Sector structure/Market size

The Indian healthcare sector is expected to become a US$ 280 billion industry by 2020
with spending on health estimated to grow 14 per cent annually, according to a report by
an industry body. "Healthcare has emerged as one of the most progressive and largest
service sectors in India with an expected GDP spend of 8 per cent by 2012 from 5.5 per
cent in 2009. It is believed to be the next big thing after IT and predicted to become a
US$ 280 billion industry by 2020," the report said.

At present the sector is estimated to be around US$ 40 billion and will grow to US$ 78.6
billion by 2012.

As per a study by an industry body and Ernst & Young, India would require another 1.75
million beds by the end of 2025. The public sector however is likely to contribute only
around 15-20 per cent of the required US$ 86 billion investment. The corporate India is
therefore, leveraging on this business potential and various health care brands have started
aggressive expansion in the country. Some of the companies that plan to increase their
footprints include Anil Ambani’s Reliance Health, the Hindujas, Sahara Group, Emami, Apollo
Tyres and the Panacea Group.

Sahara Group is planning several healthcare projects such as a 200-bed multi-specialty

tertiary care hospital at Gorakhpur in Uttar Pradesh, a 1,500-bed multi super-specialty,
tertiary care hospital at Aamby Valley City and 30-bed multi-speciality secondary care
hospitals across all the 217 Sahara City Homes Townships.

Meanwhile, Artemis Health Sciences (AHS), a health care venture of the Apollo Tyres
Group, is also planning to establish four to eight multi-specialty hospitals in Punjab, Uttar
Pradesh, Madhya Pradesh, Rajasthan and Haryana over the next three years.

The rural healthcare sector is also on an upsurge. The Rural Health Survey Report 2009,
released by the Ministry of Health, stated that during the last five years rural health sector
has been added with around 15,000 health sub-centres and 28,000 nurses and midwives.
The report further stated that the number of primary health centres have increased by 84
per cent, taking the number to 20,107.

The size of the Indian medical technology industry may touch US$ 14 billion by 2020 from
US$ 2.7 billion in 2008 on account of strong economic growth, higher public spending and
private investments in healthcare, increased penetration of health insurance and emergence
of new models of healthcare delivery, according to a report ‘Medical Technology in India:
Enhancing Access to Healthcare through Innovation’ released by PwC and an industry body.

Health Insurance
The Indian health insurance market has emerged as a new and lucrative growth avenue for
both the existing players as well as the new entrants. According to a latest research report
"Booming Health Insurance in India" by research firm RNCOS released in April, 2010, the
health insurance market represents one the fastest growing and second largest non-life
insurance segment in the country. The Indian health insurance market has posted record
growth in the last two fiscals (2008-09 and 2009-10). Moreover, as per the report, the
health insurance premium is expected to grow at a CAGR of over 25 per cent for the
period spanning from 2009-10 to 2013-14.

Investments in Healthcare

As per data released by the Department of Industrial Policy and Promotion (DIPP), the
drugs and pharmaceuticals sector has attracted foreign direct investment (FDI) worth US$
1.82 billion between April 2000 and September 2010, while hospitals and diagnostic centres
have received FDI worth US$ 955.10 million in the same period.

 Care Institute of Medical Sciences (CIMS), a hospital venture brought forth by a

group of doctors in Ahmedabad, has come up with India’s first ‘green hospital’.
 Drug maker Lupin plans to invest an average US$ 100 million each in the coming
years for capital expansion and acquisition of foreign companies, according to
Ramesh Swaminathan, President – Finance and Planning, Lupin.
 The Apollo Hospitals Educational and Research Foundation (AHERF) has firmed up
its stem cell research collaboration with US-based StemCyte, investing US$ 15
million in the 50-50 venture.
 Apollo Hospitals also plans to invest US$ 650.04 million by 2014 to add 4,000 beds.
 New Delhi-based hospitals chain Fortis Healthcare plans to invest US$ 146.81 million
over next 12-18 months to add 2,100 new beds, said Bhavdeep Singh, Chief
Executive Officer, Fortis on November 3, 2010.
 Nova Medical Centres, a specialised day care surgery centre chain, plans to invest
nearly US$ 225.5 million for setting up 100 centers across the country by 2014, said
Suresh Soni, Chairman, Nova Medical Centres.
 Manipal Hospitals plans to invest US$ 45.23 million in the next three years to
double its capacity to 8,000 beds, said Rajen Padukone, Chief Executive Officer,
Manipal Hospitals.
 Wockhardt Hospitals plans to invest up to US$ 158.32 million to double its bed
capacity to 2,000 by 2013, said Anil V Kamath, Managing Director, Wockhardt
Hospitals Ltd.

Medical Tourism

According to a new report published by RNCOS, titled "Booming Medical Tourism in India"
India’s share in the global medical tourism industry will reach around 3 per cent by the end
of 2013. The report states that medical tourism is expected to generate revenue around
US$ 3 billion by 2013, growing at a CAGR of around 26 per cent during 2011–2013. The
number of medical tourists is anticipated to grow at a CAGR of over 19 per cent during the
forecast period to reach 1.3 million by 2013.

The Indian medical tourism industry is presently at a nascent stage, but has an enormous
potential for future growth and development on the back of low cost range of treatments
provided by the country. The growth in India’s medical tourism market will be a boon for
several associated industries, including hospital industry, medical equipments industry and
pharmaceutical industry.

Domestic medical tourism in the country has also seen growth in the recent years. As per
the report ‘Domestic Tourism in India, 2008-09’ released by the National Sample Survey
Office (NSSO), trips for ‘health and medical’ purposes formed 7 per cent of overnight trips
in the rural population and about 3.5 per cent in the urban population. ‘Health and medical’
purposes accounted for 17 per cent of same-day trips in rural India and 8 per cent in urban
India. Expenditure on medical trips accounted for 30 per cent of all overnight trip
expenditure for rural India and 15 per cent for urban.

Mobile Healthcare

Computer-based bio-surveillance projects generating data about diseases and creating

databases on healthcare in rural areas are becoming popular in India with various
organisations entering into this arena.

 The Indian Institute of Chemical Technology (IICT) in Hyderabad has developed a

model to forecast possible epidemics of diseases such as malaria and encephalitis
in rural Andhra Pradesh.
 A recent initiative by a global consortia consisting of the Indian Institute of
Technology, Madras, the National Centre for Biological Sciences, Carnegie Mellon
University's Auton Lab, LIRNEasia, University of Alberta, Respere Lanka, Lanka
Jathika Sarvodhaya Society and the International Development Research Centre
(IDRC), called the Real Time Biosurveillance Program (RTBP), has attempted to use
the power of the mobile phone in developing a healthcare model.
 Narayana Hrudayalaya and the Mazumdar Shaw Cancer Centre tied up with SANA,
a research group at Harvard/MIT, to use smart phone-based detection of oral cancer
and other diseases.

Government Initiative
The Government launched the National Rural Health Mission (NRHM) in 2005. It aims to
provide quality healthcare for all and increase the expenditure on healthcare from 0.9 per
cent of GDP to 2-3 per cent of GDP by 2012.

According to Union Budget 2010-11, the Finance Minister, Mr Pranab Mukherjee increased
the plan allocation for Ministry of Health and Family Welfare from US$ 4.2 billion in 2009-10
to US$ 4.8 billion in 2010-11.

Moreover, in order to meet revised cost of construction, in March 2010 the government
allocated an additional US$ 1.23 billion for six upcoming AIIMS-like institutes and
upgradation of 13 existing Government Medical Colleges.

The Union Cabinet on October 20, 2010 approved the proposal of the Ministry of Health &
Family Welfare to declare National Institute of Mental Health and Neuro Sciences
(NIMHANS), Bangalore as an Institute of National Importance on the lines of All India
Institute of Medical Sciences, New Delhi, Post Graduate Institute of Medical Education and
Research, Chandigarh and Jawaharlal Institute of Postgraduate Medical Education &
Research, Puducherry.

“The Healthcare System and Delivery Network in Emerging Economies (China, India and Brazil) -
Growth Opportunities Driven by Awareness, Affordability and Access” provides key data, information
and analysis on the Healthcare Delivery in Emerging Economies. The report provides market
landscape, competitive landscape, medical equipment market analysis and trends on Healthcare
Delivery in China, India and Brazil. The report provides comprehensive information on the key trends
affecting healthcare delivery, and key analytical content on the market dynamics. The report also
reviews the competitive landscape and technology offerings. This report is built using data and
information sourced from proprietary databases, primary and secondary research and in-house
analysis by a team of industry experts.

Scope

- Key geographies covered include China, India and Brazil.

- Market size and company share data for Healthcare Delivery
- Annualized market revenues data from 2002 to 2009, forecast forward for 7 years to 2016.
Company shares data for 2009.
- Qualitative analysis of key market trends, market drivers, and restraints by each category within
the Healthcare Delivery market
- The report also covers information on the leading market players, the competitive landscape, and
the leading pipeline products and technologies.

Reasons to buy

- Develop business strategies by understanding the trends and developments that are driving the
Healthcare Delivery in Emerging Countries.
- Design and develop your product development, marketing and sales strategies.
- Exploit M&A opportunities by identifying market players with the most innovative pipeline.
- Develop market-entry and market expansion strategies.
- Identify key players best positioned to take advantage of the emerging market opportunities.
- Exploit in-licensing and out-licensing opportunities by identifying products, most likely to ensure a
robust return.
- What’s the next being thing in the Healthcare Delivery in Emerging Countries? – Identify,
understand and capitalize.
- Make more informed business decisions from the insightful and in-depth analysis of the Healthcare
Delivery in Emerging Countries and the factors shaping it.

India Healthcare Trends 2008

Technopak Advisors Pvt. Ltd., Nov 2007

  Table of Contents                 

  Description  

       Enquire before  Send to a

Buying   Friend  

The Indian healthcare industry has grown manifold during the last few years. Although there
is a yawning divide between healthcare facilities available in rural and urban India and in
the demand and supply of healthcare services across the country, overall the Indian
healthcare infrastructure is fast improving with initiatives by the government and the private
sector. The entry of private players has further spurred the development of the healthcare
sector.

The striking feature of the sector is that it has the potential to grow at a much faster rate
in the foreseeable future and will present new ' sectors of opportunity' within healthcare,
which will emerge as growth drivers. The Indian healthcare industry overview indicates it
has the same exponential growth potential as software and pharmaceutical industries in the
country. Till now only 12% of the opportunities in the Indian healthcare sector have been
employed.

With abundant opportunities for businessmen, equipment makers and service providers to
invest in curative and preventive services and possibilities of investing in medical
infrastructure and medical tourism, it becomes imperative for providers to get a feel of what'
s happening in the industry to make informed decisions on investment options.
The India Healthcare Trends 2008 aims to be an informed view of trends and drivers for
the Indian Healthcare industry by delving into how providers like hospitals and physicians
conduct their business and the issues they face in doing so, as well as dissect it in terms
of what healthcare means to the end consumer.

This study reflects the opportunities that exist, the challenges faced, emerging trends and
the future scenario of the healthcare service sector in India and provides a comprehensive
understanding of the healthcare market and practices, customer attitudes and behavior study
in India. The report will serve as a market / investment guide for healthcare providers,
investors in healthcare and allied businesses.

Key highlights

-One-of-its-kind report with primary survey data from a cross-section of sources including
consumers, physicians, hospitals.

-Identification of opportunities in Healthcare Infrastructure, financially & geographically,

manpower requirements & opportunities

-Identification of the allied businesses' role and their individual market share, the future
dynamics of healthcare delivery

-Tracking the business modules of physicians, their outlook on future practices, and how
they gear up to face the challenge posed by organised healthcare sector

-Consumer insights: Current behavior and practices in the household, decision making
process on physicians, hospitals, perceptions on current options and satisfaction levels

-Health and wellness of Mr and Mrs India: A derivation of the health quotient of the chief
wage earner and the homemaker across a cross-section of families based on their own
perception of health and a gradation from a series of behavioral measures that demonstrate
commitment to keeping in good health

-Current healthcare insurance coverage, limitations and opportunities

The methodology

-An analysis of the market both from the provider and consumer angles across Urban India.
-Coverage of 39 towns to represent all towns with a population of 50000+ in Urban India.

-11,000+ consumers of healthcare services

-600+ physicians and 250+ hospital administrators