POOR CARE NO MORE
BPJS implementation ends an era of uncertainty around the government's commitment to launch universal coverage. Assigned as
the chairman for the implementation of universal health care coverage in Indonesia is the country's Vice Minister of Health,
Mukti Ali Ghufrom MSc, PhD. Ghufron and his team define government commitment as a key success factor to a successful implementation.
"From a legal point of view, a law has already been formulated and launched. We have created a roadmap, together with all
stakeholders, including the unions and the Chamber of Commerce, for the successful implementation of the plan. From a financial
point of view, a budget has already been agreed upon: for 2014, an amount of IDR 1.75 trillion (USD 1.7 billion) will be provided
to cover the poor and the 'near poor'," he said.
Eric NG, President Director - Sanofi
In parallel, increasing the quality of care is seen as equally important to the Ministry. "My main concern is the quality
of our health care services. It would not make sense to provide health care to everyone in the country if its quality is poor,"
said Minister of Health, Nafsiah Mboi, Phd. "So far, we have been preparing rigorously to improve the quality of care. For
health care facilities, our vision is a very strong primary care network combined with a good quality referral system." According
to the Ministry, Indonesia now has roughly 9,500 primary care centers or one for every 30,000 people. "Although these numbers
match the required standards, we need to work on improving the quality at primary care level," she said. "In terms of hospital
care we now have 2,138 hospitals, 829 which are government owned, across the country. These hospitals have standards and accreditation
which guarantee the quality of care that we need."
Parulian Simanjuntak, Executive Director - IPMG
FROM ROSE-COLORED GLASSES TO REALITY CHECK
MNCs are ramping up their sales force, a scarce resource, to serve a growing medical community at Indonesia's private hospitals,
but they remain puzzled about public procurement opportunities to serve public hospitals and BPJS. "These companies are trying
to understand what their place will be within the system," said Parulian Simanjuntak, executive director of the International
Pharmaceutical Manufacturers Association (IPMG). "In order to contain cost, the government has already proclaimed that generics
will be mainly used under the new plan. Therefore, the question arises whether the MNCs are allowed to participate in the
generics business. "We would like more clarity on what exactly will happen with regards to the social insurance system. There
should be no limitation as to who can participate in the universal health care plan." And even though Indonesia is the fourth
most populated country in the world, big pharma still only touches a fraction of that market. Universal health care coverage,
however, is expected to enlarge the patient base that can afford innovative medicines.
Dorodjatun Sanusi, Executive Director-GP Farmasi
"Today, just about half of the Indonesian population has some sort of access to health care insurance," said Eric Ng, president
director of Sanofi Indonesia. "When you zoom into the situation however, you immediately see that the most advanced coverage
is only provided for the civil servants through the Asuransi Kesehatan Indonesia (ASKES) program. Most of the MNCs primarily
operate in this segment of the market, which at present only amounts to an estimated 20 to 30 million people. Universal health
care coverage sometimes sounds exciting, but it may not be an opportunity for everyone. The plan targets a very basic package
of health care based on low cost generics. However, we believe that the growing base of the population, which the government
aims to cover in full by 2019, will serve as a driving force to increase the overall access to medicines. We believe that
the base of the aforementioned 20 to 30 million people, which most of the MNCs target today, will theoretically increase to
roughly 120 million people in 2014 alone. While we should not assume that our business will increase proportionally because
of the price-volume effect, which implies that greater volumes will gradually push down the price of medicines, we do believe
that Sanofi will have a much greater role to play in this country when such a large number of population requires access to
Johannes Setijono, Chairman-Kalbe Farma