Singapore: An Emerging Hub for Medical Devices

By Emerging Strategy

It comes with little surprise that Singapore consistently ranks as one of the top countries to do business in; the country’s infrastructure and well educated workforce attracts multinationals, SMEs and start-ups alike. What may shock some investors, however, is Singapore’s involvement in the medical devices industry – still a relatively young sector overall – and its push to become one of the top medical technology hubs in Asia.

Singapore’s medical devices industry is currently aiming to hit SG $5 billion in manufacturing output. The government is targeting up to 1 million foreign patients a year, which will contribute SG $2.6 billion (US $1.55 billion), or about one percent, to Singapore’s GDP. Already there are 30 global medical technology companies, including the industry’s leading manufacturers, who carry out their operations and R&D in Singapore.

Singapore’s Advantages

At a time when major countries in North America and Europe have experienced economic slowdowns, the ASEAN economy has maintained robust growth, particularly in the healthcare industry. Of the 10 ASEAN members, Singapore is by far the most developed and efficient healthcare provider and annually spends the most per capita on health. The country also possesses excellent transportation and communication infrastructure, making it an ideal base for further pushes into the ASEAN region.

Singapore’s medical technology sector contributes about SG $4.3 billion and around 9000 jobs to the country’s economy. To put this into perspective, 10 percent of the world’s contact lenses, over 70 percent of microarrays, and roughly half of the world’s thermal cyclers and mass spectrometers are currently produced in Singapore – numbers which are likely to rise. Medtech sectors which are already growing include cardiovascular, eye care, diagnostic, imaging, research tools, scientific instruments and orthopedics. This is largely due to the government’s interest in supporting the medtech sector, exemplified in numerous incentive schemes. The EDB’s Partnerships for Capability Transformation (PACT) was initiated in 2010 to develop the competencies of OEMs and to enable suppliers to meet manufacturing quality and certification requirements.

Healthcare Financing and Government Schemes

In terms of healthcare plans, Singapore can be placed eye to eye with some of the leading western nations, as almost 100 percent of its population is covered. Since almost all Singaporeans enjoy unrestricted access to healthcare facilities, there is little red tape, which makes for a viable industry landscape for businesses. Due to the well-developed healthcare financing schemes, it is almost guaranteed that medical treatment will be sought and paid for in case of need. For many healthcare providers and manufacturers, this means a steady and stable source of income. For start-ups and companies engaged in R&D, it presents an opportunity for their products.

Singapore’s financing framework for medtech is in fact driven by two slightly different principles – namely individual responsibility and community and government support for those in need. The family centric approach of many Asian countries dictates that an ill person should first look to themselves or family members to finance treatment. For those in need who can’t afford treatment, government subsidies and community support ensure that basic healthcare remains affordable to all.

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Overview of Healthcare Plans 

Medisave

Medisave is a national medical savings scheme which lets individuals set aside part of their income into their Medisave Accounts. Every employee can contribute eight to 10.5 percent of their monthly salary to cover future personal or immediate family’s hospitalization, day surgery and certain outpatient expenses.

How much an employee can contribute depends on their age group. Savings can be withdrawn to pay the hospital bills of the account holder and their immediate family members, in line with the financing framework outlined above.

MediShield Life

On November 1, 2015 MediShield was replaced was MediShield Life, which will offer the following:

• If a patient is faced with a large hospital bill, the plan offers better protection and higher payouts, which will ease payment demands (Medisave/cash) on patients
• Full coverage for all Singapore Citizens, including Permanent Residents, which covers aging citizens and those with pre-existing conditions
• Lifelong protection

MediShield is administered by the Central Provident Fund (CPF) Board and is essentially a basic healthcare plan. Additionally, it covers selected and expensive outpatient treatments, such as dialysis and chemotherapy.

Medifund

Medifund was set up by the Government as an endowment fund to help Singaporeans in need. It offers security for patients who face large bills and financial difficulties in paying them after obtaining government subsidies, MediShield Life, private Integrated Shield Plans, Medisave and cash.

Eldershield

The ElderShield plan was set up for people of old age and is an affordable severe disability insurance scheme which provides basic financial protection to those who need long-term care. It takes the form of a monthly cash payout to help cover out-of-pocket expenses that arise for the care of a severely-disabled person.

Labor Market

Singapore has built a well-educated and globally oriented workforce that is prepared to meet the needs of companies and which is already familiar with Asia’s healthcare needs. This multi-disciplinary workforce is supported by programs such as EDB’s Medical Technology IDEAS (Innovate, Design, Engineer for Asia in Singapore) or the Singapore-Stanford Biodesign Program.

Due to a lack of domestic competition in other ASEAN markets and the strategic geographical location of Singapore in the region, medical device companies often decide to set-up their headquarters in the city state. Currently, the medtech sector employs around 9000 workers – a number projected to grow with more than 20,000 science and engineering graduates each year and around 300,000 skilled employees in related sectors, such as pharmaceuticals.

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Government Incentives and Regulations

In addition, ASEAN has been developing a uniform system for registering and assessing medical devices across all member states. The ASEAN Medical Device Directive (AMDD) was signed by the 10 member countries in August 2014. The directive is expected to be rolled out by the end of 2015 and will require ASEAN members to adopt uniform classification criteria for medical devices. For medical device companies, this means that they will be able to more easily access a common medical device market with a market size of more than 600 million people.

A comprehensive list of grants and incentives offered by the government can be found here. Generally speaking, incentives are in the form of limited tax exemptions and deductions for establishing new business lines.

R&D and IP Security Advantages

To promote continued innovation and R&D efforts, the government launched a biomedical sciences initiative in 2000 and has since built several new research facilities to promote continued growth. Investment in R&D efforts has created high-value jobs in Singapore, with the sub-sector’s workforce reaching 31,900 in 2013 – an increase from 30,100 in 2012. Gross Expenditure on R&D (GERD) reached US $7.6 billion in 2013, rising from US $7.3 billion in 2012. Singapore’s investment in the medtech sector’s R&D stood at two percent of its annual GDP in 2013.

Besides its push to support R&D efforts and to build a supportive environment for companies’ efforts, Singapore is also attractive to carry out research overall, with the Political and Economic Risk Consultancy consistently rating Singapore as number one for IP protection in Asia.

Challenges

Although Singapore is an ideal spot to carry out research and manufacturing, the country’s medtech sector is still relatively young and is faced with a rapidly aging population, a growing middle class, and pressure on both pricing and availability. Further challenges lie in the market, such as the long path from product development to commercialization, as well as additional barriers for new market entrants. For example, obtaining a GDPMDS certificate, an initiative by the Centre for Medical Device Regulation of Singapore (HSA) which requires each organization to demonstrate its ability to maintain quality standards throughout the medtech supply chain, is needed to effectively bring products to market in Singapore.

While some may see the above as challenges, an increased focus on product quality and supply chain standards in Singapore ensures that medtech products are internationally marketable and follow a high quality standard.

Closing Thoughts

Adil Husain, Director of Emerging Strategy, comments, “As Singapore aims to become a state-of-the-art innovator in the medtech sector, foreign companies looking to enter Asia or expand Asia operations should consider the city state as a base for such activities. With the right market intelligence, Singapore’s excellent infrastructure, well educated workforce, and strategic access to other ASEAN economies make it an excellent choice. Challenges regarding its ageing population and market entry barriers can in fact be converted into opportunities with pointed regulatory, customer and target intelligence.”

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