Fitofarmaka sebagai Ajudan Pengobatan Kanker

The majority of the pharmaceutical industry in Indonesia is still focused on treating cancer using conventional therapy under the general guidelines on cancer management, such as surgery, radiotherapy, chemotherapy, and most recently by targeted therapy, including biologicals. These conventional treatments, especially the radiotherapy and chemotherapy, unfortunately generate negative side effects and, in particular, the potential resistance of cancer cells to above treatments. This would require a dose increase, or replacement of the chemotherapy which would cost the patient much more. MD Anderson Cancer Center is the leading cancer research center in the United States who has conducted various research and development of curcuma longa plant, which is similar to the temulawak (curcuma xanthorizza) in Indonesia, as an alternate cancer treatment. More than fifty clinical trials have been conducted to prove the safety and efficacy of curcuminoid, which is the active substance content in curcuma longa, and research has it that the active substance has several extraordinary functions such as anti-inflammation, anti-oxidant, anti-anti angiogenesis or new blood vessel formation, apoptosis or destruction of abnormal cells, and the most recent discovery is that that the curcuminoid serves as chemo/radio-sensitizer, which sensitizes cancer cells to be ready to be destroyed by chemo/radiotherapy and reduces the likelihood of resistance, as well as chemo/radio protector, which protects normal cells in the body not to be damaged by chemo/radiotherapy. The group saw the insight and opportunity to enter into the oncology market in Indonesia with curcuminoid herbal based products to be developed and marketed in Indonesia as an adjuvant therapy to current conventional treatments in order to provide a better quality of life for the cancer patients, as well as to the cancer survivors. Looking into current lifestyle and environmental conditions in Indonesia, the number of new cancer patients (cancer incidence) in Indonesia will continue to rise nearly doubled from 292 thousand patients in 2008 to 535 thousand people with cancer in 2030 (GLOBOCAN research, WHO, 2008). In 2008, it is reported that cancer comes second as the most killer disease in Indonesia after heart disease (around 215 thousand deaths). The 5-year compounded annual growth rate (CAGR) of conventional cancer drugs sales in Indonesia is 24% CAGR (ITMA MAT Q1 2010), well above the 5-year CAGR of total Indonesia pharmaceutical market at only 9%. The data above shows a significant market opportunity to enter, and particularly with the introduction of herbal products (made from curcumin), which has undergone various trials both in-vitro and in-vivo testing for safety, pharmacokinetics, pharmacodynamics, which were tested both on healthy humans, as well as to cancer patients. To excel in competition, by assessing our value chain model, we decide to focus on the marketing program (holistic customer relationship management) and by making cGMP as the way of life in the operation. We will carry out aggressive marketing strategy with a capacity leading strategy in the production capacity. To meet the marketing target, highly qualified medical representatives are crucial. The medical reps must have good understanding of the pharmacology and pharmacoeconomics, especially for the treatments of cancer disease. Medical reps and plant operators will go through a process of intensive training prior to commercial operations, and refreshment training as well as update trainings will be provided on a periodical basis to update knowledge, skills, and market conditions. The initial investment is IDR 23.25 billion to support the pre-operation activities in the first two years of establishment. The initial investment will be financed by shareholders' equity and shareholder loans. In the fifth year of operations, shareholders' loans will be converted to a bank loan using current assets as collateral. This is necessary to optimize the WACC since Kd bank loans are cheaper than Kd shareholder loans. It would also be advisable to establish a relationship with the bank for future reference, should the company needs to expand and company will provide funding to expand the business i.e.: marketing of new products. From the financial simulation, the rate of return is 28.43% of the WACC of 15.36%, 8 years discounted payback period, and a positive shareholder value (NPV) of IDR 33.85 billion. Based on sensitivity analysis, the coefficient of variance of the NPV and IRR is 0.62 and 0.25 respectively, low enough so we can conclude that the business has low risks. In terms of ratio, simulation shows YoY improvement with very good cash flow towards the end of the period. It is then concluded that the business is feasible to run.