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Opportunities in Indian Healthcare
            Industry
India - An Introduction
Population              Over 1 billion

States/UTs              35

Geographical Area       3.3 mn sq kms

Languages recognised    22

Business language       English

Per Capita Income**     US$ 534

GDP**                   US$ 650 bn
                                     Source:CSO Statistics
India – Growth in Fast Lane

Largest democracy in the World

4th largest economy by PPP index

6th largest energy consumer

ForEx reserves skyrocket from US$ 42 bn (2001) to

US$ 250 billion (November 2008)

GDP growth to continue between 7-8%

3rd largest economy by 2050: Goldman Sachs

Leading in IT, KPO and BPO

Oil & Gas, Healthcare and Biotechnology sunrise industries
India - Advantages

•   India is one of the top 3 countries where companies plan to
    spend the most R&D dollars over the next 3 years.
•   Favoured destination ahead of countries like Israel, Philippines,
    Canada, China, Ireland & Russia in terms of Overall Climate
    (Gartner Report, January 2003)
•   Some of the top medical/technical universities in Asia
• The clinical community is populated with English speaking,
  western-trained graduates
• Sophisticated technological infrastructure
• 100 million plus English speaking / trained professionals (Largest
  outside US)
• Over 2 million science post graduates
India - Advantages

• Cost effective operations
• Higher GMP/GLP/GCP Compliance and other standards
  for Diagnostic Labs and Hospitals
• Maximum number of approved GMP plants outside USA
• Excellent quality management, Technology and
  infrastructure
• Strong IT industry availability of IT skilled manpower
India – Beyond Cost Advantage
The Indian healthcare story is not about cost advantage only. It has
  a high success rate and a growing credibility.

•   Indian specialists have performed over 500,000 major surgeries
    and over a million other surgical procedures including cardio-
    thoracic, neurological and cancer surgeries, with success rates
    at par with international standards.
•   The success rate of cardiac bypass in India is 98.7 per cent
    against 97.5 per cent in the U.S.
•   India's success in 110 bone marrow transplants is 80 per cent.
•   The success rate in 6,000 renal transplants is 95 per cent.
India’s Vital Clinical Statistics
•   Cancer: 3 million
•   Diabetes: 34 million
•   HIV: 8-10 million
•   Epilepsy: 8 million
•   Hypertension: 150 million
•   Schizophrenia: 1 million
•   Asthma: 40 million
•   Alzheimer's: 1.5 million
•   Cardiac-Related Deaths: 2 million
Indian Healthcare Industry
• Indian Economy growing at 8%+ despite global economic
  meltdown
• Size of the Indian Healthcare Industry - US$35 billion –
  contributes over 5% of GDP and offers employment to over 4%
  population
• Indian Healthcare Industry – Growing at Rapid pace of 18%+ -
  fastest in the world
• 600,000 practicing physicians
• 15,000 hospitals
• 875,000 hospital beds
• 737,000 nurses
• 170 medical colleges
• 350,000 retail pharmacies
• 18,000 new doctors every year
• 50,000 pathology laboratories
Indian Healthcare Industry

• 280 million strong upper middle and middle class population,
  with 10 – 12 million high income group which could afford
  the lifestyle of their western counterparts
• By 2012 industry size is expected to increase to $60 billion.
• India spends 5.1% of GDP on health – government spending
  is increasing
• Per capita expenditure on health is US$80 in year 2001
• Two thirds of healthcare spending is out of pocket, I.e. about
  US$20 billion is private spending
Indian Healthcare Industry

• Life expectancy in India has improved from 37
  years in 1951 to 63 years in 2001 and imporving
• Expanding working population group – 65% by
  2020
• Reasonably Recession Proof due to growing
  domestic demand
• Healthcare infrastructure in India is dominated by
  government hospitals
Indian Healthcare Industry
Key Segments in Healthcare

1.   Pharmaceutical – US$10 billion growing at 12% despite global
     economic pressures
2.   Hospitals/Nursing Homes – $12 billion – growing at 20%
3.   Medical Equipment – $2 billion, growing at 15%
4.   Clinical Lab Diagnostics –US$2 billion – growing at 30%
5.   Imaging Diagnostics – US$1 billion – growing at 30%
6.   Other Services (includes Training & Education; Aesthetics &
     Weight loss; Retail Pharmacy; etc.– US$2 billion – growing at
     40%
Doctor/Nurses Demand & Supply

•   Europe doctor to population ratio – 3.5 doctors per
    1,000 population.
•   India doctor to population ratio is 1 doctor per 1,784
    people
•   US Number of Nurses per 100,000 population – 972
•   India Number of Nurses per 100,000 population - 78
Health Insurance
•   Less than 15% of population is covered through pre paid
    insurance scheme – this is very low.
•   Medical Claim schemes has less than 3.5 million
    members.
•   3.4% Population is covered through ESI Scheme
•   5% Population is covered by Employer Schemes
•   5% Population is covered through Community Insurance
    Schemes
•   85% Population pays out of pocket, known as private
    spending
•   Slow entry of Health Insurance companies, due to
    regulatory issues and market dynamics
•   In the last two years growth of insurance cover is 100%
Healthcare IT
•   Hospitals and other healthcare businesses are
    realising that IT can be a great to to increase
    efficiencies
•   IT companies are offering wide ranging
    solutions
•   Indian IT market is poised to be US$250 million
    by 2012
Medical Tourism - Why India?
• High Quality Medical Facilities – Apollo; Fortis, Max; Escorts;
  Hinduja are some of the best facilities comparable with any good
  international facility
• Indian doctors are perhaps amongst the best doctors in the world - NRI
  doctors recognized as amongst best in adopted countries
• Cost Advantage – First world treatment at Third world costs
• English speaking manpower – better communication with the patients
• Indian Nurses are now in demand worldwide
• Software technologists facilitating tech revolution in healthcare
Why India?
• Extensive use of Computerized Hospital Information Systems
•   Excellent 24-Hour On ground Support
     –   Well Equipped Ground & Air Ambulance Support
     –   Doctors on call
     –   Nurses
     –   Pharmacies
     –   Diagnostic facilities
     –   Transportation
     –   Hotels
     –   Internet & Mobile Phones
Why India?
• India is an attractive tourism destination

   – 5000 year old civilization
   – Renowned for Historical, Cultural and Religious
     diversity
   – Diverse geographical landmarks; vast coastline
   – Traditional arts and crafts
   – Vibrant democracy: Freedom for citizens; empowered
     women population
India – Cost Advantage
  Procedures costs in India and US
                            All figures in US$
  Procedure             US         India
  Heart Surgery         30,000 7,000
  Bone Marrow           250,000 30,000
  Transplant
  Liver Transplant      500,000 40,000
  Orthopaedic           20,000 4,500 -
  Surgery                          6,000
  Cosmetic Surgery      20,000 2,000
  LASIK                 3000       700
  Metal Free Bridge     5500       500
Key International Companies with major
 investments in India (select examples)
•   Philips
•   Siemens
•   Drager Medical
•   GE Medical Systems
•   Proton Healthcare
•   Quest Diagnostics
•   Gleneagles
•   Qunitiles
•   Novartis
•   Pfizer
Future of Healthcare Industry
•   The current healthcare infrastructure in India is
    inadequate
•   The overall number of beds, physicians and nurses is
    low compared to other developing countries and
    international averages. The situation is worse in the
    case of tertiary beds and specialist physicians.
•   The quality of provision too is poor due to the
    dominance of unqualified practitioners and sub-
    optimal size of facilities.
•   Higher Investment in Training required.
•   Meeting the expected demand in 2012 will require
    and investment of US$25 billion
Future of Healthcare Industry
•    An additional 750,000 beds will be required (from 1.5 million
     today to 2.25 million in 2012), of which 150,000 beds need to
     be tertiary beds.
•    The number of doctors and nurses enrolled in medical
     colleges and nursing schools will have to triple over the next
     10 years. Additional 520,000 students physicians will be
     required by 2012.
•    The bulk of the investment will need to be made by private
     providers
•    Total Healthcare Market in India could increase from US$35
     billion today to US$60 billion by 2012.
•    Preventive Healthcare market is for over 160 million people –
     largely funded by corporate / government sector
Manpower Demand
• The manpower demand of the healthcare industry would
  double up in the next 7 years. For example, the current
  Marketing & Sales manpower in the healthcare and
  pharmaceutical segment is 200,000 plus, which is expected
  to double up in the next 7 years. In clinical research the
  current shortage is 10,000 personnel, which is going to
  increase to 50,000 personnel by 2012.
• At present there is huge shortage of trained healthcare &
  pharmaceutical marketing and sales executives, medical
  representatives and managers.
• There is a major shortage of quality professionals for
  hospital services; service professionals for bio medical
  equipment, diagnostics, pharma R&D professionals.
Training Opportunities in
          Healthcare/Medical Sector
• Short term programs for hospital staff offering technical
  courses; hospital services, bio medical equipment
  maintenance – Target market – both hospitals & direct
  students.
• Short term professional development programs / continued
  medical education for the clinicians, nurses and other
  healthcare staff in the clinical and non-clinical/
  management areas.
• Medium to Long term programs for skill enhancement –
  directly for science graduates/post graduates
• Programs in the field of clinical research.
• Program Delivery – Online; Classrooms; Distance
  Learning & Corporate Programs
Business Opportunities in India
(This list is broad and only indicative in nature – please feel contact us for your product or service)


          Service providers                      Curative and preventive in primary, secondary and
                                                    tertiary care; lab and imaging diagnostics; retail
                                                    pharmacies rehabilitative - geriatric and others


          Training & Education Doctors, managers, nurses,technicians, clinical
                                                      research, healthcare management, clinical
                                                      research

          Devices
                                                 Medical equipments & Service equipments;
                                                   Telemedicine

          Services                               Health Insurance; Architecture; Hospital
                                                   Management; Healthcare Business / Knowledge
                                                   Process Outsourcing (e.g. medical
                                                   billing/coding); Telemedicine
          Materials
                                                 Medicines / Disposables / Surgical Products
          Pharmaceutical
                                                 R&D; Clinical Research;Contract Manufacturing
          & Biotechnology
Favourable Policies

• Custom Tariff on medical equipment is reducing – 0%
to 15%

• 100% Foreign Investment allowed in the Healthcare,
Pharma, Clinical Research – most investments are under
automatic route

• Tax Holidays for R&D companies

• Favourable profit repatriation policies
MEDIMINDS – YOUR INDIAN
        CONNECTION
Business Management Services
 Market Entry Strategy Services
 Setting up Indian Subsidiary and Joint Ventures
 Office Infrastructure & Human Resources
 Representative Office
 Market Research
 Identify Office / Hospital / Business Premises and
 Lease Negotiations
 Business Strategy
 Distribution & Marketing Network
 Licensing Technology
 Product Registration & Regulatory Services
 Contract Manufacturing
 Lobbying with Federal & State Governments
 Public Private Partnership Opportunities
MEDIMINDS – YOUR INDIAN
      CONNECTION


Regulatory Services
Investigators’ Site Identification &
Qualification Services
Clinical Research Outsourcing
Medical Writing & Content Development
SOPs Development
Education, Training & Recruitment
Contact Details
  For more information and details, please contact :


         Director – Mediminds / Cliniminds
                  C-55 First Floor
           Preet Vihar, Main Vikas Marg
                Delhi 110092, India

                Tel : +91 9810068241
             Office : +91 11 42427800
              Fax : +91 11 42427802
Email : info@mediminds.com; info@cliniminds.com
Website : www.mediminds.com; www.cliniminds.com

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Indian healthcare industry presentation

  • 1. Opportunities in Indian Healthcare Industry
  • 2. India - An Introduction Population Over 1 billion States/UTs 35 Geographical Area 3.3 mn sq kms Languages recognised 22 Business language English Per Capita Income** US$ 534 GDP** US$ 650 bn Source:CSO Statistics
  • 3. India – Growth in Fast Lane Largest democracy in the World 4th largest economy by PPP index 6th largest energy consumer ForEx reserves skyrocket from US$ 42 bn (2001) to US$ 250 billion (November 2008) GDP growth to continue between 7-8% 3rd largest economy by 2050: Goldman Sachs Leading in IT, KPO and BPO Oil & Gas, Healthcare and Biotechnology sunrise industries
  • 4. India - Advantages • India is one of the top 3 countries where companies plan to spend the most R&D dollars over the next 3 years. • Favoured destination ahead of countries like Israel, Philippines, Canada, China, Ireland & Russia in terms of Overall Climate (Gartner Report, January 2003) • Some of the top medical/technical universities in Asia • The clinical community is populated with English speaking, western-trained graduates • Sophisticated technological infrastructure • 100 million plus English speaking / trained professionals (Largest outside US) • Over 2 million science post graduates
  • 5. India - Advantages • Cost effective operations • Higher GMP/GLP/GCP Compliance and other standards for Diagnostic Labs and Hospitals • Maximum number of approved GMP plants outside USA • Excellent quality management, Technology and infrastructure • Strong IT industry availability of IT skilled manpower
  • 6. India – Beyond Cost Advantage The Indian healthcare story is not about cost advantage only. It has a high success rate and a growing credibility. • Indian specialists have performed over 500,000 major surgeries and over a million other surgical procedures including cardio- thoracic, neurological and cancer surgeries, with success rates at par with international standards. • The success rate of cardiac bypass in India is 98.7 per cent against 97.5 per cent in the U.S. • India's success in 110 bone marrow transplants is 80 per cent. • The success rate in 6,000 renal transplants is 95 per cent.
  • 7. India’s Vital Clinical Statistics • Cancer: 3 million • Diabetes: 34 million • HIV: 8-10 million • Epilepsy: 8 million • Hypertension: 150 million • Schizophrenia: 1 million • Asthma: 40 million • Alzheimer's: 1.5 million • Cardiac-Related Deaths: 2 million
  • 8. Indian Healthcare Industry • Indian Economy growing at 8%+ despite global economic meltdown • Size of the Indian Healthcare Industry - US$35 billion – contributes over 5% of GDP and offers employment to over 4% population • Indian Healthcare Industry – Growing at Rapid pace of 18%+ - fastest in the world • 600,000 practicing physicians • 15,000 hospitals • 875,000 hospital beds • 737,000 nurses • 170 medical colleges • 350,000 retail pharmacies • 18,000 new doctors every year • 50,000 pathology laboratories
  • 9. Indian Healthcare Industry • 280 million strong upper middle and middle class population, with 10 – 12 million high income group which could afford the lifestyle of their western counterparts • By 2012 industry size is expected to increase to $60 billion. • India spends 5.1% of GDP on health – government spending is increasing • Per capita expenditure on health is US$80 in year 2001 • Two thirds of healthcare spending is out of pocket, I.e. about US$20 billion is private spending
  • 10. Indian Healthcare Industry • Life expectancy in India has improved from 37 years in 1951 to 63 years in 2001 and imporving • Expanding working population group – 65% by 2020 • Reasonably Recession Proof due to growing domestic demand • Healthcare infrastructure in India is dominated by government hospitals
  • 11. Indian Healthcare Industry Key Segments in Healthcare 1. Pharmaceutical – US$10 billion growing at 12% despite global economic pressures 2. Hospitals/Nursing Homes – $12 billion – growing at 20% 3. Medical Equipment – $2 billion, growing at 15% 4. Clinical Lab Diagnostics –US$2 billion – growing at 30% 5. Imaging Diagnostics – US$1 billion – growing at 30% 6. Other Services (includes Training & Education; Aesthetics & Weight loss; Retail Pharmacy; etc.– US$2 billion – growing at 40%
  • 12. Doctor/Nurses Demand & Supply • Europe doctor to population ratio – 3.5 doctors per 1,000 population. • India doctor to population ratio is 1 doctor per 1,784 people • US Number of Nurses per 100,000 population – 972 • India Number of Nurses per 100,000 population - 78
  • 13. Health Insurance • Less than 15% of population is covered through pre paid insurance scheme – this is very low. • Medical Claim schemes has less than 3.5 million members. • 3.4% Population is covered through ESI Scheme • 5% Population is covered by Employer Schemes • 5% Population is covered through Community Insurance Schemes • 85% Population pays out of pocket, known as private spending • Slow entry of Health Insurance companies, due to regulatory issues and market dynamics • In the last two years growth of insurance cover is 100%
  • 14. Healthcare IT • Hospitals and other healthcare businesses are realising that IT can be a great to to increase efficiencies • IT companies are offering wide ranging solutions • Indian IT market is poised to be US$250 million by 2012
  • 15. Medical Tourism - Why India? • High Quality Medical Facilities – Apollo; Fortis, Max; Escorts; Hinduja are some of the best facilities comparable with any good international facility • Indian doctors are perhaps amongst the best doctors in the world - NRI doctors recognized as amongst best in adopted countries • Cost Advantage – First world treatment at Third world costs • English speaking manpower – better communication with the patients • Indian Nurses are now in demand worldwide • Software technologists facilitating tech revolution in healthcare
  • 16. Why India? • Extensive use of Computerized Hospital Information Systems • Excellent 24-Hour On ground Support – Well Equipped Ground & Air Ambulance Support – Doctors on call – Nurses – Pharmacies – Diagnostic facilities – Transportation – Hotels – Internet & Mobile Phones
  • 17. Why India? • India is an attractive tourism destination – 5000 year old civilization – Renowned for Historical, Cultural and Religious diversity – Diverse geographical landmarks; vast coastline – Traditional arts and crafts – Vibrant democracy: Freedom for citizens; empowered women population
  • 18. India – Cost Advantage Procedures costs in India and US All figures in US$ Procedure US India Heart Surgery 30,000 7,000 Bone Marrow 250,000 30,000 Transplant Liver Transplant 500,000 40,000 Orthopaedic 20,000 4,500 - Surgery 6,000 Cosmetic Surgery 20,000 2,000 LASIK 3000 700 Metal Free Bridge 5500 500
  • 19. Key International Companies with major investments in India (select examples) • Philips • Siemens • Drager Medical • GE Medical Systems • Proton Healthcare • Quest Diagnostics • Gleneagles • Qunitiles • Novartis • Pfizer
  • 20. Future of Healthcare Industry • The current healthcare infrastructure in India is inadequate • The overall number of beds, physicians and nurses is low compared to other developing countries and international averages. The situation is worse in the case of tertiary beds and specialist physicians. • The quality of provision too is poor due to the dominance of unqualified practitioners and sub- optimal size of facilities. • Higher Investment in Training required. • Meeting the expected demand in 2012 will require and investment of US$25 billion
  • 21. Future of Healthcare Industry • An additional 750,000 beds will be required (from 1.5 million today to 2.25 million in 2012), of which 150,000 beds need to be tertiary beds. • The number of doctors and nurses enrolled in medical colleges and nursing schools will have to triple over the next 10 years. Additional 520,000 students physicians will be required by 2012. • The bulk of the investment will need to be made by private providers • Total Healthcare Market in India could increase from US$35 billion today to US$60 billion by 2012. • Preventive Healthcare market is for over 160 million people – largely funded by corporate / government sector
  • 22. Manpower Demand • The manpower demand of the healthcare industry would double up in the next 7 years. For example, the current Marketing & Sales manpower in the healthcare and pharmaceutical segment is 200,000 plus, which is expected to double up in the next 7 years. In clinical research the current shortage is 10,000 personnel, which is going to increase to 50,000 personnel by 2012. • At present there is huge shortage of trained healthcare & pharmaceutical marketing and sales executives, medical representatives and managers. • There is a major shortage of quality professionals for hospital services; service professionals for bio medical equipment, diagnostics, pharma R&D professionals.
  • 23. Training Opportunities in Healthcare/Medical Sector • Short term programs for hospital staff offering technical courses; hospital services, bio medical equipment maintenance – Target market – both hospitals & direct students. • Short term professional development programs / continued medical education for the clinicians, nurses and other healthcare staff in the clinical and non-clinical/ management areas. • Medium to Long term programs for skill enhancement – directly for science graduates/post graduates • Programs in the field of clinical research. • Program Delivery – Online; Classrooms; Distance Learning & Corporate Programs
  • 24. Business Opportunities in India (This list is broad and only indicative in nature – please feel contact us for your product or service) Service providers Curative and preventive in primary, secondary and tertiary care; lab and imaging diagnostics; retail pharmacies rehabilitative - geriatric and others Training & Education Doctors, managers, nurses,technicians, clinical research, healthcare management, clinical research Devices Medical equipments & Service equipments; Telemedicine Services Health Insurance; Architecture; Hospital Management; Healthcare Business / Knowledge Process Outsourcing (e.g. medical billing/coding); Telemedicine Materials Medicines / Disposables / Surgical Products Pharmaceutical R&D; Clinical Research;Contract Manufacturing & Biotechnology
  • 25. Favourable Policies • Custom Tariff on medical equipment is reducing – 0% to 15% • 100% Foreign Investment allowed in the Healthcare, Pharma, Clinical Research – most investments are under automatic route • Tax Holidays for R&D companies • Favourable profit repatriation policies
  • 26. MEDIMINDS – YOUR INDIAN CONNECTION Business Management Services Market Entry Strategy Services Setting up Indian Subsidiary and Joint Ventures Office Infrastructure & Human Resources Representative Office Market Research Identify Office / Hospital / Business Premises and Lease Negotiations Business Strategy Distribution & Marketing Network Licensing Technology Product Registration & Regulatory Services Contract Manufacturing Lobbying with Federal & State Governments Public Private Partnership Opportunities
  • 27. MEDIMINDS – YOUR INDIAN CONNECTION Regulatory Services Investigators’ Site Identification & Qualification Services Clinical Research Outsourcing Medical Writing & Content Development SOPs Development Education, Training & Recruitment
  • 28. Contact Details For more information and details, please contact : Director – Mediminds / Cliniminds C-55 First Floor Preet Vihar, Main Vikas Marg Delhi 110092, India Tel : +91 9810068241 Office : +91 11 42427800 Fax : +91 11 42427802 Email : info@mediminds.com; info@cliniminds.com Website : www.mediminds.com; www.cliniminds.com