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Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara

Self-Medication

Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan

Who benefits and who is at loss?

Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan
Self-Medication Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan

Hermawan Kartajaya

Who benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan Irawan

Jacky Mussry

benefits and who is at loss? Hermawan Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan Irawan Jie

Taufik Bayu Asmara Irvan Irawan Jie

Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan Irawan Jie Iwan Setiawan Nastiti Tri Winasis Levina Yulianti
Kartajaya Jacky Mussry Taufik Bayu Asmara Irvan Irawan Jie Iwan Setiawan Nastiti Tri Winasis Levina Yulianti

Iwan Setiawan

Nastiti Tri Winasis

Levina Yulianti

B.E. Satrio

Bayu Asmara Irvan Irawan Jie Iwan Setiawan Nastiti Tri Winasis Levina Yulianti B.E. Satrio Anthony Darmaja
Bayu Asmara Irvan Irawan Jie Iwan Setiawan Nastiti Tri Winasis Levina Yulianti B.E. Satrio Anthony Darmaja

Anthony Darmaja

14 APRIL 2011
14
APRIL
2011
About MarkPlus Consulting MarkPlus is the premiere and highly-focused marketing strategy consulting firm in Indo-
About MarkPlus Consulting MarkPlus is the premiere and highly-focused marketing strategy consulting firm in Indo-
About MarkPlus Consulting MarkPlus is the premiere and highly-focused marketing strategy consulting firm in Indo-

About MarkPlus Consulting

MarkPlus is the premiere and highly-focused marketing strategy consulting firm in Indo- nesia. It was established 20 years ago by Hermawan Kartajaya, co-author of five international marketing books with Prof. Philip Kotler, the Father of Modern Marketing at the Kellogg School, Northwestern University. Just as early as 2001, an industry publication had ranked MarkPlus first among national consulting firms.

MarkPlus is able to provide a comprehensive service to its clients without the need to engage third-party vendors. MarkPlus consist of three main divisions of MarkPlus Consulting, MarkPlus Insight, and MarkPlus Institute of Marketing, which aim to provide clients with Solution, Insight and Knowledge respectively.

MarkPlus operates in 10 major cities and owns research network in 14 cities in Indonesia. Since 2004, MarkPlus has established ASEAN operations in Kuala Lumpur and Singapore. Head- quartered in Jakarta, Indonesia, MarkPlus is strategically positioned to provide South East Asian companies with marketing expertise and breakthrough insights.

About MarkPlus Insight

MarkPlus Insight is a respected Southeast Asian-based research firm and the market re- search arm of MarkPlus, Inc. We are a leading research service provider which promises to provide clients with reliable information and relevant customer insights, so that our client can enhance their decision-making process. We are also a member of ESOMAR – a world organization with 4,500 members in 100 countries with the mission to enable better research into markets, consumers and societies. We have a strong in-house research team which is supported by an extensive local and regional network.

We provide clients with the most cutting-edge but client-friendly research approaches and methodologies. Our conventional research approaches include quantitative research

through face-to-face interview, computer assisted telephone interview (CATI), online survey, mystery shopping, central location (CLT), retail census, data mining to competitive intelligence (CI), whilst for qualitative research include focus group discussion (FGD), in-depth interview, and observation. We also serve the unconventional research approaches through customer insight to discover the customers’ unspoken needs and wants by using a combination of observational, eth-

nographic, and metaphoric research approach as well as a research for advertisement evaluation through eye tracking technology. We currently also provide clients with comprehensive media monitoring to measure market sentiments towards a brand from both offline media and online media including social media such as Facebook, Twitter, Foursquare, etc.

a brand from both offline media and online media including social media such as Facebook, Twitter,
a brand from both offline media and online media including social media such as Facebook, Twitter,
a brand from both offline media and online media including social media such as Facebook, Twitter,
a brand from both offline media and online media including social media such as Facebook, Twitter,
a brand from both offline media and online media including social media such as Facebook, Twitter,
a brand from both offline media and online media including social media such as Facebook, Twitter,
a brand from both offline media and online media including social media such as Facebook, Twitter,
a brand from both offline media and online media including social media such as Facebook, Twitter,
a brand from both offline media and online media including social media such as Facebook, Twitter,
a brand from both offline media and online media including social media such as Facebook, Twitter,
a brand from both offline media and online media including social media such as Facebook, Twitter,
a brand from both offline media and online media including social media such as Facebook, Twitter,
a brand from both offline media and online media including social media such as Facebook, Twitter,
a brand from both offline media and online media including social media such as Facebook, Twitter,
a brand from both offline media and online media including social media such as Facebook, Twitter,
a brand from both offline media and online media including social media such as Facebook, Twitter,

Self-Medication

Who benefits and who is at loss?

Swamedikasi

Swamedikasi dapat diartikan secara sederhana sebagai upaya seseorang untuk mengobati dirinya sendiri. Swamedikasi menjadi alternatif yang banyak dipilih masyarakat untuk meredakan/ menyembuhkan keluhan kesehatan ringan atau untuk meningkatkan keterjangkauan akses terhadap pengobatan. Berdasarkan hasil Susenas tahun 2009, BPS mencatat bahwa terdapat 66% orang sakit di Indonesia yang melakukan swamedikasi. Angka ini relatiflebihtinggidibandingkanpersentasependuduk yang berobat jalan ke dokter (44%). Walaupun demikian, persentase swamedikasi di Indonesia masih lebih rendah dibandingkan dengan tingkat swamedikasi di Amerika Serikat yang mencapai 73%. Angka ini bahkan cenderung akan meningkat karena terdapat enam dari sepuluh orang di Amerika yang mengatakan bahwa mereka mungkin akan melakukan swamedikasi lagi di masa yang akan datang terhadap penyakit yang dideritanya.

Menurut situs www.wsmi.com (world self-medication industry), bentuk swamedikasi yang bertanggung jawab adalah penggunaan obat bebas secara tepat berdasarkan inisiatif pribadi pasien, dengan bantuan tenaga kesehatan ahli (dokter atau apoteker) jika diperlukan. Dengan keberadaan swamedikasi ini, tidak dapat dihindari terjadinya peresepan sendiri (self-prescription, yaitu penggunaan dari obat resep oleh pasien atau konsumen tanpa pengawasan dari dokter). Sebetulnya hal peresepan sendiri sudah diatur pada permenkes No.919/MENKES/PER/X/1993, yang di dalamnya ditentukan jenis dan batasan jumlah obat yang dapat diserahkan kepada konsumen tanpa harus menyertakan resep dari dokter (lihat Exhibit 1).

Tercatat bahwa ada 30% konsumen Indonesia yang pernah dan biasa melakukan swamedikasi dan peresepan sendiri (termasuk pembelian obat tanpa resep). Yang lebih mencengangkan, 47% di antaranya adalah untuk jenis obat-obatan antiobiotik. Dengan

Self-Medication

Self-Medication can be defined simply as any effort by an individual to medically treat themself. Self-medication is an alternative that many people choose to relieve / cure minor health complaints or to improve the affordability of access to medical treatment. Based on results of the National Socio- Economic Survey in 2009, BPS-Statistics Indonesia notes that 66% of sick people in Indonesia practice self-medication. This figure is relatively higher than the percentage of people who go to a doctor for medical treatment (44%). However, the percentage of self-medication in Indonesia is still lower than in the United States reached 73%. This figure will potentially continue to rise because 6 out of 10 people in the United States admit that they will probably self-medicate in the future.

Accordingto www.wsmi.com(worldself-medication

industry), a responsible form of self-medication is the proper use of nonprescription medicine by people on their own initiative, with the help of skilled health personnel (a doctor or pharmacist) when necessary. With self-medication, we can’t avoid self- prescription, which is usage of prescription drugs by

a person without the proper supervision or advice

of a doctor. The Indonesian Health Ministry has already issued a ministry regulation (PerMen) which governs self-medication with ruling 919/MENKES/ PER/X/1993. This regulation specifies the type and amount of medicine which can be given to a consumer without the requirement of a doctor’s prescription (see Exhibit 1).

It is known that around 30 percent of Indonesian

consumers have practiced self-medication and self- prescription (including the purchase of a medicine without a prescription) at least once. The more astonishing fact is that 47 percent of them self- prescribe antibiotics. With this statistic in mind, the

120.0

100.0

80.0

60.0

40.0

20.0

0.0

Exhibit 1. Medical Treatment According to Type of Disease (%) Total Flu Gastric Cough Headache
Exhibit 1. Medical Treatment According to Type of Disease (%)
Total
Flu
Gastric
Cough
Headache
Cold
Fever
Self-medication
Visit to the docter(outpatient)
Percentage

Source: MarkPlus Insight Research

30

25

20

15

10

5

0

kondisi ini, maka tepatlah tindakan pemerintah Indonesia meluncurkan Pedoman Penggunaan Antibiotik sebagai salah satu respon terhadap

peringatanHariKesehatanDunia,7Aprilkemarin,yang

tahun ini bertemakan “Antibiotic Resistance”. Tema hari kesehatan dunia ini diambil karena berdasarkan data WHO, pada tahun 2010 terdapat sekitar 25 ribu orang di Eropa yang meninggal karena infeksi bakteri yang kebal terhadap antibiotik. Jika dilakukan studi di Indonesia, ada kemungkinan ditemukan indikasi yang sama juga karena keberadaan antibiotik yang selama ini sangat mudah diperoleh sehingga penggunaannya menjadi cenderung tidak rasional. Apalagi di Indonesia sangat banyak sekali penyakit yang disebabkan oleh bakteri. Antibiotik selama ini dianggap sebagai obat segala penyakit yang dapat dibeli bebas dengan harga terjangkau.

Adapun dalam fenomena swamedikasi, peresepan sendiri (termasuk pembelian obat tanpa resep) ini disebabkan oleh beberapa hal. Pertama, perkembangan teknologi informasi, dengan semakin berkembangnya teknologi, masyarakat menjadi lebih mudah dalam mengakses informasi, termasuk di dalamnya informasi mengenai kesehatan. Masyarakat jadi lebih terbuka dengan adanya informasi di Internet mengenai pengobatan, termasuk juga pengobatan alternatif. Masyarakat jadi lebih berani untuk melakukan pengobatan terhadap penyakit yang dideritanya berdasarkan aneka informasi yang didapatkan melalui Internet.

Kemudahan mendapatkan obat juga mendukung pergeseran ini, yang didukung peningkatan jumlah

Indonesian government has taken the right step

in publishing a formal guide on antibiotics usage

in conjunction with the commemoration of world

health day on April 7th, 2011. The main theme this year is “Anti-biotic Resistance.” This theme was apparently selected because, according to WHO data, in 2010 around 25,000 people in Europe have

died due to antibiotic-resistant bacterial infection.

If this study were to be done in Indonesia, there is

a possibility that the results would be similar. It is

widely known how easy it is for Indonesians to obtain antibiotics without prescription. And because it is so

easy to access, people tend to use it irrationally. This

is especially true in Indonesia where a lot of diseases are caused by some form of bacteria and antibiotics

is widely considered as a cure-all which is affordable, and widely available.

This self-medication and self-prescription phenomena is caused by several factors. First is the development of information technology. With the widespread use and availability of information technology, it has become easier for people to access information, including information related to healthcare. Through the Internet, people have become more exposed to medication information, including alternative treatments. This in turn, increases people’s self-confidence in practicing self- medication on their illness, based to the information that they gather from the Internet.

The ease of obtaining pharmaceutical drugs also supports this trend, along with the increasing

apotek dan toko obat di Indonesia. Jika dilihat dari perkembangan tahun 2007 sampai 2009, perkembangan jumlah apotek dibandingkan total jumlah saluran distribusi relatif meningkat stabil, berbeda halnya dengan pedagang besar farmasi dan toko obat. Jika dibuat rata-rata, maka satu apotek akan melayani ± 17.800 orang (lihat Exhibit 2).

Selain peningkatan jumlah apotek dan toko obat, juga terjadi perkembangan baru dalam pelayanan penjualan obat melalui apotek. Kini apotek tidak hanya mau melakukan pengiriman obat ke rumah, tapi juga buka 24 jam, hingga melayani pemesanan melalui Internet. Kemudahan semacam ini juga punya kontribusi dalam swamedikasi.

Di lain pihak, sebetulnya terjadi peningkatan yang signifikan terhadap jumlah rumah sakit dan dokter di Indonesia. Jumlah peningkatan rumah sakit bahkan mencapai angka 151 rumah sakit pertahun dari 2008 sampai 2009. Namun, jika dibandingkan dengan pertumbuhan penduduk, pertumbuhan rumah sakit masih kalah cepat. Dengan jumlah penduduk Indonesia yang mencapai jumlah 237,641,326 penduduk, satu rumah sakit tercatat harus menangani sekitar ± 155,000 orang. Hal tersebut sangat jauh dari kondisi yang ideal, terutama di daerah-daerah luar Jawa yang tingkat pembangunannya masih tertinggal dibandingkan dengan daerah-daerah di pulau Jawa.

number of pharmacies and drug stores in Indonesia. Looking at the numbers from 2007 to 2009, the growth of pharmacies when compared to other type of outlets is relatively stable. When we average them out, one pharmacy will serve ± 17.800 people (see Exhibit 2).

Beside the growth in the number of pharmacies and drug stores, there is also a shift in the service given by pharmacies. Not only will a pharmacy send your medicine to your house, but they are also open 24 hours and even provide an online ordering system. This convenience also contributes to the rise of self- medication.

On the other side, there is actually a significant rise in the number of hospitals and doctors in Indonesia. Hospital growth reached 151 hospitals per year from 2008 to 2009. However, this number quite low when compared with the growth of the Indonesian population. With 237,641,326 Indonesians, one hospital has to serve around ±155,000 people. This is far from ideal, especially outside of Java where the level of development typically lags behind areas in Java.

In the three year period from 2005 to 2008, the ratio of doctors to patients rose from 18 doctors per 100,000 people to 23 doctors per 100,000 people. This indicates that there is an increase of 5 doctors per 100,000 people in that 3 years period. The number of health personnel such as midwives and paramedics are also increasing (see Exhibit 3).

Exhibit 2 Percentage of Medical Distribution Channel 2007 - 2009

34

33

%

%

44% 35% 22%
44%
35%
22%

Pharmaceutical WholesalerDistribution Channel 2007 - 2009 34 33 % % 44% 35% 22% 36% Pharmacy 27% Drug

36%

Pharmacy- 2009 34 33 % % 44% 35% 22% Pharmaceutical Wholesaler 36% 27% Drug Store 20072007

27%

Drug Store33 % % 44% 35% 22% Pharmaceutical Wholesaler 36% Pharmacy 27% 20072007 2008 2009 Source: Indonesia

35% 22% Pharmaceutical Wholesaler 36% Pharmacy 27% Drug Store 20072007 2008 2009 Source: Indonesia Health Profile
35% 22% Pharmaceutical Wholesaler 36% Pharmacy 27% Drug Store 20072007 2008 2009 Source: Indonesia Health Profile
35% 22% Pharmaceutical Wholesaler 36% Pharmacy 27% Drug Store 20072007 2008 2009 Source: Indonesia Health Profile
35% 22% Pharmaceutical Wholesaler 36% Pharmacy 27% Drug Store 20072007 2008 2009 Source: Indonesia Health Profile
35% 22% Pharmaceutical Wholesaler 36% Pharmacy 27% Drug Store 20072007 2008 2009 Source: Indonesia Health Profile
35% 22% Pharmaceutical Wholesaler 36% Pharmacy 27% Drug Store 20072007 2008 2009 Source: Indonesia Health Profile

20072007 2008

2009

Source: Indonesia Health Profile 2009

Table 1 Number of Hospitals According To Its Ownership

 

2005

2006

2007

2008

2009

Indonesian Health Department / Local Government

452

464

477

509

552

Government / Province

112

112

112

112

125

Army/Police

78

78

78

78

78

Private

626

638

652

673

768

Total Hospitals

1268

129

1319

1372

1523

Source: Indonesian Health Department

Dalam periode tahun 2005-2008, rasio jumlah dokter meningkat dari 18 dokter per 100.000 penduduk menjadi 23 dokter per 100.000 penduduk. Hal ini mengindikasikan adanya penambahan 5 dokter untuk setiap 100.000 penduduk dalam jangka waktu 3 tahun. Jumlah tenaga kesehatan terdidik seperti bidan dan mantri juga mengalami peningkatan.

Meski ada peningkatan jumlah rumah sakit dan dokter, tapi ternyata hal tersebut seperti tidak menghalangi minat orang untuk melakukan swamedikasi. Sebagaimana ditunjukkan dalam hasil survei MarkPlus Insight, alasan swamedikasi, peresepan sendiri, atau pembelian obat tanpa resep di masyarakat Indonesia, adalah karena penyakitnya dinilai ringan (46%), harga yang lebih murah (16%), dan obat mudah didapat (9%). Terlihat bahwa faktor biaya dan waktu menjadi alasan yang melatarbelakangi swamedikasi. Dengan kata lain, swamedikasi menjadi suatu tantangan yang mesti disikapi secara aktif oleh para pemain di healthcare industry (lihat Exhibit 4).

Tantangan bagi Rumah Sakit

Semakin banyak rumah sakit baru yang bermunculan, khususnya rumah sakit swasta -- termasuk rumah sakit asing, dan rumah sakit pemerintah yang memberikan layanan seperti rumah sakit swasta -- menciptakan persaingan yang semakin ketat di industri ini (lihat Exhibit 5). Selain menghadapi persaingan yang semakin ketat, rumah sakit juga harus dapat mempertahankan eksistensinya di tengah fenomena swamedikasi yang semakin meningkat. Ini sebuah hal yang harusnya bisa menjadi semacam wake up call bagi rumah sakit yang selama ini belum berorientasi pelanggan atau customer centric.

This increase in the number of hospitals and doctors, apparently does not hinder people’s interest in self- medication. As shown by the result of MarkPlus Insight’s survey, the reason for self-medication, self-prescription or buying a medicine without a doctor’s prescription are due to the mildness of the disease (46%), lower cost (16%) and easiness to obtain (9%). Time and money are the main factors that push self-medication. In other words, self-medication has become a significant challenge that players in healthcare industry must actively address (see Exhibit 4).

Challenges for Hospital Industry

With the rapid growth of new hospitals, especially private institutions -- including international, as well as government-owned hospitals that are operated as private institutions – competition in the industry

is becoming very tight (see Exhibit 5). Besides fierce

competition, hospitals also have to maintain its existence amidst the rise of self-medication. This trend should serve as a “wake-up call” for hospitals that are not customer-centric yet.

Hospitals are often considered to offer similar service standards; therefore there are no significant difference between one hospital and another. According to a study by MarkPlus Insight, it is found that the consideration factor for a person to choose

a

hospital -- besides its location and doctor quality

--

is its service standards. Therefore, a hospital has

to be able to provide a unique service standard, different from other hospitals, to stand out and gain competitive advantage. This means that hospitals have to start creating and maintaining close relationships with its patients (customer intimacy) so

Exhibit 3 Health Personnel Ratio per 100,000 People in 2009

100

90

80

70

60

50

40

30

20

10

0

83 68 43 36 35 24 23 18 Doctor Midwife Paramedic Traditional Midwife
83
68
43
36
35
24
23
18
Doctor
Midwife
Paramedic
Traditional Midwife

(Dukun Bayi)

Source: Indonesia Health Profile 2009

2005

2008

Rumah sakit seringkali identik dengan standar pelayanan yang kurang lebih sama, sehingga tidak ada perbedaan signifikan antar rumah sakit. Berdasarkan salah satu studi MarkPlus Insight, ditemukan bahwa pertimbangan utama orang dalam memiliih rumah sakit -- selain lokasi yang dekat dan kualitas dokter yang dimiliki -- adalah standar pelayanan. Karena itu rumah sakit harus mulai menawarkan layanan yang berbeda dari rumah sakit lain, sehingga dapat menunjukkan differensiasi mereka dan memberikan keunggulan kompetitif tersendiri. Dengan kata lain, rumah sakit harus dapat meningkatkan kedekatannya dengan pasien (customer intimacy), sehingga pasien akan merasa nyaman ketika berada di rumah sakit.

Upaya meraih customer-intimacy ini merupakan sebuah tantangan yang tidak mudah, terutama kalau mengingat banyak rumah sakit yang masih berjuang untuk menggerakan semua bagian yang ada agar bisa memberikan layanan yang bagus. Rumah sakit yang sudah memiliki dedicated doctors dalam jumlah signifikan misalnya, masih mencari bentuk penerapan standarisasi layanan dokter. Standarisasi ini mencakup ketepatan waktu berada di rumah sakit, lamanya waktu berinteraksi dengan pasien, kebijakan rekomendasi pengobatan, hingga perlu atau tidaknya penggunaan obat. Dokter inilah yang sesungguhnya punya peran penting dalam membangun customer intimacy. Peran dokter semakin kuat ketika pasien sudah mulai akrab dengan sistem asuransi kesehatan

that a patient will feel comfortable in their hospital.

This is not an easy challenge, especially considering that there many hospitals are still trying to mobilize all of their division to provide good service. Even hospitals that mainly have employed – as opposed to independent -- doctors, are still trying to standardize the service standards of its doctors. These standards include timeliness, duration of patient interaction, medication recommendation, etc. Yet doctors hold

a crucial role in building customer intimacy. This is

increasingly true as patients today are more familiar

with the managed-care insurance system which requires the involvement of a family doctor who truly understands the condition of each patient.

Challenges for The Pharmaceutical Industry

The pharmaceutical industry is also facing challenges with the rise of this phenomenon. According to BPS-Statistics Indonesia, from 2007 to 2009, the percentage of modern pharmaceutical companies is decreasing compared to companies offering traditional medicine. This could be interpreted as

a signal for the pharmaceutical industry to start

considering producing traditional (i.e. herbal) medication. MarkPlus Insight’s survey indicates that jamu and herbal medication are two alternatives which are increasingly gaining public trust for self- medication (see Exhibit 6).

Exhibit 4 Self-Medication Reasons 45.5 16 8.7 7.9 5.4 4.7 3.9 3.6 3.3 2.2 2.2

Exhibit 4 Self-Medication Reasons

45.5 16 8.7 7.9 5.4 4.7 3.9 3.6 3.3 2.2 2.2 2.2 2 1.1 0.9
45.5
16
8.7
7.9
5.4
4.7
3.9
3.6
3.3
2.2
2.2
2.2
2
1.1
0.9
0.8

Source: MarkPlus Insight Research

managed care yang membutuhkan keberadaan dokter keluarga atau dokter yang benar-benar mengerti keadaan pasien.

Tantangan bagi Industri Farmasi

Perkembangan yang menarik bukan hanya terjadi di sektor industri rumah sakit, tapi juga sektor industri farmasi. Berdasarkan data BPS dari 2007-2009, tercatat bahwa persentase jumlah industri farmasi modern dibandingkan industri obat tradisional semakin berkurang. Hal ini bisa jadi salah satu sinyal untuk industri farmasi agar mulai mempertimbangkan memproduksi lebih banyak obat tradisional seperti obat herbal, jamu, dan lain-lain. Survei yang dilakukan MarkPlus Insight mengindikasikan bahwa jamu dan obat herbal adalah dua alternatif yang semakin mendapat kepercayaan publik untuk swamedikasi setelah obat bebas (lihat Exhibit 6).

Selain itu, pengembangan jenis obat-obatan baru juga penting karena jika hanya mengandalkan produksi obat non-paten, maka kompetisi yang dihadapi pun sangat banyak. Sebabnya, semua kompetitor dapat memproduksi obat dengan kandungan yang sama dan efek yang sama. Perbedaannya hanya terletak pada merek yang digunakan. Dalam hal ini, perusahaan-perusahaan farmasi, terutama yang kecil, pada umumnya menghadapi kesulitan dalam mengembangkan obat paten karena beberapa

The development of new drugs is also increasingly important. If pharmaceutical companies only rely on non-patented drugs, the competition is limitless. Any competitor can produce the same medicine with the same active-ingredients and more-or-less similar results. The only difference is its brand. In this case, pharmaceutical companies, especially smaller ones, seem to be having difficulties in producing patented medications, mainly due to limited financial and human resources.

On another front, the growth of hospitals and clinics, seem to bring positive hope toward the pharmaceutical industry, particularly ethical drugs.

Challenges for Pharmacies and Drug Stores

As the numbers of pharmacies and drug stores continue to increase, they are also increasingly competing with modern outlets such as minimarkets and supermarkets that provide over the counter medicines, which are typically used for self-medication. A survey by MarkPlus Insight reveals that supermarkets/minimarkets are also becoming alternative destinations where respondents go to buy over the counter medicine, right after pharmacies and drug stores. The increasing number of minimarkets create new challenges for pharmacies and drug stores. While it may be difficult for some people to find a pharmacy or drug store, it

1400

1200

1000

800

600

400

200

0

1400 1200 1000 800 600 400 200 0 Exhibit 5 Hospitals Growth Rate 2005-2009 1202 1080
Exhibit 5 Hospitals Growth Rate 2005-2009 1202 1080 1033 1012 995 436 441 451 535
Exhibit 5
Hospitals Growth Rate 2005-2009
1202
1080
1033
1012
995
436
441
451
535
535
559
571
582
613
667
2005
2006
2007
2008
2009
Goverment hospital
Private hospital
Number of percentage

Source: Indonesia Health Profile 2009

batasan, terutama dalam hal finansial dan sumber daya.

Di lain pihak, bertambahnya jumlah rumah sakit dan klinik membawa harapan positif terhadap industri farmasi, terutama dalam penjualan obat ethical.

Tantangan bagi Apotek

Seiring dengan terus bertambahnya jumlah apotek, secara tidak langsung apotek juga mendapatkan persaingan dari toko-toko modern seperti minimarket dan supermarket, terutama yang juga menyediakan berbagai obat OTC yang biasa digunakan untuk swamedikasi. Survei yang dilakukan MarkPlus Insight mencatat bahwa supermarket atau minimarket juga menjadi tempat yang dituju untuk pembelian obat setelah apotek dan toko obat. Jumlah minimarket yang semakin banyak menciptakan tantangan baru untuk apotek. Beberapa orang merasakan kesulitan menemukan lokasi apotek di tempat-tempat tertentu namun tidak sulit untuk menemukan minimarket.

Berdasarkan peraturan pemerintah tentang pendirian apotek (Keputusan Menteri Kesehatan RI No. 1332/ MENKES/SK/X/2002), salah satu kriteria wajib dalam pendirian apotek adalah keberadaan apoteker pengelola apotek. Selain sebagai persyaratan wajib, keberadaan apoteker menjadi salah satu keunggulan apotek dari berbagai saluran distribusi obat lain yang biasa diakses konsumen untuk swamedikasi. Apoteker memiliki peranan yang sangat penting bagi swamedikasi karena langsung berinteraksi dengan konsumen dalam hal pemilihan obat. Posisi apoteker ini menjadi sangat strategis dalam mewujudkan

Exhibit 6 The Ratio of Modern and Traditional Pharmaceutical company 2007-2009

2007 19.97

80.03

2008 18.56

81.44

2009 14.83

85.17

Modern pharmaceutical company80.03 2008 18.56 81.44 2009 14.83 85.17 Traditional pharmaceutical company Source: Indonesia Health

Traditional pharmaceutical company81.44 2009 14.83 85.17 Modern pharmaceutical company Source: Indonesia Health Profile 2009 is relatively easier

Source: Indonesia Health Profile 2009

is relatively easier for anybody to find a minimarket near them.

According to government ruling regarding building

a pharmacy (Indonesian Minister of Health Rule

Number 1332/MENKES/SK/X/2002), one of the main criteria in building a pharmacy is the availability of

a pharmacist as its administrator. Aside from the government regulation, a pharmacist presence

could also be the strength of a pharmacy compared

to

other drug outlets. A pharmacist is easily accessible

by

society for their self-medication consultation.

A

pharmacist plays an important role in self-

medication because they interact directly with the consumer when choosing a drug. The pharmacist’s position becomes strategic in building a responsible self-medication culture. Unfortunately, in reality, a pharmacy does not always have a pharmacist on duty when a consumer needs them.

If a pharmacy has already gained an advantage

compared to other drug distribution outlets, all pharmacies also need to gain an advantage when compared to each other. Nowadays, a pharmacy

does not only have to sell a product, they also have

to serve. More than just offering friendly service, but

also providing operational excellence, especially with regards to speed and medicine availability. The existence of a pharmacy network could be one operational advantage to meet the consumer’s need in an efficient medication provision. With an integrated information system, each pharmacy in the network can support each other to fulfill the comprehensive need of its consumers. On the

pengobatan swamedikasi yang bertanggung jawab. Namun pada kenyataannya seringkali sebuah apotek tidak memiliki apoteker yang selalu siap siaga ketika konsumen membutuhkan.

Jika apotek sudah memiliki keunggulan dibandingkan jenis outlet obat lainnya, maka setiap apotek juga perlu memiliki keunggulan dibandingkan apotek lainnya. Dewasa ini bisnis apotek tidak hanya dituntut untuk mengedepankan sisi produk saja melainkan juga harus mengedepankan pelayanan. Pelayanan dalam hal ini tidak hanya menyangkut bentuk pelayanan yang ramah saja tetapi juga diperlukan suatu sistem operasi yang excellent khususnya dalam kecepatan pelayanan dan ketersediaan obat. Keberadaan apotek-apotek berjaringan merupakan salah satu keunggulan dalam segi operasional untuk menjawab kebutuhan konsumen terkait dengan ketersediaan obat secara efisien. Dengan sistem informasi terpadu, masing-masing apotek dalam jaringan dapat saling mendukung untuk memberikan solusi ketersediaan obat yang lengkap bagi konsumen. Selain itu apotek jaringan ini juga mampu memberikan berbagai layanan tambahan, seperti antar jemput resep, dan layanan buka 24 jam.

Tantangan bagi Pasien

Hal penting lain yang perlu diperhatikan oleh masyarakat Indonesia adalah mengenai catatan kesehatan pasien. Sekarang ini catatan kesehatan pasien masih dipegang oleh masing-masing rumah sakit, sehingga pasien tidak memiliki catatan kesehatan jika akan melakukan pengobatan lanjutan, khususnya ke rumah sakit yang berbeda. Berbeda halnya dengan di beberapa negara lain seperti di Inggris dengan sistem NHS (National Health Service), catatan kesehatan dapat diakses di manapun dan kapanpun sehingga ketika seorang pasien membutuhkan pertolongan medis, pihak penolong dapat mengetahui riwayat kesehatan si pasien, seperti alergi yang diderita, atau sejarah penyakit terdahulu.

Hal ini merupakan tantangan dan juga kesempatan

bagi pemerintah dan para penyedia jasa kesehatan

di masa yang akan datang untuk dapat bersinergi

dalam membagi catatan kesehatan masyarakat.

Selain berguna untuk masyarakatnya sendiri, hal

ini juga turut akan memberikan efek positif bagi

pertumbuhan ekonomi Indonesia secara tidak

langsung.

other hand, a pharmacy network can also provide additional service, such as prescription pick-up and delivery, 24 hours service, etc.

The Challenges for Patients

Finally, there is another crucial factor that Indonesians need to pay more attention to, the patient’s medical record. At this moment, a patient’s medical record

is created and stored by each hospital, therefore a

patient will not have it readily available when they are trying to obtain service from another hospital or healthcare institution. In contrast, several modern countries such as the United Kingdom, with its NHS (National Health Service), this record is accessible anywhere and anytime. So when a patient is in need of a medical help, the caregiver can easily obtain the patient’s medical history, such as allergies, prior illness, etc.

This is a challenge and also an opportunity for government and medical institutions in the future

to collaborate in developing a shared medical record

system. This will not only be useful for the society as

a whole, this will also indirectly provide a positive effect for the growth of Indonesian economy.

About the Authors • Hermawan Kartajaya is the Managing Partner of MarkPlus Consulting. He has

About the Authors

Hermawan Kartajaya is the Managing Partner of MarkPlus Consulting. He has over 20 years of consulting experience. Hermawan was dubbed as “One of the 50 Gurus Who Have Shaped the Future of Marketing” by Chartered Institute of Marketing, United Kingdom

Taufik is a Partner at MarkPlus Consulting. He has over 15 years of consulting experience. Taufik has an MBA from the Nanyang Fellows Programme (Nanyang Technological University and MIT Sloan School of Management).

Jacky Mussry is a Partner at MarkPlus Consulting. He has over 15 years of consulting experi- ence. Jacky has a doctorate degree in Strategic Management from University of Indonesia.

Iwan Setiawan is a Principal at MarkPlus Consulting. He has over 6 years of consulting experi- ence. Iwan has an MBA from the Kellogg School of Management.

Bayu Asmara is an Engagement Manager at MarkPlus Consulting with over 4 years of consult- ing experience.

Nastiti Tri Winasis is a Chief Operation at MarkPlus Insight with over 15 years experience in marketing research.

Bernardus E. Satrio is a Associate Research Manager at MarkPlus Insight with over 10 years experience of social research and media industry.

Irvan Irawan Jie is a Senior Research Executive at MarkPlus Insight With 3 years experience in research and 3 years in high-end fashion retail.

Levina Yulianti is a Senior Research Executive at MarkPlus Insight with over 3 years experience in marketing.

Anthony Darmaja is a Business Analyst at MakPlus Consulting with over 2 years experience in marketing.

• Anthony Darmaja is a Business Analyst at MakPlus Consulting with over 2 years experience in
• Anthony Darmaja is a Business Analyst at MakPlus Consulting with over 2 years experience in
• Anthony Darmaja is a Business Analyst at MakPlus Consulting with over 2 years experience in
• Anthony Darmaja is a Business Analyst at MakPlus Consulting with over 2 years experience in
• Anthony Darmaja is a Business Analyst at MakPlus Consulting with over 2 years experience in
• Anthony Darmaja is a Business Analyst at MakPlus Consulting with over 2 years experience in
• Anthony Darmaja is a Business Analyst at MakPlus Consulting with over 2 years experience in
• Anthony Darmaja is a Business Analyst at MakPlus Consulting with over 2 years experience in
• Anthony Darmaja is a Business Analyst at MakPlus Consulting with over 2 years experience in
•
• Anthony Darmaja is a Business Analyst at MakPlus Consulting with over 2 years experience in
• Anthony Darmaja is a Business Analyst at MakPlus Consulting with over 2 years experience in
For Inquiries, Please Contact: Iwan Setiawan (iwan.setiawan@markplusinc.com) PT MarkPlus Indonesia Segitiga Emas
For Inquiries, Please Contact:
Iwan Setiawan (iwan.setiawan@markplusinc.com)
PT MarkPlus Indonesia
Segitiga Emas Business Park CBD B 01/01
Jl. Prof. Dr. Satrio Kav.6
Jakarta Selatan 12940
Indonesia
Phone : +62-21-5790 2338 (Hunting)
Fax : +62-21-5790 712
Hasanuddin (hasanuddin@markplusinc.com)
PT MarkPlus Indonesia
Segitiga Emas Business Park CBD B 01/01
Jl. Prof. Dr. Satrio Kav.6
Jakarta Selatan 12940
Indonesia
Phone : +62-21-5790 2338 (Hunting)
Fax : +62-21-5790 712
Phone : +62-21-5790 2338 (Hunting) Fax : +62-21-5790 712 Copyright © MarkPlus, Inc. All rights reserved
Phone : +62-21-5790 2338 (Hunting) Fax : +62-21-5790 712 Copyright © MarkPlus, Inc. All rights reserved
Phone : +62-21-5790 2338 (Hunting) Fax : +62-21-5790 712 Copyright © MarkPlus, Inc. All rights reserved

Copyright © MarkPlus, Inc. All rights reserved

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© MarkPlus, Inc. All rights reserved General Disclaimer: This paper has been prepared for general guidance
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