“Gov­ern­ment sup­port is es­sen­tial to stay ahead of rapidly chang­ing mar­ket”

BioSpectrum (Asia) - - Bio Content - Priyanka Bajpai priyanka.bajpai@mmac­tiv.com

De­mand for health­care con­tin­ues to es­ca­late in Asia Pa­cific (APAC), driven by rapidly ag­ing pop­u­la­tion with com­plex health­care needs, a shift in fo­cus from in­fec­tious to life-threat­en­ing diseases and a more in­formed pop­u­lace. In Sin­ga­pore, di­ag­nos­tics has emerged as a way for ear­lier and bet­ter iden­ti­fi­ca­tion of diseases to con­trol ris­ing health­care costs. Along with the coun­try’s state-ofthe-art in­fra­struc­ture and high stan­dards of med­i­cal prac­tice, Sin­ga­pore has be­come a nat­u­ral choice for many global di­ag­nos­tic com­pa­nies to es­tab­lish their re­gional busi­ness op­er­a­tions. How­ever, de­spite in-vitro di­ag­nos­tic (IVD) be­ing an im­por­tant early in­ter­ven­tion tool for diseases, only two per cent of over­all world­wide health­care spend­ing goes to­wards in-vitro di­ag­nos­tics. Re­cently, Charmian Cher, Direc­tor, Clin­i­cal Strat­egy (Asia Pa­cific), Di­ag­nos­tics and Ge­nomics Group, Agi­lent Tech­nolo­gies Sin­ga­pore Pte Ltd spoke to BioSpec­trum Asia about the grow­ing de­mands of di­ag­nos­tics and in­no­va­tion in Asia Pa­cific and Sin­ga­pore in par­tic­u­lar.

Edited ex­cerpts;

How is the med­i­cal di­ag­nos­tics land­scape evolv­ing in APAC re­gion?

Asia Pa­cific makes up more than half the global pop­u­la­tion. The re­gion is a melt­ing pot of dif­fer­ent cul­tures, each with unique char­ac­ter­is­tic and needs. Ac­cord­ing to a study con­ducted by McKin­sey and Com­pany sup­ported by the Asia Pa­cific Med­i­cal Tech­nol­ogy As­so­ci­a­tion (APACMed), the re­gion’s health­care needs is a re­flec­tion of its grow­ing pop­u­la­tion. Trends such as an in­creas­ing ag­ing pop­u­la­tion, ur­ban­iza­tion and chronic res­pi­ra­tory diseases un­der­pin the de­mand for im­proved health­care. As such, pri­vate hos­pi­tals and MedTech com­pa­nies are ex­pand­ing rapidly in the re­gion es­tab­lish­ing their R&D fa­cil­i­ties, and man­u­fac­tur­ing cen­ters. The study added that MedTech in­dus­try in Asia-Pa­cific is es­ti­mated to have reached al­most $90 bil­lion in 2015 and is ex­pected to dou­ble by about $190 bil­lion by 2025 over­tak­ing the EU as the sec­ond largest mar­ket next to the US.

Molec­u­lar di­ag­nos­tics is another area that is rapidly grow­ing. Its key ap­pli­ca­tions of in­ter­est are on­col­ogy, re­pro­duc­tive health and post­na­tal di­ag­nos­tics. For APAC, this is mainly driven by pre­ci­sion medicine as most com­pa­nies look to have more per­son­al­ized treat­ment and dis­ease man­age­ment widely avail­able to all pa­tients. Rapid de­vel­op­ment of new ge­netic tech­nolo­gies such as mi­croar­rays and next gen­er­a­tions se­quenc­ing are help­ing fuel this growth. As this mar­ket evolves, new guide­line on ge­netic test­ing, data pri­vacy and re­im­burse­ment will be es­tab­lished.

As a com­par­a­tive, which coun­tries have shown more po­ten­tial in busi­ness growth and adop­tion?

The fastest grow­ing mar­ket is China. In 2016, the coun­try an­nounced the world’s largest pre­ci­sion medicine ini­tia­tive which is ex­pected to draw in­vest­ment of up to $9 bil­lion. In ad­di­tion, with the rapid growth of nextgen se­quenc­ing, in Jan­uary 2018, China Food and Drug Ad­min­is­tra­tion (CFDA) re­fined their in-vitro di­ag­nos­tic (IVD) for im­muno­his­to­chem­istry and in­stru­ment reg­u­la­tion which means that more prod­ucts can be reg­u­lated to the pa­tients which opens op­por­tu­nity for MedTech com­pa­nies like Agi­lent to in­vest in the coun­try. Sin­ga­pore is start­ing to catch up. Cur­rently it is home to more than 60 multi­na­tional MedTech com­pa­nies. Eight out of 10 top global play­ers in the life sci­ence tools in­dus­try have some form of ac­tiv­ity in Sin­ga­pore across man­u­fac­tur­ing, R&D and head­quar­ter func­tions. As part of Sin­ga­pore’s de­vel­op­ment plans, the com­mer­cial arm of the coun­try’s sci­ence and re­search agency A*STAR launched the Di­ag­nos­tic De­vel­op­ment (DXD) hub in 2014 to ac­cel­er­ate Sin­ga­pore’s readi­ness of lo­cally de­vel­oped di­ag­nos­tic prod­ucts. In ad­di­tion, the South Korean gov­ern­ment is putting funds into clin­i­cal pre­ci­sion medicine and we see that grow­ing in the com­ing years. Ja­pan is the most reg­u­lated mar­ket in APAC. For South Asia-Pa­cific, the fastest grow­ing coun­tries are Aus­tralia, Thai­land and Viet­nam where they are adopt­ing to new tech­nolo­gies faster than rest of the re­gion.

What is the driver or com­pet­i­tive ad­van­tage fu­el­ing this growth?

Gov­ern­ment fo­cus is em­i­nent. Apart from that, the pop­u­la­tion is ed­u­cated about the need for test­ing via me­dia and in­ter­net and thus drives de­mand for di­ag­nos­tic check.

What are your views on the con­ver­gence of dig­i­tal tech­nol­ogy and med­i­cal di­ag­nos­tics? Can you please elu­ci­date this with some ex­am­ples and trends?

Dig­i­tal tech­nol­ogy has dra­mat­i­cally changed ev­ery in­dus­try in­clud­ing the med­i­cal field. In or­der to en­hance our equip­ment and so­lu­tions, Agi­lent has lever­aged both ac­qui­si­tions and in­ter­nal in­no­va­tions.

For Agi­lent Di­ag­nos­tic and Ge­nomics Group (DGG) the ac­qui­si­tion of Carta­ge­nia (clin­i­cal grade SaaS-based NGS and CGH vari­ant assess­ment soft­ware), Laser­gen (next gen­er­a­tion se­quenc­ing tech­nol­ogy) and Genohm (lab­o­ra­tory in­for­ma­tion man­age­ment sys­tem) will com­ple­ment the vi­sion of the full lab­o­ra­tory work­flow in NGS from when the pa­tient sam­ple comes into the lab un­til the fi­nal di­ag­no­sis. This com­plete work­flow so­lu­tion will even­tu­ally al­low a clin­i­cian to have all the data and in­for­ma­tion needed to make a di­ag­no­sis at his/her fin­ger­tips, con­sol­i­dated from mul­ti­ple test­ing modal­i­ties. Like many com­pa­nies, Agi­lent is mov­ing to a dig­i­tal model that de­pends heav­ily on cloud tech­nol­ogy. We plan to dig­i­tize life sciences through dif­fer­ent ini­tia­tives from of­fer­ing our cus­tomers with SaaS-based lab­o­ra­tory man­age­ment to con­nected lab tools through our iLab So­lu­tions Group.

High-qual­ity di­ag­nos­tic tech­nolo­gies still re­main in­ac­ces­si­ble and un­af­ford­able in many places. What ef­forts are be­ing made to in­crease this out­reach and adop­tion? Is Agi­lent do­ing any­thing to han­dle this?

Sin­ga­pore is a strate­gic lo­ca­tion for us be­cause it gives us ac­cess to neigh­bor­ing coun­tries where we have yet to es­tab­lish our pres­ence. We break ge­o­graph­i­cal bound­aries and come as close as pos­si­ble to the coun­tries we feel we can help make a dif­fer­ence by in­tro­duc­ing to them our equip­ment to im­prove their health­care so­lu­tions.

Agi­lent is fo­cused on de­vel­op­ing com­plete NGS and mi­croar­ray so­lu­tions for can­cer and con­sti­tu­tional anal­y­sis which will al­low labs with lit­tle ex­per­tise to adopt and im­ple­ment. Th­ese sim­pli­fied so­lu­tions will not only in­clude the nec­es­sary com­po­nents to go from sam­ple to re­port but will in­volve ex­pert ser­vice and sup­port to guide users through ver­i­fi­ca­tion within their labs. In 2015, we launched Agi­lent Univer­sity in Sin­ga­pore which of­fers more than 200 tech­nol­ogy cour­ses for our cus­tomers and field sup­port en­gi­neers across Asia Pa­cific and the Mid­dle East re­gions. We have also col­lab­o­rated with other uni­ver­si­ties, most re­cently with Monash Univer­sity in Malaysia. The Monash-Agi­lent Cen­tre for In­te­gra­tive Bi­ol­ogy com­bines Monash’s re­search ex­cel­lence with Agi­lent’s break­through so­lu­tions. Agi­lent pro­vides hard­ware and soft­ware as well as train­ing and on­go­ing sup­port to the staff of Monash Univer­sity. Just last month, Agi­lent opened a new 11,000 square feet Global So­lu­tion De­vel­op­ment Cen­ter in Sin­ga­pore to meet the in­creas­ing de­mand for fully tested so­lu­tion, op­ti­mize lab­o­ra­tory pro­cesses and in­tro­duce trans­for­ma­tive ways to boost pro­duc­tiv­ity.

What may be some of the lo­gis­ti­cal or reg­u­la­tory im­ped­i­ments that hin­der such ini­tia­tives?

As men­tioned ear­lier, ge­o­graph­i­cal bound­aries hin­der us from reach­ing other mar­kets to in­tro­duce di­ag­nos­tic tech­nolo­gies. As such, th­ese mar­kets lack aware­ness that we pro­vide such equip­ment to im­prove their health­care so­lu­tions. Sin­ga­pore is a strate­gic lo­ca­tion for our com­pany as it gives us ac­cess to the sur­round­ing coun­tries where we have yet to es­tab­lish our pres­ence.

What changes, reg­u­la­tory or other­wise, can help ac­cel­er­ate the growth of in-vitro di­ag­nos­tics?

The pa­tient is of course the most im­por­tant part of the equa­tion. In or­der to give them the best treat­ment it is im­por­tant that lab­o­ra­to­ries should have ac­cess to the best equip­ment and so­lu­tion in the mar­ket. Gov­ern­ment as­sis­tance and fund­ing sup­port is es­sen­tial to help lab­o­ra­to­ries to stay on top of tech­nol­ogy and ahead of the rapidly chang­ing mar­ket. One ini­tia­tive that can be done is by al­low­ing pa­tient for test re­im­burse­ment. To­day it is mostly only the drug pre­scrip­tion that is elic­itable for re­im­burse­ment. Much the same way, it will en­cour­age more pa­tients to track their health to drive de­mand for IVD.

How do you see med­i­cal di­ag­nos­tics in­dus­try evolv­ing over the next decade? What can be some of the reg­u­la­tory and in­fra­struc­ture driv­ers to re­al­ize bet­ter global health­care for the pop­u­la­tion at large?

The med­i­cal di­ag­nos­tics in­dus­try will move to­wards a more tar­geted and per­son­al­ized di­ag­nose that will pro­vide more suit­able treat­ment for the pa­tient. As men­tioned in the ear­lier ques­tion, it is es­sen­tial for gov­ern­ment to pro­vide as­sis­tance and fund­ing sup­port to help lab­o­ra­to­ries stay on top of tech­nol­ogy and ahead of the rapidly chang­ing mar­ket. In ad­di­tion, pro­vid­ing ed­u­ca­tion to in­crease aware­ness will en­cour­age peo­ple to track their health.

Charmian Cher, Direc­tor, Clin­i­cal Strat­egy (Asia Pa­cific), Di­ag­nos­tics andGe­nomics Group, Agi­lent Tech­nolo­gies, Sin­ga­pore

Charmian Cher, Direc­tor, Clin­i­cal Strat­egy (Asia Pa­cific), Di­ag­nos­tics and Ge­nomics Group, Agi­lent Tech­nolo­gies, Sin­ga­pore

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