Optimasi Biaya tanpa

mengurangi kualitas

IAI PIT 2017

Banten

Pre Agusta Siswantoro

Efisiensi Industri Farmasi di era JKN

Learning Outcome

• Mengetahui sekilas tentang JKN- BPJS

• Memahami pengaruh JKN terhadap industriFarmasi

• Memahami cara2 optimasi biaya agar industri“survive”dan berkembang di era JKN-BPJS

Economy(GDP growth)

Political(JKN _BPJS)

Regulation(cGMP)

Trends that will impact the Pharmaceutical Industry: Indonesia

•GDP Growth• Indonesia economy is

expected to growth +/- 6%• Indonesia healthcare spending

projected 2.7-5% of GDP• Pharma market growth 10.7% by

2017• Asia harmonization

implementation• Implementation of

universal coverage (BPJS) to all citizen

• Increasing pressure for good and clean government

• BPOM following PIC regulation for GMP implementation

• Start 01 January 2014• All citizen of Indonesia

• Mandatory on year 2019 the coverage is 100%

JKN

All Citizens of Indonesia (UUD 45 ps. 28 & 34)

Who has the right to get SJSN?

TOTAL POPULATION = 234.18 MIO

46 %

54 % of Indonesia population without health insurance coverage

Existing Healthcare Insurance Coverage

54 %

Scenario : Jan 2014 : start and done 2019

Market obat2 untuk common diseases akanterjadi commoditizationMarket share obat2 generik akan terusmeningkat (2014 :13.8% 2020 :20%)Pengembangan produk dengan added value menjadi pilihan ke depan (Orphan drugs, Biology, DDS, Vaccine )

Layanan kesehatan

Profesi kesehatan

Industri Farmasi

Fasilitas kesehatan baik pemerintah maupun sebagian besar swasta akan ikut dalam program JKNCOB & OPE menjadi pilihan pada private sector untuk menjaga sustainabilitynyaChallenge di profitability outletPrimary care akan makin berkembang terkait perbaikan JKN

Pada layanan kesehatan yang menerima JKN, terjadi load pelayanan pasien yang tinggi, namun terjadi penurunan/peningkatan incomePilihan obat possibility ke low cost product

Pasien

Pasien lower segment danchronic disease menikmatilayanan JKNSaat ini upper level masihberobat seperti semula (OPE)

Diduga Peran asuransi swastaakan makin meningkat jika adaimplementasi yg jelas dari JKN untuk layanan COB & TopUpmarket

Private insurance

Pengaruh JKN-BPJS terhadap Industri

kesehatanIndonesia

Konsep BPJS dengan pembayar Tunggal

PendudukRI

BPJSKes

DPU, DK, Klinik, Puskesmas

RSUD, Dr Spesialis,

RS Pusat Rujukan

PemerintahAPBN/APBD

Iuran Wajib % gaji dan Nominal

SubsidiIuran

RU

JUK

AN

Melayani

Obat-MD

Obat-MD

Impact SJSN

• PESERTA SJSN (penduduk RI)– Pengobatan Gratis

– Ada iuran bulanan

– Sistem pelayanan Kesehatan diatur (sistem rujukan)

• PROVIDER SJSN (Industri dan Distributor Framasi

– Volume penjualan bertambah banyak

– Harga”dikontrol”

– Margin mengecil

Kondisisebelum JKN

2015 2019

Non JKN/ BPJS

JKN/BPJS

• Innovative products, biosimilar, biology products, etc

• Special Product for Private Insurance

• M&A

•OGB •Common Dissease•Brandedd Generic(Increased in Volume)

dampak JKN/BPJS terhadap Industri Farmasi

Current condition

Strategy Scenario

Maintaining % Profitability

New Business Landscape

•High Margin-high Price•Low Volume•Innovative Product•Special/High tech•Out-pocket•Negotiating

Non JKN/BPJS JKN/BPJS

•Low Margin-Low Price•High Volume•Generic Product•Mass Production•Goverment Insurance•Bidding/ e Catalog

200Pharm Co.10 – 20% 80 – 90%

Shifting Strategyto Efficient Generic Drug Comppany

• Product Port folio

• Marketing strategy

• Production strategy

Strategic Initiative

• Improve Sourcing of Raw Material

• Infra structure Optimizing

• Process Efficiency– Shortend lead tie

– Reduce Inventory cost

Raw Material

Cost &

Availability

Process Efficiency

Production Process of Pharmaceuticals

Infra-Structure

Optimizing

Provide Good Quality

Product, Affordable in

acceptable price

E-catalogBidding

Lowest PriceWin all

Strict QualityStandard

from BPOM/MOH

Optimizing COST &Maintaining High Quality

Products

Challenges – HOW ? Alternatif:SCM

BPJS product supply

• Optimasi COGS– Raw material Cost– FOH Cost

• Manage Inventory Cost

1.Incr.Volume

2.Incr. Price

3.New Prod.Mix Sales

Fixed

Cost

Variable

Cost

Profit Margin

People

Asset (deppr)

Total CostRp

Unit0

Operational

Excellent in

SCM

Cost Reduction

2.Direct Labor

3.Direct Energy

RM-PM

Marketing And sales

cost

Reduce :•COGS•Inventory Cost•Transportation Cost

Mengoptimalkan Biaya tanpamengorbankan Kualitas

• Optimasi COGS

– Raw material Cost

– FOH Cost

• Optimasi Inventory Cost

– NOC (nett Operatring Capital)

– DOI + DOAR – DOAP

Critical Aspects of API – Raw Material :

Quality of Product start with quality of Raw material- API

QUALITY

SUPPLY

COST

EFFICACYSAFETY

ISSUE IMPACT

• Sub-Potency• Super-Potency• Impurities• Contamination

High- Price Affordability

Limited Source/supply Availability

OPTIMASI BIAYA BAHAN BAKU

High Risk

High Value

Low Risk

High Value

Low Risk

Low Value

High Risk

Low ValueHigh Risk

High Value

Low Risk

High Value

Low Risk

Low Value

High Risk

Low ValueAnalysis of

Supply Markets

PARETO Analysisof Materials

(based on value)

SLA & VMI

Vertical Integration

Strategic(High Risk,High Value)

“Squeezing”

Aggregation of orders

‘VMI’

Leverage(Low Risk,

High Value)

Modifying demandrequirement

Holding emergency stockLong-term contract

Bottleneck(High Risk,Low Value)

Routine(Low Risk,Low Value)

Centralized

Long-term contract

– Negotiation Strategy base onRisk Value Analysis

OPTIMASI BIAYA BAHAN BAKU

Lean Factory Approach

Cost Effectiveness

Optimize Lead time

• Kaizen + Lean Manufacturing

– Eliminate Inefficiencies

• Better utilized Input

• Reducing Cost,

• Improving cycle time / Lead time

OPTIMASI BIAYA FOH

OEE : Overall Equipment Effectiveness

Ok, cukup jelas!

Apa saja komponen

OEE ?

Productivity measurement OPTIMASI BIAYA FOH

Perhitungan OEE

OEE dapat dijaga dengan

• Desain Pabrik yg optimum

– System batch atau dedicated

• Pemilihan dan investasi mesin yang tepat

Production Process

Mixing

TabletingFilm/Sugar CoatingPacking

Drying Final Mixing

Stripping

Computerized System, assure weighing processfree from mistakes, such as wrong materialweighted or wrong quantity of material weighted.

Logistic

Net Operating Capital

(DOI) (DOAR) (DOAP)

The best way to Reduce NOC is reducing Days of Inventory.Reducing DOAR will impact on competitionIncreasing DOAP will impact on Company image

OPTIMIZING INVENTORY

+ -

OPTIMASI NOC

Synchronized Planning – VMI

Managing Inventory

RM-PM WIP finished Good

SLA

VMI

Lean

Manuf

Improved

lead time

Improve

Forecast &

More frequent

delivery

OPTIMASI NOC

Penutup

• Penerapan SJSN/BPJS1 akan meningkatkan secarasignifikan volume penjualan Obat (in unit) denganharga yang Murah

• Memaksa Industri farmasi untuk bekerja efisienagar bisa bersaiang dalam lelang e-Catalog

• Harga murah tidak boleh dengan penurunanMutu sehingga perlu penghematan pada cost ygtidak bersinggungan dengan mutu: (Inv Cost, Transport Cost, dll)

• Diharapkan Keluhan masyarakat tentang hargaobat terasa mahal akan berkurang.

THANK YOU

Excellence Execution

Profile

Drs Pre Agusta Siswantoro, Apt , MBA

Education Background

Pharmacy Graduated, Gadjah Mada University, 1985

WM 16 (1986), MBA Graduated in IPPM Jakarta, 1992

WORKING EXPERIENCES

1. R&D - Production manager , PT PRAFA, 1987 - 1992

2. Production Manager- Assisten Director R&D, PT KALBE FARMA, 1992-2000

3. Plant /Manufacturing Director PT BINTANG TOEDJOE, 2000- 2008

4. Corporate R&D Director KALBE FARMA 2006 -2008

5. Director of PT Global Chemindo Megatrading (GCM)- Raw Material Trading, 2011- 2014

6. Director Logistic PT Enseval PM Tbk . 2013 -2015

7. Supply Chain Director KALBE Group 2008 – 2015

8. Manufacturing Director Kalbe (pharma division) 2015 - present

OTHERS

1. Jury of “ Indonesia’s Innovation” organized by BIC and KNRT, 2008 – present

2.Wakil Ketua, Pengurus Pusat, IKATAN APOTEKER INDONESIA, 2009 -2013

3. Ketua Hisfardis (Himpunan Seminat Farmasi Distribusi)2009-2013

3.Pengurus Pusat Gabungan Perusahaan Farmasi Indonesia –GPFI ,2011-2016