Overview of ASEAN healthcare market
Appendix 1: Overview of ASEAN healthcare market
Exhibit 118: ASEAN forms c.5% of world population...
Exhibit 119: ...c.3% of world GDP...
70% 20013-20 CAGR
2004-13 CAGR
20013-20 CAGR
2004-13 CAGR
2020E ASEAN-4
Rest of World
ASEAN-4
Rest of World
Source: Euromonitor, Goldman Sachs Global Investment Research.
Source: Euromonitor, Goldman Sachs Global Investment Research.
Exhibit 120: ...but only c.1% of world healthcare spending Exhibit 121: Healthcare expenditure as % of GDP of ASEAN countries is among the lowest globally (2013)
Healthcare spending
Healthcare expenditure as % of GDP
2004-13 CAGR
20013-20 CAGR
u rope s tr
Rest of World
out S
Source: Euromonitor, Goldman Sachs Global Investment Research.
Source: Euromonitor.
Exhibit 122: ASEAN-4 HC spending showed
Exhibit 124: …rising needs and affordability for strong growth at 1.2X of GDP growth and…
Exhibit 123: …2X its global market share in the
last decade; this is driven by….
better healthcare from individuals…
ASEAN-4 Global HC market share
US$bn 2004-13 CAGR
Singapore Thailand Indonesia Malaysia
Singapore: 15.2%
ASEAN-4 HC expenditure % GDP - RHS
Obesity/overweight as %
60 Indonesia : 17.9% ASEAN-4 : 14.3%
R-square with HC % GDP
Median age (yrs)
R-square with HC % GDP
GDP per capita (US$)
73% 27% 9% Source: Euromonitor.
Singapore Malaysia
R-square with HC % GDP
Source: Euromonitor.
Source: Euromonitor.
Exhibit 127: Outlook is bright as HC expenditure though lagging private spending, and…
Exhibit 125: …decent government support,
Exhibit 126: …from robust medical tourism
spending trends during this period
as % of GDP still low relative to other countries (2013)
Public HC exp % Total
Public HC exp % Total
Medical tourism as % private HC spending - RHS
OECD average 13.1%
and world average 10.5%
Thailand 4.3% Singapore 5.2% and Indonesia 3.5% and
ta n co b ia n bl ic liz e ia d go ru ent n ta Fi nes ville nei ra in
lA idad n
Source: Euromonitor.
Source: Frost & Sullivan.
Source: Euromonitor.
Exhibit 128: ASEAN hospitals generally show
Exhibit 130: ….achieved by growing beds, solid DACF growth over 2009-2013 due to….
Exhibit 129: …strong gains in revenue market
share especially in Thailand, which was…
increasing market share and price increases
25% DACF CAGR
EBITDA CAGR
Bangkok Dusit 2013 Bumrungrad Raffles Medical Bangkok Chain KPJ
Singapore Malaysia Thailand
Source: Company data.
Source: Company data, Euromonitor.
Source: Company data, MOH Malaysia, MOPH Thailand, MOH Indonesia, MOH Singapore.
Exhibit 133: …this depressed asset turns / similar to US, but less leverage/higher growth
Exhibit 131: ASEAN hospitals have high CROCI,
Exhibit 132: CROCI did decline for some hospitals
as new capacity takes time to be utilized and…
EBITDA margins
20% USA ASEAN South Africa
Tax Burden 18%
Asset turns
EBITDA margins - RHS 17%
CROCI (%)
DACF/(EBITDA - taxes)
Bangkok Dusit
Bangkok Chain
KPJ 0.6X 12% 12% 10% 8% 6%
Source: Company data, Bloomberg.
Source: Company data.
Source: Company data.
Exhibit 134: Healthcare spending to grow 1.5X
Exhibit 136: Private to outgrow public, as we GDP by 2020E (1.2X in past 10 years) as Indo hits
Exhibit 135: ASEAN-4 global HC market share
expect govt. funding to be increasingly stressed more sweet spots
and HC expenditure as % of GDP to continue to
rise
Public HC exp % Total 180
US$ bn 2014-20E CAGR
ASEAN-4 Global HC market share
Private HC exp % Total
Singapore: 9.4%
ASEAN-4 HC expenditure % GDP - RHS
Thailand: 9.0% Indonesia: 16.6%
Singapore 3.5% Malaysia Thailand Indonesia
2017E 2018E 2019E 2020E
Source: Euromonitor, Goldman Sachs Global Investment Research.
Source: Euromonitor, Goldman Sachs Global Investment Research.
Source: Euromonitor, Goldman Sachs Global Investment Research.
Exhibit 137: Rising contribution from China/LCMV
Exhibit 139: …given the roadmap of beds tourists a driver for private HC expenditure
Exhibit 138: GS-covered Indo hospitals’ revenues
mkt. share to gain most, followed by TH/MY/SG
additions ahead, and not including M&A