinion than is typical in and costly digital infrastructure. And while emerging established markets—facets that have not gone unno- markets may seem to be stuck in the Stone Age by rel- ticed by the private sector. ative standards, a new digital health model will soon Increasingly, for healthcare and life science compa- warrant a shuffling in the leaderboard. nies, “digital strategy [has become] a key success fac- “The lack of legacy infrastructure can [actually] lib- tor for Asia Pacific and Southeast Asia,” affirms Keith erate health systems (both public and private) from the Lostaglio, partner and head of A.T. Kearney’s health financially daunting capital costs which have led to gov- practice in Asia Pacific. “Access to patients and physi- ernment-sponsored initiatives such as Meaningful Use cians poses such a challenge that it will be essential to in the United States,” observes John Forsythe, PwC’s dig- use digital platforms to engage physicians and phar- ital healthcare leader in Australia, Southeast Asia, and macists effectively,” he stresses. New Zealand. “Cloud-based technology, mobile ena- Merck (MSD), for example, has recently invested in blement and fees for service models will lead to faster a global innovation hub in Singapore, dedicated to

50 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com DIGITALIZATION IN SOUTHEAST ASIA Innovative Solutions

CLOUD-BASED TECHNOLOGY, MOBILE ENABLEMENT AND FEES FOR SERVICE MODELS WILL LEAD TO FASTER DEPLOYMENT AND INCREASED BENEFITS FOR PATIENTS. PERHAPS THEN THE EMERGING MARKETS WILL INSTEAD BECOME THE LEADERS, WITH THE FOLLOWERS QUICKLY SHEDDING THEIR ‘ON PREMISES’ TECHNOLOGY

JOHN FORSYTHE PwC harnessing digital technologies. It effectively consol- closing healthcare gaps, but also reveals its limitations. idates end-to-end capabilities in data analytics, cyber “Advancements such as image-data sharing capabili- security, and UX/UI—collectively working in tandem ties present tremendous opportunities in healthcare to ultimately enable a greater understanding of patient – yet these sophisticated technologies are still highly behavior. dependent on the level of education and training of “These are the new skillsets that may not traditional- healthcare professionals in the region. The ease and ly exist in a healthcare company, but are areas that we speed in which an image could be shared, for example, increasingly see as important for the industry,” ana- will only go so far without a skilled radiologist to accu- lyzes Ho Weng Si, the director of biomedical sciences rately analyze the data. This dire reality of remote rural at Singapore’s Economic Development Board (EDB). areas is compounded by the complexity of data priva- In the realm of the digital age, other players have cy concerns, which we need to mitigate as we become chosen to leverage the power of connectivity, bridg- more digitalized,” she cautions. ing geographical and physical limitations. Worldwide Nevertheless, A.T. Kearney’s Lostaglio maintains a leader in orthopedic medical devices, Stryker, broad- bullish outlook on digital adoption in emerging Asia. casted the first surgery ever completed at Shanghai “There are some very positive signs that things are mov- Hospital No. 6 over a WeChat channel subscribed to ing in the right direction, at least in Southeast Asia. First, by 70,000 surgeons in China. “This example alone most of the companies I have spoken to have autonomy demonstrates the impact that social media and dig- in Asia such that they can develop an effective digital ital technology can have on training, education and strategy that fits the specific opportunities and chal- communication,” attests the company’s president of lenges in the region. The leadership of these companies Asia, Brent Scott. understands that the challenges for digital platforms in Similarly, Hitachi Medical Systems is utilizing digital Asia are different than in Europe or the US. Many also technologies to link and promote telemedicine, specif- regard the opportunities are bigger, and understand ically in the more rural areas of places like Thailand that local and regional organizations need the flexibil- or Vietnam that lack clinical expertise. “We are train- ity to develop an appropriate strategy as such.” ing technicians to send images to a regional hub where From the creation of highly sophisticated telehealth qualified doctors can diagnose and decide whether platforms to filling very basic primary care gaps with to send the patients to the larger institutions, which technology, clearly innovation can take multiple forms may require them to travel for many hours,” illustrates across all types of healthcare systems. Private sector Leslie Chua, the general manager of Asia Pacific for stakeholders are effectively redefining the way stake- the company’s solutions division. “We are focusing on holders approach or even think about healthcare. the less developed areas where it is of benefit to bring Although many still need to focus on closing critical medical care to the people instead of the people to the gaps in healthcare, developing countries entering the medical care,” he succinctly remarks. digital era can now leapfrog traditional constraints such Recently appointed as GE Healthcare’s president as access or costs and start to find themselves standing and CEO in ASEAN, Myra Eskes largely recogniz- on equal footing with their peers in the developed world, es the profound impact of digital innovations in if not greater. www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 51 INNOVATIVE NETWORKING Ong Wee Min, Marina Bay Sands

THE SCIENCE OF HOSPITALITY

Preface: Ong Wee Min, Executive Director of Sales, highlights why Marina Bay Sands is the venue of choice for many international and regional healthcare conferences, the importance of being a true partner in accommodating very diverse client needs, and how Marina Bay Sands has been able to significantly contribute to Singapore’s economic development strategy.

HCLS: How would you assess well positioned and is being served and of course the life sciences. We Singapore’s positioning within the by Changi Airport, which is voted are seeing a trend where events of competitive global Meetings, In- as the best airport in the world in such nature, where two or three centives, Conferences and Events 2016. Moreover, event organizers industries crossover, are becoming (MICE) industry? want their attendees to be “wowed” more prevalent in the future. The ONG WEE MIN (OWM): and they want to co-create memo- convergence between industries Singapore is a leading Asian city rable experiences together with tends to drive innovation, and it for all MICE events and we have their stakeholders. Singapore and is of great benefit to Singapore been the number one meeting Marina Bay Sands are very good and Marina Bay Sands to be in- destination for many years, for at doing exactly that; creating and volved in such globally innovative numerous reasons. Singapore ben- co-creating memorable experiences discussions. efits from its strategic geographi- for our clients, their stakeholders From another perspective, cal location as well as being a hub and their immediate community. Marina Bay Sands’ diverse offer- for trade, outstanding hotels and ings can significantly add to the world-class infrastructure right in HCLS: Singapore has a clear success of almost any event. Using the heart of town. economic development strategy an example from the healthcare Today, people do not choose a with objectives for strategic indus- industry, when we hosted Medical MICE destination simply because tries – how has Marina Bay Sands Fair Asia in 2016, the show floor it is a nice destination to visit, been able to support the growth of grew by 30 percent compared with wonderful hotels and fan- the wider Singapore economy? to the previous edition in 2014, tastic convention centers – these OWM: We are very much a part along with similar increases in are indeed part of the equation, of the Singapore success story. other key performance indicators but many other factors come into Since we opened in 2010 we have such as interest and stakeholder play as well. Given the needs of the hosted events in every single stra- satisfaction. We like to say that modern traveler, accessibility is key tegic sector for Singapore, in both this is a “win-win”, situation for and thus Singapore as a whole is the traditional sectors like oil & everyone, and given the success gas, finance and architecture as this year we are delighted to wel- ONG WEE MIN well as newer, innovative cross-sec- come Medical Fair Asia back to tor industries, such as FinTech, Marina Bay Sands for its 2018 edi- Executive Director a mix of finance and technology, tion as a multi-year show. of Sales, Marina Bay Sands WE ARE VERY MUCH A PART OF THE SINGAPORE SUCCESS STORY.

52 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com MICROSOFT’SSTRAP HEALTHCARE IN HERE PLANPLEASE AnStrap Emerging subhead Digital in here Player please

WINDOWS INTO THE FUTURE OF HEALTHCARE

Preface: Callum Bir, Director of Health and Social Services APAC for Microsoft, explains the tech giant’s four-point plan for using technology to transform healthcare.

hen speak- Bir makes it clear however that CALLUM BIR ing about “Microsoft does not supply fin-

the power ished products for the end user in Director of of technol- general, rather we are a platform Health and Social ogy to dis- and resource provider. Whether Services APAC, Microsoft W rupt and its Artificial Intelligence (AI) or transform healthcare systems and data management and analytics, delivery models, a company like we provide the plumbing or infra- Microsoft with a presence in every structure and the platform level AI is one of the most dynam- industry and in billions of lives is innovation to make other develop- ic investment categories in the well positioned to discuss the full ers’ disruptive ideas work.” Their APAC region at present.” One scope of ‘healthcare digitization’. clients and partners, the compa- contributing aspect to this “When we look at overall health- nies that actually innovate with dynamism has been the quick- care spending, we see the biggest the context of a specific industry’s ly increasing access to AI tech- opportunities for transforma- challenges and drive disruptive nologies, as “in the past compa- tion lie in delivery of care as this business models “typically fall nies had to reach a certain size accounts for the largest portion into three categories; established to higher PhD’s to develop their of cost and resources,” explains software developers that aim to own AI systems and then invest Callum Bir, Director for Health sell software as a product, health- in significant computing power & Social Services for the APAC care IT providers like Philips who to make it work,” whereas today region at Microsoft. With that in use our platforms as a base for “Microsoft has made significant mind, Mircrosoft has “identified building their own systems, and investments in developing AI, four broad topics where we sig- disruptive startup companies.” where we have 6000 people glob- nificant potential for technology When asked which of ally working to democratize AI to transform healthcare.” Microsoft’s capabilities current- platforms and make them high- Essentially, these four topics ly on offer to innovators has the ly accessible to startups.” With are: how patients engage with most potential to revolution- the innovative community hav- care providers; using technology ize healthcare, Bir immediate- ing access to powerful platform to empower healthcare workers ly answers AI. “According to a technologies, it is only a matter to achieve more; areas of clinical recent CB insights report, health- of time before their solutions operations where the efficiency care is the largest investment cat- begin to revolutionize patient and efficacy of clinical operations egory for AI globally,” explains access to healthcare in devel- can be improved; and improv- Bir, adding that “from our dis- oping markets across the Asia ing the efficiency of healthcare cussions with startups, VCs and Pacific region and around the administrative operations. inventors, it is also apparent that world.

www.pharmaboardroom.com Healthcare & Life Sciences Review: Singapore 53 VALUE-CENTRICITY Elisabeth Staudinger, Siemens Healthineers

SHIFTING THE PAR ADIGM

ELISABETH STAUDINGER

Preface: Siemens Healthineers’ president of Asia Pa- President Asia cific, Elisabeth Staudinger, speaks about the compa- Pacific, Siemens ny’s redefined strategy—an overarching move from Healthineers product-centric to value-centric services—and how this ultimately serves to benefit their customers and the patients. and mature market with an advanced healthcare system, Singapore essentially sets the standards for the HCLS: How would you describe the main pillars of rest of the region. Singapore serves as a reference point Siemens Healthineers’ new strategy and how does Asia for many countries both in terms of the regulatory en- Pacific fit into this framework? vironment and the infrastructure of healthcare delivery ELISABETH STAUDINGER (ES): One key pillar systems in Southeast Asia. is to be more engaged in the services space and embrace more complex business models. This is a funda- HCLS: For Siemens Healthineers, more specifically, mental shift away from our traditional product-centric what significance does Singapore play in terms of its approach because moving into services platforms re- operational activities? quires partnerships, joint ventures, and having more ES: Singapore houses a main office of the regional assets in the book, therefore necessitating a difference headquarters for our customer services organization, in organizational dynamics. in addition to having sales activities in the region. Another key pillar is the strengthening of the region- Unlike some of the other countries in the region, we al organizations within Siemens Healthineers’ global do not have manufacturing activities here, as they setup. The rationale behind it is connected to the core would be very costly, in addition to the lack of a sup- of the strategy – developing our service offering. In plier base. Nonetheless, our presence in Singapore is order to establish a relationship with our customers, it leveraged by its strong intellectual power base through is imperative to have a tailored understanding of their collaborative research and working with top-notch ac- needs and build our offering together with the custom- ademia and research centers, particularly in the likes ers themselves. Customer proximity is extremely val- of National University of Singapore (NUS), Nanyang uable as we can keep up with the development of the Technological University (NTU) or A*STAR. regional markets and their needs. Within A*STAR, for example, there are two areas where we entered into very promising discussions HCLS: How does a small market like Singapore fit – namely with the Clinical Imaging Research Center into the larger Asia Pacific context? (CIRC), a joint venture setup with NUS, and Singapore ES: Singapore is a unique market in that it is ma- Bioimaging Consortium (SBIC), which are two agen- ture and therefore characteristically closer to a market cies that are very involved in the imaging space. One like New Zealand or even Europe than to the neigh- focuses more on the pre-clinical cardiac imaging for boring markets surrounding Singapore. The regional animals, whereas the other focuses on radiopharma- headquarters of Siemens Healthineers is located in ceutical technology for humans. Both are of prime Singapore given favorable factors such its geographic interest to us, and we are also looking to expand our and politically stable position, as well as significant ac- presence in Singapore in other areas of research and tivities in the medtech sector. Additionally, as a wealthy development in the coming 12 months.

54 Healthcare & Life Sciences Review: Singapore www.pharmaboardroom.com INDEX Including advertisers Advertisers COMPANY NAME PAGE

A*STAR Biomedical Research PwC 52, 53 Council (A*STAR BMRC) 2, 19, 22, 24, 26 QuintilesIMS 25, 26 A.T. Kearney 21, 27, 30, 52, 53 Siemens Healthineers 56 American Chamber of Commerce 19 Singapore Airlines Cargo 20, 34, 36 Asia Pacific Medical Technology Association (APACMed) 2, 16, 17, 26, 37, 39 Singapore Clinical Research Institute (SCRI) 22

ASLAN Pharmaceuticals 25 Singapore Economic Development Board (EDB) 2, 4, 14, 15, 18, 22, 31, 32, 45, 53 B. Braun 39 Singaporean Association of BD 27, 29, 32, 39 Pharmaceutical Industries (SAPI) 18, 19, 30

BioSingapore 18, 25 Takeda 37, 39, 40, 41

Changi Airport 33, 34, 35, 36 Terumo 28, 36

DB Schenker 31, 44, 45 UPS 32, 34, 35, 49

DHL 34, 35 Vela Diagnostics 32, 38

Evonik 50, 51 Zimmer Biomet 23, 28, 38

French Chamber of Commerce & Industry (FCCI) 18

GE Healthcare 53

Hitachi Medical Systems 53

INC Research 37, 39

Janssen 24, 25, 26, 37

Johnson & Johnson 26

K8 Global 28, 30

Marina Bay Sands 13, 38, 54

McKinsey 17, 30, 37

Medical Technology Industry Group (MTIG) 30, 31

Medtronic 28, 42, 43

Microsoft 53

Mundipharma 32

Novartis 30, 31, 32, 46

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