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52 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM GROWTH PROSPECTS In Indian Pharma Despite Global Headwinds IN-DEPTH By Bhupendra Paintola The credit rating agencies have estimated that the Indian pharma industry grew 9.3 percent in FY23 and 14.6 percent in FY22, and its strong performance was the reason why India was a priority market for pharma heavyweights
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 53 With revenues in the US, Europe, and emerging markets taking a slump, pharmaceutical corporations are drawing their attention towards the Indian market. Both mid-sized companies and heavyweights of the sector like Sun Pharma, Dr. Reddy’s, and Cipla are keeping an eye on the Indian market to harness solid domestic revenues. The recent rapid growth of the Indian market is another aspect that has prompted pharma companies to devote more attention to it. The credit rating agencies have estimated that the Indian pharma industry grew 9.3 percent in FY23 and 14.6 percent in FY22, and its strong performance was the reason why India was a priority market for pharma heavyweights. After a successful Covid-19 era in which pharmaceutical companies made fortunes, dynamics have altered. The business has relatively slowed down due to a lack of consistent demand for drugs and vaccinations. GDP and drug spending correlate strongly worldwide. With the RBI’s Annual Report for 2022–23 suggesting India’s growth momentum will sustain in FY24 amid easing inflationary pressures, there seems to be much headroom for pharma growth in India. Positive Financial Performance In Q4 FY23 The Q4 FY23 pharma results have shown a trend towards double-digit profit for most of the pharma companies in India. “Indian Pharmaceutical Market IPM in Q4FY23 grew by 11.0 per cent YoY as per Pharmaceuticals Earnings Preview Q4FY23, by Centrum. Respiratory, anti-infectives, pain, analgesics, and derma are some of the leading therapies that have witnessed significant growth in Q4FY23,” said Nikhil Patil, Partner, KPMG in India, delineating the latest quarter growth prospectus. Ms. Kinjal Shah, Vice President & Co-Group Head, Corporate Ratings, ICRA Limited, explaining other facets of Q4 FY23 growth, conveyed, “Despite continued price erosion in the US and Europe pharma markets, most companies have reported sequential improvement in margins, supported An increasing geriatric population and lifestyle changes are supporting the growth of chronic and subchronic therapies in India, which is expected to remain the major contributor to growth in the Indian pharma industry KINJAL SHAH Vice President & Co-Group Head, Corporate Ratings ICRA
54 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM by some stabilisation of raw material costs and steady performance in other key markets. However, companies are also taking active cost optimisation measures, including discontinuation of low margin products and rationalisation of R&D spends with an increasing focus on complex molecules and specialty products.” Shah, further expounding on India’s demographic leverage, stated that structural factors such as an ageing population and continued rise in lifestyle and chronic diseases, in addition to new product introductions, have supported revenue growth for the industry. Moreover, several key players also invested in salesforce enhancement, which has also improved performance, she added. Challenges Faced by Pharma Companies The US is the pharmaceutical industry’s most lucrative market, representing about 34 per cent of all Indian exports during FY22. The U.S. and European pharmaceutical manufacturing markets were valued at USD 378.51 billion in 2022 and are expected to grow at a compound annual growth rate (CAGR) of 6.81 per cent from 2023 to 2030. Commenting on the headwind from the US, Patil mentioned, “Generic medicines have an important role to play in patient treatment, not only in developing countries but also in developed countries. USA, the biggest export market for Indian companies, is undergoing a combination of rising healthcare costs, higher inflation, higher inventories shored up during COVID-19, rising competition, pressure for localization, etc., which resulted in tepid demand. While exports have gone down, the US market is still attractive to Indian manufacturers.” Underscoring the ripple effect, Shah conveyed that high competition and price erosion in US have had a significant impact on the margins of pharma companies and have led to constant optimisation of their product portfolios, such that some companies have exited certain low margin products. “Some companies have also taken impairments on earlier investments made in this market due to reduced revenue visibility for the same. However, being the largest pharma market, the US remains an important market for Indian players and continues to attract a significant part of the overall capital allocation,” Shah stated. Furthermore, Shah reflected that most pharma companies continued to launch new products or develop a specialty product portfolio to combat pricing pressure in this market. Indian Market and Global Opportunities For FY2024, the rating agency ICRA expects revenues from a sample set of 16 Indian pharmaceutical firms, including the likes of Wockhardt, Torrent Pharmaceuticals, Pfizer, Abbott India, Cipla, Lupin, Sun Pharmaceuticals and Dr Reddy’s, to grow by 6-8 per cent primarily driven by the domestic and emerging markets. Highlighting the factors providing global opportunities and impetus to the Indian market, Shah mentioned that an increasing geriatric population and lifestyle changes are supporting the growth of chronic and sub-chronic therapies in India, which is expected to remain the major contributor to growth in the Indian pharma industry.” “While there was a decline in demand for chronic therapies during Covid, it has improved over the past few quarters. While therapies like cardiology and anti-infectives continue to remain important, genercisation of some key anti-diabetic drugs has resulted in a drop in the performance of existing players in the anti-diabetic therapy,” Shah expressed distinctively. Furthermore, she added that in recent quarters, earnings for some leading pharma companies have IN-DEPTH
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 55 also been supported by first-to-file launches of certain complex generics in the US market, with exclusive marketing rights for a select period. Role of Generics & New Product Approvals An analysis of 2022 ANDA approvals shows that 10 of the top 15 companies receiving the highest number of ANDA approvals in 2022 are Indian. Indian companies dominated the ANDA approvals, with 355 ANDA approvals out of a total of 742 ANDA approvals granted during the calendar year 2022. This further improves their share from 42 per cent (267 approvals) from last year, a 33 per cent growth of ANDA approvals for Indian companies versus 2021. India was followed by the US, China, Europe, and Israel, in that order, in the number of ANDA approvals. Attributing this growth to specific segments, Patil mentioned that ANDA approvals have improved over the last few years, and a majority of these approvals are for oral medications, while injectables make up a lower percentage of the total approval pie for Indian companies. “Indian pharma companies have accounted for 42-48 per cent of the ANDA approvals by the USFDA in recent years. With continued capital allocation by major players towards business in the US, this trend is expected to continue in the future as well. Indian players have a larger share of oral dosages in their ANDA approvals as compared to other global pharma companies,” Shah stated. Pricing Policies & Infla- tion Impact: Lately, we have experienced WPIlinked price hikes for products under the National List of Essential Medicines (NLEM) and annual price hikes for non-NLEM products. Non-NLEM drugs can take an annual increase up to a maximum of 10 per cent, and changes in WPI do not have a direct impact on price increases. While for NLEM drugs, price hikes continue to be decided based on the change in WPI. Due to higher inflation, the annual price hike allowed under NLEM was 10.8 per cent and 12.1 per cent in 2022 and 2023, respectively. This is the second consecutive double-digit hike for NLEM drugs. In spite of this hike, Shah underlined the reduced average prices of NLEM drugs, commenting that despite the 12.1 per cent hike in 2023, the average prices of NLEM drugs Despite continued price erosion in the US and Europe pharma markets, most companies have reported sequential improvement in margins, supported by some stabilisation of raw material costs and steady performance in other key markets. However, companies are also taking active cost optimisation measures, including discontinuation of low margin products and rationalisation of R&D spends with an increasing focus on complex molecules and specialty products have gone down since April 2023 as the capping of ceiling prices for 651 drugs (out of 870 falling under NLEM) by the NPPA resulted in a 16.6 per cent decline in prices. Impact of US FDA Inspections & Compliance The US being the largest market for pharma, restrictions on the launch of new products or the sale of existing ones in the US have had some negative impact on the business of Indian players. While US FDA inspections were kept on hold during the pandemic, the pharma industry has now witnessed an increasing influx of US FDA inspections. “There have been several instances of adverse observations, including Form 483s, OAIs, warning letters, etc. Since resolution of these processes can be a lengthy process, including several iterations of to and fro with the US FDA, multiple rounds of inspections, additional consultancy fees, etc., it has an impact on the performance of the company. However, these companies are able to combat the same to some extent through dual filings for products and an increased level of contract manufacturing on an outsourcing basis,” Shah delineated. Conclusion The Indian pharma market presents opportunities for growth despite challenges in other regions. The market’s rapid growth, favourable demographics, and increasing focus on complex generics and specialty products contribute to the industry’s success. Indian pharma companies play a significant role globally, and their performance in the domestic market as well as emerging markets helps offset pricing pressures. However, compliance with regulatory standards and addressing pricing policies remain crucial for sustained growth and success in the Indian pharma industry.
56 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM How do you think the concept of marginal thinking has helped India sail through the recent pandemic? This is a very important question because we learn a lot from history and we learn preparedness as well. The unprecedented devastating Covid pandemic left a trail of death, destruction and misery for all of us. Most of the people in the healthcare sector saw something which was never witnessed in the last 5 decades of my practice. However, it gave us huge insights for the future of medicine and a right example of marginal thinking, so to speak. Here is that all extra efforts, and promoting digital health, remote monitoring, home care, day care, future pandemic preparedness, I am sure will go a long “Private Hospitals Provided More Than 80 Per Cent Of Their Beds To Covid Patients At Nominal Fees” Q&A By Shiv am Tyagi BW Healthcare World in conversation with Dr. H. Sudarshan Ballal, Chairman, Manipal Health Enterprise Pvt. Ltd. DR. H. SUDARSHAN BALLAL Chairman Manipal Health Enterprise Pvt. Ltd.
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 57 D u r i n g t h e pandemic, for the first time in many years all governments across the globe felt that healthcare was probably the most important factor in how strong your country is. Not just financial status or defence or where you are located, but how strong the health sector is way in significant and viable management of healthcare in the future. As business leaders we look forward to the bud- get every year because that refines the growth that we can expect in the coming fiscal year. Do you think that the current fiscal allocations for healthcare in India are sufficient in the long run? As much as the dark clouds of Corona caused tremendous amounts of misery and devastation to all of us, there were some silver linings and one of them is definitely the use of technology in medicine. Fortunately for us, India did quite well in spite of the challenges we had,and for the first time I saw that in 2021 the budget took healthcare as one of its pillars in the budgetary allocation. There was a significant increase in the budget allocation for healthcare. This was certainly a great silver lining. This would not have happened, but due to the pandemic which alerted the citizens in general and the government to the fact that we have to improve and allocate more money for the healthcare sector. We still have a long way to go as we currently have around 2 per cent allocation of our GDP (Gross Domestic Product) for healthcare. In my opinion, that should probably rise to 4 to 5 per cent over the next few years. There are obviously other priorities too but 4 to 5 per cent allocation in the future is what we should definitely look at. Are slow pandemics still a threat in India when it comes to long-term goals? I think you have raised a very important point and distinction between the pandemic of communicable diseases is like what we saw with Covid and other viral illnesses, and certainly we cannot ignore the pandemic of lifestyle diseases or non-communicable diseases. Very honestly, before the Covid pandemic hit us, we were focusing a fair
58 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM amount on communicable and noncommunicable diseases or even lifestyle diseases as what we call it. In fact, the mortality from these were more than mortality from communicable diseases, even in a developing country like India. Hence, we cannot ignore one for the sake of the other. I think we should be future prepared for both the pandemics – the pandemic of communicable diseases, because I am sure Covid is not the last pandemic disease that we will see among infectious viruses or other illnesses and diabetes, hypertension, obesity, cancer, which are still growing, I think we should be prepared both for the onslaught communicable diseases and-non communicable diseases in the future. Vigorous surveillance, robust public health measures to prevent and manage both the communicable and non-communicable pandemic of the future, is what we need to do. How can the educational sector play a role to create a balance between the quality and quantity, keeping in mind we still start medical colleges is huge. In the good old days you needed 25 acres of land but today if you need 25 acres of land in Mumbai or Bangalore, that itself would cost Rs 2,000 crores to 3,000 crores. There is no way you can cut down the cost of medical colleges. That has been changed as there is a cut down in the amount of land needed. Also, we should certainly look at having shared infrastructure. For example, if there are 4 or 5 medical colleges in Bangalore, why should all of them have departments of anatomy, physiology etc. as we could have a common shared platform for 4 medical colleges. That would bring a huge reduction in the cost of medical education. Now it is too expensive to open a medical college. We need to start reducing the costs of building medical colleges. T h e p e o p l e n e e d t o b e aware that India has state of the art facilities, they are safe, the quality of care is excellent, and this is most importantly one of the major things that have to be done. Cost-effective treatment as well is key to building trust in the minds of the patients have a huge gap to fill? A. Medical education is a very interesting point which you have pointed out at and the shortage of doctors. However, tremendous work has happened in the last few years. We now have close to 700 medical colleges coming up with a 100,000 under graduates, maybe 60,000 post graduates. We are the largest producers of so to speak doctors in the world. Interestingly, a current data report suggests that we are not short of doctors, but have actually reached the WHO (World Health Organisation) standards of patient-doctor ratio or the doctorpatient ratio. However, what we really need to look at is the inequitable distribution of doctors. If you look at Chhattisgarh versus Karnataka, we have a large number of doctors in Bangalore but we have a tremendous shortage of doctors in many of the under-served areas. There is certainly a need to increase the number of doctors and more importantly make medical education less expensive. One of the things we have suggested to the government and which I am sure they are acting upon, the infrastructure needed to Q&A
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60 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM Exploring India’s Increasing Role in Clinical Trials, Addressing Key Concerns IN-DEPTH By Bhupendra Paintola Despite having a huge population, India only contributed 4 per cent on average annually to global clinical trials from 2010 to 2022, according to the report. Italso noted that of all trial participants worldwide, India’s contribution was only 3 per cent compared to 30 per cent for the US
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 61 During the SARSCoV-2 epidemic, the speedy approval of Covid-19 vaccinations demonstrated the value of clinical studies that it had a great deal of potential to aid patients, improve therapeutic regimens, and ensure the advancement of evidence-based medical practise. According to a joint report by PwC India and USAIC (US-India Chamber of Commerce), India is becoming a sought-after venue for conducting clinical trials for a number of key reasons. The regulatory reforms since 2013 and the New Drugs and Clinical Trial Rules of 2019 have streamlined the licencing processes, cutting timeframes by 30 per cent to 40 per cent, making India an attractive location for clinical trials, according to the above-mentioned report. Despite having a huge population, India only contributed 4 per cent on average annually to global clinical trials from 2010 to 2022, according to the report. It also noted that of all trial participants worldwide, India’s contribution was only 3 per cent compared to 30 per cent for the US. Key drivers for clinical trials Commenting on factors weighing on clinical trials in India, Sudarshan Jain, Secretary General, Indian Pharmaceutical Alliance, conveyed that India is a desired destination for clinical trials because of its large and diverse patient pool, streamlined regulatory framework, and highly qualified workforce. “The key drivers for clinical trials in India include access to treatment-naïve patients (especially in Tier 2 and 3 cities), a high disease burden, lower cost, and good medical infrastructure (even in Tier 2/3 cities),” Jain added. Further expounding on the impetus from the amended rules, the Secretary General reflected, “The New Drugs and Clinical Trials Rules (NDCTR) of 2019 aim to promote clinical research in India by providing a predictable, transparent, and effective regulation and ensuring faster accessibility of new drugs to the Indian population. The new rules have also reduced the time for approving applications. The positive impact of NDCTR is reflected in the approval of an increasing number of trials and the reduction in the time taken for the approvals by 30–40 per cent.” Requisites for conducive clinical trials In conveying the requisites for leveraging clinical trials, Gayatri Saberwal, Professor, Policy Research, Institute of Bioinformatics and Applied Biotechnology, in an article for a science journal, mentioned that steps like bringing together all the documentation on every trial on one platform are in the interest of transparency. She further suggested that Central Drugs Standard Control Organization (CDSCO) should allow public access to regulatory documents, as it is well-known that there have been several inconsistencies between trial data in a registry and the publication of the study or U.S. Food and Drug Administration documents. “I think regulators should look more at final outcomes and not focus too much on intermediates. The industry SUDARSHAN JAIN Secretary General, Indian Pharmaceutical Alliance
62 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM should be able to self-regulate on the intermediate steps, while the final step, which is the interface between industry and patients, needs to be strictly regulated. This is the approach that is taken by most regulators in the West, and a mindset change is needed to allow that to happen. To give a specific example, for every substance produced, separate approval is needed, which takes time and money. This is unnecessary at this stage. Rather, policing needs to be done on how any substance, once manufactured, is ultimately utilised,” said Dr Jogin Desai, Founder and CEO, Eyestem. On exemptions to improve the efficiency of conducting clinical trials, Jain stated, “The NDCT Rules, 2019 have an elaborate framework that clearly lays down the process of approvals for clinical trials in India. The new rules provide for an exemption for clinical trial data in the Indian population for drugs already approved and marketed in any of the developed countries. Trials in discussion with DCGI can be conducted after the Marketing Authorization Application (MAA).” Technology as an enabler for clinical trials Speaking on deploying technology for leveraging clinical trials, Jain stated, “Clinical trials are increasingly leveraging digital tools for patient recruitment, retention, data collection and analytics, and remote monitoring of recruits. Companion diagnostics are being used to enrol patients with the best chances of success from therapies. Digital tools are also helping in streamlining inclusion-exclusion criteria and patient recruitment for clinical trials.” “Just as it has done in the telecom industry, India has the potential to leapfrog in electronic health records (EHR), especially given that most of our hospitals do not have a first-generation system that is entrenched. Common standards for EHR, which are currently under consideration, would help provide an immensely valuable pool of information for patient recruitment and would instantly transform India’s potential as one of the most attractive destinations to do clinical trials in the world,” Dr Desai defined future prospects with EHR. “In high-income countries, particularly the US, collaborative enterprises are prevalent to facilitate rapid progress. Large research programmes involve numerous collaborators across disciplines. India can greatly enhance its participation in such multidisciplinary, multi-centric collaborations. We need more collaboration between social science, biological science, and computer and data scientists,” said Soumya Swaminathan, former Chief Scientist of the World Health Organisation (WHO), in a recent interview with the media. Addressing concerns and enhancing transparency: Despite the vaccine’s success during covid, there have been concerns expressed about the transparency of the clinical trials as well as the IN-DEPTH The key drivers for clinical trials in India include access to treatmentnaive patients (especially in Tier 2 and 3 cities), a high disease burden, lower cost, and good medical infrastructure (even in Tier 2/3 cities)
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 63 safety and effectiveness of the vaccinations due to the haste with which some Covid-19 vaccine-related phases were certified in India. There have been instances where trial data and findings were not made available openly, raising questions about the validity and dependability of trials done in India. The Clinical Trials Registry of India (CTRI) mandates that every trial be registered before commencing. Saberwal, in the same article mentioned above, enumerated practises that have kept CTRI from becoming “world class,” such as not complying with WHO regulations for primary registration, undefined classification of type of study, internal consistencies, confusion over definitions, missing data, messy data, misleading information, a faulty search function, etc. Clinical trials carried out in India have occasionally involved ethical violations, such as a lack of informed consent, insufficient participant compensation, and the exploitation of vulnerable people. Large-scale clinical trial capability and India’s healthcare infrastructure have both undergone scrutiny. Challenges have included a lack of facilities, qualified staff, and quality control procedures. Problems around funding resources Industry pundits have reiterated problems around securing funding for clinical trials, both domestically and internationally. Moreover, it’s estimated that out of every 1000 molecules with potential as new drugs, only one successfully overcomes all barriers, which means that when you invest in 1000, only one succeeds. Furthermore, the scientist who discovers the molecule doesn’t assume responsibility for all subsequent steps. Subsequent steps need pharmacologists, organic chemists, biochemists, experts in animal and toxicology studies, facilities for conducting those studies, pharmacokinetics specialists, and experienced individuals for clinical trials. “The first thing is that R&D for new drugs, diagnostics, and vaccines is risky. Therefore, a company, especially a small to medium-sized one, would not want to take major risks. They prefer to use their money to ensure marketable products and returns for shareholders. In the US, the initial risky investment is typically made by the government, specifically the NIH, which has a huge budget of billions of dollars. I think regulators should look more at final outcomes and not focus too much on intermediates. The industry should be able to selfregulate on the intermediate steps, while the final step, which is the interface between industry and patients, needs to be strictly regulated. They invest in basic science and allow scientists to spin off companies or sell their intellectual property. Once a company knows that a product has been developed to a certain stage by scientists, they can upscale and manufacture it,” Swaminathan mentioned. Way forward Clinical research in India is a sunrise sector and can provide satisfying employment to students not only from life science, pharmacy, medicine, and nursing, but also from statistics, IT, and supply chain backgrounds. As the world’s most populous country, India constitutes 18 per cent of the global population. But only 6-7 per cent of clinical trials happen in India. Leveraging the diverse population and digital prowess will help accelerate clinical trials in India. Experts have been advocating for creating a system where there is synergy and collaboration between these different groups. There are several initiatives by the government of India, the department of biotechnology, the Council for Scientific and Industrial Research (CSIR), and the ICMR focused on collaboration between academia, the public, and industry partnerships in order to actually move a product, whether it’s a vaccine or a drug candidate. India’s potential in clinical trials is immense, with the opportunity to contribute to medical advancements and improve patient outcomes. Addressing concerns regarding transparency, safety, and effectiveness is essential to build trust and credibility. By implementing reforms, improving registry systems, and fostering collaboration between stakeholders, India can emerge as a leading hub for transparent, efficient, and impactful clinical trials.
64 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM Industry Desires Express Implementation Of Medical Device Policy IN-DEPTH By Shivam Tyagi Recognized as one of the sunrise sectors under the Make In India scheme, the medical device industry is valued at USD 11 billion and is growing at a Compound Annual Growth Rate (CAGR) of 15 per cent, according to a 2022 India Brand Equity Foundation (IBEF) report
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 65 The Union Government has announced the much awa ited framework for the medical devices sector, the National Medical Devices Policy, 2023, after it had asked for proposals on the draft policy issued in 2022. Under the policy, the government has proposed six strategic areas which it says will enable the medical devices industry to grow exponentially in the coming years. Recognized as one of the sunrise sectors under the Make In India scheme, the medical device industry is valued at USD 11 billion and is growing at a Compound Annual Growth Rate (CAGR) of 15 per cent, according to a 2022 India Brand Equity Foundation (IBEF) report. The report also states the industry in India is growing 2.5 times faster than the global growth rate and that India is the fourth largest medical device market in Asia after Japan, China and South Korea. As per the IBEF report, The Indian medical device market is driven by 70-80 per cent imports from countries such as the US, China and Germany. The centre through the policy aims to reduce this dependency and envisions to expand the share of Indian manufacturers in the global market to 12 to 15 per cent from current 1.5 per cent over the next 25 years, while also helping the industry to reach a valuation of USD 50 billion by 2030. Presently, as per the Invest India website, there are close to 750-800 domestic medical device manufacturers, accounting for 65 per cent of the players in the Indian market. Whereas the start-up ecosystem in the sector contributes over 250 companies engaged in innovation, addressing crucial health challenges. What Does The Policy Entail? The six strategies of the National Medical Device Policy 2023, propose to augment the growth story of the medical devices industry in India and entail focus areas such as streamlining regulation, enabling infrastructure, facilitating R&D and innovation, inviting investments, facilitating skilled manpower and promoting the industry for exports. In an effort to streamline the regulatory framework, the government has proposed a ‘Single WinThe reality that India still imports 75 per cent of its medicinal equipment is a major obstacle when it comes to making medical care affordable for all. Therefore, the substantial investment of Rs 1,206 crore which the policy commits to the allotment, will be tremendously beneficial in reinforcing its domestic production MUDIT DANDWATE CEO and Co-Founder Dozee dow Clearance System’ for availing speedy licensing of medical devices, which will encompass all the stakeholder departments such as AERB, MeitY, DAHD etc. The regulatory framework of the policy will also enhance the role of Indian Standards like Bureau of Indian Standards (BIS) and further plans to design a coherent pricing regulation of the medical devices. The next key area that the policy caters to is enabling a strong infrastructure for the sector by establishing and strengthening medical device parks, clusters equipped with common infrastructure facilities in close proximity to economic zones. While briefing the media on the policy launch, Union Minister of
66 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM Health and Family Welfare, Mansukh Mandaviya stated that in order to develop the medical device sector, enabling of the required infrastructure is quite crucial, “We have made the medical device parks ensuring the clustered approach so that small industries can flourish, and for these industries you need specific training and the comprehensive policy plan ensures that,” he said. The Minister further added that the policy also plans to create a framework for researching and manufacturing of the small components that are required to make the medical devices. The policy has also given due diligence to the R&D and innovation segment in which the government aims to establish Centre of Excellences, innovation hubs and plug and play infrastructures in the country. The policy also encourages investor interest in the sector by promoting private investments from Venture Capitalists (VCs) and also Public Private Partnerships (PPPs). Further, to strengthen and power the medical devices sector with sustained manpower, the National Medical Device Policy 2023 has envisaged supplying a skilled workforce across the medical devices value chain by leveraging the Ministry of Skill Development and Entrepreneurship. Lastly, the medical device policy will also focus on branding the Indian devices in foreign markets and will initiate studies to learn from the best global practices of manufacturing and skilling by the establishment of an Export Promotion Council which the government announced in September last year. Industry Lauds, Wishes Speedy Implementation The announcement of the National Medical Devices Policy 2023, has been welcomed by open arms from the medical devices industry, with lauds, praise and hope pouring from the different stakeholders of the sector. Rajiv Nath, Forum Coordinator of Association of Indian Medical Device Industry (AiMeD) while applauding the Government told BW Healthcare World “We congratulate the Government wholeheartedly for approving the much-needed, longawaited direction we had sought since the initial draft policy of June 2014 for a ‘National Medical Devices Policy” Nath said that the industry is hopeful that the policy details will help boost local manufacturing while helping traders and importers to start investing in putting up factoWe hope for speedy implementation of the policy by actionable tasks as have been sought by the Parliamentary Health Committee and AiMeD to realise the vision and mission stated in the policy RAJIV NATH Forum Coordinator AiMeD IN-DEPTH
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 67 ries and end the 70-80 per cent import dependency forced upon India. “We hope for speedy implementation of the policy by actionable tasks as have been sought by the Parliamentary Health Committee and AiMeD to realise the vision and mission stated in the policy. The Parliament Committee had recommended a separate Law, Separate department, tariff correction and price control and other measures which if implemented will give direct benefit to consumer and industry,” added Nath. Mudit Dandwate, CEO and CoFounder of Dozee stated that the reality that India still imports 75 per cent of its medicinal equipment is a major obstacle when it comes to making medical care affordable for all. “Therefore, the substantial investment of Rs 1,206 crore which the policy commits to the allotment, will be tremendously beneficial in reinforcing its domestic production,” he said. He further delineated that the policy’s special emphasis on skill development to equip medical proHaving a dedicated body to understand the nuances of medical devices will enable the sector to implement the right decisions and will be a major factor in building the medical device sector. The policy will boost Make in India rapidly and accelerate growth SUNIL KHURANA CEO and MD BPL Medical Technologies fessionals better adapt to technology will help bring innovators and healthcare practitioners together to work towards providing quality care. While speaking to BW Healthcare World, Sunil Khurana, CEO and MD, BPL Medical Technologies stated that having a dedicated body to understand the nuances of medical devices will enable the sector to implement the right decisions and will be a major factor in building the medical device sector. “The policy will boost Make in India rapidly and accelerate growth,” he said. Welcoming the policy, Pavan Choudary, Chairman, Medical Technology Association of India (MTaI) said, “Though we still have to go through the fine print, we are encouraged by the spotlight turned on R&D. While India has only 1.5 per cent of the global medical device market, it has 8 per cent share of the MedTech R&D work force already. This is a fertile and proven area to focus on.” He further said that the emphasis on creating a systematic brand positioning and awareness creation program is also long due and laudable. “All in all from what is available so far in the public domain it seems a policy which harnesses both the domestic and international currents to optimally forge the path ahead,” Choudary added. Concerns While applauding the new medical device policy the industry leaders
68 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM IN-DEPTH Though we still have to go through the fine print, we are encouraged by the spotlight turned on R&D. While India has only 1.5 per cent of the global medical device market, it has 8 per cent share of the MedTech R&D work force already. This is a fertile and proven area to focus on PAVAN CHOUDARY Chairman MTaI also highlighted certain concerns and expectations awaited from the details of the policy, Khurana told BW Healthcare World that at present garnering support from the State and Central governments in exporting Indian-made products to other countries is challenging, for instance the easy issuance of Free Sale Certificates (FSC) especially when Central Drugs Standard Control Organisation (CDSCO) is overloaded with pending approvals and regulatory framework. Nath said that many points in the policy are not clearly spelled out but that’s expected in a policy to give much needed direction to over 20 stakeholder Ministries and Departments. Nath also pointed out that the consumers should benefit from this policy. He said that so far there is no restriction or capping on the MRP prices of medical devices from the government. And especially some private hospitals give the brand they want to the consumer on their own free will. “We have been seeking a system whereby ethical manufacturers and importers can offer low priced MRP products and still they are able to sell. We have been seeking MRP of imports to be monitored and compared with imports landed prices and steps taken to control when found irrationally excessive,” Nath added. Promising Catalysts Going forward the medical devices sector is expected to benefit from promising catalysts such as the growing Indian population with rising life expectancy, disease burden shifting to Non Communicable Diseases (NCDs), a growing middle class with rising disposable income, increasing health insurance penetration and a booming medical value tourism sector which will ensure a steady rise of the sunrise industry. According to the IBEF report, the diagnostic imaging market is estimated to expand at a CAGR of 13.5 per cent between 2020 to 2025. The report also states that in 2021, India exported medical devices worth USD 2.53 billion which is set to touch USD 10 billion by 2025. As per the report, Foreign Direct Investment (FDI) in the medical and surgical appliances sector stood at USD 2.71 billion between April 2000 to June 2022.
Chetan Mehra +91 98117 02464 [email protected] For Speaking Opportunity: Aparna Sengupta, +91 99580 00128, [email protected] Ravi Khatri, +91 98913 15715, [email protected] Shruti Arora, +91 79826 28913, [email protected] Kiran Dedia, +91 98333 99009, [email protected] CS Rajaraman, +91 93422 62859, [email protected] For Sponsorship: EVENT PARTNERS REGISTER NOW AUGUST 18-19, 2023 Imperial Hotel, New Delhi Scan to Register #BWFestivalOfMarketing AJAY DANG President Head Marketing UltraTech Cement DAMYANT SINGH KHANORIACMO OPPO India ATIT MEHTA Marketing Head Byjus APARNA BHAWAL CMO KFC India and Partner Countries RACHIT GUPTACMO Hero Cycles ANKIT DESAI CMO India Hershey Company VIRAT KHULLAR Group Head Marketing Hyundai India DEEPALI NAAIR Group CMO CK Birla Group GUNJAN KHETAN CMO Perfetti Van Melle India AMIT GUJRAL CMO Jk Tyres & Industries GIRISH KALRA CMO Tata AIA Life Insurance RAHUL ALWAR Executive Vice President & CMO Max Life Insurance POOJA BAIDCMO Philips Domestic Appliances India TUSHAR MALHOTRA Head of Marketing Bisleri International KARAN KUMAR Group Chief Marketing and Growth Ocer, Art Fertility Clinics AMEDEO ARAGONA Marketing Head, Kinder Brands Ferrero India PUNEETH BEKAL Director Marketing Mastercard SUNIL NARULA Senior Vice President- Sales & Marketing Panasonic Life Solutions India AJAY KAKAR Brand & Marketing Strategist AKASH DEEP BATRA Executive Director & Head of Marketing Customer Experience & Analytics DBS Bank HARI HARA SUDHAN Head of Marketing Communication Nippon Paint India (Decorative) LLOYD MATHIAS Business Strategist & Angel Investor DEEPAK GULATI Chief Marketing & Innovation Ocer Bridgestone India CHARU KISHNANI Executive Vice President Marketing CarDekho Group NITIN SETHI Chief Digital Ocer - Consumer Business, Founding Leader – Adani Digital Labs MILI KAPOOR Head – Marketing Nestle Professional Beverages PARTH JOSHI CMO BharatPe SAI NARAYANCMO Policy Bazaar SHAMIK BANERJEE CMO Apollo 24|7 SUNIL RAINA President and Business Head Lava International JAYEN MEHTA Managing Director Amul (GCMMF) DR ANNURAG BATRA Chairman & Editor in Chief, BW Businessworld & Founder, Exchange4media KEYNOTE & HEADLINE SPEAKERS SUPER MARKETERS
70 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM CAHOCON 2023 In The City Of Pearls By Team BW The city of pearls in the state of Telangana recently hosted a mega festival for healthcare professionals, the seventh edition of CAHOCON which was held on April 15-16, 2023 at Novotel Hyderabad Convention Centre. The two-day conference for healthcare professionals was attended by over 1500 delegates from across 26 Indian states and 15 countries, and it was by far the highest-ever attended CAHOCON conference. The event was organised by CAHO (Consortium of Accredited Healthcare Organisations), a notfor-profit body that aims to enable quality and patient safety initiatives in Indian healthcare. The theme of CAHOCON 2023, “Leadership is the Key to Quality,” was chosen to emphasise the importance of leadership in promoting patient safety SPOTLIGHT The two-day conference for healthcare professionals was attended by over 1500 delegates from across 26 Indian states and 15 countries in the healthcare delivery systems. Speaking at the event , the guest of honour, Dr Annurag Batra, Founder, exchange4media and Editor-in-Chief, BW Businessworld said that after Covid anything is a bonus. No one ever thought they would survive, especially the way the virus devastated the world. In business sustainability is important. But, in healthcare patient outcomes are important, stated Dr Batra. He talked about the 3Cs to stay away from which were Complain, Criticise and Compare. And asked the audience to embrace the 3Hs—Hope, Hardwork and Humility for a better life. Dr B. Bhaskar Rao, Organising Chairman of CAHOCON 2023 said that India is now the healthcare hub. Hyderabad is a medical tourism hub. Earlier people used to go abroad for advanced treatment. But now patients come here from various countries. The city has done remarkably well. Hyderabad is the place which does 100 lung transplantations in a year, which is a record, not just in India but across Asia, stated Dr Rao. He appealed to the state government as well as all the governments across India to create green corridors for ambulances, the way Hyderabad police have done for organ transportation. CAHO must work along with the governments to devise ways and means to transport patients, especially in emergencies, Dr Rao said. Dr Ravi P.Singh, Secretary General, Quality Council of India (QCI), stated that in order to encourage and promote quality, QCI will rate and rank 1000 NABL accredited hospitals in India. This work may begin in July this year. The few topranked hospitals will be accorded status as centres of excellence, he said. During the valedictory function, three medical professionals were recognised for their outstanding contributions. Dr Narottam Puri, an ENT specialist, a veteran in the field of clinical practice and healthcare management was honoured with the Lifetime Achievement Award.
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 71 Addressing Sustainability Challenge In Healthcare With Electrification & Digitisation In an exclusive interview with BW Healthcare World, David Evans, Global Segment Director, Schneider Electric, spoke on addressing the sustainability problem in healthcare along with electrification, digitisation as the driver of change We know that healthcare institutions contribute to 5 per cent of global carbon emissions. How can we address this sustainability problem? The healthcare sector is indeed a significant contributor to global emissions, accounting for around 5 per cent. To put it into perspective, if we consider all healthcare estates as a fictional country, it would be the fifth-largest emitter, comparable to countries like Germany and Russia. This is a pressing issue because the impact of climate change varies across regions, with countries like India facing more severe consequences, such as adverse effects on agriculture and public health. At Schneider, we work with developing countries to improve healthcare while also emphasising the need for sustainable development. Our strategy revolves around two key components: electrification and digitisation. Electrifying healthcare estates, both new and existing, is crucial because electricity is a sustainable source of power. Continually relying on fossil fuels for energy management in healthcare facilities will only exacerbate the challenges, especially in tropical and equatorial regions where temperatures can rise up to 2.73 degrees above the average. Additionally, digitisation plays a vital role in optimising healthcare facilities, enabling better resource management and reducing environmental impact. What is the sustainability challenge that healthcare institutions are facing at the moment? While electrification is important, digitisation is the real driver of change. By utilising digital technologies, we can optimise healthcare estates and reduce emissions. It’s essential to recognise that addressing sustainability in healthcare goes beyond the estates themselves. Patient movement, supply chain management, and other factors contribute to emissions. Thus, changing behaviours and adopting new strategies are crucial. For example, in busy cities like London, improving operational efficiency can help reduce the carbon footprint associated with healthcare activities. Another challenge is the renovation and upgrade of existing healthcare facilities. We need to reinvest and repurpose these buildings to align with sustainability goals. By adopting a mindset of embracing change and leveraging technologies together, we can drive performance improvements. Collaboration among different technology providers and adopting simple protocols and operational processes can yield significant results. For instance, starting with LED lighting, integrating sensors, booking systems, and occupancy management can improve efficiency by up to 40 per cent. In summary, to address the sustainability challenge in healthcare institutions, we need to focus on electrification and digitisation. These strategies will help us reduce emissions, optimise resources, and create a more sustainable healthcare sector. DAVID EVANS
72 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM Transforming Healthcare: NABH’s Journey Towards Establishing Patient Safety In India During a one-on-one conversation with BW Healthcare World, Dr Atul Mohan Kochhar, Chief Executive Officer, NABH, shed light on the essential considerations regarding patient safety and the role of NABH, along with its outlook for establishing patient safety in India Tell us about the role of NABH in developing patient safety in India. Patient safety holds a significant lesson for us in India. Prior to 2005, the concept of patient safety or policy existed mainly in textbooks, confined to paper. However, with the formation of NABH (National Accreditation Board for Healthcare Providers and Private Companies) under the TC umbrella in 2006, a transformative change occurred. NABH, an autonomous national accreditation board, has been progressively raising standards since the release of its initial standards. These standards have gained global acceptance, validation, and further aggregation by its umbrella body. What are NABH’s achievements in fos- tering a culture of patient safety in India? NABH’s standards revolve around a comprehensive framework of patient safety and healthcare quality. Today, we proudly run approximately 25 programmes, starting with that initial programme. Over the past 18 years, we have reached out to 70,000 hospitals, both large and small, not only in India but also in eight other countries. Our influence extends to various corners of the globe, including the Philippines, Oman, the Middle East, and several South American countries, where our standards have garnered significant favour. What is the future outlook for patient safety in Indian healthcare? While acknowledging that we have not yet reached the pinnacle of success, it is undeniably a monumental achievement. India has now fostered a culture of patient safety that is poised for further growth. The demand from consumers for patient safety and quality healthcare is evident, and going forward, I am confident that this trend will continue to gain momentum. Patients will increasingly assert their right to safe and high-quality healthcare, solidifying our commitment to patient safety as an essential aspect of healthcare provision. About NABH The National Accreditation Board for Hospitals and Healthcare Providers (NABH) is a constituent board of the Quality Council of India, set up to establish and operate accreditation programmes for healthcare organisations. The board is structured to set benchmarks for the progress of the health industry. Its vision is to be the apex national healthcare accreditation and quality improvement body, functioning at par with global benchmarks. Its mission includes operating accreditation and allied programmes in collaboration with stakeholders, focusing on patient safety and quality of healthcare based upon national/international standards, through a process of internal and external evaluation. DR ATUL MOHAN KOCHHAR SPOTLIGHT
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 73 Advancements In Indian Healthcare: Patient Safety, Standardisation & Quality Control In an exclusive interview with BW Healthcare World, Dr B. Bhaskar Rao, Chairman & Managing Director, KIMS Hospitals, spoke on the growth momentum in Indian healthcare along with the expansion decision of KIMS Hospitals Where is the healthcare industry headed towards at this juncture? When compared to the pre-pandemic era, healthcare providers are growing much faster due to increased awareness among patients. The government is also coming forward to provide good quality care to each and every person, as a result of which they have increased the number of medical graduates. Apart from that, they are also increasing the number of nurses available to deliver quality service to patients. Every organisation is trying to increase bed strength too. Moreover, there is more awareness around terms of insurance as the patients also realise that quality will come at a cost. More and more people are opting for insurance. So, insurance penetration, enhanced bed strength, and leveraging the strength of providers like doctors, nurses, and paramedics add to the growing healthcare system in India. Will we see KIMS Hospitals expand in the north? Healthcare, in itself, is a very different vertical than any other sector. Cultural differences and different governments are the reasons why we have kept our focus on specific regions in the past. In two decades, we have grown in Telangana and Andhra Pradesh. And now, three years after we went for an initial public offering, we are concentrating on Maharashtra, Karnataka, and Tamil Nadu. Once we establish ourselves in these regions, we can think of going towards bigger acquisitions in other regions of India. Where do you think India is in terms of patient safety, standardisation, and quality control? Indian healthcare is the best healthcare as of now if we compare it with the healthcare provided two or three decades ago. In comparison with many other countries, the technology available in India is much faster, like getting an MRI done in one to two hours. There are countries where patients have to wait for three to four days, and even at times, the waiting perod for consultation may go up to a month. Comparatively, we have built good leadership, good infrastructure, a good diagnostic system, and, more importantly, have well trained nurses and paramedics. This is the reason why we are attracting a lot of medical tourism to India. Moreover, we are building a lot of our own accreditations, like NABL and NABH. So, on all fronts, we are moving in the right direction. DR B. BHASKAR RAO
74 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM Importance Of International Accreditation & Standardisation In Indian Healthcare In an exclusive interview with BW Healthcare World, Dr Joel Roos, Vice President - International Accreditation, Quality Improvement, and Safety, JCI, spoke on Indian hospitals’ challenges in getting international accreditation along with the other standardisation methodologies Globally, India is advancing towards becoming the “Preferred Healthcare Destination.” Hospitals and healthcare organisations in India are working hard to receive Joint Commission International’s (JCI’s) “Gold Seal of Approval.” The JCI accreditation plays a significant role in attracting patients from around the world to India. JCI is the premier organisation for accrediting healthcare organisations. It is the benchmark for international health accreditation. As a regulator of strict worldwide standards in healthcare quality and patient safety, it offers the most knowledgeable and experienced consultants in the healthcare sector. Where do the challenges of accreditation and standardisation in India lie? In India, only 36 healthcare institutes are internationally accredited. Accreditation is a difficult process that requires time and money. You need facilities at a standard cost; this is an issue. There is no denying that this process is expensive. However, some of the bigger hospitals are pursuing the process of acquiring international accreditation. NABH accreditation is one of the requirements, but our standards are even higher and tougher. Though I would say that things are changing, there is a lot more interest as the Indian healthcare system and economy mature. What are the standardisation measures or patient safety measures that are important for Indian healthcare institutions to get accredited internationally? There is everything from the governance and leadership in hospitals to the physical standards like fire safety, fire prevention, sanitation, and food to the delivery of healthcare, like training the staff. It’s a very long list: medication management, infection control, etc. Anytime you pursue quality or patient safety in an organisation, it starts from the top. If the leadership is not committed or dedicated, if it doesn’t create a culture of safety, everyone is free to speak up to address any problem. If this is not done, everything else will not work. That is what I have started to see in India: people are really committed and have total interest in advancing that agenda. DR JOEL ROOS SPOTLIGHT
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 75 Healthcare Quality Control: Mitigating Human Errors & Ensuring Patient Safety In an exclusive interview with BW Healthcare World, Dr RavindranJegasothy, President, Asian Society of Quality in Health Care, spoke on imperatives around quality control in healthcare and mitigating mistakes As countries commit to achieving Health for All, it is imperative to carefully consider the quality of care and health services. According to the WHO, quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes. It is based on evidence-based professional knowledge and is critical for achieving universal health coverage. As per the Lancet analysis of 2018, around five million people die every year due to inadequate healthcare, and almost a third of them are in India (1.6 million). Moreover, addressing the role of quality of care in maternal and newborn mortality, it is estimated that every year 303,000 mothers and 2.7 million newborn infants die around the time of childbirth and that many more are affected by preventable illnesses. 2.6 million babies are stillborn each year. With a population of about 1.44 billion, healthcare services are not dispersed fairly throughout India. What are the imperatives around quality control in healthcare? Quality is an important facet of healthcare. It has many aspects. First, the person providing healthcare needs to be competent; second, he should recognise the patient’s condition; third, communication is vital; and fourth, the outcome of the procedure followed. Although “healthcare” is a simple word, it has a very complex dimension to it. How can we make sure that human errors are mitigated in Indian healthcare? I think nobody comes to work in the hospital thinking I’m going to make a mistake today. It so happens that in these systems, all the issues are aggregated into one issue that creates the error. Today we have safe surgery services, which means that before the patient is anaesthetised, the team, which includes anesthesiologists, asks the patient questions about who the patient is and what he or she has come for. This system is used all over the world. This comes as a result of a commitment to reduce medical errors, along with the acknowledgement that errors do occur not because of the intention to do so but because the systems are not fully proofed enough to prevent them. DR RAVINDRAN JEGASOTHY
76 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM IN FOCUS By Shivam Tyagi
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 77 I n an extraordinary achievement, Indian organ donors and recipients participated and won several medals at the World Transplant Games (WTG) 2023 held in Perth, Australia. The 32 players who flew from India carrying dreams came back with 35 medals. This was the largest contingent of 32 players ever to go from India to the WTG and it is the highest tally of medals ever for India in the transplant games. The Indian contingent was led by their captain Karhun Nanda, a golfer who secured two silvers at the games and was supported by ORGAN India, the Organ Receiving and Giving Awareness Network and non for profit organisation, Manav Rachna who helped train the athletes. BW Healthcare World honoured the winners with appreciation certificates and accolades, celebrating the grit, courage and hardships of the organ donors and recipients who crowned India with several medals. Dr Anurag Batra, Founder, exchange4media and Editor-inChief, BW Businessworld thanked the players for their efforts and stated that the whole country will take inspiration from the valour shown by the players who participated in the games in Australia. Dr Amit Bhalla, Vice President of Manav Rachna Educational Institutions (MREI) said that he was thrilled with the performance of Indian athletes at the World Transplant Games 2023, adding that their participation and winning performances have made India proud. These athletes are a shining example of resilience and the power of the human spirit. “We are overwhelmed with the amazing performance of the Indian athletes at the World Transplant Games. Our collective effort has put India firmly on the map at the games, and this conference is to celebrate this brilliant innings. The athletes’ participation in WTG 2023 has created more awareness about organ donation across India and we are confident that their victory will inspire all Indians”, said Sunayana Singh, CEO, ORGAN India and Country Representative from India at the World Transplant Games Federation (WTGF). World Transplant Games 2023 World Transplant Games 2023 The 32 players who flew from India carrying dreams came back with 35 medals
78 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM “We tend to be happier than normal people” KARHUN NANDA Won Two Silvers At WTG23 Karhun Nanda, the captain who led the Indian contingent of players into the World Transplant Games 2023 started playing football when he was 12 years old and ever since he has dreamt of representing India. He went through heart failure and then a transplant, which gave him a new life. For him in the past five years, the most amazing thing is that what he couldn’t do in his last life, he can do in this life – play for his country! His heart transplant gave him an opportunity to represent India at an international level in golf and at the World Transplant Games 2019 in Newcastle. Leading the team this year in Perth, he secured two slivers for the country in golf. Nanda says,“This year we had the biggest contingent ever. As a team, I am extremely proud as this is the highest medal tally we have ever got. And from the youngest to the oldest everyone has contributed.” Describing the health cum sports journey of players, Nanda says, it’s very difficult to express what all of us, whether donors or recipients have gone through, it has been a life-changing experience. The recipients have been in a neardeath experience with an organ failing and the donors have come forward to save someone’s life. He says, “So in both cases, there has been a life-changing experience and they are nothing short of fighters, warriors and survivors to the core. But what I find most encouraging and fascinating is that the average Happiness Index for a recipient or a donor is much higher than a normal person because of the tragedy that they have gone through in life. We tend to be happier than normal people because we have seen the worst of life.” IN FOCUS “As long as you play sports, you’re not old, you are always younger” P. V. RAMANAIAH Born in 1960, P. V. Ramanaiah was a sportsman from the very beginning. He represented India at the Junior Asian Youth Football Championship in Nepal, and has represented Andhra Pradesh at the U-19 Football Championship. Following his liver transplant in 2017, he has continued to be extremely active, taking up tennis and participating in several local tournaments in Andhra Pradesh. He keeps exceptionally fit and represented India at the World Transplant Games 2023 in both tennis and football. Ramanaiah says he felt very proud, representing the Indian team at the World Transplant Games. “I did not feel any difficulty in playing at this age after transplantation. I’m a liver recipient. My surgery was held in 2017 and after transplantation I have become more active. I want to advise people that as long as you play sports, you’re not old, you are always younger.” Fighters To The Core
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 79 V ijay Bahadur Yadav’s organ donation journey began when his wife’s blood pressure led to kidney scars and, eventually, drastically reduced kidney function. She was on dialysis for a year and a half when it became apparent that a transplant was the only option. Despite his willingness to donate a kidney, he was not a match for his wife. Yadav then registered himself as a donor swap donation, through which his wife was able to get a kidney. Post-transplant, both husband and wife are fit and healthy. Though not a sportsman in his youth, Yadav began his journey in sports eight years ago to stay fit and healthy. An avid runner, he has participated in several 5K/10K events and plays badminton regularly. He secured two golds and a silver for the country at the WTG23. Talking about his experience at the games, Yadav said when he landed in Perth there was only one dream that he was after: winning a medal in the five kilometres race. “It was a dream that I was preparing for to be honest and when I won the gold medal in the five kilometres race, it was like a dream come true. And in the closing ceremony, I was given the outstanding athlete living donor award. That was something unexpected and I was truly amazed.” Choosing sports after his kidney donation was not easy for Yadav. He says that he too was reluctant to play again initially due to not being fully aware. “I was reluctant like any other person but fortunately I was surrounded by a number of donors around me. I met a girl who donated her kidney to her husband. And then she was running half marathons, climbing mountains and I was like if she can do it then so can I.” He adds, “Post the completion of the donation process, I asked my doctor as to when I can run. The doctor said that your body will tell you. So, it might take one week, one month or even six months, but your body will give you a signal, don’t rush.” Giving a message out to the world Yadav states, “I would only say that think about organ donation. Even if you can’t do living organ donation, please register yourself.” “Think about organ donation” VIJAY BAHADUR YADAV Won Two Golds, One Silver At WTG23 “Everyone should be aware of organ donation” VARUN ANAND Won Three Golds At WTG23 Varun Anand, a young 13-year-old from Bengaluru was diagnosed with chronic kidney disease (CKD) when he was just nine years old. His parents had to watch their little one undergo very painful treatments, dialysis and innumerable hospital stays. It soon reached a point where a kidney transplant was imminent. Then Anand’s mother, Deepa donated one of her kidneys to her son to give him a new lease of life. As Anand grew up, he discovered a love for racquet sports. He finds games like table tennis, badminton, tennis etc. challenging and exhilarating, so he works hard to excel in these sports and to keep himself fit. Anand won a gold medal each in all the three games he participated in at the WTG23. Anand states, “I only want to tell two things to the world. First, if you have self-belief and positivity then you can overcome tough times and secondly everyone should be aware of organ donation because if one donates their organs then they a give new life to a person who is possibly in a miserable state.”
80 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM IN FOCUS Following his kidney transplant, Dharmendra Kumar Soti assumed sports was out of the question for a transplant patient. During a follow-up appointment with his doctor, he asked if he could play again. To his surprise the doctor not only approved of the request, but actively encouraged him to take up the sport again. After that, there was no looking back. Soti threw himself into the game and has participated in three editions of the World Transplant Games. This year too he won a gold in badminton at WTG23. Describing his journey in the games, Soti delineates, “I feel very happy to say that I have won gold for India in badminton this year. I have been participating in the World Transplant Games since 2013 where I got my first gold for the country. After that, in 2015 I won a gold and a silver for India, in 2017 I won a bronze but unfortunately in 2019 I could not participate as I had my second kidney transplant.” Soti says that the normal sportsperson takes care of their lifestyle, diet, protein needs and their practice but for the people who have had a transplant, they live a prescribed life and need to take a lot of medicines, certain precautions and at the same time keep themselves fit if they want to play sports. He further says, “All this success was possible because I could get an organ in time and if organ donation in India rises it will save more lives like mine.” ORGAN India has been the support system behind the Indian team which has come back with 35 medals this year. How are you feeling? It’s a feeling of immense pride for me. It’s overwhelming to see so many transplant patients for whom it seemed that life is really going to be over. But they’ve lived not only like normal people, they’ve lived like superhumans, and fantastic athletes. Also it’s a matter of great personal and national pride that we were there with 46 other countries, 3000 transplant patients and for the first time ever, we managed to take an entire contingent of Indian athletes to the World Transplant Games that have been happening for 40 years. When can organ donors or recipients choose to start their sports journey? The body is intuitive and it is about listening to your body and seeing what you’re comfortable doing. A lot of them have had very long and arduous journeys with their health. A lot of them have almost been at death’s door and come back from it. But they are leading absolutely normal, healthy lives, they are healthier and more normal than they were at the pre-transplant stage because the new organ has given them a second lease of life. So it is about listening to their body, listening to their doctor, and making sure they get that clean chit to be able to participate and to compete internationally and to play professional sport. What is your message to the country? My message is that life doesn’t change if you are an organ donor. You can donate an organ and still compete in an international forum like the World Transplant Games. You can go ahead and live a completely normal life. You can go ahead and get married, have children, work in a very exciting career or have an adventurous lifestyle, life doesn’t change, so pledge your organs. Why take them with you? “It was all possible because I could get an organ in time” DHARMENDRA KUMAR SOTI Won Gold At WTG23 “Life doesn’t change if you are an organ donor” ANIKA PARASHAR Founder Chairperson, ORGAN India
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82 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM Promising Future Of India’s Healthcare Sector By Bhupendra Paintola By FY22, it is expected that the Indian healthcare infrastructure will amount to USD 349.1 billion. Additionally, the e-health market is estimated to reach USD 10.6 billion by 2025.
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 83 I ndia has made remarkable progress in revolutionising the delivery and management of healthcare over the past few decades. In the post-pandemic world, the healthcare sector has emerged as one of the most significant areas of focus. The Indian healthcare ecosystem is rapidly integrating technology to keep pace with evolving demands. In the face of the global public health crisis, healthcare professionals, including doctors, nurses, pharmacists, entrepreneurs, and scientists, played a vital role in mitigating risks and providing improved healthcare services to the masses. The Indian healthcare sector is projected to experience a three-fold rise, with a compound annual growth rate (CAGR) of 22 percent between 2016 and 2022, reaching USD 372 billion in 2022 from USD 110 billion in 2016, as reported by the Indian brand equity foundation. By FY22, it is expected that the Indian healthcare infrastructure will amount to USD 349.1 billion. Additionally, the e-health market is estimated to reach USD 10.6 billion by 2025. India boasts a large pool of highly skilled medical professionals. The number of allopathic doctors with recognised medical qualifications registered with state medical councils and the national medical council increased to 1.3 million in November 2021, up from 0.83 million in 2010, the IBEF report added. This availability of trained medical personnel further strengthens the healthcare system in the country. Primary clinics will also transform into e-clinics, where robots will conduct checkups. Smart devices, whether implanted or attached, will monitor and transmit realtime health data for interpretation and provide recommendations for remedial measures DR. H. SUDARSHAN BALLAL Chairman Manipal Health Enterprises
84 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM The Indian government has also demonstrated its commitment to the healthcare sector through significant financial allocations. In the Union Budget 2023–24, the Ministry of Health and Family Welfare (MoHFW) received an allocation of Rs. 89,155 crore (USD 10.76 billion). Moreover, the government plans to introduce a credit incentive programme worth Rs. 500 billion (USD 6.8 billion) to boost the country’s healthcare infrastructure. The Economic Survey of 2023 revealed that India’s public expenditure on healthcare stood at 2.1 per cent of GDP in 2021–22, an increase from 1.8 per cent in 2020–21. The BW Healthcare World 40 Under 40 event recognises and celebrates healthcare influencers under the age of 40 who have redefined and excelled in their respective domains. These individuals possess expertise, empathy, innovation, and foresight, making significant contributions to the field of healthcare. The speakers delineated the significant advancements the sector is poised for in wellness, personalised care, and the integration of artificial intelligence. The Paradigm Shift With Technology Dr. H. Sudarshan Ballal, Chairman, Manipal Health Enterprises, conveyed that healthcare is undergoing a paradigm shift, moving from illness-focused to wellness-focused care. “The future of healthcare will involve several key changes. First, there will be a shift from hospital care to home care, with hospitals being reserved for necessary procedures and surgeries. Primary clinics will also transform into e-clinics, where robots will conduct check-ups. Smart devices, whether implanted or attached, will monitor and transmit real-time health data for interpretation and provide recommendations for remedial measures,” he commented on the future of healthcare. During the 2nd edition of BW Businessworld’s Annual Healthcare Summit, Tathagato Rai Dastidar, Founder and CEO of SigTuple, emphasised the rapid adoption of technology in healthcare. While new technologies emerge frequently, thorough clinical trials are essential to determining their efficacy. Dastidar highlighted the potential of using neural networks, which are already employed for tasks like image recognition, for disease detection. He mentioned that the issue of patentability arises since these neural networks are often open-source and applied across a wide range of solutions. AI and Data Leverage AI in healthcare currently focuses on personalization and customization. Sahil Pruthi, Founder and CEO of Livofy, delineated that AI aids the medical fraternity by reducing resources and time required for patient care. Customization is a general trend in the industry. However, Purthi also reflected that the data collected by these new-age technologies can be more disastrous than helpful if accessed by the wrong hands. Before focusing on security, ensuring the sanctity of the data used to train AI models is essential. AI is trained using vast amounts of data it generates itself, so maintaining the accuracy of that data is crucial for effective training, as Pruthi emphasised. While new technologies emerge frequently, thorough clinical trials are essential to determining their efficacy TATHAGATO RAI DASTIDAR Founder and CEO SigTuple The period of two years of the pandemic has shown the importance of robust health infrastructure. After this, investors look forward to investing more in health startups and business entities functioning in the health sector GANESH Serial Entrepreneur & Partner Growth Story
AI is trained using vast amounts of data it generates itself, so maintaining the accuracy of that data is crucial for effective training SAHIL PRUTHI Founder and CEO Livofy WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 85 Genetic Modification & Organ Transplantation Commenting on genetic modification and Organ transplantation, Ballal stated, “Pharmacogenomic therapy, based on individual genomic characteristics, will replace conventional pharmaceutical medications. This personalised approach will utilise nanodelivery systems for targeted therapy. Genetic modification and gene therapy will offer early detection and complete cures for genetic diseases. Organ transplantation will be revolutionised by growing organs in labs using stem cells, tissue engineering techniques, and 3D printing.” He even delineated the possibility that predicting lifespan will become possible through tests that analyse telomeres. “Surgeries will evolve to involve the injection of stem cells and gene transfer, with surgeons remotely directing robots to perform procedures. However, the presence of surgeons during surgeries will still be necessary to address patient concerns about robotic intervention,” the chairman commented on remote surgeries. Investment Ganesh, Serial Entrepreneur & Partner, of Growth Story, speaking on the expectations of investors in the healthcare sector post-pandemic, stated, “The period of two years of the pandemic has shown the importance of robust health infrastructure. After this, investors look forward to investing more in health startups and business entities functioning in the health sector. That eventually resulted in the entry of more health startups into the space.” Ganesh said that the future seems very promising in terms of the healthcare sector because tectonic changes are taking place. He also shared that he looks for a ‘platform business instead of a pipeline business’ when he is going to invest in the industry. Where he explained that a pipeline business suggests the traditional line of businesses such as hospitals and pharma, about platform businesses, he said, “It is a new buzzword and a new age business model that is governed by network effects in healthcare.” Conclusion The healthcare sector in India is on a transformative journey, driven by innovation, technology, and increased investments. With a growing focus on wellness, personalised care, and the integration of artificial intelligence, the sector is poised for significant advancements. The combination of a skilled workforce, government support, and the emergence of healthcare influencers paves the way for a promising future.
86 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM Using new technologies to build efficiencies I have personally observed that the healthcare and wellness industry ha s been going through a transformation at a faster pace than anytime we have seen before. This transformation has been disruptive in many aspects, whether it is in the way patient-to-doctor connect is happening; the way surgeries are performed; the ways in which artificial intelligence is leading to early diagnosis; how genomics is leading to personalised treatment; how remote monitoring is saving lives and real-time monitoring is equipping nurses to efficiently manage patients; how increased use of AI in pharmaceutical research & development, and medical equipment development is reducing dependency on highly skilled people,thus facilitating access to health services in rural India,among many other developments. I have always believed that disruption is not about displacing something with something entirely new, but it is also about remodelling or using new technologies to build efficiencies in how things already operate. A lot of work is happening to do exactly this. Efficiencies are being built not just to better the medical outcomes, but also improve how the healthcare business is managed. We are seeing a fresh approach in creating patient experiences, hiring models, employee engagement, purchase models for and optimal use of medical equipment, building mental wellbeing for healthcare workers, seamless engagement between healthcare players like hospitals and insurance companies etc. Better cost management has direct impact on the ability to make healthcare affordable and reducing the burden. All of the above requires continuity that is an outcome of perseverance and conviction in doing something innovative. And this conviction and perseverance is fuelled by inspiration and motivation so that more and more people take these initiatives. Our efforts such as the BW Healthcare World 40 under 40 awards recognise young people who have taken action to create a positive impact by contributing to what I believe are the three pillars of healthcare growth – accessibility, quality and affordability. Being recognised for their work makes their journey worthy and also serves as an inspiration for others to embark on their own journey to create an impact. We had an enviable jury that offered their commitment of time to screen the nominees. As a part of the jury, I know how difficult it was to choose the winners since the quality of the nominees and the work done by them was of higher quality than what we saw last year. The jury was chaired by Dr Sudarshan Ballal, Chairman of Manipal Health Enterprises. The jury, the transparent process of selecting the winners and the quality of nominees all together make BW HealthcareWorld 40 under 40 Awards one of the most prestigious awards of the Indian healthcare industry, something that my team and I take pride in. I wish each and every winner the best, and also wish for them to continue their work to further the positive impact in the industry. Harbinder Narula CEO - BW Healthcare World & BW Wellbeing World
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AMRIT AGARWAL 88 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM Through the right use of technology, various resources such as diagnostic centres, path labs, hospitals, equipment etc. that are under utilised can be utilised effectively to provide quality services at affordable pricing Creating Access In Tiers mrit Agarwal joined Pristyn Care at a point when the company was looking to widen its reach by expanding across metro cities. The market research, he says, showed that people in the tier 2 cities of India had good spending capacity but there was a lack of quality healthcare services in these cities. “They had to travel to metro cities to get quality multi speciality and superspeciality healthcare services that made it expensive and involved a lot of time and effort. Keeping this market gap in mind, I, along with my team, adopted this strategy to provide the best asset light quality services platform for the elective surgery in their cities,” Amrit says. However, he adds that it was the execution that played a further significant role. “In around five years, this approach and the execution by the team, led by me, has given a platform and shape to over 35 cities across India where we are performing more than 1600 surgeries a month which is contributing more than 25 per cent of revenue at the company level. This Amrit says is happening because of the speed and the way this team executes the operation along with sales and marketing. “The results today have been remarkable. We are able to discharge the patients in an average of 26 to 28 hours of admission be it any insurance or any cities. We provide the best follow up to all patients at free of cost no matter which part of the country they are living in - meeting the prime vision of providing quality healthcare services at an affordable price to everyone,” Amrit informs. On creating sustainable profitability, Amrit delineates from beginning to present, the company has improved 39 per cent of its revenue share from the market and improved the inventory procurement cost by 35 per cent, concierge by another 40 per cent. On being asked about the challenges in healthcare Amrit says that the healthcare services sector in India faces challenges that cannot be met only as individual organisations but the entire ecosystem needs to come together. “There should be more dialogue and discussions among various stakeholders. Another important point is the use of technology that we are yet to utilise to the fullest which can highly improve the healthcare services in India. Through the right use of technology, various resources such as diagnostic centres, path labs, hospitals, equipment etc. that are under utilised can be utilised effectively to provide quality services at affordable pricing,” he believes. Amrit Agarwal, Vice President - International Business, Pristyn Care speaks on his journey and how he made a difference in tier 2 cities of the country
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 89 The future growth will be driven by a shift from volume focus to volume plus value focus. We are undertaking various initiatives with focus on strengthening infrastructure, talent, regulatory and capital to help companies move up the value chain Finding Innovative Pathways is working in? Going forward, how do you see this space growing? I strongly believe that there exists a huge under tapped opportunity for affordable and accessible healthcare in industry collaboration. With true collaboration, we stand at the cusp of an enormous opportunity to drive exponential growth globally. Furthermore, it is no secret that there are resource limitations in the Government. My team and I therefore strive round the clock to find innovative ways of mobilising resources from various stakeholders by building appropriate value for them without compromising the objective. Other secondary bottlenecks like addressing critical diseases (to serve local population) can be solved by strengthening the regulatory landscape, advancing research infrastructure to position the state as the clinical trials destination of India. The future growth will be driven by a shift from volume focus to volume plus value focus. We are undertaking various initiatives with focus on strengthening infrastructure, talent, regulatory and capital to help companies move up the value chain. What are the government’s financial targets or future plans that it will take on in the coming years? Telangana has attracted over USD 3 billion in net new investments in the past seven years, fueling economic growth and creating over 4,50,000 jobs. Our life sciences services sector caters to more than 1,000 global companies, including the top 10. In 2018, we started out with the aim of doubling the life sciences ecosystem value in Telangana to USD 100 billion by 2023. We have witnessed an extraordinary growth over the last couple of years and are growing at the rate of 23 per cent compared to the national average of 14 per cent, thereby reaching USD 80 billion valuation in 2022 itself. Now we have grown our ambition and revised our target to become USD 250 billion ecosystem by 2030 Shakthi M. Nagappan, Director Life Sciences and Pharma. CEO Hyderabad Pharma City, Govt. of Telangana talks about Telangana government’s ambitions to transform the life sciences ecosystem in the state SHAKTHI M. NAGAPPAN S hakthi M. Nagappan, Director Life Sciences & Pharma & CEO Hyderabad Pharma City , Govt. of Telangana thanked the jury and called the award reflective of his achievements, and of the strides made by the Life Sciences Team, Government of Telangana, which he leads. “I would also like to attribute this recognition to my leadership, mentors, and my family, who have been extremely supportive and a constant source of inspiration,” he says. What are some of the present challenges in the segment that your department
90 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM Avnish Chhabria, Founder, Wellbeing Nutrition says winning the award fills him with pride, reflecting the hard work of the Wellbeing Nutrition team aiming to redefine health by combining nature and science to deliver innovative, high-quality nutrition solutions. “Our core values of excellence, integrity, and customer-centricity have played a vital role in this achievement. By prioritising wellbeing, conducting cutting-edge research, and understanding customer needs, we have created a meaningful impact, resonating with customers and experts. I express my heartfelt gratitude to BW Healthcare for this honor, inspiring us to solidify our position as a leading brand in the healthcare industry,” Chhabria says. How do you view the present gaps in the Nutrition space in India, how do you foresee the segment in the future? One significant gap is the lack of awareness and education about holistic wellbeing and nutrition. We strive to bridge this gap by spreading awareness through educational initiatives, informative content, and engaging platforms that empower individuals to make informed choices about their health. Accessibility and affordability of high-quality nutrition products are also challenges. To overcome this, we AVNISH CHHABRIA We foresee a future where awareness, accessibility, and personalization are at the forefront of the nutrition space. Wellbeing Nutrition is committed to driving positive change, empowering individuals to prioritise their health, and contributing to a healthier and more informed society. Driving Positive Change Avnish Chhabria, Founder, Wellbeing Nutrition speaks about his company’s strategic initiatives and growth plans are committed to developing innovative and accessible products that benefit a broader audience. We foresee a future where awareness, accessibility, and personalization are at the forefront of the nutrition space. Wellbeing Nutrition is committed to driving positive change, empowering individuals to prioritise their health, and contributing to a healthier and more informed society. How are you planning your future revenue targets and future initiatives? At Wellbeing Nutrition, we have ambitious revenue targets for the coming years. This year, we aim to surpass 150 crores in revenue, with a confident outlook towards achieving this milestone. Looking ahead, our target for the following year is even higher, as we aim to exceed 250 crores in revenue. To support these targets, we will focus on strategic initiatives and delivering exceptional products and services. Expanding our product portfolio will remain a key priority, allowing us to cater to a diverse range of customer needs. By introducing innovative and highquality nutrition solutions, we seek to capture a larger market share and drive revenue growth. Expanding our distribution channels is another crucial aspect of our plans. We will increase our presence in modern retail spaces, establish strategic partnerships with key retailers, and expand our online presence. These efforts will enable us to maximise our revenue potential and reach a wider customer base.
ZOYA BRAR WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 91 Zoya Brar, Founder - CORE Diagnostics & Chief of Staff, Eli Health speaks on the gaps in diagnostics industry and future growth of her company At Eli Health we are building the first of its kind at-home hormone testing device using saliva “Hiring, training, retaining the best people is the key scaling lever” Zoya Brar, Founder - CORE Diagnostics & Chief of Staff says that she sees the award not as a recognition of the work done in the past instead, she hopes to use it as an opportunity to spread the word that a culture like that at CORE is possible and that she is available as a coach to help enable it. “I believe the recognition is due my work at CORE, specifically, the success of our social experiment of radical transparency and no-hierarchy that has differentiated CORE as a healthcare startup. Whereas at Eli Health where we are building the first of its kind at-home hormone testing device using saliva. I have also mentored over 60 startups in North America that are at varied stages of progress,” Brar says. What hurdles do you see in the diagnostics industry in India? In diagnostics as I see it, the biggest challenge is access. While we have managed to address the upper 20-30 per cent of the population in the geographies we serve, and that’s an impressive number in absolute terms of nearly 300 million people, still large swaths of the population do not have access to molecular diagnostics. The issue is not just the price point, but logistics of sample transfer and availability of inexpensive point of care instruments that can be deployed in a decentral manner, as opposed to centralised labs. It is only when we solve these problems that we can truly scale – at a societal level. What are your company’s revenue targets or future plans? At CORE we have managed to grow in the range of 5-10 per cent month over month in the past decade. In recent years, the growth rate has been in the range of 5 per cent month over month – simply because we have a much larger revenue base. What’s the rate limiting factor? It is not in demand. It is not capital. It is talent. Hiring, training, retaining the best people – both from a cultural fit and from a competence perspective, is the key scaling lever. Some of this scarcity can be addressed with technology, especially AI, but it will be a disservice to take the human element of healthcare out of healthcare. So, to answer your question more specifically, we do see a CAGR of 40-50 per cent over the next several years – despite the talent shortage – and a growth beyond that would require a de novo look at technology.
92 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM We will focus on strategic partnerships and collaborations to accelerate our growth and reach our vision of making efficacious healthcare accessible to 100 million Indians Expanding Reach In Healthcare What are some of the roadblocks that you see in the healthcare industry today? In the healthcare segment, the rapid pace of technological advancements and evolving patient expectations present significant challenges. Keeping up with the latest innovations can be demanding, especially when it comes to leveraging advanced technologies and meeting the evolving needs of patients. To stay updated, healthcare organisations must continuously update their systems and processes. Patients now demand convenience, personalisation, and access to digital healthcare services, requiring providers to embrace patient-centric approaches and invest in remote consultations, telemedicine, and virtual care. In addition to technological integration, it is important for healthcare providers to recognize the significance of providing tender, loving care to patients. While technological advancements and patient-centric approaches are crucial, the human touch and compassionate care should not be overlooked. Incorporating empathy, active listening, and emotional support into healthcare services is vital for creating a holistic patient experience. What are your future plans? Our future plans revolve around expanding our reach and impact in the healthcare industry. We aim to continue growing our user base and strengthening our position as a leader in the digital healthcare space. We plan to further enhance our technology-driven solutions and expand our service offerings. Additionally, we will focus on strategic partnerships and collaborations to accelerate our growth and reach our vision of making efficacious healthcare accessible to 100 million Indians. VIJAYENDRA SINGH V ijayendra Singh, Chief Operating Officer, Apollo 24/7 says that he is honoured and thrilled to have received the award adding that the award is a validation of the hard work and dedication put in by the entire team at Apollo 24|7. “I believe this recognition is a result of our commitment to delivering accessible and convenient healthcare services, leveraging technology, and continuously innovating in the healthcare space. Our focus on patient-centric care and the impact we have created in terms of downloads, medicine orders, doctor consultations, and patient health records have contributed to this recognition,” Singh states. Vijayendra Singh, Chief Operating Officer, Apollo 24/7 speaks on expanding reach and impact in the healthcare industry
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 93 Vishwa Modi, Chief Psychologist, The Mood Space says that she feels humbled to have received the award adding that the recognition has led her to be aware of professionals doing some wonderful work in the field of healthcare. “While healthcare in India is still developing, events like these offer a chance to meet with like-minded people to bring about a change in how we perceive several disciplines and can create an intersectional society focused on holistic care,” Modi says. What gaps do you see in mental health care in India? To think of it, mental health affects every aspect of our lives, from our relationships with loved ones to our work and daily activities. Unfortunately, for many people, mental health care is not easily accessible or affordable We believe that mental health care should be accessible to everyone, regardless of their financial background. Keeping with that, we extend financial aid to those in need. Our goal is to ensure that every individual gets the help they need to lead a happy and fulfilling life. In addition to financial aid, we also provide pro-bono mental health care services to those who need it the most. Our team of experts works tirelessly to provide the best care and support to individuals who are struggling with their mental health. We ensure that all therapists are trauma-informed, queer allies/affirmative along with therapists and employees from different sects of the society to bring in a caste-affirming lens to cater to the needs of different communities PAN India. What are some of the future goals of The Moods Space? Reaching 3 lakh community members globally in 2023- 24 looking for mental health care and support and proVISHWA MODI We believe that mental health care should be accessible to everyone, regardless of their financial background. Keeping with that, we extend financial aid to those in need. Our goal is to ensure that every individual gets the help they need to lead a happy and fulfilling life Driving Mental Health Access Vishwa Modi, Chief Psychologist, The Mood Space speaks on the inaccessibility of mental health services in India and how his company is plans to take on this challenge viding services to over a 100 corporate companies for the B2B vertical our aim is to cater to 100 companies in the upcoming year. And also launching the Neuropsychology vertical - in a country where there is a dearth of neuropsychologists, TMS will be one of the organisations catering to psychological and neurological concerns.
94 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM ment to improve existing technologies and develop new techniques to improve outcomes for our patients. We want to move towards a more personalised approach, considering individual patient characteristics and optimising treatment protocols accordingly. This could involve leveraging patient-specific data, genetic profiling, and predictive analytics to tailor treatment plans and increase success rates. We also are aiming to enhance the patient experience by providing comprehensive support services, emotional counselling, and educational resources throughout the fertility treatment journey. And ultimately expanding services domestically and globally, seeking to provide accessible and quality reproductive care in different regions is an important goal for us and we are open to partnerships or establishing clinics in areas with limited access to advanced fertility treatments. DR KESHAV MALHOTRA We aim to continue to invest in research and development to improve existing technologies and develop new techniques to improve outcomes for our patients. We want to move towards a more personalised approach, considering individual patient characteristics and optimising treatment protocols accordingly Improving Patient Outcomes Via IVF Dr Keshav Malhotra, Chief Embryologist & Director, Rainbow IV states that he felt incredibly honoured and grateful adding that it is a tremendous achievement to be recognized as one of the top professionals in the healthcare industry. “Several factors have likely contributed to this recognition. Firstly, I believe my dedication and passion for my work have played a significant role. I have always strived to make a positive impact in the infertility sector and improve patient outcomes, Dr Malhotra says. What are the gaps or challenges you believe are there in the IVF segment. Go- ing forward, how do you see this space growing? In vitro fertilisation (IVF) has undoubtedly revolutionised reproductive medicine and helped numerous individuals and couples achieve their dreams of starting a family. However, there are still some gaps and challenges within the field. IVF treatment can be expensive, making it inaccessible to many people who may benefit from it. The high cost of procedures, medications, and multiple cycles can pose a significant financial burden. Improving affor dability and expanding access to IVF treatments would be crucial for ensuring equitable reproductive healthcare. On the other hand while IVF success rates have improved over the years, there is still room for further advancements. Enhancing success rates, especially for older women and those with specific fertility challenges, would be beneficial. What are your company’s future plans that the company will take on in the coming years? We aim to continue to invest in research and developDr Keshav Malhotra, Chief Embryologist & Director, Rainbow IVF speaks on gaps in the IVF segment and how it will grow in times to come
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 95 experience in orthopaedics under Shalby Orthopedics centre of excellence (SOCE) brand. We are also quite optimistic about homec are services on the back of high demand of healthcare services at doorstep in all segments like medical attendant, pharmacy, physiotherapy, diagnostics, doctor’s consultation and many more. With better clinical outcomes, state of the art medical facilities, experienced medical talent and affordable medical services, India has become a preferred medical destination in the international markets in recent times. We are the largest player in western and central part of India, have a core advantage to attract international patients to provide them the right treatment with right services at a right price point. Shalby also contributes to providing high quality and affordable knee & hip orthopaedic medical implants to fulfil the demand and supply gap in India and global markets and became a vertically integrated healthcare player in the orthopaedics segment. What are your revenue targets or future plans? Shalby would continue to be the largest player in Orthopaedics in the world through maximum no of joint replacement performed and growing other specialities as well. With the current in-house infrastructure in place, we aim to double our revenues to Rs 1600 crore from the current levels in the hospitals, devices and franchise businesses in the next 3-4 years. With better clinical outcomes, state of the art medical facilities, experienced medical talent and affordable medical services, India has become a preferred medical destination in the international markets in recent times. We are the largest player in western and central part of India, have a core advantage to attract international patients to provide them the right treatment with right services at a right price point Mastering Orthopaedics SHANAY SHAH S hanay Shah,President, Shalby Ltd says that winning the award gives him a sense of accomplishment, fulfilment and makes him more confident to raise targets and achieve them in the coming future. What gaps or roadblocks do you pres- ently see in healthcare? As an individual, I always take gaps or challenges as an opportunity. We see a huge opportunity in the healthcare sector in the next five to ten years in India. With low doctors and nurse to patient ratio and lack of good healthcare infrastructure especially in Tier-2 and 3 cities, Shalby would like to take this opportunity to expand its presence in those markets through its unique assetlight franchise business model to leverage its 29 years of We aim to double our revenues to Rs 1600 crore from the current levels in the hospitals, devices and franchise businesses in the next 3-4 years
96 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM With a focus on online consultations, Dr Shirolkar is able to reach patients globally and deliver dermatological expertise to a diverse range of individuals. On social media, Dr Shirolkar busts common myths regarding skincare; as well as shares insights on everyday skin conditions and products, which in turn helps a diverse range of people who may not have had access to such information otherwise. “Online consults have allowed me to expand my reach and also ensure that people in remote areas can still receive the care they need,” she says. Apart from this, she has also contributed to several scientific articles and is also an assistant editor of a national dermatology indexed print journal. “In the last two years, I have authored 3 chapters in dermatology textbooks and been a faculty member in several conferences,” she delineates. On being asked about the road to an affordable and accessible healthcare Dr Shirolkar believes that making healthcare more affordable across all sections of society requires a multi-dimensional approach. “Governments can play a crucial role in making healthcare more affordable by implementing policies and initiatives aimed at reducing healthcare costs. This can include subsidising essential medicines, implementing price controls on essential drugs, and regulating healthcare service charges. Implementing universal health coverage ensures that everyone has access to essential healthcare services without experiencing financial hardship,” Dr Shirolkar explains. Dr Shirolkar further says that by providing basic health insurance to all individuals, regardless of their socio-economic status, healthcare becomes more affordable and accessible. “Emphasising preventive healthcare and early intervention can help reduce healthcare costs in the long run. By promoting healthy lifestyles, encouraging regular screenings and check-ups, and addressing health issues at an early stage, the burden of expensive treatments and hospitalizations can be minimised.” Dr Shirolkar’s unique blend of expertise, innovation, and dedication to patient care along with strong online presence set her apart from her peers in healthcare, she says. “Through my verified Instagram account with 3,80,000 followers (and counting!) I have been able to connect with people from all walks of life, both in India and internationally and provide easy to understand, reliable information about various skin conditions, treatments, and skincare routines,” Dr Shirolkar informs. By doing so, she says she empowers the followers to make informed decisions about their skincare and seek appropriate medical help when needed. Governments can play a crucial role in making healthcare more affordable by implementing policies and initiatives aimed at reducing healthcare costs Busting Myths On Skincare DR MANASI SHIROLKAR Dr Manasi Shirolkar, Consultant Dermatologist & Founder, Founder - dr.manasi.skin speaks on her journey as a dermatologists and how healthcare can be affordable and accessible
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 97 ters to more than 650k patients a year in Delhi NCR & Jaipur providing quality diagnostics and imaging services in a patient friendly atmosphere. By providing imaging services for clinical trials for local and international trials and projects, my work allows me to provide impact on drug development and MedTech product development, to a much wider and larger patient population.” He further stated that by partnering with leading pharmaceutical companies working on chronic diseases such as cancers, his company impacts the way treatment will be delivered for such diseases. “Through the research projects, I impact not just Indian patients but also global patients who use the products developed through the research. For example, we work with leading OEM’s such as GE Healthcare, Philips Healthcare to develop products for a global patient base, unaddressed currently,” Mahajan added. On being asked about his work’s impact on sustainable profitability of the company Mahajan revealed that he has implemented a cross subsidisation model which relies on differential pricing for diagnostic tests where the rich subsidise the poor, enabling Mahajan Imaging & Labs to adhere to its principle of not denying a test to anyone for lack of financial means. “This has allowed countless patients with limited means to get access to the best and highest quality imaging & diagnostics. All research projects at CARING have a strong scientific and social impact to them,” Mahajan said. Mahajan further stated that reducing cost of drug and medical product development is crucial for affordability and accessibility of healthcare in India. “Developing a sustainable business model for providing clinical trials and research adhering to highest standards in the world is the need of the hour in India. Given the cost advantage that India has for highly skilled resources as compared to the West, we can perform clinical trials for new drugs and therapies in India at a substantially lower cost than the West, the benefits of which will be passed on to the patient.” Given the cost advantage that India has for highly skilled resources as compared to the West, we can perform clinical trials for new drugs and therapies in India at a substantially lower cost than the West, the benefits of which will be passed on to the patient Placing India On Global R&D Map KABIR MAHAJAN s the leader for the Centre of Advanced Research in Imaging, Neurosciences & Genomics (CARING), the research and clinical trials division of Mahajan Imaging & Labs, Kabir Mahajan works with more than 40 research groups. Which subsume national and international universities, MedTech companies and pharmaceutical companies, putting Mahajan Imaging & Labs and India on the global research and development map. His team performs cutting edge research and serves as the imaging & diagnostics partner in global and national clinical trials. Talking about the diagnostic company’s expanding research Mahajan said, “Mahajan Imaging & Labs caKabir Mahajan, Associate Director, Mahajan Imaging & Labs speaks on how India can leverage clinical trials and research to create affordability in healthcare
98 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM positive patient experiences. “The right way to do so is to build a more reliable and responsive healthcare infrastructure that offers standardised quality care where patients feel valued and satisfied. We need to formulate policies that encourage people to take charge of their health and wellbeing. For instance, the cost of delayed diagnosis, treatment and disease progression of cancer is very expensive and can drive down families into poverty,” Varde believes. He further states that India must bring in a framework of centralised and decentralised, hospital-based, and mobile site testing infrastructure comprising near-patient testing, self-tests, drive-through centers, and sample collection via community health workers, among others to improve access to diagnostics which is first step towards early detection of diseases that can tremendously reduce healthcare costs. NARENDRA VARDE We need to formulate policies that encourage people to take charge of their health and wellbeing Balancing Costs While Delivering Positive Patient Experiences With a career of over 16 years spanning across diverse portfolios from strategy, marketing, service delivery, and complete P&L responsibility in microfinance, IT, consulting and healthcare, Narendra Varde, the Managing Director of IMCD Group & Ex-MD - Roche Diagnostics believes that great companies often measure success through financial sustainability, positive influence on the economy and ecosystem as well as the social value they create. “I have worked for organisations that strongly rely on these pillars for success,” he says. During the devastating second wave in April & May 2021, Varde was invited by Dr Balaram Bhargava Chief of ICMR, Gaurav Masaldan Chief of Customs, VG Somani Chief of CDSCO and Anu Nagar Additional Secretary, on how Roche Diagnostics could support the nation at the critical hour. “The entire healthcare system was overwhelmed by the crisis and hospitals and clinicians needed access to bio-markers. We promised to expedite access to critical bio-markers such as Interluken-6, PCT, D Dimer, CRP and Ferritin that during non-covid times do not have significant uptake as these are critical care parameters for severe hospitalisation. I worked closely with our global CEO and head of Supply Chain to ship stocks from warehouses in Germany and the US via special chartered flights to India,” He further says that Roche worked with Customs officials to secure same-day clearance and transport these bio-markers to hospitals and labs across the country. Additionally, to expedite COVID testing across the country, the company supplied 20 lakh RT-PCR tests to the ICMR to be supplied in a short span of 3 months. Speaking on affordability in healthcare Varde states that for a long time, affordability in healthcare is linked to reduced costs. However, in his view, healthcare systems must focus on balancing costs while delivering Narendra Varde, Managing Director - IMCD Group & Ex-MD - Roche Diagnostics speaks on his ex company’s contribution in Covid times and balance in affordable care
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE JULY - AUGU S T 2023 99 Balancing Costs While Delivering Positive Patient Experiences In addition, Singh says that his company has evolved from being a pure aggregator of healthcare to owning the inputs of supply – as such, true to any HMO model, up to 70 per cent of all Physicians, Technicians, and Paramedics across the organisation are in-house contributing to self-established medial teams across the country to drive standardisation and operational excellence. “This is complemented with our reach extending to one of the largest out-patient health networks available in the country with 10,000 OPD clinics and hospitals, 4400 ambulances, 3700 screening partners etc with coverage in over 8,000 pin codes in India,” Singh states. Speaking on affordable healthcare Singh explained that universal healthcare would ensure that all citizens regardless of income levels have access to healthcare. This can be done via a single-payer system or through government subsidies for private insurance. He further says that improving transparency in healthcare pricing will also come as boon for the industry. “By providing complete information up-front, patients are able to make better-informed decisions about their care – This is implemented across our outpatient services where we give a choice at different price points for patients to ensure we are able to cater to all income levels in society,” Singh says. Singh adds that promoting value-based care will also reduce healthcare costs as this incentivises providers to deliver high-quality, efficient care regardless of various strata of society. “This can be done by tying payments to patient satisfaction and outcomes, rather than the volume of services provided,” Singh believes. By providing complete information upfront, patients are able to make betterinformed decisions about their care – This is implemented across our outpatient services where we give a choice at different price points for patients to ensure we are able to cater to all income levels in society Improving Transparency In Healthcare Pricing ELWINDER SINGH Whilst too many healthcare solutions are focused on episodic care or are transactional in nature, Connect and Heal (CNH Care) provides a coordinated solution leveraging on all aspects of the care cycle across primary, preventive emergency response and tertiary care. “We understand that pure virtual or discovery platforms have their intrinsic limitations in delivering better care outcomes. To this end we ensure that patients have access to both virtual and in-person care via strong offline delivery partners and a team of care concierges to follow up on all aspects of patient care,” states Elwinder Singh, Co-Founder, Connect and Heal (CNH Care). Elwinder Singh, Co-Founder, Connect and Heal (CNH Care) speaks on his company’s journey and affordable healthcare in India
100 BW HE ALTHCARE JULY - AUGU S T 2023 WWW.BWHEALTHCAREWORLD.COM Employing Best Practices ANKIT MAHESHWARI I nnovaccer’s journey began in 2011. Co-founders Abhinav Shashank, current Chief Executive Officer, and Kanav Hasija , current Chief Product Officer began a data analytics project at Wharton and Harvard University that focused on bringing distributed data sets together and leveraging them through analytical technologies. The project explored how Big data can be studied, crunched, and analysed to derive valuable insights. Soon, universities like Stanford and MIT were taking an interest in the pair’s research findings. As a result, Abhinav, Kanav, and Sandeep Gupta (current Chief Operating Officer) founded Innovaccer in Silicon Valley in 2014. Initially targeting enterprise customers in the finance, healthcare, and retail sectors, Innovaccer soon realised that in order to bring about a major data-driven revolution, they’d need to operate in an area small enough to drive focus yet large enough to create an impact. That’s when they decided to focus solely on the healthcare market. As a founding member of that team, Ankit Maheshwari has been an essential part of bringing the fivepeople-in-a-basement organisation to the enterprise and unicorn it is today. He has been at the helm of Innovaccer’s engineering vertical and has worked closely Ankit Maheshwari, Chief Technology Officer & President - India Operations, Innovaccer is the founding member of Innovaccer and has been at the helm of affairs from $1 million valuation to present $3.2 billion valuation of the platform with the organisation’s clients and partners over the years to develop and deploy the Innovaccer Platform. In his cross-functional role, along with leading the engineering and product verticals, he now serves as the CTO of Innovaccer and brings a unique strategic advantage while maintaining and solidifying the organisation. It has been a journey of hyper growth. During Ankit’s time at the helm, the organisation has grown over 80 times in terms of valuation, transitioning from a $1 million valuation to a present $3.2 billion, and more than 100 times in revenue growth, maintaining at least an 80 per cent revenue growth YoY ever since. Ankit has put practices in place to ensure that the employees work in close collaboration with them to create the most relevant technology solutions that not just solve a problem but eliminate it at the grassroots level. Ankit inspired Innovaccer’s decision to focus solely on unifying healthcare delivery systems by helping health systems make their crucial IT systems—including EHRs, claims, labs, pharmacies, and more—interoperable, as well as enable third-party external data (such as social determinants of health) to be integrated. Innovaccer allows healthcare organisations to create a unified record that provides a comprehensive, holistic view of patients that leads to exceptional experiences, high-quality care, and better financial outcome.