Sectoral Analysis (Healthcare Sector) - November '21

EDITOR'S NOTE ConQuest, the Consulting & Strategy Club of IIM Shillong, was founded in 2008 with a vision of delivering sustainable solutions to society by acting as a forum between the industry and students passionate about strategy and consulting. It strives to equip the students with domain knowledge and skills by facilitating consulting assignments, expert talks, online newsletters, and competitions.

Healthcare is one of India's most important industries in terms of both revenue and employment.

Hospitals, clinical trials, outsourcing, medical devices, telemedicine, health insurance, medical tourism, and medical equipment are integral parts of the healthcare industry. The Indian healthcare system is expanding rapidly due to improved coverage, services, and increased spending by both public and private entities. The public and private sectors of India's healthcare delivery system are divided into two categories.

The enormous pool of highly trained medical personnel in India gives an edge to this industry in India. The Indian healthcare industry is also cost-competitive in comparison to its Asian and Western counterparts. In India, surgery costs around a tenth of what it costs in the United States or Western Europe.

The healthcare market in India is being driven by growth in incidences of lifestyle diseases, technological advancements, rapid health insurance penetration, rising demand for affordable healthcare delivery systems due to increasing healthcare costs, the emergence of telemedicine, and government initiatives such as e-health, as well as tax benefits and incentives.

SENIOR TEAM MEMBERS:

ADITYA AGARWAL

ANURAG KUMAR THAKUR

SANYAM JAIN

SATYAM GOYAL

SURAJ AGARWAL

AVNI DHINGRA

SAURABH AGGARWAL

VIDHI MUNDHRA

JUNIOR TEAM MEMBERS:

AANCHAL CHOWDHURY

ADITI PATHAK

NAVAL MITTAL

PARIDHI JAIN

SHRUTI GUPTA

VIVEK BANSAL

DEEPALI SINGH BAGHEL

PRATIK RATHI

This edition looks at this critical sector of our economy from a consultant's lens.

YUGADHYA MATHURIA

CONTENTS INTRODUCTION

1

PORTER'S FIVE FORCES

2

COST DRIVERS

3

REVENUE DRIVERS

4

VALUE CHAIN

5-6

GOVERNMENT POLICIES

7

CHALLENGES FACED

8-9

RECENT EVENTS

10

EMERGING TRENDS

11-13

TRENDS IN TRADITIONAL MEDICINE ROAD AHEAD

14

15-16

INTERESTING FACTS

17

REFERENCES

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INTRODUCTION Imagine being thrown off to a faraway island wholly isolated from the world, gives you shudders, doesn't it? However, this practice was the reality for a large number of people just a century ago.

Be it typhoid or leprosy because there are no cures for them, millions of people were left to die on islands with no resources to live. The Covid-19 pandemic with its necessary quarantine gave us all a little glimpse of what it might feel like to be isolated. However, fortunately for us, we had a better healthcare system in place that helped us ride through the pandemic and were not as helpless as the person on that isolated island.

Gone are the days when the cataract was not curable or when natural intercourse was the only way babies were born. And has more to go. With increasing innovation in technology, specifically AI, healthcare is set to witness a sea of changes for the betterment of humankind. Come-on then! Take a tour with us in the latest edition of sectoral analysis.

Global Market Cap: 11.2 trillion USD Indian Healthcare: 372 billion USD

However, the journey does not stop here; with rising population, climate change, and the pandemic, the industry has and is set to encounter many challenges ahead on the road.

Being one of the few industries that touch each and every life on the planet, it becomes imperative to know and be aware of it.

Defined as an aggregation and integration of sectors that provide goods and services to provide patients curative, rehabilitative, preventive, and palliative care, healthcare has come a long way.

Growth trend (US $ Billion)

400 300 200 Number of doctors in India are 1.27 million as of 2021

100 0

2016

2017

2020

2022

Number of medical colleges in India are 558 as of 2021

1

PORTER'S FIVE FORCES The threat of New Entrants Because just a few companies dominate this sector, the risk of new companies entering the market is comparatively minimal. A larger and more dominant firm would pull down a smaller firm performing better despite its rapid growth.

Companies must emphasize policies that cut costs through a more efficient system while also maximizing value for customers.

Supplier’s Power Because this industry is entirely reliant on the services it provides, suppliers have muchnegotiating leverage. In most circumstances, every person will need to visit a healthcare professional at some point in their life, which means that everyone will be a customer of the business. Despite the rising expense of healthcare, demand continues to grow because people and the government are increasingly concerned about their health and quality of life.

Buyer's Power In the healthcare industry, purchasers have little bargaining power, or in other words, customers have a disadvantage. Customers are more interested in purchasing and paying for health insurance because they may not finance any life-saving procedures if they are injured.

Value creation, according to Porter, is more essential than price. Hence, high-quality care at a lower cost should be explored so that this industry can profit from the value-based competition.

Substitution Threat Customers want less expensive prescription drugs. Drugs are cheaper at Wal-Mart, Target, and other small in-house medical stores, but there are no substitutes for a comprehensive health insurance plan, and the situation is less concern for the future.

Customers today choose to follow the "do it yourself" strategy. In the digital world, they prefer to follow trends that allow them to stay connected through technology while keeping most of their medical equipment at home.

Competitive Rivalry Healthcare companies were determined to lead in terms of margin over other health care companies in the industry, according to research from 2008 concerning market capitalization, indicating severe competition. Because of the high switching costs, this industry is also better able to benefit.

Individuals who sign a healthcare policy are limited to using only one provider and cannot switch to another.

2

COST DRIVERS Managing a hospital necessitates a sizable initial investment as well as hefty recurring costs.

Capital expenditures, employee or staff pay and bonuses, building maintenance, and utilities are all examples of fixed costs.

Health-care worker supplies, patient-care supplies, diagnostic and therapeutic materials, and pharmaceuticals are variable expenditures.

There are two types of costs - Operational and Non-operational cost These expenses are incurred in the following departments: Medical departments Medical Support Department Service Departments

1 Operational expense Medical Department Expenses These include expenses like salaries of Doctors, Surgeons, & Nurses, Clinical costs, OT expenses, Emergency & casualty expenditures, etc. These costs vary between government and private hospitals, with private hospitals paying more than government hospitals.

Medical Support Service Department These include expenses related to Pharmacy, setting up and operating expenses of Medical labs, Radiology, Pathology centre, Blood Banks, etc. These also include the service expenses like Buying ambulances, its fuel cost, Mortuary expenses, R & D expenses, and other Central Sterile Services Division costs.

Service Department Apart from the medical services, the health sector includes other secondary but essential services to manage the facilities. These include help desk services, stores, food beverage, housekeeping, maintaining medical records, Maintenance costs, training expenses, etc. These further include the charge for fuels, power, oxygen & gas, bio-medical waste management cost, etc.

2 Non-Operational expenses Apart from their core services, every sector also requires a management backbone for its functioning, and thus, a considerable cost goes into the salaries and payments for these services. These come under this category

Administrative Payments to the hospital staff and medical centre’s staff like cleaning department, receptionists, and compounders. Expenses for maintenance, travelling, transportation, telecommunication, books and periodicals, and rent.

Capital expenditure (Capex) Like all other sectors, the Health sector has a significant capital expenditure for patents, copyright & trademark, advanced surgical types of equipment, medical tools, furniture, etc.

Others Other non-operational costs include finance and legal expense, advertisement and sales promotions costs, insurance & audit fees, etc.

3

REVENUE DRIVERS The source of income in a typical hospital comes from direct medical services and medical support services, such as the blood bank, radiology department, pharmacy department, etc. Each of the sources listed above is further divided into two categories: serving outpatient (OP) and in-patient (IP) channels. Regardless of the source, it is influenced by several complicated qualitative and quantitative parameters, as listed below.

Qualitative Factors a) Usage of Advanced medical equipment b) Complexities of Critical Cases c) Types of services hospital’s offers d) Frequency of services e) Quality of employees(such as doctors, nurses, etc) f) Management policies on patient handling Quantitative Factors a) No. of patients b) No. of beds c) Capacity occupancy level d) Infrastructure availability e) No of backup facilities Out-Patient Revenue Medical Services: These include consultation fees, cardiology fees, injection & immunization charges, neurology, daycare, master health check-up, ambulatory care, ENT services, etc.

Medical Support Services: These include OP registration charges, lab services, radiology services, blood bank services, diet counselling, physiotherapy, ambulance services, etc.

In-Patient Revenue Medical Services: These include doctor’s fee, surgeon’s fee, neurology services, OT charges, ICU charges, room rent, special nursing, etc.

Medical Support Services: These include admissions & documentation, lab services, blood bank charge, oxygen, mortuary charges, medical & surgical consumables, etc Pharmacy Income a) Out-Patient (O.P.) Pharmacy b) In-Patient (I.P) Pharmacy c) Trauma Centre Pharmacy d) Rehabilitation Centre Pharmacy Other Operational Income: These include admission charges, outsourced lab & pharmacy, infrastructure charges, telemedicine consultancy, and R&D income on an assignment basis.

4

VALUE CHAIN The value chain is a way of looking at a company, a hospital, or any other form of organisation from the perspective of value-adding potential. Primary activities and support activities are the two major components of the value chain.

The activities involved in bringing resources and customers into the firm, changing those resources into products or providing services, marketing, and distribution are primary activities. Supporting activities are anything that helps you manage your business but isn't directly related to your product.

By tracing an organisation's value chain, it's possible to see where the most value is added, where most costs are incurred, and where inefficiencies exist. Regularly adjusting these processes can help a company gain and maintain a competitive advantage, cut expenses, or enhance efficiency.

Manufacturers, wholesalers, distributors, providers, professionals (nurses, midwives, etc.), and payers are all part of the healthcare value chain, as are most other businesses (patients). The value of healthcare services is to give the most satisfactory treatment at the lowest possible cost.

PAYERS

PROVIDERS INSURERS

Government: Medicare medicaid VA/DOD Employee: Large Accounts Small Group

DISTRIBUTORS

Insurers: Hospital Medical Work Disability Vision/ Dental

Hosiptals/ system

IWholesalers

Suppliers:

Physicians/ Clinic

Distributors

Pharmaceuticals

Nursing Homes

Mail-order distributors

Biologics

Managed Care HMO,PPO,POS

Home Health Pharmacies

Individuals: Premiums Out-of-pocket Philanthropy

PRODUCERS

Consumer directed health plans Pharmacy Benefit Managers (PDMs)

Public Health Complementary and alternate medicine (CAM)

Devices Group Purchasing Organisations (GPOs)

Capital Equipment Information systems Contract Research organisations

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The value chain of a hospital is comprised of the following components: 1. Payers: Because the government runs specific healthcare programmes, it pays for some treatments. Insurance firms compensate employees or clients. The individual pays for the number of medical expenses.

2. Providers include hospitals, nursing homes, speciality clinics, pharmacies, and home health services.

3. Producers: A producer is a company that makes the equipment, medicines, or other items utilised in a hospital.

Primary Activities: All actions are considered primary hospital activities from when a patient is brought to the hospital until he leaves. Primary activities include activities such as transporting patients to the hospital. These include the admission to discharge procedure, ambulatory services, and the organisation's marketing activities.

Secondary Activities: Infrastructure management, hiring and keeping new employees (human resource management), implementing new technologies and IT services, and supply chain management are all examples of support services.

A Health Sector Value Chain for Contraceptive Products and Services

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GOVERNMENT POLICIES Ayushman Bharat Yojana The health protection scheme aims to provide good quality medical treatment to about 50 crore Indians who are deprived of it because of financial incapability. It allows people to have access to ₹5 lakh per family annually, with additional coverage of ₹2 lakh for senior citizens.

Under this scheme, people can get free access to services across the country at any government or listed private hospitals covering various diseases and ailments that require immediate attention. A positive point about the scheme is that it will not exclude anyone because of pre-existing conditions.

National Rural Healthcare Mission (NRHM) A system ensuring improved access to quality healthcare at affordable costs to India's rural population with a mission to provide adequate, accessible, affordable and accountable healthcare through a community-centric approach and with emphasis on equity and empowerment. It aims to keep up the standards of existing facilities to reduce out-of-pocket expenditure for accessing health care services in public hospitals/dispensaries and curbing the incidence of avoidable hospitalization through preventive and promotive health care measures. The program emphasizes preventive rather than curative services, and such programs are being enhanced instead of being expanded.

Pradhan Mantri Surakshit Matritva Abhiyan A comprehensive package for pregnant women was launched in 2016. Under the scheme, every pregnant woman in India will get free antenatal checkups and treatment if required.

Electronic Health Record (EHR) To make healthcare services more efficient, the Indian government is planning on establishing EHR. It allows for easy access to the patient's medical history. So, if an individual applies for health care when they move to another location, their medical history can be transferred electronically to their new doctor/hospital. It can be used to facilitate medical records and ensure continuity of care and allow for the secure transfer of medical records between providers, thus reducing duplication in tests and procedures, especially in emergencies.

To protect citizens against identity theft or medical fraud, the Indian Government is encouraging encryption on all healthcare records.

A patient's medical history typically contains private information such as social security numbers, credit card numbers and banking details.

Encryption makes this personal data unreadable to anyone who may intercept it.

Further, the government should not be blind to the inadequacies of the private sector. Instead of promoting the public-private partnership (PPP) model, it should provide more incentives for setting up public healthcare systems like medical colleges and research institutes.

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CHALLENGES FACED Globally, the healthcare sector saw an unprecedented challenge in the past two years, with the Covid19 pandemic testing the infrastructure’s limits and the workforce involved in the sector. Even before the shakedown, the sector had seen some disruptive changes, with the startups mushrooming and the digital technology taking a more prominent place in the industry. The sector in India is already divided into three broad categories of the primary, secondary and tertiary healthcare sectors. The government has provided significant healthcare services in a country that is plagued with income inequality. The pandemic exposed the myriad challenges and gaps in the health care system.

Infrastructure gap -Access to quality and affordable healthcare has always been a significant roadblock for most Indians.

India’s spending on healthcare is at 1.28% of the GDP presently, which will go up to 2.5% of its GDP by the year 2025. This amount of spending is the lowest amongst all the developing countries. There are 10 beds per 10,000 people in India against a global average of 29. These statistics themselves speak for the harrowing state of the hospital infrastructure in the country, which has 18% of the world’s population. In order to counter these specific problems, India needs to develop an efficient healthcare system. The government investments in building infrastructure in medical and nursing schools, training the medical staff, manufacturing specialized medical equipment, drug or vaccines manufacturing, and promoting telemedicine to optimize the utilization of capacity are seen to fill the gaps. In order to build a futuristic and innovative healthcare delivery system, the ‘triple helix model of innovation’ should be used in India. The Government, academia, and the private sector need to work in tandem to overcome these challenges.

High patient load – Even before the pandemic hit, the country suffered from the issue of high patient load. With poor infrastructure and low density of trained staff, managing the health care requirements with 1.4 billion people becomes a herculean task. The Indian population lacks awareness about preventive healthcare measures and avoids patient care till the disease turns serious. The wait till the end puts additional pressure on the already burdened hospitals. The solution again warrants heavy infrastructure development push from both the government and private sectors in the industry.

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Rising healthcare costs – The healthcare sector is plagued with high costs due to various factors in the healthcare value chain, from device manufacturers to medical drug providers to insurance policy providers. These increased costs and low insurance penetration discourage patients from seeking health care on time and cutting down on essential pre and post-medical procedures.

With various stakeholders involved in the healthcare value chain and laws to provide healthcare at regulated costs, the public sector hospitals find it difficult to recover their costs. They ultimately have to rely on funding from the government, thereby making the business unsustainable in the long run.

Inadequately trained staff - The doctor-topatient ratio in India is relatively low, at 0.7 doctors per 1,000 people. The World Health Organisation (WHO) states an average of 2.5 doctors per 1,000 people. This situation gets worse as one moves from urban to rural India. Moreover, the density of qualified active health workforce is as low as 11 or 12 per 10,000 person who is half of WHO standards. This gap stems from the lack of qualified doctors being present in the country. India produces only 13 new medical graduates per annum per 100000 persons compared to 55 new graduates per 100000 persons per annum for developed countries.

Moreover, many health professionals are not part of the current health workforce because either they are unemployed or migrate to other countries due to better benefits and salaries. An investment push by the government in the future workforce that understands the medical needs and the technology is essential.

Data privacy – With the rapid advent of technology in the healthcare sector, it is increasingly important to ensure that patients’ sensitive and private data remains secure.

Cybersecurity and disaster recovery are two key areas that are becoming important for the sector. The sector must abide by the continuously evolving laws and regulations that impact the public’s data management. Even though India does not have any data protection law for the healthcare sector like the Health Insurance Portability and Accountability Act in the United States, the Personal Data Protection Bill 2019 covers the necessary regulations for health data protection.

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RECENT EVENTS Recent Merger and Acquisitions PharmEasy acquired a majority stake in Thyrocare Technologies, a diagnostics chain, to diversify and bolster its testing business.

Tata Digital infused Rs. 100 crore (US$ 13.45 million) debt in 1mg, the online medicine startup, and in June 2021, acquired a majority stake in the company.

PharmEasy, an online pharmacy, announced that it had acquired Medlife to become the leading platform for healthcare delivery in India.

The first half of 2021 has seen 23 M&As, of which the 18 deals with announced value have shown that the mergers and acquisitions have seen $1.89 billion worth of contracts.

Unique Digital Health ID The Ayushman Bharat Digital Mission intends to equip everyone with a digital Health ID that will store their medical records and be usable across the country. With the worldwide implementation of the digital Health ID, a seamless online platform will be created, allowing for a wide range of data, information, and infrastructure services while maintaining the security, confidentiality, and privacy of health-related personal information. This health account will be detailed in every test, every disease, the doctors seen, the medicines taken, and the diagnosis.

This information will be crucial because it is portable and easy to retrieve, even if the patient moves to a different location and sees a new doctor.

Vaccination India has administered over 116 Crore Covid jabs since it started its vaccination drive in January this year.

This milestone makes it the second country to reach this mark - China crossed it in June 2021.

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EMERGING TRENDS Wearable and IoT devices Wearable gadgets significantly affect client wellbeing. Through a mix of equipment, prescient examination, and portable applications, wearable innovations reclassify patient diagnostics, illness the executives, and preplanned care methods.

Wearable gadgets permit clients to share their wellbeing records continuously and get speedier, more precise findings. Sometimes, they even enable clients to deal with their conditions in a hurry. These gadgets imply that a consistent progression of information is accessible to medical care experts, who can utilize such measurements as pulse, breathing examples, and rest information to analyze and treat patients more likely. Besides, ubiquitous wearable innovation implies that patients are engaged to assume responsibility for their wellbeing. Easy to understand, moderate, and subtle elements urge them to be more mindful of their day-by-day propensities.

Wearables have, as of now, caused a disturbance in the singular health and wellness market, with organizations like Fitbit and Beddr accomplishing record numbers in client reception just as subsidizing adjusts.

Telemedicine Telemedicine arrangements have gradually and consistently become well-known choices to specialist visits among underinsured patients. In any case, telemedicine will not have the option to arrive at its maximum capacity until new laws are passed to permit specialists to be paid similarly for virtual meetings.

Telemedicine alludes to the distant analysis and treatment of patients through computerized innovations - and it is giving indications of satisfying its capability to drive advanced change in medical care. Specialists are progressively speaking with patients utilizing email, telephone and webcam. Doctors are likewise speaking with

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Virtual, Augmented, and Mixed Reality Augmented reality gives help to patients in various ways like sadness, malignant growth, mental imbalance, vision treatment. The virtual and genuine universes are interwoven in mixed reality. This guides progressed instructive offices to specialists to treat patients via cautiously understanding their condition.

one another, which means more uncomplicated cooperation and more educated choices. This kind of connection would have been an abomination 10 years prior.

Big Data Huge information is ready to help researchers, strategy creators, and associations. Health sector employees can make extraordinary approach proposals by figuring out trillions of information that never got dissected at this scale until recently.

Information at this large scale has changed how we dissect many data in any industry. However, it has specific pertinence to clinical and wellbeing information.

Medical care investigation can assist patients with essentially decreasing the expense of therapy, staying away from preventable illnesses, and working on their satisfaction. The very progressed information mining and examination methods that have changed various businesses could empower medical services experts to investigate a patient's condition and take care of oneself, prompting better wellbeing results.

One of the various ways of doing this is to make a patient's customized 'clinical guide', utilizing such straightforward data as life systems and physiology just as more perplexing identifiers as DNA, RNA, and substance pieces. This data examination was previously impractical to do and can demonstrate essential in determination and treatment later on.

'Cognihab' has used this progressive innovation of augmented reality to assist patients with ascending past their constraints.

It benefited both the specialists and the patients in driving foundations like AIIMS, Indian Spinal Injury Center, National Institute of Ayurveda. It arose as the world's pioneer VR-based medical care arrangement supplier.

Be it clinical preparing, basic strategy reenactments, patient mindfulness, engine recovery, non-engine restoration, Autism care, relief from discomfort, uneasiness decrease, or in any event, battling misery, our modules have shown extraordinary outcomes all through the patient's treatment lifecycle and fundamentally diminished agony discernment, tension levels and narcotics among patients.

Consequently, Congihab is reclassifying the medical care innovation pattern made by the direction of senior specialists, which endeavours to revive, overhaul and restore your whole self for fast recuperation.

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Experience the changes achieved by augmented reality in the coming years to liberate yourself from severe illnesses through technology.

3D printing of certain medications As the drug business moves from large-scale manufacturing towards a more customised model, 3D printing of medications can reform the market.

The fundamental advantage of utilising 3D printing innovation for tailored drugs is the capacity to deliver tiny clusters with painstakingly custommade measurements, shapes, sizes, and delivery qualities. It likewise permits flavours to be consolidated into a pill without the need of a film covering, altogether veiling the flavour of synthetic mixtures. 3D printers can be introduced in drug stores, clinics, facilities, and far off areas, empowering on-request creation of medications, especially those with helpless solidness or cold chain stockpiling prerequisites. 3D printing can essentially diminish expenses, squander, and ecological weight for drug organisations as printers store the specific measure of natural substances required.

E-Pharmacies The trend of e-pharmacies had gained traction back in 2015 in India and had since received a boost due to the pandemic. These pharmacies are giving a tough competition to the traditional pharmacies by ensuring safer and genuine drug supplies, greatly improving availability of drugs by providing last-mile access to medicines and making drugs affordable with efficient and optimised supply chain management.

Even though e-pharmacies exist peacefully with retail pharmacies throughout the world, India has specific challenges in this respect. Due to severe competition and vast market share which can be serviced, e-pharmacies are pushing aggressively to capture a significant market share.

With digitisation spreading its wings and convenience becoming an utmost priority for consumers in the coming year, e-pharmacies will see a definite upward trend.

Improvement In Data Science and Predictive Analytics It can be difficult to compress all of the data generated by people with chronic illnesses.

Nonetheless, significant advancements in data science and predictive analysis have provided clinicians with deeper insights, such as obtaining information about genealogy and family history, spotting patients at high risk, and effectively diagnosing diseases.

By making real-time reports available to doctors, Congihab assures that they can readily access, monitor, and intervene in their patients' development at the touch of a button.

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TRENDS IN TRADITIONAL MEDICINE

Ancient civilizations such as India, China, South America, and Egypt continue to use a variety of plant-based treatments to cure such problems.

According to the World Health Organization (WHO), herbal medicine is used by 60% of the world's population. About 80% of developing nations rely on it nearly entirely for their primary health care requirements.

The herbal sector is worth over US$100 billion and has good growth potential around the world.

According to the World Health Organization, trade in medicinal plants, herbal raw materials, and herbal pharmaceuticals is rising at a pace of roughly 15% each year.

Herbal medicine is gaining popularity and acceptance because all-natural products are safe, inexpensive, and widely available.

Advances in Traditional Medicine's impact score (IS) 2020 is 1.34. Compared to the previous year, 2019, Advances in Traditional Medicine IS has increased by a factor of 0.67, and the approximate percentage change is 100 per cent, indicating a rising trend.

1.5

Impact score

1

0.5

0

20 13 20 14 20 15 20 16 20 17 20 18 20 19 20 20

Skin illnesses, tuberculosis, diabetes, jaundice, hypertension, mental problems, cancer, AIDS, and various other infectious diseases have all been successfully treated with plant-based medications.

Research approach to Herbal products

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ROAD AHEAD The healthcare scenario in the country today points towards increasing awareness of diseases and their treatment.

Universal Healthcare The 'Jal Jeevan Mission' (Urban) was launched to achieve universal health was announced in the Union Budget 2021. The mission's goals include universal water delivery to all 4,378 urban local bodies, 2.86 crore residential tap connections, and liquid waste management in 500 AMRUT cities. It will be carried out over five years at the cost of Rs. 2,87,000 crore (US$ 39.41 billion).

Enabling Policies-100% FDI in Hospitals, Private Equity and Venture Capital Investments The government's decision to open its borders to dollar money should reassure investors interested in investing in India's healthcare sector. With a favourable foreign direct investment (FDI) policy for hospitals, we could see foreign investors acquiring majority ownership of our facilities.

Under the automated procedure, 100 per cent FDI is currently permitted in hospitals. Soon, this is expected to get much traction in this arena.

Recently, private equity funds, generalist asset managers, tech-focused funds, and corporate buyers have expressed interest in this market.

Only a few private equity firms had specialised healthcare teams a decade ago, but the situation has changed dramatically, with healthcare investing becoming a viable option.

Ayushman Bharat Ayushman Bharat scheme was designed to offer universal health coverage and financial risk protection for all citizens and provide excellent and inexpensive necessary health care.

Over 75,500 Ayushman Bharat-Health and Wellness Centres (AB-HWCs) were functioning in India as of April 2021.

The government is also planning to establish 1.5 lakh Ayushman Bharat Health and Wellness Centres by December 2022.

National Nutrition Mission The Union Cabinet approved the National Nutrition Mission (NNM) to monitor, supervise, set targets, and guide nutrition-related interventions across ministries.

Every year, the initiative aims to reduce stunting by 2%, undernutrition by 2%, anaemia by 3%, and low birth babies by 2%.

Over 100 million individuals are expected to benefit from this programme, implemented across all states and districts.

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The government announced intentions to begin 'Mission Poshan 2.0' in the Union Budget 202122, which will unite the 'Supplementary Nutrition Programme' with the 'Poshan Abhiyan' (Nutrition Mission) to enhance nutritional results in 112 aspirational districts.

To strengthen the data-sharing mechanism between the Center and the states for effective disease control.

India aspires to be a regional and international leader in managing global events that pose a public health threat.

Technology-led Innovations India Accelerator (IA) has announced its plans to develop a 'Pulse' programme for budding healthtech startups. IA will run a sixteen-week accelerator programme for a group of 5-7 emerging start-ups in this industry. The initiative's goal is to use start-ups to accelerate innovation and change Indian healthcare.

A shift towards Generic Medicines The recent trend of healthcare providers switching to generic pharmaceuticals is quite encouraging for local pharmaceutical businesses and patients, who are anticipated to benefit from the more significant cost-effectiveness. Indian pharmaceutical companies have repeatedly demonstrated their ability to provide low-cost generic medications that help patients make treatment more feasible.

Government Commitment to increase GDP Spending The government aims to increase its spending in the healthcare sector to 3 % of GDP by 2022.

On the back of increasing income level, health awareness, a disease occurring due to lifestyle will be a critical factor in the expected size of the Indian healthcare sector to the US $372 Billion by 2022.

Vision 2035: Move towards Public Health Surveillance in India To increase action preparedness at all levels by making India's public health surveillance system more flexible and predictive.

A citizen-friendly public health surveillance system supported by a consumer feedback procedure would ensure individual privacy and confidentiality.

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INTRESTING FACTS GDP Spending The United States has the highest health spending based on GDP share. It spends 16.9 % of its GPD on healthcare, while India spends just 2.5 % of its GDP

Life Expectancy Between 2010 and 2015, average life expectancy increased by five years with the healthcare industry improvements

Doctor People Ratio ·India has a doctor people ratio of 1:1511, which is much below the WHO norm of 1:1000. Austria tops the the list with 1:186

Bed People Ratio India has a bed to people ratio of 5:10000, ranking 155th out of 167 countries on bed availability

Covid Vaccinations As of date, India has 30.29 % people fully vaccinated against covid-19. The United Arab Emirates tops the list with 88.40 %

Covid Drugs As on date, there are 1367 drugs and vaccines in development targeting coronavirus disease

Most Presrcibed Drug Amoxicillin, a penicillin antibiotic, topped the list as the most commonly prescribed drug in 2020

Health Tech StartUps There are currently a whopping 3225 health tech startups in India

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REFERENCES While compiling this sectoral analysis, we have taken references from the following sources: IBEF Report on Healthcare Industry https://www.ibef.org/download/Healthcare-March-2021.pdf National Health Policy https://www.nhp.gov.in/nhpfiles/national_health_policy_2017.pdf Global Healthcare issues, Report by PwC https://www.pwc.com/gx/en/healthcare/pdf/pwc-global-top-health-industry-issues-2021.pdf Statista https://www.statista.com/

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