Indonesia Financial Assistance Programs Market Analysis

Indonesia Financial Assistance Programs Market Executive Summary

The Indonesia Financial Assistance Programs Market is at around $170 Mn in 2023 and is projected to reach $441.4 Mn in 2030, exhibiting a CAGR of 14.6% during the forecast period 2023-2030.

Drug makers provide patient financial assistance with the goal of minimizing or eliminating out-of-pocket costs as a barrier to prescription choice, keeping patients on name-brand pharmaceuticals longer. Among the popular financial help programs offered under patient assistance programs include co-pay assistance, free drug trials, bridge programs, sliding scale programs, coupons, bulk purchasing programs, and so forth. Patients' out-of-pocket drug cost sharing is determined by their health plans or pharmacy benefit manager's (PBM's) formulary--a list of preferred and nonpreferred prescription drugs. Preferred status is based on a drug's effectiveness, price, and the level of rebate the payer receives from the manufacturer for giving the drug preference over its competitors. Generics and preferred brand drugs are generally assigned lower patient cost sharing than nonpreferred brand drugs. As drug prices have increased, so has patient cost sharing, causing some patients to stretch, forgo, or discontinue medication that is too expensive. Drug manufacturers often seek to mitigate these effects by providing or funding various forms of patient financial support.

The prevalence and number of Diabetes cases (total) in Indonesia and in each province is estimated to increase quite high in 2020–2045. Nationally, Diabetes prevalence increased from 9.19% in 2020 (18.69 Mn cases) to 16.09% in 2045 (40.7 Mn cases). Therefore, the market is predominately driven by factors such as rising drug cost, and increasing prevalence of chronic diseases prevalence whereas regulatory challenges, lack of awareness and budgetary pressures restrict market growth.

Pharmaceutical companies providing financial assistance to patient are such as Mayer, Cipla, Merck, GSK, Pfizer, Johnson & Johnson, Novartis among others.

Market Dynamics

Market Drivers

Chronic disease prevalence: The increasing prevalence of chronic conditions such as diabetes, heart disease, and autoimmune disorders necessitates ongoing access to medications. Patient assistance programs are particularly important in this context, as they can help ensure continuity of care for patients who require long-term treatment but may face financial barriers to consistent access. The prevalence and number of Diabetes cases (total) in Indonesia and in each province is estimated to increase quite high in 2020–2045. Nationally, Diabetes prevalence increased from 9.19% in 2020 (18.69 Mn cases) to 16.09% in 2045 (40.7 Mn cases).

Increasing cost of medicines: Specialty and innovative drugs, especially those for rare diseases or complex conditions, are becoming more expensive. This rising cost results in higher out-of-pocket expenses for patients, even for those with insurance. Consequently, an increasing number of patients require financial assistance to afford their prescribed treatments.

Market Restraints

Regulatory concerns: Patient assistance programs must navigate a complex web of healthcare laws and regulations. Ensuring compliance with anti-kickback statutes, privacy laws, and other relevant regulations can be challenging and may limit the scope of assistance that can be offered. The fear of running afoul of these regulations may cause some organizations to be overly cautious in their program designs.

Limited awareness: Despite the existence of many patient assistance programs, awareness among eligible patients often remains low. This lack of knowledge means that many who could benefit from these programs don't access them. Outreach and education efforts are crucial but can be costly and challenging to implement effectively, particularly for reaching vulnerable or isolated populations.

Budgetary pressures: Pharmaceutical companies need to manage the expense of assistance programs while keeping profit margins intact. Economic challenges or shifts in company strategy could lead to cuts in funding for these programs, potentially resulting in more restricted or selective assistance options.

Regulatory Landscape and Reimbursement Scenario

Indonesia's pharmaceutical regulatory body is the National Agency of Drug and Food Control (BPOM), responsible for ensuring the safety, efficacy, and quality of pharmaceutical products. BPOM regulates the importation, manufacturing, and distribution of medicines, as well as the registration of new drugs and medical devices. Key responsibilities include drug registration, inspection and monitoring, drug recall, and labelling and packaging. The agency also conducts regular inspections of pharmaceutical manufacturing facilities and distribution centres to ensure compliance with good manufacturing practices (GMP) and good distribution practices (GDP).

Indonesia's reimbursement policy is governed by the National Formulary (NF), which is a list of medicines covered by the social health insurance (JKN) program. The National Health Ministry (MOH) compiles the list, and it is used to determine which medicines are eligible for reimbursement. The e-Catalogue is an electronic platform that lists medicines covered by the JKN program, used by healthcare facilities to procure medicines and by patients to access medicines at a lower cost. The reimbursement ceiling, set by the Case-Based Groups (INA-CBGs), determines the maximum amount that healthcare facilities can claim for a particular medicine, affecting the pricing of medicines and reimbursement rates. The MOH negotiates prices with pharmaceutical companies for medicines included in the NF, considering factors such as the drug's clinical value, production costs, and market conditions. The Health Technology Assessment (HTA) process is used to evaluate the clinical and cost-effectiveness of new medicines.

Competitive Landscape

Key Players

Here are some of the major key players in the Indonesia Financial Assistance Programs Market:

• Cipla
• Mayer
• Baxter
• Roche
• Pfizer
• Bayer
• Sanofi
• Novartis
• Merck
• GSK