Health x Wellness
How healthcare companies are adapting as rising costs reshape access to medicine in Asia
Rising costs, regulatory complexity, and uneven demand are changing how medicines reach patients — and why healthcare companies are rethinking how medicines are made available across Asia.
For most people, access to medicines feels like a straightforward process. A drug is approved, doctors prescribe it, pharmacies stock it, and patients receive the treatment they need — often with price seen as the main barrier.
In reality, getting medicines from development to patients, especially across many parts of Asia, has become far more complicated than it appears.
Rising costs, complex regulatory requirements, and uneven demand across markets mean that some medicines take longer to reach patients, reach fewer patients, or are not widely available through normal pharmacy channels. In smaller markets, access may depend on medicines being brought in from overseas or obtained through special access pathways.
These gaps tend to affect patients who rely on newer or more specialised treatments, including therapies for chronic conditions, rare diseases, or complex illnesses, where patient numbers are smaller, and access is harder to sustain.
And cost pressures are becoming more visible across the region. Medical costs in Asia-Pacific are projected to rise by around 14% in 2026, with Singapore expected to see increases of close to 17%, outpacing the regional average and adding strain to already complex healthcare systems.
These pressures are explored in a recent whitepaper series by DKSH Healthcare, which examines why long-standing approaches to bringing medicines to market are becoming harder to sustain, and why partnerships are increasingly part of how access is created and maintained across the region. One such approach is commercial outsourcing — where companies rely on specialised partners to manage how medicines are supplied, supported, and kept compliant in local markets.
This is the backdrop against which healthcare companies are rethinking how medicines reach patients. Commercial outsourcing itself isn’t new — pharmaceutical and life sciences companies have worked with external partners for sales, distribution, and market access across Asia-Pacific for years.
There is no single trigger behind this shift, nor a sudden policy reset or regulatory shock. What has changed is that this approach is increasingly seen as a practical way forward rather than a temporary workaround.
Why this model makes sense now
Traditionally, the optics surrounding outsourcing in regulated industries have not always been positive, especially in Asian markets. Today, it is increasingly viewed as a practical way to maintain presence while managing complexity, rather than as a signal of retreat or reduced commitment.
For a long time, healthcare companies could justify maintaining their own local sales, regulatory, and support teams in smaller, complex markets like Singapore. High per-capita healthcare spending and regional hub value often offset concerns about scale. That margin has since narrowed, and in some cases, disappeared.
Despite its high standards and sophistication, Singapore remains a relatively small pharmaceutical market by revenue, estimated at around USD 1.4 billion in 2023 — less than 1 percent of the global market — which limits how far traditional, fully in-house commercial models can scale sustainably.
Today, more medicines are designed for specific conditions affecting smaller patient groups. New treatments are often introduced first in the largest markets, while companies become more selective about where they commit time and resources. As a result, keeping permanent teams in every market has become untenable for many companies — not because those markets matter less, but because the economics no longer scale sustainably.
According to the whitepaper, commercial outsourcing already accounts for an estimated 10–16 percent of pharmaceutical sales across Asia-Pacific, reflecting how widely this model is already used to support medicine availability in smaller and complex markets. It also notes that more than 90 percent of Asia-Pacific healthcare executives surveyed already use some form of commercial outsourcing, with 62 percent increasing their investment since 2021.
In smaller markets, the rules and requirements stay the same (i.e. the workload required) even when only a few patients need a medicine. As this imbalance became clearer, outsourcing began to make more sense as a way to keep treatments available without locking companies into disproportionate risk.
What the model actually requires to work
Commercial outsourcing only works when partners bring specialist healthcare expertise and deep familiarity with local regulatory and administrative requirements.
Day-to-day operations aside, they must also manage compliance, safety obligations, and market-specific access pathways — effectively standing in for ownership while ensuring medicines remain available, compliant, and properly supported.
For that to happen, several conditions need to be in place:
- Strong governance
Regulators continue to hold companies accountable for how medicines are handled, even when third parties are involved. Partners therefore need established, auditable systems to manage compliance, safety, and oversight. - Existing scale and infrastructure
Regulatory compliance, safety monitoring, and distribution systems are costly to maintain. Outsourcing only works when this infrastructure already exists at scale and does not need to be rebuilt for each market or product. - Operational independence
One reason companies turn to partners is to avoid spreading limited attention and resources too thinly. To be effective, partners must be able to operate independently within clear boundaries, without requiring constant involvement from headquarters. - A minimum level of demand
Outsourcing reduces fixed costs, but it does not remove the need for scale altogether. Below a certain threshold, even partner-led models struggle, which is why some ultra-small or highly specialised therapies continue to rely on limited or alternative access routes.
These help explain why outsourcing works in some cases and struggles in others. In practice, the model tends to favour organisations that already operate at a regional scale, such as DKSH, which already have the infrastructure to manage regulatory and operational complexity across multiple markets.
A model with boundaries
None of this suggests that outsourcing replaces ownership entirely. Flagship products, fast-growing markets, or situations involving exceptional regulatory or legal complexity may still warrant direct control, where the cost of getting things wrong outweighs the benefits of flexibility.
The DKSH whitepaper highlights that in the Asia-Pacific, price erosion following loss of exclusivity can reach up to 40 percent in some markets, with Singapore seeing average post-exclusivity declines of around 24 percent, further tightening the economics of maintaining fixed commercial structures.
For a growing share of portfolios and markets, however, the balance now looks different. Rather than signalling reduced commitment, outsourcing can offer a way to maintain current presence and operations until scale, demand, or strategic importance warrant a different approach.
With tighter constraints, commercial outsourcing has emerged as a pragmatic response; one that recognises both the limits of traditional models and the rising cost of sustaining medicine availability in markets where economics have become increasingly difficult to justify.
Pictures under license from Freepik.
