In Cambodia, pharmacists are often the first point of contact for patients seeking medical care. Pharmacies are convenient, offer readily available drugs, and are often much more accessible and cheaper than visiting a medical clinic, especially in rural areas.
The 2014 Cambodia Demographic Health Survey reported that 67 percent of ill or injured residents sought first treatment in the private sector, while 22 percent turned to the public sector. Of those seeking treatment in the private sector, the most popular destinations were private clinics (18 percent) and private pharmacies (18 percent).
However, the pharmaceutical industry is susceptible to counterfeit drugs, and pharmacies often operate simply as businesses instead of encouraging environments where patients can receive the attention and advice they need.
Local entrepreneur and pharmacist Dr. Chea Vireak is hoping to change this.
To cut down on counterfeit drugs, Vireak founded PillTech in 2021, an online ordering platform that allows pharmacies to purchase over 5,000 different medications approved by the Ministry of Health.
He estimates that about 20 to 30 percent of medications available at pharmacies are not approved by the ministry. The World Health Organization estimates that 10 percent of all drugs offered in low and middle-income countries are “substandard or falsified”.
Vireak told Cambodia Investment Review: “When I first started PillTech, I had only one goal, and that was to make sure pharmacists are purchasing their drugs through legal channels. This would ultimately have a positive impact on the millions of patients they see daily.
“We wanted to make sure that they buy good, affordable products so that they can give them to the patients. If we can control that, then we can eliminate a lot of the counterfeit products that the patients are getting.”
He said pharmacists often don’t know their products are fake, because it can be impossible to discern the fake goods from authentic products.
US-inspired system built for Cambodia
Vireak draws on his experience studying and working in the United States for inspiration. He emigrated to California to live with his uncle when he was 13 and later earned his doctorate in pharmacy at Pacific University in Oregon.
After working at pharmacies for 14 years in the US, Vireak moved back to Cambodia in 2013 to be with his family and apply his pharmaceutical expertise in his home country.
Once PillTech started to grow, Vireak started envisioning an entirely new pharmaceutical ecosystem. He’s since introduced a first-of-its-kind point-of-sale platform for pharmacies using his service.
Pharmacists can keep track of their inventory, find out which medicines are in demand, and receive automatic alerts when supplies are running low.
“We could tell you right away, your pharmacy should have these top 500 drugs, these are fast movers. We provide these kinds of benefits because we have data from users in the past. That’s one thing that Olympic Market cannot do.”
Vireak said he currently uses about 100 suppliers and around 1,000 pharmacies have signed up for his service. Although it’s hard to compete with the traditional wholesalers’ prices, and is offering much more than just shipments of drugs.
“For us it is more than just pricing, we want to build relationships and grow with the pharmacies,” he said.
Vireak also created TovPet, a consumer-based app that connects patients to pharmacies and allows for remote medical consultations with doctors.
“A lot of times patients go to the pharmacy and the pharmacist prescribes anything that they want, like prescription medication, without seeing a doctor first. So we tell the patients, look you have an option to also see a doctor online.
Once they talk to you, they would then prescribe on the backend, and we would send the prescription to the pharmacy owners, who would then deliver the product to you. The pharmacist would then be able to consult you on how to take the medication properly. This is the ecosystem that we’re trying to build.”
Reaching out to rural communities
The focus for 2022 is improving access to care in rural provinces, where stocking medicine is traditionally a time-consuming process and private pharmacies play an important role in providing first-treatment care.
Pharmacists often have to travel to the capital to buy products or rely on truck shipments from wholesalers who offer inconsistent stocks and varying prices. Distributors often require large orders to place a shipment and can take four to five days to make a delivery, Vireak said.
PillTech relies on third-party logistics providers and utilizes multiple distribution points to make deliveries within a day in Phnom Penh and 48 hours in the provinces, a tactic that drastically cuts down on procurement time.
In terms of volume, sales in the provinces outpaced sales in the capital last year, proving the concept could work.
“During the last quarter of 2021, we started to notice a big growth of pharmacy customers purchasing using our ordering platform from the provinces and the remote areas of Cambodia. This is because it is much harder to procure products for pharmacies in the provinces versus the city,” he said.
One main benefit of freeing up pharmacists’ time is to allow them to spend more time with patients and less time managing stock. Vireak hopes this will provide pharmacists with the opportunity to build stronger relationships with patients, something he said is severely lacking in the industry.
He said some pharmacists and doctors lack the soft relationship-building skills needed to provide good healthcare and even lash out at patients who ask too many questions.
To fix this, Vireak travels to universities and offers soft skills training to pharmacy students while trying to instill a sense of duty to care for patients rather than simply act as cashier.
Traditionally, he said pharmacists get into the industry because of their parents, not because they are passionate about healthcare. They typically work for low wages at first with the intent of opening their own pharmacy.
While focusing on sales instead of patient care can lead to more short-term gains for pharmacists, Vireak believes building long-term relationships with patients will bear the most fruit.
“Do you want a short-term gain or a long-term relationship? When a patient trusts me, they know I’m not going to overprescribe just to make money. Maybe I don’t gain in the short term, but in the long run, they will always come back to me, and not only that, they will tell their friends and family to come too,” he said.
Cambodian government collaboration
As the Ministry of Health focuses on regulating the rapidly growing private healthcare sector, Vireak said it’s important that the government continues to provide increased support and incentives for companies like his.
Vireak, who is also the chairman of the European Chamber of Commerce’s health committee, has already advised the government on policies to help regulate the sector.
He’s also helped the government in its fight against Covid-19 by teaming up with the Ministry of Posts and Communications to use TovPet as a means to help disburse Covid-19 testing kits. TovPet will be used to distribute the recently approved Molnupiravir Covid-19 pills.
For Vireak’s next product, he’s working on a machine-learning app that would allow pharmacists to input patient symptoms and receive recommendations for which medications to provide.
After Vireak and his co-founder poured their own money and time into PillTech to keep it operating, profits have been up, but there’s not enough to sustain operations.
The future looks bright, however, as Vireak is close to finalizing investments with investors that will keep his dream of transforming the pharmaceutical industry alive for the foreseeable future.
PillTech also recently signed an MoU with PhilipBank to offer more flexible payment plans and the company took home ASEAN’s Top Startup Award at the ASEAN Information and Communications Technology (ICT) awards last month.
Vireak said his goal isn’t to get rich – pharmacists aren’t charged to use PillTech – but rather to create a better service for patients.
“When you’re in healthcare, you must have the ethics, otherwise you won’t last long. You’re not in healthcare to make money, you’re in healthcare to help people. For me, it’s the same way. How can we improve the lives of patients through our job? Everyone has a part to play. Pharmacists, doctors, dentists, nurses, we have our roles. If we’re able to collaborate, in the end, the patient will benefit the most.”