Indonesia Healthcare - Opportunities in the medical devices sector

Healthcare SH JW SC 393 2nd Dec, 2024

Large potential market size

Based on our conversation with industry players and data from Indonesia Association of Medical Devices Manufacturer (ASPAKI), we estimate the current Indonesia medical device market size has reached more than USD3bn. On a per-capita basis, the value is still low compared to other countries (see Fig. 2), leaving significant upside for growth, in our view. We note that most of the Indonesia medical devices are imported (see Fig. 1) as local production does not have enough production capacity and has relatively low quality of products, in our view. We project Indonesia medical devices' revenue to record a 4.5% CAGR over 2019-2024F. Under Prabowo, we believe medical devices market value would expand faster in 2024F-26F, by a 7.8% CAGR, on the back of the national free medical check-up program. Local firms would likely lead in growth, gaining market share from imported products as we believe the government will increasingly prioritize companies with higher local content level (TKDN). 

Growth acceleration from upcoming free medical check-up program

President Prabowo has introduced a national free medical check-up program under his Quick Win program, which we think can be a growth driver for the Indonesia medical check-up program industry. In 2025, tuberculosis eradication would be the main focus; this program will be conducted through early detection/case findings and treatment with an initial budget of IDR8tn. In 2022, Indonesia was the second-largest country with tuberculosis diseases (see Fig. 8). Moreover, the government will roll out free medical check-up program in 2025 for general diseases with an initial budget of IDR1.7tn; this program initially targets 52mn population and, hence we think finding the workforce to run medical check-up would be the next task. We calculate these programs can contribute at least 4-5% of total medical devices market value in 2025F. All the budgets are allocated under the Ministry of Health. In the next few years, we believe the budget for medical check-up program may increase gradually along with addition of new diseases eligible for free check-up added to the list.

More market share for local firms

In order to reduce import dependency, the government has imposed a higher minimum local content requirement policy (current minimum level is 40%) for medical devices. Note that all procurement of government healthcare facilities should prioritize higher local content products. The government also has developed an online central procurement system, e-Katalog, which enables suppliers and users to transparently monitor prices, product specifications, and local content levels. Products with a higher local content may get a better e-catalogue display, such as being placed on the front page, based on our observation. We believe the government will gradually raise the minimum local content. We also expect the government to diligently monitor and freeze imports of products in order to incentivize more players to produce locally.

Medical device sector’s growth opportunity

We expect growth acceleration in the medical devices sector under Prabowo. There are several medical devices players, including Enseval Putera Megatrading (EPMT IJ, Not rated), UBC Medical Indonesia (LABS IJ, Not rated), and Jayamas Medica Industri (OMED IJ, Not rated). EPMT has a complete low-high tech medical devices portfolio with the largest distribution network in Indonesia, according to management; currently, EPMT is one of the largest listed domestic medical devices players with sales potentially reaching ID LABS has expertise and capacity to produce rapid testing devices for tuberculosis, liver, and other general diseases. Lastly, OMED is a major producer for medical disposables and consumables, while R2tn in annualized 2024. It also has capacity in medical testing. On the other hand, Kalbe Farma (KLBF IJ, Buy), being the parent of EPMT, could be an option for investors to capture medical devices growth.

Fig. 1: Indonesia medical devices market value growth forecast
National free screening and early detection programs to boost growth next year
Source: Company data, ASPAKI, Verdhana estimates

 

Fig. 2: Global medical devices market value per capita by country (USD/person) as of 2023
Indonesia relatively still has low level compared to peers
Source: World Bank, Verdhana research
Fig. 3: Total global medical devices market value in 2023

Source: World Bank, Verdhana research

 

Fig. 4: Indonesia's number of hospital growth, 3.8% CAGR 2012-2023
We expect the growth will be accelerated on the back of increasing supply of doctor
Source: BPS, Verdhana research
Fig. 5: Number of hospital per 1,000 population

Note:  Sources include CEIC, WHO, BPS, etc.
Source: Various sources, Verdhana research

 

Fig. 6: Indonesia total healthcare budget

Source: Ministry of Finance, Verdhana research
Fig. 7: Healthcare spending to total state revenue
Indonesia spending level is still below global average
Note:  South Korea's spending includes social welfare
Source: Various sources, Verdhana research

 

Fig. 8: Tuberculosis cases by country in 2022
Indonesia has the second-largest estimated cases and deaths
#CountryEst. CasesDeaths
1India             2,820,000                 331,000
2Indonesia             1,060,000                 134,000
3China                 748,000                    28,000
4Philippines                 737,000                    39,000
5Pakistan                 608,000                    47,000
6Nigeria                 479,000                    88,000
7Bangladesh                 379,000                    42,000
8Congo                 314,000                    34,000
9South Africa                 280,000                    23,000
10Myanmar                 257,000                    44,000
Source: Ministry of Health, Verdhana research

 

Fig. 9: Medical check-up for general diseases

Infant, Toddler, and Preschool (0-6 years old) School Children and Adolescent (7-18 years old) Adult and Elderly (> 18 years old)
Congenital Hypothyroidism Hearing Hearing
G6PD Enzyme Deficiency Vision Vision
Congenital Adrenal Hyperplasia Dental Diseases Dental Diseases
Critical Congenital Heart Disease Mental Health Mental Health
Growth (weight, height) Obesity Obesity
Development (motor, sensory, cognitive) Hypertension Hypertension
Hearing Smoking Behavior Diabetes Mellitus*
Vision Fitness Smoking Behavior
Dental Diseases Anemia Fitness
Mental Health Diabetes Mellitus* Stroke, Heart Disease*
Thalassemia* Thalassemia* Uro-nephrology*
Hepatitis B Hepatitis B Breast Cancer
Hepatitis C Hepatitis C Cervical Cancer
Cirrhosis, Liver Cancer Cirrhosis, Liver Cancer Cholesterol
    Chronic Obstructive Pulmonary Disease/COPD
    Lung Cancer
Note:   Osteoporosis
Located at health centers; screenings highlighted are conducted at school in new academic year  Functional Disorders in Daily Activities
  Colon Cancer
*) Once in a lifetime to family with close relatives to sufferer or carrier of thalassemia  Degenerative Diseases
  Thalassemia*
In Risk Group,   Hepatitis B
*) Indication of Obesity and HT, ≥ 40 year, all population   Hepatitis C
*) Indication of HT and DM   Cirrhosis, Liver Cancer
Source: Ministry of Health, Verdhana research

 

Fig. 10: E-Katalog display
Higher local content (TKDN) are given better display.
Source: E-Katalog, Verdhana research

 

Fig. 11: EPMT sales trend
We suspect EPMT has gained market share in the past two years
Source: Company data, Verdhana research

 

Fig. 12: LABS sales trend
Visible sales growth
Source: Company data, Verdhana research

 

Fig. 13: OMED quarterly sales trend
A decent sales recovery this year
Source: Company data, Verdhana research

INVESTMENT RATINGS
A rating of ‘Buy’, indicates that the analyst expects the stock to outperform the Benchmark over the next 12 months. A rating of ‘Neutral’, indicates that the analyst expects the stock to perform in line with the Benchmark over the next 12 months. A rating of ‘Reduce’, indicates that the analyst expects the stock to underperform the Benchmark over the next 12 months. A rating of ‘Suspended’, indicates that the rating, target price, and estimates have been suspended temporarily to comply with applicable regulations and/or firm policies. Securities and/or companies that are labelled as ‘Not Rated’ or ‘No Rating’ are not in regular research coverage. Benchmark is Indonesia Composite Index (‘IDX Composite’). A ‘Target Price’, if discussed, indicates the analyst’s forecast for the share price with a 12-month time horizon, reflecting in part of the analyst’s estimates for the company’s earnings, and may be impeded by general market and macroeconomic trends, and by other risks related to the company or the market in general. 

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Sandy Ham (sandy.ham@verdhana.id)

Jody Wijaya (jody.wijaya@verdhana.id)

Samuel Christian (samuel.christian@verdhana.id)