By Radhika Wijesekera –
SINGAPORE (January 04, 2024) – The disturbing reality of life today in Southeast Asia is that 62% of deaths result from non-communicable diseases (NCDs), with over 50% affecting those under 70, contributing significantly to premature mortality. Paired with the anticipated doubling of ageing populations — from 630 million in 2020 to 1.3 billion by 2050 — the need for urgent intervention is undeniable.
The challenge is significantly more complicated in countries such as Singapore where health systems are already grappling with a shortage of qualified personnel, hospital beds and overwhelming workloads for medical professionals.
Can we effectively curb chronic illness and premature mortality?
Speaking exclusively to AsiaBizToday, Bijay Singh, global head of business unit healthcare for market expansion services provider, DKSH, says that the APAC’s medical device sector is expected to bring in $ 156 billion in revenue in the next five years, and holds the key to this very essential and urgent transformation.
The following are excerpts of what he had to say.
Q: Aside from the well-known factors that contribute to the pandemic of non-communicable diseases (NCDs) or chronic diseases (such as bad eating habits, lack of physical exercise, and overall bad lifestyle choices), what other lesser known/hidden factors contribute to the alarming rise of NCDs in Southeast Asia today?
A: While not a hidden factor, socioeconomic conditions is a massive contributor to surging non-communicable diseases (NCDs) in Southeast Asia that warrants greater attention. These conditions range from proximity to care, to financial capacities and healthcare infrastructure constraints, among others.
In Asia Pacific, financial hardship poses a significant barrier to accessing care owing to high levels or catastrophic out-of-pocket health spending. Furthermore, a significant amount of healthcare resources is required for the effective management of chronic diseases or NCDs, including detection, screening, treatment, and providing access to palliative care. In developing economies, many health systems simply don’t have the resources to keep up with these requirements. In fact, many face a severe shortage of healthcare specialists — some countries in the region have a physician-to-population ratio of less than 10 physicians per 10,000 people.
These circumstances ultimately thwart individuals from embracing healthier lifestyles and obtaining timely and necessary medical assistance, which has the potential to escalate the prevalence of NCDs in the region.
Q: How do you envision the demands on the healthcare sector changing with the combined problems of the rising aging population and the premature decline in the working population (of those under 70 years old), owing to NCDs?
A: Primary and preventative care will likely take centre stage in the years to come, with the combined forces of aging populations and premature mortalities on the rise.
When we look at the aged and aging populations in isolation, healthcare needs may vary across the two. The prevalence of elderly individuals, for instance, will undoubtedly intensify the need for specialised care and geriatric services. For this group, initiatives in health promotion and prevention will increasingly need to address cognitive and functional decline such as frailty and falls. However, health systems will also need to focus on those who are younger and aging or susceptible to NCDs. The reality is that as people age, they develop multiple comorbidities of chronic diseases. To that end, an effective preventative approach offers a feasible way to reduce the number of new cases and complications, subsequently reducing strain on healthcare resources.
I therefore envision a renewed focus on primary care, which is capable of managing 90% of healthcare demands and holds significant potential in reducing chronic disease burdens. Primary care preventative practices such as regular monitoring and management can prevent or delay the onset of life-changing complications. Taking the example of type 2 diabetes, this can include prevention of end-stage renal disease and limb amputations.
For the Asia Pacific, this shift means leveraging technology and virtual care models to connect public and private resources, engage communities, and extend the reach of essential healthcare products and medical devices to the last mile.
A prime example of this shift in action is Singapore’s Healthier SG programme, signifying a strategic reorienting in healthcare from acute hospitals to the community. The programme is rooted in an approach that moves away from treating ailments reactively, towards preventative ways that ward off disease before they become systemic. This shift will ultimately see improved patient outcomes by way of more personalised, patient-centred care, engagement with community partners, and more robust public health initiatives — reining in chronic disease burdens amid aging populations and premature mortalities. Importantly, these trends provide players across the ecosystem with the opportunity to turn effective and affordable care for all into reality.
Q: As the sector stands today, what are the medical devices that are currently available for use by laymen? How widely used are they?
A: In today’s landscape of accessible medical devices for the general public, various commonly used instruments have emerged as essential tools for self-monitoring and healthcare management. This includes devices such as blood pressure monitors, glucometers, thermometers, pulse oximeters, and fitness trackers.
The emergence of personal care devices has shifted the paradigm of healthcare, empowering individuals to take charge of their well-being within the comfort of their own homes, as there is a growing emphasis within the regions on encouraging individuals to become their own health ambassadors. This trend is unfolding across different countries at varying paces with a burgeoning middle-class population.
While adoption levels of these devices may vary, they are definitely increasing due to various factors. For example, the rise in cardiovascular diseases among the geriatric population, as well as lifestyle diseases such as obesity and diabetes, is driving the adoption of blood pressure monitoring devices in the region. At the same time, the increasing prevalence of diabetes in the region is propelling the market growth for self-monitoring blood glucose devices, which is expected to record an 11% CAGR from 2020 through 2027.
Notably, innovative technologies are also contributing to early detection and prevention, as exemplified by a device for breast cancer detection. This portable breast cancer scanner, discreetly placed inside a bra and worn overnight for two nights each month, monitors the temperature and humidity of the breast, providing data for breast cancer assessment. Overall, medical device sales in the region are forecasted to reach approximately $ 225 billion by 2030, up from $ 160 billion in 2022, signalling greater demand in the long-term.
Q: Why is it imperative to reshape healthcare delivery in Asia Pacific, and what opportunities does the medical devices sector hold in facilitating these changes? How do you see the medical devices sector contributing to filling the void that will inevitably be created owing to the high premature mortality rate?
A: Healthcare is a complex and multifaceted industry, with life-changing impact. While it is not feasible to address all the challenges facing the industry at once, we can start with some of the most pressing ones — aging populations, premature mortality, and chronic disease prevalence. While these challenges have been plaguing the industry in Asia Pacific for years, its urgency cannot be overstated.
Firstly, according to the Organisation for Economic Cooperation & Development, we can expect the share of the population aged 65 years and over to double in lower-middle and low-income countries in the region, reaching 13.4% in 2050. This level is less than half of that of the average in high-income countries. The speed of aging in the Asia Pacific will be unprecedented; what this means is that many countries will be pressured with shorter timeframes to prepare for the healthcare challenges that come with this change.
Secondly, the painstaking reality is that each year 74% of all deaths globally are attributed to NCDs, equivalent to 41 million people. Of this, 17 million people die from NCDs before the age of 70. The majority of premature NCD deaths come from cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes. This situation was largely exacerbated by the pandemic, which severely disrupted the treatment of chronic diseases.
With the above in mind and the current state of healthcare, improving population health can be an insurmountable challenge. We already know, for instance, that many countries simply cannot come with the demands of managing NCDs. There is therefore a strong need to change healthcare delivery — and to me, this means bringing healthcare into the home.
Bringing healthcare outside of a clinical setting has the potential to optimise patient outcomes and improve patient experiences by encouraging them to advocate for their own care — while simultaneously maximising healthcare resources and manpower. We have already seen the tremendous impact of such services during the pandemic. For instance, self-monitoring tools ensured that patients could receive high-quality care at home, without needing to visit a clinic or hospital. In turn, this allowed healthcare workers to focus on delivering greater care to higher-risk patients in hospitals. This where the opportunity lies for the medical devices sector. By enabling remote monitoring, telemedicine, virtual care systems, and so on, patients are empowered to manage their own health in the comfort of their own home.
Q: What do you feel is the next frontier in healthcare innovation?
A: The medical devices sector is a growing industry set to reshape the way health systems approach healthcare and wellness. The prospect for growth in the Asian medical devices market is nothing short of extraordinary, with revenue projections soaring to an impressive $ 156 billion by 2028. The next frontier in healthcare innovation will involve the increased digitalisation of medical devices to drive access, convenience, and more patient-centred care.
We are already seeing more modernised and technologically improved products in recent years. For example, in the blood pressure monitoring device market, bluetooth-enabled devices or devices that use sensors and computerised mathematical modelling for pulse recording are propelling the business forward. Another example is the advancements in self-monitoring blood glucose devices. The Dexcom G6 continuous glucose monitoring system, now available in Singapore and Japan, allows for real-time monitoring, integrated with wearable sensors and a transmitter for the measurement of blood glucose values. Sustained advancements as such will drive the adoption rate of medical devices in the region, which will set the stage for a transformative era in healthcare.
Q: In what ways do you see healthcare evolving in the future? To what degree would self-care be required?
A: I foresee a stronger focus towards primary and preventative care. However, the true benefits of this shift cannot be achieved without self-care. Self-care has the potential to ease the pressure on health systems as they cope with older populations, NCDs, and healthcare spending skyrocketing. How?
Firstly, empowered patients with higher self-esteem can influence more positive behaviours that contribute to improved wellness and longer life expectancies. These include lifestyle practices such as better eating habits and physical exercise, for instance, which plays a vital role in prevention. Importantly, it helps to decrease individuals’ dependence on the healthcare system, alleviating existing burdens faced by health systems globally.
Secondly, it also provides a superior patient satisfaction experience by allowing people to take charge of themselves. Studies have shown that when patients actively participate in decision-making aspects with regards to their care, including choices about treatment and management, it results in better adherence to medications and improved management of chronic or long-term conditions.
The good news is that many countries in the region are already making a concerted effort to engender a culture of self-care among populations. One example is Singapore, where the government is progressively driving self-accountability, self-responsibility, and self-obligation in care, through its Healthier SG programme. In Malaysia, its work in self-care dates back a few years, when the Pharmaceutical Association of Malaysia (PhAMA), set up a “Self-Care Taskforce” in 2017, with the aim of advancing self-care among Malaysians.
Hence, a crucial component of healthcare evolution will also see greater maturity in self-care practices across the Asia Pacific.
Q: What forces do you foresee propelling the growth of the region’s medical device sector? Which markets are expected to contribute to the growth of the medical device sector in the region?
A: There are a number of factors fuelling the growth of the medical devices sector in Asia Pacific. Aside from demographic and socioeconomic factors, such as the prevalence of chronic diseases and aging populations, as well as technological advancements, it is important to also consider the regulatory landscape.
Notably, in ASEAN, the harmonisation of standards, conformity assessment procedures, and technical regulations, has reduced barriers to deploying registered products across the region. We’re seeing greater harmonisation efforts in North Asia, particularly for life-saving devices, which will help streamline the deployment of more products across Asia overall. For example, the Hong Kong government has entered into an agreement with Mainland China to allow for imports of hospital products that are not available locally in China. Such measures will facilitate greater movement of medical devices across borders, thereby fostering growth in the sector.
Therefore, the interplay of technological advancements, socioeconomic conditions, and the regulatory landscape will contribute to a thriving medical devices industry in the years ahead.
To that end, certain markets within Asia stand out as hotbeds of opportunity, poised to significantly contribute to the region’s overall growth in the medical devices sector. One such market is Vietnam, where the industry is projected to reach a staggering $ 2,862.6 million by 2028. The forecasted growth can be attributed to improvements in effective and efficient diagnosis, treatment, and monitoring procedures, further complemented by increasing investments in medical technology.
Another market that stands out is Singapore. Its medical technology segment expanded 8.2% amid higher export demand for medical devices. Today, Singapore is home to more than 60 multinational MedTech companies undertaking a range of activities, from regional headquarters and manufacturing to research and development.
Q: Would collaborations serve as a catalyst for advancement in the medical devices sector? If yes, why?
A: As the Asian medical devices sector charts its course towards unprecedented growth, collaboration will be a linchpin for sustained advancement.
Cross-border and industry partnerships, for instance, can facilitate the exchange of knowledge and expertise, enabling the development of medical devices that cater to diverse healthcare needs. It can also help facilitate greater access to medical devices. For instance, at DKSH, we have an ongoing partnership with an agency in Hong Kong with a collection of start-ups in medical devices. With our extensive expertise, we provide them with the registry, regulatory guidance, and commercialisation advice to ensure the effective distribution of their devices beyond the Hong Kong market. Such collaborations can further help to bridge the gaps and capabilities that not only accelerate the growth of the industry within individual markets, but also contribute to their global competitiveness.
Ultimately, collaboration is not simply a strategic choice; it is a commitment to a future where medical devices contribute significantly to enhancing the wellbeing and outcomes of patients across the region and the globe.