Health and medical to Singapore
Trends and opportunities
There is a dual system of healthcare delivery in Singapore. Both public and
private providers of healthcare are regulated by the Ministry of Health and
its statutory boards, and the standard of medical practice ranks among the
best in the world. The international healthcare accreditation body, Joint
Commission International (JCI) has accredited 11 hospitals and three
medical centres in Singapore. JCI as an entity, works to improve patient
safety and quality of health care in the international community through
education, publications, advisory services, and international accreditation
Singapore’s healthcare system is designed on an integrated care model
platform which provides holistic and integrated care. The public healthcare
system comprises three integrated healthcare clusters, anchored by a regional
Hospital working with a variety of Primary, Intermediate and Long-Term care
sector and support services to deliver patient-centric care. The healthcare
clusters are the National Healthcare Group (NHG), Singhealth, and National
University Health System (NUHS). All heathcare clusters are supported by an integrated care agency, the Agency for Integrated Care (AIC), which has
been set up to smooth the transition of patients from one care setting to
National healthcare expenditure on healthcare is about 4 per cent of
GDP, which is low among developed countries, but expected to grow as the
population ages. There are four schemes to help citizens ‘co-pay’ for
healthcare services in the public healthcare system:
Around 70-80 per cent of Singaporeans obtain their medical care within the
public health system via the the above public healthcare finance schemes.
Private healthcare demand is also high, and is paid for by private
There are more than 50 companies undertaking biomedical sciences R&D,
including drug discovery, translational and clinical research, in
collaboration with key research institutes in Singapore.
Singapore is also a growing medical technology (medtech) manufacturing hub
for global original equipment manufacturers (OEMs) and specialist medtech
equipment R&D, designers and manufacturers, registering an industry
output of about A$5 billion - and set to grow at a compounded rate of 5 per
cent per year until 2020. There are about 30 medtech devices manufacturers
(mid to large) based in Singapore, with manufacturing activities geared
towards global and regional exports markets, all of whom must meet strict
regulatory compliance, e.g. ISO 13485 quality management standards, in
design and manufacture of medical devices.
As Singapore is a small market and adopts international regulatory medical
standards from established countries, Australia’s respected Therapeutic
Goods Association (TGA) is often one of the key bodies where the Singapore
regulatory authorities make reference to for internationally recognised
guidelines and standards.
Singapore is heavily dependent on imported health and medical products.
With the challenge of rising healthcare costs, there are opportunities for:
- advanced and cost-effective medical devices and equipment
generic drugs for expiring patented drugs (asthma and high cholesterol)
home care products.
As this is an advanced market, health and medical products with
international accreditation are highly sought after. There are also
opportunities for biomedical sciences organisations to consider foreign
direct investment into Singapore, especially in the area of:
- biotechnology research.
In the medtech segment, Singapore looks to TGA’s global standing as one of
its benchmarks. This has implications for Australian medtech businesses as
they can be positioned to tap into the growth of the Singapore medtech
R&D and design and manufacturing sector.
Singapore faces competition from neighbouring countries, Thailand, Malaysia
and India. Each have been aggressive in promoting medical capabilities in
their countries. For example, Thailand, a popular tourist destination, has
leveraged its traditional spa and massage facilities to improve the attraction of its
wellness tourism industry, moving beyond providing health-screening and
oncology treatments. India focuses on cardiac treatment, transplants,
orthopaedics, issuing medical visas and has special lanes in its main
airports for those seeking medical treatment.
Australia can learn from Singapore, and its (Singapore’s) competitors and
seek to highlight its world class standing in scientific discoveries and
commitment to medical research. It also has a vibrant and
knowledge-intensive health and medtech industry with a long history of
globally recognised breakthroughs in biomedical devices and diagnostics,
making it an ideal partner in for collaboration and partnership in market
expansion and R&D.
Tariffs, regulations and customs
Singapore is a free trade country, with taxes applicable to the import of
alcohol, cigarettes and cars. Generally, goods imported attract a 7 per
cent goods and services tax.
The Health Products Regulation Group, under Health Sciences Authority
(HSA), ensures that drugs, innovative therapeutics, medical devices and
health-related products are regulated to meet appropriate standards of
safety, quality and efficacy. The Group comprises:
- Therapeutic Products Division
- Complementary Health Products Division
- Manufacturing and Quality Audit Division
- Pharmacovigilance and Compliance Division
- Enforcement Division
The HSA and TGA have an enhanced technical cooperation and information
exchange through the Memorandum of Intent for cooperation on scientific and
regulatory affairs. However, local distributors of Australian health and
medical products will still need to ensure that the products they wish to
represent comply with HSA’s regulatory requirements.
The Health Products Act (HPA) was introduced in 2007 with the aim to
consolidate and streamline the regulatory controls of health products under
one single Act. The consolidation is done in phases to cover a range of
Pharmaceutical products, commonly known as chemical or biologic drugs, will
be regulated as “therapeutic products” in the HPA. Thereafter, the existing
controls under the Medicines Act (MA) and Poisons Act (PA) will no longer
be applicable to pharmaceutical products.
The following six pieces of legislation, effective since 1 November 2016,
have been introduced in the HPA for the regulation of therapeutic products:
- Health Products Act (Amendment of First Schedule) Order 2016
- Health Products (Therapeutic Products) Regulations 2016
- Health Products (Clinical Trials) Regulations 2016
- Health Products (Therapeutic Products as Clinical Research Materials) Regulations 2016
- Health Products (Advertisement of Therapeutic Products) Regulations 2016
- Health Products (Licensing of Retail Pharmacies) Regulations 2016
Correspondingly, the following are legislation for the controls of medicinal products (MP) under MA and medical devices (MD) under HPA, used in clinical trials/clinical research:
- Medicines (Clinical Trials) Regulations 2016
- Medicines (Medicinal Products as Clinical Research Materials) Regulations
- Health Products (Medical Devices) (Amendment) Regulations 2016
Marketing your products and services
In the public healthcare system, commonly used health and medical products
are collated by a central procurement office and purchases are put up for
tender. Government tenders are posted on the Singapore government’s
one-stop procurement portal Government Electronic Business (GeBiz). The
public healthcare facilities can separately call for tenders for items that
may be unique to their requirements.
Relationship and personal selling are important to both private and public
healthcare providers as most tend to prefer liaising with distributors that
they are familiar with.
When introducing new products to the health and medical sector, it is
important to engage key opinion leaders and associations, organise seminars
and forums or even take part in conferences to raise awareness. Most
importantly the product must satisfy all claims and be safe for use.
For the medtech devices sector, the strategy to drive market access for
Australian organisations is the ability to value-add at each stage of the
medtech value chain. Each stage of the value chain essentially revolves
around patient care (including striving for cost efficiencies) and
collaboration across the broad spectrum of stakeholders would be important
- Clinical needs development (considered as R&D stage e.g. clinician-researcher collaboration to develop new medical devices to improve patient care and lower cost. Potential partners include research institutions and universities)
- Device conceptualisation (design stage e.g. accelerators/design firms/ incubators/pre-clinical testing services)
- Clinical research and regulatory approvals (design/niche manufacturing stage e.g. clinical institutes/research organisations/HSA)
- Production and manufacturing (niche manufacturing stage e.g. contract manufacturers/multinational companies (MNCs) or small and medium enterprises)
In Singapore, key entities for potential collaboration include:
- Research communities (A*STAR: Agency for Science, Technology &
Research), National University of Singapore (NUS), Duke-NUS Graduate
- Clinical groups (hospitals within Singhealth or National Health Group,
where there are Medical Devices Development Offices (MDDOs) including Tan
Tock Seng Hospital, NUH, Singapore General Hospital
- Industry partnerships (with MNCs such as Johnson & Johnson, Becton
- Government entities supporting the medtech sector, e.g. Economic
Development Board and Enterprise Singapore.
In addition to registration of health and medical products, local distributors usually undertake the entire sales, marketing and distribution process, and will also involve the principal firm as needed.
Links and industry contacts
Government, business and trade
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