Healthcare, Regulatory and Reimbursement Landscape - Singapore, New Report Launched

Singapore’s healthcare market is driven by universal access to health insurance schemes and world-class biomedical sciences research facilities, although the healthcare market is small in comparison to those of other developed countries, due primarily to the limited size of its population.

The value of the pharmaceuticals market in Singapore increased from $489m in 2008 to $761m in 2013 at a Compound Annual Growth Rate (CAGR) of 9.3% and is expected to increase further from $776m in 2014 to $873m in 2020 at a CAGR of 2.0% (Tarn et al., 2008; DoS, 2014; EDB, 2014c).

Universal healthcare coverage covers 100% of the population. The five types of healthcare insurance plans available are Medisave, MediShield, Medisave-Approved Integrated Shield Plans, MediFund and ElderShield.

Singapore is known for its world-class biomedical sciences research facilities for the development of the pharmaceutical and medical device markets at medical technology hubs such as Medtech, Biopolis and Tuas biomedical park. The country has emerged as a regional hub for the manufacture and R&D activities of multinational pharmaceutical companies and offers excellent opportunities for Biomedical Sciences (BMS) companies via a pro-business environment, low unit labor costs, low corporate tax, and strong government support. The BMS industry consists of four sectors: pharmaceuticals, medical technology, biotechnology, and healthcare services. The BMS Industry Partnership Office (IPO) was established in 2010 and includes the National Medical Research Council, Ministry of Health (MoH), A*STAR and the Singapore Economic Development Board (EDB).

Singapore is a small country with a total population of approximately 5.4 million as of 2013 (DoS, 2014), which is less than in neighboring countries Indonesia (248 million) and Malaysia (29.9 million) (IMF, 2014f; IMF, 2014g). Domestic companies have fewer opportunities for permanent establishment due to the limited patient population, which in turn has a negative effect on the revenue generated by domestic companies, ultimately impeding pharmaceutical market growth.

The medical device market is expected to grow as Singapore strengthens its position as the region’s healthcare hub. Medical devices are imported primarily from the US, Japan and Germany (ITA, 2014). Products such as syringes, catheters and research instruments are manufactured domestically. In 2011, the output of the medical technology sector was SGD4.3 billion ($3.4 billion) and this total is expected to reach SGD5 billion ($4 billion) in 2015 (EDB, 2014a).

Singapore offers a transparent regulatory system for the drug and medical device approval application process and a strong Intellectual Property (IP) protection framework.

Singapore offers a transparent drug and medical device approval application process system with a strong intellectual property protection law. The regulatory agency for IP - the Intellectual Property Office of Singapore - is efficient and operates in a very transparent way, making it relatively straightforward for owners to protect their IPs. Singapore is ranked number one in Asia and second in the world for strong IP protection in the world, followed by Finland (IPOS, 2014a). This will help companies to protect their IP and attract them to invest in the healthcare market.

Efficient healthcare infrastructure and increasing public healthcare expenditure is expected to drive the healthcare market in Singapore.

In 2010, Singapore was ranked fourth globally for its healthcare infrastructure. The MoH is responsible for providing for the healthcare service needs of the people, through policy planning and co-ordination. Singapore’s healthcare institutions consist of public hospitals, private hospitals and specialty centers, covering the entire spectrum of clinical services, from basic health screening to dental surgery and quaternary care.

The MoH has restructured the healthcare system into an integrated care model in order to provide patients with integrated care facilities. Singapore’s healthcare system is split into six regional healthcare systems, which are supported by a regional hospital providing primary to long-term care services. Various healthcare clusters such as SingHealth and Alexandra Health have also been set up by the government to provide integrated services for patients.

Singapore’s Healthcare 2020 Masterplan aims to enhance the accessibility and quality of the healthcare system for the people so that anyone in need of healthcare services can receive the attention required within an appropriate time frame (MoH, 2012).

In 2008, the public-sector health expenditure share was approximately 30.2%, which increased to an estimated 39.7% in 2013 at a CAGR of 5.6% (World Bank, 2014j). This is expected to drive the country’s healthcare market.

Singapore’s economy is stable due to continued government initiatives, which are aimed at increasing Foreign Direct Investment (FDI) and attracting investors. These factors are important for the growth of the economy.

The country offers a stable economy for investors due to the stable government and its initiatives. Gross Domestic Product (GDP) per capita of Singapore was $56,113 in 2014 and is expected to increase further to $67,808 in 2020 at a CAGR of 3.2% (IMF, 2014a). This increasing growth in GDP per capita reflects the economic growth.

The unemployment rate decreased from 2.2% in 2008 to 2% in 2013 at a negative CAGR of 1.9% (DoS, 2014). The increase in the employment rate is due to the manufacturing operations of the medical technology and pharmaceuticals sectors under BMS, which have increased the employment opportunities in the country.

In 2014, Business Environment Risk Intelligence (BERI) ranked Singapore first among 50 countries as an investment destination followed by Switzerland and Taiwan (EDB, 2014g). Singapore continues to boost its knowledge-based free market economy, which is primarily dependent upon exports. Singapore provides a corruption-free and open market environment. The country’s exports primarily consist of consumer electronics, information technology products, pharmaceuticals, and on a growing financial services sector (CIA, 2014b).

The government has taken steps to upgrade the skills of the local workforce in order to meet the increasing demands of the domestic market. In 2010, the government launched the Workfare Training Support (WTS) scheme to encourage low-wage workers to undertake training by providing them with subsidies (up to 95% of course fees) and absentee payroll funding ($320 per annum (pa)). In 2011, the government extended the coverage of the Continuing Education and Training (CET) scheme, which was previously available only for low-wage workers, to professionals, managers, executives and technicians.

All of these measures are set to attract major investment in pharmaceuticals, medical technology production and other manufacturing sectors, while maintaining the status of being Southeast Asia's financial and high-tech hub (OECD, 2013).

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