HEALTHCARE

AND
MEDICAL
EQUIPMENT

By Brig.Joe Curian,CEO S.L.Raheja

Hospital
 BACKGROUND
• We have an ambitious agenda with India. Our
agenda is practical. It builds on a relationship
that has never been better. India is a global
leader, as well as a good friend. My trip will
remind everybody about the strengthening of an
important strategic partnership. We will work
together in practical ways to promote a hopeful
future for citizens in both our nations. –
President George W.Bush-22.2.2006
• The U.S.-India Strategic partnership is rooted in
shared values and is broad in nature and scope
with supporting innovation and technological
advances and promoting public health.
• Economy – The United States and India are
expanding co-operation to enhance job creation
and economic growth; support economic reform
and liberalization; develop a bilateral business
climate supportive of trade & investment and
improve market access for goods and services.
• Trade – Over the last five years, U.S. exports to
India have more than doubled, helping to create
better-paying jobs in the United States. The
United States and India agree that trade is
essential to promoting global economic growth,
development, freedom and prosperity. Both
countries are committed to completing the WTO
Doha Development Agenda before the end of
2006
• Investment: The United States and India
welcome the report of the U.S-India CEO Forum
and agreed to work on its recommendations
through the Economic Dialogue; endorsed the
efforts of the U.S.-India Trade Policy Forum to
reduce barriers to trade and investment; agreed
to hold a high level public-private investment
summit in 2006; and are continuing the dialogue
on various issues including further liberalization
of investment restrictions, regulatory
transparency, dispute settlement and reducing
tariff and non-tariff barriers to trade.
 HEALTHCARE - INDIA
• Global Healthcare Industry = US $ 3.5 Trillion
• Total Spend India = 5.7% GDP
• Private = Rs.925 billion
• Public = Rs.170 billion
• Pre payment = Less than 15%
• Out of pocket = 2/3rd
• Tertiary market = 11% of total spend
• Outpatient = 61%
• In patient = 39%
• Growth of Industry = 15% annually
• Drivers of demand = middle income
group
 HEALTHCARE INDIA (contd.)
• Beds = 0.7/1000 people
• Extra Beds needed = 80000 beds / per year
for 10 years
• Expected spend on = Rs.2000 billion by 2012
Healthcare
% of GDP =0.9% to grow
up to 8.5% of GDP
Govt. Spend expected = up 6% by 2010
Health Insurance = Less than 10% of
market potential
De-regulation expected
shortly
Inference: The demand and growth potential is
phenomenal, especially in high-tech tertiary and
secondary sectors
 NORMS AND SHORTFALLS
A) Norm for rural Health Centres –
1 per 4000 population
Shortfall(201663-136815) = 64848
Cost per unit = 20 Lakh
B) Norm for Community Health Centres –
1 per 100,00 population
Shortfall (8067-2078) = 5359
Cost per unit = 90 Lakh
C) Norms for Urban Health & Family – 1 per
100,000
population
Shortfall (4344-1083) = 3261
Cost per unit = 1.5 Cr.
GNP% needed cap. = 0.25%
Population above 60 years will go up from 55
million to 200 million by 2020.
 BIO-INFORMATICS
• Leadership for India
• Global Market – Growing to be worth $6.5 billion
by end 2006.
• India’s Growth – 25% annually
• - 75% is by exports.
- 2.2% of Biotech Industry
• Significant opportunity for sourcing research &
development functions.
• Opportunity for Indian Companies to carry out
contract research.
• Current Global Spend on outsourced
– Research = US$ 7 billion
– Growth = 30%
 TECHNOLOGY - TRENDS(Healthcare will
be the largest user of technology and the largest Employer)

• Micro-processor based implantables in patients.

• CPU-driven technology supported by artificial
intelligence.
• Robotics in OTs
• Robotics in Path-labs / Research.
• Laser Technology in surgery
• Instrumentation in medical and surgical practices.
• IT tools for net-working examination, diagnostics,
treatment rooms and OTs.
• IT Tools along with artificial intelligence and
microprocessor technologies for equipment
maintenance and trouble shooting.
• IT tools for generation of disease specific data.
• Biotechnology, Genomics, Molecular Biology and
Stem cell research.
 TECHNOLOGY UTILIZATION -
INDIA

• Management of Technology in Hospitals through

HIS.
• Management of IT including Medical Records
• Applying emerging technology in the process of
delivery – E-Health, Telemedicine,
• Applying emerging technologies in standards,
Government regulations and ethical issues.
• Managing Technology for Emergencies and Crisis
Management
 US & MEDICAL DEVICE MARKET
• US produces half of the world’s medical devices –
70 billion US $
• Domestic Consumption = 40%
• 17 Biggest companies account for 65% of the
total revenue.
• Total < 6000 medical device manufacturers.
• Nine of the top ten in the world are based in the
US.
• Cardio vascular products form the single largest
sector.
• Orthopedics - fastest growing
• Spinal & Pain Management and Cosmetic &
Elective surgical form the next.
 INDIA – Medical Device Market

• The fastest growing Medical Devices market

- Rs.5750 crores.
• Growth Rate - 23% annually for next
five to six years
• Increased foreign involvement is a must.
• Market Segments -
• Diagnostic Equipment - Rs.2000 cr.
• Surgical Equipment supplies - Rs.1300 cr.
• Imaging - Rs.1300 cr.
• Electronic treatment devices - Rs.1000 cr.
 STRATEGIES
• R&D – Software & Hardware
• Clinical Trials / User trials
• Manufacture
• Distribution/Dealership
• Logistics and Maintenance support
(Trouble-shoot, Spares, Labour)
Upgradation
Training (Users, Engineers
- Joint Ventures
- Licensing Agreements
- Local distributing agencies
Group Purchase Organizations
 REGULATORY ISSUES

• Most Devices do not need import licence

• Import duties vary
• Hospitals and research organizations have no
import duty.
• Life saving devices also exempt.
• General reduction of tariff on imports
• Specified ones – 15% import duty, others 40%
• Government Hospitals more bureaucratic than
private.
• General Liberalization of trade and investment
laws.