2. Pakistan the Land of endless
opportunities
Land of 210 million People growing with 2.1% annual rate.
Geo- Strategic Location (Economic Super power China, land locked Afghanistan, Energy rich Central Asian
states, financially liquid Gulf state and economical advanced far east countries)
Growing Democracy (Democratic Governments since last 15 years)
Rule of Law (Independent Judiciary and Media)
Controlling Terrorism
Business Friendly Policies
Economic indicators on growth trajectory.
Attracting Foreign Direct Investment by permitting 100% foreign equity
Part of One belt one Road (OBOR) initiative, Chinese investment of US$ 60 Billion in China Pakistan
Economic Corridor (CPEC) Projects.
Pakistan has 18th largest middles class in the world.
Growing Middle Class 40% (84 million people), young, educated population base. Tele density of 150 million
people shows the economic condition of large population base.
The annual new registration of motorcycles is 1.2 million and motor cars 150,000 compared to 200,000
motorcycles and 50,000 cars 10 years ago in the biggest province of Punjab.
3. Pakistan Healthcare Sector
Pakistan’s rapidly expanding population means there are exciting opportunities in the
consumer healthcare segment, the generic and patent medicines market.
Healthcare spending in Pakistan stands at US$ 9.2 billion.
Mixture of Public Sector Hospitals, Private Commercial Hospitals, Private Not for Profit
Hospitals, Foundation and Trust Hospitals for poor patients.
Public Sector Hospitals varies from 200 bedded Tehsil Headquarter Hospitals to 2000 bedded
Teaching Hospitals in cosmopolitan Cities.
Public and Private Hospitals are part of Integrated Healthcare Facilities including Medical
college, Nursing School and Teaching Hospital.
World Bank gave US$ 100 million loan to Punjab Province to introduce healthcare reforms
aimed at enhancing the number of people who have access to high quality health services.
Government is struggling Hard to cope with increasing population and their medical needs by
increasing five time Healthcare budget in last 5 years.
The condition of Public sector hospital is just miserable because of heavy inflow of patients,
mismanagement, lack of facilities, lack of resources.
Every year 5,000 new Doctors are graduated from Medical Colleges.
US$ 3 billion pharmaceutical market, creating some 70,000 direct and 150,000 indirect
employment opportunities in more than 400 pharmaceutical manufacturing units and
increasing at CAGR of 12% in last three years.
4. Public Sector Healthcare
Pakistan spend less than 1 % of GDP on health.
There are only 7,000 midwives serving 210 million people instead of the
required 70,000.
Of the USD 44 spent per person annually on health, USD 28 is out of pocket
expense and only USD 16 are contributed by the Government.
There are just 12 healthcare attendants (physicians and nursing staff) for
every 10,000 people.
Burden of Disease; 40% infectious/communicable diseases, 12 % reproductive
health problems, 6% Nutritional deficiencies, 10% Non-communicable diseases
(NCD)
The current ratio of one doctor per 1,073 persons.
There are long waiting time due to shortage of beds, OT and specialists.
5. Role of Private Sector
Private Sector is Quickly filling the vacuum created due to non availability of
Quality Public Sector Hospitals.
There is large increase in affluent population who can afford good quality
medical treatment at Private Clinics.
With increase in trend of Medical insurance, many organizations are providing
private medical insurance to their employees thus large number of middle
class segment of society are enjoying private medical facilities.
About ¼ of the patients treated in Private Hospitals are covered under
insurance/institutional coverage.
There was great number of affluent people, who used to go to Fareast, Middle
east and Europe for their medical treatment. With quality Private Medical
Treatment available in the country, now they are enjoying the same facilities
here in Pakistan.
6. Opportunities of Private Investment in
Pakistan’s Healthcare Sector
Development of Greenfield Hospitals
Opening of Specialized Clinics
Mergers & Acquisitions M&A Opportunities
Public Private Partnerships
Professional Hospital Operators.
Funding of Healthcare startups in m health, Telemedicine and biotech
domain.
7. Market Landscape for Private Hospital
Although there are number of private hospitals available in major cities of
Pakistan but still due to enormous demand and large affluent class there is
still demand of more private Hospitals.
Due to loose grip of regulators, the private hospitals are charging at their will
and there is large price gap of same treatment at different private hospitals.
Most of the private hospitals are working as tertiary hospital and serving the
needs of specific area and location and offering services for all the general
diseases.
There are some private hospitals offering specialized services e.g. cancer,
ophthalmology, urology, cardiology, Obstetrics etc.
8. Private Hospitals
Private Hospitals can be categorized in to following:
Commercial Hospitals
Private Non for profit Hospitals
Trust/Foundation Hospitals
9. Specialties Dealt at Private Hospitals
Orthopedics
Internal Medicine
Pediatrics
Cardiology
Cardiac Surgery
Vascular Surgery
Ophthalmology
Infectious Diseases
Pulmonology
General Surgery
Urology
Nephrology with Dialysis
Dentistry
Dermatology
Endocrinology
Obstetrics / Gynecology
ENT
Plastic Surgery
Neurosurgery
Neurology
Psychology
Psychiatry
10. Typical Financials, Area and Employees
of 300-400 bedded Private Hospitals
Revenue US$ 75-85 Million
Profit US$ 6-7.5 Million
Employees 2500-3000
Consultants Doctors 100-150
Area 10-20 Acres
11. Leading Commercial Hospitals
Hospital Name City Capacity Year of
Establishment
Doctors Hospital Lahore 250 2000
National Hospital Lahore 250 1999
Hameed Latif
Hospital
Lahore 250 1994
Farooq Hospital Lahore 220 2012
Shifa International
(JCI)
Islamabad 400 1987
Quaid-e-Azam
Hospital
Islamabad 400 2012
12. Private Not for Profit Hospitals
Hospital Name City Capacity Year of
Establishment
Agha Khan
University Hospital
(JCI)
Karachi 540 1987
Shaukat Khanum
Memorial Hospital
Lahore 200 1994
Fatima Memorial
Hospital
Lahore 510 1977
Indus Hospital Karachi 150 2007
Liaqat National
Hospital
Karachi 700 1958
13. Feasibility for 300 Bedded Private
Hospital
Capex
Land & Land Development US$ 5
Million
Hospital Building & Construction
US$ 10 Million
Equipment & Furnishing US$ 15
Million
Professional fee US$ 2 Million
Allied Facilities US$ 1 Million
Contingency US$ 2 Million
Total Capex US$ 35 Million
Opex
Salaries & Benefits of employees
US$ 6 Million
Marketing & Advertising Expenses
US$ 500,000
Utilities Expenses US$ 400,000
Travel & Transportation Expenses
US$ 100,000
Other Expenses US$ 200,000
Total Opex US$ 7.2 Million
14. Projected Revenue & ROI of Private
Hospital
Revenue from Beds Occupancy US$
5.6 Million
Revenue from Consultancy US$ 3.4
Million
Revenue from Medicine US$ 1
Million
Revenue from Diagnostic US$ 1.2
Million
Revenue from Allied Facilities US$
1 Million
Total Annual Turnover US$ 12.2
Million
Total Annual Opex US$ 7.2 Million
Operating Profit US$ 5 Million per
annum.
Return on Investment 14.28%
Pay Back Period 7 Years
IRR 2.99%