IRACST- International Journal of Research in Management & Technology (IJRMT), ISSN: 2249-9563

Vol. 5, No.1, February 2015

MARKETING PRACTICES OF INDIAN

MEDICAL TOURISM- A REVIEW
Sangeeta
Research Scholar, Haryana School of Business, Guru Jambheshwar University of Science and Technology, Hisar, Haryana,
India. Email-Id - sangeeta047@yahoo.co.in 

Abstract Healthcare industry is one of the most growing sectors

The paper present the review of medical tourism in in world economy. Most of the customers of health
relation with the marketing practices of Indian tourism. care services in developing countries are from rich
The paper entails the product, price, place, promotion countries (Crooks, Turner, Snyder, Johnston, &
and integration of marketing practices performed for
Kingsbury, 2011; USAID, 2009; Reddy & Qadeer,
medical tourism in India. The paper covers wide
collection of academic literature on medical tourism 2010). Medical tourism is a niche market and very few
which specifies different approaches and emphases of customers are concerned in availing medical facilities
research in diverse disciplines. The paper emphasis on abroad. A large number of JCI* accredited Indian
the proactivity of Indian medical tourism in order to
survive under competitive pressure. hospitals, large pool of highly qualified and often
Keywords- Healthcare, Marketing Practices, Medical foreign-trained physicians provide substantial proof of
Tourism, Service providers its advancement in this field (Leng, 2007; ECLAC,
2010). Despite the many comparative advantages that
I. INTRODUCTION India enjoys, there are still several barriers to the
The past few years have seen the emergence of India export of health services (Chanda, 2002; Rath, Das,
as a credible healthcare delivery destination, with a Mishra & Puthan, 2012) including the lack of
strong backbone of clinical talent, contemporary portability of health insurance coverage (Deloitte,
infrastructure and very cost effective delivery (Mudur, 2008; Hadi, 2009) and the lack of recognition of
2004). The steady and aggressive growth of the Indian medical qualifications (Chanda, 2002).
economy has provided a huge momentum to India’s
healthcare sector. With a view to provide quality Medical tourism is emergent phenomenon that entails
healthcare, government and private, both players are economic benefits and healthcare concerns. Medical
exhibiting keen interest to promote the growth of this tourism involves patients leaving their country of
sector due to steep growth rates (Deloitte, 2008; Grail residence outside of established cross-border care
Research, 2009; IITM, 2011). India is witnessing a arrangements with the intent of accessing medical
steady increase of overseas patients particularly from care, often surgery, abroad (Bookman & Bookman,
Bangladesh, Nepal, Afghanistan, Uzbekistan, 2007; Deloitte, 2009; Medical Tourism Association,
Kazakistan, Middle East, and Africa, parts of Europe, 2011; Rath et al., 2012). There is an ongoing debate
UK, and USA (Emerging Market Report, 2007; to illustrate the overseas movement of individuals for
Karmakar, 2011). The Indian Prime Minister’s treatment. A range of nomenclature has been used
Council on Trade and Industry policy framework for like health tourism, medical outsourcing, and medical
reforms in health care (Ambani and Birla, 2000) refugee. Here we go for medical tourism, a much
declares an objective to develop and promote India as *JCI (The Joint Commission International) is a U.S based
a destination for affordable and high quality medical accreditation body dedicated to improving healthcare
quality and safety around the world.)
services in the global health care industry.

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broader notion having longstanding historical Medical tourism industry is ever under pressure to
background in country like India, including spas, justify their marketing practices and expenditures
Ayurveda therapy, and Homeopathic treatments. carried out in response. What are the major indicators
Medical tourism has been stated as that affect the medical tourism and what are the
strategies obligatory to opt has a major issue.
‘….when consumers elect to travel across Marketing strategies helps in achieving increased
international borders with the intention of receiving sales in an organisation with a sustainable
some form of medical treatment. This treatment may competitive advantage by focusing on the limited
span the full range of medical services, but most resources. Marketing practices like promotion of
commonly includes dental care, cosmetic surgery, health care service, physical evidence, price
elective surgery, and fertility treatment.’(OECD, effectiveness etc. have contributed in medical tourism
2010). development most. Price and promotional sensitivity
is expected to increase as downturn depreciates the
‘….to people who live in one country and travel to value of rupee. Sales sensitivity in medical tourism
another country in order to receive medical, dental signify the receipts from medical tourist in form of
and surgical care while at the same time receiving selling services and price sensitivity deals with the
equal to or greater care than they would have in their change in price of services with effect to fluctuations.
own country, and are traveling for medical care Most of the studies have been undertaken in USA,
because of affordability, better access to care or a UK and developed nations to find out the marketing
higher level of quality of care.’ (Medical Tourism practices opted in healthcare industry. However
Association, 2011). different possible mechanisms should be explored to
understand the ways through which service providers
Broadly speaking, medical tourism is the act of can rebuild the strategies for attracting large no. of
traveling to obtain medical care among three patients inbound or outbound. The paper is structured
categories as outbound, inbound and intrabound in three parts and next section covers the research
(Deloitte, 2008; USAID, 2009). As travel with the methodology and objectives of study. The third part
aim of improving one’s health, medical tourism is an considers broader literature pertinent to propositions
economic activity that entails trade in services and formed in respect of marketing practices opted by
represents the splicing of at least two sectors: medical tourism and findings pertaining to same.
medicine and tourism (Bookman & Bookman, 2007;
Deloitte, 2009; Rath et al., 2012).
II. OBJECTIVES OF THE STUDY
General agreement on Trade in services (GATS) has This paper aims to scrutinize how India could
defined the health service through four modes of become a magnet for medical tourists by streamlining
supply examine by Chanda (2002) as Cross-border marketing practices in this regard. So present study
delivery of trade (mode 1), Consumption of health try to explore the marketing practice opted for
services abroad (mode 2), Commercial presence restructuring of medical units in India.
(mode 3), Movement of health personnel (mode 4).
Medical tourism falls under mode 2 which considers III. RESEARCH METHODOLOGY
the movement of persons to the service providing The framework mainly considers the marketing
countries. Here patient’s home country is considered practices of Indian medical tourism. The focus of this
as ‘importer’ of the medical services while country article is on the major marketing practices like
that offer medical tourism services is termed as promotion of health care service, physical evidence,
destination country, hence, ‘exporter’ of services. price effectiveness, price competitiveness. The paper
Over 35 countries are serving around a million review relevant literature from respective journals
medical tourists annually. World medical tourism which are most important source of study. The paper
market is estimated to be around $60 billion currently covers wide collection of academic literature on
(Deloitte, 2008; IITM, 2011) medical tourism which specifies different approaches
and emphases of research in diverse disciplines.

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Vol. 5, No.1, February 2015

industry, the product represents goods, services, or

A. Propositions ideas offered by a healthcare organization.
P1- Distinct products/offers delivered have positive
role in growth of medical tourism in India. The product is difficult to precisely be defined in
P2- Price effectiveness has direct impact on growth healthcare, creating a challenge for healthcare
of medical tourism in India. marketers (Hazarika, 2010; Lunt, Smith, Exworthy,
P3- Channel decisions (facilitate to consumers) have Horsfall & Mannion, 2011; Rath et al., 2012; Faidon
direct impact on growth of medical tourism in India. & Vasiliki, 2012). Medical tourism model endowed
P4- Promotional effectiveness has direct impact on with surgical procedures; dental treatment, facelifts,
growth of medical tourism in India hair transplants, liposuction and non-surgical
P5- The integration of marketing practices lead procedures; hair removal, most of which are not
medical tourism towards proactivity. covered by health insurance and are either costly or
restricted for legal reasons in most developed
IV. DISCUSSION countries (Turner, 2007; Shetty, 2010). Many
A. Distinct products/offers delivered hospitals in India, Thailand, Singapore and Malaysia
Since medical tourism is a new phenomenon, much have provided hotel like amenities to the patients. In
published data is not available. A recent trend has order to provide attractive offers, hospitals provide
shown that people from developed nations are maximum comfort to the patients in form of private
seeking treatment from the developing countries elevator, discreet expedited check in process, special
(Johnston, Crooks, Snyder & Kingsbury, 2010; in room services, adjustable beds, and medical
Reddy & Qadeer, 2010). At individual and friendly bathrooms design & fixtures (Suthin,
community level, lifestyle is growing rapidly leading Assenov & Tirasatayapitak, 2007; Kumar, 2009;
towards various numbers of problems termed as Grewal, Das, Nandan & Kishore, 2009; Khan, 2010;
lifestyle diseases. Therefore, need arises to de-stress Dawn & Pal, 2011).
and introduce distinct medical products to resolve the
dilemma (Smaha, 2010; ECLAC*, 2010; Helble, Receiving safe and quality care is the primary issue
2011). Hospitals are traditionally not in tourism for consumers considering outbound medical tourism
business but understanding the importance of as a treatment option (Chinai & Goswami, 2007; Hall
sustainable practice towards their consumers, are now & James, 2011; Faidon & Vasiliki, 2012).
in the hunt for providing medical tourism services to Destination countries are offering best treatments in
them (Eggertson, 2006; Kumar, 2009; Bristow, Yang both conventional medicine; Ayurveda, Homeopathy,
& Lu, 2011). In this regard Whittaker (2008, p. 273) naturopathy & Yoga and modern medicines;
has put in plain words the exact state of affairs of cardiology, orthopedic surgery, gynecology, cosmetic
hospitals as surgery & dental surgery (Horowitz, Rosensweig &
Jones, 2007; Kalshetti & Pillai, 2008). Variety of
‘many of the hospitals involved present themselves as health care products, capturing the larger market, in
having relaxed, resort-type, accommodations, expanded areas provides manifold alternatives to the
conducive to convalescence and rehabilitation, with distant tourist (Hadi, 2009; SINET, n.d.; Kangas,
services….’ 2010).

To promise high quality health care hospitals are Medical destination countries, by providing access to
looking for accreditation from JCI as more than 200 a set of service packages, encourage patient’s
hospitals worldwide have been accredited. preference with alternative costs and unfound quality
Accreditation is predominantly essential because it in developed nations (Turner, 2007; Hadi, 2009; Rath
can offer consumers and employers a level of et al., 2012). Thus, India is on the edge to play an
assurance that the services provided are comparable essential role in medical tourism, fastest growing
to those available in their respective home countries industry, of extensive repute in surgical treatments.
(Leng, 2007; Deloitte, 2008; Grail Research, 2009; *ECLAC stands for Economic Commission for Latin
Medical Tourism Association, 2011). In the health America and the Caribbean.

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Vol. 5, No.1, February 2015

2009). Limited involvement of third party payers,

With continued efforts and initiatives of hospitals by less stringent regulatory environment, and lower cost
rapidly offering the superior medical services and associated with the malpractice litigation and
treatments, medical tourism is expected to grow @ insurance coverage (Emerging Market Report, 2007;
15% per annum over the coming few years (Bhat and Karmakar, 2011).
Jain, 2006; Emerging Market Report, 2007). For inbound and outbound tourists, most of the
Therefore based on available literature, here study operational treatments are done on the basis of
propose that exclusive packages. Since expenditure has been fixed
P1- Distinct products/offers delivered have positive prior to operation, patients need not to be worried
role in growth of medical tourism in India. about aforesaid practices (Grewal et al., 2009; Hall,
2011). Most popular destinations for medical tourism
B. Price Effectiveness are termed as ‘third world’ and offering first world
Like other international trade, competitive pricing has health care. Turner (2007, p. 309) has explained third
a great significance in the medical care to attract world price as
medical tourist at certain destination for undergoing ‘…..there needs to be a significant spread between
medical treatment (Lee, 2007; Rath et al., 2012). the average price of the procedure in country of
Lower cost is key aspect that catches the attention of origin and the cost of the procedure in the destination
patients from high developed nations to less setting. There must be financial justification to travel
developed countries (Sood & Cox, 2008; Johnston et after taking into account the cost of the procedure,
al., 2010; Hult & Philipson, 2012). The accessibility accommodation, travel expenses and all other
of economical pharmaceuticals, lower labour costs, expenses.’
and deficiency of insurance encourage developing
countries to offer treatments at significantly lower India had come late into medical tourism market but
prices by including travel and accommodation catching up other competitors to turn out to be chief
(D’Essence Consulting, 2004; Whittaker, 2008; health care provider (Whittaker, 2008; Kumar, 2009;
Grewal et al., 2009). Cost saving differ by destination Dawn & Pal, 2011). The main strength of the Indian
and by procedure according to specific commercial approach is its capacity to provide medical services at
and non commercial sources (Martin, the lowest cost among all international health care
Ramamonjiarivelo & Martin, 2011; Hall & James, providers. Therefore based on available literature
2011). A shoulder operation performed in India which depict that price has a significant effect on
within 10 days from the initial contact, would cost $ growth of medical tourism, the study purposes that
1700 compared to rich nations cost approximately $ P2- Price effectiveness has direct impact on growth
10000. For instance hip replacement that cost about $ of medical tourism in India.
50000 in USA will cost $ 8000 in India and Thailand
(Deloitte, 2008; Smaha, 2010; ECLAC, 2010).
C. Channel decisions facilitate to Consumers
Aiming opportunity to travel to exotic locations and
India, Thailand, Singapore and Malaysia have a spending vacations in lavish locations lead some
competitive advantage in pricing in spite of high patients to exert medical care abroad. Effective
standard of medical treatments and services offered marketing is unified with adequate channel decision.
to the patients (Kalshetti & Pillai, 2008; Tourani, The major hospitals seeking patients will have to
Tabibi, Tofighi & Zadeh, 2010; Shetty, 2010). Smaha focus on messaging and offers, delivered to niche.
(2010) has put out the two categories of patients one Positioning the distribution channels and constructing
which consist of middle income adult patients who a message will serve as a decisive proposal for
needs surgical treatments not having insurance growth in this sector (Kotler & Keller, 2008;
coverage and second who have insurance coverage Kalshetti & Pillai, 2008).
seeking lower price medical care. Medical travel
provides an opportunity to reduce cost by as 94% of For disseminating information related to medical and
total USA, UK’s cost of procedure (Grail Research, non medical care services, healthcare service

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Vol. 5, No.1, February 2015

providers are using internet; the most effective way units (Suthin et al., 2007; Apollo Healthcare Annual
to reach the product to its target customers (Lunt, Report, 2011; Crooks et al., 2011). Hence here it
Hardy & Mannion, 2010; Turner, 2012). Interactive could be concluded that channel decisions have a
communications, full description of treatment and unified role among marketing practices. So hereby
quality assurance have been put on the website so study proposes that
that potential patients may easily locate the desire P3- Channel decisions (facilitate to consumers)
medical services (Bezruchka, 2002; ECLAC, 2010; have direct impact on growth of medical tourism in
Laesser, 2011). Along with internet, medical travel India
agents are major link between hospitals and patients,
who recommend patients about best treatment
facilities available in destination country (Peters & D. Promotional Effectiveness
Sauer, 2011; Turner, 2012). Foreign tour operators, Health care service providers adopted an approach
insurance companies, travel agents, local tour that most multinational and corporate business
operators, and independent medical referral enterprises follow in terms of designing marketing
companies are the chief channels which facilitate strategies, pricing, branding, management and
consumers to avail medical facilities with best care maintaining the quality of services (Bookman &
and affordable prices (SINET, n.d.; Lunt et al., 2010). Bookman, 2007; Turner, 2007; Rerkrujipimol &
Assenov, 2009). This approach, along with increasing
Although medical tourism agents and travel global integration of businesses, and the cost & wait-
professionals facilitates the tourism aspect of time crises in western health care systems, created
offshore care by managing the channel decision opportunities for many health facilities in developing
because the recreational value of travel has countries (Bezruchka, 2002; Emerging Market
decreasing importance to patients with complex Report, 2007). Advanced communication technology
medical problems (Voigt, Brown & Howat, 2011; made crucial changes in the development of medical
Martin et al., 2011; Fortis Healthcare Annual Report, tourism industry as it becomes quite unproblematic to
2012 ). The primary reason that medical centers in locate the best medical facility over the world. Travel
developing countries are able to provide healthcare agencies provide reassurance, legitimacy and a
services inexpensively is directly related to the proper check out for right medical care according to
nation's economic status. India’s corporate hospitals patient’s conditions (Khan, 2010; Tourani et al.,
such as Fortis, Apollo, Max Care, AIIMS, Escorts 2010; Lam, Cros & Vong, 2011). Crooks et al. (2011)
hospitals etc are honored to make country a medical argued that best medical practices is to inform the
destination by offering world class treatments’ (a patients each and everything about the medical
combination of traditional and modern medical procedures, medical treatments, tourism opportunities
practices) and less waiting time (Eggertson, 2006; and travel arrangement and justify the cost in this
Jagyasi, 2010). Overstretched health plans in regard as
industrialized nations push patients to move to more ‘Promotional costs are likely to be more manageable
relax planned countries likewise India where if brochures, booklets, and flyers can be produced for
corporate hospitals provide elective surgery in all markets, rather than separate sets for potential
minimal waiting period (Garg & Bhardwaj, 2012). international patients from developed nations and
those from developing nations.’ (Crooks et al., 2011)
Around the world, various medical travel companies
have set up linkages with the hospitals in India
(Grewal et al., 2009; Rath et al., 2012). Delhi, To better inform the potential patients, corporate
Mumbai, Bangalore and Chennai gratify more no. of hospitals of developing nations participate in trade
patients by enhancing infrastructural facilities, fairs, travel marts, exhibitions, conferences and
coordinating facilities, hospitality services, and advertised in travel magazines (Rerkrujipimol &
medical transportation. Many hospitals in India are Assenov, 2009; Dawn & Pal, 2011). Healthcare
expanding their business abroad so that follow up service providers advertise in both local & global
care of foreign patients may carry out in operating media and attempt to create awareness with the help

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Vol. 5, No.1, February 2015

of articles or news related to latest accreditation, skills and less understanding of patients’ culture has
medical treatments. Moreover, hospitals and health remained unsolved challenges in front of healthcare
care service providers’ collaborate with the medical service providers.
schools/universities to exchange knowledge and to
promote medical facilities (Boga & Weiermair, 2011; Health care service providers must ensure state of art
Crooks et al., 2011). in medical technology and procedures. To remain in
market place, service providers take initiatives by
Government of destination countries has also take marketing the best health services (Kangas, 2010;
initiatives in promotion of medical tourism as Crooks et al., 2011). Regarding the marketing
destination countries established medical travel strategies government should encourage cheaper
associations and websites so that potential patients transport and accommodation, special training for
can approach easily desired treatment (Lunt et al., service providers and there should be round the clock
2010; Lunt & Carrera, 2011; Turner 2012). services for communication and promotion of health
Government provides various value added measures services inbound or outbound (Lee, 2007; Grewal et
for the development of health service (Whittaker, al., 2009).
2008). Reforms of medical benefits scheme in India
by providing 1 year’s visa validity to the foreign Kangas (2010) has illustrated four models of medical
patients make eager to the private owned hospitals to journey as the market, resources, government, and
attract patients from abroad (Chinai & Goswami, individuals. These models depicted the
2007; IITM, 2011). Promotional elasticity has been interconnection of four factors that individuals,
defined by the George & Swamy (2006) by doing government, resources of healthcare and health
case study of three major hospitals in India (Apollo, providers must work together for placing country as
Kerala Tourism Development Council and Amrita one of the most preferred destination for healthcare.
Institute of Medical Science and Global Health To create USP (unique selling proposition) of Indian
Tours) providing services of medical consultants, medical tourism, healthcare service providers need to
brokers and establishing rejuvenation centers so that team up with government and need to adopt country
customers need to visit over again. It, therefore, specific marketing strategies. Commodification of
implies that promotional effectiveness catches the health services, physical evidence, and drawing up a
attention of local and international patients. So study price band, opening up facilitation centers, and tie
purposes that ups with overseas insurance companies enlightens the
P4- Promotional effectiveness has direct impact on way towards a more proactive approach. Therefore,
growth of medical tourism in India the study concludes that integrated marketing
practices has a direct impact on the medical tourism
industry and healthcare service providers should
V. FINDINGS propose effective marketing practices as
P5- The integration of marketing practices lead
Medical tourism is a source of hard currency for the medical tourism towards proactivity.
‘destination countries’ facilitating health care
services (Johnston et al., 2010). Earlier medical In summary, it is imperative to appraise the potential
tourism was generally regarded as travel to rich in each and every segment by shared value
nations from developing countries, now it goes in proposition, information and quality care. Hospitals
both directions (Smith, 2008; Hadi, 2009). need to maximise strengths, maintain consumer
Developing nations are engaging in developing choice and improve quality standards. Price
integrated marketing practices to capture the attention transparency efforts like low cost of labour, cost
of patients. Well trained doctors and medical staff associated with malpractices litigation & insurance
have been promoted on the website of hospitals as and limited association with third payers are essential
specialized doctors proved competitive advantages to articulate. It can be concluded that Indian medical
(Suthin et al., 2007; Mainil, Platenkamp & tourism ought to be proactive and focus on integrated
Meulemans, 2011). Furthermore, communication

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marketing practices in order to survive the • Chanda, R. (2002). Trade in health services.
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VI. LIMITATIONS OF THE STUDY
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Annexure
Table 1. Cost Structure
Treatments USA India Koreo Mexico Singapore Thailand Jorden
Heart Bypass $1,44,000 $8,500 $24,000 $20,000 $13,500 $24,000 $10,000
Heart valve $1,70,000 $1,200 $36,000 $30,000 $13,500 $22,000 $12,000
Replacement
Hip Replacement $50,000 $8,000 $16,450 $13,125 $11,100 $14,000 $8,000
Hip Resurfacing $50,000 $8,000 $20,900 $12,800 $12,100 $16,000 $8,000
Dental Implant $2,000- $12,000 $3,400 $9,10 $2,900 $3,000 $5,00
1,000
Face Lift $15,000 $7,000 $3,000 $7,200 $4,000 $6,600 $3,000
Knee $50,000 $7,000 $17,800 $10,650 $10,800 $12,000 $7,000
Replacement
Source- Indian Medical Tourism Association, 2011

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