Insights: Accelerating Market Access in Exceptional Times – Southeast Asia

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In July of 2020, as many markets around the world started opening up from varying degrees of lock-down to stem the spread of COVID-19 infections, I aptly had the pleasure of facilitating a discussion on the topic “Accelerating Market Access in Exceptional Times – Southeast Asia” with four amazing speakers sitting across Indonesia, Singapore, Thailand and Vietnam.

Exceptional times make for exceptional opportunities. The past months have seen a sea change of mindset towards accelerated adoption and growth of HealthTech solutions.

While some businesses may be seized by change, it is prime time for others to seize this window for growth. In this session, we were exploring what it takes to accelerate market access for HealthTech solutions in these markets.

Our awesome panel of founders and industry experts from the region

I am grateful to the following speakers for their time and generosity:

These are my key takeaways summarised in three themes:

  1. Establish Your Right to Exist
  2. Know Your Payer Game
  3. Develop Your Patient Capital for Change

Establish your Right to Exist

In a very entrepreneurial market like Indonesia where local startups have increased exponentially over the past few years to take on problems with contextual knowledge and low-cost labour, it has become very difficult for foreign startups to make a competitive entry. Therefore, partnering a local startup or company with market access channels and the ability to navigate local laws can be crucial to gaining a foothold. 

To have a compelling partnership proposition, incoming startups need to be able to provide these potential local partners with new solutions or technology that they can jointly commercialise in adapting to the local market’s needs. For example, superior technology which could help local partners leapfrog the development of advanced solutions, especially in diagnostics, or evidence-based patient outcome models you established in other markets which could add to the robustness of introducing new solutions to the local market.

There is also local consumer psychology to contend with, for example ProSehat needed to bundle screening and diagnostic products with treatment products as the consumer psychology for perceived value in healthcare tends to be treatment based. Therefore, service providers would need to be creative in designing solutions to fit these local nuances while putting thought into the target segment and process design to make sure the follow through after consumers buy into the solution is clinically sound.

For Vietnam, while the market is growing rapidly, it is still very fragmented for healthcare access. The local players generally have an open mindset to work with newcomers local or foreign if they can see how the collaboration can add economic value to them. The challenge is for newcomers to frame, design and communicate how the partnership will help these incumbents increase their customer base or value instead of disrupt them.

In Thailand, a segment that is especially open to work with foreign solution providers with innovative therapeutics and patient experience solutions are the private hospitals. This is becausethe market is very competitive for these players, hence this is their way of differentiation to compete for medical tourism demand. According to Binh, the country is also preparing for a larger focus on medical services post-COVID for growth in tourism.

In terms of a specific use case for e-pharmacy, we had discussed how it is important to find a niche to create a base of returning customers with Bimo and Peter suggesting to look at drugs for diseases such as cancer and diabetes which are hard to access in local pharmacies. Binh brought out three areas of opportunities where there is demand for e-pharmacy to solve: medicine access in rural areas, counterfeit drugs and traceability for genuine drugs and adherence. 

Know Your Payer Game 

Though the current payment model for HealthTech solutions in the region are largely out of pocket based, startups can tap insurance as a potential payment model if they know how to engage the payers in this space with a proposition that improves their customer engagement level or profitability. 

Propositions that fit into one of these buckets are likely to be more compelling than lowering distribution costs or streamlining operations. It is important to know the payer game you are playing, what metrics matter for that specific proposition and provide data as compelling proof points.  

Here I am adapting from Susan’s outline of five steps to broach a deal with private payers:

(1) Understand the type of insurer or distributor or player you are engaging.

(2) Check what KPIs/metrics they use for product profitability.

Know where you can move the dial, examples of metrics: (admits per thousand) total admissions/total exposure *1000, (inpatient utilisation) admissions per thousand* average length of stay, (outpatient utilisation) total utilisation units/exposure*1000

(3) Determine whether you are discussing a local/regional/global deal and who can approve what. 

Always start with a local pilot first and get a quick win with minimal length of approval and an understanding to consider expanding it.

(4) Be clear as to whether your product is driving engagement or enhanced profitability. Have data to back up your claims.

For example, behavioural economics principles and behavioural psychology principles for engagement; For reducing morbidity, you would ideally need 5 years of solid historical data to run analytics on and need to be able to link data.

(5) Explain your commercial model and any willingness/threshold for payment based on shared outcomes.

Develop Your Patient Capital for Change

The speakers were in unanimity that there had been a rapid acceleration of adoption of HealthTech solutions in the Southeast Asian markets over the past 6 months, however to cross the chasm for the majority of the population will require a breakthrough for public health reimbursement pathways. While the sensing was that most healthcare providers and public payers in the region are not currently ready for this change, there is optimism for the next wave of change to be driven by the demands of citizens/consumers.  

In the short term, market access for innovative health solutions in the regional markets will still need to rely on out-of-pocket payment models. Advancing solutions with this approach also meant greater patient centricity and ownership in their health journey. With COVID-19 having accelerated adoption of digital health solutions and creating an enlarged base of citizens who have tasted its benefits, solution providers should press on in advancing patient education for these consumers to be pushing the next wave of change to enable mainstream adoption. 

Even as stakeholders may require some time to catch up, startups should start collecting data to provide evidence-based outcomes and build cases towards value-based healthcare as emerging opportunities to be seized will favour the prepared. Susan had also shared her observations that pointed to expectations for digital health solutions to have an expanded role in insurance. With telemedicine consultation adoption paving the way, insurers are looking at supporting more outpatient and community based care driven by consumer demand as well as optimising overall healthcare cost management.

In a Nutshell: Accelerating Market Access in Exceptional Times – Southeast Asia

To enter and create access to your solution in any given market, you need to develop a compelling proposition for not just your potential customers but also your key channel partners and value chain. 

To expand payment models for your solution to tap private payers, you need to understand the player’s position in the value chain, know what is the primary game you are trying to beat (e.g. engagement vs profitability), have data to prove your claims, align stakeholders to get started on a pilot and ideally be prepared for some level of shared outcomes. 

To bring market access to the next level in the region, we need to leverage on immediate term gains from advancing solutions with out-of-pocket payment models into long term gains to eventually unlock public health reimbursement pathways for greater access by empowering patient advocacy and building a data driven case for outcomes.     

Do comment if you have learnings from market access for healthtech solutions in the region to share!

I’d also invite you to follow our BlueChilli HealthTech page if you’d like to be updated on all the latest happenings in healthtech!

– Hui Hong