challenges & opportunities healthcare in india
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HEALTHCARE SECTOR IN INDIAHEALTHCARE SECTOR IN INDIA
Challenges and Opportunities
OUTLINE
Healthcare Sector in IndiaHealthcare Sector in India
Current ScenarioCurrent Scenario
Growth DriversGrowth Drivers
Public vs Private sectorPublic vs Private sector
Healthcare Value ChainHealthcare Value Chain
Government Policies and IncentivesGovernment Policies and Incentives
Major PlayersMajor PlayersMajor PlayersMajor Players
Future GrowthFuture Growth
ChallengesChallengesChallengesChallenges
Business OpportunitiesBusiness Opportunities
HEALTHCARE SECTOR IN INDIA
Health administration in India is governed by theMinistry of Health and Family Welfare
The central administration provides co-ordination anddirection to a network of state health ministries for
l i l iactual implementation
The healthcare sector constitutes
Medical care providersDiagnostic service centres and pathological labsMedical equipment manufacturersMedical equipment manufacturersContract research organizationsPharmaceutical manufacturersThird party support service providers
HEALTH INFRASTRUCTURE A COMPARISON
BedsP ’000 l ti
PhysiciansP ’000 l ti
NursesPer ’000 population
Countries
India
Per ’000 population
1 5 1.2
Per ’000 population
0 9
Per 000 population
Low income (e.g., sub-Saharan Africa)
1.5
1.5 1.0
0.9
1.6
Middle income (e.g., China, Brazil) 4.3 1.8
1.6
1.9
High income (e.g., US, Western Europe) 7.4 1.8
7.5
World average 3.3 1.5 3.3
HEALTHCARE - INFRASTRUCTURE
Investment in Major States
189157
150
200
11194
100
SD M
illion
0
50US
Maharashtra Delhi Karnataka Meghalaya
States
HEALTHCARE–REGISTERED DOCTORS
Availability of Doctors in Major States
95,299100,000
120,000
d
72,72564,492
53,456
40 000
60,000
80,000
ors r
egist
ered
0
20,000
40,000
No. o
f Doc
to
Maharashtra Tamil Nadu Karnataka West Bengal
States
OUTLINE
Healthcare Sector in IndiaHealthcare Sector in India
Current ScenarioCurrent Scenario
Growth DriversGrowth Drivers
Public vs Private sectorPublic vs Private sector
Healthcare Value ChainHealthcare Value Chain
Government Policies and IncentivesGovernment Policies and Incentives
Major PlayersMajor PlayersMajor PlayersMajor Players
Future GrowthFuture Growth
ChallengesChallengesChallengesChallenges
Business OpportunitiesBusiness Opportunities
CURRENT SCENARIO
The healthcare industry is estimated at USD22 billion22 billion
Estimated growth at 13 per cent annuallyt f 15 20 t f thassures a return of 15-20 per cent for the
healthcare providers
Healthcare sector at present employs 4 millionpeople directly and indirectly
Private healthcare market currently estimatedat Rs 690 billion (USD 14.8 billion)
CURRENT SCENARIO
85 per cent private sector establishmentshave less than 25 bedshave less than 25 beds
Speciality and super speciality hospitalsaccount for 2 per cent of total institutesaccount for 2 per cent of total institutes
Corporate hospitals constitute less than 1 percent of all institutescent of all institutes
Private sector accounts for 82 per cent of allout patient visitsout-patient visits
Private sector accounts for 52 per cent of allh it li tihospitalization
CURRENT SCENARIO
Current Healthcare InfrastructureHealthcare Indicators: India Vs World
Hospitals 15,393
Public 4,049
Private 11,344
6378
Life expectancy at birth
Developed CountriesIndia Today
Developing CountriesIndia at 1990
Developed CountriesIndia Today
Developing CountriesIndia at 19901951
Hospital beds 875,000
Doctors 592,215
Nurses 737,000
37
63 65
56146Infant mortality
Dentists 80,000
Medical Colleges 170
Retail chemist outlets 350,000
656
70
Th i bi f i t h t i t t t iti
New doctors every year 18,000
There is a big scope for improvement, hence vast investment opportunities…
STATUS OF HEALTHCARE SECTOR
Sector Direct employment Revenues/GDP
Million, 2000-2001 Per cent, 2000-2001
4.0
5.3
5.2
4.8
Healthcare
Education
1.0
1.2
1 6
3.5
3.0
1 8
Retail banking
Power
R il
Healthcare is the largest service
industry in terms of revenues and
the second1.6
0.8
1 7
1.8
1.4
0 9
Railways
Telecom
Hotels, restaurants
the second largest after education in
terms of employment
1.7
0.4
0.9
1.7
,
IT
By 2012, the sector could account for 6 to 8 per cent of GDP and providedirect and indirect employment of 8 million
HEALTHCARE ISSUES & CONCERNS
Small hospitals – 80 per cent < 25b dbedsSpecialised services available in only 2per cent hospitalsper cent hospitalsGood healthcare available only inmetrosLack of infrastructureMismanaged Public hospitalsI d t ti f bliInadequate remuneration for publichospital staffLack of commitment Lack of commitment
OUTLINE
Healthcare Sector in IndiaHealthcare Sector in India
Current ScenarioCurrent Scenario
Growth DriversGrowth Drivers
Public vs Private sectorPublic vs Private sector
Healthcare Value ChainHealthcare Value Chain
Government Policies and IncentivesGovernment Policies and Incentives
Major PlayersMajor PlayersMajor PlayersMajor Players
Future GrowthFuture Growth
ChallengesChallengesChallengesChallenges
Business OpportunitiesBusiness Opportunities
GROWTH DRIVERS
“Physicians, Nurses, Medical Technicians and Other Scientific Occupations will Become Growth Industries to Rival the IT Sector
within the Next Decade”
- India Vision 2020 Report
GROWTH DRIVERS
Private Healthcare Spending
42
30354045
n 8 4 bn
if health insurance cover is available to the rich and the middle class it
14.8
51015202530
USD
Bill
ion 8.4 bn
33.6 bn
would rise to this level
05
2007 2012
Year
Private healthcare expected to grow to Rs 1,560 billion (USD 33.6 billion) in 2012
GROWTH DRIVERS
This would account for
Total Healthcare Sector
52-6970
80
This would account foraround 6.2 to 8.5% of GDPby 2012
22 230
40
50
60
USD
Bill
ion
Currently 5.2% of GDP
22.2
0
10
20
2007 2012
Year
Total Healthcare market including Pharma to account for 6.2 to 8.5% of GDP in 2012
GROWTH DRIVERS
Corporates are sensing a huge untapped opportunity indelivery of quality healthcare to the Indian masses
Policies and budgetary considerations towardspharmaceutical as well as biotech organizations are nowf blfavorable
De-regulation of health insurance has paved the way for theentry of foreign health insurance companiesentry of foreign health insurance companies
Medical equipment industry too being opened to foreigncollaboration for manufacturing high and middle-levelcollaboration for manufacturing high and middle leveltechnology medical equipment
Global Private Equity players and Venture Capital companiesGlobal Private Equity players and Venture Capital companiesalso actively exploring opportunities
GROWTH DRIVERS
INDIA – COST ADVANTAGE
PROCEDURE COST (US$)
THAILANDTHAILAND INDIA
Heart Surgery 7,500 6,000
USUS
40,000
UK
23,000
Bone Marrow Transplant
Liver Transplant
-------
-------
26,000
69,000
2,50,000
3,00,000
1,50,000
2,00,000
Knee Replacement
Cosmetic Surgery
8,000
3,500
6,000
2,000
20,000
20,000
12,000
10,000
GROWTH DRIVERS
HEALTHCARE SNAPSHOTS
0.5 million major surgeries carried out
Over a million surgical procedures carried out
Cardiac bypass success rate – 98.7 per cent
B t l t 80 t tBone marrow transplant – 80 per cent success rate
Renal transplant – 95 per cent success rate
INTERNATIONAL RECOGNITION
As per NHS of UK - India is a favored destination for surgeries
British Standards Institute has accredited Delhi-based EscortsHospital
Wockhardt Hospital has an exclusive association with HarvardWockhardt Hospital has an exclusive association with HarvardMedical International, global arm of Harvard Medical School
US-based Joint Commission on Accreditation of HealthcareOrganisations has certified:
Indraprastha Apollo Hospital (New Delhi)Apollo Hospital (Chennai)Apollo Hospital (Hyderabad)Apollo Hospital (Hyderabad)Wockhardt Hospital (Mumbai)
Shroff Eye Hospital (Mumbai)
OUTLINE
Healthcare Sector in IndiaHealthcare Sector in India
Current ScenarioCurrent Scenario
Growth DriversGrowth Drivers
Public & Private SectorPublic & Private Sector
Healthcare Value ChainHealthcare Value Chain
Government Policies and IncentivesGovernment Policies and Incentives
Major PlayersMajor PlayersMajor PlayersMajor Players
Future GrowthFuture Growth
ChallengesChallengesChallengesChallenges
Business OpportunitiesBusiness Opportunities
HEALTHCARE - PRIVATE & PUBLIC
Private sector offers tertiary-level, preventive and diagnosticy , p ghealthcare
Public/Private share of Non Hospitalization
78 81
50
60
70
80
90Public/Private share of Hospitalization
5862
50
60
70
22 19
0
10
20
30
40
Rural Urban
4238
10
20
30
40
Public Private0
0
Rural Urban
Public Private
ROLE OF PUBLIC SECTOR
Public sector focus is on prevention and elimination of infectious diseases and accessibility of basic healthcare facilities to the
rural and urban masses
PRIVATE SECTOR INITIATIVES
At Rs 690 billion, private spending accounts for 80 per cent of the healthaccounts for 80 per cent of the health care market
61 per cent is spent on outpatient care
Over 50 per cent of outpatient spend is on acute infectious diseases
Over 80 per cent of inpatient spend is in five d d fareas: cardio, cancer, accidents, acute infections
and maternity
Urban Indians and rich account for a disproportionate spenddisproportionate spend
HEALTHCARE EXPENDITURE
Public & Private Sector Initiatives
138 bn
552 bn
Private Spending Govt Spending
Out of Rs 690 billion, (USD17 billion) the private sector accounts for 80 per cent or Rs 552 billion of the spending
PRIVATE EQUITY IN HEALTHCARE
Private equity deals in Healthcare in India, 2006 (USD Million)
Diagnostic
2006 (USD Million)
Hospitals, 82.33
Diagnostic chains, 8
Ph tiPharmaceuticals, 377.56
PRIVATE EQUITY IN HEALTHCARE
MAJOR HEALTHCARE DEALS
George Soros’ fund Quantum and Blue Ridge bought 10per cent in Fortis HealthcarepManipal Health Systems Private Limited raised overUSD 20 million of equity from IDFC Private Equity FundBangalore-based HealthCare Global Enterprises LimitedBangalore based HealthCare Global Enterprises Limited(HCG) raised over USD 10 million in equity from IDFCPrivate Equity FundMetropolis Health Services Ltd. India’s leadingMetropolis Health Services Ltd. India s leadingCorporate Diagnostics Chain raised over USD 8 millionin equity from India Advantage Fund-I managed byICICI Ventures
OUTLINE
Healthcare Sector in IndiaHealthcare Sector in India
Current ScenarioCurrent Scenario
Growth DriversGrowth Drivers
Public vs Private sectorPublic vs Private sector
Healthcare Value ChainHealthcare Value Chain
Government Policies and IncentivesGovernment Policies and Incentives
Major PlayersMajor PlayersMajor PlayersMajor Players
Future GrowthFuture Growth
ChallengesChallengesChallengesChallenges
Business OpportunitiesBusiness Opportunities
HEALTHCARE VALUE CHAIN
Business Objectives Expected Ch
Business O t iti
• Health insurance•Quality services
•Changing diseases pattern
•Changing socio economic profile
us ess Object es Changes Opportunities
Patient
H it l
• Medical tourism
• Preventive healthcare
• Healthcare BPO
• Value for money• Minimum co-pay
• Minimization of the cost
profile
•Changing life style patterns
•Demand for quality healthcare
Hospital • Telemedicine
• Laboratory and diagnostic services
• Medical devices
• Health IT
• Wealth maximization• Increase value per patient• Operational efficiency
•Corporatization of Indian healthcare
• Increasing penetration of private health insurance
Insurance• Health IT
• Consulting
• Wealth maximization• Minimum annual pay put
•Foreign alliances
•Information technology in healthcare
Investment opportunities exist in multiple segments along the value chain
OUTLINE
Healthcare Sector in IndiaHealthcare Sector in India
Current ScenarioCurrent Scenario
Growth DriversGrowth Drivers
Public vs Private sectorPublic vs Private sector
Healthcare Value ChainHealthcare Value Chain
Government Policies and IncentivesGovernment Policies and Incentives
Major PlayersMajor PlayersMajor PlayersMajor Players
Future GrowthFuture Growth
ChallengesChallengesChallengesChallenges
Business OpportunitiesBusiness Opportunities
GOVERNMENT POLICIES & INCENTIVES
Infrastructure status conferred on healthcare industry
Budgetary allocation to healthcare – Rs 62 billion (USD 1 51Budgetary allocation to healthcare Rs 62 billion (USD 1.51billion)
40 per cent depreciation limit on medical equipment imports
Income tax exemption for the first 5 years to 100 bed hospitalsIncome tax exemption for the first 5 years, to 100 bed hospitalsset up in rural areas
Reduced duties (between 5–8 per cent) on certain medicalequipment and devicesequipment and devices
Customs duty exemption on specific personal medical aids likecrutches, wheel-chairs, walking frames, artificial limbs
Customs duty, excise duty and CVD exemption on specific medicaldevices such as talking books, Braille computer terminals, etc.
OUTLINE
Healthcare Sector in IndiaHealthcare Sector in India
Current ScenarioCurrent Scenario
Growth DriversGrowth Drivers
Public vs Private sectorPublic vs Private sector
Healthcare Value ChainHealthcare Value Chain
Government Policies and IncentivesGovernment Policies and Incentives
Major PlayersMajor PlayersMajor PlayersMajor Players
ChallengesChallenges
Future GrowthFuture Growth
gg
Business OpportunitiesBusiness Opportunities
GOVERNMENT INSTITUTIONS
Major Government institutions in healthcare
All India Institute of Medical Sciences (AIIMS), NewDelhi (Central Government)Armed Forces Medical College (AFMC), Pune (Ministryg ( ), ( yof Defence)JIPMER, Pondicherry (Central Government)Madras Medical College (MMC), Chennai (StateGovernment)Maulana Azad Medical College (MAMC), Delhi (StateGovernment)Stanley Medical College Chennai (State Government)Stanley Medical College, Chennai (State Government)Grant Medical College, Mumbai
MAJOR PRIVATE HOSPITAL CHAINS
Hospital Speciality Services Size Global Forays
Apollo Hospitals
Open heartsurgery, angioplastic surgeryand renal
130 retail pharmacies across India
40 hospitals with 6,000 beds
Existing overseas facilities in Colombo andMiddle East
Plans to set up hospitals in Mauritius andFijiand renal
transplantsFiji
Bidding for a diagnostic facility in the UKApollo-Gleneagles Hospitals, a joint
venture between Apollo Hospitals andParkway Group of Singapore, plans 2 morehospitals in India, after the first set up atK lk tKolkata
Business opportunities in West Asia andNorth Africa
Partnership with Yemen’s Hayel SaeedAnam Group to provide advisory services forits hospital project
Will provide consultancy to set up a 160-bed super specialty hospital at Taiz, Yemen.
Wockhardt Hospitals
Tertiary level heart centre
Product and services formulations, nutritional
10 hospitals with 1500 beds
•Eyeing markets in Europe, particularly UK•Building tie-ups with leading healthcareinsurance providers in the US, UK andSingapore
products, vaccines, pharmaceutical ingredients, bio pharmaceuticals
Singapore
Fortis Provides the Super speciality 12 hospitals Fortis Healthcar
e
Provides the latest medical care to patients
Super speciality hospital
12 hospitals with 1,900 beds
N.A
.Cont…
MAJOR PRIVATE HOSPITAL CHAINS
Hospital Specialty Services Size Global Forays
Max Healthcare
Focusing on becoming th l t
3-tier business model for delivering h lth i
7 hospitals with 800 b d
Trying to enter the US, UK and far-eastmarkets.
the largest healthcare player in India
healthcare services beds Expanding operations in neighbouringcountries like Bangladesh and Afghanistan.
Max Healthcare and Singapore GeneralHospital (SGH) have entered into collaborationfor medical practice, research, training andeducation in healthcare services.
Aravind Hospitals
Single largest provider of eye surgery in the world
Operates an international research foundation and a resource and training centre
5 hospitals and a manufacturing center for ophthalmic
N.A.
products
*Escorts Group
World class treatments
Diagnostic services, treatment services,
20 hospitals and 8 p
for heart ailments
Preventive cardiology and Rehabilitation services and Pediatric heart care
facilitation centres
N.A.
*Escorts group has been taken over by Fortis Healthcare (Ranbaxy Group)
PRIVATE SECTOR INFRASTRUCTURE
Leading Hospital ChainsLeading Hospital Chains
Group No of beds
Apollo 2,164
Manipal 3,858
Fortis 1,790
Max Healthcare 750Max Healthcare 750
Wockhardt 700
FOREIGN COLLABORATIONS
Global real estate major Emaar Properties and its Indianpartner MGF group to set up 50 hospitals across Indiap g p p p
Pacific Healthcare Holdings, Singapore – VitaeHealthcare Pvt Ltd for setting up medical centre inHealthcare Pvt Ltd for setting up medical centre inHyderabad (Andhra Pradesh)
Parkway Group Singapore Apollo Hospitals set up aParkway Group, Singapore – Apollo Hospitals set up a325-bed super-speciality Apollo Geneagles Hospital,Kolkata
Prexus Health USA’s through its Indian subsidiary isplanning state-of-art hospitals around Delhi
OUTLINE
Healthcare Sector in IndiaHealthcare Sector in India
Current ScenarioCurrent Scenario
Growth DriversGrowth Drivers
Public vs Private sectorPublic vs Private sector
Healthcare Value ChainHealthcare Value Chain
Government Policies and IncentivesGovernment Policies and Incentives
Major PlayersMajor PlayersMajor PlayersMajor Players
Future GrowthFuture Growth
ChallengesChallengesChallengesChallenges
Business OpportunitiesBusiness Opportunities
FUTURE GROWTH
By 2012, revenues estimated to reach USD 52-69billion, 6.2 to 8.5 per cent of GDP; employment willd bldouble
The pattern of healthcare spending will also change
The share of outpatient spend will decrease from 61 percent to 53 per cent
Lifestyle diseases will drive the growth of outpatient spendLifestyle diseases will drive the growth of outpatient spend
Cancer and heart diseases will drive most of the growth ofinpatient spend
80,000 additional hospital beds required every year forthe next 3 to 4 years to meet growing demands
INVESTMENTS IN HEALTHCARE
77,962
70,00080,00090,000
n
38,824
20 00030,00040,00050,00060,000
USD
Mill
ion
7,828
010,00020,000
2006 2009 2012Year
Investment in healthcare to grow nearly 11 times to touch USD 77 billion in 2012
OUTLINE
Healthcare Sector in IndiaHealthcare Sector in India
Current ScenarioCurrent Scenario
Growth DriversGrowth Drivers
Public vs Private sectorPublic vs Private sector
Healthcare Value ChainHealthcare Value Chain
Government Policies and IncentivesGovernment Policies and Incentives
Major PlayersMajor PlayersMajor PlayersMajor Players
Future GrowthFuture Growth
ChallengesChallengesChallengesChallenges
Business OpportunitiesBusiness Opportunities
CHALLENGES
The growing demand for the quality healthcare and theabsence of matching delivery mechanisms pose a challengeg y p gand certainly a great opportunitySeveral barriers need to overcome to attract sizeable privateinvestment in healthcare…
Unwillingness of lending institutions to finance healthcareprojects due to failures in early ’90sCapital intensive industry with long gestation periodPoor availability of doctors, nurses and paramedicpersonnelInability to lower prices to attract required number of
ti t b f fi d t f tti f ilitpatients because of fixed cost of setting up a facilityLow availability of qualified practitioners in rural areas
CHALLENGES
No clarity within various government departments andministries about issues faced by the healthcare industry
Low consumer awareness about differences in quality of careacross different provider types
By 2010, 4,53,785 doctors and 1,290,174 more nurses will berequired by the Indian Healthcare Industry, which is both abig challenge and an opportunity
OUTLINE
Healthcare Sector in IndiaHealthcare Sector in India
Current ScenarioCurrent Scenario
Growth DriversGrowth Drivers
Public vs Private sectorPublic vs Private sector
Healthcare Value ChainHealthcare Value Chain
Government Policies and IncentivesGovernment Policies and Incentives
Major PlayersMajor PlayersMajor PlayersMajor Players
Future GrowthFuture Growth
ChallengesChallengesChallengesChallenges
Business OpportunitiesBusiness Opportunities
HEALTH–COMPARATIVE STRENGTHS
Key Competencies Key Outsourcing Areas in focus
IndiaHigh Quality Talent poolProven Track recordFavorable Governmental Policies for healthcareCost savingsConventional Medicinal Facilities like AyurvedaHigh Quality infrastructure
Medical TourismHealthcare Customer careNetwork supportHealthcare BPO outbound Healthcare analytics
Philippines Cost BenefitsThe US accent Talent poolThe cultural affinity with US
Healthcare Customer Care
China Bigger talent pool at a lower costHigh end medical facilitiesConventional Chinese medicine
Healthcare Customer CareNetwork SupportTraditional medical facilities
Eastern EuropeQuick deploymentHigh Quality output and FacilitiesCost savings
Oral and Surgical facilities especially in OphthalmologyHealthcare Customer serviceHealthcare BPO outbound
S i i d lThailand Service oriented cultureHigh Quality facilities at low prices
Medical Tourism
BUSINESS OPPORTUNITIES
India needs an investment of USD 203 billion to meet the ‘Healthfor All’ target by 2010Significant requirement in increase in number of beds per 1000population – from 3 beds per 1000 population to 5 beds per1000 population by 2010 (in both private and public)This translates to an addition of 2 2 million beds requiringThis translates to an addition of 2.2 million beds requiringinvestment of USD 77.9 billion, majority of which will come fromthe private participationIncreasing preference for private medical care amongst theurban populationHigh growth domestic market arising from increasing healthawareness
d h dRapid growth in private sector companies owning and managinghospitalsCost of advanced surgeries in India is about 10 per cent of that inUSAService Providers: Curative and preventive in primary, secondary andtertiary care
BUSINESS OPPORTUNITIES
Medical Equipment
Market size estimated at USD 2 billion in 2006Market size estimated at USD 2 billion in 2006Growing at a rate of 15 per cent, expected to touch USD 4.9billion in 201265 per cent of equipment is importedMajor suppliers include Siemens, GE, Philips, Toshiba, Hitachi,Boston ScientificCardiology equipment - 20 per cent of total market Imagingsystems - 15 per cent of total marketsystems 15 per cent of total marketDriving forces
Investments in specialty hospitals and diagnostic centresCompetitionCompetitionUp gradation of equipmentFavorable government policies- reduction in import dutiesExpanding market boundaries
BUSINESS OPPORTUNITIES
Medical Equipment Market Size
4,977.985,000.00
6,000.00
nRising 15 %
per year
2,176.68
3,275.42
2,000.00
3,000.00
4,000.00
USD
Mill
ion
0.00
1,000.00
2006 2009 2012
YYear
Medical equipment requirement to touch USD4.9 billion in 2012
BUSINESS OPPORTUNITIES
Medical Equipment: Market Distribution
3%19%
52%26%
Medical furnitures Equipment Consumable Orthopaedic productsMedical furnitures Equipment Consumable Orthopaedic products
BUSINESS OPPORTUNITIES
BUSINESS OPPORTUNITIES
Health Insurance
Health insurance market is estimated at USD 2.8billionMore than 80 per cent of the expenditure onp phealthcare is out of pocketOnly 3 per cent of country's population is covered byinsuranceExpected growth rate of 13 per cent per annumPrivate and public players registered a growth of 77per cent and 25 per cent over 2004-05S i R ti t t ti l f USD 7 700 illi iSwiss Re estimates a potential of USD 7,700 million inhealth insurance premium by 2015
BUSINESS OPPORTUNITIES
Health Insurance Market
7.7 bn
56789
illio
nOnly 3% of country's
population is covered by insurance
2.8 bn
012345
USD
Bi
2007 2015
Health insurance market at USD 2.8 billion - Only 3 per cent of country'spopulation covered by insurance - a potential of USD 7,700 million inhealth insurance premium by 2015
BUSINESS OPPORTUNITIES
Affluent middle-class population willing to pay for higherstandards of healthcareForeign Direct Investment (FDI) limit in health insurance maybe raised from 26 per cent to 49 per centThird Party Administrators business has also witnessedgrowth
Private players in Health insurance
Royal Sundaram9%
Cholamandalam4% Tata AIG
6%
Reliance
HDFC Chubb1%
Bajaj Alliance18%
ICICI Lombard50%
2%
Iffco Tokyo10%
50%
BUSINESS OPPORTUNITIES
Medical Tourism
- Healthcare tourism market, currently at USD 450 million, expected to bring in over USD 1.5 billion revenues by 2012 2012
- Attracts patients from South East Asia, Africa, MiddleEast UK and USEast, UK and US
- Number of tourists visiting India increased from 10,000 in2001 to 150,000 in 20052001 to 150,000 in 2005
BUSINESS OPPORTUNITIES
Medical Tourism
14801500
2000io
n
CAGR 22%
450500
1000
USD
Mill CAGR-22%
02006 2012
Medical Tourism market to grow at a Compound Annual Growth Rate of 22 per cent to touch USD 1.48 billion in 2012.
BUSINESS OPPORTUNITIES
Clinical Research
Present market size around Rs 1 billion (USD 25 million)Present market size around Rs 1 billion (USD 25 million)Expected to grow to Rs 50 billion (USD 1.25 billion) by 201050 per cent Contract Research Organisations in India at present
L b t & Di ti S iLaboratory & Diagnostic Services
India becoming a competitive outsourcing destination for high-end laboratory and diagnostic testingD L l' P hl b M li H l h S i SRL R bDr Lal's Pathlabs, Metropolis Health Services, SRL Ranbaxy –some diagnostics chains catering to the high-end services forhospitals in the UK, the US and West Asia
BUSINESS OPPORTUNITIES
Healthcare BPO and IT
Healthcare industry under pressure due to regulations and theHealthcare industry under pressure due to regulations and theneed for cutting costs
Huge potential for Indian IT companies to tap this market
BPO opportunities in more advanced sectors such as imaging,disease management and claims processing
Need for transformation into paperless and film-less environmentby corporate hospitals and big trust hospitals
BUSINESS OPPORTUNITIES
Radiology Outsourcing
Indian corporate hospitals are in talks with hospitals in US andIndian corporate hospitals are in talks with hospitals in US andUK, who are interested in outsourcing radiology workRadiology images can be transferred to Indian hospitals througha dedicated line, which can be analysed by the Indian doctors
d t b kand sent backRadiology outsourcing to Indian hospitals can cut down cost by50 per cent or lessThe 12 hour time difference with India enables the hospitals inpthe US to work 24x7
BUSINESS OPPORTUNITIES
Total Healthcare Outsourcing
7400
600070008000
Growing at 11% Per annum
3700
20003000400050006000
USD
Mill
ion
01000
2006 2012
Year
UPCOMING PROJECTS
Naresh Trehan’s MedicityRs 12 billion project in Gurgaon (near Delhi), spread over 93acresacresWill consist of 1600 beds, with a complete biotechnology backupand R&D facilityWill have major institutions for cardiology, oncology, bone andjoint, neurosciences, regenerative medicine and trauma care
Fortis MedicityRs 12 billion project in Gurgaon, having 2 campusesHospital campus will have high end multi speciality hospital andHospital campus will have high end multi speciality hospital andresearch centreCollege campus will have a medical college, a dental college,nursing college and facility for primary and applied research inmedicine along with a 600-800 bed hospital
Madras Institute of Orthopaedics and Traumatology(MIOT) Medical City
MIOT Hospitals plans to set up a multi speciality medical cityMIOT Hospitals plans to set up a multi speciality medical citynear Chennai
UPCOMING PROJECTS
Apollo Health CityR 10 billi j i H d b d d 33Rs 10 billion project in Hyderabad, spread over 33 acresHas a postgraduate college for doctors, a nursing school andcollege, college of physiotherapy, institute of hospitaladministration, institute of medical informatics, institute foremergency medicine and institute for paramedicsemergency medicine and institute for paramedicsHas 500 beds and 200 more will be added in next 6 months
Dhirubhai Ambani Health CityR li A il Dhi bh i A b i G i t t d i b ildi 60Reliance Anil Dhirubhai Ambani Group interested in building a 60acre health city in Kolkata
CMC Ajit Singh Lottery MedicityRs 500 million medicity project in Ludhiana by the ChristianRs 500 million medicity project in Ludhiana by the ChristianMedical College and HospitalWill have a general and a speciality hospital and an educationinstitute
INVESTMENTS PLANNED
N E t tNew Entrants
New Hospital Investment Proposed (Rs million)
A t i 5000Artemis 5000
Prexus Health, USA 2500
Emaar MGF 30,000
Pacific Healthcare 750
Parkway group 2000
C l bi A i 6600Columbia Asia 6600
DRIVERS OF M&A
Proactive government policies – Infrastructurestatus to healthcare, financial incentives etc.
Demand for quality healthcare in India
Health insurance leading to higher spends on healthHealth insurance leading to higher spends on health
Synergies between Indian and foreign firms
Need for benchmarked foreign technology
Investment opportunities for global PE and VC firmsg
Medical equipment industry open to foreign collaboration
EXPANDING INDIAN MARKETEXPANDING INDIAN MARKET
Healthcare industry will grow at 13 percent per annum
Assured return of 15-20 per cent annually
Annual Demand for 80,000 bedsAnnual Demand for 80,000 beds
Private sector accounts for 52 per cent of all hospitalization p
VALUE PROPOSITION
Some options for investment are
Medical Infrastructure
Clinical Research
Healthcare BPOHealthcare BPO
Indian medical institutions can commit assured supply ofmanpower - doctors, nurses, paramedics
Conduct joint research in medical delivery, clinical trialsj y,etc – Ability to generate large volumes and an easier regulatory regime
Access Indian capability in IT in the medical arena
S di l i f i b i I diSet up medical equipment manufacturing base in India
Leverage cost advantage for Medical Value Travel
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