Lance Duan, general manager of Roche Malaysia, discusses the dynamic changes in the country’s health system and the possibilities that exist for Roche to establish a collaborative relationship with the new government. Duan also describes the many initiatives Roche has to support Malaysian patients from a varying degree of angles, including education, prevention, access, and treatment.
Overall, how would you rate the performance of the Malaysian affiliate over the last several years?
Looking into Roche’s performance, there is a high correlation with the market performance of Malaysia. For example, in 2014 the affiliate’s performance matched the positive economy of the country, growing by ten percent from the previous year. Consequently, when the 2016 oil crisis hit the nation and caused the economy to suffer, Roche felt a similar impact. Despite the challenge, we have grown 23 percent in 2017 compared to 2016 in terms of patient numbers, especially in our key disease areas. This year we have even experienced 30 percent growth since last year and if the new government holds their promise of a rejuvenated healthcare system, Roche Malaysia will grow even faster.
In Malaysia, healthcare expenditure only accounts for around 4.5 percent of GDP. In regard to drug expenditure, we have seen a decreasing trend – going from RM 2.4 billion in 2014 to RM 1.9 billion currently. The new government has stated that they aim to double public spending, increasing the GDP percentage from 4.5 to six or seven percent. However, we have yet to see any specific agenda created. While we are excited to see the ambition for monitory investment, discussing the specific steps to be taken in order to achieve these goals is critical.
How does Roche ensure that products are launched effectively and what are the key assets for success in Malaysia?
Open communication with the government is the key to ensuring a smooth access to any market. I believe the best time for government engagement is not at the time of a product launch, but rather as early as possible, especially in regards to bringing clinical trials to the country. We are pleased that since last year, we have begun to advance with new clinical trials which will elevate our pipeline in Malaysia.
Secondly, it is necessary to have a clear understanding of the market access dynamics and the country’s ecosystem. The demand for drugs in Malaysia is quite different from other countries, for example, Japan or Switzerland.
It is disheartening to know that 75-88 percent of patients in Malaysia are not diagnosed with lung cancer until the late stages of the disease. We must understand each country’s unique patient needs and with this in mind, we are in the midst of increasing dialogue with the regulators to negotiate how we can streamline market access of new drugs. Niche diseases, like haemophilia, is the next area we are focusing on in the country. The medical needs of this disease is very high, so the speed of access makes an impactful difference to patients.
The recent suspension of the PASc program of free medicine delivery by the new Malaysian government has shaken the industry, especially in regard to innovative treatments. What initiatives has Roche put in place to ensure patients access to innovation in Malaysia?
When discussing patient access in Malaysia, one must consider the landscape of both the public and private sectors. The public sector is driven by a universal healthcare system, whereas the private side is self-funded by out-of-pocket patient costs. Looking at the patient population, although a sizable percentage of our reach is in private institutions, most oncology patients are treated in the public sector. The priority for Roche has always been to make the most advanced drugs available to all patients. Therefore, we have established a PASc program in the private sector, but we did not propose one for the public sector at this point in time. We believe that the PASc program is remarkably beneficial for patients, but it is just one of many ways to improve market access in Malaysia.
However, we are faced with a level of uncertainty at the moment due to the suspension of the program by the new government in order to reevaluate the scheme. We can only look forward with anticipation to what the future holds for drug delivery and we hope to work alongside the new government players and the Ministry of Health in this area. They have many priorities on their plate and once they have established their own goals, Roche will look forward to collaborating with them on this matter.
How is Roche Diagnostics positioned in relation to Roche Pharmaceuticals to provide healthcare solutions in Malaysia from all angles?
Although the Diagnostics program is a separate entity, we closely collaborate to tailor the best treatments to each patient which is why we are referred to our services as personalized healthcare. Together, we use different benchmark tests to determine what types of treatment are most suitable for a variety of patient groups. To achieve this goal calls for combining the strength of Roche Diagnostics and Pharmaceuticals. We also have a growing initiative in Malaysia to deliver learning opportunities to HCPs such as pharmacists, surgeons, and pathologists
We believe prevention should be a highly prioritized area, not only in Malaysia but in all healthcare systems. Prevention begins with awareness. Looking at the reason patients in Malaysia receive a very late diagnosis, we know that patients are unfamiliar with the disease and often do not perform regular screenings. Therefore, Roche is working to develop public awareness of cancer, especially lung, colorectal and breast cancers. We have over 20 collaborative partnerships with associations and NGOs to bring knowledge and better educate the public.
Moreover, in line with the published National Strategic Plan for Cancer Control Programme (NCCP) from past governments, Roche gathered its resources to support a war on cancer initiative recently, in February. We organized a workshop to engage Malaysian stakeholders in discussions and experience sharing. This was the first time we were able to gather patients, healthcare professionals, and government players together at the same time. There were many meaningful discussions regarding the NCCP addressing patient needs, HCP concerns, and areas for enhancement.
What are the investment opportunities in Malaysia?
There is a supportive environment for clinical trials in Malaysia, not only for medical experience but also to generate data on Malaysian patients specifically. From this perspective, Roche has developed more than 86 clinical trials in Malaysia since 2007. There is a massive benefit to understand the variation in treatment results when comparing Malaysian patients to other nationalities, like in China for example.
Another key area of investment in Malaysia has been the establishment of the Roche APAC Shared Service Center (SSC). Malaysia is one of three operations worldwide providing finance, procurement, and IT services to 15 countries in the Asia Pacific region. Since the center began operations in 2016, we are proud to say it has grown swiftly, creating over 350 positions in Malaysia. Roche APAC SSC has a very aggressive plan to expand its services to support more countries, helping us to also develop Roche presence in Malaysia.
As a final message, what are your top three priorities for the next several years moving forward?
We created our five-year strategy this past December with the single priority focus being patient access, a priority for any Roche affiliate around the world. In Malaysia, we are looking at access in two perspectives: the speed of launching a new product in the market and the expansion of products already in the market.
Roche has a global reputation for innovation. As of now, the affiliate offers many products on the market which will benefit patients and we have several product pipelines which are almost ready to be launched. Just this year we have already had several new products launches along with exciting developments in research. For example, in July we completed our Phase III trial for IMpower132, and advanced stage lung cancer treatment. We also have campaign streams in both diagnostics and pharmaceuticals, which makes us quite unique. In the next few years, we anticipate the launch of five to seven new molecules, which will be another motivating accomplishment for Roche.
In the future, we also anticipate the prevalence of personalized healthcare discussions. Before this development can be realized, we have two major questions to address with the government: is the country ready for the radical change in the healthcare system and equipped with the knowledge to handle personalized healthcare, and what is their intent to distribute that knowledge across to all stakeholders. For example, all policymakers, regulators, payers, healthcare professionals, and patients should be on the same page. Once these issues are addressed, the health system will be ready to include personalized healthcare into the conversation.
At Roche Malaysia, we believe strongly in identifying the local healthcare needs of patients. We also have a multi-stakeholder collaboration approach to bring and provide innovative solutions, while increasing patients’ accessibility to our medicines.
We hold close to our purpose statement, of contributing to the society and Malaysian patients, which is doing now what patients need next.
