Mega Trends In
Asia's Medical Device Market
Faced with an increasingly ageing society and rising
healthcare costs, countries in Asia Pacific are expecting cost-effective medical
devices to be developed by local companies, as per Frost & Sullivan, Singapore.
Despite the fact that Asia has 60% of the world population providing large
market potential, Asian healthcare expenditure constitutes only 15% of the
global healthcare expenditure. In 2007, the total global healthcare expenditure
was at US$ 4.981 trillion. With a growth rate of 6.2%, the total healthcare
expenditure of Asia is expected to be at US$ 791.7 billion by 2008. While some
parts of Asia are experiencing high population growth, other countries such as
Japan and China are facing the problem of accelerated ageing population. For
instance, Japan is estimated to have 22% of its population above 65 years by
2012 as compared to 20.6% in 2007. With the current Asian lifestyle, the
prevalence of chronic diseases such as diabetes, cancer, obesity and
cardiovascular diseases has increased significantly. Other diseases that
threaten the region include auto-immune diseases, infectious diseases and
neurological disorders. Accelerated ageing population and increasing prevalence
of chronic diseases are the key drivers that contribute towards the increase in
total healthcare expenditure on medical devices in the region.
When it comes to medical devices, reliability and
safety are very critical. This is an industry where quality and reliability of
the devices cannot be compromised. Even a low device-failure is unacceptable to
the patient and the healthcare providers. For example, a current leakage of as
little as 10µA (10-6 A) on a pacemaker will cause a microshock to patient, which
will eventually bring death to the patient in minutes. Therefore, reliability is
critical for medical devices. Unreliable readings given by devices might lead to
misdiagnosis, further leading to delay in treatments or false alarms. To ensure
zero-defect reliability of the medical devices, manufacturers use the Failure
Mode and Effect Analysis (FMEA) tools. FMEA is used to evaluate the risks
associated with the devices produced and to develop strategies to overcome them.
Using flexible circuits instead of rigid circuits in medical devices is yet
another option that could be employed by the manufacturers to increase the
reliability of devices. Technology advances have made it possible to use smaller
and thinner integrated circuit boards. Self-monitoring devices such as blood
glucose meter and wrist blood pressure monitor now come with more functions that
are smaller in size due to availability of denser and thinner printed circuit
boards. Miniaturisation of devices has made it possible to save space in the
operating theatres or intensive care units that have limited space.
Power sources are critical for medical devices such
as hearing aids and neurostimulators of a pain control therapy device. Batteries
for these devices must be small, of right weight, easy to replace or recharged
and have a reasonably long life span. For example, the rechargeable battery of a
neurostimulator has 10 years of lifespan. Other batteries under development
include biothermal battery that uses body heat to generate low current source of
power, and nuclear microbatteries that use the decay of tritium and nickel-63 to
generate power. In order for medical devices to be more marketable in the
increasingly competitive market, these devices need to have breakthrough
technologies. Medical devices are increasingly coming up with enhanced features
and performance such as connectivity through wireless solution or LAN. Devices
such as cochlear implant can be programmed wirelessly, and ultrasound images can
be transferred from a patient's bed to the nearest workstation through LAN or
Wi-Fi.
Asia with its large population is considered as a
lucrative market for device makers. Further, accelerated ageing population in
few developed countries, such as Japan, Korea and Taiwan will eventually
increase its healthcare expenditure. Asia continues to experience economic
growth amidst slowdown in the US and Europe.
Realising the importance of disease prevention, the
Asian governments invested billions of dollars annually to improve their
healthcare infrastructure. For instance, the Ninth Malaysia Plan (2006-2010) is
to work 'towards achieving better health through consolidation of services'
whereby emphasis has been placed on sustainability, upgrading and maintenance of
existing facilities and equipment, and improving the quality of healthcare.
China announced its Healthy China 2020 plan in January this year, which aims to
provide safe, effective, convenient and low-cost public health and basic medical
care to both rural and urban citizens by 2020. Some key goals of the plan
include making public medical institutions 'non-profit'; reducing the
involvement of hospitals in the sale of drugs, increase the role and
responsibility of government and establish basic medical care network for all
Chinese citizens. These policies clearly showed the eagerness of the government
to provide better healthcare infrastructure with better medical devices and
facilities. In recent years, the medical industry has experienced a paradigm
shift from sickness care to healthcare. Higher priority is given to prevention
rather than to cure. This phenomenon is also seen in Asia, where finding cures
and fighting infectious diseases have become the priority. Asians are becoming
more aware of their health, especially people in China, Hong Kong and Singapore,
which were hit by SARS and Avian Influenza several years ago. Both the
governments and people in Asia are now more receptive towards medical technology
and encourage home-based monitoring. With advanced technology and communication
systems available in most of the countries in the Asia, people now have access
to the information resources available and are more demanding in seeking
healthcare options. On the other hand, direct-to-customer marketing strategies
of some pharmaceuticals and medical device companies have indirectly educated
Asians on the healthcare options available to them. Employers, in their effort
to increase company's efficiency are becoming more aggressive in pushing for
preventive care. This paradigm shift has increased the demand for medical
devices in the healthcare industry.
High participation from private healthcare providers
in developed countries in Asia promotes healthcare expenditure. For instance,
Taiwan has fairly high participation of private healthcare, which contributes 65
per cent of Taiwan's total hospital beds. Private involvement has enabled
efficient healthcare delivery to the people, which could be clearly seen in the
case of Taiwan. This private participation was driven by Taiwanese comprehensive
National Health Insurance scheme, which has eventually helped to increase the
healthcare quality.
Most hospitals in the Asia rely heavily on
government subsidy, and in most cases government purchases control the prices of
medical devices. For instance, in Taiwan, huge pressure is put on National
Health Insurance to reduce its account deficit, which leads to stricter medical
examination. Unnecessary health screening such as MRI and blood screening are
excluded from the insurance coverage, which leads to reduction in device
purchase. Government restriction discourages the installation of medical devices
that are considered by it as non-critical items. This causes initial barriers in
introducing new medical technology into the region. In addition to government
control over the price, Asian countries have started to implement regulations
following the increased concern of product safety when imported into these
countries. Increased healthcare regulation has brought varying regulations in
different countries. Most of the countries in the Asian region are now
implementing and adopting different medical device standards. Some of these
countries, such as China and Japan have taken a step further to develop their
own regulations that suit their local requirement. These complicated regulation
structures in these countries pose challenges to investors.
Distribution costs in Asia have increased in recent
years due to continuing high oil prices and inflation. Labor charges too have
increased over the years compared to a decade ago, with the increasing demand
for labour. Although the overall cost is still lower than Europe and US, the
effect of the increase is significant. Increased involvement of local medical
device companies in countries such as Korea and China is a threat to the
multinational companies. These companies, supported by their governments, are
able to provide medical devices that suit local requirements at a price far
lower than that offered by multinational medical device companies.
Geographic vastness of the Asian region poses
challenges to distribution, logistic, communication and promotion activities of
medical device companies. In most of the Asian countries such as Thailand,
Vietnam and Indonesia, the well-equipped hospitals are in the urban areas and
rural residents barely have an access to medical services. Lack of penetration
to rural part of Asia is due to poor transportation systems in these countries.
Healthcare infrastructures in these countries are not well developed and may
take another two decades to reach such a level. Vast geography with poor
transportation increases the delivery time and operation costs. These factors
have hindered the growth of medical device market.
The full potential of Asian markets can be realized
by establishing key partnerships and alliances with the local companies, keeping
mind the market drivers and challenges posed by the region. The fastest way to
penetrate these highly protected, untapped Asian markets is through effective
joint ventures with the emerging medical device companies of Asia.
Geographically big Asian countries provide great opportunity for telemedicine
and teleradiology. In view of the poor transportation facilities in parts of
Asia, telemedicine and teleradiology could help in providing more efficient and
timely medical care in rural areas. Companies should consolidate their
distribution function throughout Asia in order to be more cost-effective and
efficient in product delivery. In order to stay competitive in the local market,
emphasis on Research & Development of medical devices should be combined with
the manufacturing of medical devices.
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