market research india - medical diagnostics market in india 2009

7/31/2019 Market Research India - Medical Diagnostics Market in India 2009

1/30

April2009
http://www.netscribes.com/


2/30


3/30

MarketOverview

Rules&Regulationsfor

Competition

ey

eve opmen s

3MEDICALDIAGNOSTICS INDIA.PPT


4/30

Indiandiagnosticsmarketiswitnessingsignificantgrowthwith

majorcontributionfromtheInVitroDiagnostic(IVD)segment

Indiandiagnosticmarketcomprisesof

Diagnostictestservicesmarket

MarketOverview Diagnostic

Test

Services

Market

37.940

+20%INRbn

Diagnosticproducts/instrumentsmarket

Diagnosticmarketaccountsfor10%ofhealthcare

sector

Indiacurrentlyhasover11,500hospitalsand40,000

.

26.3

10

20

30

In2008,

IVD

servicesmarket

wasINR36bn

About70%ofthetreatmentsinIndiaarebasedonlab

diagnostictests

IVDInstruments&ReagentMarketIVDTestSegments(2008)

2006 2007 2008

Marketsizeestimationisdifficultasdiagnosticmarketishighlyunorganized

5%

6%

4%

3%

37%

BioChemistry

Immunology

Haematology15.8

12.815

20 +18%

INRbn

7% Criticalcare

UrineRoutine

Others

Microbiology

14%

.

0

5

10


24%oagu a on

2006 2007 2008


5/30

Technologicaldevelopmentshasledtothediagnosisofawide

spectrumofinfectiousdiseases

Diagnostics Consumption&

trends Type

of

testing CAGR

%

(2004

08)

InfectiousDisease

Tuberculosis Increasing ELISA90%;Rapid10% 11.0

HIV Increasing ELISA65%;Rapid35% 10.6

Malaria Increasing Immunodiagnosticm 9.4

HepatitisB Steady ELISA65%;Rapid34%Agglutinationmethods1% 7.7

HepatitisC Steady ELISA80%;Rapid20% 7.7

engue tea y ; ap .

Syphilis Steady ELISA65%;Rapid35% 5.7

Typhoid Steady ELISA65%;Rapid35% 5.6

Hormones

Reproductivehormones Increasing ofLH35%,FSHandprolactinkits65% 8.6

Thyroid Increasing ELISA90%,RIAandChemiluminescence10% 7.7

Others

BloodGroupingreagents Steady Haemagglutination 5.7

Pregnancydiagnosis Steady Immunochromatography/Latex 5.7

CancerMarkers Steady Fluorescence,ELISA,Chemiluminescence 5.7

MolecularDiagnosticsNascentmarket.MaximumpenetrationobservedonlyinPolymeraseChainReaction(PCR)basedtechnologies.

Companiesofferingimmunodiagnosticshavebeenlargelyimportingequipments


Thisshows

that

the

market

for

diagnostic

tests

has

been

rising


6/30

MarketOverview


Competition

ey

eve opmen s



7/30

Drivers&Challenges

Drivers

Increaseinlifestylerelateddiseases

Changingdemographics

Growth

in

medical

outsourcing

Differenceinimportdutyon

diagnostickitsforpublicandprivate

sector

formedicaltourism

Increasingpenetrationofmedical

insurance

Lackofaccreditation certificationof

diagnosticcenters

RisingPE/VCinvestments



8/30

Mountinginstancesoflifestylediseasesinurbanareasandthe

demandforqualitydiagnosis

Increasinginstancesoflifestylediseasesisanurbanphenomenon,especiallyamongtheyoung

andworkingclassinmetropolitanareas

Growthin

lifestyle

related

diseases Impact

Lifestylediseasessuchascardiacailments,diabetesetc.requireexpensivediagnostictests

makingthissegmentincreasinglylucrativeforplayers

54.91% 2005

2015% of Population

500USD/Treatment

reva enceo c ron c es y e seases n n a agnos c es s os ompar son

1

2

3

4 3.31%2.80%

3.70%

280

150

100

200

300

400

0

Cardiac Diabetes

. .

Cancer

50

HepatitisA

Thyroid Cardiac Diabetes Cancer



9/30

ChangingdemographicscenarioinIndiaisexpectedtodrive

demand

Increaseinaveragelifeexpectancyandgrowthinelderlypopulationisexpectedtoboost

demand

Changingdemographics Impact

Largescalemovementofruralpopulationtourbancenterswillalsooptfortheseservices

AverageLife

Expectancy Population

(Age

65

years

and

above)

66.065.163.3

50

1005.85.3

4.7

2

4

6

2000-04 2005-09 2006-10 2000 2005 2010



10/30

Strongoutsourcingopportunitiesduetotechnological

enhancementsandcostbenefits

Diagnosticsoutsourcinghasbeengrowingduetotechnologicalupgradationofequipmentin

Indianlaboratoriesmeetinginternationalstandards

Growthin

outsourcing

Impact

Costbenefitshavealsoplayedamajorrole

Specializedtestslikemoleculardiagnosticsorhormonerelatedtestscost7080%lessinIndia

thanin

US

MedicalinstitutionsfromUSandUKhavebeenoutsourcingabulkoftests

OutsourcingopportunityspecificallyfromtheUK,inhealthcaresector,ispeggedataroundUSD800mn

Indiaprovidescostarbitrage:

Tests Costin

US/UK

(USD) Cost

in

India

(USD) %

Difference

Blood tests Xra s and ultrasounds 574 84 583

Magneticresonanceimaging(MRI)scan 700 60 1067

Thyroidprofilebloodtest 3050 5 500900

Note:Theratesareindicative



11/30

Medicaltourismisprovidingsupplementalrevenuesforthe

diagnosticmarket

Inadditiontogrowingdomesticdemand, medicaltourismisgeneratingadditionalrevenuefor

diagnosticsservices

Medicaltourism

in

India Impact

Medicaltourismhasbeengrowingat30%andisexpectedtobecomeatUSD2bnindustryby

2010

Somepart

of

medical

tourism

market

is

expected

to

accrue

to

the

diagnostics

market,

primarily

benefiting thehospitalswithdiagnosticcenters

a n r versan c a enges orme ca our smare

Drivers Challenges

Significantsavings

Worldclassfacilities

Inadequateair

connectivity

Visare uirementsfrommostcountries

Qualityandexperienceofmedicalprofessionals

Minimalwaitingtime

Largemarketofuninsuredindevelopedcountries

Medicolegaljurisdictions

Countryspecificrestrictions



12/30

Growingpenetrationratesofhealthinsurancehasmadequality

diagnosticservicesmoreaffordable

InIndia,penetrationofhealthinsuranceisverylowbutgrowing:

Morefamiliesfrommiddleclassarenowpurchasinghealthinsurance

Risinghealth

insurance

levels Impact

20%ofpopulationislikelytohavemedicalinsuranceby2015comparedtocurrent2%

Additionally,

many

companies

are

providing

health

insurance

coverage

to

employees

therebydrivingpenetration

Increasin insurancecovera e rovideadditionalrevenuetothedia nosticscentres

Insurancecompaniestieupwithdiagnosticcentrestoprovidebetterhealthassessment

services(medicalscreening,diagnostictesting)tolifeinsurancecandidates

Birla

Sun

Life

Insurance

Company

Ltd

entered

into

a

partnership

with

Quest

Diagnostics

India

Private

Ltd.

ICICILombardenteredintoaninsurancepartnershipwithManipal,FortisandApolloGroup

HealthInsurancePremium

INRbn

212

47

500

1,000+35%


2008 2013 2018


13/30

LargescaleinvestmentsfromPE/VCfirmstowardscapitalizing

onthegrowthprospectsinthemarket

PrivateequityplayersarebullishonthehealthcareindustryinIndia

In2008,thehealthcaresectoraccountedfor13%oftotalinvestmentsamountingtoUSD

Increasedfocus

of

PE/VC

firms Impact

5570.48mn

Apartfromhospitalsandpharma,privateequityplayersarealsoshowinginterestindiagnostic

centersin

India

% Amounta e nves or arge

Stake USDmn

Nov2007ePlanetVenturesandHSBC

PrivateEquity

(Asia)

Ltd

Trivitron n.a. 11

. .

Jun2006 Bennett,ColemanandCo. Thyrocare n.a. n.a.

May2006 ICICIVentures MetropolisHealthServicesLtd n.a. 8

2005 Se uoiaCa ital

India

Dr

Lal

PathLabs 26 6



14/30

Biasedgovernmentregulationandthelackofaccreditation

affectingtheofqualityservicesarethemajorbarriers

Theimportstructurehasbeensoformulatedthatitfavorsthepublicsector

Privatesectorisfacedwiththeissueofprovidingservicesatcompetitivepricesacrossincome

Differencein

import

duty

on

diagnostic

kits

for

public

and

private

sector Impact

groupsandareoftenreducedtoprovidingservicesonlytoanichemarket

Public Private

Inordertoimportequipmentsandreagents

Forimportingdiagnosticequipmentsadutyof19.8

21.7%islevied

license;adutyof5%islevied

Equipmentandsuppliesareprocuredthrough

tenderswithpricebeingtheforemostbasisof

decisionmaking

Equipmentsandsuppliesareprocuredbasedon

qualityandprice,leading tocostescalations

Lackof

accreditation

or

certification

has

led

to

alarge

pool

of

medical

centers

with

minimal

Lackofaccreditation/certification ofdiagnosticcenters Impact

focusonthequality,whichisincontrasttomandatoryrequirementsforotheraspectsof

healthcaresuchashospitals,doctors,nursesandevenpharmacies

Lessthan1%ofthetotallaboratoriesareaccredited

14haveCollegeofAmericanPathologists(CAP)accreditation


45

have

National

Accreditation

Board

of

Laboratories

(NABL)

accreditation


15/30

Market

Overview


Competition

ey

eve opmen s


f h hl l d b h


16/30

Diagnosticequipmentmanufacturersarehighlyregulatedbythe

centralandstategovernmentbodies

Majorgoverning

bodies

GovernmentAuthorities Operation

TheDirectorateGeneralofHealthServices

StandardControlOrganization(CDSCO)

FDAand

CDSCO Regulates

the

manufacture

of

all

diagnostic

kits

and

reagents

as

it

belongs

to

the

categoryofdrugs

Responsibleforapprovaloflicensesofspecifiedcategoriesofdrugsanddiagnostics

Segmentationofproducts

products

Statedrugoffices/StateFDAsTheymonitorthequalityofdrugsanddiagnosticsproductsthataremanufacturedby

respectiveStateunitsandthosemarketedintheState

CriticalDevices

Productsusedforthe

diagnosisofHIV,HBsAg,

HCV, Bloodgrouping

reagents,malariatests

NonCriticalDevices Otherdiagnosticsproducts


Alldiagnostics

products

manufactured

or

sold

in

India

requires

alicense

h diff i l i f i i l d i i l


17/30

Thedifferenceinregulationsforcriticalandnoncritical

diagnosticsdeviceshasledtolackofqualitycontrol

Regulatoryprocess

for

diagnostics

equipments Quality

checksare

conducted

b

Manufact

uring

CriticalDevices

pp ca on s

submittedtothe

DrugsController

GeneralofIndia

National

Instituteof

cense

granted

afteran

auditof

36monthsble

disease

manufact

uringunit

NonCriticalDevices

Testmanufacturinglicenseortestbatchevaluationisnotrequired

Noinspectionsneedstobecarriedoutbythecentralauthorities


Lackof

sufficient

quality

control

measures

has

led

to

substantial

number

of

questionable

products

in

the

market

M f d i li d d i i


18/30

Manufacturersneedanimportlicenseandproductregistration

certificatefromthe CentralDrugsStandardControl

RegulationsRelated

to

Imports

CDSCOisresponsibleforqualitycontrolofimportedproductsaswellasthelicensingofnewproducts

RegistrationCertificate:Applicationinrespectofthe

premisesandthedevicestobeimported

Documentation

Form9istobeforwardedbythemanufacturerandshouldbe

RegistrationCertificate ImportLicense

Submission: TheapplicationisreviewedbytheDrugs

ControllerGeneral

Registrationfee:USD1000perproducttoberegistered

OtherDocuments:

Bank

slips

showing

requisite

fee

paid,

Form

40PowerofAttorneytotheIndianAgent/Officeanddossiers

attestedbytheIndianEmbassyinthemanufacturerscountry

GMP(GoodManufacturingPractices)certificate

CompanyRegistrationcertificate

FreeSales

Certificate

in

the

country

of

manufacture

Manufacturin License Duration:Theregistrationprocesstakes9months

Forwardedbythemanufacturer,importerortheagentin

India

CountryofOriginCertificate

Listofcountrieswheretheproductisalreadybeingexported

ISO/TUV/CEcertificate

BatchReleaseCertificate(foranyonebatch)

QCcertificates(foranyonebatch)

Otherrequirementsforimportedmedicaldiagnosticequipmentsare

Abatchreleasecertificateforthespecificgoodsthathavebeenimported

Shelflifecertificatewhichmuststatethatthe oodshaveashelflifeofmorethan60%atthetimeoflandin


Certificateof

Analysis

for

the

products

supplied


19/30

Customdutyisleviedonthediagnosticequipmentsimported

Importduty

structure

TheGovernmenthasbeenfocusingonenhancingprivatesectorparticipationbyreducingthe

customsdutyleviedonimportsofdiagnostickitandreagentsimportedbytheprivateplayers

34.4 34.5

30

40

Pregnancy confirmation reagents/Reagents for diagnosing

%

21.719.8

0

10

20 Diagnostic reagents designed to be administered to thepatient/Blood grouping reagents

Feb 2009Jan 2008



20/30

Market

Overview


Competition

ey

eve opmen s


O i d thl b idl di i th h b d


21/30

Organizedpathlabsarerapidlyexpandingusingthehubandspokemodel,includingsmall,independentlabsinthenetwork

CC CC

DiagnosticTesting

Market

Structure Hub

and

Spoke

Model

Highlyfragmentedwith~40,000laboratories:

Hospitals:43%

Reference

Lab

CC CC Independentlabs:52%

AmongthelabsinIndia

Automated 5%

Semi Automated 38%

CC CC CC CC

Laba e e

Lab

Organizedplayersaccountfor10%ofmarketand

expandingwithhubandspokemodel:

Referencelabs

act

as

regional

hubs

and

are

usually

located

inlargemetros

Collectioncentresarelocatedinhospitals,nursinghomes,

pathologylabs,doctorsclinicsetc.

Satellitelabsandcollectioncentresareeitherownedor

franchised

Referencelabs:Hubwithcomprehensiveorspecializedtesting

capability

,

,

independentlabsare:

Becomingfranchiseesinthehubandspokemodel

Partneringwithlargechainsonreferralbasis

Gettingacquiredbylargechains,whichlowersthecostof

Collectioncentres(CC):Collectsamplesforforwardingto

eitherasatellitelaborreferencelab

Avariationinthismodelistheabsenceofsatellitelabsand

theexistenceofonlyreferencelabsandcollectioncentres


expansionandstartuptimeforthelatter


22/30

MajorPlayers DiagnosticTestServicesMarket(1/2)

Company Overview BusinessOutlook

ApolloHospitals Startedin1983

DiagnosticfacilitiesintheirsubsidiaryApolloClinics

EnteredintoaJVwithAmcareLabs,an

affiliateofJohnsHopkinsInternationalof

theUS,tosetupadiagnosticlaboratoryin, ,

ClinicalPathology,Microbiology,Xray,UltrasoundwithColor

Doppler,ECG,EchoCardiographyandTreadmill

HyderabadataninvestmentofUSD2.2mn

DrLalPathLabs Startedin1977

40labsand500samplecollectioncenters

Establishedaninternationalalliancewith

QuestDiagnosticsNicholasInstitutefor

Accreditation:NABL,CAP Planningtosetup50labsand1000

collectioncentersby2012

Expandoperationsinsouthernandwestern

regionsinvestingINR600mn

P anningtoinvestINR100mnin ran

building

MetropolisHealth

Services

Startedin1981

10000laboratoriesacross125citiesglobally,13laboratoriesin

India,350

collection

centers

Growinginorganically

Itislookingatoverseasexpansionaswellas

outsourcin

o ortunities Capabilitytocarryover3600routineinvestigationswithover

100technologies e.g.biochip,DNAsequencing,pathology,

radiology

ICICIVenturesowns18%ofthecompany

Plansonincreasingtheirportfolioto9more

labs

TargetedrevenueofINR5bnby2010

In2008,acquiredtwolabsinNorthIndia


,

DiagnosticLaboratory

Note:Thislistisnotexhaustive


23/30

MajorPlayers DiagnosticTestServicesMarket(2/2)


PiramalDiagnostics

/Wellspring

Startedin1988

104diagnosticcentersin48cities,300collectioncenters

PlanningtoinvestINR2.5bntoexpandits

diagnosticchainin75urbancentersby2010

Ac uiredMinradInternationalIncforUSD

Accreditation:NABL,CAP40mn

SuperReligare

Laboratories

Limited SRL

Startedin

1996

35labs,800collectioncentersdistributedin400townsacross

thecountryand7franchiseelab

Tieups

with

UK

based

organizations

for

outsourcing

Plansondeveloping23reference

Ranbaxy Catersto25000doctors,650hospitalsand~1000smallerpathologylabsandcarriesout34000tests/daybasedon95

technologies

Accreditation:CAP,

NABL,

CLSI,

GCLP

Re ortedtotalrevenuesofINR804mninFY2007

laboratoriesin2009

ExpansionbudgetispeggedatINR1.5bn

In2008,acquiredDubaibasedMena

Healthcarefor

USD

20

mn

Thyrocare Startedin1995

Carriesout30000test/day,over600franchisedcollection

centers

Accreditation:CAP,NABL

Centralizedoperationsthroughasingle

laboratorymodel,locatedinNaviMumabi

Onlyplayerexpandingthrougha100%

franchiseemodel




24/30

Manufacturers IVDProducts/InstrumentsMarket

TheIVDproductsmarketinIndiaisprimarily

dominatedbyforeigncompanies

Playersin

the

market IVD

Products

Market

Share

(2008)

GlobalIVDcompanieslikeRocheDiagnostics,

Abbott,J&J,

Siemens

Healthcare

Diagnostics,

BeckmanCoulterhavestrongpresenceinthe36%

n anmar e

Domesticplayershaveforayedintothemarket

and

are

establishing

themselves

by

producing

costeffectiveand ualit oods

64%

60%ofdiagnosticmedicalequipmentand

suppliesisimported

Lowcostreagentkitsarebeingimportedfrom

ForeignPlayers

DomesticPlayers

China,Taiwan,andKorea


Major Domestic Players Diagnostic Equipment Manufacturing


25/30

MajorDomesticPlayers DiagnosticEquipmentManufacturingMarket(1/3)


AgappeDiagnostics Reagents:Clinicalchemistry,SyReBiochemistry),SyRe(Immunoturbidimetry), Controls/Calibrators,serology,

hemoscreen,coagulation,Urinalanalyzer,infectiousrapidcard

Focusingontheexportmarketswithplans

ofestablishingasubsidiaryinDubaiunder

AgappeMiddleEastLLC

test,infectiousELISA,hepatitismarkers,torchpanel,

Glucometer

Instruments:Clinical

Chemistry

Analyzer,

Hematology

Analyzer,

CoagulationAnalyzer,Sodium&PotassiumAnalyzer

AlsoplanstoexpandoperationstoAfrica

andEurope

LaunchedBiolis

12i

,afully

automatic

analyseraswellasCystatinC,amore

sensitiveinstrumentfortheestimationof

GlomurularFiltrationRate

J.Mitra Rapidtestkits:HIVrange,HCVrange,HBVrange,Malariarange

ELISAtest

kits:

HIV

range,

HCV

range,

HBV

range,

Dengue

FocusesonPointofCare(POC)for

infectiousdiseaseslikeHIVandmalaria

Massproduction

at

affordable

prices

, ,

ConfirmatoryTests,BloodGroupingRange

MarketleaderinHIVdiagnosisequipment

OrchidBiomedical

Systems(Tulip

Fertilityrange,Infectiousdiseasesrange, Parasitologyrange FocusesonPOCsforinfectiousdiseases

Massproductionataffordableprices





26/30



RFCL IVD,animalhealthcare,laboratorysolutionsandcustomsynthesis

Adoptedaninorganicgrowthpath

InApril2008,acquiredBremerPharma

InSeptember2008,acquiredUSbased

MallinckrodtBakerforUSD340mn

InJanuary2008,acquiredGodrejMedical

DiagnosticsandAlvedPharma&Foods

InJuly,2007acquiredWiproBiomedical

TargetedrevenueofINR5bnby2010

SpanDiagnostics

Ltd.

Diagnosticreagents&kits:Bloodbankingproducts,clinical

chemicalreagents,hematology,infectiousdiseasesserology,

histopathology,antibioticdiscs

Instruments:Biochemistry,

ELISA,

Hematology,

Chemiluminescence

ItisaleaderinSphilisandthyroiddiagnosis

equipment

TransasiaBio

Medicals

Relatedtobiochemistry,hematology,urineanalysis,

coagulation,ESR,immunology,liquidhandlingsystem

Plansto expanditsexistingproductrange

andventureintomicrobiologyand

veterinaryscience

TulipGroup ImmunologyReagents,CardiacMarkers,CancerMarkers, Itisoneoftheleadersinsyphilis,typhoid,

Instruments Coagulometers,ELISAreader&washer

,

,

groupingreagents,cancermarkers and

tuberculosisdiagnosticequipment





27/30



Xcyton Immunodiagnostickits:HIVCheXandHEPCheXC,JEVCheX,CYSTI CheX,Dengue CheX

Moleculardia nostickits

StrategicpartnershipwithQualigensfine

chemicalsinordertomarkettheirHIV

andhe atitisdia nostickits

YashrajBiotech Antigens:Customizedmonoclonalandpolyclonalantibodies Focusingonreducingcostsofmoleculardia nostics throu h innovative technolo

OtherPlayer: AccurexBiomedical,BhatBiotech,MedsourceOzoneBiomedicalsPvt.Ltd.,Trivitron




28/30


29/30

KeyDevelopments

Date Development

17Mar09 RocheDiagnostics,aswissbasedcompany,plansonconsolidatingtheir positionintheIndianmarketin2009.TheyplanonexpandingtheirreachthroughinnovativediagnostictestssuchastheNTproBNPandKRASmutationtestsrelatedtocolorectalcancer.

10Feb09 AlokaTrivitronMedicalTechnologies,amedicalequipmentmanufacturingJVofAloka,JapanandTrivitronhealthcarebegan

productionofAlokaSSD500,portableultrasoundscannerfromitsfacilityatPoonamalleeinChennai.Itplansondeveloping

highquality

products

on

acost

effective

basis

catering

primarily

to

the

developing

nations.

06Oct08 WiproanITgianthasenteredthemedicaldiagnosticsmarketthroughitssubsidiaryWiproBiomed.Theyhavetiedupwith .

telemedicine,especiallyinthediagnosticradiology.

10Mar08 SnehaDiagnosticsplansondeveloping10stateoftheartmedicaldiagnosticscentresacrossAndhraPradeshby2009.AcapitalinvestmentofINR50mnisexpectedtowardsthisexpansionventure.

09Jan08 RFCLLimited,anICICIventurecompanyacquiredGodrejMedicalDiagnostics.ThisledtopartnershipswithQBCDiagnostics,, , , .



30/30

ThankyouforyourtimeForanupdatedreportoranycustomizedresearchrequirements,pleasecontact:

GauravKumarEMail: [email protected];[email protected]

NetscribesServices:

Phone: +913340646214;+919830309715

InvestmentResearch

EnterpriseMarketResearch

PatentResearch

MarketMonitoring&Competitive

Intelligence

Sales&

Prospect

Intelligence

SocialMediaMarketing

MarcomSupportServices

ContentManagement

Services

yn ca e ar e esearc s en ng e a on or ng

BrandSurveillance

oo ac ag ng erv ces

Forfurtherdetails,visitusat:www.netscribes.com

AboutNetscribesNetscribessupportstheorganicandinorganicgrowthobjectivesofglobalcorporationsthroughacombinationofEnterpriseMarket,Investment&PatentResearch,Market&SalesIntelligence,SocialMediaMonitoring&ManagementandCustomPublishingsolution.

.however,Netscribes,Inc.orNetscribesisnotresponsibleforanylossordamagearisingfromuseofthisdocument.ThisdocumentisthesolepropertyofNetscribesandpriorpermissionisrequiredforguidelinesonreproduction.