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On Tuesday 11 July 2023, Indonesia’s House of Representatives (or DPR) passed the Omnibus Health bill into law. The only two political parties (both opposition parties) that voted against this bill were the Democratic Party (PD) and Prosperous Justice Party (PKS). Main reasons behind their rejection involved the rushed deliberation, and the removal of mandatory government spending on the health sector.
On 06 March 2023, Indonesia Investments released its latest monthly report titled 'Normalizing Economic Growth'. As usual, we aim to present in-depth analyses of topics that are relevant in the context of economic, political and social developments in Indonesia.
Although Indonesia’s healthcare industry has grown in terms of size and access in recent years, concern persists about the quality and capacity of Indonesia’s healthcare industry. Hence, those Indonesians who have enough money at their disposal (or expats residing in Indonesia) often prefer to travel to a hospital in Singapore or Malaysia when they need a medical checkup or treatment.
Per September 2017 around 70 percent of the Indonesian population participates in the government's universal healthcare program (in Indonesian: Jaminan Kesehatan Nasional or JKN), a program that was implemented by the social security agency Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS) in early 2014. This government-subsidized program aims to provide all Indonesian citizens with access to a wide range of health services by 2019.
During the first trading session on Monday (11/09) shares of Mitra Keluarga Karyasehat, Indonesia's largest listed hospital operator in terms of market capitalization, plunged 4.27 percent to IDR 2,020 per share after a high degree of negative attention in Indonesian media. This weak performance is linked to a scandal that emerged over the weekend.
The hospital sector of Indonesia is promising. Therefore, several investors are eager to expand into the nation's hospital business. For example, the Mayapada Group will add five hospitals to its portfolio over the next 12 months. Another example is Mitra Keluarga Karyasehat that also plans to acquire a number of hospitals with a focus on the new market that is created under the central government's universal healthcare program.
Siloam International Hospitals, Indonesia's largest private hospital operator, received the green light from shareholders to conduct a rights issue. Through the rights issue the company will issue 325.2 million brand new shares, equivalent to 25 percent of its enlarged share capital. Siloam aims to obtain IDR 3.09 trillion (approx. USD $232 million) worth of fresh funds through the corporate move.
Indonesia's pharmaceutical industry remains promising for foreign investors, evidenced by rising growth in the first half of the year. For the first time in three years growth in Indonesia's pharmaceutical industry could touch double-digit figures again. Parulian Simanjuntak, Executive Director of the International Pharmaceutical Manufacturers Group (IPMG), said the industry has improved compared to the situation one year ago.
Foreign pharmaceutical companies have already invested more than USD $1 billion in Indonesia over the past couple of years. These investments involves 34 companies that are all members of the International Pharmaceutical Manufacturers Group (IPMG). Parulian Simanjuntak, IPMG Executive Director, informed that these investments have been conducted not only to establish new factories but also for other forms of business expansion as well as marketing. It is estimated that 205 pharmaceutical companies are competing for market share in Indonesia.
Indonesian President Joko Widodo signed Presidential Instruction No. 6/2016 on the Acceleration of Development of the Pharmaceutical Industry and Medical Devices on 8 June 2016. Through this instruction Widodo calls on all relevant ministries - including the Health Ministry, Industry Ministry and Finance Ministry - to take efforts to boost development of Indonesia's pharmaceutical industry. The Health Industry has a key task to write an action plan for the development of a self-sufficient pharmaceutical industry and to boost competitiveness.
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It is interesting to take a quick look at Indonesia’s national healthcare program (in Indonesian: Jaminan Kesehatan Nasional, JKN) that is managed by the government’s Social Security Agency (BPJS Kesehatan).
At the start of 2014 the government of Indonesia launched its ambitious universal health coverage (UHC) program. This program aims to ensure that all Indonesians (whether rich or poor) have access to health services (of sufficient quality), while also ensuring that the Indonesian people do not suffer financial hardship when paying for these health services. In other words, the program aims to deliver affordable healthcare to all citizens.
The Indonesian government launched its universal healthcare program (Jaminan Kesehatan Nasional, or JKN) on 1 January 2014. This government-subsidized program aims to cover all Indonesian citizens - providing them with access to a wide range of health services – by the year 2019.
Vincent Harijanto, Head of the Indonesian Pharmaceutical Association (GP Farmasi) business development committee, said about 95 percent of raw materials used in Indonesia's pharmaceutical industry need to be imported from abroad. This dependence on imports causes several problems, for example prices of pharmaceutical products are relatively high on the Indonesian market, while Indonesian pharmaceutical companies (and Indonesian consumers) can suddenly face rising prices in times of rupiah depreciation.
A new report shows Indonesia lacks behind its regional peers in terms of innovation. This is a concern because it means Indonesia's workforce is not equipped with the skills, knowledge or health that are necessary to be innovation-driven. Therefore, the Indonesian government needs to remain focused on enhancing the quality of education and healthcare. Innovation is widely regarded as a driver of economic growth and development.
Exports of pharmaceutical products from Indonesia have declined due to increasing competition from China on the international market. Chinese pharmaceutical companies dominate export markets supported by China's low production cost environment and the availability of raw materials at home. However, despite this situation, the Indonesian Pharmacy Association (GP Farmasi Indonesia) remains optimistic that Indonesia's pharmaceutical exports can climb in 2017.
State-controlled pharmaceutical company Kimia Farma is expected to show steadily improving corporate earnings in the years ahead supported by Indonesia's universal healthcare scheme (in Indonesian: Jaminan Kesehatan Nasional or JKN) that was implemented by the social security agency Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS) in early 2014. The scheme aims to provide all Indonesian citizens with access to a wide range of health services. Obviously, local pharmaceutical companies are in a great position to benefit from this program.
Although Indonesia's National Health Insurance program is not without problems, it does benefit Indonesian hospitals and makes investment in the nation's hospital sector attractive, particularly as the Indonesian government targets to provide universal health care to all Indonesians by the year 2019. Reportedly, those hospitals that receive patients that fall under Indonesia's Healthcare and Social Security Agency (Badan Penyelenggara Jaminan Sosial, or BPJS Kesehatan) are the busiest hospitals in Indonesia at the moment.
Companies active in the pharmaceutical industry of Indonesia need to find strategies to overcome sharp rupiah depreciation. Indonesia’s pharmaceutical industry is still - to a large extent - dependent on the import of raw materials, hence a weakening rupiah raises the costs of imports thus eroding profit margins. Since May 2013, when the US Federal Reserve started to hint at monetary tightening, the US dollar has experienced bullish momentum. Between the May 2013 and July 2015, the rupiah depreciated around 37 percent against the US dollar.
A new World Bank report, entitled “The Double Burden of Malnutrition in Indonesia”, says that 37.2 percent of Indonesian children under the age of five - or 8.4 million children - are stunted (meaning excessively small for their age) and suffer from chronic malnutrition. As such, Indonesia has the fifth-highest level of stunting in the world. The report also states that 19.6 percent of Indonesian children under five years old (approximately 4.4 million) are underweight as a result of malnutrition. Public awareness about this issue is low in Indonesia.
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