Case Competition Finals and APAC Healthcare Industry Panel Discussion

Case Competition Finals and APAC Healthcare Industry Panel Discussion

The Singapore Life Science Case Competition (SLSCC) ended on a high note with pitches from the top 4 finalists, a keynote speech on “Living Well, Dying Well: Prevention and Cure in the Healthcare Industry” and an exciting panel discussion on the current and future state of the healthcare industry in the Asia Pacific (APAC) region. Biotech Connection Singapore (BCS) and our co-organizers (L.E.K. Consulting and ESSEC Business School, Asia-Pacific) were heartened to see a great turnout of over 100 attendees at the Grand Amphitheatre of ESSEC Business School.

SLSCC Finals

The top 4 teams (ELCision Consulting, Med Inseaders, Fate Consulting and Athena Consulting) defeated 24 others for a chance to present in front of the distinguished panel of judges with rich experiences in the management consulting and healthcare space. All 4 teams impressed the judges with the breadth and depth of their analysis and the creativity of their growth strategies for a fictitious company, Cybertron Pharmaceuticals.

The winner of the competition, Athena Consulting (Joeri Coppens, Alessia Landi and Daniel Tay) took home the grand prize, which comprises a $1000 cash award, a tour of the L.E.K. Consulting office and the opportunity to network with L.E.K. consultants. Fate Consulting (Yanxin Wang, Wallie Wee, Ling Wu, Shifali Chatrath) was named runner up of the competition.

Top Left: Winner (Athena Consulting); Top Right: Runner up (Fate Consulting); Bottom Left: Finalists (Med Inseader) presenting to the judges; Bottom Right: Finalists (ELCision Consulting) in action

Keynote Speech: “Living Well, Dying Well: Prevention and Cure in the Healthcare Industry”

In his keynote speech, Arijit Chatterjee, Associate Professor at ESSEC Business School, highlighted three important trends in the healthcare industry:

1) Unsustainable drug prices

2) Emergence of social media as a market intermediary

3) Huge growth in the global wellness economy

Unsustainable drug prices

Professor Chatterjee narrated the interesting story of Gleevec to illustrate how high drug prices cause medicines to be inaccessible to most of the developing world. Gleevec is a blockbuster drug approved for chronic myeloid leukemia (CML). Siddhartha Mukherjee, the biographer of cancer, wrote in his book, The Emperor of All Maladies, that oncologists use the phrases “pre-Gleevec era” and “post-Gleevec era” when discussing CML treatments, an indication of Gleevec’s blockbuster status. With Gleevec, CML went from a death sentence to a largely manageable disease. Unfortunately, majority of CML patients in India (and in most developing countries) cannot afford Gleevec. The drug used to cost about US$4000 for a month when it came to market in 2001 and escalated to US$10,000 per month in 2015. Since Gleevec’s patent was not granted in India, drug manufacturing companies in India could manufacture a generic version of Gleevec that they can sell for under $200 per month. A high-profile legal battle between Novartis (the owner of Gleevec) and the Indian government ensued. Eventually, Novartis lost the lawsuit in 2013, ensuring a win for CML patients in India. The Gleevec case is one of many cases in the Healthcare Industry that highlight the tension between public good and monopolistic pricing, and between innovation and affordability.

Professor Chatterjee giving the keynote presentation.

Emergence of social media as a market intermediaryProfessor Chatterjee raised the issue that social media has now empowered patients to share their experiences with each other and is fast becoming a powerful market intermediary alongside medical experts. Not only are patients able to gain access to scientific information on specific diseases and treatments, they are also forming virtual communities and openly sharing their experiences in taking an approved drug or experimental therapy. Such information can have dramatic influences on a patient’s decision, resulting in a shift in authority from doctors to patients, with patients increasingly telling doctors what they want for their treatment.

Huge growth in the global wellness economy

Finally, Professor Chatterjee brought up the question of prevention versus cure, specifically wellness, or prevention, as a substitute for drug treatments, or cure. The pharmaceutical industry is a US$1.4 trillion industry and the global wellness industry stands at US$4.2 trillion. With that, he left us with a thought-provoking question, “Do you want to be in cure or prevention? Maybe both?”

Panel Discussion on the Healthcare Industry in APAC

The panel discussion drew from the diverse and deep experiences of our panelists who have worked in the healthcare industry for many years. The discussion spanned a wide range of topics that were of key interest and relevance to audience members. Fabio La Mola, Partner and Managing Director of L.E.K. Consulting Singapore, was the panel’s moderator. Here are some notable excerpts:

Healthcare innovation trends in APAC

Fabio: In my 6 years here in APAC, I have seen this region transforming from a receiver of technology to a developer of technology. Asia is innovating extremely fast in the healthcare sector. This is reflected in the fact that there are 131 clinical trials in Chimeric Antigen Receptor [CAR]-T cell therapy in China and less than 100 in the US. How do you see healthcare innovation changing the path of APAC?

John: The DxD hub was set up to grow the diagnostics ecosystem in Singapore. I think the future for us lies in developing diagnostic products that suit Asian phenotypes. For example, gastric and hepatic cancers are very rare in North America and Western Europe, so developing diagnostics for these diseases do not make sense in those regions. But gastric and hepatic cancers are prevalent in Asia and we need to have good diagnostic tests here. We want to build Asian diagnostic tools with good accuracy that are affordable for people in this region.

Raphael: In the past, technology in almost all sectors in Asia mirrored that in the western world. But right now, you see more innovation in Asia surpassing that in the US. For instance, Amgen has a new product for bone disease that is going to be approved in Japan as the first country in the world, ahead of the US. This is probably the first time a drug is going to be marketed in an Asian country before it is approved in the US.

Joyce: Innovation comes with demand and is supported by regulations. From the company’s perspective, we encourage and support innovation by working with startups. In fact, J&J has set up innovation centres in APAC to collaborate and foster innovation with startups.

Panel members (from left to right): Fabio La Mola, Dr. John Thornback, Joyce Lim, Raphael Ho

Regulatory frameworks in supporting innovation

Fabio: The strength of regulatory frameworks currently in Asia is insufficient to allow a product that is approved in Asia to be recognized in the US/Europe. Conversely, a product that is approved in US/Europe is often recognized here in Asia. Do you see changes in regulatory frameworks that will help support greater innovation?

Raphael: We are definitely seeing improvements in the regulatory structures in the region. For instance, Vietnam has overhauled its regulatory system. China is also improving its regulatory capacity to increase the speed of drug approvals. Singapore is leading the Centre of Regulatory Excellence (CORE) to develop standards that can be applied across the ASEAN region. The overall goal of these efforts is to get products to the market faster.

John: As Asian countries are getting richer, there is a greater incentive for marketing authorization holders to register their products in the region. We have seen a global move towards harmonization driven in part by organizations like the International Council for Harmonization (ICH).

Joyce: I agree that regulation standards are definitely moving towards convergence. Other considerations for a company in selecting where to launch their product first include regulatory risks and pricing issues.

Fabio: From a start up’s perspective, it is much easier to get approval and do their first launch in a large market like the US. A small country like Singapore has more to benefit from harmonization of regulatory frameworks.

Factors driving innovation in Asia

Member of audience: There is a strong push for innovation in Asia. Do you think this is driven by profit or a grander goal of lifting the region out of poverty?

John: Singapore has invested so much in biomedical research, in part to create high value jobs for locals. Other countries are doing the same. Providing good jobs for the educated population is a key driver behind the investment in healthcare and the push for innovation.

Raphael: The push for innovation is driven by immediate problems that governments face, specifically the healthcare needs of an aging population. Healthcare innovation is necessary to keep up with the changing demands as people live longer lives.

Fabio: In innovation and health care, you need to have a big market to make enough money to be sustainable. The cost of developing a diagnostic or a new drug is enormous. Many Asian countries aspire to be innovative, for instance, Thailand has a 4.0 framework to create knowledge jobs for its increasingly educated population. But not every country can become like the West Coast of the US where Amgen was born. Governments need to think about what niche they want to occupy in the ecosystem and what their strategy is to push that innovation that is specific for their country.

Career advice for aspiring bio-entrepreneurs

Fabio: What advice do you have for aspiring bio-entrepreneurs? Where would you encourage young people to focus their efforts on?

Joyce: Explore China, there are plenty of opportunities there.

Raphael: If you have a proprietary technology, consider markets with very strong frameworks for protecting your inventions; for instance, the US is known to be very innovation-friendly. Singapore has strong intellectual property protection as well. Also, be aware of where the venture capital funds and other types of investments are available.

John: Venture capital firms have 3 to 5-year horizons, so you have 3 to 5 years to grow the value of your company and try to make the most impact within this time frame.

Fabio: Consulting firms used to lose a lot of people to big companies like J&J and Amgen, now more people who leave consulting are becoming entrepreneurs. What I have observed is that successful entrepreneurs tend to be the ones who start a business later in life, after having some experience in established companies. These sorts of experiences teach you what building a business means, which is very important for an entrepreneur.

Impact of stricter regulations on innovation

Member of audience: Regulations seem to be getting stricter in the US and Europe and may potentially hinder innovation. Is APAC going to be any different? How is that going to affect innovation in this region?

Raphael: There are a couple of trends. 1) Asian governments have recognized the need to open market access to innovative healthcare products and that the regulatory curve is way behind the innovation curve, but this is improving. We have seen approvals based on phase II data for certain orphan diseases to reduce the time to market. 2) The demand for real world evidence is becoming important for regulatory agencies. Sometimes even phase III data is not enough. We need to understand how to fulfil the demand for real world evidence without lengthening the time to market.

John: I think software for medical devices need to be better regulated, particularly application software that help doctors make clinical decisions. Too many apps are not doing what they say they can do. Many healthcare apps are wellness apps that are not clinically-relevant. There are a lot of Artificial Intelligence (AI) type technologies coming through and they are not very expensive to do.

Fabio: If your data is not clinically relevant, the data is irrelevant. This is because you can’t make decisions on clinical treatment based on incomplete or statistically difficult to interpret data.