LAERS INVESTNT & AD ZOCHT HET VOOR U UIT€¦ · The Indian healthcare market *1 $ = 60.9 INR 4 The...

FLANDERS INVESTMENT & TRADE ZOCHT HET VOOR U UIT

HEALTHCARE

IN INDIA

Infrastructure in India

Healthcare in India

Study made by FIT office in Mumbai

Flanders Investment & Trade Consulate General of Belgium TCG Financial Centre, 7th Floor C-53 G-Block, Bandra-Kurla Complex Bandra (E) Mumbai 400.051 India

E-mail: [email protected]

T.: +91 22 66 71 06 27

mailto:[email protected]

Healthcare in India|April 2014 __________________________________________________________________________ 1

1. TABLE OF CONTENTS

2. EXECUTIVE SUMMARY ........................................................................................................ 2

3. SNAPSHOT OF THE HEALTHCARE SECTOR IN INDIA ........................................................... 3

4. INDIA COOPERATION STRATEGY AT A GLANCE .................................................................. 4

India cooperation strategy at a glance – international partners ............................................................ 5

The Indian healthcare market ................................................................................................................. 6

5. MARKET BREAK-UP ............................................................................................................. 7

Market segmentation ............................................................................................................................. 7

6. SUB – SEGMENT: HOSPITALS .............................................................................................. 8

Structure of the healthcare network - hospitals ..................................................................................... 9

Dubious dispensary? ............................................................................................................................... 9

Top PRIVATE Hospital Groups in India .................................................................................................. 10

7. INDIA’S PRICING ADVANTAGE .......................................................................................... 11

8. RISING FDI AND PRIVATE SECTOR INVESTMENTS ............................................................ 12

9. SUB – SEGMENT: PHARMACEUTICAL / BIOTECH ............................................................. 14

10. KEY DRIVERS AND RESTRAINTS - PHARMACEUTICALS ..................................................... 14

Drivers ................................................................................................................................................... 14

Restraints .............................................................................................................................................. 15

Recent mergers & acquisitions ............................................................................................................. 15

11. SUB – SEGMENT: In VITRO DIAGNOSTICS / BIOSIMILARS ................................................ 17

12. SUB – SEGMENT: MEDICAL devices & equipment ........................................................... 17

13. KEY GROWTH OPPORTUNITIES FOR FLEMISH COMPANIES ............................................. 19

14. GOVERNMENT INITIATIVES AND HEALTHCARE POLICIES ................................................ 20

15. HEALTHCARE Regulatory AUTHORITIES in India .............................................................. 21

16. CONTACTS IN THE HEALTHCARE SECTOR ......................................................................... 23

17. OVERVIEW OF BELGIAN COMPANIES IN INDIA ................................................................ 30

18. GLOSSARY ......................................................................................................................... 32

19. USEFUL LINKS FOR FURTHER READING ............................................................................ 33

2 ______________________________________________________________________

2. EXECUTIVE SUMMARY

Healthcare in India has improved significantly over the last few years. Small pox and polio have been eradicated, mass killer diseases such as leprosy, malaria, and cholera have been largely controlled. Life expectancy has increased from 61 years in 2000 to 66 years in 2011. Infant mortality rate has reduced from 67 in 2000 to 56 in 2012 per 1,000 live births, and significant success has been achieved in dealing with dreaded diseases. Despite such progress, India’s mortality and morbidity rates are higher than global averages and in comparison to other emerging economies such as China, Brazil, and Russia, indicating that a lot more needs to be done in the area of healthcare.

India has only 9 beds per 10,000 people as compared to global average of 29 beds. It had only 6.5 physicians, 0.8 dentistry personnel and 10 nursing personnel per 10,000 people as compared to the global average of 14.2, 2.2, and 28.1, respectively during 2005–2010 (WHO statistics 2012). Less than 15 percent of the population is covered under any kind of health insurance. India’s expenditure on health as a percent of GDP is 4.1 percent (2010, World Bank Statistics) which stands lowest when compared with other emerging economies, and less than half when compared with the global averages. These insufficiencies are creating huge gaps or market demand for private participants to capitalize on. Taking advantage of the untapped market demand, insufficient supply and prevalent optimistic atmosphere, many foreign participants in the healthcare delivery segment, medical devices and equipment segment are looking to enter and establish themselves in the country (especially in tier-II and tier-III cities, which have huge potential because of low penetration of healthcare services).

The healthcare sector in India will grow to $158.2 billion in 2017 from $78.6 billion in 2012 i.e. at a growth rate of 15 per cent1. Such high growth is resulting in a number of challenges for this market as it is a supply - constrained market and is facing a severe shortage of infrastructure, human resources, health insurance, health expenditure, and so on. Indian private hospitals are coming up with various innovative models, such as hub and spoke, maintenance contracts etc. to leverage on the insufficient healthcare infrastructure (especially in tier-II and tier-III cities) and increase their market share and profitability.

Medical devices and equipment companies are coming up with favorable terms and conditions to penetrate into the Indian untapped market. Pharmaceutical companies have started focusing on penetrating in rural areas and started investing in bio similar drugs which holds significant potential. The government of India aims to develop the country as a global healthcare hub and hence provided significant policy support in the form of reduction in excise duties for medical devices, reduction in prices of life-saving drugs, encouragement to the private sector, tax benefit on preventive health check-up, encouraging investments in rural areas, increasing allocation for Rashtriya Swasth Bima Yojana (literally "National Health Insurance Programme) & National Rural Health Mission.

1 Source KPMG, Hospital Market – India & IBEF – Healthcare August 2013.


3. SNAPSHOT OF THE HEALTHCARE SECTOR IN INDIA

2*Trend

2http://timesofindia.indiatimes.com/business/vote-on-account/economic-survey/Economic-Survey-2013-India-has-lowest-spend-on-

health-in-BRICS-group/articleshow/18720675.cms

http://www.financialexpress.com/news/healthcare-woes-india-has-1-govt-hospital-bed-for-879-people/1159232/1

http://pib.nic.in/newsite/PrintRelease.aspx?relid=98206

Market sizeUSD 158

billion

Rate of growth

15 %Market

penetration rate

Medium

Market Nature

Fragmented

Healthcare expenditure as % of GDP

4.1%Total no. of

hospitals35.416

Total no. of hospital beds

1.3 million

No. of beds per 10.000

people9

No. of physicians per 10.000

people

6.5

Increasing

Stable

4 ______________________________________________________________________

4. INDIA COOPERATION STRATEGY AT A GLANCE

India Global average

Total population (2012) 1.240.000.000 7.162.000.000

Gross national income per capita (PPP international $, 2012)

3.910 11.600

Life expectancy at birth ‘both sexes’ (years, 2012) 65 70

Life expectancy at age 60 ‘both sexes’ (years, 2011) 17 20

Probability of dying under five (per 1 000 live births, 2012)

56 49

Total expenditure on health per capita (Intl $, 2011) 59 4.962 (Belgium)

Total fertility rate (per woman) 2.5 1.65 (Belgium)

3 India accounts for 21% of the world’s global burden of disease. India is home to the greatest burden of maternal, newborn and child deaths in the

world. Infant mortality rate declined from 83 per 1000 live births in 1990 to 56 per 1000 live births in 2012 and maternal mortality ratio reduced from 570 per 100,000 live births in 1990 to 212 in 2007–2009. The neighbouring countries of India like Nepal and Sri Lanka had better child mortality rates. Ministry of Health has targeted to bring it down to less than 27 per 1000 live births by year 2017. One of the millennium development goals is to reduce the child mortality rate to 42 by 2015. India is striving hard to achieve this goal but is likely to miss the target date of 2015.

Though, significant advances have occurred in addressing communicable diseases such as the progress towards polio eradication, rapid changes in India’s society and lifestyles have led to the emergence of noncommunicable diseases, which are already responsible for two-thirds of the total morbidity burden and about 53% of total deaths (up from 40.4% in 1990 and expected to increase to 59% by 2015).

Gender issues are of great concern. The worrying proportions of selective gender abortion became even more visible with the 2011 census; the female-to-male sex ratio in the 0–6-year age group declined steeply from 0.945 in 1991 to 0.914 in 2011. The

3Global Health Observatory - World Health Statistics 2012


Gender Equality Index (GEI) in India is 0.748, well below, for example, China (0.405) or Sri Lanka (0.599). In 2008, India ranked 122nd in gender equality among 168 countries. (The Gender Equality Index assigns a score from 1, total inequality, to 100, full equality. The target is the equality point, benchmarked in 100)

India is losing more than 6% of its GDP annually due to premature deaths and preventable illnesses, according to a 2010 World Bank report.

India cooperation strategy at a glance – international partners

The Government of India restrategised development cooperation and partnership in 2004–2005, accepting direct development assistance from restricted donors under specific conditions only for socially important projects. International agencies and partners are now expected to provide only state-of-the-art evidence, methodological inspiration and high-level support. Key bilateral support is provided by the:

UK Department for International Development (DFID) US Agency for International Development (USAID) European Commission (EC) Japan International Cooperation Agency (JICA) The United Nations Country Team (UNCT) works within a Development

Assistance/Action Framework (UNDAF). The World Bank and the United Nations Children’s Fund (UNICEF) have significant involvement in the health sector.

Other stakeholders are: Global Health Partnerships (e.g. Global Fund to Fight AIDS, Tuberculosis and

Malaria [GFATM] Global Alliance for Vaccines and Immunisation [GAVI] Roll Back Malaria and Stop TB) International private sector development partners (e.g. the Bill & Melinda

Gates Foundation, Bloomberg, Clinton, Sasakawa and Norway India Partnership Foundations among others) and international and national civil society organizations (e.g. Oxfam, Action Aid, World Vision and the Red Cross).

Source - Business today, January 19 2014.

6 ______________________________________________________________________

The Indian healthcare market

*1 $ = 60.9 INR 4

The Indian healthcare market was valued at $68 billion in 2011. The market is forecast to reach $158 billion by 2017 witnessing a growth of 15 percent from 2011 to 2017. It is one of the largest service sectors and is expected to add over 400.000 jobs by 2014.5

4 All figures are rounded. 5 Source – LSI Financial Services, Aranca Research & IBEF Healthcare study

68,4

78,52

90,25

103,83

119,3

137,54

158,17

0

20

40

60

80

100

120

140

160

180

2011 2012 2013 2014 2015 2016 2017

Rev

en

ue

$ B

illio

n

Total healthcare market: revenue forecast, India, 2011–2017


5. MARKET BREAK-UP

Hospitals account for a notable share of the market break - up followed by pharmaceuticals at 13 %.6

Market segmentation

7

6 Source – Hospital Market – India, IBEF 7Source: Hospital Market – India by Research on India, Aranca Research

71

13

9 4 3

Market segmentation by revenue

Hospitals

Pharmaceuticals

Medical equipment &supplies

Medical insurance

Hospitals

Government Hospitals - It includes healthcare centres, districthospitals and general hospitals

Private Hospitals – It includes nursing homes, and mid-tier and top-tier private hospitals

PharmaceuticalIt includes manufacture, extraction, processing, purification andpackaging of chemical materials for use as medications forhumans or animals

DiagnosticsIt comprises businesses and laboratories that offer analytical ordiagnostic services, including body fluid analysis

MedicalEquipmentand Supplies

It includes establishments primarily manufacturing medical equipment and supplies, e.g. surgical, dental, orthopaedic, ophthalmologic, laboratory instruments, etc

Medical Insurance

It includes health insurance and medical reimbursement facility,covering an individual’s hospitalisation expenses incurred due tosickness

8 ______________________________________________________________________

6. SUB – SEGMENT: HOSPITALS

The Indian healthcare network is divided into two major segments—public and private. The public healthcare system (government hospitals) provides treatment at the taxpayers’ expense. Most of the essential drugs are offered free of charge in these hospitals. However, the investments currently being made in India’s public healthcare are inadequate to meet the healthcare needs of the country.

8

According to WHO, the global share of government healthcare expenditure was nearly 61 percent of the total healthcare expenditure in 2009. This proportion was significantly higher than the Indian government's expenditure, which was 30 percent of the total healthcare spending in the country in 2009–2010.

To overcome this, many state governments are collaborating with the private sector through PPP models to improve the efficiency and decrease the inequity in the healthcare system.

8WHO statistics, 2012, and Frost & Sullivan

30,3

59,1

69,7

40,8

INDIA GLOBAL

TOTAL HEALTHCARE MARKET: HEALTH EXPENDITURE, COMPARISON OF HEALTH EXPENDITURE RATIO

General government expenditure on health as% of total expenditure on health

Private expenditure on health as % of totalexpenditure on health


Structure of the healthcare network - hospitals

DUBIOUS DISPENSARY?

Even though there has been a mushrooming of huge, well-equipped, multi-discipline hospitals in big cities serving the rich, thousands of rural India's poor patients have to go without even a semblance of medical care when they desperately need it. Take for instance the recent case with the Seven Hills Hospital, Mumbai. The Brihanmumbai Municipal Corporation (BMC) alleges it agreed to provide land for the 1,500-bed super-specialty hospital only after it committed to reserve 20 per cent beds in all wards for the patients recommended by the civic body. After three years of litigation the hospital has finally agreed to sign a Mou with the BMC but they continue to ill-treat poor patient according to a Bombay High Court warning issued towards Seven Hills Healthcare Pvt Ltd.9 Such is the case with several multispecialty hospitals in India.

http://archive.indianexpress.com/news/high-court-warns-seven-hills-hospital-of-action-if-poor-patients-ill-treated/898635/ http://www.mumbaimirror.com/mumbai/others/Seven-Hills-refuses-to-refit-mans-skull-bone-unless-family-pays-up/articleshow/34555367.cms

Tertiary care hospitals Secondary care hospitals Primary care hospitals/ Government community health centres/Private nursing homes

They comprise colleges, and single and multi-specialty facilities.

They mostly have 25–100 beds and some hospitals may have up to 100 – 200 beds.

They have up to 30-40 beds

They are mostly located in metros and tier-1 cities.

Such hospitals usually have OTs and ICUs

They may have ICUs and minor OTs

They offer super specialty services

Patients shift to Tier I cities for advanced treatment

Their primary role is to treat ailments that do not require surgical intervention or advanced care

They are located in Tier 2, Tier 1 and metros

They are mostly located in Tier 3and Tier 2 cities

They lack super specialty services and are general hospitals.

Services vary across cities

10 _____________________________________________________________________

TOP PRIVATE HOSPITAL GROUPS IN INDIA

The high level expert committee of the Planning Commission of India estimates that to increase the number of beds from the current level of about 9–10 to 20 per 10,000 people, about 1.5 million beds will have to be added in the next few years which will require a multi-billion dollar investment. Thus it creates an excellent opportunity for private participants in this sector. See below the top private hospital groups with the number of beds:

Hospital Established Number of Licensed Beds

Revenue 2014 (USD)

Fortis Healthcare 12000 (5500 operational beds)

15.39 billion

Apollo Hospitals

8420 (7762 operational beds)

691 million

Manipal Health Systems

5000 170 million

Global Hospital 2000 58 million

Care Hospital 1700 79 million

Max Healthcare 1900 78 million

MedantaMedicity 1250 130 million

Healthcare Global 1100 33 million

Columbia Asia 1280 22 million

Healthcare in India|April 2014 _________________________________________________________________________ 11

7. INDIA’S PRICING ADVANTAGE

Medical tourism is a global phenomenon and the number one growing niche segment of the tourism industry. The key reasons for the US, UK and other European countries patients to visit India are low cost procedures, absence of waiting lists, best quality treatment, clinical and Para-medical talent, and third party intervention through health insurance. Presented below is a comparison of indicative costs in India versus some other medical tourism destinations10

COMPARATIVE COSTS OF KEY PROCEDURES SOUGHT

Coronary artery bypass

surgery

Bypass surgery, heart

valve replacement

Hip replacement

Knee replacement

Face lift

France 33,100 33,137 15,000 17,000 12,300

India 7,000 9,500 1,200 4,300-7,200 3,100 – 4,800

Malaysia 12,000 13,400 7,500 12,000 6,400

Singapore 16,300 22,000 12,000 9,600 6,250 – 7,500

South Korea 31,750 42,000 10,600 11,800 6,650

Thailand 22,000 25,000 12,700 11,500 5,000

UAE 40,900 50,600 46,000 40,200

UK 43,00 90,000 13,000 52,000 13,000

USA 70,000 75,000 – 2,00,000

33,000 – 57,000

30,000 – 53,000

10,500 – 16,000

10 Indian Medical Travel Association &US News & World Report, dated May 12, 2008

12 _____________________________________________________________________

8. RISING FDI AND PRIVATE SECTOR INVESTMENTS

Due to the large demand-supply gap of hospital beds in the country, the private healthcare providers have made aggressive expansion plans with capital flowing in through FDI and private equity. Some of the major investments which happened are as follows:

Company invested in Investor

Center for Sight Matrix Partners (US)

Care Hospitals Advent International (US)

Diwanchand Medical Services Asian Healthcare Fund (India)

Fortis Healthcare GIC Special Investments (Singapore)

HealthCare Global Milestone Religare Investment Advisors (renamed Quadria Investment Advisors Pvt. Ltd), (India)

Max India Ltd GS Capital Partners LP (US)

Max Healthcare Life Healthcare (South Africa)

Metropolis Healthcare Warburg Pincus (US)

Manipal Hospital Kotak PE (India) & India Value Fund (India)

Narayana Hrudayalaya J P Morgan (US)

Nova Medical Center New Enterprise Associates & GTI (US)

Practo Technologies Sequoia Capital (US)

Sudhir Srivastava Robotic Surgery Centre Intel Capital (US)

Star Health and Allied Insurance Company ICICI Venture (India), Carlyle Growth Fund, Sequoia Capital (US)

Super Religare Laboratories Ltd Avigo PE Investments Ltd., (Mauritius) &NYLIM (India)


Vaatsalya Healthcare Aquarius India Fund (Singapore) and Seed fund (India)

Vasan Eye Care Sequoia Capital (US) and GIC (Singapore)

Wellspring Healthcare Catamaran, Reliance Venture Asset Management (India), Blue Cross Blue Shield Venture Partners (US)

Since India’s FDI policy is very liberal for the hospital sector, several foreign players have entered the market. Apart from the one detailed in the exibit above are ‘Pacific Healthcare’ of Singapore, which has a JV with ‘Vital Healthcare in Hyderabad’; ‘Steris’, a US-based medical equipment company that has set up a wholly-owned arm in India; and ‘Amcare Labs’, an affiliate of Johns Hopkins International of the US, which has set up a diagnostic laboratory in Hyderabad through a JV with the ‘Apollo Group’.

Foreign players have also evinced interest in establishing research and development (R&D) centres in India; for example, In May 2012, ‘Abbot Laboratories’ inaugurated its first nutrition research & development center in collaboration with ‘Syngene’, a contract research subsidiary of Biocon Ltd., to develop nutrition products in India; US pharma company ‘Merck’, which is known as MSD outside of the US and Canada, plans to set up a laboratory in New Delhi for developing vaccines at an estimated cost of USD 133 million.11

11www.investindia.gov.in www.thehindubusinessline.com/industry-and-economy/healthcare-tech-is-hot-for-venture-capitalists/article5602511.ece http://www.business-standard.com/article/companies/health-care-remains-hot-pe-option-fmcg-disappoints-114010801863_1.html

http://www.investindia.gov.in/

http://www.thehindubusinessline.com/industry-and-economy/healthcare-tech-is-hot-for-venture-capitalists/article5602511.ece

http://www.thehindubusinessline.com/industry-and-economy/healthcare-tech-is-hot-for-venture-capitalists/article5602511.ece

14 _____________________________________________________________________

9. SUB – SEGMENT: PHARMACEUTICAL / BIOTECH

Pharmaceuticals/biotech, life sciences research tools and In vitro diagnostics (IVD) segment generated revenue of $22.29 billion in 2012 and is forecast to reach $48.73 billion by 2017.12

Note: *1 $ = 60.9 INR.

10. KEY DRIVERS AND RESTRAINTS - PHARMACEUTICALS

Drivers

Strong low cost manufacturing sector

The Indian pharmaceuticals segment offers participants the advantages of low wages (20–30 percent lower compared to that in developed nations) and availability of inexpensive material such as bulk drugs and chemical intermediates (approximately 50 percent lower compared to that in developed nations). Thus overall drugs manufacturing in India is up to 50 percent more inexpensive than in the United States and European nations. As a result, majority of the growth in the Indian market has been driven by expansion in volumes and new product introductions as against prices increases.

Greater occurrence of chronic disease

With rapid economic growth and urbanization, lifestyle of a large section of the society has become unhealthy and sedentary over the last decade. Decreasing physical activity, increasing stress level and increasing intake of alcohol and tobacco are leading to greater prevalence of non-communicable disease (NCDs) such as cardiovascular (CVS), respiratory,

12 Source: Government of Pharmaceuticals and Frost & Sullivan

Note: All figures are rounded. The base year is 2011.

22,2925,24

28,6932,64

37,24

42,52

48,73

0

10

20

30

40

50

60

2011 2012 2013 2014 2015 2016 2017

Re

ven

ue

$ (

Bill

ion

)

Pharmaceuticals/Biotech, Life Sciences Research Tools, and IVD Segment: Revenue Forecast, 2011–2017


and central nervous system diseases. Thus there will be significant demand for cardiovascular and respiratory therapy drugs in the coming years. Companies should try to focus on this segment as it offers significant opportunities.

RESTRAINTS

Low research and development budget

Average R&D expenditure by an Indian pharmaceutical company is close to 6 percent of its sales. This is significantly lower compared to the R&D spend of an American or European company which is about two to three times greater. The major reason for such a vast difference is that success ratio in R&D is quite low, that is, even if a company is spending billions, there is no certainty on returns on investment (ROI). Indian pharmaceutical companies business is based on generic drug manufacturing which has not helped them to take the path of innovation. Rather than innovating, they prefer to replicate branded drugs when their patents expire. Besides the Indian red tapism and needless bureaucracy inhibits R&D growth.

Highly fragmented

The Indian pharmaceutical industry is highly fragmented. It has about 8,000 companies, out of which only about 250 are organised units. The fragmented nature of the segment ultimately reduces the growth of the industry in value terms.

Governmental regulatory concerns

There are three tiers of regulations - on bulk drugs, on formulations and on overall profitability. This has made the profitability of the sector susceptible to the whims and fancies of the pricing authority. Indian pharmaceutical companies are restricted by the price regulation for 74 drugs and the department of pharmaceuticals had proposed price control for all 348 essential medicines. This regulation has limited the pricing abilities of the companies, thus leading to lower profitability.

Skill shortage

India has a huge human resources base. The employees are English - speaking and have high managerial and technical competence. Companies can hire highly-skilled scientists, technicians and management personnel at comparatively lower pay packages. However most of the human resources are unskilled, not trained, underutilized, and not developed at all.

Recent mergers & acquisitions

The revenue (annual turnover) of the Indian pharmaceutical sub segment was $21.36 billion in 2012 and is forecast to reach $45.30 billion by 2017 witnessing a growth rate of 13 percent from 2011 to 2017.13 Domestic pharmaceuticals market accounted for 55 percent of the total

13Goverment of India,Department of Pharmaceuticals * Now purchased by Sun Pharmaceutical Industries Ltd (http://in.reuters.com/article/2014/04/07/daiichi-sankyo-ranbaxy-sunpharma-idINDEEA3600G20140407)

16 _____________________________________________________________________

production of the Indian pharmaceuticals segment in 2012 and it was valued at $11.68 billion that year.

Some of the challenges faced by MNCs include rising expenditure on R&D and patent expiries. To counter these challenges, Indian companies are leveraging the competencies of MNCs in drug development through strategic tie-ups.

India ranks third in terms of volume of production and fourteenth by value. One reason for lower share in terms of value is lower cost of drugs. Cost of drugs manufactured in India is 5 to 50 percent lower than that of drugs manufactured in developed nations. Moreover, the Indian pharmaceuticals/biotech, life sciences research tools, and IVD segment's growth has been fuelled by exports. Anti-infective and cardiovascular are the two largest therapeutic categories of the Indian pharmaceuticals segment and held 18 percent and 13 percent share, respectively, in 2012-2013. As India is the global capital of diabetes, anti-diabetics sub-segment is growing at a rapid rate and this is projected to be the third largest therapeutic segment in the coming years. Some of the leading participants in the Indian pharmaceuticals industry by sales are Ranbaxy, Dr Reddy’s, Lupin, Cipla, and so on.

Pharmaceuticals/Biotech, Life Sciences Research Tools, and IVD Segment has witnessed major mergers and acquisitions.

Indian Company Multinational company Type

Matrix Labs Mylan (US) Acquisition Ranbaxy Labs Daiichi Sankyo * (Japan) Acquisition Dabur Pharma Fresenius Kabi

(Germany) Acquisition

Shantha Biotech Sanofi Aventis (France) Acquisition Orchid Chemicals Hospira (US) Business

Buyout Piramal Healthcare Abbott (US) Business

Buyout Paras Pharma Reckitt Benkiser (UK) Acquisition Strides Acrolab Watson Pharma (US)

Now known as Actavis

Dental Holdings Corporation Ltd

Bupa Care Services Ltd (UK)

Orchid Chemical & Pharmaceuticals

Hospira (US)

AgilaSpecialities Pvt Ltd Mylan, Inc Business Buyout


11. SUB – SEGMENT: IN VITRO DIAGNOSTICS / BIOSIMILARS

The In Vitro Diagnostic sub segment was valued at $400million in 2012 and is forecast to reach $1.13 billion by 2017 witnessing a CAGR of 19 percent from 2011–201714.

Immunology and biochemistry forms the major portion of IVD market. The major participants in IVD market are Roche, Abbott, J&J and Siemens. Prominent domestic companies in this market include Transasia, Span Diagnostics and Tulip. Some of the key trends witnessed in this market include shift towards completely automated solutions and rapid growth of the molecular diagnostics segment. In fact international players form 55% of the total IVD market in India.

Biosimilars sub segment in India was valued at $533 million in 2012 and it is forecast to reach $2.3 billion witnessing a growth rate of 28 percent from 2011 to 2017. The products in the market mainly include insulin and erythropoietin (disease of the bone marrow or kidneys).

There are about 25 biosimilars companies in India with Biocon and Dr. Reddy’s being the leading ones. Other participants such as Ranbaxy, Shantha Biotechnics, Cipla, Wockhardt and Intas are trying to increase their market shares and are making large investments either by setting up their own biosimilars research firms or forming joint ventures with foreign multinationals.

Insulin is the largest segment of the Indian Biosimilars market mainly due to the extremely high incidence of diabetes in the country. Erythropoietin is the second-largest segment and has over four brands by Biocon (Erypro), Dr. Reddy’s (Cresp), Wockhardt (Wepox), Intas (Epofit), and Reliance Life Sciences (Relipoeitin).

Lack of stringent regulatory and approval pathways, generic manufacturing prowess and lower cost of clinical trials are some of the factors favouring the Indian biosimilars market whereas affordability, low acceptance of domestically manufactured biosimilars in regulated markets for exports and non-government organisations in the US lobbying against biosimilars are few challenged faced here.

12. SUB – SEGMENT: MEDICAL DEVICES & EQUIPMENT

India is one of the fastest-growing markets for medical devices and equipment. It generated a revenue of $4.10 billion in 2012 and is forecast to reach $9.48 billion in 2017 witnessing a growth rate of 15 percent from 2011–2017.15

14 Frost & Sullivan – Healthcare landscape outlook & growth opportunities in India, 2013 15 Frost & Sullivan – Healthcare landscape outlook & growth opportunities in India The Economic Times, 9 Feb, 2014 - http://economictimes.indiatimes.com/articleshow/30096275.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst

18 _____________________________________________________________________

Three major changes expected to take place in the next few years in the medical devices and equipment market are introduction of new products and services, business expansion in tier 2 and tier 3 cities, and improvement in operational efficiency.

Multinational companies in this segment are using India as a manufacturing base these days, for example, as done by 3M in Pune.

Medical imaging and consumables and all other devices and equipment segments constitute a major portion of the medical devices and equipment market.

Setting up a medical devices manufacturing plant requires huge investment. Even though the market is currently in growth stage, the overall market is small due to low penetration and patients’ inability to afford expensive devices. As a result, volumes are low and do not provide manufacturers economies of scale. The high capital requirements along with a lack of a distinct status for the industry are key restraints.

The medical devices market is the most unregulated market in the country vis-à-vis the healthcare sector. There are no prescribed 'gold standards' for manufacturing in India, no data on Indian studies for 'safety standards', no studies showing efficacy and even indications of use in India, no MRP is ever fixed and even the variations in cost prices is very wide. This scenario is made worse by unscrupulous vendors and manufacturers offering incentives to doctors for use of their products.

Regulations affect not only product marketing but also issues such as import and export of devices. As mentioned earlier, over 75 percent of medical devices sold in India are imported, primarily because taxation is skewed to favor imports. Currently, import duty on medical devices averages about 10 percent, which is usually passed onto consumers. As the product is imported on a SICOI (sale in the course of import) basis, value added tax (VAT) is not applicable. However, if parts and equipment were imported for the manufacture of medical devices domestically, a similar import duty would apply, plus excise and VAT. This means taxation on domestically-produced products is much higher than the 10 percent duty paid on finished, imported medical goods. The Association of Indian Medical Device Industry (AIMED) has been petitioning the government to change the tax structure. They are also lobbying for changes to the taxation structure of medical devices with an eye to making it uniform across different states.


13. KEY GROWTH OPPORTUNITIES FOR FLEMISH COMPANIES

PHARMACEUTICALS

•Despite widespread poverty and inadequate public healthcare provision, India has much tooffer to the Belgian drug makers. An increase in lifestyle diseases resulting from adoption ofunhealthy western diets, combines with a growing middle class that has more disposableincome to spend on treatment, will provide new opportunities for Belgian pharmaceuticalfirms.

•India’s regulatory framework permits advertising for OTC products, and consumers can buythem without a doctor’s prescription.Some global pharma companies are already launchingOTC products in India or buying OTC products. Novartis India, Belgian Omega Pharma signed ajv with Modi - mundipharma to market their OTC products in India, Pfizer etc

MEDICAL DEVICES

•The production of low value medical supplies and disposables is dominated by domesticmanufacturers whereas the high end medical equipment is generally imported. The Belgiandiagnostic imaging and healthcare IT solutions company, Agfa Heathcare has enhacedproductivity and workflow at several hospitals like Hinduja, Mumbai and SCTIMST Trivandrumamongst others. Vermeiren India Rehab Pvt. Ltd; sales subsidiary of Flemish companyVermeiren, supplies and manufactures high-quality wheelchairs and orthopaedic beds.

TELEMEDICINE & ICT

•Telemedicine is a technology, which if used effectively can double the productivity of healthworkers. It not only allows the underserved population to access quality healthcare but at thesame time improves the productivity of medical personnel too. A number of corporate andtrust hospitals such as Apollo Hospitals, Fortis Hospitals, Narayana Hrudayalaya, Tata MemorialHospital, and Shankara Nethralaya have introduced telemedicine initiatives.

•In India enabling technology such as home telemetry systems and remote monitoringtechnologies have spurred demand. 2013 saw deals worth USD 12 million in healthcare IT.Virinchi Technologies, a Secunderabad-based financial IT products, solutions and servicescompany, acquired a majority stake in Asclepius Consulting & Technologies, a softwaresolutions provider for mid-size hospitals and nursing homes in India

•Belgium based bio-pharmaceutical company UCB launched the telemedicine project calledHope -on-wheels reaching out to over 50,000 patients and healthcare providers in Rajasthanthrough a Mobile Health Clinic

HEALTH INSURANCE

•Health insurance has been the fastest growing segment in the non-life insurance industry inIndia over the last few years. Reasons behind this growth are increasing awareness abouthealth insurance, rising healthcare costs and government schemes.

•Currently, insurance pays nearly 10 percent of all hospitalization expenditures in the country.The increasing penetration of health insurance is boosting revenues at private hospitals. Healthinsurance accounts for 25 - 30 percent of total revenue for corporate hospitals in tier 1 cities.Increasing awareness about insurance and extended coverage to include dental care, out -patient surgery, Laser-Assisted In Situ Keratomileusis (LASIK) surgery, and so on, will result ininsurance accounting for nearly 40 percent of corporate hospital revenue by 2015.

•The Belgian multinational insurance company Ageas N.V. holds 26% stake in IDBI Federal LifeInsurance Co.

20 _____________________________________________________________________

14. GOVERNMENT INITIATIVES AND HEALTHCARE POLICIES

Encouraging public -private Partnership (PPP Model)

• Government is encouraging the PPP model to improve availability of healthcareservices and provide healthcare financing

• GE Healthcare partnering with public hospitals to open diagnostic centers in such hospitals

• Subsidies being provided to private practioners for institutionalizing deliveries in Gujarat.

Encouraging investment in rural areas

• Five year tax holiday has been announced for setting up hospitals anywhere in India,specially in tier-2 and tier-3 towns in order to serve the rural interland. Certainspecified urban agglomerations will not be covered.

• This is going to increase investment in rural areas where majority of the Indianpopulation resides.

• Customs duty on life-saving equipment has been reduced to 5 per cent from 25 percent and exempted from countervailing duty. Import duty on medical equipment hasbeen reduced to 7.5 per cent

Union Budget Financial Year 2014

• Ministry of Health and Family Welfare allocated USD6.9 billion, an increase of 21 percent from FY13

• Creation of new National Health Mission (NHM) for providing effective healthcare toboth urban and rural population, with emphasis on states with weak healthinfrastructure and indicators.NHM extended to encompass Ayurveda, Unani, Siddhaand Homeopathy to strengthen traditional medical forms.

• Scope of Rashtriya Swasthya Bima Yojana (RSBY) enhanced to include rickshaw pullers,taxi drivers, sanitation workers, rag pickers and mine workers.

• Fund allocation to provide accessible and affordable services to elderly under NationalProgramme for the Health Care of Elderly.

• Allocation of USD 875 million for improving medical education, training and research.


15. HEALTHCARE REGULATORY AUTHORITIES IN INDIA

DEPARTMENT OF HEALTH Website: www.mohfw.nic.in Details: The Department of Health deals with health care, including awareness campaigns, immunization campaigns, preventive medicine, and public health. DEPARTMENT OF FAMILY WELFARE Website: www.mohfw.nic.in Details: The Department of Family Welfare (FW) is responsible for aspects relating to family welfare, especially in reproductive health, maternal health, pediatrics, information, education and communications; cooperation with NGOs and international aid groups; and rural health services DEPARTMENT OF AYUSH Website: www.indianmedicine.nic.in Details: It aims to provide focused attention to development of Education & Research in Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy systems. The Department continues to lay emphasis on up gradation of AYUSH educational standards, quality control and standardization of drugs, improving the availability of medicinal plant material, research and development and awareness generation about the efficacy of the systems domestically and internationally. DEPARTMENT OF HEALTH RESEARCH Website: www.dhr.gov.in Details: Department of Health Research (DHR) aims at bringing modern health technology to people. It is by encouraging innovations related to diagnostics, treatment methods as well as prevention- vaccines; translating the innovations into products/ processes by facilitating evaluation/ testing in synergy with other departments of MOH&FW. CDSCO (CENTRAL DRUGS STANDARD CONTROL ORGANIZATION) Website: www.cdsco.nic.in Details: Functions under the aegis of the Ministry of Health and Family Welfare, Government of India and provides general information about drug regulatory requirements in India. INDIAN MEDICAL ASSOCIATION Website: www.ima-india.org Details: National voluntary organisation of medical practitioners NIPPA (NATIONAL PHARMACEUTICAL PRICING AUTHORITY) Website: www.nppaindia.nic.in Details: Keeps a check on the drug prices. D&C ACT, 1940 (DRUG AND COSMETIC ACT) Details: Regulates the import, manufacture, distribution, and sale of drugs.

22 _____________________________________________________________________

THE PHARMACY ACT, 1948 Details: Regulates the profession of pharmacy in India. THE DRUGS AND MAGIC REMEDIES (OBJECTIONABLE ADVERTISEMENTS) ACT, 1954 Details: Controls the advertisements regarding drugs; it prohibits the advertising of remedies alleged to possess magic qualities. THE NARCOTIC DRUGS AND PSYCHOTROPIC SUBSTANCES ACT, 1954 Details: Controls and regulates operations relating to narcotic drugs and psychotropic substances. NABH (NATIONAL ACCREDITATION BOARD FOR HOSPITALS AND HEALTHCARE PROVIDERS) Website: www.nabh.co Details: A constituent board of Quality Council of India, set up to establish and operate accreditation programmes for healthcare organisations. It is structured to cater to the needs of the consumers and set benchmarks for progress of health industry. BIO MEDICAL WASTE RULES,1988 Details: Regulates the mode of treatment and disposal of biomedical waste. CLINICAL ESTABLISHMENT BILL, 2010 Details: Makes it mandatory for all clinical establishments to register under it. It may lead to closure of nursing homes and hospitals which do not meet specific requirements. INDIA MEDICAL TOURISM ASSOCIATION Details: Consists of Indian hospitals, healthcare providers (both modern medicine and traditional Indian medicine), travel and medical tourism industry providers who have come together and aim to make India the leading global healthcare destination


16. CONTACTS IN THE HEALTHCARE SECTOR

See below contacts of importers/distributors of medical equipment and devices ACCUREX BIOMEDICAL PVT. LTD. Address: 212, Udyog Mandir No. 1, 7/C, Bhagoji Keer Marg, Mahim, Mumbai -

400 016 Telephone: + 91 22 67446744 Fax: +91 22 67446755 Email: [email protected] Website: www.accurex.org Contact Person: Mr. Ambili Nair Designation: Procurement Manager Details: Distributing as well as manufacturing a wide array of products ranging

from Clinical Chemistry reagents, Serology test kits, Urinalysis analyzer and strips, blood glucometer, Semi & Fully Automated Clinical Chemistry Analyzers, Electrolyte Analyzers and Hematology analyzer.

ELITE LIFECARE Address: UL shop No. 101, Aashray Tower, opp. dew priya bangalo part -II, Nr.

Anand Nagar Cross Roads, satellite, Ahmedabad - 380015, Gujarat Telephone: +91 79 26937137 Mobile: +91 9824051336 Email: [email protected] Website: www.elitelifecare.com Contact Person: Mr. Nainesh Desai

Designation: Director Details: Exporters and importers of well known and international brands of

surgical (both General and Open heart), medical products of use in ICCU, sutures, hospital furniture and linen.

JANAK HEALTHCARE PVT. LTD Address: Janak House, Opp. Indian Oil Corporation Depot, Sheikh Misry Road,

Wadala (East), Mumbai-400037 Telephone: +91 22 24150408 / 2413 0407 Fax: 91 22 24139870 Email: [email protected] Website: www.janakhealthcare.com Contact Person: Mr. Atman Mehta Designation: Vice President Details: Imports Division: Operating tables (Mediland), surgical lights - LED

(Mediland), examination furniture (Midmark), examination couches, transfer systems, and sterilizers Medical Equipment Division: Innova EX6000, fully motorized beds, deluxe beds, comfort beds, operation tables, arrive LDRP beds, monitor trolleys, emergency trolleys

24 _____________________________________________________________________

KIRAN MEDICAL SYSTEMS LTD. Address: 303-A, Kiran Chambers; Linking Road Khar, Mumbai 400052

Telephone: +91 22 26007090 Fax: +91 22 26007093 Email: [email protected] Website: www.kiranxray.com Contact Person: Mr. Shivram Iyer Designation: COO Details: Company produces imaging accessories and radiation protection

products MAX MEDITECH PVT. LTD Address: 205, Opal Square, Behind Hotel Express, Alkapuri, Baroda - 390005

Telephone: +91 265 2310289 Fax: +91 265 2355191 Email: [email protected] Website: www.max-ventilator.com Contact Person: Mr. Rashesh Sanghvi Designation: CEO Details: Max Meditech is a medical equipment manufacturer. product segments

include Anesthesia, Critical Care, and Ambulance. It manufactures and markets ventilators suitable for anesthesia and critical care; and ambulances in India and overseas

NOX INDIA CORPORATION Address: B-9, Jay Appartment,Opp. Azad soc., Ambawadi, Ahmedabad - 380015

Telephone: +91 79 65231005 Fax: +91 79 25623302 Email: [email protected] Website: www.noxindia.com Contact Person: Mr. Nayan Brahmbhatt

Designation: Director Details: Manufacturers of medical ophthalmic surgical instruments,medical

supplies,cutting tools and other medical supplies

NASAN MEDICAL ELECTRONICS PVT. LTD.

Address: ''Rangali'', 1st Floor, Opp. Karve Statue, Kothrud, Pune - 411 038.

Telephone: + 91 22 67446744

Fax: +91 22 67446755

Email: [email protected]

Website: www.nasanmedical.com

Contact Person: Mr. Y.B Samant

Designation: CEO


Details: Nasan Medical's product range includes Cardiology, Critical care, Anesthesia and Neurology based devices.

NIDHI SURGICALS PVT. LTD. Address: 2/19, Bhuta Niwas, Dr. Ambedkar Road, Matunga, Mumbai 400019

Telephone: +91 22 24104271/24103613 Email: [email protected] Website: www.nidhisurgicals.com Contact Person: Mr. Manish Shanghavi Designation: CEO Details: Importers, exporters & suppliers of various medical disposables and

surgical products , authorised dealers of Kyoling K&L South Asia TRANSASIA BIO-MEDICALS PRIVATE LIMITED Address: Transasia House, 8 Chandivali Studio Road, Andheri (E), Mumbai - 400

072 Telephone: +91 22 40309000, Fax: +91 22 28573030 Email: [email protected] Website: www.transasia.co.in Contact Person: Mr. Suresh Vazirani Designation: CMD Details: Alliances include Sysmex Corporation, Japan, Medica - Usa, Diesse -

Italy, Wako - Japan, Vircell - Spain, Immco Diagnostics - USA, Gen - Probe - Usa

VINOD MEDICAL SYSTEMS PVT. LTD. Address: B/523, Chintamani Plaza, Mohan Studio Compound, Chakala, Andheri

Kurla Road, Andheri (E), Mumbai - 400099 Telephone: +91 22 42152020 /21 Fax: +91 22 42152024 Email: [email protected]/ [email protected] Website: www.vinodmedical.com Contact Person: Mr. Vinod Jaisinghani

Designation: Director Details: Manufacturer of medical products healthcare imaging, accessories and

equipments and photographic products.

26 _____________________________________________________________________

TOP HOSPITALS APOLLO HOSPITALS ENTERPRISE LTD Email: [email protected] Website: www.apollohospitals.com Contact Person: Dr. Preetha Reddy

Designation: MD Details: Apollo hospitals have emerged as the single largest private hospital group

in South Asia. It operates hospitals, dispensaries, clinics and laboratories. It manages a network of approximately 41 specialty hospitals and clinics with a bed capacity of over 9,000 across the country and abroad. It has tied up with insurers like BUPA (UK), Vanbreda (Belgium) and Mondial (France). It has a joint venture with Singapore based Parkway Group Healthcare PTE Ltd.

ASIAN HEART INSTITUTE Address: Bandra Kurla Complex, Bandra East, Mumbai 400051

Telephone: +91 22 66986666 Email: [email protected]; [email protected] Website: www.asianheartinstitute.org Contact Person: Ms Zainab Hafiz

Designation: International Business Contact Person: Ms. Shradha Vermani Designation: PR Officer Details: Manufacturer of medical products healthcare imaging, accessories and

equipments and photographic products.

BREACH CANDY HOSPITAL Address: 60 A, Bhulabhai Desai Road, Mumbai - 400026

Telephone: +91 22 23671888 / 23672888 Ext. 987/ 670 Email: [email protected] Website: www.breachcandyhospital.org

Details: Situated on the coastline of South Mumbai, Many procedures in routine use including Coronary Angioplasty, Magnetic Resonance Imaging, Critical Care ICU and Hysteroscopy were first performed here The hospital has a dedicated Charity Wing where eligible patients are treated at nominal charge or free of cost.


DR.L.H. HIRANANDANI HOSPITAL Address: Hill Side Avenue, Hiranandani Gardens Powai, Mumbai 400076

Telephone: +91 22 25763300 / 33 / 25763321 Mobile +91 9820138100 Email: [email protected],

[email protected] Website: www.hindujahospital.com

Contact Person: Mr. Arun Shetty

Designation: Medical Director Contact Person: Helen Murgeshan Designation: Assistant to medical director Details: This 240-bed facility includes Advanced Cancer Care, Centre for Advanced

Dental Surgery, physical Rehabilitation and Sports Medicine Centre, Ophthalmology Centre

DR. BALABHAI NANAVATI HOSPITAL Address: S. V. Road, Vile Parle West, Mumbai 400056

Telephone: +91 22 26183170 Email: [email protected], [email protected] Website: www.nanavatihospital.org

Contact Person: Mr. Rajendra Vartak

Designation VP - HR & Admin

Contact Person: Dr Ashok Hatolkar

Designation Medical Superintendent & Chief Operating Officer

Details: Multi-specialty state – of - the art medical facility housing the latest equipments and backed by renowned international acclaimed doctors, nurses and other paramedics. The hospital also includes an Alternative medicine department that started 25years ago. It has successfully treated a wide range of diseases including rheumatology, arthritis, colitis, gastritis, piles, asthma, allergies, skin disorders, migraine and the disorder of the GI. tract

HOLY FAMILY HOSPITAL & MEDICAL RESEARCH CENTRE Address: St. Andrew's Road, Bandra (West); Bandra (West), Mumbai 400050

Telephone: +91 22 30610555 Email: [email protected] Website: www.holyfamilyhospital.in

Contact Person: Sr Aquinas Designation: Executive Director Details: 232-bed public charitable, trust-run hospital. The hospital also runs

institutions, divisions and courses that include a post-graduate degree course for DNB resident medical officers, Continuing Medical Education programme for doctors, Nursing Institute, School of Medical Technology and Patient Education Programme.

28 _____________________________________________________________________

JASLOK HOSPITAL & RESEARCH CENTRE Address: 15 , Dr. Deshmukh Marg, Pedder Road, Mumbai 400026

Telephone: +91 22 66573333 / 66573240/ 66573436 Email: [email protected] Website: www.jaslokhospital.net

Contact Person: Dr. Tarang Gianchandani Designation: CEO, Director Medical Services Details: Jaslok hospital is a private, full-fledged multi-specialty hospital with 364

beds of which 75 are ICU beds. Specialties include Stereotactic and functional neurosurgery for movement disorders like Parkinson's disease, dystonia and tremors.

KOKILABEN DHIRUBHAI AMBANI HOSPITAL & MEDICAL RESEARCH INSTITUTE Address: Rao Saheb Achutrao Patwardhan Marg, Four Bunglows, Andheri (W),

Mumbai 400053 Telephone: +91 22 30999999 Mobile +91 9323364719 Email: [email protected] Website: www.kokilabenhospital.com

Contact Person: Ms Sejal Mody

Designation: Corporate Communications Details: Currently at 750-bed hospital has over 103 full-time doctors, 520 nurses

and about 200 paramedics.

LILAVATI HOSPITAL AND RESEARCH CENTRE Address: A - 791, Bandra Reclamation, ; Bandra (W), Mumbai 400050

Telephone: +91 22 26455888/ 26455891/ 26552222 Mobile +91 9833449080 Email: [email protected] Website: www.lilavatihospital.com

Contact Person: Mr. Nikki Mehta Designation: CEO Details: It is a private hospital located at Bandra in Mumbai, India, established by

the Lilavati Kirtilal Mehta Medical Trust. The hospital has engaged in charitable endeavours across India; Mr. Nikki Mehta is a Belgian national. It boasts of 314 beds with one of the largest Intensive Care Units (ICUs), most advanced 12 Operation Theaters, more than 300 consultants and manpower of nearly 1,800. The hospital attends to around 300 In-patients and 1,500 Out-patients daily.

P D HINDUJA HOSPITAL & MEDICAL RESEARCH CENTRE Address: Veer Savarkar Marg, Mahim, Mumbai 400016

Telephone: +91 22 24452222 / 24449199 /24451515 / 24447000 Mobile +91 9820138100 Email: [email protected]


Website: www.hindujahospital.com

Contact Person: Ms. Priya Bhandari/ Mr. Joy Chakraborty

Designation: Director Administration Details: Hinduja Hospital is a leading health care hospital in India with medical

research center and multi specialty care

SEVENHILLS HOSPITAL Address: SevenHills Health City, Marol Maroshi Road, Andheri East, Mumbai –

400059 Telephone: +91 22 67676767 Email: [email protected] Website: www.sevenhillshospital.com

Details: Built on a sprawling area of 17 acres with up to 2 million sq. ft. of built up area, 120 OPD chambers on one level ensures convenience to the patients. The hospital has an inpatient bed capacity of 1500 and 24 Dialysis units, 36 Operation Theatres & 4 Cath Labs.

WOCKHARDT LIMITED Address: Wockhardt Towers, Bandra Kurla Complex, Bandra East, Mumbai 400051

Telephone: +91 22 26596510/26534444 Email: [email protected] Website: www.wockhardt.com

Contact Person: Mr. H. F. Khorakiwala Designation: Chairman Details: This is among India's leading pharmaceutical and healthcare companies.

Since inception in 1989, the Wockhardt Hospital & Heart Institute has become a renowned tertiary level heart centre providing cardiac care to patients of all age groups. It is the first recognized hospitals in South Asia on the worldwide panel of Blue Cross blue Shield, the largest provider of health insurance in USA. It has approximately 10 hospitals with 1500 beds. It has entered into public private partnership with the Government of Gujarat to manage the 275 - bed Palanpur Civil General Hospital in Gujarat.

30 _____________________________________________________________________

17. OVERVIEW OF BELGIAN COMPANIES IN INDIA

AGFA HEALTHCARE Website www.agfa.com

Details: Agfa HealthCare, a member of the Agfa-Gevaert Group, is a leading global provider of diagnostic imaging and healthcare IT solutions. In India they provide Imaging products and services for health care industry with a sales office in Mumbai and a regional office in Delhi.

AGEAS N.V. Website www.ageas.com

Details: Belgium's largest multinational insurance company Ageas N.V. holds 26% stake in IDBI Federal Life Insurance Co. The company offers its services through a vast nationwide network 2,308 partner bank branches of IDBI Bank and Federal Bank in addition to a sizeable network of advisors and partners

BARCO ELECTRONIC SYSTEMS PVT. LTD Website ww.barco.com

Details: Barco, a global technology company, designs and develops visualization solutions for a variety of selected professional markets. In healthcare, they provide medical imaging and solutions for displays in radiology, mammography, surgery, dentistry, pathology and modality imaging, along with clinical displays for healthcare specialists, digital OR systems, and point-of-care devices.

BESINS HEALTHCARE INDIA PVT LTD Website www.besins-healthcare.com

Details: Subsidiary of Besins Healthcare S.A., Brussels, Belgium. They are renowned in the area of hormonal therapies besides innovative drugs for the treatment of gynecological, fertility and obstetrical conditions as well as androgen deficiency.

JANSSEN PHARMACEUTICAL NV Website www.janssen.com

Details: Janssen Pharmaceutical, Belgium is part of the Janssen Pharmaceutical Companies of Johnson & Johnson. Also Jubilant Biosys, subsidiary of Jubilant Life Sciences has a drug discovery alliance with Janssen. Jubilant will carry out research services and will deliver preclinical candidates to Janssen for potential development and commercialization. They also operate a research and development center in Mumbai.

IBA MOLECULAR IMAGING (INDIA) PVT LTD Website www.iba-asiapacific.com

Details: IBA develops medical equipment, radiopharmaceuticals and software solutions for cancer diagnosis and therapy. They have a presence in India in Noida.


IMEC INDIA Website www.imec-in.in

Details: Imec is a leading independent applied research organization. Imec leverages its scientific knowledge with the innovative power of its global partnerships in ICT, healthcare and energy. In India, Imec and Wipro have created a joint initiative to co-innovate in intelligent IT solutions.

MODI OMEGA PHARMA (INDIA) Website www.omega-pharma.be/ www.umeshmodigroup.com

Details: Modi Omega pharma is a 50:50 joint venture between Modi-Mundipharma and Omega Pharma Holding, a leading Belgium pharma OTC company with operations in almost 40 countries. Through this alliance they have bought several OTC products in India.

VERMEIREN INDIA REHAB PVT. LTD Website www.vermeiren.in

Details: Vermeiren India Rehab Pvt. Ltd; sales subsidiary of Flemish company Vermeiren, supplies and manufactures high-quality wheelchairs and orthopedic beds

UCB INDIA Website www.ucb.co.in

Details: UCB INDIA is a subsidiary of the Belgian research-based company UCB. It employs over 450 employees operating across the country with offices in Mumbai - Headquarter and Bengaluru. UCB provides solutions for patients treated by neurologist, ENTs, Dermatologist, Pediatricians, General Physicians, particularly in the fields of central nervous system disorders (including epilepsy) and immunology disorders (including allergy)

32 _____________________________________________________________________

18. GLOSSARY

Maternal Mortality Rate: Number of maternal deaths per 1, 00,000 live births during a specified time period, which is usually one year.

Maternal Death: It is the death of a woman during pregnancy or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.

Life Expectancy at Birth: It is the average number of years that a new-born is expected to live if current mortality rates continue to apply.

Infant Mortality Rate: It is the probability of a child born in a specific year or period dying before reaching the age of one, if subject to age specific mortality rates of that period.

Total Expenditure on Health: It is the sum of general government health expenditure and private health expenditure in a given year, calculated in national currency units in current prices.

Gross Domestic Product: It is the value of all goods and services provided in a country by residents and non-residents. This corresponds to the total sum of expenditure (consumption and investments) of private and government agents of the economy during the reference year.

Gross Domestic Product Growth: It refers to the annual percentage growth rate of GDP at market price based on constant local currency.

Public Private Partnership: These are collaborative efforts between private and public sectors with clearly identified partnership structures, shared objectives, and specified performance indicators for delivery of a set of health services.

General Government Expenditure on Health (GGHE): It includes consolidated direct outlays and indirect outlays, including capital of all levels of government. It includes healthcare investment by social security institutions and autonomous bodies, as well as other extra-budgetary funds.

Private Health Expenditure (PvtHE): This is the sum of expenditures on health by prepaid plans and risk-pooling arrangements, firms' expenditure on health, non-profit institutions serving mainly households, and household out-of-pocket spending.

IVD – In Vitro Diagnostics: In vitro diagnostic products are those reagents, instruments, and systems intended for use in diagnosis of disease or other conditions, including a determination of the state of health, in order to cure, mitigate, treat, or prevent disease or its squeal. Such products are intended for use in the collection, preparation, and examination of specimens taken from the human


body.

WHO: World Health Statistics.

National Rural Health Mission ( NHM) – Ministry of Health & Family Welfare, Government of India.

19. USEFUL LINKS FOR FURTHER READING

www.articles.economictimes.indiatimes.com/2013-12-

02/news/44657410_1_healthcare-sector-healthcare-delivery-fortis

www.forbes.com/sites/forbesasia/2014/01/08/the-reddy-sisters-have-indias-apollo-hospitals-covered-four-ways

www.livemint.com/Companies/XKAuyZKn6BmbV1BeSDsgaL/Manipal-Health-Enterprises-aims-to-double-sales-in-3-years.html

www.business-standard.com/article/companies/medical-tourism-set-to-be-in-the-pink-of-health-113082100489_1.html

http://www.pharmabiz.com/NewsDetails.aspx?aid=79020&sid=1

http://articles.economictimes.indiatimes.com/2013-08-15/news/41413559_1_apollo-hospitals-prathap-c-reddy-overseas-patients

www.whoindia.org

www.dipp.nic.in

www.mohfw.nic.in

www.dipp.nic.in

www.rbi.org.in

www.fipbindia.com

www.mca.gov.in

www.finmin.nic.in

www.sebi.gov.in

www.moia.gov.in

34 _____________________________________________________________________

TOM VERMEULEN Trade and Investment Commissioner

RANJAN APTE Invest Deputy

SHERLYNN D’COSTA Trade Assistant

SOMA SENGUPTA Trade Assistant

Flanders Investment and Trade

Consulate General of Belgium 7 ׀th Floor TCG Financial Centre

C-53 "G" Block Bandra - Kurla Complex,

Bandra (E), ׀ Mumbai - 400 051

E-mail: [email protected]

Website: www.flandersinvestmentandtrade.com

LAERS INVESTNT & AD ZOCHT HET VOOR U UIT€¦ · The Indian healthcare market *1 $ = 60.9 INR 4 The...

Documents

Transcript of LAERS INVESTNT & AD ZOCHT HET VOOR U UIT€¦ · The Indian healthcare market *1 $ = 60.9 INR 4 The...