Headquartered in Dublin, Medtronic provides medical technology, services and solutions to millions of people worldwide, helping them alleviate pain, restore health and prolong life. It is a well-established company, with operations in more than 260 locations across 155 countries. With Medtronic's mission on collaborating with stakeholders worldwide to take healthcare "Further, Together", Medtronic opened its new Asia Pacific headquarters in Singapore at Mapletree Business City on May 31, 2016. This allows the global leader to improve on meeting rising healthcare demands across the region.
One of the most pressing healthcare issues in Asia Pacific is diabetes, with Singapore seeing one of the highest incidences of diabetes in the region. As of 2014, there have been 400,000 diabetes patients. As the population ages and life expectancies extend, the prevalence of diabetes will only increase. As such, Medtronic and SingHealth have signed a Memorandum of Understanding (MOU) to develop a Centre of Excellence that aims to fight diabetes across Southeast Asia. SingHealth is Singapore's largest group of healthcare institutions and acts as an academic medical centre that pursues innovations to improve patient care. With both Medtronic's and SingHealth's visions aligned in having a patient-centric approach to healthcare, Medtronic will help in piloting and developing new model-based treatments for combating diabetes.
With its growing presence, Medtronic demonstrates its strong commitment to transforming healthcare through strategic partnerships in Asia Pacific. Here, APBN interviews Ms Zenobia Walji, Medtronic’s Vice President, Southeast Asia, to learn more about this exciting new venture in the war against diabetes.
1) Could you tell us more about the long-term plan between Medtronic and SingHealth's cooperation to treat and manage diabetes? How did this collaboration come about?
Medtronic has been transforming the lives of people living with diabetes for more than three decades. We have a long legacy of innovation in diabetes, such as being the first in the world to bring about the portable insulin pump and the first portable continuous glucose monitoring sensor technology, among others.
With the government’s focus on diabetes and the new Diabetes Prevention and Care Taskforce in Singapore, there is tremendous opportunity for us to partner closely with different stakeholders to help manage the rising prevalence of diabetes. Medtronic has been collaborating with SingHealth since 2015 to address healthcare challenges associated with diabetes care. With the MOU to set up the Centre of Excellence in the treatment of diabetes across Southeast Asia, it pairs our expertise in advanced diabetes management with SingHealth’s experience in holistic diabetes care.
Together with SingHealth, there are plans to have continuous patient education programmes as we seek to deepen education and raise therapy awareness. With the Centre of Excellence, both parties will further develop clinical practice, training and education for healthcare professionals, clinical research and patient support. In the long run, Medtronic and SingHealth aim to reach out to and benefit more patients.
2) What are some of the current medical technologies in diabetes that are being used in this region and what are the new technologies planned around this partnership?
Medtronic has a long legacy of innovation in diabetes such as:
Partnership with IBM Watson Health to develop innovative patient management services
- First in the world with portable insulin pump
- First portable continuous glucose monitoring sensor technology
- First sensor augmented insulin pump
As part of the MOU with SingHealth, both parties are aiming to reach out to two patients per month with the insulin pump initiation.
Insulin pump therapy is physiologically closest to the human pancreas for diabetes patients who require insulin therapy (and indicated or as advised by their doctor). Typically, Type 1 and Type 2 patients take multiple injections of insulin per day. Compared to insulin injections, the pump delivers the following benefits:
- Discretion: Worn on the patient’s body, the pump delivers tiny drops of rapid-acting insulin to match his or her needs
- Fewer injections: Change the pump tubing only once every two to three days
- Easy evaluation: Simpler insulin dosing using the Bolus Wizard® calculator which makes it easier to calculate mealtime insulin and may avoid insulin stacking
- Flexibility: Set temporary basal rates and patterns around the patient’s activities
- Continuous glucose monitoring: Get readings every five minutes, right on the pump
- More complete picture: Track glucose levels throughout the day, including the effects of food or exercise
- Helpful alerts: Receives alert when the patients’ glucose level is trending high or low, so that the patient can make adjustments ahead of time
Insulin pumps have been shown in several randomised clinical studies to provide superior outcomes. These include reduced HBA1c, fewer instances of hypoglycaemia, reduced complications and eliminates the need for multiple daily injections.
3) From your point of view, what is currently lacking in the fight against diabetes in Southeast Asia?
The World Health Organisation (WHO) has stated that the number of people estimated to be living with diabetes has quadrupled since 1980, cautioning that the drastic increase is attributable to physical inactivity and unhealthy diets.  With the increasing prevalence, there are some areas where we have opportunities to do more and do better, including:
- Help people living with diabetes live longer and better with fewer complications
- Enhance physicians’ awareness of new technologies to manage diabetes
- Deliver holistic diabetes care for people living with diabetes across the care continuum, including physicians and caregivers, to ensure better disease control and management.
Medtronic is looking at new ways and avenues to improve healthcare delivery and systems to drive better patient outcomes. By signing the MOU with SingHealth, we hope to advance joint efforts to address the needs of people living with diabetes, especially in terms of developing and deploying innovative products and integrated solutions to improve quality of care and patient outcomes.
4) How prevalent do you expect diabetes to be in the near future?
We are expecting a ‘tsunami of diabetes’ across Southeast Asia due to increased life expectancy, improved quality of life and the adoption of westernised lifestyles. In Singapore, there are 400,000 people who are diagnosed with diabetes, yet one in three remains undiagnosed. There are also 15% of adult Singaporeans who have pre-diabetes.  Chronic diseases such as diabetes are highly preventable and manageable. Without the right resources to increase awareness and improve the management of lifestyle and diet, diabetes will continue to be a key healthcare challenge for this region.
5) From 2018, Britain will introduce a tax on sugary drinks to tackle their obesity crisis. Do you think imposing a similar sugar tax in Singapore will help curb the problem of diabetes?
Every country faces unique challenges in addressing obesity and diabetes. What remains consistent is the need to focus on improving outcomes and maximising efficiencies across the care continuum, committing ourselves to new approaches and new forms of innovation to help people living with diabetes improve their quality of life.
6) There has been a lot of attention recently in the news on the eating of white rice being adverse for health. Is this concern justified? Is our Asian staple really worse than sugary drinks?
Much like sugar, there are multiple factors beyond dietary requirements that impact health. Rather than focusing on a single aspect when it comes to addressing diabetes, our efforts should apply across the entire care continuum to evaluate how best to support and care for those living with diabetes.
7) Are there any other ongoing or future plans for Medtronic to tackle diabetes or other chronic diseases?
We are focused on helping patients with certain chronic and complex medical conditions, including but not limited to diabetes, stroke and coronary heart diseases. We realised that these types of conditions are high volume, high cost, well-studied medical conditions and disease states with significant variation in treatment costs and outcomes. These types of conditions deserve our equal care and attention, and by focusing on them, it can result in meaningful improvements in costs and outcomes.
This is why, beyond focusing on developing technologies and services, Medtronic is looking at new ways and avenues to create value within the healthcare delivery and systems to drive better patient outcomes.
8) Will there be further collaborative ventures between Medtronic and SingHealth in other health areas in the future?
Medtronic and SingHealth recently signed an MOU in June 2016 to advance joint efforts to address the needs of people living with diabetes, especially in terms of developing and deploying innovative products and integrated solutions to improve quality of care and patient outcomes.
We believe this marks the first step towards stronger partnerships to address and advance healthcare challenges for chronic and complex medical conditions with heavy burden such as stroke, coronary heart diseases and obesity among others.
Medtronic is always looking for opportunities to partner with like-minded stakeholders to deliver more in healthcare. Working with partners to find new approaches, new forms of innovation and new partnerships will help us to strengthen health systems and improve delivery of innovative treatment and therapies.
9) What are some of the prevalent healthcare challenges in the Southeast Asia region? How does Medtronic intend to approach these challenges and what are the adoption rates of med tech that can address these issues?
Like many parts of the world, healthcare in Southeast Asia faces many challenges as well as opportunities. The developed markets of Southeast Asia have a growing ageing population combined with rising costs in a tight economy. The emerging markets of Southeast Asia face a higher demand for healthcare, but with inadequate infrastructure and clinical capacity to serve the needs of the population. This places a heavy toll on both the healthcare providers as well as patients and their families, as infrastructure development will take time to catch up with demand. At Medtronic, we recognise the constraints of the developed and emerging markets and are committed to improving patient outcomes, optimising costs and expanding access to care to counter these growing challenges.
The WHO indicates that the three highest contributors of non-communicable disease mortality are cardiovascular disease, cancer and diabetes.  Medtronic’s portfolio covers a broad spectrum of these disease areas as well as other therapies and as such, we take a ‘continuum of care’ approach to addressing these conditions, taking into consideration the awareness and education of patients and diagnosis at the front end, looking at referral pathways and treatment and post intervention care at the back end. We recognise that no one party can do all that is needed to take this transformative approach, so a key aspect of our strategy focuses on instituting new ways of working and collaborating with like-minded partners.
As an example, Medtronic recently signed two MOUs – one with National Neuroscience Institute to establish a Centre of Excellence for deep brain stimulation to advance treatment for patients with Parkinson’s Disease, and another with SingHealth to set up a Centre of Excellence in diabetes treatment and management in Southeast Asia. Through these efforts, we are educating physicians and patients about advanced life-enhancing technologies and therapies, while working to make them more accessible in the region.
Accessibility to care in Southeast Asia is not limited to challenges of patient and physician awareness and education, but as mentioned earlier, they include a variety of other constraints, such as inadequate infrastructure, clinical capacity as well as many inefficiencies, which drive up the cost of care. Each of these requires different solutions and different partnerships to strengthen health systems and improve delivery of innovative treatments and therapies across the region. Guided by our Mission, Medtronic is committed to alleviating pain, restoring health and extending life, and this means taking a progressive approach to leading, partnering and facilitating the development of solutions to help take healthcare Further, Together.
10) How does Medtronic plan to partner and align focus with governments and healthcare organisations to address the pressing healthcare issues in Southeast Asia?
At the 26th Ministerial Meeting in 2014, the Asia Pacific Economic Cooperation (APEC) Leaders endorsed the “Healthy Asia Pacific 2020”.  This immediately becomes very relevant for Medtronic to play a role in the seven countries in Southeast Asia: Brunei Darussalam, Indonesia, Malaysia, Philippines, Singapore, Thailand, and Vietnam with high growth potential.
We believe that the initiative sets forth a new set of health management responses through 2020 that can help in inclusive growth for the region’s people, trade and economic security.
With that, Medtronic plans to partner with relevant stakeholders, including healthcare organisations and the governments in Southeast Asia to build focus on the following:
- Enhance healthcare access and reimbursement
- Explore value-based healthcare through integrated healthcare solutions
- Expand relevant training and awareness to expand therapy access to meet the needs of national healthcare priorities
- Ensure a voice for patients through working with patient organisations
- Enhance government’s understanding of the value of health to economic growth and development
- World Health Organization. WHO Global report on diabetes. www.who.int/diabetes/global-report. World Health Organization 2016 WHO/NMH/NVI/16.3. Last updated 6 April 2016.
- Ministry of Health, Press Room. https://www.moh.gov.sg/content/moh_web/home/pressRoom/speeches_d/2016/speech-by-minister-fo-health--mr-gan-kim-yong--at-the-moh-commit.shtml. Last Updated 13 Apr 2016.
- World Health Organization. Media Centre, Noncommunicable diseases, Fact Sheet. https://www.who.int/mediacentre/factsheets/fs355/en/. Last accessed January 2015.
- Asia-Pacific Economic Cooperation. Health Working Group. https://www.apec.org/Groups/SOM-Steering-Committee-on-Economic-and-Technical-Cooperation/Working-Groups/Health.aspx. Last accessed August 2014.