Rxilient (Kanglianda): Powering Chinese Innovative Pharma’s Expansion into Emerging Markets

As innovative drugs expand into the global market, small and medium-sized pharmaceutical companies in China, Europe, and the United States are increasingly focusing on rapidly growing emerging markets, particularly Southeast Asia and the Middle East. Currently, the vast and unmet medical needs in these two regions have attracted significant attention from many small and mid-sized Western pharmaceutical firms as well as Chinese innovative drug developers, who are actively establishing their presence there. However, given the complex and fragmented nature of these markets, how can high-quality innovative medicines reach local patients, and how can their rapid deployment be facilitated? With these questions in mind, VCBeat recently held a dialogue with Paul Koolenbrander, CEO of Rxilient Health.

The following is a verbatim transcript of the conversation, with certain portions edited by VCBeat without altering the original meaning:

VCBeat: The name “Rxilient” is quite distinctive. Does it carry any particular meaning?

Paul Koolenbrander: Rxilient is a variant of the English word “Resilient.” As an emerging pharmaceutical company in new markets, Rxilient provides high-quality, affordable treatment solutions to local patients through product introduction, development and registration, manufacturing, and commercialization. Despite facing numerous challenges, we remain committed to doing the difficult yet right things with resilience, true to our name, Rxilient (“Resilient”).

VCBeat: Why is this considered a difficult yet right thing to do?

Paul Koolenbrander: The Southeast Asian and Middle Eastern markets covered by Rxilient are emerging markets characterized by both challenges and opportunities. Over the next five years, GDP growth in these regions is projected to be approximately 4%–6%, while the pharmaceutical market is expected to grow at around 7%. Large multinational pharmaceutical companies have also achieved notable performance in these two markets, leveraging their mature product portfolios. The overall size of the pharmaceutical market in Southeast Asia and the Middle East is nearly $50 billion, accounting for approximately 30% of China’s $160 billion pharmaceutical market. However, unlike China’s unified market, the Southeast Asian and Middle Eastern markets are highly diverse and complex, with varying regulatory frameworks and market access policies. These regions also face challenges related to the accessibility and affordability of innovative drugs, resulting in substantial unmet medical needs across the markets.

For large multinational pharmaceutical companies, global pricing strategies for innovative drugs may not align with local economic conditions, and they tend to promote only their proprietary products. Local pharmaceutical companies primarily focus on generic drugs and have limited resources for introducing innovative drugs from Europe, the United States, and China. For small and medium-sized innovative pharmaceutical companies in Europe and the United States, as well as Chinese innovative pharmaceutical companies, current presence in the complex and fragmented markets of Southeast Asia and the Middle East is very limited. There is an urgent need to collaborate with enterprises that can cover multiple markets simultaneously, possess extensive local market experience, and maintain an open model toward innovation from all companies.

True to Rxilient’s corporate mission, establishing an enterprise that integrates innovations from Europe, the United States, and China; registers innovative drugs locally; launches them at reasonable prices; and ensures a long-term, stable, high-quality supply chain is a challenging yet righteous endeavor. Successfully executing this vision would benefit countless local patients while simultaneously opening pathways for high-quality Chinese innovative drugs to enter multiple markets across Southeast Asia and the Middle East.

VCBeat: Why is Rxilient Health capable of undertaking this initiative? Could you provide a detailed overview of its business model and current progress?

Paul KoolenbranderHeadquartered in Singapore since its inception, Rxilient has established a presence in 14 key markets across Southeast Asia and the Middle East. It has built localized teams with extensive experience in local registration and commercial sales, covering Singapore, Malaysia, Thailand, Indonesia, Vietnam, the Philippines, Hong Kong (China), Taiwan (China), and the six Gulf Cooperation Council (GCC) countries, including the United Arab Emirates and Saudi Arabia. Leveraging its in-house team and support from its shareholders, CMS Pharmaceutical Group and Legend Capital, Rxilient possesses strong capabilities in sourcing innovative drugs. The company adopts a dual-track strategy: on one hand, it introduces innovative drugs from China, such as toripalimab, the first PD-1 monoclonal antibody developed by a Chinese company to receive approval from both the U.S. FDA and China’s NMPA; on the other hand, it actively sources innovative drugs from Europe and the U.S., such as ruxolitinib cream, the first treatment approved by the U.S. FDA and the European EMA for non-segmental vitiligo. For key products, Rxilient also holds rights for localized manufacturing. It has jointly established a manufacturing facility in Singapore with the capability for technology transfer, enabling “Made in Singapore” production and ensuring a long-term, stable, and high-quality supply chain for Rxilient.

VCBeat: What are Rxilient Health’s specific development plans for the coming years?

Paul Koolenbrander: We adopt a strategy that places equal emphasis on product development and commercialization. As the soul of our company, our product portfolio leverages diverse resources to continuously introduce high-quality innovative drugs from Europe, the United States, and China, thereby building a robust and sustainable pipeline. We accelerate technology transfer for key products to enable local manufacturing in Singapore, ensuring supply chain security. Meanwhile, we refine our regulatory registration and market access systems to expedite product approvals and facilitate the entry of Chinese pharmaceutical products into Southeast Asian and Middle Eastern markets. In alignment with product launch timelines, we rapidly establish and expand our sales and distribution network through in-house teams and mergers and acquisitions, creating a solid infrastructure to ensure that innovative drugs from Europe, the United States, and China reach and benefit local patients.

VCBeat: What advice do you have for Chinese innovative pharmaceutical companies expanding into emerging markets?

Paul Koolenbrander: For Chinese innovative drugs entering emerging markets, registration and market access are two areas requiring particular attention. From a regulatory perspective, innovative drugs already approved in developed countries such as those in Europe and the United States have traditionally enjoyed higher recognition from local regulatory authorities in Southeast Asia and the Middle East. In contrast, innovative drugs approved only in China still face stringent challenges during the registration process. However, if domestically produced products are developed in accordance with international standards, featuring robust clinical data and stable, reliable pharmaceutical development quality, and if they address unmet medical needs in the target regions, they may have opportunities to pursue registration and market launch in Southeast Asia and the Middle East. Meanwhile, local religious, cultural, and specific regulatory requirements—such as Halal certification and climate stability studies for Zone IVb—must not be overlooked.

From a market access perspective, both Southeast Asia and the Middle East are highly diversified markets, whether in terms of the macroeconomic environment or the healthcare sector itself. Comprising multiple countries with diverse languages, cultures, and religious beliefs, these regions exhibit significant disparities in economic development. Some markets, such as Singapore, the United Arab Emirates, and Saudi Arabia, boast higher per capita GDP and healthcare expenditure than China currently does, while others, including Indonesia, the Philippines, and Vietnam, have lower levels, with per capita healthcare spending comparable to that of China 15 years ago. Regarding the healthcare landscape itself, unlike China’s unified market, Southeast Asian and Middle Eastern countries vary considerably in their healthcare security systems, reimbursement policies, and the structure of private and public sectors. Given this high degree of market diversity and the relatively low familiarity and acceptance among local physicians and patients toward products approved only in China, it is essential to either build a frontline team with local marketing and sales experience or collaborate with local pharmaceutical companies, such as Rxilient Health, when entering these markets. Tailored product launch strategies should be developed for each specific market.

Five years ago, the global expansion of China’s innovative drugs was largely met with distant observation. However, as the globalization of China’s pharmaceutical innovation deepens, “going global” has become an imperative path. This journey is fraught with challenges, demanding thorough preparation and ample patience. It is essential to remain steadfast in the belief that while this road is difficult, it is the right one.

As going global becomes an imperative, companies face a critical strategic choice: whether to “build their own ship” or “borrow a ship” to navigate international waters. “Building your own ship” entails independent R&D, establishing proprietary distribution channels, and cultivating an international brand and market presence. While this approach requires substantial upfront investment and carries higher risks, it grants greater autonomy and long-term growth potential once successful. In contrast, “borrowing a ship” refers to leveraging existing international resources and channels through partnerships, joint ventures, or licensing agreements to rapidly enter overseas markets. This strategy lowers entry barriers, reduces initial capital outlay, and enables quicker revenue generation.

The market landscapes in Southeast Asia and the Middle East are relatively fragmented and diverse, with complex regulatory environments. Consequently, partnering with established players to enter these markets is a common strategy for Chinese pharmaceutical companies. Firms such as Junshi Biosciences, Innovent Biologics, and Akeso have all adopted collaborative approaches to expand into Southeast Asia. More importantly, as emerging contenders, Chinese pharmaceutical companies must identify their unique positioning within the Southeast Asian market, which is already divided among multinational corporations, local firms, and Indian pharmaceutical companies. This strategic differentiation is key for Chinese pharma companies targeting Southeast Asia and the Middle East.

However, Chinese pharmaceutical companies have now reached a stage where they must take action, regardless of which global expansion strategy they adopt.