Opportunities and Chalengges in Pharma Industry Development to Improve Indonesia Pharma Industry Competitiveness-GP Farmasi

Opportunities and Challenges in Pharma Industry Development

to Improve Indonesia Pharma Industry Competitiveness
06 October 2015

“It is Health that is Real
Wealth and not pieces of Gold
and Silver”
Mahatma Gandhi-

Why Developing Indonesia Pharma Industry?
Social Aspect

Availability, Independency,
and Sustainability of Supply

Economic Aspect

Medication Cost
Optimalization


Devisa Saving
Technology Aspect

Indonesia Herbal & Marine
Potency

Pharma Technology
Acquisition

Contribution to GDP
and Job Opportunity

Current Status Indonesian Pharma Industry

No. of Manufacturers

State Owned

Local


MNC

4

178

24

Value (IDR bio)

45,699

16,388

Share (%)

74.6%

25.4%


Growth vs. LY (%)

6.72%

15.3%

 27% of total ASEAN pharmacy market and 73% dominated by local
industry, the only country in ASEAN which dominated by national industry

Source : Kemenkes 2014, IMS Report Q2 2015

Indonesia Pharma Market has hit >60 trillion
MAT Q2 2015: Growth 8.9% (value) or 9.7% (volume)
JKN Implementation
(Unbranded Generics
VOLUME )

Branded Generics &
OTC Price 


JKN Implementation
(Unbranded Generics
PRICE )

Rp-USD
Exchange Rate 

Source : IMS Report Q2 2015

Hospital Demand 

New Product Launched 

400

82

In mio IDR

500


80
78
76

300
74
72
200
70
68

100

66
-

64

Productivity Rate per Labor

Source: http://www.ieconomics.com

GDP per Capita

Life Expectancy

Years

Indonesia Expectation Heading 2025

Indonesia Health Care Expenditure as % of GDP
Total Health Expenditure as % of GDP
(2013)
Australia

9.2%

China

5.6%


Japan

9.3%

India

4.0%

Indonesia

2.7%

Thailand

4.1%

South Korea

7.7%


Singapore

4.9%

Malaysia

0.0%

3.8%

2.0%

4.0%

6.0%

8.0%

10.0%


Government shall increase Health Care Expenditure
to 5% of APBN
(Ref. UU Kesehatan No. 36/2009 pasal 171.1)
Source : Pharmaceutical & Healthcare Countries Report Q2 2014, Business Monitor International;
Economic 360 for Indonesia Healthcare Industry, 2011, Frost & Sullivan

Indonesia Health Care Expenditure per Capita

Source : Asia Pacific Healthcare Outlook 2014, Frost & Sullivan

Strong Industry Growth & Future Objective
Indonesia Pharmaceutical National Market Value
500

300

Value T IDR

400


450 T
Optimistic Annual Growth: 20%
GDP Contribution : 1.3-1.5% (2025)

Global
Top
20

200
100

147 T

from
Global
Top
15

2015


2020

2025

Value T IDR

Import Value : +/- IDR 21 T (2013),
dominated by raw material import

needed
Rp 215 T

Indonesia Pharmaceutical Export Value

200

ABCG

Investment

-

300

Commitment

250 T

100 T

Job Opportunity

100

2 million jobs

-

2015

2020

2025

Source: http://www.kemendag.go.id/id/economic-profile/indonesia-export-import/growth-of-non-oil-and-gas-export-sectoral

Rencana Induk Pengembangan Industri Nasional
Peraturan Pemerintah nomor 14 tahun 2015

12

Indonesia Pharma Industry Roadmap Journey

Kick Off Meeting
(16 Apr 14)

Presentation to Dirjen Binfar
(05 Sep 14)

Presentation to Kepala BPOM
(16 Sep 14)

Presentation to Menteri Kesehatan I
(10 Oct 14)

Indonesian Phar
maceutical Indu
2015 - 2025
stry Road Map
December 2014

Presentation in Rakor
Kemenko Perekonomian
(05 Aug 15)

PP 14/2015:
Pharma Industry as
National Industry Priority
(06 Mar 15)

Final version
(17 Dec 14)

Presentation to Menteri Kesehatan II
(12 Dec 14)

Rakor Kemenko Perekonomian – 05 August 2015
Participants: Menko Perekonomian, Menteri Kesehatan, Menteri RistekDikti; Dirjen Kemenkes, Kemenperin, Kementan, Kemenkeu, BKPM, etc

Conclusion:
1. Deputy V Kemenko Perekonomian will develop Peraturan Presiden draft to
support Pharma Industry Roadmap implementation.
The draft then will be distributed to relevant stake-holders for feedback.
2. Deputy V Kemenko Perekonomian will coordinate with Kementerian
Kesehatan, GP Farmasi Indonesia, and relevant stake-holders to form
a task-force to ensure and monitor the roadmap implementation.

National Pharma Pillars to realize the Transformation 2025

INDONESIA PHARMA INDUSTRY AS NATIONAL STRATEGIC INDUSTRY
Vision

1. To become Top 15 World Pharma in 2025 with IDR 700 T market value

Mission

1. To satisfy domestic drugs and medication market, including JKN & KIS
2. To contribute foreign exchange, export & import substitution
3. To master pharmaceutical technology, including R&D and talent pool

JKN & KIS:
Availability, Affordability, Accessibility

Bio-Pharma

15

Vaccine

Export Program & Import Substitution:
Foreign Exchange Contribution

Natural

Chem-API

Collaborative R&D

ABGC forum Alignment

Quality and efficient Manufacturing

Infrastructure to support industry growth

Regulation to support industry

Competent Human Resource

Transformation of Indonesian Pharma Industry
From Formulation to Integrated Pharma Industry

Current
Import (API & Excipient)

Formulation

Manuf.

Dist.

Formulation

Manuf.

Dist. &
Export

Future

R&D

16

Clinical
Trial

Intermediate

API

Pharma API R&D and Manufacturing Scenario 2015 - 2025
PERIOD

API

BIOPHARMACEUTICALS

VACCINE

NATURAL

2015-2018











EPO (Erythropoetin)
GCSF (Granulocyte Colony Stimulating Factor)
Probiotic
Insulin (utk diabetes)
Stem cell protein (Wound care and cosmetics)
Somatropin
EGF (Epidermal Growth Factor)
Enoxaparin (pengencer darah)






Dengue (Demam Berdarah)
MR (Measles Rubella)
HB (Hepatitis-B)
Hexavalent (dimulai)






Sabin IPV (Inactivated Polio Vaccine)
Rotavirus (dimulai)
Typhoid Vi-Conj
Rabies (dimulai)









Dehidro-di-Isoeugenol (Ekstrak Biji Pala)
Curcumin (terkadung dlm temulawak utk liver)
Gingerol (komponen kimia dalam jahe)
Phylantin (ekstrak daun meniran)
Piperin (ekstraksi lada hitam)
Steviosid (pemanis non kalori)
Xanthorhizol (komponen minyak atsiri khas
temulawak)
Zederone



2019-2022






















2023-2025

Blood Fractionation (Albumin,
Immunoglobulin, Factor VIII, Factor IX)
Growth Hormone (hormon pertumbuhan)
Interferon (pelindung tubuh dari berbagai
virus)
Trastuzumab (antibodi monoklonal yang
dirancang untuk bekerja pada target
HER2 positive breast cancer)
Insulin
MAB (oncology)




MAB (Monoclonal Anti Body)
Insulin analogue

DTaP (Diphteri, Tetanus, acellular
Pertussis)
Hexavalent
MenACWY
New OPV type 2 (for stockpile)
Pneumococcal (vaksin pneumoni)
Rotavirus
Rabies




HPV (Human Papiloma Virus)
New TB Recombinant

Glucosamin (utk persendian dproduksi
dlm tubuh atau diekstrak melalui kulit
kepiting atau udang)
Omega-3
Resveratrol (anti oksidan alami)
Vinca alkaloid derivates
Isolat gandarusa (kontrasepsi pria dan
wanita)
Isolat alga coklat (wound care)
Isolat mikroba simbion karang laut
(antibiotik)
Isolat Guazuma longifolia




Andrographolide (anti malaria)
Etil-p-metoksi Sinamat (hasil isolasi
rimpang kencur utk pelindung kulit)
Ekstrak cacing tanah (thrombolisis)



Pharma API R&D and Manufacturing Scenario 2015 - 2025

PERIOD

API

NATURAL

CHEMICALS

2015-2018









2019-2022

Ekstrak sambung nyawa (antihiperkolesterolemia)
Ekstrak temulawak (antihiperkolesterolemia)
Ekstrak seledri (antihipertensi)
Ekstrak kumis kucing (antihipertensi)
Palm sugar
Ekstrak Cinnamomum burmanii
Fitoestrogen (Trigonella foenum-graceum)
Dermifix Wound Healing (Centella asiatica)

• Statin derivates (menurunkan kadar kolesterol:
Simvastatin, Atorvastatin, Rosuvastatin)
• Pantoprazole
• Clopidogrel
• ARV (Entecavir, Tenofovir)
• Beta-Lactam
(Amoxicillin)
• Pharma Salt (garam farmasi)
(NaCl pharma-grade)
• Dextrose pharma-grade
• Lyophilisation substances
• Pen-V
• Pen-G
• Magnesium stearate
• Paracetamol








Ascorbic Acid (vit. C)
Cephalosporin (7 – ACA)
7-AVCA
7-ACCA
7-ADCA
ARV (Entecavir,
Tenofovir)

2023-2025

Healthcare Sector Transform to Become Personalized, Predictive,
and Preventive

Genetic
Mapping

Patient
segmentation
tailored treatment
regimens

Advancements in
predictive and
preventive
medicine

Personalized
Medicine

Healthcare is becoming a precision-based industry...

Source: Frost & Sullivan Analysis

Transformation in Health Sector
FROM

TO

One size fits all

APPROACH

Personalized Medicine

Fragmented, One way

INFORMATION FLOW

Integrated, Two Way

Provider centric

FOCUS

Patient Centric

Procedure – based

REIMBURSEMENT

Bundled, Capitated

Centralized, Hospital-based

LOCATION

Decentralized, Communitybased

Fragmented, Specialized

TREATMENT

Collaborative, Shared
Information

Based on Individual Expert

DECISION MAKING

Based on Protocols and
Analytics

Treating Sickness

OBJECTIVE

Preventing Sickness
(Wellness)

Source: Frost & Sullivan Analysis

Transformation in Health Sector
Global Healthcare Spend
100%
Monitor, 10%
90%

Monitor, 12%

Monitor, 16%

80%
Treat, 35%

60%
Treat, 70%

Treat, 60%

50%
40%
Diagnose, 27%
30%
20%
10%

Diagnose, 19%
Diagnose, 15%

0%
Global

Healthcare
Spend

Predict, 22%

Predict, 5%

Predict, 9%

2007

2012

Source: Frost & Sullivan Analysis

2025

The most advantageous
way to combat many
diseases,
such
as
diabetes or cancer is to
predict
susceptibility,
characterize and begin
preventive
treatment
before the onset of the
disease
Better health through
earlier diagnosis

Increasing Lifespan

70%

Screening and Localizing
diseases is the most
efficacious
and
cost
effective
approach
to
improving quality of life

The Five Selected Future Technologies

Natural

Bio-Tech

DDS

Diagnostic

Cell Therapy

Main Opportunity for Indonesia Pharma Industry
1. Future Economy Growth will Enlarge Pharma Market Significantly

• High growth in GDP per Capita will enhance people awareness to
their health. This may lead health expenditure to 4-5% of GDP
• Government commitment to support Pharma Industry as one of
their priority in next 20 years, will boost pharma investment

• Opportunity in export market, including to advanced countries, is not
yet explored optimally today

2. High Volume Growth for Generics
• JKN will endorse high volume growth for generic drugs demand,
and may slow-down branded-generic drugs growth
• The most efficient industry, both in raw material purchase price
and operational cost, will win JKN generic drugs market
3. “Out of Pocket” Market will be still Exist and Growing
Niece-market that not covered by JKN (e.g. for aesthetic purpose) and
for some treatment which ceiling compensation is relatively small
(e.g. for cataract-medication, etc); advanced medication, premium
treatment / service, and private insurance will be the main drivers for
future “out of pocket” market

Main Challenges for Indonesia Pharma Industry
1. Dependency on Raw Material Importation
• More than 95% raw materials (pharma-grade) are still imported,
mostly from China, India, and western Europe.
• Pharma product cost structure is vulnerable to Rp-USD exchange rate
fluctuation
• Generic product price, which regulated by government, become nonfeasible due to weakening Rp-USD exchange

2. Strangling Regulation
• As Indonesia joining PIC/s, industry must adopt PIC/s regulation to
comply cGMP. At the moment, most industries (and other supporting
industries) are not yet ready to fully adopt it, e.g. requirement to use
GMP-approved raw materials starting 2016.
• Government too focus on role to “supervise” industry, while their role
to “develop” industry was still minimum

 Maturity of GMP Attitude and Compliance
5. GENERATIVE

9

Compliance is just part of how we do business
here (CAPA, QMS, QRM, MAI and CI)

4. PROACTIVE

We work sensibly on the problems that
we still find (CAPA, QMS, QRM, MAI?? and
CI?? )

3. CALCULATIVE

We have systems in place to manage
most compliance risks (CAPA, QMS and
QRM??)

2. REACTIVE

Compliance is important, so we do a lot
every time we have a problem (CA and PA??,
QMS?? No QRM)

1. PATHOLOGICAL

We haven’t ever been caught, so we
must be doing pretty good (No CAPA,
NO QMS and No QRM)

60

18

93

Continuous
Improvement (CI)
Monitoring,
Assessment and
Improvement (MAI)

35
28
14-20

Main Challenges for Indonesia Pharma Industry
3. “Jaminan Produk Halal” (JPH) Law Implementation

• UU no. 33 / 2014 requires all drugs should follow halal-certification

• UU JPH may potentially disturb products availability to support JKN
• Future pharma product will be dominated by biologic-products,
will be challenge to adopt halal-certification
• International Halal Pharma Summit (in CPhI Conference) stated
that NO international standard for halal pharma products.
4. Fast Demand Growth vs. Capacity Building
• High investment for new plant with relative low ROE, especially for
generics product
• Long lead-time to setup new production facility, dominated by permit
issuance (CPOB certification and product registration)
• Limited human-resources (Apoteker, Assisten Apoteker, Lab-Analyst)
to support Pharma industry growth, both in quantity and quality /
competency
• Threat of new MNC generic drugs player to enter the market

THANK YOU !

28

Rekomendasi Roadmap Industri Farmasi (1)
Memperkuat Struktur Industri Farmasi

• Kolaborasi industri farmasi (untuk R&D)
• Kolaborasi industri-akademisi-pemerintahkomunitas (Forum ABGC)
• Ketersediaan & kontinyuitas bahan awal dan bahan
penunjang lainnya
• Penyiapan kluster industri dan infrastruktur
• Peran Kemenkes, Kemenperin, Kemendag untuk
membina-mendukung industri farmasi
PIC: Kemenkes, Kemenperin, Kemendag, Kementan

Pengembangan Investasi

• Promosi investasi untuk industri farmasi
• Penyiapan infrastruktur dan peraturan untuk menarik dan
mempermudah investasi
• Evaluasi peraturan yang berpotensi menghambat investasi
(misalnya terkait fraksinasi darah, JPH)
• Penyediaan lahan/kluster industri dan infrastuktur
• Pengembangan industri penunjang (bahan kimia dasar,
budi daya tanaman / plant-tissue culture, dll)
PIC: Kemenkes, Kemenperin, Kementan, Kemenkeu, BPOM, BPKM

Rekomendasi Roadmap Industri Farmasi (2)
Insentif Fiskal, Pembiayaan





Harmonisasi tarif impor
Pembatasan kuota impor
Insentif pajak dan bea-masuk
Kemudahan akses pembiayaan, baik dalam & luar negeri)

PIC: Kemenperin, Kemenkeu, OJK

Teknologi dan Sumber Daya Manusia

• Pendanaan untuk penelitian dan start-up industry bahan
baku obat
• Mendorong transfer teknologi kefarmasian
• Memperkuat joint-research, baik dengan universitas
ataupun lembaga riset lainnya
• Memperjelas proses, timeline, dan screening paten
• Dukungan pengembangan SDM sesuai kebutuhan industri
farmasi
• Program pemanggilan kembali ilmuwan asal Indonesia
• Pembangunan pusat uji klinik dan CRO
PIC: Kemenkes, Kemenperin, Kemenristek-dikti, Kemenkumham, Kementan,
Kemenkeu, BPOM, BPPT, LIPI,

Rekomendasi Roadmap Industri Farmasi (3)
Pengawasan





Peredaran bahan baku obat (API), bahan penunjang, dan obat illegal
Pengendalian impor obat, khususnya suplemen dan produk herbal
HAKI
Peredaran obat melalui jalur non-konvensional, misalnya MLM dan on-line
shopping
• Implementasi peraturan yang mewajibkan industri farmasi asing
mendirikan industri berbasis riset di Indonesia
PIC: Kemenkes, Kemenperin, Kemendag, Kemenkumham, Kemenkeu, BPOM

Jaminan Penggunaan Hasil Produksi Industri

• Penggunaan untuk JKN melalui skema long-purchase
agreement
• Persyaratan bahan baku lokal untuk program pengadaan
obat pemerintah
• Pengendalian (buka-tutup) impor bahan baku obat
• Promosi ekspor dan menghilangkan hambatan ekspor
• Edukasi, pendampingan, prioritisasi oleh regulator untuk
perijinan dan registrasi produk
PIC: Kemenkes, Kemenperin, Kemendag, BPOM

Rekomendasi Roadmap Industri Farmasi (4)
Penunjang Lainnya

• Pendirian Biofarma Life Science Industry (BLSI) :
• Animal Laboratory Center (BSL 3)
• Research Center
• Manufacturing
• Bio-conservation
• Penyertaan Modal Negara (PMN) untuk lahan Jasinga
merupakan prerequisite pendirian BLSI
• Menyiapkan industri ADS (Auto Distract Syringe), cartridge,
prefilled syringe
• Menyiapkan infrastruktur cold chain
PIC: Kemenkes, Kemenperin, KBUMN, Kemenkeu