The Indian government’s ‘Make in India’ initiative is boosting domestic production of medical devices and helping to lower the prices patients pay for products such as stents and implants, which were imported in the past
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Healthcare in India faces several challenges, including lack of access, low insurance penetration, and a growing burden of chronic diseases. At the same time, traditional business models are struggling to show an attractive ROI, except for a few large vendors. The infusion of technology, along with extensive infrastructure and process efficiency improvements, could help improve the accessibility and affordability of health care, according to experts who spoke about emerging trends in that sector at the Wharton Economic Forum. India 2020, held in Mumbai this month.
Despite its shortcomings, the Indian healthcare sector has a lot to offer on several fronts. A government-led effort to get healthcare providers to adopt electronic medical records is enabling artificial intelligence (AI) to extract information from patient data to provide better treatment. The availability of telecommunications bandwidth enables the medical expertise to reach underserved rural markets through telemedicine and teleconsultation programs delivered via mobile phones.
The Indian government’s ‘Make in India’ initiative is boosting domestic production of medical devices and helping to lower the prices patients pay for products such as stents and implants, which were imported in the past. At the same time, the political environment and regulators in India must adapt to technological interventions, such as the growth of online pharmacies, with the necessary controls, the panelists said. Innovation in healthcare in India could serve as a global model for a shift from treating the sick to preventive care and wellness, given the size of underserved populations, they said.
Health care has the potential to drive economic growth and jobs, but it is also a critical sector in terms of “protecting the health and wealth of the nation,” said Sangita Reddy, deputy director of Apollo Hospitals, a chain of companies. of health care institutions. and President of the Federation of Chambers of Commerce and Industries of India.
Healthcare offers the opportunity to find ways to make health services “more understandable, affordable and accessible,” said Gaurav Agarwal, co-founder and chief technology officer of 1mg, an online pharmacy and digital healthcare platform. The three-year-old company, based in Gurugram in Northwest India’s Haryana state, has already received 85 million customer visits a year to its platform, enabling patients to not only buy medicine, but also make reservations for laboratory tests or medical consultations. .
Healthcare in India is becoming increasingly attractive to investors, with technological innovations helping to penetrate second- and third-tier markets, said Puncham Mukim, managing director of Everstone Capital Advisors in Mumbai. The company has investments in healthcare investment categories, including hospitals and medical device manufacturers, and has invested $ 400 million in recent years, he said.
Change dialog
Describing healthcare challenges in India, Reddy noted that across the entire supply chain, from primary care physicians to tertiary hospitals to government-run facilities, “everyone is working towards incremental access.” . At the same time, he said that the country has “high quality health care” and the private sector provides more than 76% of that care. She described that scenario as “islands of excellence in an ocean of insufficiency.”
“Care is shifting from hospital to clinic, clinic to home, and home to ubiquitous access to care 24 hours a day, 7 days a week, powered by the mobile phone.” -Sangita Reddy
A significant portion of the country’s population lacks health care, Reddy said. India has a doctor-to-patient ratio of 1: 10,189, about 10 times lower than the 1: 1000 recommended by the World Health Organization, according to a report from the Center for the Dynamics, Economics and Policy of Disease, Washington, DC- based research organization. The country’s doctor-patient ratio should increase as the number of doctors doubled; India needs three times as many nurses and five times as many paramedics as it does now, she said.
While these challenges are daunting, they present “an incredible opportunity to disrupt traditional models of healthcare,” Reddy continued. She called for a shift from what was traditionally “sick care” to wellness, saying it offers opportunities “to turn the health paradigm around and focus on prevention.” A two-pronged approach: “growing the [healthcare] infrastructure, improving methodology, efficiency and the way we do things; and reducing the burden of disease ”will address supply-side constraints, she said. “If we do these things together, we may not only help solve India’s health problems, but we will also show a model to the world.”
Agarwal noted that India has a chronic disease burden or a non-communicable disease burden of nearly 20% of the population, where nearly 200 million people are chronically ill. Of these, diabetes and hypertension alone affect about 100 million people, and that patient population is growing at a rate of 13% a year, she said. To make matters worse, the percentage of patients who adhere to prescribed treatments is abnormally low, she added.
According to an article from the Indian Institute of Medical Sciences, drug non-compliance by patients ranges from 24% for heart patients to 50% to 80% for hypertensive patients. The reasons include complex drug regimens, depleted drug supplies and drug side effects, she noted.
At the Technological Altar
Agarwal saw the technology as the need to address some of the shortcomings and listed a few. “Unlike the West, which has become this huge healthcare-driven healthcare ecosystem, India has a consumer-driven healthcare ecosystem,” he said. “When you go to a hospital, you see patients walking around with their files. Insurance penetration in India is 15%. There is no outpatient insurance, which means that when you see a doctor for your daily needs, there is no insurance of any kind available. So from a cost improvement standpoint, both the payer and the patient are incredibly motivated to figure out how to lower their monthly healthcare costs. ”
At the same time, the patient in India owns the health data – which Agarwal found “extremely fascinating” – it turned out to be the seed of the idea behind the establishment of his 1 Mg online pharmacy. “In the United States, my medical records were digital, but no one had access to that data,” he said, recalling his decade-long stint as an engineer in the San Francisco Bay Area. “But in India, we own our data and we think it’s actually pretty cool that people have access to that data.” Such a data-rich country could provide an opportunity to do groundbreaking work on disease progression models and the like, and share it with the rest of the world, he added. “Health care is geared towards the consumer. India will drive that revolution. ”
In September 2018, India launched its National Health Protection Mission called “Ayushman Bharat Yojana” with the aim of providing 100 million poor and vulnerable families (around 500 million beneficiaries) with health insurance of up to Rs. 500,000 each (approximately $ 7,150) for second and third line hospitalization. “From a large swathe of population that was hitherto untreated and undiagnosed, Ayushman Bharat [provides] large swathes of the population the opportunity to get diagnosed,” said Mukim.
However, Mukim noted that there is insufficient capacity in primary and secondary healthcare even in Tier 1 markets, or those with populations of 1,000,000 or more, which are typically major metropolitan cities like Mumbai or Chennai (Tier 2 and Level 3 are governed by smaller and smaller populations). Most of the existing healthcare facilities are in those markets and are also attracting the majority of new capacity investments, she added. However, some pockets realize the need. Hyderabad and Chennai, for example, are no longer “low,” he noted.