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healthcare review healthcare review &review
HEALTHCARE HEALTHCARE LIFE SCIENCES LIFE SCIENCES REVIEW REVIEW PHARMACEUTICALS: SHAKING UP THE SYSTEM PHARMACEUTICALS: HEALTH POLICY AT THE PAGE 21 PHARMACEUTICALS: SHAKING UP THE SYSTEM FOREFRONT: INTERVIEW SHAKING UP THE SYSTEM PAGE 21 WITH DR SUBRAMANIAM, PAGE 21 MINISTER OF HEALTH PAGE 4 & CARVING OUT A MEDICAL DEVICE MARKET CARVING OUT A MEDICAL PAGE 56 CARVING OUT A MEDICAL DEVICE MARKET DEVICE MARKET PAGE 56 AN INTERESTING PAGE 56 MANUFACTURING BASE? PAGE 12 CONVERGENCE IN ACTION: CASE STUDY: SILANES FOCUS ON DIABETES CONVERGENCE IN ACTION: PAGE 70 CONVERGENCE IN PAGE 82 ACTION: CASE STUDY: SILANES FOCUS ON DIABETES DENGUE CASESANOFI’S STUDY: SILANES FOCUS ON DIABETES PAGE 70 PAGE 82 PATROL LAUNCHES MEDICAL TOURISM: PAGE 70 PAGE JUST 82 NATIONWIDE PAGE 22 A (FLIGHT) TICKET AWAY PAGE 23 MEXICO 2013 MEXICO 2013 COFEPRIS Revamped COFEPRIS Revamped Mikel Arriola, the man who changed an institution and an industry PAGE 18 Mikel Arriola, the man who changed an institution and an industry PAGE 18 Mikel Arriola, the man who changed an institution and an industry PAGE 18 CHAMPIONING HEALTHCARE published in association with published in association with published in association with HEALTHCARE AS A NATIONAL KEY ECONOMIC AREA PAGE 7 MALAYSIA 2013 2013 2013 January 2015 Brought to you by 2 Acknowledgements PharmaBoardroom would like to thank the Ministry of Health, Dato Azman Mahmud the Ministry of Health, CEO, MIDA, Yew Wei Tarng, President, PhAMA Dr Mohamed Ali Abu Bakar, CEO, Clinical Research Malaysia (CRM) Tan Sri Dato’ Seri Dr. Robaayah Zambahari, Chief Executive Director, IJN National Heart Institute and Alexander Stedtfeld, General Manager, Malaysian-German Chamber of Commerce and Industry (MGCC) for their support, assistance, and enthusiasm! MALAYSIA JANUARY 2015 3 CONTENTS Health Policy to the Forefront 4 Championing Healthcare 7 Partnering for Malaysia’ Success 8 Four Years Down the Road 8 Entry Point Projects for the Pharma Sector 9 Three Ethnicities, One Malaysia for Clinical Trials 12 Bringing Phase 1 to Malaysia 12 An Interesting Manufacturing Base? 13 That’s Halal, Folks! 14 Sea Cucumber: Natural, Halal and Conquering New Markets 14 Outsourcing on Your Own Doorstep 16 One Care Malaysia Strides Ahead 18 Invest in Malaysia’ Healthy Future 20 Can Malaysia Compete Regionally on Healthcare? 22 SANOFI’s Dengue Patrol Launches Nationwide 23 Medical Tourism – Just a (Flight) Ticket Away 24 Beating Heart Disease in Malaysia 26 Improving Malaysian Hospitals 26 Trials & Counting 28 CCM: Pharma’s Role in a Diverse Portfolio 30 The Future of Malaysian Clinical Research 32 This report was prepared by Pharmaboardroom.com Project Director: Alina Manac Project Coordinator: Valerie Baia Contributions: Jessica Circi, Teddy Lamazere Editor: Karim Meggaro Project Publisher: Julie Avena Graphic Assistance: Nisha Albuquerque, Rahli Omar To read exclusive interviews and more info, please log onto www.pharmaboardroom.com or write to [email protected] Copyright All rights reserved. No part of this publication maybe reproduced in any form or by any means, whether electronic, mechanical or otherwise including photocopying, recording or any information storage or retrieval system without prior written consent of Focus Reports. While every attempt is made to ensure the accuracy of the information contained in this report, neither Focus Reports nor the authors accept any liabilities for errors and omissions. Opinions expressed in this report are not necessarily those of the authors. MALAYSIA JANUARY 2015 4 Exclusive interview with Malaysia’s Health Minister Health Policy to the Forefront Datuk Seri Dr. S. Subramaniam, Minister of Health of Malaysia PharmaBoardroom: The Healthcare NKEA, under The Economic Transformation Program, has been a success so far with the participation of international players. How is the Ministry of Health (MoH) collaborating and helping international investors like Servier (EPP3) participate in the development of pharmaceutical excellence in Malaysia? DATUK SERI DR. S. SUBRAMANIAM: We have been quite successful in meeting the various targets set for the Healthcare NKEA under the Economic Transformation Program. We will continue our efforts to attract both local and international companies to participate in the Healthcare NKEA, especially as lead organizations in the various EPPs. This will help grow the healthcare industry and further encourage collaboration between the public and private sectors. On June 28th, 32013, MoH signed a memorandum of understanding (MoU) with IMS Health Malaysia. This MoU facilitates the sharing of the pharmaceutical database for the public sector with the private sector. The MoH is able to tap into IMS’s pharmaceutical database on the private sector while IMS can access the MoH’s pharmaceutical database as well. EPP3 saw strong interest from private sector players in the field of respiratory medicine. Four project owners have come forward with plans to manufacture respiratory products, such as metered dose inhalers and dry powder inhalers. It has been announced that these four projects are being implemented. Malaysia is committed in the development of pharmaceutical excellence for the country. Recently, on the 23rd and 24th of September, 2014, the prime minister chaired a Bio International Advisory Panel meeting in New York City, USA. Deliberations were focused on Bio-Economy Development programs as well as on technology bridging between bio-based companies and international research and development institutions. The introduction of an Off-Take Agreement scheme under EPP3 has generated much interest for both MNCs and local pharmaceutical companies. This initiative has provided some assurances of market access for public sector purchase as well as facilitating exports of these products as these manufacturers have a record that the Malaysian government is purchasing and using their products, thereby providing confidence to the export market of the safety and efficacy of these pharmaceuticals. Under the Healthcare NKEA, a monthly steering committee meeting is held that is chaired jointly by the minister of health and minister in the PM’s department overseeing the performance management MALAYSIA JANUARY 2015 5 & delivery unit (Pemandu). The steering committee meeting also serves as a problem-solving meeting, where various parties, including those from the private sector can raise issues to be resolved. Industry organizations from the pharmaceutical industry, such as the Pharmaceutical Association of Malaysia, whose memberships are mainly from the MNCs, are represented on the Steering committee. This forum has certainly facilitated both MNCs and local pharmaceutical companies to achieve the goals of EPP3. PB: The industry has been voicing positive comments about the participation and support of the Ministry of Health in Malaysia. How are you planning to remain a true partner to the industry? DATUK SERI DR. S. SUBRAMANIAM: Malaysia is taking steps and moving forward to build a good partnership within the industry. One of the targets for 2014 is the introduction of Off-Take Agreement incentives for Medical Devices under the Healthcare NKEA. This OTA agreement for Medical Devices has similar features with the OTA for pharmaceuticals. This is one way forward to further build collaboration with the industry. “The Malaysian Government continuously strives to provide a business-friendly environment for the private sector in which to operate. These efforts have been affirmed by the World Bank, which ranked the country 6th best location in the world in which to conduct business in its Doing Business 2014 report. The World Bank’s competitiveness criteria in the Doing Business ranking include ease of starting a business, licensing approvals, tax administration efficiency, and ease of cross-border trading.” The MOH has also taken the initiative to undertake a business process reengineering a review to reduce bureaucracy and improve efficiency for stakeholders that conduct business with the Ministry, whether for permits or licenses. On this note, out of a total of 89 licenses/approvals that are granted by the Ministry, we have done away with two, while 11 were composited into seven. For the remaining seven licenses/approvals, improvements were to shorten the time taken for processing them. Moreover, for ease of submitting applications, it can be made online. The country has also taken measures to ensure the security of foreign investments, signing on to Investment Guarantee Agreements (IGA) with 58 countries, including members of the Association of Southeast Asian Nations (ASEAN), and the Organization of Islamic Cooperation (OIC). These agreements protect foreign companies against nationalization and expropriation; they ensure prompt and adequate compensation in the event of nationalization or expropriation, and assurances on free transfer of profits, capital and other fees. The MoH will continue to work closely with relevant agencies to address coordination and implementation issues in the healthcare sector as well as engaging with private sector stakeholders to better understand their needs and remain a true partner to the industry. MALAYSIA JANUARY 2015 6 MALAYSIA JANUARY 2015 pharmaboardroom.com 7 Special SponSored Section Malaysia report MALAYSIA: Championing Healthcare Credits: Ong Yong Da, 17. Ong has limited speech, yet is armed with a cheerful smile. He participates in many exhibitions locally and internationally in the “Special Artist” category. Courtesy: Deloitte Malaysia O O verver thethe lastlast decade, the Malaydecade, the sian pharma sector has grown Malaysian pharma sec- at a rate of between and ten tor has grown eight at a rate percent per year, faster than of between eight and ten percentthe country’s GDP over the same period. The per year, faster than the country’s latest WHO data for Malaysia puts spendGDP over the same period. The ing on healthcare at four percent of GDP latest WHO data for Malaysia puts in 2012, lower than many developed spending at four countries buton thehealthcare second highest expendipercent of GDP in 2012, lowerThis ture per capita in the ASEAN region. than many spending is setdeveloped to increase countries as the Malaybutgovernment the secondishighest sian aiming expenditure for universal per capita ASEAN coverage. At in thethesame time, region. in 2010, healthcare has beenis identified as one of ten This spending set to increase National Key Economic Areas (NKEAs) as the Malaysian government is with the ambition that a growing healthaiming for universal coverage. At care advance Malaysia the sector same will time,help in 2010, healthcare into a high-income nation by 2020. has been identified as one of ten According to Tan Sri Dato’ Seri Dr. National Key Economic Areas Robaayah Zambahari, chief executive (NKEAs) with the ambition that director of the IJN National Heart Instia growing healthcare will tute, one of the main rolessector of the health- care NKEA isMalaysia to encourage help advance into afurther private investment in Malaysian high-income nation by 2020. healthcare:According “While the to local has been Tanindustry Sri Dato’ dominated by the public healthcare Seri Dr. Robaayah Zambahari, sector, over the past decade, there has been chief executive director of the IJN tremendous growth of private healthNational Heart Institute, one of the care services. As such, the government, main roles of the healthcare NKEA through the healthcare NKEA, aims to is to encourage private infurther grow this further sector by encouraging vestment in Malaysian healthcare: more private investments in areas such as “While the local industry has been manufacturing of pharmaceutical proddominated the public healthucts, medicalbydevices, clinical research, care sector, over the decade, colaged-care services andpast supporting laborative efforts between public and there has been tremendous growth private healthcare providers.” of private healthcare services. As Thethe private sector currently accounts such, government, through the for 45 percent of Malaysia’s total spendhealthcare NKEA, aims to further ing on healthcare. But the dual healthgrow this sector by encouraging care system currently in place is having more private investments in areas an impact on access, according to Yew such as manufacturing of pharmaWei-Tarng, President of PhAMA, Maceuticalassociation products,for medical devices, laysia’s innovators: “One clinical research, aged-care serThis sponsored supplement vices and supporting collaborative was produced by Pharmaboardroom. efforts between public and private healthcare providers.” Project Director: Alina Manac The private acProject Coordinator:sector Valeriecurrently Baia counts for 45 percent of Malaysia’s Contributions: Jessica Circi, Teddy Lamazere total spending on healthcare. But Editor: Karim Meggaro theProject dual Publisher: healthcare Juliesystem Avena currently in place is having an impact Graphic Assistance: Nisha Albuquerque on access, according to Yew Rahli Omar WeiTarng, President of PhAMA, MaFor exclusive interviews for and more info, please laysia’s association innovators: log onto www.pharmaboardroom.com “One of the main challenges is market access or the timely access the main challenges is market access ofofinnovative drugs to patients. or the timely access of innovative In Malaysia, 60 to 70 percent of drugs to patients. In Malaysia, 60 to 70 percent patients go to public hospitals; so of patients go to public hospitals; so if if the drug is not listed in public the drug is not listed in public hospitals, hospitals, the patient does not get the patient does not get access to these access to these innovative drugs.” innovative drugs.” JanUarY 2015JANUARY FOCUS REPORTS MALAYSIA 2015S2 pharmaboardroom.com 8 Special SponSored Section Malaysia report Partnering for Malaysia’s success Servier was one of the first multinational companies to take part in an Entry Point Project (EPP). “The NKEA program, coupled with Malaysia’s PIC/S certification, show that Malaysia is ready to blossom and compete with any consolidated hub in Southeast Asia in the near future,” says Servier Malaysia’s general YB Dato’ Seri Dr. manager Glen Lingam. S. Subramaniam, Malaysia has long been in the shadow of Minister of Health other Asian hubs when it comes to healthcare, most notably from its neighbour Singapore, but also countries like Taiwan and South Korea. As a result, much investment naturally flows to these other hubs. “It is true that not many MNCs are participating to the government’s healthcare NKEA and EPPs,” Lingam admits. “This must change, as local companies have great capabilities to offer, and it is important to contribute to the sucGlen Lingam, cess of government programs such as the General Manager, healthcare NKEA. Not only are we increasing Servier Malaysia GNI, we are also creating new job opportunities and helping Malaysia become a high value manufacturing nation.” “The ministry has been working toward attracting more private companies to invest, in line with the desire of the government to make the sector more dynamic, strong and competitive,” says YB Dato’ Seri Dr. S. Subramaniam, Malaysia’s minister of health. “By working together, I am confident that we will be able to deliver an effective and responsive healthcare system that will benefit all Malaysians. Indeed, I am confident that we can truly become a nation working together for better health.” Under the agreement, Servier will transfer the technology for Diamicron MR 60mg to local manufacturer Kotra Pharma, and explore the opportunity to export locally manufactured Vastarel MR 35mg to countries in South Asia and also for supply to the public sector in Malaysia. This project is expected to augment Malaysian GNI by USD 12.43 million by 2020, and create seven new jobs. This technology transfer is one of 36 projects launched under the healthcare NKEA between 2010 and December 2013 that the Malaysian government hopes will add USD 2.06 billion to the country’s gross national product, create 26,476 new job opportunities and add new investment opportunities worth USD 1.5 billion in total by 2020. “The reception of healthcare NKEA by the private sector continues to be promising,” continues the minister, “as healthcare NKEA continues to nurture the industry by encouraging the participation from the private sector.” Lingam believes that the opportunities for multinationals in Malaysia are promising, a message reinforced by Servier’s participation in the country’s development program. “I truly encourage others to join hands and take part into the healthcare NKEA,” he says. “Every player in the industry has a role to play for the development of the country.” S3MALAYSIA FOCUS REPORTS JanUarY 2015 JANUARY 2015 This dual system may not be sustainable for much longer. “There are concerns in terms of financing the system and whether we should maintain our current dual public private system,” explains Dato’ Dr. Noor Hisham, director general of health at the Ministry of Health. “We know Dato’ Dr. Noor for sure that in the long run our curHisham, Director rent system is not sustainable.” General of Health, Increased collaborative efforts Ministry of Health between public and private healthcare providers will be a great source of growth for the pharma sector, according to Zarif Munir, partner and managing director of Boston Consulting Group Malaysia. “As companies who provide private healthcare insurance start to see the logic of partnerships with hospitals and pharmaceutical companies, it’s only Leah Goodman, Managing Director, going to increase the willingness of Sanofi Malaysia, the consumers to buy branded and Singapore and Brunei innovative products. This is what makes Malaysia a very attractive market for originators who have innovative solutions.” Four years down the road How successful has the healthcare NKEA been so far? “The NKEA has transformed the Malaysian healthcare sector, bringing a set of opportunities for many stakeholders,” opines the president of PhAMA. However, he believes more needs to be done in order to increase the effectiveness of the NKEA. “In order to boost EPP 2 and 3 we need to have the right incentives in place, which have not been present so far. This means better tax incentives, faster regulatory approval and innovative medicine funding.” But so far, the concrete investments that have come as a result of the NKEA have been impressive, as Dato’ Azman Mahmud, CEO of the Malaysian Investment Development Authority, explains: “Based on MIDA’s Investment Performance Report, investment in the pharmaceutical industry (2011-2013) under EPP 3 was USD 340 million with domestic investment of USD 164 million (46.9 percent) and foreign investment of USD 176 million (53.1 percent).” “We have been quite successful in meeting the various targets set for the healthcare NKEA,” states the Health Minister. “We will continue our efforts to attract both local and international companies to participate in the healthcare NKEA, especially as lead organi- pharmaboardroom.com Special SponSored Section Malaysia report 9 Entry Point Projects for the Pharma Sector By 2020, the healthcare NKEA aims to generate USD 10.15 billion in GNI and create 181,000 new jobs. Below are the highlighted entry point projects (EPPs) under the NKEA that impact most the pharmaceutical sector. From left: Tan Sri Dato’ Seri Dr. Robaayah Zambahari, Chief Executive Director, IJN National Heart Institute; Dato’ Azman Mahmud, CEO, Malaysian Investment Development Authority; Yew Wei Tarng, President, PhAMA zations in the various EPPs. This will help grow the healthcare industry and further encourage collaboration between the public and private sectors.” Leah Goodman, Sanofi’s general manager in Malaysia, Singapore and Brunei concurs. “Malaysia is a priority for Sanofi and we are doing everything we can to keep this priority status.” Not only is the French drugmaker involved in EPP3 through a partnership with local company Hovid, they have also been working with the government in anticipation of the launch of their breakthrough dengue vaccine. “ In 2012, Sanofi launched a program named “Dengue Patrol” in collaboration with the Ministry of Health and Ministry of Education. This program played a significant role with school children located in dengue hot spots, where we must main- magenta cyan yellow black EPP 2: Creating Supportive Ecosystem to Grow Clinical Research 1,000 clinical trials per year targeted by 2020. Aims to set up of more clinical research centers, develop more clinical practice-certified investigators and improve approval timelines. EPP 3: Malaysian Pharmaceuticals – Increasing Local Generics Manufacturing for Exports Aims to help upgrade local manufacturing plants, develop strong ties between MNCs and local manufacturers, establish off-take agreements with the Ministry of Health, and have more comprehensive national pharmaceutical data EPP 4: Reinvigorating Healthcare Travel Phase 1: Growing patient volume through extensive marketing, cross-border alliances and enhanced customer experience Phase 2: Investing in better infrastructure and specialist capacity to shift towards more profitable in-patient care Sanofi HP Artwork_1-1.pgs 12.12.2014 19:23 JanUarY 2015 FOCUS REPORTS S4 ADVANSTAR_PDF/X-1a MALAYSIA JANUARY 2015 pharmaboardroom.com 10 Special SponSored Section Malaysia report tain the information and an extremely high awareness level.” explains Sanofi’s Goodman. “The Ministry of Health and Ministry of Education have been crucial elements in raising awareness and keeping everyone alert. Government stakeholders are fundamental for the successful launching of the dengue vaccine.” three ethnicities, one Malaysia For clinical trials “Today, around 20 percent of trials are done in public hospitals and our objective is to reach at least 30 percent this year and in the near future 50 to 60 percent. Clinical trials represent a national priority and we are proud to be the catalyzer of this goal.”, explains Chua Hong Teck, the director of the Healthcare NKEA at PEMANDU, the unit charged with overseeing the implementation of the NKEAs. “Malaysia has a unique advantage over other countries: its ethnicity base,” says Leonard Ariff Abd. Shatar, acting Source: National Pharmaceutical Control Bureau From left: Rhenu Bhuller, Senior VP Healthcare, Frost & Sullivan Malaysia; Alan Ong, Executive VP for the Asia Pacific Region for INC Research CEO of CCM Berhad, a large local company, when asked about clinical trials. “Therefore diverse patient recruitment is possible in Malaysia with a community comprising people of Malay, Chinese and Indian extraction. This Asian DNA present in Malaysia allows companies to concentrate trials in Malaysia instead of having to pursue various trials in various countries, resulting in possible savings.” Tomorrow’s healthcare, today. Advanced and complete, because we care. • Take control with the most powerful health informatics solution • Managing healthcare costs in a challenging economic cycle is difficult for all stakeholders, requiring the best systems available • Accessing the right patient demographic information, clinical history, and financial coverage facilitates managing patient care • End to end solutions for hospitals, from managing assets to billing and insurance Contact us at: Malaysia (+)603 27766867 50-6-13 Wisma UOA Damansara, 50, Jalan Dungun Damansara Heights, 50490, Kuala Lumpur WP, Malaysia www.gcinfosys.com S5MALAYSIA FOCUS REPORTS JanUarY 2015 2015 JANUARY 11 There’s more than one way to solve a Rubik’s cube. There’s more than one name for each life-saving medication. As one of the largest pharmaceutical manufacturers We will leverage our expertise in sterile manufac- in Malaysia, CCM Pharmaceuticals has been meeting turing and our robust quality control mechanisms the growing global demand for high-quality to provide cost-competitive, safe and effective alternatives to brand name medication to combat biologics to treat some of the most serious and the rising cost of healthcare. life-threatening diseases and improve the lives of our customers. To further strengthen our position as the leading regional manufacturer of generic medication, CCM We will also continue to bolster our portfolio of Pharmaceuticals is prioritising the development of Halal pharmaceuticals and expand our export biosimilars, vaccines and cancer biologics in the market to enhance the quality of our customers’ coming years. lives in Malaysia and beyond. Solutions for Enhancing Quality of Life CHEMICAL COMPANY OF MALAYSIA BERHAD 13th Floor, Menara PNB, 201-A, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia • MALAYSIA • SINGAPORE • (5136-T) T : + 603 2612 3888 INDONESIA • F : + 603 2612 3999 PHILIPPINES URL : www.ccmberhad.com MALAYSIA JANUARY 2015 pharmaboardroom.com 12 Special SponSored Section Malaysia report However, not everyone is as optimistic about this fact as Shatar. “I don’t believe that we are able to become a clinical trial hub because while we are ethnically diverse, the size of populations for each is not equal,” admits Rhenu Bhuller, senior VP in charge of healthcare for Frost & Sullivan Malaysia. “While the Malaysian society is diverse, the overall population is still too small to be relevant.” “The Malaysian government is incredibly supportive of clinical trials,” says Alan Ong, executive VP for the Asia Pacific region for INC Research, a CRO, but explains that concrete advancements are needed. “Whilst the vast growth potential for clinical trials in Malaysia is very clear, the country is in need of additional talented professionals to conduct clinical research. Malaysia, like most areas where clinical development is on the rise, is in need of an influx of investigators, monitors and other research professionals.” an interesting ManuFacturing base? Under EPP 3, the Malaysian government initially set out just to promote generic manufacturing, but has recently expanded its mandate to look at OTC, supplements, biologics and vaccines, in order to boost its export platform. “The priority should be to focus on manufacturing value added products, and we must InFo KInetIcs, your cRo of choice. Better - Greater - Faster Info Kinetics www.info-kinetics.com S7 FOCUS REPORTS JanUarY 2015 MALAYSIA JANUARY 2015 also focus on being early into certain fields like biologics, for example,” opines Tan Sri Dato’ Dr. Abu Bakar Suleiman, president of Malaysia’s International Medical University. “A country will not become developed and advanced if it focuses on low cost manufacturing and basic healthcare. We need to take Malaysia to the next level and the government will play a big role in this journey to excellence.” Bringing Phase I to Malaysia In the last three years, Malaysian CRO/ SMO Info Kinetics has grown at an impressive rate. One of the keys to this has been the decision to house a centralized 25,000ft2 facility at the Gleneagles Hospital Penang, which has given the company the space for Dr. Lee Toong Chow, international expansion. The vision of Managing Director, the founder, TC Lee, is to use the in- Info Kinetics ternational model as a benchmark for the company, since its inception in 2001. Today IK is the partner of choice to some of the leading international biopharmaceutical companies. As the company’s clients move their focus to Asia, IK aims to connect them to the best regional opportunities. “Being closely associated with an international hospital such as Gleneagles and encouraged by Dr Lim Cheok Peng, ex-MD of Parkway-Gleneagles, provides me the passion and confidence to excel beyond our shores,” says adjunct associate professor Toong-Chow Lee, managing director of Info Kinetics and University of Queensland. “Secondly, the US FDA has recently inspected our facilities and uplifted our image with further accreditation. This is a key advantage for us as we are the only early phase CRO/ SMO in Southeast Asia that has been inspected by major international agencies - Germany, France and the US. This has resulted in a larger stream of international studies from Europe, North America, India, Taiwan and Japan.” It is a point of pride for countries to be able to attract Phase I trials – the sign of a well-developed research base. “Phase I trials are definitely an area where Malaysia stands behind compared to other countries in Asia Pacific,” admits Lee, “but it is only a matter of time until this improves, thanks to Malaysia’s well-established regulatory system, infrastructure, bio-diversity and multi-ethnicity population, As a member of the ASEAN committee and technical chair for BA/BE task force, we are able to share our experience with member countries to achieve ASEAN harmonisation.” “With Malaysia taking over the ASEAN chair as well as a friendly business environment, I am sure more companies from the West will use Malaysia as their gateway and platform to ASEAN. In fact, IK has begun the journey to link smart and strategic partnerships,” Lee concludes. Special SponSored Section pharmaboardroom.com 13 Malaysia report According to PEMANDU, pharmaceutical exports grew by 8 percent between 2012 and 2013, with an export value of USD 187 million, but Big Malaysian manufacturers still struggle today to make exports a major part of their turnover. “Our exports represent 11 percent of our total revenues,” explains Leonard Ariff Abd. Shatar of CCM. “Malaysia still has man- Tan Sri Dato’ ufacturing plants from the 1980s; it does Dr. Abu Bakar Suleiman, President not show an image of modernity and high of Malaysia’s standards even though many of the players International have invested in new equipment and new Medical University greenfield facilities in order to maintain quality manufacturing standards. We need to have a local industry effort to raise our standards and show to the rest of the world that Malaysia is advanced in terms of manufacturing assets and ability to meet all necessary international standards.” One way to improve exports is through government intervention. “The introduction of an Off-Take Agreement scheme under EPP 3 has generated much interest for both MNCs and local pharmaceutical companies,” explains Minister of Health Subramaniam. “This initiative has provided some assurances of market access for public sector purchase, as well as facilitating exports of these products, as these manufacturers have a record that the Malaysian government is purchasing and using their products, thereby providing confidence to the export market of the safety and efficacy of these pharmaceuticals.” Sanofi is one MNC that has partnered Leonard Ariff Abd. with a local manufacturer to boost its Shatar, acting CEO, CCM Berhad Malaysian domestic production. “Local manufacturers are going to become more and more attractive to MNCs, especially for those wanting to properly enter the public sector,” says Sanofi’s Goodman, managing director of Sanofi Malaysia, Singapore and Brunei. Today, Malaysia is Sanofi’s largest country in terms of generics production in Asia. “We know that other MNCs in Malaysia have tried making a success of their own generics without significant sustainability, so we can be proud of our achievements so far.” ing and molecules present in original patented formulas. Since quite a few innovator products have porcine or other kind of animal molecules, it has been a challenge on our side to develop halal generic equivalents and source raw materials that meet strict Halal guidelines. Halal will become the next differentiating standard in generics and market demand will dictate what manufacturers do, so CCM is proud to be a pioneer in this field At the end of the day, only doctors and pharmacists dispense medications to patients in Malaysia, so all we are hoping for is that they allow patients to have access to information and to exercise their rights to choose from the alternatives available which would include halal medications.” Nashmir Capsule is a halal-only producer, which Dato’ Kadhar Shah Abdul Razak, the company’s managing director, believes gives them an advantage over traditional pharma companies trying to move into halal. “Being a company Dato’ Kadhar Shah Abdul Razak, Managing Director, Nashmir Capsule focused on gelatin cap- that’s halal, Folks! With the global halal medicines market estimated at around USD 34 billion in 2013, Southeast Asian countries like Malaysia and Indonesia, along with the Middle East, have a natural advantage in this arena because of strong domestic markets. “We like to believe that in the sea of generics, halal is a true differentiator,” says Leonard Ariff Abd. Shatar of CCM. “When speaking about halal, ethical issues arise because of animal test- JanUarY 2015 FOCUS REPORTS S8 MALAYSIA JANUARY 2015 14 pharmaboardroom.com Special SponSored Section Malaysia report sules, you can see how we can stay true to halal principles, as it is all about the animal bone used to produce our products and this can obviously be controlled. This is how we can provide our halal guarantee. I can say with confidence that the demand is constantly increasing and our plants are struggling to keep up with customer need.” Razak explains that being a Malaysian company has its advantages in other markets. “As a Malaysian company, we are not requested to pay taxes within ASEAN countries. So for example it would be more expensive for companies in Korea, China or India to enter this market. Also, the reputation of Malaysian products, which stand for quality, might have helped. Overall, I can say that the market demand is very good not only within Malaysia but amongst ASEAN markets too. And once we consolidate our presence here, we will surely look to expand further.” outsourcing on your own doorstep “As a global services location, Malaysia is third in the world behind India and China,” explains Kana K Thamby, CEO of GCI, a healthcare IT company, but business process outsourcing has not been widely adopted by the Malaysian industrial base to date. “One of the things we do here in Malaysia is post-implementation support, which lends to the overall healthy BPO environ- Sea Cucumber: natural, halal, and conquering new markets. “In 1989, I noticed an ancient trend coming back amongst the Malaysians that saw people using boiled gamat—one of 23 species of sea cucumber present in Malaysia—as a remedy for injuries and pain,” explains Professor Dato’ Dr. Has- Dato’ Dr Hassan Bin Yaacob, Executive san Yaakob, executive chairman of Heal- Chairman, Healwell well. The initial research Yaakob con- Pharmaceuticals, ducted led to a scientific breakthrough Malaysia that was awarded first prize at Malaysia’s National Scientific Awards, and eventually, a product— Gamogen. “One of the most successful markets where our products are currently marketed is Indonesia, with a great response from consumers and impressive sales volume. Our next step will be to set up ‘House of Healin’ in Indonesia, giving patients direct access to our products.” says Yaakob. “Another country I am looking at is Saudi Arabia, and the United States, which would come naturally after the UAE. Our recent obtainment of Halal certification, which has become an anchor for the marketing of our products here in Malaysia, will definitely be of great help when entering these markets as well. The only minor concern I had initially is related to production: our factory here may not be able to cope with such expansions. But I am already considering different platforms overseas and I am confident we have exciting times ahead.” ment”. GCI operates in multiple geographical locations across the world and has experienced a wide range of BPO environments and healthcare systems. But how can this experience be brought back to Malaysia? “We hope that Malaysia continues to implement more and better systems to help serve the patient base here,” says Thamby. “It’s definitely more exciting to be here in a developing market where you have more opportunities, despite the increased challenges of a young and developing market.” Kana K Thamby, Thamby believes that the biggest hurdle Chief Executive, in implementing BPO processes in the Ma- GCI MSC, Malaysia laysian healthcare sector is budget. “It’s not so much a lack of desire to do it; the funding is just not there yet. Perhaps the formula needs to be changed. I think the national health insurance program is the right way to go, where the burden of the healthcare costs in the country are shared by the employer, the government and the patient. With this type of model there is more accountability and it reduces the burden of spending all the money on reactive care: funds can be more effectively allocated towards proactive care as well. It’s just a matter of time.” 1.pgs 12.12.2014 magenta cyan yellow 19:32 black ADVANSTAR_PDF/X-1a MALAYSIA 2015 S9 FOCUS REPORTSJANUARY JanUarY 2015 15 Info Kinetics Bioanalytical Services BA/BE Studies Ethnic Bridging Studies Analytical Method Validation Clinical Outsourcing And Contract Research Contact us at: Tel: +604-228 5760 Fax +604-228 5715 Info Kinetics Sdn Bhd / Clinical Research Centre, Gleneagles Penang, 5th Floor, 1 Jalan Pangkor, 10050, Penang, Malaysia www.info-kinetics.com Phase I, II, III Pharmaceutical Testing MALAYSIA JANUARY 2015 16 Interview One Care Malaysia Strides Ahead The director general of health at the Ministry of Health explains the need for a solid plan for the development of universal coverage in Malaysia, and how the country’s One Care Malaysia plan is progressing in its implementation. PharmaBoardroom: The Malaysian government has been pushing for the development of One Care in Malaysia. Can you tell us about the prospects of this system and the benefit for patients? DATUK DR. NOOR HISHAM: Our vision is to have the public and private sector working together, with the patient as the main focus. The private sector has done well so far, contributing to 4.6 percent of GDP, whereas the government is only spending 2.6 percent of GDP. In order to bridge the gap, One Malaysia Care system is the solution and what we have been working on for many years. While the private sector has excellent facilities and services given their high financial resources, they lack in terms of teamwork or collaborations and don’t perform training or research. For One Care Malaysia to work we need to change this. On the other hand, the public sector has limited resources and an overly large number of patients. While the poor use the public sector for obvious financial reasons, we are also seeing patients from the private sector moving to the public and this is creating huge queues. PB: In order to bridge this gap and bring together the public and private sector, what should be the focus? DATUK DR. NOOR HISHAM: For One Care Malaysia, we have engraved four fundamental pillars of success: quality, accessibility, affordably and equity. These four pillars are to be combined in different phases, which are to be implemented over time. Stage one is strengthening the public healthcare system. We must upgrade all infrastructure and equipment like we have with some of the new public clinics or hospitals like Putrajaya hospital. Also, we must provide proper training to our medical staff and ensure that we retain the best doctors in the public sector. While many decide to go to the private sector for financial purposes, we are working through this issue through our specialist program retention. While we don’t offer a similar salary, we offer incentives, research, training and conferences. We of course believe in flexibility so we would allow public doctors to perform in private hospitals on the weekends for example. We will focus on corporate culture, team work, fun working environment and professionalism in order to create the best conditions for doctors to work and stay in the public sector. We are also working on Datuk Dr. Noor Hisham, DIRECTOR GENERAL OF HEALTH, MINISTRY OF HEALTH MALAYSIA JANUARY 2015 17 a new outcome base reward system, where the doctors will be rewarded by the number of patients they attend and treat successfully. For sure this system will motivate our doctors. PB: One of the main issues with public hospitals is dealing with queues and excessive number of patients. How do you intend to resolve this? DATUK DR. NOOR HISHAM: To decongest our hospitals, we must also reengineer our services. Sometimes this means something as simple as helping customers pick up their prescribed medicine by installing a drivethrough at the hospital or send the medicines directly to their home in order to avoid long queues at the hospital. Another example is the current issue we have with fulfilling 300,000 cataract surgeries a year. While our 37 hospitals can perform around 10,000 cataract surgeries, our idea is to work in partnership with other agencies that have facilities and are able to fulfill high quality cataract surgeries. One center is capable of doing 30 operations a day or 10,000 per year; this is why there are indispensable to us. Some centers are capable of doing a cataract surgery for RM 103 (USD 33). We know that one critical factor to reduce the financial burden will be to significantly reduce hospitalization time for patients. We are therefore incorporating the pain free hospital concept where for instance every surgery has to be little invasive by performing keyhole surgery. PB: Reducing the burden on healthcare is a priority for governments worldwide. How is One Care Malaysia financed and what can we expect on the long run in terms of financing? DATUK DR. NOOR HISHAM: Integrating primary and secondary care is at the base of One Care Malaysia and the only way to reduce financial burden. While today we operate on a curative system, we must move towards a stronger preventive sys- tem. Not only will this generate huge savings, it will also help to save many lives. This is the only way to reduce the incidence of diabetes and hypertension. While we know that affordability is fundamental, we must start looking at new ways to finance our system to ensure the prosperity of our Malaysian healthcare system. Hence, we have no other option but to start charging local and foreign patients for the actual cost of treatment or operation. Foreigners will have to pay full out of pocket price or through their private insurance. Locals will also have to pay but the difference is that the government will be reimbursing. We don’t have any information regarding the level of reimbursement yet but we will be evaluating the best options in the next three years. And of course for the poor patients, they will have 100 percent full reimbursement. Many questions still arise in terms of premium and exactly what treatment will be covered, but it is fundamental for everyone to understand that this whole process of setting the foundations needs time. PB: What can you tell us about Malaysia’s goal to still remain a reference in terms of healthcare quality and implement Universal Health Coverage? DATUK DR. NOOR HISHAM: The best hospitals in the world are at the forefront in services, research and training. If we are able to implement this in private Malaysian hospitals, we can be certain that Malaysia will remain among the best worldwide healthcare providers. While many speak of implementing Universal Health Coverage UHC in the future, I would like to reply that UHC is already in place in Malaysia and WHO has already recognized Malaysia with UHC. While we are aware that UHC is perfectly implemented in our public sector, now we must transfer it to the private side and One Care Malaysia will be the key to this transition. MALAYSIA JANUARY 2015 18 Interview Invest in Malaysia’s Healthy Future The CEO of MIDA, Malaysia’s investment agency, discusses Malaysia’s potential as a pharma manufacturing hub. PharmaBoardroom: In the past years Malaysia has seen a flow of new manufacturing projects (GSK, Novartis) and joint ventures. What challenges do you see to further develop these investments and collaborations? DATO A ZMAN MAHMOUD : It is expected that more international manufacturers will look at the opportunities in cooperating with local established manufacturers through strategic partnership to manufacture their products locally. We know that it makes sense for MNCs to come into Malaysia and use the existing capabilities of local manufacturers. We have also been advising the government on setting up the right environment for investors. For instance, regulations in the pharma industry must be transparent and coherent with international standards to make Malaysia an attractive place for long term settlement. But also, companies must find attractive financial incentives as many companies today are looking at reducing costs when looking for places to manufacture and conduct clinical trials. PB: Could you give us an overview of the incentives offered to foreign and local investors? DATO AZMAN MAHMOUD: Many incentives exist in Malaysia and target a wide array of elements and stakeholders. These target manufacturing companies, high technology companies, strategic projects, Dato Azman Mahmoud, CEO, MIDA MALAYSIA JANUARY 2015 special funds, exports, services, R&D, import duty exemptions, fiscal and nonfiscal incentives. For manufacturing companies a (PS) Pioneer Status has been implemented with income tax exemption of 70 percent or 100 percent on statutory income for a period of 5 years or also the option of an (ITA) Investment Tax Allowance of 60 percent or 100 percent on qualifying capital expenditure incurred for a period of 5 years. For the production of pharmaceuticals/medicaments which involves mixing and blending activities, normal PS or ITA is granted if the company undertakes R&D activities with expenses amounting to at least one percent of annual gross sales. Also, the government is offering a (DISF) Domestic Investment Strategic Fund of RM 1 billion (USD 310 million) to accelerate the shift of Malaysian-owned companies in targeted industries to high value-added, high technology, knowledge-intensive and innovation-based industries. This fund is for manufacturing and services companies with Malaysian equity ownership of at least 60 percent. PB: Which factors are currently limiting manufacturing expansion? DATO AZMAN MAHMOUD: Countries in Asia such as India, China, Korea and Taiwan are recognised as the leading manufacturers regionally, producing and export- 19 ing a large number of drugs in bulk, as well as in dosage forms, to the more developed countries. Global competition will intensify, as these major generic manufacturers in the region increase their efforts to expand their presence in emerging markets. Competition also arises from MNCs, which acquire companies manufacturing generic products in these countries. Given the limited domestic market, there is a need for local manufacturers to venture into export markets, as part of their growth strategy. The industry will need to adopt effective measures to enhance their level of efficiency and reduce costs of production. The domestic market is also expected to face further competition from imports, as a result of trade harmonisation efforts and mutual recognition arrangements (MRAs) with trading partners, especially ASEAN countries. To facilitate and enable Malaysian manufacturers to compete on fair grounds internationally, efforts are needed to reduce and eliminate non-tariff barriers, which impose complex or ambiguous requirements or certifications, labelling, packaging and testing. PB: What is Malaysia’s main competitive advantage when facing consolidated hubs like Singapore and Taiwan or very populated countries like Indonesia and the Philippines? DATO AZMAN MAHMOUD: Malaysia is strategically located in the heart of South East Asia and offers a cost-competitive location for investors intending to set up offshore operations for the manufacture of advanced technological products for regional and international markets. The infrastructure in Malaysia is designed to serve the business community; it is one of the best in Asia. Telecommunications network served by digital and fibre optic technology, five international airports (all with air-cargo facilities), well-maintained highways and seven international seaports make Malaysia an ideal springboard to the Asia-Pacific market. With a combined population of 600 million and gross domestic product of USD 1.8 trillion (RM5.68 trillion), the ASEAN market offers immerse trade opportunities. Malaysia offers investors a young, educated, productive and cost competitive workforce, which makes Malaysia highly attractive in Asia. Backed by the Government’s continued support of human resource development in all sectors, the quality of Malaysia’s workforce is one of the best in the region. Literacy levels are high and school leavers entering the job market have at least 11 years of basic education. Also English is widely spoken as a language in the country. To this day, there are 20 public and 21 private universities and as well as more than 400 colleges, polytechnics and industrial training institutes that offer courses leading to certificate, diploma, degree and post-graduate degree qualifications. Courses related to pharmaceuticals such as pharmacy, microbiology, biotechnology, biochemistry, and biomedicines are being offered by several public universities and private institutions of higher learning, which includes: Universiti Malaya, Universiti Sains Malaysia, Universiti Kebangsaan Malaysia, and so on. Finally Malaysia has a wide availability of supporting facilities which include research institutes such as the Institute for Medical Research (IMR) and Malaysian Institute of Pharmaceuticals & Nutraceuticals (IPHARM). Also, for clinical trials we benefit from the Clinical Research Centre (CRC), comprising a network of 27 centers nationwide, acts as the one-stop-centre by providing a single point of contact to access all Ministry of Health hospitals and clinics to conduct clinical trials in Malaysia. And finally we offer high technology and science parks like the Technology park of Malaysia or the Penang Science Park. MALAYSIA JANUARY 2015 20 Interview Can Malaysia Compete Regionally on Healthcare? The president of PhAMA offers his perspectives on the implementation of Malaysia’s healthcare NKEA, and how Malaysia compares on a regional level as a healthcare hub. PharmaBoardroom: With the introduction of healthcare as one of the 12 National Key Economic Areas (NKEA) for Malaysia, great developments have come forward in the last four years. Could you share with us the strong points of this implementation? YEW WEI TARNG : The NKEA has transformed the Malaysian healthcare sector, bringing a set of opportunities for many stakeholders. Through the NKEA were developed a multitude of specialized programs called Entry Point Projects (EPPs). Two of them, EPP 2 and EPP 3, have set new ambitions for clinical research and local manufacturing in Malaysia; both are fundamental to the development of healthcare in Malaysia. PhAMA is very active in EPP 2, representing innovative companies investing in clinical research. Under EPP 2, clinical research has been expanding rapidly as a key program under the healthcare NKEA. In fact, it has been outperforming and exceeding initial targets. At the moment we can count over 300 clinical trials in Malaysia. In order to boost EPP 2 and 3 we need to have the right incentives in place, which have not been present so far. This means better tax incentives, faster regulatory approval and innovative medicine funding. The NKEA programs are well aligned Yew Wei Tarng, PRESIDENT, PHAMA MALAYSIA JANUARY 2015 with the government’s 11th Malaysian plan (2016 -2020 ) to boost various industries and grow the economy. PB: What do you believe to be the current challenges and opportunities for pharmaceutical CEOs in the Malaysian pharma market? YEW WEI TARNG: One of the main challenges is market access or the timely access of innovative drugs to patients. In Malaysia, 60 to 70 percent of patients go to public hospitals; so if the drug is not listed in public hospitals, the patient does not get access to these innovative drugs. Intellectual property is also a key issue for pharma companies and needs attention as it encourages innovation. The government needs to emphasize this for more and better innovative drugs to become available. In terms of opportunities, the pharma market is growing at a fast rate and medical tourism is becoming a real asset for Malaysia. The government has an EPP dedicated to medical tourism and such program will attract more patients to Malaysia. If we want to promote medical tourism, it also ties in well with getting access to innovative medicines, as foreign patients demand the best drugs available. In order to attract medical tourism, the government is giving tax incentives that should allow more private hospitals to adver tise and at trac t overseas patients. 21 PB: How does an increasing national income, shifting disease profiles, and ageing population affect pharma companies? YEW WEI TARNG: We believe that companies in Malaysia are facing similar challenges to the most developed western countries. Obesity, diabetes, heart disease, neurodegenerative diseases and cancer are common here, but are expanding fast. The government has set up a network of clinical research centers under the National Institutes of Health (NIH) and Ministry of Health where investigators and companies can perform their clinical trials. With over 27 branches at major hospitals, clinical trials facilities and infrastructure is still available to attract more international companies to Malaysia. In the end, with the government’s will to achieve a higher level of clinical trials, we shall see many positive outcomes. PB: What are the main competitive advantages of Malaysia among Southeast Asian countries? YEW WEI TARNG: Malaysia is attractive because we have different ethnic groups: Malay, Indians and Chinese. We also boast excellent infrastructure, healthcare institutes and hospitals where clinical trials are carried out, with high level medical and clinical trial investigators. The government is also aiming for a more competitive edge of Malaysia’s industry base. With the advantage of having a wide range of ethnicities, skilled labor and English speakers, Malaysia is an attractive place to conduct business. With a strong base of local manufacturers the government is encouraging foreign companies to work with local companies and develop contract manufacturing. The government will offer incentives to foreign companies partnering with local manufacturers using Malaysia as a regional hub. Also, with NCDs increasing at a fast pace, especially diabetes, foreign companies can provide their innovative products knowing there will be a high demand. Currently, for the public sector, innovative drugs in terms of value represent 60 percent and 40 percent in volume, while generics represent 40 percent in value and 60 percent in volume. This is encouraging, but we believe there is still room to grow for innovative drugs. PB: What can we expect for the development of the Malaysian pharmaceutical and healthcare sector in the next five years? What role will PhAMA play? YEW WEI TARNG: The government is looking at healthcare transformation with many ambitions. The government through its National health finance scheme is looking at how they can better subsidize or bring better health coverage. We believe the future lies with universal health coverage and the formulation of one and only healthcare, with the merger of public and private sector under one reimbursement system. From the industry’s side, at PhAMA we are eager to help companies embrace this transformation and lead them to even more prosperity in a sector which is already experiencing double digit growth year after year. Of course, we see generic companies at the moment gaining more momentum than innovative ones, but with the recent EPP implementations, we shall see new opportunities for innovative companies, especially with improved market access. PhAMA is actively engaged in discussions about NKEA and national health policies. These include discussions on medicine governance, market access, regulatory approval, rational drug utilization and industrial partnerships. We hope the government will not engage in cost containment measures in the coming years as this will limit the innovative development of the sector. We also want to empower consumers and raise the level of self-medication. This is supported through initiatives from our member companies. MALAYSIA JANUARY 2015 22 CSR Initiative Sanofi’s Dengue Patrol Launches Nationwide Initially launched in 2011 as a pilot program, Sanofi’s complications. The severe form of the disease, known Dengue Patrol program went nationwide across as dengue hemorrhagic fever (DHF), affects around Malaysia in 2014. The program was developed in a half a million people each year, most of them children, bid to spread awareness of dengue among younger and is the leading cause of hospitalization from dengenerations. Under the program, students gue. In countries where healthcare systems across the country are encouraged to form are strained, dengue is an enormous burpatrols that then carry out activities to proden, but the WHO aims to reduce dengue mote dengue prevention, and awareness mortality by 50 percent and morbidity by of the Aedes mosquito, in a six-week pro25 percent by 2020. gram, supervised by a teacher advisor. Sanofi Pasteur has been working on a The program consists of six compulsory dengue vaccine for more than 20 years, elements that are incorporated by the stuwhich is now the world’s most clinically and dents into the daily activities, both at industrially advanced candidate vaccine, school and at home. These elements range having gone through Phase I and II studies from community outreach programs, the in adults and children in the US, Asia and creation of a mosquito cartoon series and Leah Goodman Latin America. With large-scale Phase III a dance movement. As part of the proclinical studies currently taking place in gram, each school will receive a USD 286 grant from Latin America. Sanofi to carry out the activities. A total of seven winLeah Goodman, Sanofi’s managing director for ners will be chosen at the end of the campaign, with Malaysia, Singapore and Brunei, believes that the Denprizes awarded to all participants of the program. gue Patrol program will be crucial for Malaysia, even Deaths from dengue fever nearly tripled in Malay- when the vaccine is released. “Having access to a vacsia in 2014, compared to the same period in 2013: in cine should not make people take less precaution in just the first eight weeks of the year, hospitals recorded their environment,” she explains, before going on to 13,915 cases and 25 fatalities from the disease. Cur- praise the Malaysian ministries of health and educarently, there is no specific treatment available for den- tion for the work they have done in raising awareness gue, and remains a health priority in many Latin Amer- of dengue through supporting programs like Dengue ican and Asian countries, where epidemics occur Patrol. “This program played a significant role with regularly. school children located in dengue hot spots, where The WHO estimates up to 100 million infections we must maintain levels of information and awareper year, and although the number of people infected ness.” with dengue annually is not fully known, the organiza“Sanofi is very prepared for access to our dengue tion has set a deadline for estimating the true burden vaccine,” Goodman continues, explaining that the of dengue by 2015. The reason that cases often slip company has a production strategy in place even through the net is that dengue is often misdiagnosed: before finishing the Phase III trials. “It is truly amazing the disease spans a large spectrum of clinical symp- to know that Sanofi has been working on the dengue toms from mild non-specific illness to life threatening vaccine for the last twenty years,” she concludes. MALAYSIA JANUARY 2015 Focus on 23 Medical Tourism - Just The (Flight) Ticket Between 2009 and 2013, Malaysia has experienced and reaccreditation in 2013,” explains Zambahari. a 129 percent increase in healthcare travelers, thanks “An increasing number of hospitals are applying for to a growing awareness of the country as a medical international accreditation with JCI (Joint Commistourism destination. This has not hapsion International),” explains Klaus pened by accident. “For the past two to Boehncke, PwC’s eHealth lead for three years we have been engaged in Southeast Asia. branding Malaysia, and showcasing the The deficit of beds in the governcountry as an alternative for people seekment plan for medical tourism still ing healthcare outside of their country,” needs to be addressed, however, either explains Mary Wong Lai Lin, CEO of the directly or through some innovative Malaysia Healthcare Travel Council, the thinking. “The government is currently government organization tasked with giving incentives to hospitals to boosting the country’s status as a health upgrade their facilities as well as for destination. “We organized programs to investors to build new facilities, but I bring the awareness of Malaysia to the strongly believe in the advancement in Zarif Munir of BCG world—we organize exhibitions and trade clinical science in Malaysia as a way to shows, and we work with different stakeholders in tackle the deficit of beds—we do a lot of minimally different parts of the world, engaging them and let- invasive procedures and services, which means we ting them know that Malaysia is a destination. We don’t need long stays in the hospital,” explains Lin also work with our tourism board here in Malaysia of the MHTC. “Even a heart bypass can be done and we collaborate to brand Malaysia as a medical within a day and in the next two days the patient can tourism destination.” be discharged. So we are not talking about needing Indeed, the Malaysian government has set targets too many beds to build capacity. We are doing a lot for medical tourism, as Chua Hong Teck, director of of procedures on a daily basis—eye surgery, spinal the Healthcare NKEA at Pemandu explains. “The tar- surgery and knee replacement are done in a miniget at hand is to reach one and half million healthcare mally invasive way.” travelers by 2020, but this means we also need ten However, there are those that believe that Malaysia thousand more beds from the private sector. The still has a long way to go to become a long-term value revenue generated from medical tourism is RM 690 proposition for medical tourists. “Medical tourism is million (USD 230 million) in 2013 with 770,000 travel- not just about the medical procedure,” opines Zarif ers and this is about 15 percent growth from previous Munir, partner and managing director of Boston Conyears.” sulting Malaysia. “It’s about the end-to-end customer This effort is paying off: Malaysia was recently experience. From the time that you land, through to ranked as the third best place to go for quality and the time that you leave and get post-operative care, affordable care. Reasons cited in the survey included everything has to be geared up to enable medical Malaysia’s cultural diversity, level of English and tourism to flourish. If you go to Thailand, for example, access to medicine and medical procedures, accord- it feels like a complete solution and customer centricing to Tan Sri Dato’ Seri Dr. Robaayah Zambahari, ity is pivotal to the offering. Today this is only seen in chief executive director of IJN National Heart Insti- pockets in Malaysia. It is only my opinion, but I think tute. This has come along with improved standards Malaysia is at a disadvantage: people who can afford and international accreditation at medical facilities. it prefer to go to Singapore where they can get sophis“IJN has taken great strides in achieving international ticated clinical care, and people who are looking for accreditation, having been first obtained the Joint an affordable solution and a total experience will go Commission International JCI accreditation in 2009 to Thailand or India.” MALAYSIA JANUARY 2015 24 Interview Beating Heart Disease in Malaysia The National Heart Institute’s CEO offers her perspectives on the impact of the healthcare NKEA on hospitals, and specifically on the prevention of heart disease in Malaysia PharmaBoardroom: How would you define IJN’s role in the context of the healthcare NKEA implemented in Malaysia in 2011? TAN SRI DATO SERI: Institut Jantung Negara (IJN) or National Heart Institute is a stand-alone institute for cardiovascular and cardiothoracic care, incorporated in September 1992, with the Ministry of Finance as the principal shareholder. IJN is a leading provider of comprehensive integrated cardiovascular and thoracic care services in Malaysia. As the national referral center for cardiovascular disease, IJN sees new cases referred from all over the country as well as follow-up cases at the outpatient clinics. The center is equipped with the best in class technologies and is poised to become the market leader in Asia by offering a comprehensive range of services for cardiovascular medicine with a wide range of interventions – medical, interventional and surgical. PB: What are your thoughts on the positive effects of the healthcare NKEA in Malaysia since it was introduced? TAN SRI DATO SERI: The healthcare sector has seen robust growth over the past decade and this sector has one of the highest multipliers in the economy in Malaysia. Changing demographics, a more affluent society and more health-conscious lifestyles have led to the creation of a robust domestic industry. While the local industry has been dominated by the public healthcare sector, over the past decade, there has been tremendous growth of private healthcare services. As such, the government, through the healthcare NKEA, aims to further grow this sector by encouraging more private investments in areas such as manufacturing of pharmaceutical products, medical devices, clinical research, aged-care services and supporting collaborative efforts between public and private healthcare providers. PB: What is the institute’s commitment when it comes to developing clinical trials in Malaysia? TAN SRI DATO SERI: Research and development are among the ingredients of a center of excellence. The mechanisms for research and development to progress are in place – research committee, research department with a qualified statistician as the head and with 11 clinical research assistants and 11 officers handling data management. In the field of research, we also have established memorandums of agreement and understanding with universities including University Kebangsaan Malaysia, University Technology Malaysia and Baker IDI Heart and Diabetes Institute in Melbourne, an independent, internationally renowned medical research facility. IJN has been involved in numerous multinational multicenter clinical trials, many of Dr Robaayah Zambahari, TAN SRI DATO SERI, CEO, IJN NATIONAL HEART INSTITUTE MALAYSIA JANUARY 2015 25 which subsequently were published in established international medical journals and the outcomes of some of these clinical trials have impacted our clinical practice and have become guidelines in our management of patients. PB: Medical tourism is also on the government’s agenda with great opportunities to grow considering what Malaysia offers. What are your views on this phenomenon and does the Institute have an interest in specifically attracting international patients? TAN SRI DATO SERI: Between 2009 and 2013, Malaysia experienced a 129 percent increase in healthcare travelers. Malaysia was recently ranked as the third best place to go in the world for quality and affordable care. Accessibility, language proficiency and cultural diversity have made our country stand out from its regional peers in the last decade. This, combined with IJN’s clinical excellence in cardiovascular and thoracic care, has led us to conclude that medical tourism is an opportunity for us to attract more international patients. Playing our role in supporting the government’s initiative towards medical tourism, we have equipped our facilities and services to meet the demand and needs of foreign patients. An international patient center has been set up in IJN, with the brief of facilitating the travel and logistics of international patients and accompanying family members. Here, the members of the IJN international patient services team provide assistance such as helping with flight arrangements, arranging for visas and helping with immigration clearance, coordinating the exchange of information between the specialists at IJN and the patient’s own doctor in his or her home country, and assisting with admission and discharge matters such as bill payment, insurance claims and medical leave. PB: What role does IJN play in raising awareness around the prevention of heart disease in Malaysia? TAN SRI DATO SERI: As an established leader in educating the community, we discuss heart disease awareness and prevention, often with health screening, at functions like world heart day, international women’s day, at corporate organization’s visits to IJN, and also when we are invited to corporate organizations’ staff days. We also regularly conduct corporate social initiative programs in various areas in the country. During these sessions, there will be health talks by health professionals on heart disease and prevention, health screening of height, body weight, blood pressure, blood sugar and cholesterol, with the results being looked over by counselors. Where feasible, we also demonstrate Cardio Pulmonary Resuscitation (CPR) techniques. PB: As the founder and charismatic leader of the National Health Institute of Malaysia, what would you like to achieve in the coming years for the Institute, for cardiology worldwide and for the international reputation of Malaysia? In Malaysia, heart disease is the main cause of death in Malaysian hospitals, for both men and women, accounting for approximately 25 percent of total deaths. We have to prevent this disease. Prevention needs to be done at various levels. From primary prevention for those not yet afflicted, to the detection and management of risk factors, with healthy lifestyle as the mainstay of treatment, and medications only if healthy lifestyle is inadequate in reaching targets. The next level is detection of disease and management of disease and its consequences. Again healthy lifestyle is the mainstay of treatment, and, if necessary, medications and intervention (coronary angioplasty or coronary artery bypass graft surgery). After these procedures and surgery, there remains the need for prevention of disease progression and hence, healthy lifestyle remains an important component of treatment. TAN SRI DATO SERI: PB: I would like IJN to continue to grow, in provision of quality healthcare, in research and education, and contribute towards a healthier Malaysian society. TAN SRI DATO SERI: I would like for Malaysia’s reputation to grow and be known for its healthy society and the advanced level of its healthcare. MALAYSIA JANUARY 2015 26 Interview Improving Malaysian Hospitals The president of International Medical University Malaysia discusses the challenges currently being faced by the country’s hospitals, and what can be done to retain talent in the country being trained by IMU today. PharmaBoardroom: What are the biggest challenges for improving medical educational standards in Malaysia today? TAN SRI DATO DR ABU BAK AR SULEIMAN: The issue is about how to develop human capital that is appropriate for the needs of the industry. We need to get our graduates up to the standards and requirements of the industry. This is not, however, peculiar to Malaysia; many countries around the world are facing this problem, because of rapid advances in science and technology: education has to run to catch up. In Malaysia, the government has been trying to improve upon this in the past ten years, however, it’s not been improving quickly enough for the needs of the industry. The focus needs now to be on the quality of education and the application of knowledge, rather than on the acquisition of knowledge alone. These are the major issues where we are trying to make a change. PB: How many companies are partnering with International Medical University (IMU) on the healthcare side at the moment? TAN SRI DATO DR ABU BAK AR SULEIMAN: IMU has over 30 partners internationally. We have a big research program; however, we are a small university, and we are private. We focus Tan Sri Dato Dr Abu Bakar Suleiman, PRESIDENT, IMU MALAYSIA MALAYSIA JANUARY 2015 on research and we also cater to the needs of the industry. PB: There is a double brain drain taking place here in Malaysia at the moment—doctors moving from the public sector to the private sector, and healthcare and medical practitioners moving from Malaysia to other countries, mainly due to higher salaries in other countries. How do you think this issue can be con tained? TAN SRI DATO DR ABU BAK AR SULEIMAN: We have to try to make things more attractive so they want to come here. Half the doctors in Singapore are Malaysian. We send a lot of our graduates to the US, the UK and Australia where they get their training and, subsequently, they get jobs there. So we have to work harder to make it attractive here so they want to come back. Other wise, it’s a waste of our expertise. We are seeing though, that as we build more and more new hospitals, they are starting to come back. Of course, our earning power is low in Malaysia, which is a problem; but on the flip side, the cost of living is so much lower here as well than it is in Singapore, for example. As the country develops, more and more of our doctors will come back. 27 PB: Would you agree that Malaysia does not have enough experienced business managers and CEOs to lead both local and multinational companies? Do you think that Malaysia has enough talent to cope with current demand? TAN SRI DATO DR ABU BAKAR SULEIMAN: We are growing too fast and human capital is a major problem here, which is why the current focus on education is so high. We need more capability for learning in this country—learning on the job, for example. And likewise, we need to invest more in education. The other thing that is important when you want to be a developed country is the way in which you do things, which must meet the mentality, philosophy, value system, and standards of a developed country. In terms of human capital, we need to train them up—to be excellent hospital managers, for example. We are growing too fast and human capital is a major problem here, which is why the current focus on education is so high. We need more capability for learning in this country PB: What is the best healthcare model for Malaysia, and how do you see this developing in the coming years? PB: Where do you see the growth of the healthcare and pharmaceutical industries in the next three to five years? Is it capable of maintaining a 10 percent growth rate year-on-year? TAN SRI DATO DR ABU BAKAR SULEIMAN: It’s going to be tough. For Malaysia the priority should be to focus on manufacturing value added products, and we must also focus on being early into certain fields like biologics, for example. A country will not become developed and advanced if it focuses on low cost manufacturing and basic healthcare. We need to take Malaysia to the next level and the government will play a big role in this journey to excellence. TAN SRI DATO DR ABU BAKAR SULEIMAN: The Philippines’ healthcare system is a good example for us. We want the standards from the west, but we have to do it in our way; for example, patient safety and product safety are very important and there is no compromise in this. But, to achieve this you have to take into account context—the training is critical, there’s no way you can avoid it. But, the software and how we motivate people and build solid relationships with people has to be local, Malaysian. The incentives are the same wherever you go, but putting it into a local context is very important. industry, there are a lot of questions to address, and these trade agreements won’t be sufficient alone to develop exports for these companies. When talking about pharmaceuticals and medical devices, our companies certainly are very competitive, but the government must also allow us to be competitive. We have witnessed many government practices which have distorted the pharmaceutical industry and therefore it is necessary for the government to be closer to the industry and understand how collaboration can be beneficial for both sides. PB: We have seen the rise of exports, which will only increase with the Transpacific Agreement and Asian harmonization. What is your perspective on these trade agreements? TAN SRI DATO DR ABU BAKAR SULEIMAN: In terms of the local pharmaceutical MALAYSIA JANUARY 2015 28 Company profile Pharma’s Role in a Diverse Portfolio Launch of Insugen. Photo Credit: CCM 2013 was not an easy year for CCM Group, with poor market conditions affecting the performance of the group’s chemical and fertilizer divisions. However, its third main division, pharmaceuticals, delivered strong results, with before tax profit increasing by 34 percent to RM 34.1 million (USD 9.49 million) on the back of higher revenues of RM 295.9 million (USD 82.32 million), a four percent increase from 2012. The pharma division saw increased sales in both the public and private sectors domestically, while also increasing export sales. MALAYSIA JANUARY 2015 On the R&D side, CCM has one product currently in clinical development, an erythropoietin (EPO) biosimilar developed for use in the treatment of anemia in end-stage kidney failure patients, in collaboration with PanGen of South Korea: clinical trials have already commenced in both South Korea and Malaysia. The development of this drug is part of the company’s strategy to Commercialize biotherapeutics while eliminating the need to invest in very expensive clinical trials and long gestation periods to deliver them to the market. The partnership with PanGen was strengthened further with the conclusion of a purchase of a 13.86 percent equity stake in the company by CCM in December 2013. The equity stake is reciprocated through exclusive marketing and commercialization rights in Malaysia, Singapore and Brunei, granted to CCM for all biotherapeutics developed by PanGen. In this regard, CCM’s equity stake in PanGen allows its pharmaceuticals division to have strategic access to a biotherapy product pipeline as there are very few start-up biotherapy companies globally with the expertise, track record and range of cell lines already developed by PanGen. In addition to its partnership with Pangen, CCM 29 is also collaborating with India’s Biocon to market its range of human insulin products in Malaysia, supplementing the portfolio of biotherapeutics being developed by CCM. Through its product pipeline strategy initiative, launched in 2012, CCM’s pharma division continued to launch new products throughout 2013 such as Dermoplex Simple Cream (for skin relief), Acetan HCT 50mg & 100mg (for high blood pressure), Dexproco Syrup (for cough and cold), CCM Cyanocobalamine (Vitamin B12 injection) and Duopidogrel (anti-thrombotic agent). Internationally, CCM has been expanding its presence in regional markets, with Singapore and the Philippines showing strong growth and profitability in recent months. Halal has also become a key area of interest and potential growth for the company, with the company obtaining the first halal pharmaceutical standard in 2013. As demand for halal products continues to grow in Malaysia, CCM is well positioned to capitalize. In 2013, Frost & Sullivan named CCM’s pharmaceutical division the generic pharma company of the year at its annual Malaysia Excellence Awards. In 2014, CCM’s pharma division had planned to have a successful year on both commercial and operational fronts. Commercially, 2014’s objective was to improve domestic market penetration initiatives, launching of new products and a continued push in export markets. Operationally, in 2014 CCM aimed to focus on supply chain to support a continuing growing business, looking at long-term storage capacity and depot management. With a continued focus in biotherapeutics, niche therapeutic areas, revitalization of OTC range, regional expansion and Halal leadership in the pharmaceutical space. MALAYSIA JANUARY 2015 30 Interview The Future of Malaysian Clinical Research The managing director of Info Kinetics remains optimistic about the future of clinical research in Malaysia and expects the country to come a true hub for Phase I by 2020 with the help of entrepreneurially-minded scientists. PharmaBoardroom: What are, in your opinion, the key aspects of clinical research that Malaysia should be looking to improve? Toong-Chow Lee: Phase I trials are definitely an area where Malaysia stands behind compared to other countries in Asia Pacific. In fact, Info Kinetics is the only organization pursuing a specialization in Phase I research. The government is not actively marketing Phase I trials and this results in a lot of skepticism amongst Malaysians to participate. However, this is definitely a matter of time and nothing that cannot be solved with more exposure and publicity. set guidelines. We have not yet achieved 100 percent of our initial goal. However, I would say we are now at 70 percent. It is my personal belief that it is relatively easy to reach 50 percent of an objective. What requires the most effort is reaching 90 percent, and to do this, the manner in which the development is managed is what is important. Having worked in this industry for 23 years, I am very optimistic about the future and I predict it will take us another five years to reach 90 percent of our goals. PB: Have you experienced any tangible development brought by the healthcare NKEA and how far do you believe Malaysia has progressed until now? Toong-Chow Lee: I am very pleased with the support the government has been giving and the generous funds they allocated towards regulations, as this will increase our exposure overseas. The government is open to discuss changes in current policies and PB: How important is it for Info Kinetics to partner up with other CROs and what do you hope for the company in the future? Toong-Chow Lee: Malaysia has been moving into two sectors: CRO (clinical research organization) and SMO (site management organization). Info Kinetics is a CRO specialized in Phase I. However, as the overall margins that CROs can make will drop, we hope to be more than that in the future. Organizations I am very pleased with the support the government has been giving and the generous funds they allocated towards regulations, as this will increase our exposure overseas. Toong-Chow Lee, MANAGING DIRECTOR, INFO KINETICS MALAYSIA JANUARY 2015 31 such as Quintile have decided to localize their costs to the Malaysian market and I believe this is the reason why they have been so successful. Other companies are still using international prices, which might be making them uncompetitive. Eventually, I hope for Info Kinetics to become part of a conglomerate or an alliance of international importance. What is most important for the future of the industry is know-how and this is something we definitely have here. We do not have a marketing team and we rely a lot on word of mouth but I would definitely appreciate working closely with more CROs and SMOs in the future. PB: How long do you think it will take for Malaysia to become a hub for early stage trials? Toong-Chow Lee: Malaysia can already be considered a hub for Phase III trials. The difficulty lies in people’s mindsets. I once told the Minister of Health that if I were the CEO of a government CRC (clinical research center), I could increase their revenue by 100 times! Being in this hospital gives us a close reach to patients and therefore I have changed our strategy towards Phase II as our expertise in Phase I will be a great advantage. Personally, I believe our forte will be Phase I and Phase II. Phase II will be possible for Malaysia to take up, but becoming a Phase I hub will not be easy. We would need a lot more understanding in terms of side effects but it would also require a lot of government support which I am not sure would be the case. Malaysia needs scientists with entrepreneurial spirit to become a hub for Phase I, and such individuals are not easy to find here at the moment. I do believe the government has done a lot to help and I genuinely think they understand the situation but one thing that can definitely be improved is the link between the private sector and government services. Malaysia needs scientists with entrepreneurial spirit to become a hub for Phase I, and such individuals are not easy to find here at the moment. I do believe the government has done a lot to help and I genuinely think they understand the situation but one thing that can definitely be improved is the link between the private sector and government services. PB: Info Kinetics is the leading organization for Phase I trials and recently managed to partner up with great hospitals like Gleneagles. How have these recent successes financially manifested in the past three years? Toong-Chow Lee: We are a company that always sets long-term goals. We are not a listed company that only looks at the bottom line. Our profits actually benefit our hosting hospital: 50 percent of our budgets go to the hospital and this helps to maintain a great relationship with Gleneagles. Looking at what makes us most welcome, first of all, we introduce new techniques that are necessary in research but are not usually part of the hospital’s general routine, so they appreciate our knowledge and give us great support. Financially, we are growing at a rate of 30 percent. However, in my view, this is still not good enough. Our team is composed predominantly of scientists and I am sure that if we had more business-minded people like at Quintiles, we would be growing at a much faster rate. MALAYSIA JANUARY 2015 32 Interview 22 Trials & Counting “Clinical trials are an area where we want to build capabilities, both internally and externally,” says Novartis’ Corporation Malaysia President and Managing Director. Novartis with 22 ongoing trials is one of the leaders in Malaysia and clearly understands the benefits as the government is promoting trials through the healthcare NKEA. PharmaBoardroom: Among the efforts that have been implemented by the government recently, especially with the healthcare NKEA program, how is Novartis performing on the clinical trial side? MICHAELA DINBOECK: The government has done a great job at raising the profile of Malaysia as a destination for good clinical trials. Since Novartis is an innovation driven company and we hold one of the richest pipelines in the industry covering a wide range of diseases, it has been mutually beneficial to perform clinical trials locally. Clinical trials are an area where we want to build capabilities both internally and externally. Therefore we have run training workshops with over a hundred scientists and experts on how to establish strong scientific hypotheses or write applications. All of these workshops have the aim to reinforce the local capabilities which then allows us to run good clinical trials. We are currently running 22 clinical trials in Malaysia with 900 patients involved and we are developing various feasibility studies to bring in more trials. Malaysia therefore represents an important trial site for the group. English is well spoken and the government supports the industry and intervenes if we are facing issues. This is not the case in many countries. Finally, Malaysia has an increasing number of institutions capa- ble of running high quality studies, which is fundamental for us. The trials we conduct are part of global multicenter studies, which means they fulfill the highest criteria and standards in terms of data, processes, safety and results. We are conducting trials locally in heart failure, oncology and ophthalmology. PB: Could you take us through the industry’s market access challenges, and the necessary steps needed before getting your products registered on the “blue book”? MICHAELA DINBOECK: The regulatory process in Malaysia is relatively straightforward; with a timeline of 12 to 15 months for non-high risk disease areas or six to nine months with fast track regulatory approval for high demand and crucial medicines targeting the most important diseases. Once this regulatory approval is fulfilled, it is possible to launch our products on the private market - The public sector requires getting listing in the blue book. From an industry perspective it is an advantage to be able to directly launch products on the private sector, while getting listed for the public sector. To access the blue book you need to go through many different steps. The first step is that you need to have a base of doctors who would be willing and Michaela Dinboeck, PRESIDENT AND MANAGING DIRECTOR, NOVARTIS MALAYSIA MALAYSIA JANUARY 2015 33 Our biggest challenge is retention of talent as there is virtually no unemployment. Therefore we see that many companies are competing for the right talent, making retention even more challenging. interested to use your product. Once they find this product to be of value, there are a series of administrative processes. Once these are fulfilled, you get listed in the blue book. Listing in the blue book is not a guarantee for funds. Registration is a straight forward process, whereas government reimbursement for broad patient access to certain drugs still requires multiple steps and effort. So far, we have blue book listings in diabetes, hypertension, ophthalmology, neurology and oncology. PB: What do you see as the main challenges faced by Novartis in Malaysia? MICHAELA DINBOECK: Managing the uncertainty around the implementation of the “One Care” program as well as the GST (Goods and Services Taxes) represent a challenge. Both will demand very different strategies and so far it is impossible to know what will be the best way to address these two issues. doing as well, we decided it would be mutually beneficial to work hand in hand on these matters to take them to the next level. In this sense, the MoU was very positive. PB: Building the right team is one of the key success factors for any pharma CEO anywhere in the world. In an emerging market, finding human capital may be even more challenging. What are your observations of the situation in Malaysia? MICHAELA DINBOECK: Our biggest challenge is retention of talent as there is virtually no unemployment. Therefore we see that many companies are competing for the right talent, making retention even more challenging. Novartis has implemented various human resources programs beyond the usual talent mapping and development planning to help develop new capabilities and to keep associates motivated. One of the most interesting ones is our program called “Be Healthy”. Be Healthy is a health and well-being initiative that encourages our associates to live healthier lives As part of a global initiative, Novartis participates in a corporate challenge, where every affiliate and participant competes on who is walking the most number of steps. Many of our employees have decided for instance to use the stairway instead of the elevator, and have moved from the average 10,000 steps per day to as high as 29,000 steps a day. Two years ago, Novartis Malaysia began a memorandum of understanding with the ministry of health. Could you tell us about your special collaboration with the government? Our collaboration with the government would have taken place with or without a MoU. But because we identified various areas where the government was focusing, such as clinical trials, capability building and access to medicine which we were MALAYSIA JANUARY 2015 34 PharmaBoardroom.com Local Conversations, Global Connections 20,000 members and counting... A directory of 4000 companies & CEOS in 35 countries and counting; Over 1500 1-on-1 discussions with C level executives Worldwide Over 45 reports available for download Press releases from around the world and articles posted MALAYSIA JANUARY 2015 35 Company index BCG 8, 23 *CCM Frost & Sullivan 10, 13, 28, 29 10, 12, 29 *GCI 14 GSK 18 *Healwell 14 IJN National Heart Institute INC Research *Info Kinetics International Medical University Kotra Pharma Malaysian Investment Development Authority Malaysia Healthcare Travel Council Ministry of Health 7, 9, 23, 24, 25 10, 12 12, 30, 31 12 8 8, 9, 18, 19 23 4, 5, 8, 9, 10, 16 , 19, 21, 22, 24, 33 *Nashmir Capsule 13 Novartis 18, 32, 33 PEMANDU 10, 13, 23 PhAMA 7, 8, 9, 20, 21 *Sanofi 8, 9, 10, 13, 22 *Servier 4, 8 * Advertiser MALAYSIA JANUARY 2015 36 MALAYSIA JANUARY 2015