HEALTHCARE

March 2021
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Table of Contents

Executive Summary 3

Advantage India 4

Market Overview and Trends 6

Recent Trends and Strategies 10

Growth Drivers 17

Opportunities 31

Key Industry Contacts 34

Appendix 36

2
Executive summary

2. IMPRESSIVE GROWTH PROSPECTS 3. STRONG FUNDAMENTALS AND

• Indian healthcare sector is expected to record a three-fold rise, COST ADVANTAGE
growing at a CAGR of 22% in 2016–2022 to reach US$ 372
• Rising income levels, ageing population, growing health
billion in 2022 from US$ 110 billion in 2016.
awareness and changing attitude towards preventive
• As of March 31, 2021, >6.30 crore (6,30,54,353) vaccine doses healthcare is expected to boost healthcare services demand
have been administered through 10,46,757 sessions across the in future.
country.
• The low cost of medical services has resulted in a rise in the
country’s medical tourism, attracting patients from across the
world. Moreover, India has emerged as a hub for R&D
activities for international players due to its relatively low cost
of clinical research.
1. FOURTH-LARGEST
EMPLOYER
• India climbed to the 63rd rank
among 190 countries in World
Banks ‘Ease of Doing Business’ 4. FAVOURABLE
rankings in 2020. INVESTMENT
• In FY19, Indian healthcare sector ENVIRONMENT
stood as the fourth-largest
employer as it employed a total of
2 3 • Conducive policies for
encouraging FDI, tax benefits,
319,780 people. The sector is
and favourable Government
expected to generate 40 million
policies coupled with promising
jobs in India by 2020.
growth prospects have helped
• The Asian Research and Training
Institute for Skill Transfer 1 4
the industry attract private equity
(PE), venture capitals (VCs) and
(ARTIST) announced plans to foreign players.
create around one million skilled
healthcare providers by 2022.

Source: Business Standard, Ministry of External Affairs, Ministry of External Affairs (Investment and Technology Promotion Division), ASSOCHAM-RNCOS joint paper, Lancet study

3
Advantage India

4
Advantage India

3. POLICY AND GOVERNMENT

2. ATTRACTIVE OPPORTUNITIES SUPPORT
• The Government of India aims to increase • The Government aims to develop India as a global healthcare hub.
healthcare spending to 3% of the Gross Domestic • Public health surveillance in India will further strengthen the health
Product (GDP) by 2022. systems.
• Two vaccines (Bharat Biotech's Covaxin and • In Union Budget 2021, the government allocated Rs. 35,000 crore
Oxford-AstraZeneca’s Covishield manufactured by (US$ 4.80 billion) for COVID-19 vaccines in 2021-22.
Serum Institute of India) – medically safeguarding • In March 2021, the Parliament passed the National Commission for
Indian population and those of 100+ countries Allied, Healthcare Professions Bill 2021, which aims to create a body
against COVID-19. that will regulate and maintain educational and service standards for
healthcare professionals.
1. STRONG DEMAND
• Rising income, greater health 4. RISING MANPOWER
awareness, lifestyle diseases
and increasing access to  Availability of a large pool of well-
insurance will contribute to trained medical professionals in
growth. 2 3 the country.
 The number of doctors with
• It is estimated that India will recognised medical qualifications
require 2.07 million more (under I.M.C Act) registered with
doctors by 2030 in order to state medical councils/medical
achieve a doctor-to-population council of India increased to
1,255,786 in September 2020
ratio of 1:1,000.
1 4 from 827,006 in 2010.

Source: KPMG, Deloitte, Hospital Market – India by Research on India, Frost and Sullivan, LSI Financial Services, ‘Report on Healthcare, Telemedicine and Medical Tourism in India’- ASA
and Associates LLP, Indian Journal of Public Health

5
 MARKET OVERVIEW AND TRENDS

MARKET OVERVIEW

6
The healthcare market functions through five segments

Government hospitals – It includes healthcare centres, district hospitals and

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

It includes manufacturing, extraction, processing, purification and packaging

Pharmaceutical
of chemical materials for use as medications for humans or animals.

It comprises businesses and laboratories that offer analytical or diagnostic

Healthcare Diagnostics
services, including body fluid analysis.

It includes establishments primarily manufacturing medical equipment and

Medical equipment
supplies, e.g. surgical, dental, orthopaedic, ophthalmologic, laboratory
and supplies
instruments, etc.

It includes health insurance and medical reimbursement facility, covering an

Medical insurance
individual’s hospitalisation expenses incurred due to sickness.

Telemedicine has enormous potential in meeting the challenges of

Telemedicine healthcare delivery to rural and remote areas besides several other
applications in education, training and management in health sector.

Source: Hospital Market – India by Research on India

7
Strong growth in healthcare expenditure over the years

 Healthcare has become one of India's largest sector, both in terms of Healthcare
Visakhapatnam
Sectorport
Growth
traffic
Trend
(million
(US$tonnes)
Billion)
revenue and employment. The industry is growing at a tremendous
pace owing to its strengthening coverage, service and increasing
400 CAGR: 17.69%
expenditure by public as well private players.

 In 2016–22, the market is expected to record a CAGR of 17.69%.

372
350
 The total industry size is estimated to reach US$ 193.83 billion by
2020 and US$ 372 billion by 2022. 300

250

200

194
150

160
140
100

50

2020F

2022F
2016

2017
Note: F – Forecast
Source: Frost and Sullivan, LSI Financial Services, Deloitte

8
Per capita healthcare expenditure has risen at a fast pace

 This is due to rising income, easier access to high-quality healthcare Government

Visakhapatnam
Healthcare
portExpenditure
traffic (million
astonnes)
a % of GDP
facilities and greater awareness of personal health and hygiene.

 Greater penetration of health insurance aided the rise in healthcare

spending, a trend likely to intensify in the coming decade.
2.5
 Economic prosperity is driving the improvement in affordability for
generic drugs in the market.

 In Budget 2021, India’s public expenditure on healthcare stood at

1.2% as a percentage of the GDP. 1.8
 The Government is planning to increase public health spending to 1.5
1.4 1.4
2.5% of the country's GDP by 2025. 1.3
1.2 1.2
 The share of healthcare in GDP is expected to rise 19.7% by 2027.

Note: BE- Budget Estimated, RE- Revised Estimate

Source: World Bank, Economic Survey FY20

9
 Recent Trends and Strategies

RECENT TRENDS AND STRATEGIES

10
Healthcare infrastructure has risen at a fast pace

Number of Medical Colleges Number of Doctors

600 1,280,000

562 1,260,000
500 529 541

1,255,786
1,240,000
462 476
400 1,220,000
412
1,200,000
300
1,180,000
200 1,160,000

1,154,686
1,140,000
100
1,120,000
0 1,100,000
FY16 FY17 FY18 FY19 FY20 FY21* 2018 2020

 India’s medical educational infrastructure has grown rapidly in the last few decades.

 As of February 2021, the number medical colleges in India stood at 562.

 The number of doctors having recognised medical qualifications (under I.M.C Act) registered with state medical councils/medical council of India
increased to 1,255,786 in September 2020 from 827,006 in 2010.

 As per information provided by the Board of Governors (March 2020), the Council of India (MCI) registered 3,71,870 allopathic doctors with the
Medical Council of India/State Medical Council for their specialist/postgraduate qualifications. This gives a 1:3629 doctor–population ratio, as per
the latest population estimate of 135 crore.

Source: National Health Profile 2019 ; *As of February 2021

11
Notable trends in the Indian healthcare sector … (1/3)

1
Shift from communicable to lifestyle diseases
• With increasing urbanisation and problems related to modern-day living in urban settings, currently, about 50% of spending on in-patient beds
is for lifestyle diseases – this has increased the demand for specialised care. In India, lifestyle diseases have replaced traditional health
problems.
• Most lifestyle diseases are caused by high cholesterol, high blood pressure, obesity, poor diet and alcohol.

2
Expansion to tier ii and tier iii cities
 Vaatsalya Healthcare is one of the first hospital chains to start focus on tier II and tier III for expansion.
 To encourage the private sector to establish hospitals in these cities, the Government has relaxed taxes on these hospitals for the
first five years.

3
Emergence of telemedicine
• Telemedicine is a fast-emerging sector in India. Major hospitals (Apollo, AIIMS, Narayana Hrudayalaya) have adopted telemedicine
services and entered into a number of PPPs.
• Telemedicine can bridge the rural-urban divide in terms of medical facilities, extending low-cost consultation and diagnosis facilities to
the remotest of areas via high-speed internet and telecommunication.
• On March 17, 2021, the Health Ministry’s eSanjeevani telemedicine service crossed 3 million (30 lakh) teleconsultations since its launch,
enabling patient-to-doctor consultations from the confines of their home, and doctor-to-doctor consultations.

Note: PPP is Public – Private Partnerships, Management contracts - An arrangement under which operational control of an enterprise is given to a separate entity for a fee
Source: IRDA, CII, Grant Thornton, Gartner, Technopak, News Articles

12
Notable trends in the Indian healthcare sector … (2/3)

4
Rising adoption of artificial intelligence (AI)
• Rising adoption of AI-based applications has enabled people to talk directly to doctors, physician, and expertise for the best treatment.
• It is also capable of solving problems of patients, doctors, and hospitals as well as the overall healthcare industry.

5
Introduction of vaccine delivery digital platform
 In December 2020, a new COVID-19 vaccine delivery digital platform called 'CO-WIN' is being prepared to deliver vaccines. As a
beneficiary management tool with different modules, this user-friendly mobile app for recording vaccine data, is in the process of
establishing the ‘Healthcare Workers’ database, which is in an advanced stage across all states/UTs.

 In January 2021, Union Health Secretary, Mr. Bhushan stated that the Government of India will proactively help other countries who
may want to use CO-WIN, India’s indigenous vaccination management system.

6
Increasing penetration of health insurance
• In FY20, gross healthcare insurance stood at 27.3% of overall gross direct premium income by non- life insurers segment.
• Health insurance is gaining momentum in India. Gross direct premium income underwritten by health insurance grew 17.16% y-o-y to
Rs. 51,637.84 crore (US$ 7.39 billion) in FY20.

Source: News Articles

13
Notable trends in the Indian healthcare sector … (3/3)

7
Focus on universal immunization programmes (UIP)
 As of December 2020, under universal immunization programmes, ~1.54 lakh ANMs (auxiliary nurse midwives) are operating as COVID-19
vaccinators. For further expansion of vaccinators, the government plans to take collaborative effort with states and UTs.

8
Technological initiatives
 Digital Health Knowledge Resources, Electronic Medical Record, Mobile Healthcare, Electronic Health Record, Hospital Information System,
PRACTO, Technology-enabled care, telemedicine and Hospital Management Information Systems are some of the technologies gaining wide
acceptance in the sector.
 In December 2020, Hahnemann Scientific Laboratory (India) Pvt. Ltd. (Haslab), in collaboration with 3EA (a management consulting group),
launched India's first homeopathy healthcare mobile application to better serve patients.

Source: News Articles

14
Covid-19 fightback from the Indian healthcare sector

Export of the COVID-19 COVID-19 Vaccination

vaccine • As of March 31, 2021, >6.30 crore
• In February 2021, India (6,30,54,353) vaccine doses have been
approved the commercial administered through 10,46,757 sessions
supply of 24 million doses of across the country.
COVID-19 vaccines to 25
countries, more than 2x the
10.5 million vaccines exported
in January 2021. Through this,
seven countries, including
Brazil, Morocco and South
Africa, were sent >~10 million
doses on a commercial basis.

Collaboration
• In March 2021, Virchow Biotech, a Hyderabad-based firm, and the Russian Direct
Investment Fund (RDIF) announced a collaboration to manufacture up to 200 million
doses of the Sputnik V vaccine in India.

Notes: R&D - Research and Development,

Source: News Articles

15
Strategies adopted
3. CO-DEVELOPMENT
2. DIFFERENTIATION AND  Key players in the industry are
focusing on start-ups for co-
DIVERSIFIED BUSINESS developing innovative healthcare
APPROACH solutions. In December 2020, a
4. MERGER &
cohort of six health-tech start-ups, ACQUISITION (M&A)
 Players in the industry are trying to
AarogyaAI, BrainSightAI, Fluid AI,  In February 2021, the Competition
differentiate themselves by providing
InMed Prognostics, Wellthy Commission of India (CCI)
multiple health care services under one roof.
Therapeutics and Onward Assist, approved acquisition of Varian
 Offering a range of healthcare and wellness
have been selected by the India Medical Systems, Inc. by Siemens
services under a single brand has become a
Edison Accelerator, fuelled by GE Healthineers Holding I Gmb (SHS
trend. Patients and healthcare services
Healthcare. India Edison GmbH).
seekers find it convenient. Demand of such
Accelerator, the company's first  In September 2020, Oncquest
arrangements boosts the healthcare sector.
start-up partnership programme Laboratories acquired the Indian
focused on Indian mentors, creates facilities of Quest Diagnostics, from
1. COST LEADERSHIP strategic partners to co-develop clinical research and diagnostics
healthcare solutions. company Strand Life Sciences.
• Private players in the
industry are making their
supply chains efficient and
leveraging economies of
scope to reduce cost. One
such example is Narayan
Hrudayalaya (NH), where
2 3
health care is provided at
affordable cost. NH
reduces cost by high
procurement of medical
supplies, high-volume by
high capacity utilisation 1 4
and staff productivity and
good human capital
management (i.e. training).

Source: PE Roundup – 1H2018 & Jun’18 report by EY, News Articles

16
 Growth Drivers

GROWTH DRIVERS

17
Indian healthcare sector is poised to grow

2. POLICY SUPPORT 3. FOCUS

 Encouraging policies for FDI in the private sector. • Expanding R&D and distribution facilities
 Reduction in customs duty and other taxes on life- in India.
saving equipment. • Use of modern technology.
 NRHM allocated US$ 10 billion for healthcare • Providing support to global projects from
facilities. India.
 National Health Insurance Mission to cover entire
population.

4. M&A
2 3
1. GROWING DEMAND • Rising FDI and private sector
investment.
• Rising incomes and • Lucrative M&A opportunities.
affordability. • Foreign players setting R&D
• Growing elderly population,
changing disease patterns. 1 4
centres and hospitals.

• Rise in medical tourism.

• Better awareness of wellness,
preventive care and diagnosis.

Note: FDI – Foreign Direct Investment, M&A - Mergers and Acquisitions NRHM - National Rural Health Mission
Source: Ministry of Health and Family Welfare, Government of India

18
Rising income, ageing population to be key healthcare
demand driver

 Rising income means a steady growth in the ability to access Visakhapatnam

GDP per Capita
port
at Current
traffic (million
Prices tonnes)
(US$)
healthcare and related services.

 Per capita GDP of India is expected to reach US$ 3,277.28 in 2024 3,500
from US$ 1,761.63 in 2016.

3,277.28
 Moreover, changing demographics will also contribute to greater
3,000

3,023.39
healthcare spending. This is likely to continue as the size of elderly
population is set to rise from the current 98.9 million to about 168

2,791.31
million by 2026. 2,500

2,578.11
2,378.67
 Per capita GDP at current prices for 2019–20 stood at US$ 2,181.14.

2,181.14
2,000

2,036.20
2,014.01
1,761.63
1,500

1,000

500

2016

2017

2018

2019

2020

2021

2022

2023

2024
Source: International Monetary Fund, World Economic Outlook Database, April 2018

19
Medical tourism: a new growth factor for India’s healthcare
sector

 Presence of world-class hospitals and skilled medical professionals has strengthened India’s position as a preferred destination for medical
tourism.

 Superior quality healthcare coupled with low treatment costs in comparison to other countries is benefiting Indian medical tourism, and in
turn, has enhanced prospects for the Indian healthcare market.

 Treatment for major surgeries in India costs approximately 20% of that in developed countries.

 India also attracts medical tourists from developing nations due to lack of advanced medical facilities in many of these countries.

 Indian medical tourism market is growing at the rate of 18% y-o-y and is expected to reach US$ 9 billion by 2020.

 Yoga, meditation, ayurveda, allopathy and other traditional methods of treatment are major service offerings that attract medical tourists from
European nations and the Middle East to India.

 The Government of India liberalised its policy by providing 100% FDI in the AYUSH sector for wellness and medical tourism segment.

 By mid-2022, a new AIIMS in Rajkot covering ~201 acres of land is expected to be established at an estimated cost of Rs. 1195 crore (US$
162.69 million). The facility will have a 30-bed AAYUSH block, a 750-bed hospital. It will also have 125 seats for MBBS and 60 seats for
nursing programme.

Source: Ministry of Health, RNCOS, KPMG, Deloitte, Medical Tourism Association, LSI Financial Services, Apollo Investor Presentation

20
Re-emergence of traditional medical care

5. Recent Developments
1. Market size and • In the Union Budget 2021, the Ministry of
services offered AYUSH was allocated Rs. 2,970 crore
(US$ 407.84 million), up from Rs. 2,122

5
• The Indian ayurvedic industry is crore (US$ 291.39 million).
expected to reach US$ 9 billion by

•
2022.
Ayurveda and Unani medicines
1
consist of more than 90% of plant
based formulations.
• The sector has broadened its
offerings and now includes services
on diet and nutrition, yoga, herbal 4. Developing infrastructure
medicine, humour therapy and spa.
2 4 • In January 2021, the Citizen
Assistance and Relief in Emergency
Situations (PM CARES) Fund Trust of
2. Leading brands and the Prime Minister allocated Rs.
players 3 201.58 crore (US$ 27.55 million) for
the construction of 162 additional
dedicated pressure swing adsorption
• Many big players such as Apollo,
(PSA) medical oxygen generation
VLCC and Manipal Group are setting
plants inside the country's public
up wellness centres across India with
health facilities.
traditional healthcare remedies as the 3. Notable trends • The country had 393 ‘Ayurveda’ and
focus of their offerings.
• The traditional medical sector is developing 221 homeopathy government
Traditional Knowledge Digital Library to prevent recognised colleges. As of April 2020,
companies from claiming patents on such number of sub-centres reached
remedies. There is a growing interest from 169,031 and number of primary health
numerous PE firms in the traditional healthcare centres (PHCs) increased to 33,987.
sector in India. • The total number of ayurveda
Notes: AYUSH - Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homoeopathy, MoU – Memorandum of Understanding practitioners in India increased to
Source: Ministry of Health, Make in India, RNCOS, KPMG, Ayurveda Industry Market Size, Strength and Way Forward report by 443,704 in 2018 from 419,217 in
Confederation of Indian Industry (CII), News Articles 2016.

21
Policy support and government initiatives… (1/8)

1
Pradhan Mantri Jan Arogya Yojana (PMJAY)
 The government announced Rs. 64,180 crore (US$ 8.80 billion) outlay for the healthcare sector over six years in the Union Budget 2021-
22 to strengthen the existing ‘National Health Mission’ by developing capacities of primary, secondary and tertiary care, healthcare
systems and institutions for detection and cure of new & emerging diseases.

2
Tax incentives
 All healthcare education and training services are exempted from service tax.
 Increase in tax holiday under section 80- IB for private healthcare providers in non metros for minimum of 50 bedded hospitals.
 250% deduction for approved expenditure incurred on operating technology enables healthcare services such as tele medicine , remote
radiology. Artificial heart is exempted from basic custom duty of 5%.
 Income tax exemption for 15 years for domestically manufactured medical technology products.
 The benefit of section 80-IB has been extended to new hospitals with 100 beds or more that are set up in rural areas. Such hospitals are
entitled to 100% deduction on profits for 5 years.

Source: News Articles

22
Policy support and government initiatives… (2/8)

3
National Nutrition Mission
 The Union Cabinet approved setting up of National Nutrition Mission (NNM) to monitor, supervise, fix targets and guide the nutrition
related interventions across ministries.
 The programme is planning to reduce the level of stunting by 2%, under-nutrition 2%, anaemia by 3% and low birth babies by 2% ever
year.
 Over 100 million people are expected to be benefited by this programme – all states and districts will be covered within the programme.
 In Union Budget 2021-22, the government announced its plans to launch ‘Mission Poshan 2.0’ to merge ‘Supplementary Nutrition
Programme’ with ‘Poshan Abhiyan’ (Nutrition Mission) in order to improve nutritional outcomes across 112 aspirational districts.

4
Recent initiatives
 In January 2021, the government has placed a purchase order with Serum Institute of India (SII) for 11 million doses of Oxford COVID-19
vaccine, Covishield. On January 16, 2020, India plans to launch its COVID-19 vaccination campaign, the world's largest inoculation
programme, with an emphasis on nearly three crore healthcare staff and frontline workers.

5
National Health Mission (NHS)
 The Government of India approved continuation of ‘National Health Mission’ with a budget of Rs. 37,130 crore (US$ 5.10 billion) under
the Union Budget 2021-22.

Source: News Articles

23
Policy support and government initiatives… (3/8)

6
Incentives in the medical travel industry
 Incentives and tax holidays are being offered to hospitals and dispensaries providing health travel facilities. Senior citizens above 80
years of age will be allowed deduction of US$ 491 towards medical expenditure if they are not covered under health insurance.

7
Universal health
 The Union Budget 2021 announced the launch of ‘Jal Jeevan Mission’ (Urban) to achieve universal health. The mission is aimed at
universal supply of water to all 4,378 urban local bodies, with 2.86 crore household tap connections, and management of liquid waste in
500 AMRUT cities. It will be executed with an outlay of Rs. 2,87,000 crore (US$ 39.41 billion) over five years.

8
Tele-medicine initiatives
 State Telemedicine Network (STN): The states and union territories have been provided support under the National Health Mission
(NHM) under Program Implementation Plan (PIP) to create reliable, ubiquitous and high speed network backbone.

 In March 2020, the Ministry of Health & Family Welfare launched National Teleconsultation Centre (CoNTeC).

Source: News Articles

24
Policy support and government initiatives… (4/8)

9
Bilateral ties
 In February 2021, the Minister for Commerce and Industry of India, Mr. Piyush Goyal, and the UK Secretary of State for International
Trade, Ms. Elizabeth Truss MP, completed a meeting to discuss the bilateral trade and economic relations of India–UK trade and
investment relationship. The Ministers also welcomed enhancement of bilateral health cooperation between the two countries, such as on
vaccines, which is allowing India to serve as a global source of strength in overcoming COVID-19-imposed challenges.

10
Single window system
 Drug Controller General of India (DCGI) has proposed to set up a single window system for start-ups and innovators seeking
approvals , consents, and information regarding regulatory requirement.

11
Medical institutions
 Under Union Budget 2019–20, the Government allocated Rs. 800 crore (US$ 110.88 million) for the upgradation of state Government
medical colleges (PG seats) at district hospitals and Rs. 1,361 crore (US$ 188.63 million) for Government medical colleges (UG
seats) and Government health institutions.
 During FY17–FY19, the Government of India permitted to start of 86 new colleges, which included 51 in FY17, 14 in FY18 and 21 in
FY19.
 In November 2020, the Health Ministry approved a new category for selection and nomination of candidates from ‘Wards of COVID-19
Warriors’ under central pool MBBS/BDS seats for the 2020-21 academic year.
Note: ^ - includes ayurveda, homeopathy and unani practitioners, along with allopathy doctors
Source: Union Budget 2019-20, News Articles

25
Policy support and government initiatives… (5/8)

12
Union Budget 2020–21
 In the Union Budget 2021, investment in health infrastructure expanded 2.37x, or 137% YoY; the total health sector allocation for FY22
stood at Rs. 223,846 crore (US$ 30.70 billion).

 Under the Union Budget 2021-22, the Ministry of Health and Family Welfare has been allocated Rs. 73,932 crore (US$ 10.35 billion) and
the Department of Health Research has been allocated Rs. 2,663 crore (US$ 365.68 billion).

 The government allocated Rs. 37,130 crore (US$ 5.10 billion) to the 'National Health Mission".

 PM Aatmanirbhar Swasth Bharat Yojana was allocated Rs. 64,180 crore (US$ 8.80 billion) over six years.

13
Establishment of health system capacities at airports under the Aatmanirbhar
Swasth Bharat Yojana
 In Budget 2021, the government proposed enhancement of the country's potential for health systems, which included entry points for
aviation. It plans to strengthen the public health units at 32 airports under the Aatmanirbhar Swasth Bharat Yojana scheme. This
programme would promote smooth movement of pharmaceuticals through India and other parts of the world by air.

Note: ^ - includes ayurveda, homeopathy and unani practitioners, along with allopathy doctors
Source: Union Budget 2021–22

26
Policy support and government initiatives… (6/8)

14
Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)
 In Union Budget 2020–21, Rs. 3,000 crore (US$ 429.25 million) was allocated to the scheme.

 The Government of India approved phase III of the scheme in August 2019. Under this, 75 more new medical colleges will be established
all over the country.

15
‘Vision 2035: Public Health Surveillance in India’
 To make the public health surveillance system in India more flexible and predictive to strengthen action preparedness at all levels.
 A citizen-friendly public health surveillance system, supported by a consumer feedback process, would ensure individual privacy and
confidentiality.
 To improve data-sharing system for effective disease control between the Centre and states.
 India aims to provide regional and international leadership in managing events of global concern, which constitute a public health
emergency.

16
Rashtriya Swasthya Bima Yojna
 In Union Budget 2019–20, Rs. 156 crore (US$ 22.32 million) was allocated to Rashtriya Swasthya Bima Yojna.

Source: News Articles, Press Information Bureau

27
Policy support and government initiatives… (7/8)

17
Ayushman Bharat
 Ayushman Bharat scheme was launched to ensure universal health coverage and provide financial risk protection, assuring quality and
affordable essential health services to all individuals.

 In February 2021, Prime Minister Mr. Narendra Modi laid the foundation stones for two hospitals and launched ‘Asom Mala’, a
programme for state highways and major district roads, in Assam. He also added that ~1.25 crore people in the state are being benefitted
from Ayushman Bharat Scheme.

 As of November 2020, ~28.10 crore citizens received free treatment under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana.
The government is also planning to establish 1.5 lakh Ayushman Bharat Health and Wellness Centres by December 2022.

 In December 2020, Prime Minister, Mr. Narendra Modi launched Ayushman Bharat Pradhan Mantri Jan Arogya Yojana SEHAT scheme
for residents of Jammu and Kashmir.

 In December 2020, the Ministry of AYUSH has approved 200 AYUSH Health & Wellness Centres (HWC) in Uttarakhand, under centrally-
sponsored scheme of National AYUSH Mission (NAM).

18
Digital India initiative
 As of February 2021, 420 e-Hospitals were established across India as part of the central government's ‘Digital India’ initiative.

Source: News Articles, Press Information Bureau

28
Policy support and government initiatives… (8/8)

19
Free Covid Vaccine For Healthcare Workers
 In the Phase 1 of COVID-19 vaccination drive, free vaccine shall be provided across the country to the prioritised beneficiaries that
include 10 million healthcare and 20 million frontline workers.

20
Intensified Mission Indradhanush (IMI) 3.0
 In March 2021, various states and UTs started implementation of the ‘Intensified Mission Indradhanush 3.0’—a campaign aimed to
reach those children and pregnant women who were missed out or have been left out of the routine immunisation programme due to
the COVID-19 pandemic. This is aimed to accelerate the full immunisation of children and pregnant women through a mission mode
intervention.

Source: News Articles, Press Information Bureau

29
FDI inflow

 100% FDI is allowed under the automatic route for greenfield Cumulative FDI inflows from April 2000 to December 2020 into
Visakhapatnam port traffic (million tonnes)
projects. the healthcare sector (US$ billion)

 For brownfield project investments, up to 100% FDI is permitted

under the Government route.
2.17
 Demand growth, cost advantages and policy support have been
instrumental in attracting FDI.

 Between April 2000 and December 2020, FDI inflows for drugs and
pharmaceuticals sector stood at US$ 17.74 billion. 7.03
 Inflows in sectors such as hospitals and diagnostic centres and US$ 26.94 billion
medical and surgical appliances stood at US$ 7.03 billion and US$
2.17 billion, respectively, between April 2000 and December 2020.
17.74

Drug and Pharmaceuticals

Hospital and Diagnostic Centers

Medical and Surgical Appliances

Note: FDI – Foreign Direct Investment

Source: Department of Industrial Policy and Promotion

30
 Opportunities

OPPORTUNITIES

31
Opportunities in healthcare

2. RESEARCH
 On January 6, 2021, Dr. Harsh Vardhan,
the Union Minister for Health & Family
Welfare, released India Report on
Longitudinal Ageing Study of India
3. HEALTH-TECH
1. HEALTHCARE (LASI) Wave-1; and stated that this
 In December 2020, India Accelerator
report will be used to further improve
INFRASTRUCTURE and expand the reach of ‘National (IA) announced its plan to launch a
Elderly Health Care’ network and 'Pulse' programme for emerging
• Additional three million beds will
contribute to implementation of a companies working in the health-tech
be needed for India to achieve the
spectrum of preventive and healthcare sector. IA will deliver a sixteen-week
target of 3 beds per 1,000 people
services for the elderly and vulnerable
by 2025. Also, India will have one long accelerator programme to a pool of
population.
doctor to every 800 patients by 5-7 emerging start-ups operating in this
2030 sector. The aim for the initiative is to
• Additional 1.54 million doctors and
2.4 million nurses will be required accelerate innovation and transform
to meet the growing demand for Indian healthcare through start-ups.
healthcare. 58,000 job
opportunities are expected to be
generated in the healthcare sector
2 3
by 2025.
• Over US$ 500 billion is expected 4. MEDICAL DEVICES
to be spent on medical
infrastructure by 2030.  The medical devices market is
• Over the years, India has made expected to reach US$ 11 billion
strategic interventions in National
Health Mission and the national
1 4
by 2022, backed by rising
geriatric population, growth in
disease control programmes to medical tourism and declining
ensure quality and affordable cost of medical services.
healthcare for all.

Source: News Articles

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Opportunities in health insurance

 In FY20, total gross direct premiums grew at 13.52% y-o-y to Rs. Health Insurance Premium Collection (US$ Billion)
51,637.84 crore (US$ 7.39 billion). The health segment has a 27.3%
share in gross direct premiums earned in the country. 8.00 CAGR: 16.01%
 According to Economic Survey 2020-21, the health insurance
industry experienced increasing insurance coverage in FY20. The 7.39
7.00
number of households in Bihar, Assam and Sikkim that had health
insurance increased by 89% in FY20, as compared with FY16. 6.51
6.00
 By leveraging strategic partnerships, WhatsApp plans to debut 5.88
opportunities for health insurance and micro-pension products in
India. WhatsApp plans to collaborate for the Sachet-Health 5.00
Insurance Programme with the State Bank of India (SBI) General 4.78
and plans to work with HDFC Pension to introduce the National
4.00
Pension Scheme. 4.08

3.00

2.00

1.00

0.00 FY16

FY17

FY18

FY19

FY20
Source: GIC

33
Key Industry Contacts

34
Key industry contacts

Agency Contact Information

I.M.A. House
Indraprastha Marg,
New Delhi - 110 002, India
Indian Medical Association
Telephone: 91 11 2337 0009, 2337 8819
Fax: 91 11 2337 9470, 2337 9178
Website: www.ima-india.org
E-mail: hsg@ima-india.org

Model Residency, 605,

Bapurao Jagtap Marg,
The Federation of Obstetric
Jacob Circle, Mahalaxmi East,
and Gynaecological Societies
Mumbai - 400 011, India
of India
Fax: 23021383
Website: www.fogsi.org
E-mail: fogsi2007@gmail.com

35
Appendix

36
Glossary

 CAGR: Compound Annual Growth Rate

 EPA: Externally Aided Projects

 FDI: Foreign Direct Investment

 FY: Indian Financial Year (April to March)

 So FY10 implies April 2009 to March 2010

 GOI: Government of India

 ICT: Information and Communications Technology

 IMF: International Monetary Fund

 Rs.: Indian Rupee

 M and A: Mergers and Acquisitions

 NHRM: National Rural Health Mission

 PPP: Public Private Partnerships

 R and D: Research and Development

 US$: US dollar

 WHO: World Health Statistics

 Where applicable, numbers have been rounded off to the nearest whole number

37
Exchange rates

Exchange Rates (Fiscal Year) Exchange Rates (Calendar Year)

Year Rs. Equivalent of one US$ Year Rs. Equivalent of one US$
2004-05 44.95 2005 44.11

2005-06 44.28 2006 45.33

2006-07 45.29 2007 41.29
2007-08 40.24 2008 43.42
2008-09 45.91 2009 48.35
2009-10 47.42 2010 45.74
2010-11 45.58 2011 46.67
2011-12 47.95 2012 53.49
2012-13 54.45 2013 58.63
2013-14 60.50 2014 61.03
2014-15 61.15 2015 64.15
2015-16 65.46 2016 67.21
2016-17 67.09 2017 65.12
2017-18 64.45 2018 68.36
2018-19 69.89 2019 69.89
2019-20 70.49 2020 74.18
2020-21 72.59 2021* 73.69

Note: As of February 2021

Source: Reserve Bank of India, Average for the year

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