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Meditech – A User Perspective & Requirements
Hospitals: Proxy for India’s healthcare boom
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The Healthcare Delivery Market in India pegged at around US$ 38 billion in 2008, compared to US$ 7.7 billion Pharmaceuticals Industry and offers a huge growth opportunity
India has 17% of the world's population, but one of the poorest healthcare infrastructures among growing economies and the lowest spend on healthcare (~5% of GDP)
Demographic changes, improving income levels, changing lifestyles, and rising insurance penetration etc will result in a rise in discretionary spending on healthcare
38.076.4
153.7
309.2
-
50.0
100.0
150.0
200.0
250.0
300.0
350.0
2007-08 2012-13 2017-18 2022-23
Indian Healthcare MarketIn US$ billion
15%
Accessible, reliable and affordable healthcare continues to be a challenge
Opportunity in healthcare being significantly leveraged by private healthcare providers
Expected to generate employment opportunities for 9 million people by 2012
India
466516
578653
740
833
0
100
200
300
400
500
600
700
800
900
2003-04 2004-05 2005-06 2006-07 2007-08 2008-09
Evolution of Healthcare in India
3
>200 beds, 1% 100-200 beds, 5%30-100 beds, 10%
<30 beds, 84%
No. of hospitals = 50,000
Source: FICCI and Ernst & Young (2008)
0.860.6
0.9
2.2
1.41
2.6
1.2
3.8
Hospital beds Doctors Nurses
India China Brazil
Source: FICCI and Ernst & Young (2008).
Distribution of Private Healthcare ProvidersHealthcare parameters per ‘000 population
India: Per Capita Income over the last few years (USD) Percentage share of India in world health parameters
Per capita health
expenditure – $33 compared to $ 2,548 in
US
US has 3.2 beds per 1,000 population and
spends ~ US$ 2 trillion on healthcare
Source: FICCI and Ernst & Young (2008)
20%
6%8% 8%
9%
1%
Diseaseburden
Beds Doctors Nurses Community &health
w orkers
Labtechnicians
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Overview Cost of Important Procedures (US $)
• Medical value travel is one of the most lucrative
segments of the healthcare sector and is expected
to grow into a US$ 1.5 billion industry by 2010
• Potential to contribute US$ 1.2 – 2.4 billion
additional revenue for up-market tertiary care
hospitals by 2012, and will account for 3 – 5% of
total healthcare market
Key drivers for the growth
• Quality Healthcare at fraction of the cost
• Availability of Skilled Doctors & Hospitals
• Good reputation of Indian Doctors
• Upsurge of Lifestyle diseases
Issues
• Inadequate healthcare Infrastructure
• Unstructured medico legal jurisdiction
• Indians hospitals’ standards below par against the
Global benchmarks of care
• Lack of Accredited Hospitals and follow up care
US UK Thailand Singapore India
100,000
1,60,000
250,000
300,000
48,000
38,000
41,726
30,000
292,470
200,000
50,109
18,000
14,250
10,500
62,500
75,000
8,000
10,000
15,312
13,000
150,000
140,000
25,000
12,000
4,800
4,800
30,000
69,000
5,000
5,200
Heart Surgery
Heart Valve Replacement
Bone Marrow Transplant
Liver Transplant
Knee Replacement
Hip Replacement
India: Potential to become the Global Healthcare destination
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Growing share of urban middle class households Health insurance market size (USDm)
• One of the fastest growing free economy
• Ranked 4th largest economy in the world in terms
of purchasing power parity
• Higher service mix, increasing urbanization
• Overall penetration at 2%.
• Growth driven by: a) increasing awareness, b) soaring
healthcare costs and c) demographic profile of the
people
Health Insurance
52.5%42.3%
34.5%
44.2%52.5%
58.6%
3.3% 5.2% 7.0%
0%
20%
40%
60%
80%
100%
2001-02 2006-07E 2010-11E
<2,100 2,100-12,800 >12,800 Health Insurance market in India is expected to grow at a CAGR of 32% to reach a market size of Rs. 27,930 crore by FY15
494713
1,1271,472
6,207
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
2006 2007 2008 2009 2015E
CAGR: 32%
Source: CRISIL Research
Applications range from the simple cleaning wipes to the advanced barrier fabrics used for operating rooms
New cost-effective ways to protect both hospital staff and their patients from bacteria; viruses & body fluid invasions in Operating room environments are being developed
Pre-operative & Post operative (High compression stocking, casting/splints, wound dressing)
Surgical & Operative (sutures, implants, grafts, patches, mesh, wound dressing)
Applications of Medical Textiles
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September 2010
Product
Commodity
Concept
Critical path
ImplantCritical Consumable Critical disposable
Non Critical disposableNon-critical consumableHygiene
High MarginLow volumes
Low MarginHigh volumes
Business division in medical textile categories
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September 2010
IMPLANTS
Vascular Graft/ Endovascular StentSoft Tissue patchHernia Repair implants- Plugs/ MeshSuturesLocal drug delivery systemsDura substituteOrthopedic implants
Business division in medical textile categories…contd.
Critical – Consumables
Vascular Support System Compression Stocking & garments, Sequential compression Pump.
Orthopedic Support SystemCasting, Knee braces, Splints neck pads, Bandages etc.
Extracorporeal DevicesAnti- Embolical Stockings, Sutures
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September 2010
Product
Commodity
Concept
Critical path
ImplantCritical Consumable CRITICAL DISPOSABLENon Critical disposableNon-critical consumableHygiene
Critical Disposable Textiles:
OT Gowns Drapes and Wraps Isolation kits Swipes Swabs – cotton based Wound Dressing
Business division in medical textile categories…contd.
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September 2010
Commodity
Cotton Gauze Cotton roll Adhesive tapes
(Plaster, Band-aid etc)
Cohesive tapes Cotton balls Surgical swabs Tissues/ wipes
Crepe bands Compression
bands – adhesive, cohesive.
Sanitary, Nappies
Add………. Adult
Incontinence
Product
Commodity
Concept
Critical path
ImplantCritical Consumable Critical disposableNon Critical disposableNon-critical consumableHygiene
Business division in medical textile categories…contd.
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September 2010
They form a large chunk of volume of usage. The pressure to dispose them is high but to manage such cost and logistic is a challenge.Fabrics which are water repellant would be preferred ones for various uniforms & bed linen
Doctors Overcoat
Uniforms
Hospital Bed Assembly
Hospital Non Critical Consumables
Business division in medical textile categories…contd.
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September 2010 Challenges
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September 2010What it means to a product Supply?
Approvals of imported products from FDA, CE marking and other agencies which assures highest quality standards
Indian hospitals aspiring for quality accreditation such as NABH / JCI
These agencies insists on Standard products – Challenge on Indigenous suppliers to match the international standards
Absence of compiled reliable data showing impact on infection control, usage of antibiotics etc.
Indian hospital Industry at loss without a local supply
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September 2010Benefits of Quality Systems?
Benefits for PatientsAccreditation results in high quality of care and patient safety. The patients are serviced by accredited medical staff. Patient’s satisfaction is regularly evaluated.
Benefits for HospitalsAccreditation to a hospital stimulates continuous improvement. It enables Hospital in demonstrating commitment to quality care. It also provides opportunity to healthcare unit to benchmark with the best
Benefits for Hospital StaffIt improves overall professional development of Clinicians and Para Medical Staff and promotes staff safety
Benefits to paying and regulatory bodiesFinally, accreditation provides an objective system of empanelment by insurance and other third parties. Accreditation provides access to reliable and certified information on facilities, infrastructure and level of care
Benefits to the industryAccreditation helps in building data on the quality of the products, pattern of infection levels, usage pattern of antibiotics etc for better understanding & confidence building
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September 2010Impact of Quality Products / Service
The Institute of Healthcare Improvement reported that about 800,000 surgeries are complicated by infections annually, with a $9.5 billion cost to the U.S. health care system. According to a study published in Clinical Infectious Diseases, the increased length of stay following an infection is 18 days.
This is an opportunity loss!!!
Despite our best practices & using good products we are still challenged!
Therefore the need for better quality and innovative products coupled with service standards are the need of the hour.
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Requirements of Hospitals in India
Quality products while keeping costs in check
New innovations to cater to growing demand
Organized market with marked presence of Indian players
Standards and certification in line with FDA/ UL/ CE
Setting up of state of the art labs for better and faster testing of various devices/ fabrics
Better logistics for improving the inventory controls of the hospitals
Building confidence of the end users
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Hospitals are ready to reciprocate with….
Prices worthy of value
Carry out joint programmes to study the feasibility of the products and do a proper cost analysis
Study the pattern of infection control & monitor usage of antibiotics
A total study of the complete usage cycle would help in reducing the overall spending of the hospitals
TCO with the industry to reduce their costs for better results to hospitals and increased patient satisfaction.
Investments as partners for collaboration in terms of defining, supporting and development of indigenous products for QPD
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Healthcare is the new sunrise sector. With emergence of private players and spread to Tier II & Tier III cities there is bound to be rapid growth.
Emergence of the insurance sector will aid growth of healthcare industry but put pressure on costs.
Gap between Quality and Cost needs to be addressed by standards, specifications and certification.
Healthcare industry is ready to collaborate with the manufacturing sector for generation of standards and conducting studies on viability and cost-effectiveness of innovative products.
Ready to invest as partners for development of new products.
A team-work between both the industries is a must for mutual strategic benefits
Conclusion
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THANK YOU…
Fortis Healthcare Limited
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