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Asia Pacific Healthcare Outlook 2012- 2015 What comes next…. Reenita Das SVP Healthcare and Life sciences

APAC Healthcare Outlook 2012 - 2015- What Comes Next

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Page 1: APAC Healthcare Outlook   2012 - 2015- What Comes Next

Asia Pacific Healthcare Outlook 2012- 2015

What comes next….

Reenita DasSVP Healthcare and Life sciences

Page 2: APAC Healthcare Outlook   2012 - 2015- What Comes Next

What’s Trending for 2012…2015

China will be the largest pharmaceutical and medical devices market in APAC.

Half of the growth in healthcare will come from the “E7”.

Mobile Health to become the biggest business model disruptor creating access for healthcare delivery on a mass basis especially in emerging economies.

Healthcare expenditure in APAC will increase by 75%.

2

Advanced medical technologies will be defined by "lower cost scaled down technology“, reverse innovation will help leapfrog cost barriers.

Surprisingly India is expected to lag behind in all healthcare segments except in Pharmaceuticals.

Competition between Asian diagnostics companies and MNCs will spur innovation.

Gen Y is going to break down some of the organizational sclerosis that is

clogging up our healthcare system.

Health enhancements set to become one of the top 10 market places in healthcare.

Higher proliferation of non - healthcare companies entering healthcare.

Page 3: APAC Healthcare Outlook   2012 - 2015- What Comes Next

2011 2015

Global Reflections from 2011 and the way forward…

Healthcare Evolves to Become a Service Industry“you’re sick…we’re quick”

The flood gate of Health Marts:Mckesson leads the way to consumerizehealthcare

Healthcare

becomes data

driven and

customized. More

focus on cost

versus outcomesSilicon Valley and the Hi-Tech industry gets involved in healthcare

Patients will be Kings and Queens of the healthcare system

1 billion seniors by 2020 and 2 billion by 2050

3

More “generics” –technologies providing same value at lower price, stripped down feature sets

R & D spend is

$ 1.15 trillion up

despite economic

recession

Gold Rush to

Emerging Markets:

Indonesia, Russia,

Mexico, Brazil, India,

Turkey and China –

comprising 1/5th of

the worldwide health

care sales

Diagnostics and Monitoring will become the golden goose

Home healthcare and care givers dominate the agenda

The big Tidal Wave: Performance based Insurance policies

Page 4: APAC Healthcare Outlook   2012 - 2015- What Comes Next

2011 2015

APAC Healthcare market sales will account for 29% in 2011

Growth of mHealth will facilitate penetration of healthcare services

Increase of green technology in

APAC Healthcare market sales comprises 35% in 2015

The Asian perspective… Mobile phone users will rise from 2.2 billion in 2011 to 3.4 billion in 2015

Asian hospitals evolve to become global brands

Multiple partnerships

4

Emergence of New markets: Vietnam, Indonesia, Laos, and Myanmar in development of healthcare infrastructure

Over half of the middle class will be from the APAC region by 2020. Gen Y to drive how healthcare is delivered

technology in manufacturing,logistics and healthcare deliveryMost countries

in APAC would have implemented EMR platforms

Traditional medicine and supplements gaining marketstrength and recognition

partnerships between NGOs, private and government for Asian disease based R&D

Page 5: APAC Healthcare Outlook   2012 - 2015- What Comes Next

APAC Healthcare Expenditure will increase 151% by 2020, while countries with the lowest projected growth rate will be UK, Italy, & Germany

Japan$563 billion

CAGR 3.0%

Hong Kong$20 billion

CAGR 3.2%

South Korea$127 billion

CAGR 5.5%

China$1446 billion

CAGR 15.5%

USA$3922 billionCAGR 4.6%

5

G7$6147 billion

50% increase 2010-2020

CAGR 4.0%

APAC$2927 billion

151% increase 2010-2020

CAGR 9.2%

Australia$198 billion

CAGR 3.0%

Singapore$23 billion

CAGR 9.6%

Malaysia$25 billion

CAGR 8.4%

Taiwan$65 billion

CAGR 7.8%

India$331 billion

CAGR 14.5%

Indonesia$47 billion

CAGR 8.1%

Vietnam$31 billion

CAGR 14.8%

Philippines$26 billion

CAGR 11.5%

Thailand$25 billion

CAGR 8.4%

BRIC$1958 billion

212% increase 2010-2020

CAGR 12.1%

Page 6: APAC Healthcare Outlook   2012 - 2015- What Comes Next

China and Japan Steal the Show by 2015Taiwan/Indonesia catching up in Tier 2 countriesIndia is disappointing despite the hype…

TIER 1 Pharmaceuticals & Biotechnology

MedicalDevices

Medical Imaging

DiagnosticsHealthcare

IT

Total Market Size (2015)

$ 389.4 bil $ 140.0 bil $ 13.4 bil $ 11.0 bil $8.2 bil

1 China China Japan Japan Japan

2 Japan Japan China China Australia

3 India Australia South Korea India Taiwan

4 South Korea South Korea Australia Australia China

6

4 South Korea South Korea Australia Australia China

5 Australia India India South Korea South Korea

TIER 2

1 Taiwan Taiwan Taiwan Indonesia Hong Kong

2 Indonesia Malaysia Malaysia Malaysia Singapore

3 Thailand Thailand Philippines Thailand Malaysia

4 Philippines Indonesia Indonesia Hong Kong Philippines

5 Vietnam Philippines Thailand Vietnam Indonesia

Page 7: APAC Healthcare Outlook   2012 - 2015- What Comes Next

• By 2020, Chronic disease deaths in APAC will grow at 20%.

• 15% of the 37 million deaths worldwide is related to Pandemic and epidemic diseases, 1/3 of such was from APAC.

• Private expenditures is increasing in China and India, private spending accounted for 49.9% and 67.2% respectively in 2009.

Market Drivers

Global vs. APAC: The New FrontierIn 2011, APAC is estimated to be 28.5% of global market

Global & APAC Healthcare Revenues US$ Bn, 2011-2015

895.6928.8

978.11017.5

1060.7

600.0

800.0

1000.0

1200.0

1400.0

1600.0

1800.0

CAGR4.3%

7

• Per capita healthcare expenditure is far below global average (lowest is Vietnam and Indonesia ).

• Shortage of healthcare professionals. Health care workers in APAC is 6.8 per 1,000 population, compared to 18.9 in Europe and 24.8 in the Americas in 2010.

• Access to healthcare and distribution limited in emerging markets.

49.9% and 67.2% respectively in 2009.

Market Restraints

APAC Share28.5 % 34.6%

• By 2015 APAC could represent of global market

356.5 396.4 440.1 491.7 562.1

0.0

200.0

400.0

600.0

2011 2012 2013 2014 2015

APAC($ Billion)

Rest of the World($ Billion)

CAGR12.1%

Page 8: APAC Healthcare Outlook   2012 - 2015- What Comes Next

Chronic disease volume and lack of preventive care in APAC - continuing to drive the Pharma market

Healthcare Industry Size by Product (2015)

23.2%

2.5%

70.7%

1.6% 2.0%

Healthcare Industry Size by Product (2011)

24.7%

2.4%

69.3%

1.6% 2.0%

8

• Pharmaceuticals and Biotechnology segment is growing at 11.5% CAGR.

• Medical devices is growing at 14.0% CAGR.

• Clinical Diagnostics is growing at 11.4% CAGR.

• Medical imaging is growing at 11.2% CAGR.

• HIT is growing at 9.7% CAGR.

Medical Devices Medical Imaging

Pharmaceuticals & Biotechnology Healthcare IT

Clinical Diagnostics

Medical Devices Medical Imaging

Pharmaceuticals & Biotechnology Healthcare IT

Clinical Diagnostics

Page 9: APAC Healthcare Outlook   2012 - 2015- What Comes Next

636.0649.0

677.6707.4

738.5

400.0

600.0

800.0

1,000.0

1,200.0 Market Drivers

Pharmaceuticals & Biotechnology, US$ Bn, 2011-2015

• Increased long term use of multiple and specialized drugs for the aging population.

• Enhanced health awareness and purchasing power boosting over-the-counter purchase.

• Government support for generics/bio-similars.

• Increased disease incidence boosted by availability and usage of new diagnostic

Pharma market will grow at almost triple the rate compared with the rest of the world, accounting for 1/3rd of total by 2015

CAGR3.8%

9

252.1 278.4 309.4 346.1 389.4

0.0

200.0

400.0

2011 2012 2013 2014 2015

APAC($ Billion)

Rest of the World($ Billion)

Market Restraints

APAC Share

availability and usage of new diagnostic tools.

• Patent expiry of major pharmaceutical products.

• Cost control measures by various governments.

• In markets with strong local manufacturing, government tenders favor local manufacturers.

28.4% 34.5%

CAGR11.5%

Page 10: APAC Healthcare Outlook   2012 - 2015- What Comes Next

By 2015, China will become the largest market in APACIndia, Philippines, and Vietnam expected to enjoy double digit CAGR

China

Japan

South Korea,Hong Kong, TaiwanSouth Korea,Hong Kong, Taiwan

US$ 108 billion

US$ 20 billion

US$ 100 billion

US$ 86 billion

CAGR 2%

CAGR 21%

CAGR 7%

Asia Pacific Total Pharmaceutical Market 2011-2015

US$ 184 billion

10

India

Total Pharma market 2011

US$32 billion

Total Pharma market 2015

US$ 16 billion

US$ 15 billion

CAGR 9.6%

Australia

SEA

US$ 23 billion

US$ 12 billion

US$ 16 billion

US$ 11 billion

CAGR 19%

CAGR 2%

Page 11: APAC Healthcare Outlook   2012 - 2015- What Comes Next

� Dengue Vaccine: current demand: 300-400 million; but supply is only: 100 million doses

� Most countries (except China, India, Japan) currently do not have the infrastructure to develop

vaccines

�0

� APAC generics and bio-similars market 2015: ~US$ 203 bn

� China and India are the two biggest markets but Japan’s generic market will grow at CAGR of

9% reaching 12.3 bn in 2015

Generics and

Bio-similars

Generics and

Bio-similars

VaccinesVaccines

Growth opportunities lie in segments that offer innovative products and services to save costs and prevent diseases

11

� HBV: US$ 1.2 bn; CAGR 15%; Pneumococcal Conjugate Vaccine: 442 mn (2010) double digit growth

� Influenza vaccine market: 425 mn CAGR 13.3% (Asia) [Malaysia: 27%, Philippines: 26%, Singapore:

22%]

0

VaccinesVaccines

OncologyOncology

� APAC Oncology market 2015: ~US$ 4.4 bn; up from US$ 3 bn in 2010

� Growth from early diagnosis of cancers and targeted therapy in top 3 types of cancer: lung

cancer, breast cancer and colorectal cancer

Page 12: APAC Healthcare Outlook   2012 - 2015- What Comes Next

• By 2015, Cardiology market is expected to reach $18 billion.

• Surgical procedures are growing at 12.0 %.• Japan and South Korea lead MIS in

APAC, demand for MIS increasing in Singapore, Malaysia, Australia and Thailand, driving devices market.

• Local Asian companies of

Market Drivers

170.92185.07

200.10201.19

208.69

150.0

200.0

250.0

300.0

350.0

400.0

APAC Medical DevicesLocal Asian companies spur growth through low cost products

Medical Devices Revenues, US$ Bn, 2011-2015

CAGR5.1%

12

• Technology based pricing approval remains a hurdle.

• Public hospitals practice- lowest price bidding, leads to price war.

• Inadequate training or certification for allied healthcare staff.

• Local Asian companies of Japan, China, Korea and Taiwan offering cost effective products.

Market Restraints

82.8 94.1 104.1 116.2140.0

0.0

50.0

100.0

2011 2012 2013 2014 2015APAC($ Billion)

Rest of the World($ Billion)

CAGR14.0%CAGR14.0%

26.3 36.6APAC Market Share

Page 13: APAC Healthcare Outlook   2012 - 2015- What Comes Next

By 2012, China’s medical device market size is expected to cross Japan and by 2015, China is expected to lead with 52% market share

China

US$ 32.5 billion

US$ 73.4 billion

CAGR 22.6%

Asia Pacific Top 5 markets of total medical devices market 2011-2015

Japan

US$ 34.8 billion

US$ 42.3 billion

CAGR 5.0%

South Korea

US$ 4.0 billion

CAGR 11.6%

13

Country total market 2011 Country total market 2015

US$ 4.0 billion

US$ 6.1 billion

Australia

US$ 3.0 billion

US$ 4.9 billion

CAGR 13.0%

India

US$ 2.0 billion

US$ 2.8 billion

CAGR 8.5%

Page 14: APAC Healthcare Outlook   2012 - 2015- What Comes Next

� Number of surgeries in hospitals across APAC is estimated to grow at 12.0% by 2015.

� Anesthetics in APAC growing at 12.4% alongside surgical procedures.

� In APAC, cardiology market is expected to reach $18bil by 2015, China leading with an incidence rate of

2.6 mil per year. CardiologyCardiology

Anesthetics & Surgical Anesthetics & Surgical

Population of India, Indonesia, Malaysia, Vietnam, Philippines and Thailand together is estimated to be 1.69 billion but they together represent only

6.7% of the medical devices market

14

0

Orthopedics,

& endoscopy

Orthopedics,

& endoscopy

� Orthopedics market in APAC is growing at 5.0 % CAGR, while endoscopy and laparoscopy is growing at

8.3% CAGR.

� Increase of awareness and availability of affordable, high quality MIS procedures drive these

procedures.

Page 15: APAC Healthcare Outlook   2012 - 2015- What Comes Next

• Increased demand for health screening.• Reverse innovation of customized Asian

medical imaging products to cater for different culture and population.

• R & D in medical imaging allows technological advancement - Molecular Imaging, Drug therapy combined with

Market Drivers

Medical ImagingChina is expected to own 30% of APAC market by 2015…

Medical Imaging Revenues, US$ Bn, 2011-2015

24.0425.00

26.1927.54

28.49

15.0

20.0

25.0

30.0

35.0

40.0

45.0

CAGR4.3%

15

• APAC Refurbished market for imaging equipments is expected to reach 9% growth by 2015.

• System interoperability hinders new systems adoption in hospitals.

Imaging, Drug therapy combined with Ultrasound.

Market Restraints

26.7 32.0APAC Market Share

8.8 9.8 11.0 12.2 13.4

0.0

5.0

10.0

15.0

2011 2012 2013 2014 2015

APAC($ Billion)

Rest of the World($ Billion)

CAGR11.2%CAGR11.2%

Page 16: APAC Healthcare Outlook   2012 - 2015- What Comes Next

China

US$ 2.6 billion

US$ 4.1 billion

CAGR 12.3%

Asia Pacific Top 5 markets of total medical imaging market 2011-2015

Japan

US$ 3.5 billion

US$ 5.5 billion

CAGR 12.0%

South Korea

US$ 0.7 billion

CAGR 11.8%

Japan will continue to lead the APAC Medical Imaging

16

Total country market 2011Total country market 2015

US$ 1.1 billion

Australia

US$ 0.6 billion

US$ 0.7 billion

CAGR 6.2%

India

US$ 0.5 billion

US$ 0.7 billion

CAGR 7.4%

Page 17: APAC Healthcare Outlook   2012 - 2015- What Comes Next

�0

� Mammography is growing at 11.0% in APAC.

� In 2010, Breast Cancer ranked the second major cancer among 7 Asian countries with an incidence

rate of 190,000 cases. By 2015, Breast cancer incidence rate is expected to be 22 affected people per

100,000 population

MammographyMammography

MRI MRI

� MRI market is projected to reach 11.6% CAGR in APAC between 2011-2015.

� Closed MRI systems in Japan represents the largest product category, accounting for an estimated

market share of 82% in 2011.

� Very High Field MRI system is expected to increase in APAC as newer hospitals opt for high-tech

Mammography, MRI and PET scans in medical imaging is expected to rise; as incidence rate for diseases are growing in APAC

17

0

� Very High Field MRI system is expected to increase in APAC as newer hospitals opt for high-tech

imaging machines.

� In 2010, among 7 Asian countries , 960,000 new cases of various types of cancer have been reported.

PET scans application is expected to rise.

� Screening for Neurological disorders and Multiple sclerosis are areas to penetrate.

PET scanPET scan

Page 18: APAC Healthcare Outlook   2012 - 2015- What Comes Next

Market Drivers

Diagnostics Revenues, US$ Bn, 2011-2015

• Government efforts to standardize testing by regulating diagnostic testing and instruments.

• MNCs setting up marketing and manufacturing bases in APAC and providing competition to local diagnostic companies.

• Greater acceptance of technology by physicians and growing awareness of middle class patients.

• The molecular diagnostics market is growing

Japan will continue to lead the APAC market with more than 40% market share

CAGR

CAGR

5.98%

18

Market Restraints

APAC Share

• The molecular diagnostics market is growing by 42% in India and 22.7% in China.

• Limited government budget for diagnostics.• Lack of awareness about healthcare

insurance coverage for clinical tests.• Highly price sensitive market.• Lack of awareness and accessibility of

diagnostic testing in rural areas.

14.5% 17.2%

CAGR

11.44%

Page 19: APAC Healthcare Outlook   2012 - 2015- What Comes Next

China & India will be driving the growth of the Diagnostics market in the next 5 years…

India

US$ 421 million

CAGR 16.1%

Asia Pacific Top 5 markets of total Diagnostics market 2011-2015

Japan

US$ 3.2 billion

US$ 4.5 billion

CAGR 8.7%China

US$ 1.9 billion

US$ 3.7 billion

CAGR 17%

19

Country total market 2011 Country total market 2015

US$ 421 million

US$ 766 million

Korea

US$ 449 million

US$ 564 million

CAGR 5.9%

Australia

US$ 494 million

US$ 624 million

CAGR 6%

Page 20: APAC Healthcare Outlook   2012 - 2015- What Comes Next

• Quality, regulatory and performance application growing at 11.0% CAGR.

• Patient and Revenue cycle management related application will drive HIT with 10.3% CAGR.

• Departmental Systems market size is expected to be $ 875 million in 2011, growing

Market Drivers

APAC HIT growing at global pace of 9.0%. Will APAC jump the curve?

Healthcare IT Revenues, US$ Bn, 2011-2015

22.5025.29

27.0131.00 31.96

15.0

20.0

25.0

30.0

35.0

40.0

45.0

CAGR9.2%

20

• System interoperability hinders market growth.

• Too many small vendors offering HIT solutions.

expected to be $ 875 million in 2011, growing at 7.1%.

Market Restraints

20.2 20.5APAC Market Share

5.7 6.2 6.8 7.5 8.2

0.0

5.0

10.0

2011 2012 2013 2014 2015

APAC($ Billion)

Rest of the World($ Billion)

CAGR9.7%

CAGR9.7%

Page 21: APAC Healthcare Outlook   2012 - 2015- What Comes Next

Japan & Australia leading the HIT market in 2015, Australia is growing faster and Taiwan is catching up…

South Korea

US$ 0.3 billion

CAGR 7.4%

Asia Pacific Top 5 markets of total HIT market 2011-2015

Japan

US$ 1.7 billion

US$ 2.0 billion

CAGR 5.0%China

US$ 0.6 billion

US$ 1.0 billion

CAGR 13.7%

21

Country total market 2011 Country total market 2015

US$ 0.3 billion

US$ 0.4 billion

Taiwan

US$ 0.7 billion

US$ 1.2 billion

CAGR 11.4%Australia

US$ 1.3 billion

US$ 2.0 billion

CAGR 10.7%

Page 22: APAC Healthcare Outlook   2012 - 2015- What Comes Next

APAC HIT Top 3 areas for growth potential...

Application Potential by Growth Rate

Patient and Physician Services

Patient and Revenue Cycle Management

Quality, Regulatory and

Performance

AP

AC

MA

RK

ET 10.33%

CAGR10.00%CAGR

11.03%CAGR

22

AP

AC

MA

RK

ET

Healthcare Interoperability

Platform

EHRDepartmental Systems

Application Potential by Market Size in 2011

CAGR CAGR

$517 mil(2.98%)

$875 mil(7.11%)

$725 mil(5.40%)

CAGR

Page 23: APAC Healthcare Outlook   2012 - 2015- What Comes Next

Where to place your bets in APAC: 2012- 2015 G

row

th

Silver Industry

Equipment

Mobile

Healthcare

Biosimilars

Vaccines

EMR/

EHR

IndiaChina

S.Korea

SingaporeMalaysia Vietnam

Hospital

Taiwan

Australia

Japan

Robotic surgery

Preventive healthcare &

Wellness monitoring

Philippines

Indonesia

Thailand

23

Time

Gro

wth

Molecular

Diagnostics

Equipment

(home care) MIS

Traditional pharmaceuticals

INNOVATIONTRIGGER

SUPERGROWTH

NORMALISATION LEADERSHIP

Source: Frost & Sullivan.

Hospital

Services

Digital

Imaging

Telemedicine

Page 24: APAC Healthcare Outlook   2012 - 2015- What Comes Next

Thank You

24

Thank You

Page 25: APAC Healthcare Outlook   2012 - 2015- What Comes Next

Asia Pacific Healthcare Delivery Outlook Asia Pacific Healthcare Delivery Outlook 2012 2012 –– 20152015

At the cusp of transformation and At the cusp of transformation and consumerisationconsumerisation

Rhenu BhullerVP, Healthcare Asia Pacific

December 2011

Page 26: APAC Healthcare Outlook   2012 - 2015- What Comes Next

2015…

Delivery of health at home

Consolidation of retail healthcare service model

Integration of primary and secondary healthcare facilities. Establishment of electronic medical records integrating primary and secondary healthcare

Satellite based hospital model using advanced medical technologies for increasing accessibility in rural areas

“We Accelerate Growth”26

Healthcare as a service industry

Influx of non-traditional healthcare institutions investments

New models of Holistic healthcare hubs integrating tertiary care, wellness, aged care and clinical R&D

Increasing funding opportunity for medical tourism through expanded international medical insurance

Differentiation of hospital models through specialty or holistic health platforms

Page 27: APAC Healthcare Outlook   2012 - 2015- What Comes Next

Rising middle and affluent income population fueling market growth

309334

362390

420

300

350

400

450

500 CAGR 8.0%

APAC Healthcare Delivery Market Size US$ Bn, 2011-2015

Market Drivers

• Aging & growing

Population

• Rise in chronic disease

• Manpower shortage

• Access disparity between

urban & rural regions

• Manpower shortage

• Access disparity between

urban & rural regions

Market Restraints

“We Accelerate Growth”27

-

50

100

150

200

250

2011 2012 2013 2014 2015

Note: All figures are rounded; the base year is 2009Source: Frost & Sullivan

• Rise in chronic disease

• Medical Tourism

• Rising middle and affluent

income population

urban & rural regions

• Inability to meet demand

of healthcare services in

smaller cities and rural

areas

urban & rural regions

• Inability to meet demand

of healthcare services in

smaller cities and rural

areas

Page 28: APAC Healthcare Outlook   2012 - 2015- What Comes Next

300 new public hospitals by 2012 in China

South Korea - 2015Public: 68,745 (CAGR:1.8%)

Private: 482,436 (CAGR:4.2%)

India - 2015Public:374,670(CAGR:1.6%)

Private:270,098(CAGR:3.2%)

China - 2015Public:3,057,442(CAGR:4.9%)

Private:191,038(CAGR:2.1%)

Indonesia - 2015Public :1,07,796

Projected Number of Hospital Beds - 2015

“We Accelerate Growth”28

Singapore - 2015Public :9,867 (CAGR:2.1%)

Private :3,181 (CAGR:3.8%)

(CAGR:4.3%)

Private:60,813 (CAGR:3.9%)

Philippines - 2015Public:51,204 (CAGR:1.2%)

Private: 58,524 (CAGR:3.0%)

Thailand - 2015Public:87,516(CAGR:2.6%)

Private:36,820(CAGR:1.8%)

Page 29: APAC Healthcare Outlook   2012 - 2015- What Comes Next

International Accreditations

JCI accredited hospitals in APAC have increased by almost 7-fold over the past 6 years

JCI Accredited Hospitals in Key Asian Countries, 2005 - 2011

I

M

• International accreditations (e.g. JCI) likely to become the prerequisite for hospitals targeting to participate in medical tourism

2425

30

2005 2011 JCI Accredited Hospitals in Asia

2005 2011

15 115

“We Accelerate Growth”29

M

P

A

C

T

tourism

• Stringent operational and stringent accreditation requirements likely to escalate the clinical and operational quality standards, thus increasing market competitiveness

01

0

2

0

2

9

1

9

5

17

1213

20

15

0

5

10

15

20

0 1 2 3 4 5 6 7 8 9

S. Korea China SporeIndiaMsia ThaiTaiwanPhil

Page 30: APAC Healthcare Outlook   2012 - 2015- What Comes Next

Hospital group consolidation to stretch beyond regional borders

Hospital Consolidation / diversification

� Liberalisation of services sector under ASEAN Economic Community (AEC): Investors will be ableto hold over 70 percent stake in four major services sectors, including healthcare

� Hospitals are diversifying to increase competitiveness (e.g. Bangkok Dusit aggressive increase oninvestment in non-core medical businesses, from USD 16.6 mil to USD 133.3 mil)

Year Region Description

2011 Singapore, Thailand

• Several Institutional investors (including Temasek Holdings) sold 5.85% stake in Bumrungrad

• More hospital group consolidation likely to stretch beyond regional borders

“We Accelerate Growth”30

Thailand Holdings) sold 5.85% stake in Bumrungrad Hospital

2011 Japan, Malaysia

• Mitsui acquired 30% stake in Integrated Healthcare Holdings (healthcare investment arm of Khazanah)

2011 India,SingaporeHong Kong

• Fortis Healthcare acquired Quality HealthCare Asia in Hong Kong and Dental Corporation

• Fortis agreed to pay half a billion US Dollar to buy Singapore-based Fortis Healthcare International PTE from investment company RHC in Mauritius

2011 SingaporeTurkey

• Parkway Singapore plans to buy stake in Turkish hospital group Acibadem; Acibadem runs 11 general hospitals, 8 medical centers and a laboratory and genetic diagnostic center in Turkey

I

M

P

A

C

T

borders

• More non-traditional healthcare players are likely to acquire stakes in health institutions; or vice versa, where traditional hospital players are extended to other healthcare related fields (e.g. health education, clinical research or medical device R&D)

• New found risks and challenges due to operations in unfamiliar territories

Page 31: APAC Healthcare Outlook   2012 - 2015- What Comes Next

Key Markets Healthcare Environments

India China Indonesia Malaysia Thailand Australia Singapore

Aging Population No Yes No Yes Yes Yes Yes

Dominant Distributer ofPHI

Life/ Non Life/ Health

Life/ Non Life/ Health

Life Life Life Health Life

Aging population driving the change in healthcare service delivery

“We Accelerate Growth”31

Tax Incentives for PHI Yes Group No Yes No Yes Yes

Restrictions on PremiumRates

Notify No No No No Yes notify

Guaranteed Renewal Some Some No No No Yes

Group biz as % of totalportfolio

45% 30% >20% 30% 20% <10% 25%

Page 32: APAC Healthcare Outlook   2012 - 2015- What Comes Next

“Paper-less Healthcare”

Singapore expected to achieved full EMR implementation by 2013

Singapore

Key Markets

I

M

• Improved operational and cost efficiency for healthcare providers

• Increased competitiveness for medical tourism

� Expected to achieved full EMR implementation (100% paperless) by 2013

� Currently fully integrated EMR between hospitals and polyclinics� Moving towards final phase of EMR integration with private GPs� Pipeline: National Tele-health and cloud computing integration

China

� HCIT implementation undertaken at institutional levels ,as part of China’s USD 124 billion Healthcare Reform

� High potential - Average 950 patients per physician per month

“We Accelerate Growth”32

S. Korea

M

P

A

C

T

medical tourism sectors

• EMR implementation is intended to enhance efficiency would pose new challenges to healthcare operators

� Government’s push for EMR penetration through pilot projects (e.g. U-Health)

� Adoption of EMR for tertiary hospitals has increased from 21.4% in 2005 to 77.3% in 2010

Taiwan

� Driven by 2008 Health Care Innovating Service Program � Taiwan Electronic Medical Record Template (TMT) to increase

Interoperability for national-wide through a portable and interoperable infrastructure for EMR exchange

China � High potential - Average 950 patients per physician per month (compared to 400 in the US) treated at more than 20,000 hospitals in China and most of which are still maintaining paper based patient data

Page 33: APAC Healthcare Outlook   2012 - 2015- What Comes Next

Where to place your bets in APAC: 2012-2015G

row

th

Retail healthcare service

Preventive Healthcare

Wellness

Monitoring

Home Healthcare

Service Delivery

Medical insurance portability

Internationally Accredited

Healthcare Service Facilities

IndiaChina

S.Korea

SingaporeMalaysia

Vietnam

Australia

Japan

Thailand

Indonesia

Philippines

Asia Pacific

Mobile Healthcare

Specialty based hospitals

vs. Holistic wellness hospitals

“We Accelerate Growth”33

Time

Gro

wth

Retail healthcare service

Primary and Diagnostic

stand alone centers

Satellite based

hospital model

INNOVATIONTRIGGER

SUPERGROWTH

NORMALISATION LEADERSHIP

Source: Frost & Sullivan.

Tier2 and Tier3

Healthcare Service

Center development

Page 34: APAC Healthcare Outlook   2012 - 2015- What Comes Next

Frost & SullivanAn Active Contributor to Global HC Market Development

Comprehensive

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Robust

Hosting Industry

Forums

Strategic

Expert Analysis

Recognizing

Best Practices

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Robust

End-user

Analysis

Thought

Leadership

Forums

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Thank You

“We Accelerate Growth”35

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For Additional Information

Donna Jeremiah

Corporate Communications

Asia Pacific

+603 6204 5832

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Carrie Low

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Asia Pacific

+603 6204 5910

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Jessie Loh

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Asia Pacific

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