Wiwy Sasongko, MD at QuintilesIMS Indonesia, describes his efforts to continuously improve the services provided to his clients and explains the revolution that the universal healthcare coverage program in Indonesia (JKN) is creating in the domestic healthcare industry.
The merger of Quintiles and IMS was completed in October 2016. How has this global corporate change affected your operations in Indonesia?
“Our clients see the opportunities created by JKN – the market has become more attractive for them and we are seeing an increase in investments, acquisitions and joint ventures in Indonesia, which provides local companies the opportunity to gain more technologies and expertise.”
This merger has given us significant new capabilities to provide our clients with more diverse and better-quality services here in Indonesia.
To contextualise Indonesia’s current healthcare situation: the JKN (Indonesian Universal Healthcare) programme has been in place since 2014. Even though there are numerous challenges within the implementation, a lot has been achieved.
Our clients see the opportunities created by JKN – the market has become more attractive for them and we are seeing an increase in investments, acquisitions and joint ventures in Indonesia, which provides local companies the opportunity to gain more technologies and expertise. Our clients also struggle with the challenges, such as regulatory uncertainty.
As QuintilesIMS we can better help our clients successfully navigate these uncertainties. Historically, IMS monitored the growth of a product once it was launched while Quintiles focused on product development. Our combination of market data and clinical trial expertise allow us to offer new end-to-end solutions to customers – across the development and commercialization spectrum.
What do you believe are the steps that the industry needs to take in order to capture the immense growth potential resulting from the implementation of JKN?
Indonesia is the largest pharmaceutical market in South East Asia and one of the fastest in terms of growth. We expect the pharmaceutical industry to grow around seven percent annually over the next four to five years.
Since JKN was implemented, many of our customers have started to invest more. By providing our clients with adapted solutions for market assessment as well as commercial insights, their success becomes our success.
Our multinational clients, which mostly provide innovative drugs sold at higher prices than the local or non-branded generics, need to prove to the government that their drugs offer greater value than existing therapies on the government formulary. With JKN being in a budget deficit, the economic factor is a strong focus when looking at gaining market access. It’s not enough to show that your drug is more effective than a cheaper alternative. You must also show that it adds greater value in terms of outcomes, e.g. longer lives, fewer hospital visits, better quality of life.
We help the government understand the nuance between the absolute cost of a drug and the long-term benefit of a costlier treatment. Pharmaco-economics is an important topic in Indonesia. We are fully committed to develop models within JKN that properly compare long-term benefits with short-term costs in evaluating the true value of competing therapies.
I think the government is still at a very early stage when it comes to assessing the value of treatments in terms of outcomes vs. costs. This shift in thinking will take some time.
What are the most pressing concerns you have when considering the current stage of JKN?
JKN is struggling in three areas: infrastructure overload, budget deficit, and implementation.
Regarding infrastructure, the challenge is significant. The ratio of hospitals and doctors per citizen in Indonesia is low when compared to neighbouring countries. For example, Indonesia has as many oncologists as Singapore, which has approximately five million inhabitants while Indonesia has 250 million.
Proposals are being considered to address this issue through partnerships with private clinics or building more public infrastructure in terms of primary care facilities and hospitals, or a combination of both.
Lastly, the government has to take a deeper look into the expenses in the JKN and how much of it reaches the patient at the end. QuintilesIMS can help analyse where the spending and the investments should be allocated to create significant healthcare breakthroughs while enhancing the financial sustainability of the model.
When we had the pleasure to meet with Michael Klein, head of Quintiles Indonesia back in 2009, he mentioned that Quintiles had the largest CRO team in the country. What is your current assessment on the CRO landscape in Indonesia?
Taking a look at the CRO landscape across South East Asia, we are aware that Indonesia is clearly underdeveloped when compared to Thailand, Malaysia or Philippines. The only way to change that is through close collaboration with authorities – sharing information and ideas to bring more clinical research to Indonesia. This will offer patients here more access to clinical research as a possible treatment option; help bring better medicines to patients faster; and expand our medical research industry.
In Indonesia, we are have regulatory barriers that limit exporting clinical samples and, therefore, such laws have a significant impact on our ability to perform clinical trials in the country.
As long as the current barriers of the MTA (Indonesian Material Transfer Agreement) are in place, the great potential Indonesia offers in terms of clinical trials will remain that – unrealized potential. Our industry has and will continue to work with the authorities to make reasonable changes necessary so that Indonesia can compete with other South East Asian countries in the clinical trials arena.
Through our other meetings with pharma players, one of the key themes that has emerged has been that the ASEAN/APAC region in many ways exhibits bigger opportunities for technology to disrupt and transform healthcare than seen in Europe or US. How can QuintilesIMS help to provide the life science industry with technological platforms to enable innovative approaches?
Indeed, the emergence of start-up technologies is a strong phenomenon in Indonesia, as illustrated by Gojek, the local motorcycle ride-sharing service. This trend can also be witnessed in the healthcare market. More companies use apps to reach the patients or the doctors and to educate them.
We are moving quickly to seize this opportunity by investing in three areas: data, services and technology.
With our recent advances, our data and reports not only become more accurate but it can now be accessed remotely online as well. In the past, this information could only be accessed from a desktop. We also help our clients reach their customers better through multi-channel marketing strategies that promote their products.
What are the main objectives that you would like to accomplish in the upcoming years at QuintilesIMS Indonesia?
Our vision is to be the most trusted partner for the Indonesian public and the private sectors. As the line between the two sectors is becoming increasingly blurred with the implementation of the JKN, the ability to work with both sectors is increasingly important. Both want to expand access to healthcare and improve outcomes while controlling costs. That’s where we can help. We wish to be positioned as the adviser of choice to drive our clients’ success in Indonesia.
The breadth of our services since the merger and our ability to provide end-to-end solutions are our main competitive advantages. Our goal is to constantly improve our ability to drive healthcare forward and be the clear partner of choice for Indonesia’s healthcare industry.
On a personal level, what keeps you motivated on a daily basis?
The challenges and the dynamic environment are what motivates me and our team in Indonesia. We help our clients deal with challenges and achieve success on a daily basis. Our industry is fast-paced – and getting faster! Helping our clients be successful is what motivates me.