A research by Asentech on the Digital Trends in India and its implications on healthcare, patients, and health care providers.

1. Asentech LLC
Digital Trends & its Implications
on Patients and HCPs in India
Thursday, February 16, 2017

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Overall healthcare market size
2
Healthcare industry in
India expected to grow at
a CAGR of
16.5% in the
2008-2020period
due to strengthening
coverage, services and
increasing expenditure by
public & private players
”
Population which can afford
sophisticated medical treatment
is significant
~250 MM
”
Total industry size is expected
to touch
US $160 billion by
2017
...and $280 billion by
2020
”
Ref.: https://www.ncbi.nlm.nih.gov/pmc/
articles/PMC3724242/

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Regulations
3
 Direct to consumer (DTC) branded marketing is NOT
allowed for Prescription drugs in India
 Unbranded or disease state DTC marketing is allowed
for such Prescription drugs
 No specific India regulation is in effect that is similar to
the FDA’s “Fair Balance”
 Similar to the US’s Sunshine Act, MCI (Medical Council
of India) has issued guidelines on marketing to doctors,
however implementation is a challenge, allowing
companies to push the envelop regarding policies; note,
no reporting requirements akin to Sunshine law exist in
India
what this means
 Leading publications suggest that in
emerging markets, market leaders
stand to benefit the most from
unbranded awareness campaigns
 Lack of regulations similar to Fair
Balance allow medical device
marketers to implement higher levels
of creativity as they launch campaigns.
e.g. paid journalistic articles in
prominent publications, without having
to declare it as advertisement.

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Internet subscribers in India are ~350MM (@~35% penetration)
with mobile wireless subscriptions contributing 94% to it
4
35% penetration
116 137
239
286
325
409
489
584
669
2011 2012 2013 2014 2015 2016 2017 2018 2019
Internet Subscribers (millions)
5.9%
0.2%
93.9%
Composition of Internet Subscriptions
Wired Fixed Wiredless Mobile Wireless
Rapidly increasing mobile
data adoption
“Source: Telecom subscription data December 2015 issued by TRAI; Telecom
services analyst presentation 2016 by CRISIL Research”

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3G / 4G devices represent ~35% of current wireless broadband
and expected to grow to 60% by 2018
5
120M
3G /4G mobile devices in India
@ 10% penetration
3G / 4G phones are expected to
increase to
~300 MM phones by 2018
(210MM of those are expected
to be 4G)
representing 60%
of wireless broadband by 2018
17M wired broadband
connections
(1.5% per hundred
inhabitants)

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Indian physicians have higher preference for personal promotion but they are not
far behind on digital adoption as compared to their American colleagues
6
Digital communication channel
preference of physicians
Digital communication channel
Channel preference of physicians
India USA
Personal
Promotion
Face to face Tablet 90% 76%
Medical Science Liaison 56% 44%
Non-
personal
Promotion
Email 56% 53%
Websites 46% 55%
Online-Detailing 55% 54%
Webinars/ Webcasts 40% 50%
Tele Rep 35% 34%
Apps 36% 27%
Text Messages 31% 29%
“Source: Digital Savvy HCP, 2015 - Indegene”

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There’s a plethora of service providers trying to tap into the digital healthcare
economy (driven by technology as well as Prime Minister’s announcement of
Digital India Initiative)
7
“Source: Indian healthcare on the cusp of a digital transformation, 2016 - PWC”
Doctor search, online appointment booking, drug delivery, etc.
One of the targets of Digital India is to connect all the villages at the panchayat level through
some 250,000 common service centers that will act as access points for delivery of various
government services to citizens including Telemedicine
Patient monitoring products that can measures blood pressure, pulse, blood sugar, etc with a
mobile application for smartphones.
Example: Fitbit launched its fitness wristbands across 300 towns in India and expects the
country to be among its top five markets in next two years.
Curofy.com - India’s Largest Community of Verified Doctors
Under Digital India initiative, companies are launching the concepts of EMR / EHR in India but
the adoption is limited to large hospitals
Online
Patient
Services
Remote
Diagnosis
Patient
Engageme
nt
Peer to Peer
Learning
EMR /EHR
The Digital India Initiative is a flagship program launched by the Government of India
with a vision to transform India into a digitally empowered society and knowledge
economy through information technology

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Patient Awareness in India: Although per capita searches for specific diseases in
India are low compared to US, Indian patients are actively searching for
healthcare information online
8
Google Search Trends
Source: Salesforce tool/ Radian 6 - total conversations on social media
(Twitter, Facebook, Mainstream Media, Forums, and Blogs) based on three
month data (Nov’16 till Jan’17)
Conversations involving “patient/ consumer
engagement in healthcare” in India vs. in US
2.5 K
Posts
India
70 K
Posts
USA
Social Media Conversations
Disease State
Search Trends
(Avg. monthly searches)
India USA
Diabetes 1M – 10M 1M – 10M
Hypertension 100K – 1M 1M – 10M
stroke 100K – 1M 1M – 10M
cancer 1M – 10M 10M – 100M
HIV/AIDS 100K – 1M 1M – 10M
Source: Google AdWords Search Trends based on one year data (Jan’16 till Dec’16)

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According to Pew Research, 31% of India’s online adult
population uses the internet to seek health related information
9
“Source: Spring 2014 Global Attitudes survey, PEW Research Center”
What are the online activities of the adult Indian Internet user?
Stay in
touch with
family and
friends
Get political
news
Get health
info
Get
government
or services
info
Look/ apply
for a job
Make or
receive
payments
Buy
products
Take an
online class
INDIA 63 38 31 43 55 23 22 22
USA 60
According to Online Activities in Emerging and Developing Nations by Pew Research Center, among adults
surveyed in India, 31% use the internet to seek health information. In US, the number exceeds 60%

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Consumer Digital tactics: examples
10
 According to practo.com, over 2 million people
are already using Practo
 Available on iOS and Android
 Practo provides several services to patients
including:
• Asking free health questions
• Searching for clinics, doctors,
diagnostics, etc
• Consulting a doctor
• Ordering medicines
 Online market place for users to buy
prescription medicines, OTC, women
health products among other categories.
 Available on iOS and Android
 Zigy offers consumers:
• Online availability of wide variety of
products
• Ability to upload, store, and access
prescriptions online
• Convenience
• Timely delivery
• Payment options

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Consumer Digital tactics: examples
11
• Available on iOS and Android
• Practo provides several services to physicians
including:
• Practo Consult to give online consultation
• Practo Health Feed to share experience
• Practo Profile to get discovered and
connect with people
• Practo Ray to delight the patients with
digital services
• Practo Tab to increase patient
engagement at practice
• According to Curofy.com, over 190K doctors
are using Curofy App from 1.5K+ cities to
discuss 70K+ difficult medical cases.
• Available on iOS and Android
• Provides several services to physicians
including:
• Discuss latest news
• Discuss and refer cases
• Get the best jobs
• Showcase their profiles

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Industry example: knowledgegenie.org, an HCP tactic by
Abbott in India
12
• Provides:
o Access to medical and
scholarly articles
o Clinical guidelines for
treatments across
specialties
o Challenging cases to
solve
o Webinars
o Conference Planner
HCP Portal

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Contact
13
Anil Bhaskar
Co-Founder, Managing Partner
Ph.: 908 751 4121 ext. 111
anil@asentechllc.com
Swati Bhaskar
Co-Founder, Managing Partner
Ph.: 908 751 4121 ext. 113
swati@asentechllc.com
Jacob Williams
Principal, Software Services
Ph.: 908 751 4121 ext. 163
jacob@asentechllc.com
Rajesh Parekar
Principal, Technology Solutions
Ph.: 908 751 4121 ext. 189
rajeshp@asentechllc.com