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Faced with an increasingly ageing society and rising 
healthcare costs, countries in Asia Pacific are expecting cost-effective medical 
devices to be developed by local companies, as per Frost & Sullivan, Singapore. 
Despite the fact that Asia has 60% of the world population providing large 
market potential, Asian healthcare expenditure constitutes only 15% of the 
global healthcare expenditure. In 2007, the total global healthcare expenditure 
was at US$ 4.981 trillion. With a growth rate of 6.2%, the total healthcare 
expenditure of Asia is expected to be at US$ 791.7 billion by 2008. While some 
parts of Asia are experiencing high population growth, other countries such as 
Japan and China are facing the problem of accelerated ageing population. For 
instance, Japan is estimated to have 22% of its population above 65 years by 
2012 as compared to 20.6% in 2007. With the current Asian lifestyle, the 
prevalence of chronic diseases such as diabetes, cancer, obesity and 
cardiovascular diseases has increased significantly. Other diseases that 
threaten the region include auto-immune diseases, infectious diseases and 
neurological disorders. Accelerated ageing population and increasing prevalence 
of chronic diseases are the key drivers that contribute towards the increase in 
total healthcare expenditure on medical devices in the region.   
When it comes to medical devices, reliability and 
safety are very critical. This is an industry where quality and reliability of 
the devices cannot be compromised. Even a low device-failure is unacceptable to 
the patient and the healthcare providers. For example, a current leakage of as 
little as 10ľA (10-6 A) on a pacemaker will cause a microshock to patient, which 
will eventually bring death to the patient in minutes. Therefore, reliability is 
critical for medical devices. Unreliable readings given by devices might lead to 
misdiagnosis, further leading to delay in treatments or false alarms. To ensure 
zero-defect reliability of the medical devices, manufacturers use the Failure 
Mode and Effect Analysis (FMEA) tools. FMEA is used to evaluate the risks 
associated with the devices produced and to develop strategies to overcome them. 
Using flexible circuits instead of rigid circuits in medical devices is yet 
another option that could be employed by the manufacturers to increase the 
reliability of devices. Technology advances have made it possible to use smaller 
and thinner integrated circuit boards. Self-monitoring devices such as blood 
glucose meter and wrist blood pressure monitor now come with more functions that 
are smaller in size due to availability of denser and thinner printed circuit 
boards. Miniaturisation of devices has made it possible to save space in the 
operating theatres or intensive care units that have limited space.   
Power sources are critical for medical devices such 
as hearing aids and neurostimulators of a pain control therapy device. Batteries 
for these devices must be small, of right weight, easy to replace or recharged 
and have a reasonably long life span. For example, the rechargeable battery of a 
neurostimulator has 10 years of lifespan. Other batteries under development 
include biothermal battery that uses body heat to generate low current source of 
power, and nuclear microbatteries that use the decay of tritium and nickel-63 to 
generate power. In order for medical devices to be more marketable in the 
increasingly competitive market, these devices need to have breakthrough 
technologies. Medical devices are increasingly coming up with enhanced features 
and performance such as connectivity through wireless solution or LAN. Devices 
such as cochlear implant can be programmed wirelessly, and ultrasound images can 
be transferred from a patient's bed to the nearest workstation through LAN or 
Wi-Fi.   
Asia with its large population is considered as a 
lucrative market for device makers. Further, accelerated ageing population in 
few developed countries, such as Japan, Korea and Taiwan will eventually 
increase its healthcare expenditure. Asia continues to experience economic 
growth amidst slowdown in the US and Europe.   
Realising the importance of disease prevention, the 
Asian governments invested billions of dollars annually to improve their 
healthcare infrastructure. For instance, the Ninth Malaysia Plan (2006-2010) is 
to work 'towards achieving better health through consolidation of services' 
whereby emphasis has been placed on sustainability, upgrading and maintenance of 
existing facilities and equipment, and improving the quality of healthcare. 
China announced its Healthy China 2020 plan in January this year, which aims to 
provide safe, effective, convenient and low-cost public health and basic medical 
care to both rural and urban citizens by 2020. Some key goals of the plan 
include making public medical institutions 'non-profit'; reducing the 
involvement of hospitals in the sale of drugs, increase the role and 
responsibility of government and establish basic medical care network for all 
Chinese citizens. These policies clearly showed the eagerness of the government 
to provide better healthcare infrastructure with better medical devices and 
facilities. In recent years, the medical industry has experienced a paradigm 
shift from sickness care to healthcare. Higher priority is given to prevention 
rather than to cure. This phenomenon is also seen in Asia, where finding cures 
and fighting infectious diseases have become the priority. Asians are becoming 
more aware of their health, especially people in China, Hong Kong and Singapore, 
which were hit by SARS and Avian Influenza several years ago. Both the 
governments and people in Asia are now more receptive towards medical technology 
and encourage home-based monitoring. With advanced technology and communication 
systems available in most of the countries in the Asia, people now have access 
to the information resources available and are more demanding in seeking 
healthcare options. On the other hand, direct-to-customer marketing strategies 
of some pharmaceuticals and medical device companies have indirectly educated 
Asians on the healthcare options available to them. Employers, in their effort 
to increase company's efficiency are becoming more aggressive in pushing for 
preventive care. This paradigm shift has increased the demand for medical 
devices in the healthcare industry.   
High participation from private healthcare providers 
in developed countries in Asia promotes healthcare expenditure. For instance, 
Taiwan has fairly high participation of private healthcare, which contributes 65 
per cent of Taiwan's total hospital beds. Private involvement has enabled 
efficient healthcare delivery to the people, which could be clearly seen in the 
case of Taiwan. This private participation was driven by Taiwanese comprehensive 
National Health Insurance scheme, which has eventually helped to increase the 
healthcare quality.   
Most hospitals in the Asia rely heavily on 
government subsidy, and in most cases government purchases control the prices of 
medical devices. For instance, in Taiwan, huge pressure is put on National 
Health Insurance to reduce its account deficit, which leads to stricter medical 
examination. Unnecessary health screening such as MRI and blood screening are 
excluded from the insurance coverage, which leads to reduction in device 
purchase. Government restriction discourages the installation of medical devices 
that are considered by it as non-critical items. This causes initial barriers in 
introducing new medical technology into the region. In addition to government 
control over the price, Asian countries have started to implement regulations 
following the increased concern of product safety when imported into these 
countries. Increased healthcare regulation has brought varying regulations in 
different countries. Most of the countries in the Asian region are now 
implementing and adopting different medical device standards. Some of these 
countries, such as China and Japan have taken a step further to develop their 
own regulations that suit their local requirement. These complicated regulation 
structures in these countries pose challenges to investors.   
 Distribution costs in Asia have increased in 
recent years due to continuing high oil prices and inflation. Labor charges too 
have increased over the years compared to a decade ago, with the increasing 
demand for labour. Although the overall cost is still lower than Europe and US, 
the effect of the increase is significant. Increased involvement of local 
medical device companies in countries such as Korea and China is a threat to the 
multinational companies. These companies, supported by their governments, are 
able to provide medical devices that suit local requirements at a price far 
lower than that offered by multinational medical device companies.
 
Geographic vastness of the Asian region poses 
challenges to distribution, logistic, communication and promotion activities of 
medical device companies. In most of the Asian countries such as Thailand, 
Vietnam and Indonesia, the well-equipped hospitals are in the urban areas and 
rural residents barely have an access to medical services. Lack of penetration 
to rural part of Asia is due to poor transportation systems in these countries. 
Healthcare infrastructures in these countries are not well developed and may 
take another two decades to reach such a level. Vast geography with poor 
transportation increases the delivery time and operation costs. These factors 
have hindered the growth of medical device market.   
The full potential of Asian markets can be realized 
by establishing key partnerships and alliances with the local companies, keeping 
mind the market drivers and challenges posed by the region. The fastest way to 
penetrate these highly protected, untapped Asian markets is through effective 
joint ventures with the emerging medical device companies of Asia. 
Geographically big Asian countries provide great opportunity for telemedicine 
and teleradiology. In view of the poor transportation facilities in parts of 
Asia, telemedicine and teleradiology could help in providing more efficient and 
timely medical care in rural areas. Companies should consolidate their distribution function throughout 
Asia in order to be more cost-effective and efficient in product delivery. In 
order to stay competitive in the local market, emphasis on Research & 
Development of medical devices should be combined with the manufacturing of 
medical devices.
   
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