Emerging Opportunities in Myanmar's Diagnostic Imaging and In-Vitro Diagnostics
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Transcript of Emerging Opportunities in Myanmar's Diagnostic Imaging and In-Vitro Diagnostics
MyanMar’s Diagnostic iMaging & in-vitro Diagnostics
Solidiance has produced this white paper for information purposes only. While every effort has been made to ensure the accuracy of the information and data contained herein, Solidiance bears no responsibility for any possible errors and omissions. All information, views, and advice are given in good faith but without any legal responsibility; the information contained should not be regarded as a substitute for legal and/or commercial advice. Copyright restrictions (including those of third parties) are to be observed.
DEcEMBEr 2015
EmErging OppOrtunitiEs in
solidiance
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ExEcutivE summary myanmar’s HEaltHcarE EcOnOmics
3 4
15 Diagnostic imaging (Di) in myanmar: market potentials
21
28
29
33
34
37
in-vitro Diagnostics (ivD) in myanmar: market challenges
registration & licensing of Diagnostic imaging (Di) anD in-vitro Diagnostic (ivD) equipment
casE studiEs
key takeaways
inFOgrapHic
aBOut us
contEnt
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Economic growth and demographic changes in Myanmar are driving healthcare spending throughout the country. Myanmar’s total healthcare expenditure is set to cross USD 2 billion for FY 2015-2016.
Rapid growth in healthcare demand is inevitably resulting in the development of the healthcare system. There is also growing awareness of regular health check-ups for early detection of non-communicable diseases.
Diagnostic Imaging & In-Vitro Diagnostics have witnessed quick penetration into Myanmar since 2012. However, demand is increasing faster than supply and global healthcare players need to adapt to a fast evolving market. Myanmar presents a set of unique growth opportunities for global healthcare players and a sustainable long-term strategy is required to capitalize on these opportunities.
ExEcutivEsuMMary
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MyanMar’sHEaltHcarE EconoMics
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Percentage of contribution from government to total healthcare expenditure has grown from 12% in 2010 to 40% in 2014
• 2.7% of total government budget was allocated to healthcare in 2014• Government proposed a plan in parliament in January 2015 to increase healthcare budget allocation with an
annual growth rate of 6% until 2020
619 790 922 1,041 1,146
85
118
456
572
757
2010 2011 2012 2013 2014
Private Spending Public Spending
908
1,378
704
1,613
1,903 27.5
13.04
1.9
14.1 17.2
11.16
MyanMar’s ToTal HealTHcare expendiTure spliT (usd Mn)
Source: World Health Organization (WHO), Ministry of Health (MOH), Solidiance Research and Analysis
coMparison of ToTal HealTHcare expendiTure in usd Bn (2014)
6 | www.solidiance.com
Myanmar has the lowest healthcare spending in Southeast Asia
3.1%
4.0%
4.6% 4.6%
6.0%
2.7%
• Around 70% of Myanmar’s population stay in rural areas with minimal access to healthcare services that are primarily concentrated in the big cities: Yangon, Mandalay, and Nay Pyi Taw
• Majority of the increase in healthcare expenditure is targeted to tier-2 cities
107
423
35
2,507
264 111
MyanMar’s HealTHcare expendiTure (% of Gdp) – 2014
coMparison of per capiTa ToTal HealTHcare expendiTure (usd) – 2014
Indonesia
Malaysia
Myanmar
Singapore
Thailand
Vietnam
Source: Solidiance Research & Analysis, WHO, MOH
www.solidiance.com | 7
Out-of-pocket (OOP) expenses are mainly used for self-prescribed medicine, diagnostics and private clinics.
Public hospitals are subsidizing costs of diagnostics and providing medicine for the most needed people.
Under the Social Security Scheme, all employers and employees who contribute to the scheme are entitled to healthcare benefits and treatment in certain hospitals which are listed by Social Security Board.
International NGOs (INGO) are financially supporting to strengthen primary healthcare services and facilities in rural areas.
In July 2015, the Myanmar government approved to sell “Health Insurance” to the public through Myanmar’s Insurance and 12 private insurance companies.• Cost of one health insurance unit is MMK 50,000, or
approximately USD 45 – and a person can buy up to 5 units• The coverage of healthcare expenses for one unit of health
insurance is mainly for hospitalization expenses, which is MMK 15,000 per day for five times in 30-day period of hospitalization (up to 150 days)
out-of-pocket payment is the key dominant source for healthcare financing, accounting for 78% of the total healthcare expenditure in Myanmar
OOP
Public & Government Hospitals
INGO
Social Security Scheme
78%
15%
6%
1%
MyanMar’s HealTH expendiTure By financinG aGenTs, 2014
MyanMar’s new HealTH insurance scHeMe
Source: Ministry of Health (MOH), Solidiance Interviews and Analysis
8 | www.solidiance.com
Effects of increased government spending in the last 2 years can be seen in the public hospitals in Myanmar’s tier 2 & tier 3 cities
69% 7%
3% 3%
2%
14% 1%
Public Primary Care Hospitals
Public Secondary Care Hospitals
Public Tertiary care Hospitals
Military Hospitals
Government's Ministry Hospitals
Private General Hospitals
Traditional Medicine Hospitals
MyanMar’s Type of HospiTals By level, 2014 (1,192 HospiTals)
Source: WHO, Health System Review 2014 Report from MOH, Solidiance Research and Analysis
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93%
7%
Public sector
Private sector
HospiTal Beds in MyanMar By secTor, 2014 (73,040 Beds)
Public tertiary care hospitals are catering to specialized medical treatments and services in big cities like Yangon, Mandalay, Nay Pyi Taw, and Taunggyi.
The Ministries of Railways, Labour, Mines, Industry, Energy & Cooperatives as well as Home Affairs are providing medical care and treatment to their employees through their own run hospitals.
The majority of hospitals are providing basic x-ray and ultrasound services.Source: WHO, Health System Review 2014 Report, MOH, Solidiance Research and Analysis
10 | www.solidiance.com
Private hospitals account for 14% of total hospitals and contribute to 7% of total beds in Myanmar
850 1,000
1,184 1,025
950 316 135
167
Public Hospitals Private Hospitals
Public hospitals account for ~86% of hospitals but are far behind regional quality standards.
In public hospitals, selected medicines and lab tests are being offered for free to the less fortunate since in the late 2014.
Private hospitals have increased in number by 10% between 2011 and 2014.
Source: Central Statistical Organization, MOH, Myanmar Private Hospitals’ Association, Solidiance Research & Analysis
nuMBer of HospiTals in MyanMar - 2014
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0 20 40 60 80 100 120 140 160
Shan State
Sagaing Region
Yangon Region
Mandalay Region
Bago Region
Ayeyawady Region
Magway Region
Kachin State
Rakhine State
Mon State
Taninthayi Region
Kayin State
Nay Pyi Taw
Chin State
Kayah State
Public Hospitals
Private Hospitals
MyanMar’s privaTe and puBlic HospiTal disTriBuTion across THe counTry, 2014
Source: Central Statistical Organization, MOH, Myanmar Private Hospitals Association, Solidiance Research & Analysis
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Half of the private hospitals in Yangon have less than 25 beds
32%
15%
4%
50% >200 100-200
25-100 <25
yanGon HospiTals By nuMBer of Beds, 2014
Number of beds Number of hospitals
<25 25
25-99 20
100-200 4
>200 3
total 52
# Name of the Hospital # of beds
1 Pinlon 300
2 Asia Royal 232
3 Shwe Gon Dine Specialist Centre (SSC) 200
4 Sakura 150
5 Bahosi 120
6 Pun Hlaing 100
7 Witoriya 100
8 Aung Yadanar 70
9 Ma Har Mying 70
10 Parami 65
11 Green Cross Specialist 50
12 Thu Kha Kabar 50
13 Shin Par Ku 49
14 Academy 40
# Name of the Hospital # of beds
15 Thiri Sandar 38
16 Shwe La Min 34
17 Rose Hill 30
18 Kaung 25
19 Aye Myittar 25
20 Aye Myittar (Baby Clinics) 25
21 Aye Yeik Thar 25
22 Kant Kaw Diagnostic & Neuro Centre 25
23 Kaung Myat Mon 25
24 Myat Tar 25
25 Royal 25
26 Shwe Baho 25
27 Win 25
Advanced diagnostic tests are only offered in large hospitals (>100 beds)
lisT of HospiTals wiTH ≥ 25 Beds in yanGon, 2014
Source: Solidiance Research & Analysis, Central Statistical Organization, Ministry of Health, Myanmar Private Hospitals Association
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Most of the private hospitals in Mandalay and Nay Pyi Taw have less than 25 beds
lisT of HospiTals wiTH ≥ 25 Beds in Mandalay in 2014
Mandalay HospiTals By no. of Beds, 2014
nay pyi Taw HospiTals By no. of Beds, 2014
lisT of HospiTals wiTH ≥ 25 Beds in Mandalay in 2014
# Name of the Hospital # of beds
1 Nyein 120
2 City 100
3 Kant Kaw 80
4 Mandalar 55
5 Myat Thu Kha 50
6 Thit Sar 45
7 Ar Yaw Jan 25
8 Aye Thiri 25
9 Chan Nyein Aung 25
10 Hans 25
# Name of the Hospital # of beds
1 Outara Thiri 250
2 Bawga Theiddhi 40
3 Kaung Thit 25
50%
2,8%
8,34% 14,58%
100 - 300 25 - 99 <25
1,14%
2,29% 4,57%
100 - 300 25 - 99 <25
Source: Solidiance Research & Analysis, Central Statistical Organization, Ministry of Health, Myanmar Private Hospitals Association
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Number of death by non-communicable diseases (NCD) has increased by 7% between 2010 & 2014 in Myanmar
125.3
45.8
27
8.7
35.7
110.25
48.51 39.69
13.23
48.51
CVD Cancers Respiratory diseases
Diabetes Other NCD
2010 2014
242.5 260.2
368 181
2010 2014
Other deaths
Non-communicable diseases
nuMBer of deaTH By non-coMMunicaBle diseases IN MYANMAR(in THousand)
nuMBer of deaTH By causes IN MYANMAR
(in THousand)
Proportion of deaths by NCD has increased from 40% in 2010 to 59% in 2014.
Increasing trend of chronic diseases suggests severe need for better diagnostic services.
The government has developed a comprehensive national policy for prevention and control of major NCDs. Priority is given to early detection of major NCDs by upgrading and installing advanced medical devices to address burden of premature deaths.
Source: National Statistical Office, Solidiance Research & Analysis
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Diagnostic iMaging (Di) in MyanMar:
MarkEt potEntials
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Number of Diagnostic imaging (Di) tests conducted in Myanmar’s private facilities has seen a big forward jump since 2012
• Basic diagnostic imaging tests such as x-ray & ultrasound are free in public hospitals for in-patients• Military hospitals have advanced devices but these are primarily for military personnel and their families• Patients in Yangon prefer to take diagnostic imaging tests in private hospitals due to 24-hour service
availability and better accuracy of results• Basic diagnostic imaging tests such as X-ray and Ultrasound can be done in private diagnostic clinics• In public hospitals, advanced diagnostic imaging devices like MRI & CT are only installed in large specialty
hospitals in major cities
MyanMar’s sHare of diaGnosTic iMaGinG TesTs By faciliTies in 2014
Source: Solidiance Interviews & Analysis
45%
24%
20%
11%
Public hospitals
Private hospitals
Military hospitals
Private diagnostic clinics
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Increasing awareness about NCD has resulted in increasing demand for Di in Myanmar
NCDs are identified as the major cause of mortality - accounting for around 60% of total death in 2014.
Estimated 60,000 cancer cases are identified each year in Myanmar. Breast cancer at 17%, is the most common cancer in women while lung cancer is the common in men.
Majority of deaths by NCD are due to non-detection in early stages which is directly related to diagnostic imaging.
MorTaliTy raTe By Type in MyanMar (2014)
Top cancer cases in MyanMar (2014)
Source: Central Statistical Organization, WHO, Solidiance Interviews & Analysis
Communicable maternal, perinatal and nutritional conditions, Cardiovascular diseases
Cancer
Other NCDs
Injuries
Chronic respiratory diseases
Diabetes
30%
25% 11%
11%
11%
9% 3%
38%
17%
16%
15%
5% 5% 4%
Breast
Lung, Bronchus, Trachea
Cervix Uteri
Stomach
Non Hodgkin's lymphoma
Oesophagus
Others
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Victoria Hospital, one of the big private hospitals in Myanmar, offers all diagnostic imaging tests
advanced Di equipment is only available in public tertiary hospitals and big private hospitals in main cities like Yangon, Mandalay, Nay Pyi Taw, and Taung Gyi
Thailand
X-ray
Myanmar
1,474
941
1,198
800
692
52
157
12
Ultrasound
CT
MRI
nuMBer of insTalled MacHines in MyanMar, 2015
Most public hospitals are equipped with 2D Ultrasound machines while 3D, 4D & Doppler machines are mostly found in private hospitals.
30 CT scanners were added to public hospitals in 2013 – most of which were second-hand machines from Japan & Singapore.
MRI scanners are only available at five public hospitals and seven private hospitals in Myanmar.
Source: Solidiance Interviews & Analysis
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Name of the Hospital Public hospitals
Military hospitals
Private hospitals
Private diagnostic clinics
X-ray
3D/4D Ultrasound
CT -
MRI -
Radiation Therapy -
Bone Scan/Dexa Scan
Mammo
ECG/Echo Scan
Color-Doppler
Radiography (Radio/Fluoro)
Trans-Vg (TVS)
Fibroscan
Comparison of key Diagnostic imaging (Di) modalities in Myanmar
Source: Solidiance Research & Analysis, Ministry of Health, Myanmar Private Hospitals Association
20 | www.solidiance.com
Radiologist, Asia Royal Hospital
at Myanmar’s public hospitals, diagnostic imaging tests are free for inpatients. Outpatients still need to pay - but considerably cheaper than in private facilities
Type of services Public Private/ Diagnostic Clinic
DI services
MRI scan USD 60 USD 190
CT scan 64-slice : USD 40128-slice: USD 40 128-slice: USD 200
X-ray scan USD 3 USD 10
Ultrasound USD 3 USD 10
Average wait time Both MRI & CT scans 2-3 weeks About 4 hours to a day
Average age of device All Devices 60% > 5 years old40% < 5 years old
70% > 5 years old30% < 5 years old
“Compared to developed countries, cost of diagnostic imaging services in Myanmar is still affordable. A major barrier to the upgrade of equipment is patient’s limited spending power as new and advanced machines will increase prices.
Source: MOH, Solidiance Interviews and Analysis
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in-vitro Diagnostics
(ivD) in MyanMar:
MarkEt cHallEngEs
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private facilities are leading IVD testing in Myanmar
60% 20%
16%
3% 1%
Private Laboratories
Private Hospitals
Public Hospitals
Foreign branches
Public Laboratories
diaGnosTic cenTers in MyanMar, 2015 ~ 200 (ToTal)
• Nearly all private laboratories are standalone with 40% market share in medical check-ups and laboratory testing services
• There are only two standalone public laboratories, each in Yangon & Mandalay
• A limited number of large private hospitals have their own laboratories providing services ranging from basic medical check-up to specific intensive testing
More than half of the population in the three major cities in Myanmar are from middle-income class, hence large private hospitals and standalone laboratories are concentrated in these cities only. A few foreign hospitals have testing centers in Yangon, however, these are only for patients that are referred by a parent hospital in the originating country.
Due to high outbound medical tourism to Thailand, Bangkok Hospital & Bumrungrad International Hospital have set up testing centers in Yangon to cater to after-care needs of their patients.
Source: Solidiance Interviews & Analysis
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Source: Solidiance Interviews & Analysis
Myanmar is facing population pressure with increasing proportion of people above 60 years old.
Growing usage of modern IVD is essential to reduce cost and increase operational efficiency for the healthcare facilities.
Furthermore, sedentary lifestyle, unhealthy eating habits and lack of regular check-up has led to high prevalence of diabetes, hypertension and cervical cancer.
7.0% 7.4% 7.8% 8.2% 8.6% 9.0% 9.4% 9.8% 10.2% 10.6%
13.8%
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
16.0%
2013 2014 2015f 2016f 2017f 2018f 2019f 2020f 2021f 2022f 2030f
increased penetration of ivD in Myanmar is due to growing aging population and high prevalence of major diseases
percenTaGe of MyanMar’s populaTion >60 years old
diaBeTes prevalence raTe
HyperTension prevalence raTe
cervical cancer incidence raTe
• 6% nationwide• 12% in rural population• Over 1 million are
undiagnosed
• 23.8% nationwide• Nearly 3.5 million are
undiagnosed
• 2.5% in Myanmar while Southeast Asia’s average is 1.7%, mainly due to lack of early diagnosis
24 | www.solidiance.com
the number of laboratories in Myanmar has increased in the last 3 years, but it is still
insufficient to meet growing demand
Key laboratories offering IVD tests in Myanmar
Hospitals Standalone local laboratories
Foreign laboratories
Key distributors in Myanmar’s medical devices industry
The majority of the tests are performed in the standalone local labs due to the affordability and the perceived accuracy of the test results. Doctors usually refer outpatients to have the specialty tests performed at standalone clinics.
On the other hand, foreign labs have been entering Myanmar since 2010.
DKSH is the leading distributor for pharmaceutical products and medical devices in Myanmar. DKSH has been in Myanmar for over 15 years - currently distributing brands like Roche & Novartis.
Sealion is also a key distributor and has had partnerships with GE healthcare, Johnson & Johnson, Festo, 3M and Medtronic.
Mega Lifesciences entered Myanmar in 1995. The rest of other local medical devices distributors include Myanmar Zircon, Okkar Thiri and Medi Power.
Source: Solidiance Interviews & Analysis
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Some key IVD tests in Myanmar
IVD Tests Sub-Category Test Private Public
Molecular Diagnostic • Quantitative tests (HBV, HCV, HIV, HPV) • USD 100-150 (per test) • USD 0-20 (per test)
Biochemistry
• Liver profile • Renal profile • Lipid profile • Protein test • Cardiac profile • Diabetes Test • Other tests
• USD 20 – 40 (for basic profiling tests)
• USD 50 - 120 (for screening package)
• USD 0-15 • No screening package
Immunology
• Quantitative test• Screening test • Hormones • Tumor markers • Rheumatology
• USD 10 – 30 (for antibody tests such as HBV, HIV, Malaria and etc.)
• USD 0-7 (for specific tests for antibody)
Haematology • Coagulation screening• Iron study
• USD 7 (basic Rh Check- blood protein test)
• USD 0-1.5 (basic RH check)
Microbiology • Culture & Sensitivity• Routine examination • USD 5 (Urine (RE) test) • USD 0-1 (Urine (RE)
test)
Histopathology • Cytology (Fluid, Sputum) • Tissue biopsy
• USD 10-12 (Biopsy test; each tissue sample from 1-3 cm)
• USD 0-1 (Urine (RE) test)
Source: Solidiance Interviews & Analysis
26 | www.solidiance.com
though majority of the ivD tests are done in Myanmar, people still opt to do tests abroad for specific diseases for better accuracy
Most of the basic IVD tests are done in Myanmar. However, to ensure accuracy, upper middle class (which represents ~10% of the population) get their IVD tests for specific diseases such as detailed tissue biopsy, tumor marker and C1 esterase inhibitor in Thailand and Singapore.
Doctor, SSC Hospital
“In Myanmar, there is little spending on IVD due to limited awareness of the usage and its benefits. However, with increasing outreach of media and health education programs, IVD will see significant growth in the next 3-5 years.
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of total healthcare budget is used for IVD in Myanmar
of total healthcare budget is used for IVD in ASEAN-5*
Director, Private Laboratory
“
<1%2% - 3%
Biochemistry tests are the majority of IVD tests done in Myanmar with its basic screening packages such as liver, renal, cardiac, and diabetes profiling tests. Microbiology and Immunology are closely linked and often difficult to distinguish. These 2 combined are one-third of the total tests. Molecular diagnostic is a very small market and we need to increase its penetration.
ivd BudGeT allocaTion in MyanMar in 2014
percenTaGe spliT of ivd TesTs done in MyanMar in 2014
40%
20%
15%
10%
10% 5%
Biochemisry Immunology Microbiology
Hematology Molecular Diagnostics Histopathology
*ASEAN 5 includes Indonesia, Malaysia, Philippines, Thailand, and Vietnam
Source: Solidiance Interviews & Analysis
28 | www.solidiance.com
rEgistration & licEnsing of Diagnostic iMaging (Di) anD in-vitro
Diagnostic (ivD) EquipMEnt
Compared with complex and long registration of pharmaceutical products, registration for imaging devices and medical equipment is quite simple and normally takes 2-3 months
• All in-vitro-diagnostics equipment is required to apply for quality check and license from FDA.
• Medical imaging devices like X-rays, MRI and CT scanners are exempted from FDA license as no formal medical devices law has been passed yet
• Timeline is up to 3 months
• Medical Association MPMEEA (Myanmar Pharmaceutical and Medical Equipment Entrepreneurs Association) has the price and control check on newly applied medical imaging devices and IVDs. it works with ministries of health and commerce for recommendation
• Timeline is up to 1-2 weeks
• After quality and price check of new products, MPMEEA sends recommendation to Department of Trade to register products with Ministry of Commerce with required documents such as test manual, country of origin and COA (certificate of evaluation analysis)
• Timeline is up to 1-2 weeks
Source: Food and Drug Administration, Ministry of Commerce, MPMEEA, Solidiance Research & Analysis
fda: approval
license
MpMeea: price conTrol
cHeck
depT. of Trade: reGisTraTion
www.solidiance.com | 29
casE stuDiEs
30 | www.solidiance.com
asia royal HospitalAsia Royal Hospital is a leading private hospital in the heart of Yangon city
Some IVD devices at Asia Royal Hospital
• Cobas e411 • Sysmex (XT 2001, CA-50, XT
2000i) • Pentra 60+ • Liza (300 Plus, 300 Hyel) • Vitros ECI • Minividasi • Partec SL3• VITEK2 Compact 30 • BACT/ALERT 3D 60
• Cyflow Counter-Partec • Easylite Plus / Plus (Na/K/
CL Analyser) • Haemocue Hb200 (+) /
Albumin 201• SYSXT-4000i • Mini Vidas • Urometer 120 • C311 • Option 2+
established :2000 (One of the first private hospitals in Myanmar)
occupancy rate : >90% (2013) for 232 beds
outpatient rate : ~250,000 (per year)
inpatient rate : ~11,000 (per year)
Di & ivD services : Available
33%
25%
18%
11%
9% 4% USA
Japan
France
Germany
China
Sweden
ivd - insTalled Base in asia royal HospiTal By counTry of oriGin (as of auG 2015)
Doctor, Asia Royal Hospital
“Most of the tests conducted in private hospital laboratories are basic tests for medical screening packages in biochemistry. But speciality tests such as immunology and biopsy are mostly referred to private laboratories.
Source: Asia Royal Hospital, Solidiance Interviews & Analysis
www.solidiance.com | 31
diaGnosTic iMaGinG devices - insTalled Base in asia royal HospiTal By counTry of oriGin (as of auG 2015)
Types of DI device Model of devices
X-ray• 630 mA Shimazu• 550 mA Siemens• 330 mA Siemens
Portable X-ray 250 mA
C-Arm X-Ray Siremobile Siemens
CT Scanner Somatom Sensation 64 SliceEmotion DUO
ECG
Cardiofax 6511Schiller AT1/CH 6340Schiller AT1Cardiofax 96 20L
Echo Scanner
Echo Cardiogram (S-2000)Acuson X 300CypressUSSH 140a
Ultrasound4D Ultrasound (X-300)G 20EUB405B
33%
25%
18%
11% Germany
U.S.A
Switzerland
Japan
Source: Solidiance Interviews & Analysis
32 | www.solidiance.com
yangon gEnEral Hospital (ygH)• YGH is a major public hospital, providing 24 specialized treatments
and is the best teaching hospital in Myanmar• Yangon General Hospital is one of the five public hospitals equipped
with MRI scanners• Fewer number of CT & MRI machines is causing long waiting time and
results are also delayed by up to 2 weeks.• In early 2014, YGH installed new equipment from Varian Medical
Systems and procured new medical linear accelerator technology for high-dose-rate brachytherapy for cancer treatment
Source: Solidiance Interviews & Analysis
Hospitals providing Radiation Therapy in Myanmar (as of 2015)
yangon general hospital (yangon) public
Mandalay General Hospital (Mandalay) Public
Sao San Htun Hospital (Taungyi) Public
Nay Pyi Taw Hospital. (Nay Pyi Taw) Public
Pin Lon Hospital (Yangon) Private
• 1,500 beds• 24 specialized departments• Emergency care for general medicine, general surgery and
traumatology• Staff: Approximately 300 doctors and over 400 nurses• Teaching hospitals of University of Medicine 1, Yangon Institute
of Nursing and University of Paramedical Science• 123 staff in Radiology Department
yanGon General HospiTal
www.solidiance.com | 33
kEy takEaways
Shifts in Myanmar’s healthcare system are creating emerging opportunities for private healthcare companies across the country, but it requires them to have a long term strategic view of the market.
Major demographic changes and fast income growth have affected a significant increase in demand for Diagnostic Imaging & In-Vitro Diagnostics. However, market still requires efforts in increasing awareness about non-communicable diseases and effects of specialized testing.
Pricing is a key challenge that needs immediate attention especially in the private sector. Local hospitals, clinics & laboratories need assistance from global healthcare companies in devising a value proposition that would be appealing to the patients.
Myanmar patients spent ~USD 210 million in 2014 on outbound medical tourism. This is a large patient base that can be tapped in Myanmar to meet their diagnostics needs.
34 | www.solidiance.com
$$ $$$$
has the lowest healthcare spending in Southeast Asia.
total healthcare expenditure
Take up 14% of total hospitals 50% of private hospitals have <25 beds
Only available in public tertiary hospitals & big private hospitals
but IVD tests for some specific diseases are done abroad for accuracy
are leading the IVD market
Diagnostic Imaging (DI)In-vitro Diagnostics
Demands are rising for :
of Myanmar’s population reside in rural areas with minimal access to healthcare services
Death by non-communicable diseases (NCD)
Drivers of IVD penetration increase
Most IVD tests are done in Myanmar
2,7%
70%
40%
7%
in 2014 on outbound medical tourism
Only
to cross
of GDP in 2014
for 2015 - 2016
(2010 - 2014)
share
Patients spent
$$ ~ USD 210 millionMyanmar
Myanmar's
USD 2 billion
Private hospitals
Take up ~86% of total hospitals Quality is far behind regional standards
Due to non-detection in early stages Suggesting need for better diagnostic services
Growing aging populationHigh prevalence of major diseases (diabetes, hypertension, cervical cancer)
Public hospitals
Private facilities
Myanmar hospitals
Myanmaris a large patient
base for healthcare
$
$$ $$
PASSPORTMyanmar'sHealthcare
overview
HOSPITAL
increased by
Advanced diagnostics
Myanmar'sDiagnostic
ImagingMARKET
Myanmar'sIN-VITRO
DiagnosticMARKET
Source: Solidiance, www.solidiance.com
www.solidiance.com | 35
auTHorsOmar Aziz | Associate PartnerOmar Aziz is an Associate Partner at Solidiance. Equipped with over 9 years of experience in consulting, he has managed large projects in pharmaceutical, healthcare devices & healthcare infrastructure domain. His expertise are in helping multinational clients understand the Asian market landscape by profiling industries and competition, sizing the markets, segmenting customers, analyzing distribution channels, preparing investment feasibility studies, identifying suppliers, reviewing potential joint ventures or acquisitions, and delivering market entry and growth strategy in Asia. Omar speaks regularly at healthcare conferences, most recently, he conducted a workshop on ‘Myanmar Hospital Build’ at ‘2nd Healthcare Facilities Asia 2015’.
Shin Thant Aung | AnalystShin Thant is an Analyst based in Solidiance’s Yangon office in Myanmar. He is a part of Solidiance’s healthcare practice and has worked on a number of key projects. He understands the distribution scenario & regulatory frameworks for healthcare products and maintains good relations with key distributors and government agencies. Prior to joining Soildiance, he had been working as an advisory associate in a top four global accounting and consulting firm. Shin holds a Bachelor of Science degree in applied accounting from Oxford Brookes University.
Mie Ko | AnalystMie Ko is an Analyst based in Solidiance’s Yangon office in Myanmar. Mie Ko worked on several projects for Solidiance in Myanmar where she supported feasibility studies and investment projects for Fortune 500 companies. Prior to joining our team, she worked at the Finance Department of a large hospitality group in Yangon. Mie Ko holds an MBA with specialization in Strategic International Marketing from the Asian Institute of Technology.
36 | www.solidiance.com
www.solidiance.com | 37
what we Do
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http://www.solidiance.com/clients.
what we are focusing on
Our industry experience is centered on healthcare, industrial applications, clean technology, and technology. Our Asian market entry and growth strategy services provide the required insights and the necessary roadmap to capture a profitable market share in the region.
additional Details
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aBout us
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solidiance
chinaSuite 2101, Hong Kong Plaza, No 283 Middle Huaihai Road,Shanghai 200021Phone: +86 21 5113 2131
indonesiaOleos I Building6th FLoor - Unit 612Jl. Mampang Prapatan RayaNo. 139A, Jakarta 12950 Phone : +62 21 7918 0330
Myanmar4th Floor, Shwe Gon Plaza Kabar Aye Pagoda RoadBahan Township, YangonMyanmar - 11201Phone: +95 979 700 6465
singaporeSuite 07-05High Street Centre, 1 North Bridge RoadSingapore 179094Phone: + 65 31520301
uaESuite 402D - Dark Green Building, TwoFour54Sheikh Zayed RoadOpposite Khalifa ParkAbu Dhabi, United Arab EmiratesPO Box 769338Phone: +971 (0) 24 420 420
indiaSuite M-38/1 3/Floor, IBC Tower. Middle Circle, Connaught Place, New Delhi – 110001Phone: +91 11 4152 7888
Malaysia23A-02 Binjai 8 Premium SOHO, 8 Lorong BinjaiKuala Lumpur 50450Phone: +60 3 21 810 692
philippinesUnit 2105, Tycoon Centre Pearl Drive, Ortigas Centre Pasig City, Metro ManilaPhone: +63 2531 8346
thailandInterchange Tower 21#2109 - 21F399 Sukhumvit RoadNorth Klongtoey, WattanaBangkok 10110Phone: +66 26112664
vietnamSuite 704, Satra Dong Khoi Building58 Dong Khoi streetDistrict 1, Ho Chi Minh CityPhone: +84 835218639
Website:http://www.solidiance.com
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