Read the Conversation

EF: What mission were you given when appointed VP to DKSH in the middle of the pandemic? 

RO: I have a fairly diverse background, with experience with multinationals in Singapore. After nearly six years in one of the Japanese leading multinationals, I felt it was time for the next challenge, and that was DKSH.

It felt like a perfect fit for the logistics and distributor landscape because it is about understanding the needs of the principals, how they want business done, and, through my expertise, fulfilling those needs. I jumped straight in, meeting with potential clients, providing assistance where it was lacking, and giving insights when needed. Being an active member of the Singapore Pharma Association also helped; I have been on the Board of Directors for the last four years. I am part of the Ethics, Business, Committee, which oversees the code of conduct for the pharma industry in Singapore. I was heavily involved in the roll-out of sponsorships of third-party congresses and guidance for virtual meetings, which was very useful when the pandemic hit, particularly in the initial upheaval of change. In DKSH, my role is to give clients and potential clients based outside of Singapore, but interested in using us, as a stepping stone into Asia Pacific and to gain an understanding of how the market works. During 2020 and into 2021, I was involved in negotiating the oncology drug list, which went live in September 2022. The next key highlight is HealthierSG, how our new Minister of Health will drive it forward, and how it will impact the Pharma Association, a key stakeholder in the healthcare landscape.

EF: What will 2022-2024 look like, and what have been the biggest lessons learned for the coming years?

RO: DKSH is about managing multiple clients, handling thousands of customers, and covering orders for clinics and pharmacies. The biggest lesson with this is that constant problem-solving is a vital skill set when working in a healthcare company, and it is an asset that has served me well in DKSH. In the coming years, I also do think that it will be a season of finding new creative and innovative ways of problem-solving.

EF: The impact of digitization and MedTech is apparent, but how does this translate to developing the different therapeutic areas? What do you think will be the biggest trends in the future? 

RO: Since the pandemic, we have seen digitalization accelerate into all sorts of industries. Some of the key problems that digitalization sort to address include the shortage of ground staff, and keeping the same or increasing levels of service during distribution. An example would be in Singapore, where our workforce is dependent on foreign talent. The pandemic has spurred an increase of talent who are returning to their countries and in order to meet this labor gap, we see new MedTech such as cloud technology coming in to close these gaps. Some examples include patients who now get reminded of their appointments through an automated text instead of a nurse calling them and no longer have to call to make appointments but can do so via their smartphones through an encrypted link. Essentially improving the experience for patients and Healthcare Providers. 

One of the biggest trends in the coming future is likely the uptake of health-tech wearables. We see the industry innovating and creating tech products that allow patients to be in greater control of their health, some of which even allow them to be connected via the cloud to their healthcare providers.

EF: Can robotics in warehouses replace the lack of workers?

RO: We have been exploring automation options in our distribution centers and call centers, looking at a digitalized platform for people to place their orders. Some orders are complex, and we could have 49 different schemes for 50 customers to complicate matters further. First, we have to simplify to make it easier to run the business -platforms instead of calling a hotline. With the current labor crunch, we struggle to fill some call center positions, forcing us to look for alternatives. People are creatures of habit, and the change will be hard, but they will migrate to an online platform if it is user-friendly and intuitive. The truth is that Singapore is still a very small market, so putting high-tech investment in distribution centers is not always a given. Also, we must keep in mind that automated robotics is not the answer in distribution centers due to the packaging and complexities of medical devices. A person must enter a locked room to retrieve medication with certain controlled drugs. Rental is also costly. Only 5.7 million people are living in Singapore, and even if it has grown over the last fifteen years, it is still a small market. There are cities in Asia bigger than Singapore. 

EF: What trends do you see in therapeutic areas regarding digitization? 

RO: We actively address patient interaction in the Ethics, Business Committee. We empower the patients and increase their knowledge of medical treatments so they can be active in their treatment of choice. We are concerned about how this interaction will develop and are actively trying to craft guidance to share with patients. Since the beginning of the year, pharma and medical devices have been working on a new patient headcount to engage with patients on a neutral platform –not to incentivize sales but to educate patients. Engaging with patients on a neutral platform is important to improve their treatment choices, empowering and educating them while crossing no ethical lines. It will help them differentiate between the truth, false truths, or half-truths, which abound on the internet. In chronic primary care, the most expensive new treatments are in oncology, which has been at the forefront for the last fifteen years. The industry has been moving away from chemotherapy to biologics such as monoclonal antibodies This includes moving into CAR T cell therapy specific to each patient. Singapore has always been at the forefront of innovative medicine. Clinical data and indications drive physicians in Singapore to give patients the best treatments. There is a go-to model, especially for the private sector, and I do not foresee that changing. The therapeutic area focus is and will be on oncology and immunology, the two key drivers of biologics. Oncology drugs drive almost 20% of the market; a big percentage of that are off-label therapies and only for the private sector. The public sector cannot use off-label drugs, making them more restrictive and making prognosis difficult. Despite the restrictions, Oncology will continue to be the main driver due to its high value. Immunology and rheumatology will also be critical because of the use of biologicals and cardiology.

EF: What are DKSH's main growth drivers? Where are your priorities and allocation of resources? 

RO: Our priority and baseline is our supply chain network but the key growth drivers are commercial alliances and commercial outsourcing. We serve as a representative for clients that are reducing their presence in Singapore or have decided to leave. In fact, some of our clients are no longer present in Singapore. In order to ensure business continuity, they engage us to manage their business operations on their behalf. Other clients have given us their legacy products to drive sales and marketing for them – this is mainly because we have one of the largest and strongest marketing and sales teams in Asia Pacific. And of course, there are some clients with a few notable market-leading products who do not want to set up shop here, thus engaging us to do the commercial management and representing them. Make us a strategic partner in Singapore. Starting a company can be costly and complex, but we cover facilities and principles as well as product registration which makes the go-to-market much simpler. We also manage different portfolios, aspects of volume and value, and my experience in these areas has been an advantage in building a network. 

EF: What has been DKSHs position, reaction, and solutions to the challenges in logistics and distribution in the supply chain; if you have had problems, that is? 

RO: We have had issues. Very early in the pandemic, the Government Procurement Office (ELPS) changed tenders from three to five-month holding of goods. It represented a 66% increase in capacity, which meant that those who participated in these tenders needed a larger stock holding, but due to Covid outbreaks, plants were not manufacturing enough to pump up the supply, and this happened worldwide, making it extremely hard to fill such a gap. Across the industry, we also see that the costs of running any distribution center have increased due to labor costs, with the cost of transporting goods going up 30 to 50% - not only freight costs but land transportation as well because of the price increase of petrol. In Singapore, taxes have also gone up 7 to 8%, and. It costs more to run our delivery trucks than last year. All the above impacts the consumers; including inflation. 

On the other hand, Singapore has invested a lot in healthcare. Free vaccines were made available. In the initial pandemic stages, when treating patients in ICUs, they were all fully covered, and there was no cost to the individual. The government took active steps in stockpiling drugs and ICU units in case of a future outbreak. The great concern is if the big pharma and medical device companies will consider Singapore a key place if innovation despite being a heavily regulated and restricted country. Life is like a pendulum; we swing to the extremes and react back each time we go too far; only by hitting the extreme can we find common ground. If our healthcare environment is overly affected or impacted by a restrictive innovative system, I am sure we will find the middle ground of where we should be. That said, Singapore remains an attractive stepping stone into the Asia Pacific and a melting pot of business activities. Singapore is not only a gateway to Asia but a market receptive to embracing innovation and the latest cutting-edge technology. Post-pandemic, we can also expect many Chinese companies or Chinese-backed companies are making their presence felt. 

EF: Fast forward five or ten years from now; when you look back at this moment of your career, how would you like to be remembered? 

RO: I have worked hard but feel fortunate to have doors opened for me. Working with my team allows me to be a mentor. I very much remember how I started, and where building connections is central to having a successful and happy operation. I am considering being part of an executive mentoring program for people interested in pursuing a career in healthcare for the next generation. This is in tandem with some of my past experiences where I have mentored diploma students to help map their futures. We do internships with pharmacies to get them on board, and we actively work on teaching them. Interns are here to learn not to do excess and fill in work but to create a platform for them to absorb the business environment and be able to contribute.  

May 2023