Country Report: Indonesia - Pharmaceutical Executive


Country Report: Indonesia

Pharmaceutical Executive


Eric NG, President Director - Sanofi
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.

Parulian Simanjuntak, Executive Director - IPMG
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."


Dorodjatun Sanusi, Executive Director-GP Farmasi
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.

Johannes Setijono, Chairman-Kalbe Farma
"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 medicines."


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