Global Health Asia-Pacific May 2020 | Page 65

Cheap anti-HIV drug pulls Asian visitors to Thailand Generic Truvada pill offers huge savings for medical trippers T Thailand’s BDMS medical group moves to take over competitor Efforts to acquire US$3.2 billion of Bumrungrad’s remaining shares now in the works T hailand’s largest private healthcare group has launched a takeover attempt of one of Southeast Asia’s biggest private hospitals. Bangkok Dusit Medical Services (BDMS) made the unsolicited tender offer to buy the remaining shares in Bumrungrad International Hospital it didn’t already own at 125 baht each. It’s currently the hospital’s biggest shareholder, with 25 percent of its shares. A tender offer is a public request to shareholders to sell their stock at a specified price that is usually higher than the company’s stock price. BDMS’s bid amounts to US$3.2 billion and is subject to BDMS shareholder and antitrust approvals. Its shareholders will decide whether to approve the transaction on April 10. Bumrungrad said in a statement it had no prior knowledge and was “surprised” by the offer. It said the plan should be examined by Thailand’s antitrust regulator, the Trade Competition Commission, in the interest of consumers. It said it would act in accordance with the law and appoint an independent financial adviser to give an opinion on the tender offer for shareholders. The two hospitals compete in the same segment and are market leaders. BDMS already has 46 hospitals and treatment centres in Thailand, with another one underway, and two more in Cambodia. It owns Bangkok Hospital, which in turn operates Bumrungrad. International patients accounted for 30 percent of its revenue in 2019. Bumrungrad has 580 licensed beds and capacity for over 5,500 outpatients per day. Outside Thailand, it manages Bumrungrad Clinic Yangon in Myanmar and Ulaanbaatar Songdo Hospital in Mongolia. It treated over 629,000 international medical tourists from over 190 countries in 2018. GlobalHealthAndTravel.com hailand is becoming an Asian hub for the supply of a drug that prevents the transmission of HIV. PrEP, or pre-exposure prophylaxis, is a preventive medicine that reduces the risk of getting HIV through sexual intercourse. It’s been shown to be almost completely effective when taken properly. However, PrEP is not a substitute for condoms as it doesn’t protect against other sexually transmitted diseases. It also requires regular blood testing for HIV and other screening to ensure the body is reacting well to the drug. While effective, it’s expensive to acquire through most Asian health services, costing up to US$400 for a month’s supply of the pills under the brand name Truvada in places like Japan and South Korea. The drug contains two medicines, tenofovir and emtricitabine. But in Thailand, a generic pill with the exact same ingredients as Truvada and manufactured by a Thai government agency costs as little as US$20 per 30- day supply. The low price and availability have prompted gay medical tourists from other parts of Asia to travel to Bangkok to stock up on the generic pills. One South Korean “PrEP tourist” told The Nikkei a trip to Thailand for a 12-month supply of pills cost about US$1,000, including medication, airfare, and hotel. In South Korea, only patients under 31 and in a relationship with an HIV-positive partner can be prescribed subsidised Truvada through the health system. A supply of pills for a year would otherwise cost US$4,200. n MAY 2020 63