Optimasi Biaya tanpa mengurangi kualitas Efisiensi Industri Farmasi di era JKN
IAI PIT 2017 Banten Pre Agusta Siswantoro
Learning Outcome • Mengetahui sekilas tentang JKN- BPJS • Memahami pengaruh JKN terhadap industri Farmasi • Memahami cara2 optimasi biaya agar industri “survive”dan berkembang di era JKN-BPJS
Trends that will impact the Pharmaceutical Industry: Indonesia Regulation (cGMP) • BPOM following PIC regulation for GMP implementation
Economy (GDP growth) • GDP Growth • Indonesia economy is expected to growth +/- 6%
Political (JKN _BPJS)
• Implementation of universal coverage (BPJS) to all citizen
• Increasing pressure for good and clean government
• Indonesia healthcare spending projected 2.7-5% of GDP • Pharma market growth 10.7% by 2017 • Asia harmonization implementation
JKN
• Start 01 January 2014 • All citizen of Indonesia • Mandatory on year 2019 the coverage is 100%
Who has the right to get SJSN? All Citizens of Indonesia (UUD 45 ps. 28 & 34) Existing Healthcare Insurance Coverage 54 % of Indonesia population without health insurance coverage TOTAL POPULATION = 234.18 MIO
46 % 54 %
Scenario : Jan 2014 : start and done 2019
Pasien
Layanan kesehatan Fasilitas kesehatan baik pemerintah maupun sebagian besar swasta akan ikut dalam program JKN COB & OPE menjadi pilihan pada private sector untuk menjaga sustainabilitynya Challenge di profitability outlet Primary care akan makin berkembang terkait perbaikan JKN
Pasien lower segment dan chronic disease menikmati layanan JKN Saat ini upper level masih berobat seperti semula (OPE)
Pengaruh JKN-BPJS terhadap Industri kesehatan Indonesia
Private insurance Diduga Peran asuransi swasta akan makin meningkat jika ada implementasi yg jelas dari JKN untuk layanan COB & TopUp market
Profesi kesehatan Pada layanan kesehatan yang menerima JKN, terjadi load pelayanan pasien yang tinggi, namun terjadi penurunan/peningkatan income Pilihan obat possibility ke low cost product
Industri Farmasi Market obat2 untuk common diseases akan terjadi commoditization Market share obat2 generik akan terus meningkat (2014 :13.8% 2020 :20%) Pengembangan produk dengan added value menjadi pilihan ke depan (Orphan drugs, Biology, DDS, Vaccine )
Konsep BPJS dengan pembayar Tunggal Melayani
Penduduk RI Iuran Wajib % gaji dan Nominal
RSUD, Dr Spesialis, RS Pusat Rujukan
RUJUKAN
Obat-MD
DPU, DK, Klinik, Puskesmas Obat-MD
BPJS Kes
Subsidi Iuran
Pemerintah APBN/APBD
Impact SJSN • PESERTA SJSN (penduduk RI) – Pengobatan Gratis – Ada iuran bulanan – Sistem pelayanan Kesehatan diatur (sistem rujukan)
• PROVIDER SJSN (Industri dan Distributor Framasi – Volume penjualan bertambah banyak – Harga”dikontrol” – Margin mengecil
dampak JKN/BPJS terhadap Industri Farmasi Non JKN/ BPJS
Kondisi sebelum JKN
JKN/BPJS
• Innovative products, biosimilar, biology products, etc • Special Product for Private Insurance • M&A
Maintaining % Profitability
•OGB •Common Dissease •Brandedd Generic (Increased in Volume)
2015
2019
Current condition Strategy Scenario
New Business Landscape Non JKN/BPJS
JKN/BPJS
•High Margin-high Price •Low Volume •Innovative Product •Special/High tech •Out-pocket •Negotiating
10 – 20%
•Low Margin-Low Price •High Volume •Generic Product •Mass Production •Goverment Insurance •Bidding/ e Catalog 200 Pharm Co.
80 – 90%
Shifting Strategy to Efficient Generic Drug Comppany
• Product Port folio • Marketing strategy • Production strategy
Raw Material Cost & Availability
Process Efficiency Infra-Structure Optimizing
Production Process of Pharmaceuticals
Strategic Initiative • Improve Sourcing of Raw Material • Infra structure Optimizing
•
Process Efficiency – Shortend lead tie – Reduce Inventory cost
Provide Good Quality Product, Affordable in acceptable price
Strict Quality Standard from BPOM/MOH
Lowest Price Win all
E-catalog Bidding
BPJS product supply
Optimizing COST & Maintaining High Quality Products Challenges – HOW ? Alternatif:SCM
•
Optimasi COGS – –
•
Raw material Cost FOH Cost
Manage Inventory Cost
Cost Reduction 1.Incr.Volume 2.Incr. Price 3.New Prod.Mix Sales
Profit Margin Marketing And sales cost
Total Cost
Rp
Variable Cost Fixed Cost 0
RM-PM 2.Direct Labor 3.Direct Energy
People Unit Asset (deppr)
Operational Excellent in SCM
Reduce : •COGS •Inventory Cost •Transportation Cost
Mengoptimalkan Biaya tanpa mengorbankan Kualitas • Optimasi COGS – Raw material Cost – FOH Cost
• Optimasi Inventory Cost – NOC (nett Operatring Capital) – DOI + DOAR – DOAP
OPTIMASI BIAYA BAHAN BAKU Quality of Product start with quality of Raw material- API
Critical Aspects of API – Raw Material : ISSUE
IMPACT
QUALITY
• • • •
EFFICACY SAFETY
COST
High- Price
SUPPLY
Sub-Potency Super-Potency Impurities Contamination
Limited Source/supply
Affordability
Availability
OPTIMASI BIAYA BAHAN BAKU
– Negotiation Strategy
base onRisk Value Analysis Strategic (High Risk, High Value)
SLA & VMI Vertical Integration
“Squeezing”
Analysis of Supply Markets
High Risk Low Value
Low Risk Low Value
PARETO Analysis of Materials (based on value)
High Risk High Value
Low Risk High Value
Leverage (Low Risk, High Value)
Bottleneck (High Risk, Low Value)
Routine (Low Risk, Low Value)
Aggregation of orders ‘VMI’
Holding emergency stock Long-term contract Modifying demand requirement
Centralized Long-term contract
OPTIMASI BIAYA FOH
Lean Factory Approach Cost Effectiveness Optimize Lead time • Kaizen + Lean Manufacturing – Eliminate Inefficiencies • Better utilized Input • Reducing Cost, • Improving cycle time / Lead time
Productivity measurement
OPTIMASI BIAYA FOH
OEE : Overall Equipment Effectiveness Ok, cukup jelas! Apa saja komponen OEE ?
Perhitungan OEE
OEE dapat dijaga dengan • Desain Pabrik yg optimum – System batch atau dedicated
• Pemilihan dan investasi mesin yang tepat
Production Process
Mixing
Packing
Drying
Stripping
Film/Sugar Coating
Final Mixing
Tableting
Logistic Computerized System, assure weighing process free from mistakes, such as wrong material weighted or wrong quantity of material weighted.
OPTIMIZING INVENTORY
Net Operating Capital (DOI) + (DOAR)
-
(DOAP)
The best way to Reduce NOC is reducing Days of Inventory. Reducing DOAR will impact on competition Increasing DOAP will impact on Company image
OPTIMASI NOC
OPTIMASI NOC
Managing Inventory RM-PM
SLA VMI
WIP
Lean Manuf Improved lead time
finished Good
Improve Forecast & More frequent delivery
Synchronized Planning – VMI
Penutup • Penerapan SJSN/BPJS1 akan meningkatkan secara signifikan volume penjualan Obat (in unit) dengan harga yang Murah • Memaksa Industri farmasi untuk bekerja efisien agar bisa bersaiang dalam lelang e-Catalog • Harga murah tidak boleh dengan penurunan Mutu sehingga perlu penghematan pada cost yg tidak bersinggungan dengan mutu: (Inv Cost, Transport Cost, dll) • Diharapkan Keluhan masyarakat tentang harga obat terasa mahal akan berkurang.
THANK YOU
Profile Drs Pre Agusta Siswantoro, Apt , MBA Education Background Pharmacy Graduated, Gadjah Mada University, 1985 WM 16 (1986), MBA Graduated in IPPM Jakarta, 1992 WORKING EXPERIENCES 1. R&D - Production manager , PT PRAFA, 1987 - 1992 2. Production Manager- Assisten Director R&D, PT KALBE FARMA, 1992-2000 3. Plant /Manufacturing Director PT BINTANG TOEDJOE, 2000- 2008 4. Corporate R&D Director KALBE FARMA 2006 -2008 5. Director of PT Global Chemindo Megatrading (GCM)- Raw Material Trading, 2011- 2014 6. Director Logistic PT Enseval PM Tbk . 2013 -2015 7. Supply Chain Director KALBE Group 2008 – 2015 8. Manufacturing Director Kalbe (pharma division) 2015 - present OTHERS 1. Jury of “ Indonesia’s Innovation” organized by BIC and KNRT, 2008 – present 2.Wakil Ketua, Pengurus Pusat, IKATAN APOTEKER INDONESIA, 2009 -2013 3. Ketua Hisfardis (Himpunan Seminat Farmasi Distribusi)2009-2013 3.Pengurus Pusat Gabungan Perusahaan Farmasi Indonesia –GPFI ,2011-2016
Excellence
Execution
