he Asia Pacific (APAC) MedTech scene is a thriving one. According to a McKinsey report, the region’s ever-growing patient population and demand for quality healthcare is expected to see a surge in the APAC MedTech market from US$88 billion a year in 2015 to US$133 billion a year by 2020. This sets the course for APAC to surpass the European Union as the second largest MedTech market globally.
In Singapore, the MedTech ecosystem has also been growing steadily. The latest data from Singapore Economic Development Board (EDB) revealed that in 2019, the MedTech sector contributed S$14.4 billion to Singapore’s economy, compared to S$3.3 billion in 2009.
Today, Singapore is home to more than 60 multinational MedTech companies undertaking a range of activities from regional headquarters and manufacturing, to research and development. Enterprise Singapore (ESG) reported a growth in home-grown MedTech companies, increasing from 100 in 2014 to more than 250 in 2018.
Despite lingering economic impact brought upon by COVID-19, the MedTech industry continues to forge ahead.
According to EDB’s media release on 27 October 2020, Singapore’s industrial production rose for a second consecutive month in September, led by a sharp increase in biomedical output and demand for pharmaceuticals amid the pandemic.
Manufacturing output increased 24.2 per cent in September as compared to the corresponding year before. Excluding biomedical manufacturing, output grew 8.5 per cent. The positive results which came after three months of decline is indicative of signs of recovery boosted by growth output for biomedical, electronics and chemical clusters.
In the biomedical manufacturing cluster, manufacturing output grew 89.8 per cent in September 2020 compared to the same period last year. Pharmaceutical output grew 113.6 per cent with higher output of active pharmaceutical ingredients and biological products, while the medical technology segment grew 15 per cent with higher export demand for medical instruments. On a year-to-date basis, the biomedical manufacturing cluster grew 26.6 per cent compared to the same period a year ago.
In this article, we look at some key factors which have contributed to the burgeoning MedTech scene in Singapore, according to government-owned venture firm SGInnovation.
Key Drivers of Growth
Unlike other industries that see fast-changing trends, the MedTech industry has to cope with higher barriers of entry and longer incubation periods – from product development to adoption and commercialisation. In Singapore, the adoption barriers are lower as there are a lot of IT, electronics and software companies.
“We now have more infrastructure in place to support innovation, and medtech-specific intermediaries. These provide early-stage incubation support and investments in MedTech startups, and enables them to fast-track the development and commercialisation of technologies,” said Mr Johnny Teo, Director for healthcare and biomedical at ESG.
Mr Abel Ang, Group Chief Executive of Advanced MedTech added that infrastructure in other areas such as Singapore’s “status as a global financial capital, the ease of doing business, and its growing prowess as a technology hub, especially in artificial intelligence, are big pluses”.
Government funding, academic expertise, a robust startup ecosystem, and cooperation by legacy institutions all help fuel the growth of Singapore’s MedTech industry.
For instance, the Diagnostics Development (DxD) Hub, formed in 2014 under the Diagnostics Development Hub Agency for Science, Technology and Research’s (A*Star) enterprise arm, has been speeding up the commercialisation of diagnostic technologies.
It brings together clinicians, researchers, entrepreneurs and industry professionals onto a common collaborative platform.
Singapore has been focusing its efforts to encourage partnerships between public healthcare clusters and MedTech startups or SMEs. Given that many major healthcare clusters have teams to accelerate clinical innovations, they serve as a platform for local MedTech companies to test out their product in a hospital setting, allowing the products to be better positioned for downstream commercialisation and eventual adoption.
In 2018, three public healthcare clusters in Singapore supported some 100 innovations.
For example, the National University Health System’s Centre for Innovation in Healthcare (CIH) allows startups and SMEs to test their products in live ward settings before they roll out their products. CIH also provides services such as health technology assessment, business evaluation and access to networks and capital.
Singapore General Hospital worked with Biobot Surgical to develop a robotic system that conducts prostate biopsies using a navigation platform to position a needle that can target tumour areas accurately. The system has since been used in Singapore, Australia and Europe, to perform prostate biopsies on more than 6,000 patients.
In 2019, the National Research Foundation (NRF) launched the Singapore Health Technologies Consortium (HealthTEC) to bridge the gap between R&D and application, by connecting academia and industry. It focuses on developing health and wellness solutions in two areas –health sensing technologies which refer to innovations to track and collect health-related data; health analytics and artificial intelligence (AI) which uses predictive modelling and machine learning technologies to make sense of collected data, with the aim of providing insights and suggesting actions that individuals can take to improve their own health and wellness. The Consortium also acts as a national resource in R&D and commercialisation by providing seed funding and facilitating licensing of locally developed technologies.
Singapore is seeing more investor willingness to support early-stage startups in the industry, including overseas companies looking to expand to Asia.
Since the launch of SEEDS Capital, an investment arm of ESG and DxD Hub, the number of Singapore-based MedTech companies has spiked by 250 per cent in just four years (2014 – 2018) to more than 250 MedTech companies. Over half of them are startups.
SEEDS Capital has co-invested more than S$90 million in over 20 MedTech startups since 2018.
More recently on 14 July 2020, SEEDS Capital and Advanced MedTech Holdings co-invested US$10 million to fund ABM Respiratory Care (ABM), a medical device company developing novel integrated airway clearance and ventilation solutions.
The funding will accelerate the global commercialisation of the Alpha, the world’s first telehealth ventilator developed by ABM in Singapore. The investment represents one of SEEDS Capital’s largest investment in the medical device sector to date and Singapore’s largest Series A medical device fundraise in 2020.
The portable ventilator remotely controls or assists breathing in patients with severe respiratory distress. Alpha uses encrypted connectivity to transmit treatment information to caregivers in real-time. In hospital settings during a pandemic, this would enable a small team of healthcare professionals to monitor, manage and adjust ventilator settings for a large number of ventilated patients via an online dashboard. The Alpha will reduce the risk of infection in caregivers by reducing the number of bedside visits to manually adjust ventilator settings.
Mr Ted Tan, Chairman of SEEDS Capital and Deputy Chief Executive Officer of Enterprise Singapore, said: “In critical times like these, it is important that our MedTech companies continue to innovate to meet the needs of our healthcare sector. ABM’s telehealth ventilator has the potential to improve productivity and, more importantly, reduce infection rates among frontline workers and caregivers, strengthening resilience against COVID-19. We are excited to work with Advanced MedTech to anchor the manufacturing of the ventilators here in Singapore as it adds to Singapore’s reputation as a MedTech hub.”
In April 2019, SGInnovate named five new co-investors to focus on early-stage deep tech startups in various fields, including MedTech. The government-owned investment firm has already invested S$40 million in around 70 local and foreign deep tech startups, which have also gone on to attract S$450 million of funding from the market.
To date, SGInnovate and its partners have completed 22 co-investment deals. These companies are primarily working on deep tech innovations that have applications across a wide range of industries. In total, more than S$52 million has been collectively invested by SGInnovate and its partners under this scheme. The total value of investments that would be made alongside these co-investors is estimated to reach up to S$80 million by 2022.
MedTech companies are recognising that medical technology solutions must be developed based on what healthcare professionals and patients need. Design must be developed in consultation with these key stakeholders to make sure the solutions can integrate with current workflows and lifestyles, thus reducing user resistance.
“If there is one thing the industry has learned from pilot tests in 2019, such as the Ministry of Health Office for Healthcare Transformation (MOHT)’s tele-health pilot on hypertension management at Ang Mo Kio Polyclinic, it’s that user-centric design is key to adoption”, says Ms Ng Ling Ling, Director (Community Engagement) & Head (Future Primary Care), MOHT. “The tech serves the patient and healthcare team, not the other way around”.
User demographics such as age, tech-savviness and data accessibility are all important practical considerations for smartphone and app-based healthcare solutions to be adopted. Such insights are a sign that Singapore’s MedTech scene is moving forward, as these lessons help make products scalable and user-friendly.
Prof Gerald Koh, Clinical Director, Future Primary Care, MOHT recommends building an interdisciplinary team. The team will focus on the healthcare staff and patients to aid implementation, and to ease the learning curve to engender a change in habits or in institutional systems.
Increased user-friendly wellness solutions and standard-issue devices
Wellness solutions are reaching scale in Singapore. The simplicity of these solutions is one key to adoption, as is the use of standard-issue devices like smartphones and smartwatches. These devices not only count the number of steps taken but are also equipped with sensors that detect heart rate or measure the intensity of the user’s activity.
It is also in the interest of MedTech companies to create wellness solutions simple enough for adoption by a growing aged population, estimated to reach 900,000 by 2030.
An example is HealthBeacon’s Injection Care Management System, a connected device for managing medication. It is digitally connected and programmed with personal medication schedules and uses customised reminders through SMS to help users stay on track. It also displays a Personal Adherence Score. Designed with patient-empowerment as top priority, smart connected devices such as this have demonstrated ability to improve medication adherence by as much as 27 per cent. HealthBeacon is based in Ireland but is expanding to Asia following an investment by SGInnovate in 2019.
There has been an increase in the development and adoption of home-monitoring solutions, where patients can track factors like blood sugar, weight, and blood pressure without having to visit a clinic or take a lab test.
WEB Biotechnology, a digital heart health company headquartered in Singapore, developed Spyder ECG, a wearable device that continuously monitors the heart’s electrical activity through a smartphone and transmits this data to a cloud database. Artificial Intelligence (AI) is applied to the data to analyse electrocardiography (ECG) rhythm abnormalities in real-time. Physicians can remotely log into the database and report findings to patients from another connected device. The Spyder system is a ‘world’s first’, using digital and cloud-based technologies to simplify collection of continuous ‘live-streamed’ ECG from any connected location world-wide.
As MedTech becomes increasingly reliant on data, AI has become indispensable to the industry, according to Deloitte. This is reflected in global investment in healthcare AI companies, which amounted to almost US$1.6 billion in Q3 2019.
The use of AI in MedTech can be seen in descriptive and predictive analytics, chatbots for wellness coaching, and imaging analysis.
Singapore-based KroniKare enables almost-instant, non-invasive assessment of chronic wounds with the use of an AI-enabled scanning device. Using cutting-edge Machine Learning, Image Processing, and multi-modal Data Analysis, the device measures the wound and evaluates it against 15 years of chronic wound data. A report is generated, which healthcare practitioners can use to determine suitable treatments.
Singapore’s existing AI expertise and infrastructure is advantageous for MedTech companies.
“AI in health is typically predicted to be felt first in imaging, and Singapore is ahead of the curve in retinal imaging through the Singapore National Eye Centre,” says Prof Robert Morris, Chief Technology Strategist of Ministry of Health Office for Healthcare Transformation (MOHT). However, with limited approval of AI-based medical devices, MedTech startups now have a better appreciation of regulatory barriers, which can affect product development.