Budget 2020 - Healthcare



Budget 2020 also stated that there would be an initial allocation of RM 60mil to kickstart pneumococcal vaccine for children.

The initiative is a good start, however the RM 60mil would not be enough to vaccinate all of the 450,000 birth cohort and the cost of refrigeration required to hold the single dose vials.

There is a RM 25mil allocation for the Malaysian Healthcare Travel Council (MHTC)  as 2020 is a Malaysia Year of Healthcare Travel 2020.

MHTC is an agency under the Finance Ministry that coordinates with the various private hospitals in facilitating medical tourists from abroad and it also promotes the country’s medical tourism sector overseas.
Meanwhile, the move to allow an Employees Provident Fund (EPF) withdrawal for fertility treatment such as in-vitro fertilisation (IVF) is lauded. 
The reason for the move is because the fertility rate in Malaysia has fallen alarmingly from 4.9 children per woman in the 1970s to 1.9 children per woman, which is below the replacement level.
There is also an income tax relief of up to RM 6,000 that was announced to include on expenses incurred on fertility treatment which is an expansion of the definition for medical treatment of serious illnesses tax relief category.
It notes that currently some 70% of of the infertile patients are local with international patients comprising the remainder 30%.
/12-10-2019

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Malaysia Health Budget 2020



The Health Ministry has been allocated RM30.6 billion under Budget 2020, marking an RM1.9 billion increase from its RM28.7 billion allocation in the previous federal government budget.
The 6.6% raise in the budget for public health care next year was smaller than the 7.8% increase in Budget 2019.
However, the Health Ministry’s percentage of allocation from the total government budget was bigger than in 2019, comprising 10.3% of the overall RM297 billion 2020 budget, compared to 9.1% out of Budget 2019’s RM316.6 billion.
The Health Ministry received the third biggest allocation, after the Finance and Education Ministries at RM37.8 billion and RM64.1 billion respectively. These three make up 44.6% of total expenditure.
The allocation under services and supplies for the Health Ministry’s operational budget also saw a minimal increase, from RM10 billion in 2019 to RM10.9 billion.
However, the services and supplies allocation under the Health Ministry’s development budget was reduced from RM476.9 million to RM318.1 million in 2020.
Drugs and medications fall under services and supplies. The government will conduct pool procurement of RM500 million worth of medicines across Ministry of Health, Defence and public university hospitals, according to Budget 2020. 
The government would intensify “Buy Made In Malaysia” product campaigns.
To support the local medical device industry, the government will introduce an initiative to encourage local producers to upgrade equipment and tools used in public clinics and hospitals, based on a minimum allocation of 30 per cent.
The government will also allow pre-retirement withdrawals for private retirement schemes (PRS) for the purposes of health care and housing, based on the same terms as the Employees Provident Fund (EPF).
The Health Ministry’s allocation for emoluments increased from RM16 billion for 2019 to RM16.5 billion. 
/11-10-2019

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Top 10 Global Pharma companies in 2019:



The global pharmaceutical industry reached unprecedented heights in 2018, being estimated at an astounding USD1.11 trillion. By 2020, this figure is set to rise to USD1.43 trillion. 
With rising pressure to develop drugs to meet ever increasing global demand, pharmaceutical companies continue to work tirelessly to bring the most innovative and cutting-edge treatments to patients.
Being a research-driven industry, approximately USD150 billion is spent by pharmaceutical companies every year on research and development projects. Out of thousands of compounds, only a small percentage gain regulatory approval to be used by patients to treat disease and improve quality of life. 
However, in 2018, a record number of novel drugs developed by pharmaceutical companies across the globe were approved by various regulatory bodies. A large proportion were approved by the US regulatory body, the FDA, which approved 55 novel drugs and smashed its record for generic approvals (781 up from 763 in 2017).
Although the USA’s market share of the global pharmaceutical industry is worth over USD 341.1 billion, the Chinese, South East Asian, Eastern European and South American markets are beginning to emerge. For example, the Chinese market is rich with preclinical and early-phase drugs, and is a growing nucleus of biotech activity. 
The next few years will see global growth thanks to the increasing wealth worldwide, as well as increasing demand to maintain high levels of innovation to combat unmet medical need.
Proclinical has ranked the leading pharmaceutical companies according to 2018 revenue from their pharmaceutical segment only.  

1) Pfizer  

USD 53.7 billion

2) Roche

USD 45.6 billion

3) Johnson & Johnson 
USD 40.7 billion

4) Sanofi

USD 39.3 billion

5) Merck & Co 
USD 37.7 billion
6) Novartis
USD 34.9 billion

7) AbbVie

USD 32.8 billion

8) Amgen

USD 23.7 billion

9) GlaxoSmithKline (GSK)
USD 23 billion

10) Bristol-Myers Squibb (BMS) 

USD 22.6 billion

/proclinical 20-03-2019

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Merdeka Healthcare Birthday Wishes



Merdeka Healthcare Wishes - CodeBlue with Choe Tong Seng
What health policies should the government focus on as we reach our 62nd year of independence?
CTS: It is time that the country formulates a “National Health Policy” that is reviewed every three years to provide focus and drive the development for the future health care needs, services and structures etc to meet the changing demographics, health care deliveries, disease burden, new medical technologies, resource allocation in manpower and financials etc.
This is also to facilitate in synchronising and/or integrate “public and private health care” development and deliveries for the future, for example health care financing, better management of patient medicine adherence and safety etc.
As at present, different health care sub sector/ stakeholder has its own priority in the development of health care needs. Further, with each change of the Minister of Health, health care priorities often do change as well.
What do you think the government can do better in terms of health care?
CTS: 1) Mutual respect and transparency for public-private partnership stakeholders’ meetings/ dialogues. There is a suspicion by the private sector that often times the meetings/ dialogues are for endorsing the government programmes, rather than a meeting/ dialogue where consensus are agreed upon and then implemented.
2) Regulatory impact analysis should be carried out for any intended policy that may have a long-term impact for the rakyat and the industry, for example the price control and dispensing separation for medicines. Any decision made by the ministry should be objective and with full transparency, with the rakyat and the national interest in mind.
What kind of health allocations are you hoping for in the upcoming Budget 2020?
CTS: The government must allocate adequate financial funding for the health care sector. Over the last few years, only about 4.5 per cent of the GDP is contributed towards health care despite the growth of population, ageing population, changing disease burden, growing NCDs, cost of medicines and new medical technology etc.
Instead of “just looking at cutting cost” for short-term solutions, where the delivery of services of the health care to the rakyat could suffer and deteriorate, the government should, in addition, consider allocating 6 to 7 per cent of the GDP, as recommended by the WHO (World Health Organization) for developing nations, towards the health care sector. A healthy nation is the anchor towards achieving economic growth and stability.
/31-08-2019

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IHH acquiring Prince Court Hospital



IHH Healthcare Bhd is planning to fully acquire Prince Court Medical Centre from Khazanah Nasional Berhad for RM1.02 billion in cash by March 2020.
IHH’s wholly-owned subsidiary, Pantai Holdings Sdn Bhd, inked a conditional share purchase agreement with Pulau Memutik Ventures Sdn Bhd, a wholly-owned subsidiary of Khazanah, for the acquisition of 100 million ordinary shares and 35,176 redeemable preference shares in the private hospital company, representing the entire issued share capital of Prince Court.
“We are pleased to be adding Prince Court Medical Centre to our existing network of 15 hospitals across Malaysia.
“This is a rare opportunity to acquire an attractive and accretive asset in Kuala Lumpur’s ‘Golden Triangle’ that will strengthen IHH’s position in Malaysia while allowing us to capture the growing medical tourism market,” IHH CEO-designate Dr Kelvin Loh said in a statement today.
Prince Court owns and operates a 277-bed private health care facility that provides a wide range of medical, surgical and hospital services in the heart of Kuala Lumpur, such as burns management, cancer, gastrointestinal diseases, interventional cardiology, in vitro fertilisation, nephrology, occupational health, orthopaedic and rehabilitation medicine.
IHH currently runs 14 Pantai and Gleneagles Hospitals in Malaysia. The government-linked corporation’s 2018 PATMI (profit after tax and minority interests) excluding exceptionals increased 73 per cent year-on-year to a record high of RM1.03 billion, and paid its outgoing CEO, Dr Tan See Leng, RM34 million last year.
“This transaction is in line with our refreshed mandate and provides Khazanah with the liquidity for our future investment capital requirements,” Khazanah managing director Shahril Ridza Ridzuan said in a separate statement.
“In addition, Khazanah is confident that Prince Court will further benefit from IHH’s wealth of experience in providing premium health care, whilst solidifying IHH’s position as leading Malaysian health care provider, where we remain a substantial shareholder with a 26.04 per cent stake.”
codeblue/17-09-2019


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Malaysia Elderly Ageing healthily?



Only 11% of Malaysian elderly people aged healthily in 2015, down from 13% from 2002 to 2006, a study has shown.
Dr Suzana Shahar, head of the Centre of Healthy Aging and Wellness at Universiti Kebangsaan Malaysia, said her 2015 research showed that only about 1 out of 10 Malaysian senior citizens experienced “successful” or healthy ageing, which means an absence of illnesses like cancer, diabetes, cardiovascular disease, or stroke; no functional limitation; good cognition or mental health; no depression; good quality of life; and good self-perception on health.
A total of 16% experienced mild cognitive impairment, while 73% had “usual ageing”, which means extrinsic factors alone increase the effects of ageing, unlike “successful ageing” in which external factors play a neutral or positive role.
According to a 1987 study by Rowe JW and Kahn RL, the effects of the ageing process are exaggerated, while the modifying effects of diet, personal habits, exercise, and psychosocial factors are underestimated.
Dr Suzana told a recent roundtable discussion organised by the Galen Centre for Health and Social Policy here on malnutrition that Malaysia’s prevalence of healthy aging at 11% was below Singapore (17.8%) and Thailand (27.5%), but was about the same as the United States (10.9%) and slightly higher than Europe (8.5%).
She also cited a 2011 study by Lee LK et al that found about 20% mild cognitive impairment among the bottom 40% of income earners (B40), higher than the national prevalence rate of 16%.
Only 3% of Singaporean elderly suffered frailty, said Dr Suzana, citing a 2014 study, compared to 7.5% in the Klang Valley in Malaysia. The Klang Valley’s pre-frailty rate was 65%, double that of Singapore’s 32%. Almost two-thirds of Singaporean elderly, or 65%, were robust, compared to just 27.5% in the Klang Valley.
Dr Suzana said her research found that almost 40% of Malaysian senior citizens suffered from cognitive pre-frailty and cognitive frailty. She had also discovered that three to four out of 10 older adults in Malaysia experienced sarcopenia, or loss of muscle mass linked with ageing.
“We found that older Malaysians have no problem with social networking, but they’re not like the Koreans and Japanese which do cognitive stimulation. You can see older adults there play games to improve cognition. But not an awareness for older Malaysians to engage with cognitive stimulation.”
Malaysia, she said, was ageing at a higher rate of disability compared to Australia, with dementia being a major cause of disability among older Malaysians, followed by musculoskeletal and visual-hearing conditions.
“As [a] conclusion, we are entering an ageing nation with little body reserve to be prepared, with little muscle mass, not so good in respect to metabolic condition, biological and brain reserve.
“Poor socio-economic status, mental health and physical function increase risk of malnutrition and poor health of aging Malaysians,” Dr Suzana said.
Malaysia was ageing much faster than other nations, estimated to take only 23 years from those aged 65 and above forming 7% of the population in 2020 to that age group forming 14% of the population in 2043. In comparison, the proportion of the aged rising from 7% to 14% of the population would take the UK 45 years, the US 69 years, and France 115 years, according to a 2015 study by Ismail et al that she cited.
Dr Suzana called for dietary changes and better nutrition, stressing that middle-age intervention was not too late.
“Now we have to focus on the middle age, if we can change something on middle age, we can see some improvement in aged population.”
codeblue/24-09-2019


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New Owner for Columbia Asia Hospitals?



Hong Leong Group, controlled by billionaire Tan Sri Quek Leng Chan, aims to make healthcare one of its core businesses, leveraging the Columbia Asia hospitals in Southeast Asia.
The banking Group and TPG (a global alternative asset firm) have entered into a share purchase agreement with Columbia Pacific Management to acquire Columbia Asia hospitals in Southeast Asia for US$1.2 billion which is expected to close by the end of the year.
Under the partnership, the purchase consists of 17 Columbia Asia hospitals and 1 clinic in Southeast Asia viz: Malaysia (12 hospitals), Indonesia (3 hospitals) and Vietnam (2 hospitals and 1 clinic) excluding the 11 hospitals in India.
Columbia Asia is leveraging the middle to upper middle-income market. It has good scale and an established brand. The asset has growth momentum and, together with the management, we will continue to grow the brand in Southeast Asia,” said Hong Leong’s Finance director Soon Seong Keat.
Columbia Asia Hospitals currently operates 1,500 beds across Southeast Asia. It plans to add another 900 beds in Malaysia, Indonesia and Vietnam over the next 3 to 4 years. These will come from 9 projects in both greenfield and brownfield assets, says Dilip Kadambi, interim group CEO and group CFO of Columbia Asia Group. 
“The group’s revenue has been growing at a compound annual growth rate of 20 per cent over the last few years and we expect the business to continue to grow at the same rate over the next few years. We will open 1 or 2 hospitals a year,” he added.
theEdge/24-09-2019


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Intensifying Medical Tourism



Malaysia is planning to establish the nation’s maiden flagship medical tourism hospital, with government-linked company (GLC) hospitals and selected privately owned medical centres.
The hospitals are National Heart Institute (IJN), Sunway Medical Centre, Thomson Hospital Kota Damansara, Ramsay Sime Darby Subang Jaya Medical Centre, Prince Court Medical Centre, Mahkota Medical Centre, Island Hospital, Gleneagles Penang, and KPJ Ampang Puteri.
IJN, Subang Jaya Medical Centre, Prince Court, Gleneagles, and KPJ are all GLC hospitals. IJN is owned by the Ministry of Finance (MOF) Inc, while IHH Healthcare Bhd runs Gleneagles and is planning to acquire Prince Court from Khazanah Nasional Bhd.
KPJ Healthcare Bhd is the health care arm of Johor state-owned conglomerate Johor Corporation, whereas Ramsay Sime Darby Health Care is a 50:50 joint venture by Sime Darby Berhad, a GLC.
“To show our commitment in further supporting the industry’s growth and sustainability, we will look into acknowledging qualified Malaysian private hospitals who are establishing themselves as flagship hospitals for healthcare travel,” the Finance Minister, YB Lim Guan Eng
said.
The Minister also announced that the government has created a joint committee to increase investments into the health care sector.
“We have established a joint steering committee to approve investments, chaired jointly by myself, and Minister of International Trade and Industry, Darrell Leiking,” he said.
“Where previously, for all foreign as well as domestic investments will take at least six to nine months to get final approval, this will be approved on a monthly basis.”
According to Lim, the government’s commitment to the private health care industry through investment tax allowance and incentives has attracted almost RM10 billion in private investments in 2018, of which more than RM1 billion was from foreign direct investments and more than RM8 billion from local investment.
Among the new investments included Penang’s Medical City, comprising an RM2 billion investment to build the largest private hospital with 1,000 beds, and the establishment of a foreign private hospital.
Malaysia has out-performed global and regional growth rates in the health care travel industry, with its compounded annual growth rate (CAGR) reaching 17 per cent from 2015 to 2018 in terms of revenue. 
In the past five years, the average global CAGR for the health care travel industry recorded between growth of between 10 and 12 per cent. In 2018 alone, revenue receipts reached RM1.5 billion from approximately 1.2 million health care traveller arrivals
“Under the 10th and 11th Malaysia Plan, a target has been set for Malaysia health care to deliver 25 per cent growth with over RM1.8 billion in hospital revenues and an estimated total economic impact of RM8 billion for 2019.
“Through incentives such as the investment tax allowances, roughly 15,000 jobs have been created within the private healthcare sector. In addition to that, we have seen an increase in private sector bed capacity to the current 15,000 units we have presently now.”
/24-09-2019

Disclaimer: Views or opinions expressed are solely those of the Author and should be used with discretion. The Author shall not be held liable for any acts or omissions arising from the use of the information. The user will be personally liable for any damages or other liability arising hereof.

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