Indonesia - Country Commercial Guide
Healthcare (Medical Devices & Equipment)

This is a best prospect industry sector for this country. Includes a market overview and trade data.

Last published date: 2020-10-11

Unit: USD millions

 

 2017

 2018 

 2019 

 2020 (estimated)

Total Market Size

2,410

2,665

2,879

3,023

Total Local Production

1,598

1,757

1,933

2,030

Total Exports

581

590

604

634

Total Imports

1,394

1,488

1,550

1,672

Imports from the U.S.

132

135

169

178

Exchange Rate

13,548

14,481

13,901

N.A.

 

Total Market Size = (Total Local Production + Total Import) - (Total Exports)

Data Sources: Indonesian Medical Device Producers Association (ASPAKI), U.S. Department of Commerce TradeStats Express (TSE), and Global Trade Atlas (GTA) on Connect Trade Data. Average exchange rate of Indonesian Rupiahs to U.S. dollars from Statista.com.

Overview

As the fourth most populous country in the world, Indonesia’s medical device and equipment sector presents excellent opportunities for U.S. manufacturers of innovative products. Although the government has implemented local content requirements and import tariffs, Indonesia continues to rely on imported innovative medical devices and equipment. Total imports of medical devices and equipment grew from $1,488 million in 2018 to $1,550 million in 2019 and are expected to reach $1,627 million in 2020.  China was the leading supplier in 2019, with an import share of over 20 percent, Germany was the number two supplier, accounting 15 percent of total imports. And U.S. products accounted for approximately 11 percent of imports (Source: Indonesia Medical Devices Report Q3 2019, Fitch Solutions).

Healthcare is a priority in Indonesia’s national agenda and the central and regional governments continue to build and upgrade healthcare facilities. Indonesia currently has over 2,877 hospitals, including 1,047 public and 1,830 private hospitals. In addition, there are 10,134 public Health Community Centers (Puskesmas), which provide comprehensive basic healthcare and vaccinations. There are 316,996 hospital beds, or 1.18 beds per one thousand people, but this number is rapidly increasing. In 2020, the Indonesian government began a process of promoting the consolidation of state-owned public hospitals in order to increase operational efficiency and quality of care through standardization. (Source: https://www.kemkes.go.id/resources/download/pusdatin/profil-kesehatan-indonesia/Data-dan-Informasi_Profil-Kesehatan-Indonesia-2019.pdf)

Despite ongoing improvements, the Indonesian healthcare system suffers from limited budgets, lagging numbers of primary care and specialist providers, and limited access in rural areas. Many Indonesians with private health insurance fly to Singapore and Thailand where the standard of care is often higher than in Indonesia.  

Medical device registration and marketing authorization in Indonesia is under the supervision of the Ministry of Health. Foreign manufacturers are permitted to own up to 49% of any local importer-distributor with which they partner. The local partner or joint venture will be the legal owner of the marketing authorization and import permit and not the foreign manufacturer. These foreign equity caps make it difficult to switch distributors. Foreign companies that wish to own 100% of their local subsidiary in Indonesia have the option to manufacture in Indonesia and meet local content requirements.

Medical equipment is subject to 5% - 30% import tax, depending on the type, in addition to the standard 10% value added tax (Source: Indonesia's Minister of Finance Regulation No. 6/2017 on Stipulation of Goods Classification and Charge of Duty Tariff on Imported Goods).  The Indonesian government prohibits the import of used or refurbished medical equipment. Indonesia’s Government Regulation No. 31/2019 will require many types of goods to be halal certified in the future and will require products that originated from haram (forbidden) material to be labelled accordingly. Voluntary halal certification is scheduled to begin in 2021 but certification will not be mandatory for medical devices until the following dates: Class A Medical Devices: 2026; Class B Medical Devices: 2029, Class C Medical Devices: 2034.

In 2014, the Government of Indonesia introduced a national health insurance system known as “BPJS-Kesehatan” (Jaminan Kesehatan Nasional, or JKN). The mandatory system has expanded rapidly and today covers 220 million enrollees who pay monthly insurance premiums. With over 80 percent of the country's 260 million population covered, Indonesia now has one of the largest public health insurance programs in the world. The national health insurance can be used at both public and private hospitals and has brought a stream of newly insured patients into hospitals and clinics. Medical devices and equipment for which there are multiple equivalent substitutes are generally purchased through large-scale public tenders.

The Indonesian government implemented an online procurement system (e-Katalog) in 2014 for medical products for which there are no equivalent substitutes. The Government Agency for Procurement of Goods (Lembaga Kebijakan Pengadaan Barang/Jasa Pemerintah "LKPP") manages the e-Katalog system, which aims to increase transparency and simplify transactions for products available for reimbursement under the national health insurance system. Thousands of medical devices are listed on the system, which allows hospitals and clinics to purchase medical equipment at a pre-negotiated price without a tender. The LKPP e-Katalog procurement system provides a searchable database of all listed medical devices and their current list prices on its public website.

For U.S. companies, the e-Katalog portal can be a rapid route to large sales volumes. However, to be listed in the e-catalogue, companies have to negotiate prices with the government and the price negotiation criteria are not fully transparent. The prices are often negotiated within a fixed range based on a multiple of the import transfer price. And the cost of providing important professional education and training to local healthcare providers is not taken into account in price negotiations. As a result, prices offered in the e-Katalog system are lower than prices in the private health insurance market. Hospitals can also conduct their own tenders for medical devices that are not available via public tender or the e-Katalog system.  Private hospital tenders may result in higher prices for such medical devices.

There is no regular schedule for medical product e-Catalogue enrollment. The most recent e-Catalogue enrollment for medical products took place in early 2018. The new enrollment and re-enrollment for medical devices into the e-Catalogue system was previously scheduled to start in June 2020, but the process was placed on hold in March 2020. Since then, new product enrollment has been temporarily limited to emergency medical products. The timing for the next round of product enrollment and price negotiation has not been announced but companies should prepare required documentation now. Medical devices that were previously enrolled in 2018 will need to re-enroll in order to be listed again.

Leading Sub Sectors

The following sub sectors are among the leading U.S. exports in terms of export value:

1.      HS 9018: Instruments and appliances used in medical, surgical, dental or veterinary sciences.

2.      HS 3822: Diagnostic or laboratory reagents.

3.      HS 841920: Medical, surgical or laboratory sterilizers.

Opportunities

Indonesia relies heavily on imported medical equipment and supplies to meet local demand. Most U.S. companies will find it most beneficial to choose a local distributor to assist with product registration, import permits and the logistics of importing and distributing their devices in the local market.

Hospital and medical trade shows are good places to search for potential local partners in Indonesia. The association of medical device importers, Gakeslab Indonesia, is also a valuable resource for firms looking for experienced local partners. In Indonesia, medical buyers prefer high-quality products but are also highly price sensitive.

To gain market share, U.S. companies need to compete on quality, safety, efficacy and after-sales service for more innovative products. In summary, by entering the Indonesian market, medical device and equipment manufacturers can tap into a large market while helping Indonesia to improve its quality of care.

Key private players in the healthcare industry include Siloam Hospitals (Siloam International Hospitals which is part of Lippo Group), Omni Group (PT Sarana Meditama Metropolitan), Mayapada Group (PT Sejahtera Anugrahjaya), Mitra Keluarga (PT Mitra Keluarga Karyasehat), Ciputra Hospital (Ciputra Development), and Eka Hospital (Sinar Mas Group).

Major private laboratory chains are also expanding their operations in terms of capacity and geographic presence. The six major players in the industry are Prodia, Kimia Farma, Pramita, Cito, BioMedika and Parahita. The largest private laboratory chain, Prodia, currently operates 288 outlets and 147 clinical laboratories.

Web Resources

  • Indonesian Ministry of Health: https://www.kemkes.go.id/
  • Directorate General of Pharmaceutical and Medical Devices, Indonesian Ministry of Health:
  • https://farmalkes.kemkes.go.id/
  • Indonesian Food and Drug Authority (Badan POM): https://www.pom.go.id/new/
  • U.S. Department of Commerce TradeStats Express and Global Trade Atlas (GTA) on Connect: http://tse.export.gov/tse/tsehome.aspx; http://my.ihs.com/connect    

For questions or more information, please contact Commercial Specialist Pepsi Maryarini at: Pepsi.Maryarini@trade.gov cultural Biotechnology Annual

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