Herbal medicines

Production and Delivery of Alternative Medicines [herbal] / Supplements

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Production and Delivery of Alternative Medicines [herbal] / Supplements

Country
Sector
Most major industry classification systems use sources of revenue as their basis for classifying companies into specific sectors, subsectors and industries. In order to group like companies based on their sustainability-related risks and opportunities, SASB created the Sustainable Industry Classification System® (SICS®) and the classification of sectors, subsectors and industries in the SDG Investor Platform is based on SICS.
Health Care
Sub Sector
Most major industry classification systems use sources of revenue as their basis for classifying companies into specific sectors, subsectors and industries. In order to group like companies based on their sustainability-related risks and opportunities, SASB created the Sustainable Industry Classification System® (SICS®) and the classification of sectors, subsectors and industries in the SDG Investor Platform is based on SICS.
Biotechnology and Pharmaceuticals
Indicative Return
Describes the rate of growth an investment is expected to generate within the IOA. The indicative return is identified for the IOA by establishing its Internal Rate of Return (IRR), Return of Investment (ROI) or Gross Profit Margin (GPM).
> 25% (in ROI)
Investment Timeframe
Describes the time period in which the IOA will pay-back the invested resources. The estimate is based on asset expected lifetime as the IOA will start generating accumulated positive cash-flows.
Long Term (10+ years)
Market Size
Describes the value of potential addressable market of the IOA. The market size is identified for the IOA by establishing the value in USD, identifying the Compound Annual Growth Rate (CAGR) or providing a numeric unit critical to the IOA.
> USD 1 billion
Average Ticket Size (USD)
Describes the USD amount for a typical investment required in the IOA.
USD 1 million - USD 10 million
Direct Impact
Describes the primary SDG(s) the IOA addresses.
Good health and well-being (SDG 3) Zero Hunger (SDG 2)
Indirect Impact
Describes the secondary SDG(s) the IOA addresses.
Responsible Consumption and Production (SDG 12)

Business Model Description

Build a network of B2B and B2C manufacturers, distributors and suppliers of herbal-based products in the form of pharmaceutical preparations, traditional medicines and affiliated products. Example of a company active in this space:

Sido Muncul, founded in 1940, is a publicly listed herbal medicine and food products company. It produces and markets a variety of consumer products related to herbal medication, such as the Jamu Tolak Angin (15). Affinity Equity Partners acquired 21% stake in PT Industri Jamu dan Farmasi Sido Muncul Tbk (IDX:SIDO) from PT. Hotel Candi Baru in December 2017 for a transaction value of USD 317.8 mn. (15)

Expected Impact

Promotion of alternative medicines [herbal] / supplements to promote local industry and exports, while ensuring improved nutrition and affordable medicines

How is this information gathered?

Investment opportunities with potential to contribute to sustainable development are based on country-level SDG Investor Maps.

Disclaimer

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Country & Regions

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Country
Region
  • Indonesia: Countrywide
  • Indonesia: Java
  • Indonesia: Sumatra
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Sector Classification

Situate the investment opportunity within sustainability focused sector, subsector and industry classifications.
Sector

Health Care

Development need
Below optimum referral system of healthcare services and lack of accessible quality health care has lead to an increase in unmet needs for healthcare from 4.66% (2015) to 5.44% (2020) (1), relatively high maternal mortality rate (MMR) (305/100,000 live births, 2015) and infant mortality rate (26.9/1,000 live births, 2015) (2).

Policy
Healthcare policy, under the National Priority (PN) 3: aims to improve human capital and competitiveness. Priority Program (PP) 3 and 2 cover the universal health coverage to address the maternal and infant mortality, communicable and non-communicable diseases, reproductive health and family planning (3).

Gender inequalities and marginalization issues
Maternal and infant mortality are among the highest among peer countries in Association of Southeast Asian Nations (ASEAN), caused by health and socioeconomic issues, such as child marriage practices in several regions (4).

According to the 2018 Socio-economic National Survey (Susenas), 1 of every 9 girls aged 20-24 gets married before the age of 18, i.e. ~1.2 mn girls, with Indonesia recording the 8th highest number of child marriages in the world (5).

Investment opportunities introduction
Healthcare spending in Indonesia was USD 38.3 bn [or USD 112 per capita (5)], i.e. 3.6% of GDP, (6) and USD 21 bn in 2019 (7). It is expected to reach USD 51 bn by 2020 (4.18% of GDP) (8).

Key bottlenecks introduction
Last-mile connectivity has been challenging since Indonesia is an archipelago with a geographically fragmented population. Availability and recruitment of quality healthcare personnel has also been a problem across the country.

Sub Sector

Biotechnology and Pharmaceuticals

Development need
Community Health Centers (CHC-Puskesmas) and Primary-Level Health Facilities (FKTP) are not functioning optimally due to lack of medication and inadequate use of drugs with dependence on import for raw materials of pharmaceuticals and medical devices (9). 95% raw materials for medicines and medical devices come from imports (10), resulting in a restricted supply of medicines.

Policy
Pharmaceuticals industry is among the 5 industry 4.0 priority projects and is part of the strategy to strengthen health systems, drug and food control. (9)

Ministry of Health's (MoH) Circular Letter for Utilization Of Traditional Medicine For Health Maintenance, Disease Prevention, And Health Care issued during Covid-19 sets apart the use of traditional medicine and conventional drugs. (11)

Gender inequalities and marginalization issues
Majority of herbal medicine businesses are dominated by women. Jamu Gendong sellers are also mostly women and through selling Jamu, women are exposed to entrepreneurship and medicinal knowledge. Thus, herbal medicine businesses can support women independence. (12 and 13)

Investment opportunities introduction
In 2019, Indonesia ranked 19th in the world's exporting countries of medicinal herbs or biopharmaceuticals with a market share of 0.61% and a value of USD 9.64 mn in January - September 2020 (higher by 14.08% compared to the same period last year). (14)

Key bottlenecks introduction
Complicated manufacturing process (including research & development, approvals, technology transfer and scaling-up of operations) results in delays in realizing efficient commercial returns for investments in the Indonesian pharmaceuticals industry.

Industry

Biotechnology and Pharmaceuticals

Pipeline Opportunity

Discover the investment opportunity and its corresponding business model.
Investment Opportunity Area

Production and Delivery of Alternative Medicines [herbal] / Supplements

Business Model

Build a network of B2B and B2C manufacturers, distributors and suppliers of herbal-based products in the form of pharmaceutical preparations, traditional medicines and affiliated products. Example of a company active in this space:

Sido Muncul, founded in 1940, is a publicly listed herbal medicine and food products company. It produces and markets a variety of consumer products related to herbal medication, such as the Jamu Tolak Angin (15). Affinity Equity Partners acquired 21% stake in PT Industri Jamu dan Farmasi Sido Muncul Tbk (IDX:SIDO) from PT. Hotel Candi Baru in December 2017 for a transaction value of USD 317.8 mn. (15)

Business Case

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Market Size and Environment

Market Size (USD)
Describes the value in USD of a potential addressable market of the IOA.

> USD 1 billion

CAGR
Describes the historical or expected annual growth of revenues in the IOA market.

> 25%

Critical IOA Unit
Describes a complementary market sizing measure exemplifying the opportunities with the IOA.

Herbal medicine exports: Jan-Sept 2020 - USD 9.64 mn; Jan-Sept 2019 - USD 8.45 mn (18)

The health and food supplement market has generated more than USD 318 mn in 2020. (16) In Q1-2020, Jamu and herbal supplements segment contributed >68% of Indonesia's USD 730.72 bn revenue. (19)

Even amid the economic downturn due to the government's Covid-19 emergency measures, Q1-2020 saw the Jamu and herbal supplements segment contribute >68% of herbal medicine market's revenue of USD 51.15 mn, a year-on-year (yoy) increase of 2.4%. (19)

Total Indonesia pharmacy market revenue in April 2021 is USD 5.92 bn (14) During 2019-2021, earnings of pharmaceuticals companies grew by 11% per annum, and revenues grew by 12% per annum. (20)

Indicative Return

ROI
Describes an expected return from the IOA investment over its lifetime.

> 25%

GPM
Describes an expected percentage of revenue (that is actual profit before adjusting for operating cost) from the IOA investment.

> 25%

Affinity Equity Partners acquired 21% stake in PT Industri Jamu dan Farmasi Sido Muncul Tbk (IDX:SIDO) from PT. Hotel Candi Baru in December 2017 for a transaction value of USD 317.8 mn. (15)

Similar transactions in the industry have closed at upto 15x Enterprise Value (EV) / Earnings Before Interest, Tax, Depreciation and Amortization (EBITDA) multiple.

Private Equity firms target 20-25% IRRs on their investment. Returns depend on stage of investment and the valuation at the time of exit. Example: Seed fund investors will earn a better return if they hold their investment, than the investors who enter at a later stage.

Investment Timeframe

Timeframe
Describes the time period in which the IOA will pay-back the invested resources. The estimate is based on asset expected lifetime as the IOA will start generating accumulated positive cash-flows.

Long Term (10+ years)

Most companies in this industry are mature, profitable and publicly listed.

Extensive time is spent in developing a product, obtaining approval and registering it, which may take upto 12-18 months. (22) All herbal product need to be approved by BPOM (The National Agency for Drug and Food Control of Indonesia). (23)

Even amid the economic downturn due to the government's Covid-19 emergency measures, the first quarter of 2020 saw the Jamu and herbal supplements segment contribute more than 68% of its USD 51.15 mn sales revenue, a year-on-year (yoy) increase of 2.4%. (19)

Ticket Size

Average Ticket Size (USD)
Describes the USD amount for a typical investment required in the IOA.

USD 1 million - USD 10 million

Market Risks & Scale Obstacles

Capital - CapEx Intensive

High upfront investments and efforts go into the development of new formulas. Registering of products can take upto 12-18 months. (22) The limited documentation of empirical treatment is also an obstacle in empirically proving herbal medicine. (24)

Market - High Level of Competition

Industry faces competition from other chemical based, pharmaceutical (alopathic) medicine industry and global herbal supplement industry.

Market - Volatile

Covid-19 challenged the export potential of the herbal supplements/biopharmaceuticals as destination countries closed their borders, making distribution difficult and reducing sales. (25)

Impact Case

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Sustainable Development Need

Indonesia has 75% of 40,000 medicinal plants in the world and is an untapped source of herbal medicines for the global market. (19). Exports of herbal medicine (9M-2020 - USD 9.64 mn; 9M2019 - USD 8.45 mn (18)) can help in economic growth.

Covid-19 has induced a shift in consumer behavior to herbal alternatives, which improves accessibility to medicines. Unmet needs of the population (for lack of access to quality and affordable medicines to prevent/manage diseases) for healthcare increased from 4.66% in 2015 to 5.44% in 2020. (26)

Use of herbal medicines can help in reducing out-of-pocket expenditure on healthcare [34.851% in 2018] (26) in the long-term. In 2019, average monthly expense on preventive care per person in urban areas was USD 0.66 (28) and in rural areas was USD 0.38 (28) [3-fold increase from 2015].

Gender & Marginalisation

Rural communities can benefit from herbal medicines as an affordable source of medication. This will reduce the preventive care cost (USD 0.38 in rural areas (28)) and help in improving the level of unmet needs for healthcare in rural areas which was 6.16% of total population as of 2020. (26)

90% of raw materials for Covid-19 drugs are imported and are expensive. (29) Since traditional medicine (jamu) is made from raw material which can be sourced locally, it is affordable for the underserved population and can be used for supporting body resistance (immunity booster) for Covid-19. (30, 31)

Expected Development Outcome

Conservation of herbal plants can support future pharmaceutical research for the development of plant-based medicines for communicable and non-communicable diseases.

Upliftment of herbal medicine industry has a positive impact on the national economy as raw materials for medicinal plants are available in abundance and are the main resources to build self-reliance in pharmaceuticals production. (21)

Pharmaceuticals release ~4 mn tonnes of CO2 a year (equivalent to CO2 produced by 3/4 of a million cars on the road). Thus, locally grown biodynamic organic herbal medicine can contribute towards better health of the planet. (32)

Gender & Marginalisation

Increase in proportion of the population with access to affordable medicines and vaccines on a sustainable basis.

Studies show that there is an improvement in nutritional status of adolescent girls and pregnant women with the use of herbal alternative medicines. (2)

Traditionally, men were involved in the agriculture sector, while women dominated selling herbal medicines. Thus, herbal medicine businesses can support women independence. (12 and 13)

Primary SDGs addressed

Good health and well-being (SDG 3)
3 - Good Health and Well-Being

3.b.3 Proportion of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basis

Current Value

92.12% in 2020 Vs. 79.38% in 2015. (26)

Target Value

94% in 2023, 96 % in 2024 (3)

Zero Hunger (SDG 2)
2 - Zero Hunger

2.1.1 Prevalence of undernourishment

Current Value

8.34 in 2020; 7.63 in 2019 (26)

Target Value

4.90% Prevalence of Undernourishment with BAU scenario in 2030 3.60% Prevalence of Undernourishment with intervention in 2030 (2)

Secondary SDGs addressed

12 - Responsible Consumption and Production

Directly impacted stakeholders

People

Affordable medicines can be made available to all as herbal medicines are made from natural ingredients which are easily available and have minimal side effects. (21)

Gender inequality and/or marginalization

Easy availability of affordable medicines which are produced in a sustainable manner can help in meeting the nutrition and preventive healthcare needs low-income population and vulnerable sections of society.

Planet

Sustainable production of medicines and conservation of natural resources.

Corporates

Traditional medicine industry is labor-intensive and dominated by MSMEs (87.2%). This industry is also has a strong backward linkage with the agricultural sector. Growth of herbal medicine industry will, thus benefit MSME and agriculture sector. (33)

Public sector

Government benefits from growth in exports of herbal medicines, thus resulting in direct contribution to economic growth

Indirectly impacted stakeholders

People

Growth of the sector will result in generation of more economically viable employment opportunities. Farmers benefit from growing herbal plants which can be used for production of medicines by corporates.

Gender inequality and/or marginalization

Usage of affordable medicines will help in reducing the healthcare component of out-of-pocket expenses for rural communities.

Planet

Reduced usage of chemicals based pharmaceutical ingredient production will help in preservation of natural resources and promote greener alternatives for manufacturing of medicines.

Corporates

Growing demand and knowledge of herbal products will encourage investment in the sector, thus resulting in more research and development initiatives and growth of the sector.

Public sector

Investment in preventive healthcare (through promotion of herbal medicine industry) will lead to better health outcomes contributing directly to the capital of human capital in the country.

Outcome Risks

Lack of regulation may induce unfair trade practices. Example: Trading of illegal products (unregistered and counterfeit products). (34)

Since the herbal medicine industry is dominated by Micro, Small and Medium Enterprises (MSME), they face challenges such as limited raw materials, equipment, capital and human resources. (33)

Challenges related to application of Good Traditional Medicine Manufacturing Practices lead to limited production and marketing capacity. (33)

Gender inequality and/or marginalization risk: If prices of herbal medicines rise due to a lack of price control, vulnerable communities may not be able to afford the medicines.

Impact Risks

Lack of proper knowledge of dosage and method of consumption may have adverse impact on the health of consumers.

Excessive production of herbal medicines may impact the environment adversely if it leads to extinction of many species of plants.

Gender inequality and/or marginalization risk: Lack of regulation may result in exploitation of local farmers or producers by large corporates for fetching low prices for herbal plant produce.

Impact Classification

B—Benefit Stakeholders

What

Sustainable production of herbal medicines using national resources to improve nutrition, health indicators and to promote export income

Risk

Excessive production may adversely impact the environment and lead to extinction of species of various crops.

Contribution

According to Susenas March 2021, the average monthly per capita expenditure for purchase of traditional medicine was USD 0.05 for urban area and USD 0.03 for rural areas. (36)

Impact Thesis

Promotion of alternative medicines [herbal] / supplements to promote local industry and exports, while ensuring improved nutrition and affordable medicines

Enabling Environment

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Policy Environment

MoH's Circular Letter No. HK.02.02/IV.2243/2020: about the Utilization Of Traditional Medicine For Health Maintenance, Disease Prevention, And Health Care during the Covid-19 which sets apart the use of traditional medicine and conventional drugs (38).

The Master Plan for the Development of Traditional Medicine Raw Materials: aims to increase the development and production of domestic traditional medicinal raw materials and reduce the imports, which are guaranteed to be of high quality (39)

Pharmaceuticals industry is among the 5 industry 4.0 priority projects and is part of the strategy to strengthen health systems, drug and food control. (9)

MoH Action Plan for health research and development programs 2020-2024: increase research and development in Biomedical and Health Basic Technology by increasing research results and development of life sciences that produce innovative products in the form of standardized herbal medicines (40).

BPOM Regulation No. 32, 2019 on Safety and quality requirements of traditional medicine sets the use of the Indonesian Herbal Pharmacopoeia for traditional medicine raw materials. It contains provisions, simple monographs and extracts for quality requirements of organoleptic, macroscopic, microscopic, chemical content, and analytical methods (procedures and equipment) (41).

Financial Environment

Research and development for herbal/traditional medicine is claimed as tax reduction upto 3x (46) Companies claim reduction in gross income of 100% total costs and 100% costs granted for human development activities for students/educators at universities diploma program on jamu processing. (47)

As per the New Investment List (under Presidential Regulation No. 10 of 2021 regarding Investment Sectors), 'Traditional Medicine Manufacturing' and 'Manufacturing Raw Materials for Traditional Medicine', are 100% closed for foreign ownership. (48)

MOF Regulation Number 128/ PMK.010/2019: Research and development for herbal/traditional medicine is claimed as tax reduction up to 3x (47). Companies claim reduction in gross income of 100% total costs and 100% costs granted for human development activities for students/educators at universities diploma program on jamu processing. (45).

Regulatory Environment

Presidential Regulation No. 49 of 2021 on Changes to Presidential Regulation No. 10 of 2021 on Investment Business: Traditional Medicine Business (Small Business Traditional Medicine / UKOT and Micro Business Traditional Medicine / UMOT) is allocated to Cooperatives and MSMEs. (42)

Reg. No. 007 of 2012 Registration of Traditional Medicine for those who would like to sell, circulate and/or distribute Herbal Medicine: standardized herbal medicines are preparations of ingredients that are standardized/scientifically proven and compliant with safety/quality requirements (43)

Decree of the MoH Number HK.01.07/Menkes/187/2017: MoH has established a formulary for Indonesian traditional medicinal ingredients (FROTI), the preparation of which is based on health problems that are commonly found in the community (44).

Decree of the MoH Number HK.01.07/Menkes/187/2017: Use of herbs in FROTI is directed to maintain health and help reduce complaints suffered (44).

BKPM regulations of the Republic of Indonesia number 7 of 2020 encourage and increase direct investment activities, both in terms of economic growth, development of business sector has a high priority on a national scale, as well as equity and acceleration development for certain business fields. (45)

Marketplace Participants

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Private Sector

Corporates: PT Pyridam Farma Tbk, SidoMuncul, PT. Futamed Pharmaceuticals Investors: PT Pyridam Internasional Corporation, Affinity Equity Partners, Mega Lifesciences Public Company Limited

Government

Government: Ministry of Health, Ministry of Industry, BRIN, Ministry of Agriculture, Ministry of Environment and Forestry, National Agency of Drug and Food Control of Indonesia

Multilaterals

Multilaterals: World Health Organization (WHO), United Nations Entity for Gender Equality and the Empowerment of Women (UN Women), United Nations Development Programme (UNDP), United Nations Children's Fund (UNICEF), Asian Development Bank (ADB), World Bank (WB), United Nations Population Fund (UNFPA), Deutsche Gesellschaft für Internationale Zusammenarbeit GmbH (GIZ)

Non-Profit

Indonesian Pharmacists Association, Indonesian Herbal Medicine Association

Target Locations

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Indonesia: Countrywide

Such business models will be focused on obtaining the raw material from the rural community, thereby contributing to growth in rural income. Medicines can be sold in semi-urban and urban areas, in addition to exports.

Indonesia: Java

There are 33 Jamu producers in Indonesia - 16 in Central Java, 4 in Special District of Yogyakarta, 11 in East Java, 1 in West Java and 1 in North Sumatera. (49)

Indonesia: Sumatra

There are 14 companies registered for herbal medicines - 7 in West Java, 4 in Central Java, and 1 each in Gorotalo, Banten and East Java. (49)

There are 6 Traditional Medicine producers - 3 in Central Java, 1 in West Java, 1 in East Java and 1 in Banten. (49)

References

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