Health and medical to Singapore
(Last updated: 2 Sep 2013)
Trends and opportunities
The Market
Singapore has an efficient and comprehensive health care system, largely shaped by government policy. This policy has five key objectives:
- Become a healthy nation by promoting good health
- Promote individual responsibility for one’s own health and avoid over-reliance on state welfare or third-party medical insurance
- Ensure good and affordable basic medical services for all Singaporeans
- Engage competition and market forces to improve service and raise efficiency
- Intervene directly in the healthcare sector where the market fails to keep healthcare costs down
Singapore’s healthcare delivery system provides primary healthcare, hospital care, long-term care and other integrated care. There is an island-wide network of outpatient polyclinics and private medical practitioner’s clinics which provide primary medical treatment and preventive healthcare. 80 per cent of primary healthcare services are offered by 2000 private medical clinics, while the 18 government polyclinics handle the remaining 20 per cent.
Hospital care comprises inpatient, outpatient, and emergency services. In contrast to primary healthcare, public hospitals provide 80 per cent of hospital care. The public hospitals are structured geographically into six broad healthcare clusters: Alexandra Health Pte Ltd, Eastern Health Alliance, Jurong Health Services, National University Health System, National Healthcare Group, and Singapore Health Services (SingHealth). The leading private hospitals are the Raffles Medical Group, and Parkway Health.
In 2012, there were a total of about 10,756 hospital beds in the 25 hospitals and specialty centres in Singapore, giving a ratio of two beds per 1,000 total population. About 85 per cent of the beds are in the 15 public hospitals and specialty centres with bed complements between 185 to 2,010 beds. On the other hand, the 10 private hospitals tend to be smaller, with capacity ranging from 20 to 345 beds.
In the area of healthcare financing, there are options ranging from public to private funding sources. Public financing for the healthcare system comprises Medisave, MediShield, and Medifund (“3M”), as well as Eldershield. Medisave is a national medical insurance scheme through which members build savings for their healthcare needs. MediShield complements Medisave in that it is medical insurance coverage that enables members to settle part of their expenses from prolonged hospitalisation as well as certain outpatient treatments for serious illnesses incurred in medical institutions. Medifund is an endowment fund set up by the Singapore government to help citizens and permanent residents when Medisave and MediShield do not adequately cover medical expenses. Eldershield is an affordable severe disability insurance, providing basic financial protection to those who need long-term care, especially for the elderly. There are also private insurers, re-insurance companies, and actuaries that specialise in healthcare financing.
Opportunities
Singapore’s life expectancy is one of the highest in the world, having increased by 10 years over the last three decades: from 72 years in 1980 to 82 years in 2010. With increasing life expectancy and low birth rates, Singapore faces the prospect of a shrinking and ageing citizen population and workforce.
The Agency for Integrated Care (AIC) was established by the Singapore government to look into the enhancement and integration of Singapore's long-term care sector. The agency works closely with community care organisations, and focuses on the needs of Singapore’s ageing population through increasing capacity, capabilities, quality and service integration.
At the same time, Singapore is also becoming a hub for clinical trials as pharmaceutical firms seek to exploit the significant population base and ethnic diversity to pilot and test their products.
In April 2013, Australia’s National Health and Medical Research Council (NHMRC) and Singapore’s Agency for Science, Technology and Research (A*STAR) collaborated on research to combat bugs which cause diseases such as tuberculosis, dengue fever and influenza. In the same month, GlaxoSmithKline signed a five-year strategic agreement with A*STAR’s Institute of Chemical and Engineering Sciences (ICES) to develop new evidence-based formulations (EBFs) specifically for emerging markets.
The market opportunities for healthcare in Singapore are varied and wide-ranging, focused broadly on:
- eHealth applications
- clinical trials
- research and development
- aged care services (training, infrastructure, long term care)
- healthcare financing
- medical devices
Competitive environment
The ageing population in Singapore, coupled with rising affluence and greater consumer education has influenced consumer needs and bargaining power. The increasing sophistication of medical technologies will change the delivery of services as it changes the way medicine is practised. These developments in the healthcare industry are not specific to Singapore alone, and many developed countries, like the United States and the United Kingdom, are facing similar challenges. In the face of uncertainty, healthcare organisations are continually looking for solutions to improve quality and cost effectiveness. An area for further development might be the need for more research into providing quality management in the healthcare sector to ensure an outcome that is both efficient and cost-effective.
Tariffs, regulations and customs
The Health Products Act 2007 covers registration for a wide range of medical instruments used in the treatment, mitigation, diagnosis or prevention of disease or abnormal physical condition. This Act is within the ambit of the Health Sciences Authority of Singapore (HSA). Medical devices vary in complexity from simple products such as tongue depressors, surgical sutures and contact lenses to more complex devices such as implantable defibrillators, prosthetic heart valves and diagnostic imaging systems. As well as registration of the medical device under the Health Products Act, the supply and use of any medical device in Singapore should comply with the requirements under other applicable legislation (eg. Private Hospitals and Medical Clinics Act, Medical Registration Act, Radiation Protection Act).
Marketing your products and services
Market entry
Singapore has a pro-business environment, established infrastructure, political stability, and investor-friendly government policies.
In May, 2012, the HSA introduced a system to ease market entry for some lower risk medical devices. This system exempts non-sterile Class A* devices from all HSA registration requirements, while Class A sterile devices will undergo 30-day registrations. For Class B medical devices, an Immediate Registration Route as well as an Expedited Registration Route took effect in September 2012.
The Immediate Registration Route allows immediate Singapore market access for Class B devices that have already been approved by at least two of the following agencies: the US FDA, Health Canada, the Australian TGA, a European Union Competent Authority, or Japan's MHLW.
Qualifying devices must also have been marketed for at least three years with no safety issues arising.
* Medical devices are divided into 4 classes: more complex devices (Class D), such as sophisticated diagnostic imaging equipment or cardiac stents, are subject to tighter regulation and scrutiny than simpler devices (Class A) such as bandages. Devices that are of very low risk like tongue depressors are exempted from pre-market approval.
Links and industry contacts
Ministry of Heath Singapore (MOH) – www.moh.gov.sg
Ministry of Health Holdings (MOHH) – www.mohh.com.sg
Agency for Integrated Care (AIC) – www.aic.sg
Health Sciences Authority of Singapore (HSA) – www.hsa.gov.sg
Association of Medical Device Industry (AMDI) – www.amdi.org.sg
Contact details
The Australian Trade Commission – Austrade – is the Australian Government’s trade, investment and education promotion agency.
Through a global network of offices, Austrade assists Australian companies to grow their international business, attracts productive foreign direct investment into Australia and promotes Australia’s education sector internationally.
For more information on how Austrade can assist you, contact us on:
Australia ph: 13 28 78 | Email: info@austrade.gov.au
A list of Austrade offices (in alphabetical order of country) is also available.