Market Analysis

The BMNCH campus is located in the rural area and on the border of five district headquarters, four from Bihar that is Saran (Chapra), Siwan, Bhojpur (Arah) and Gopalganj and two from U.P. Balia and Deoria. Location is known as a place of Lord Shiva - A century old Baba Mahendranath temple, one of the oldest temples in Bihar built by the Nepal King Mahendra veer Vikramsah Deva, is believed to cure all diseases, especially leprosy. There is a pond in the north of the temple known as kamaldaah sarover spread over 551 bigha area from where devotees take water to do jal abhishekam to lord Shiva.  In November Siberian migrant birds come here and stay till March. The location is converted into a Tourist place by Govt. Of India & Bihar too.

The site is located along Hajipur-Chhapra-Siwan national highway. To reach the campus it is required to travel by N.H.85 from Chhapra to Siwan or vice-versa and deviate to west from Rasulpur by link road to Chainpur state highway. The approximate distance of the campus from Siwan 32km, from Balia 30km, from Gopalganj-60km, from deoria-60km, from Arah-40km & from patna-110 km.

District profile

Saran District is one of the thirty eight districts of Bihar. The district part of Saran division is also known as Chapra district after the HQ of district, Chapra. It is considered as one of the richest districts of the state. Total area of the district is 2641 sq KM. 

Siwan district situated in the western part of Bihar State, geographically situated at 25.58 to 26.23 north and 84.10 to 84.47 east. The total area of the district is about 2219 sq KM. The district is bounded on the east by Saran district, on the north by Gopalganj district and on the West and South by the two districts of UP Deoria and Ballia respectively.

Demographic

District socio demographic & Health profile

All three districts are distinguishable for their high TFR greater than 3.5 as shown in NCP / ICMR reports. On the basis of various surveys, the National commission on population has identified the vulnerable districts of the country on the basis of 13 key indicators of socio-demo-graphic indicators. Twenty four districts of Bihar fall under the identified category and SARAN, SIWAN and GOPALGANJ are one of them.  The Government of India has expressed serious concern regarding the very poor socio-demographic situation of the district SARAN, SIWAN, & GOPALGANJ with other districts.

MARKETING SIZE/SECTOR STRUCTURE OF INDIA

Healthcare industry in India comprises hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance and medical equipment. The industry is growing at a tremendous pace owing to its strengthening coverage, services and increasing expenditure by public as well as private players.

• Health care sector in India is expected to grow to reach a size of 50 Billion Dollar by 2025.
• The diagnostic industry in India is currently valued at 13 Billion, the share of the organized sector is practically negligible in this case.
• By 2020, India is expected to rank amongst the top 3 health care markets in terms of incremental growth
• By 2020, the healthcare information technology market is expected to grow 1.5 times from current $1bn
• By 2022, the diagnostics market is expected to grow at a CAGR of 20.4% to reach $32bn from$5bn in 2012
• During 2015-20, the in-patient market is expected to grow at a CAGR of 13%
• By 2020, the Indian tele-medicine market is expected to grow at a Compound Annual Growth Rate(CAGR) of 20% to reach $32mn from $15mn
• Over the next 10 years, the National Digital Health Blueprint can unlock an incremental economic value of over $200 bn for the health sector.
• 100% FDI is allowed under the automatic route for Greenfield projects. For investments in brownfield projects, up to 100%FDI is permitted under the government route.

Industry Scenario

• Healthcare industry in India comprises hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance and medical equipment. The industry is growing at a tremendous pace owing to its strengthening coverage, services and increasing expenditure by public as well private players.
• The hospital industry in India, accountingfor80% of the total health care market, is witnessing a huge investor demand from both global as well as domestic investors. The hospital industry is expected to reach $132 bn by 2023 from $ 61.8 bn in 2017; growing at a CAGR of 16-17%.
• The Indian Medical Tourism market is expected to grow from its current size of $3 bn to $7-8 bn by 2020.
• The diagnostics industry in India is currently valued at $4bn.The share of the organized sector is almost 25% in this segment (15% in labs and 10% in radiology).
• The primary care industry is currently valued at $13bn.The share of the organized sector is practically negligible in this case.

Despite modest increases in budget outlays over the last year, India continues to spend some of the lowest amounts as a country on health, around 1.1% of its GDP. The National Health Policy recommends increasing the outlay – Centre and state combined – to 2.5%. It further recommends that state budgets increase health allocation 8% of the total budget. At the moment, all states except Delhi a lot less than 8%. The Union budget also received a modest increase of 19% after near-constant allocations for two years.

GOVERNMENT INITIATIVE

Overview

Healthcare has become one of India’s largest sectors, both in terms of revenue and employment. Healthcare comprises hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance and medical equipment. The Indian healthcare sector is growing at a brisk pace due to its strengthening coverage, services and increasing expenditure by public as well private players.

The Indian healthcare delivery system is categorized into two major components - public and private. The Government, i.e. public healthcare system, comprises limited secondary and tertiary care institutions in key cities and focuses on providing basic healthcare facilities in the form of primary health care centers (PHCs) in rural areas. The private sector provides a majority of secondary, tertiary, and quaternary care institutions with major concentration in metros and tier I and tier II cities.

India's competitive advantage lies in its large pool of well-trained medical professionals. India is also cost competitive compared to its peers in Asia and Western countries. The cost of surgery in India is about one-tenth of that in the US or Western Europe. India ranks 145 among 195 countries in terms of quality and accessibility of healthcare.

Some of the major initiatives taken by the Government of India to promote Indian health care industry are as follows:

• In the Union Budget 2020-21, Rs35,600 Crore (US$5.09billion) has been allocated for nutrition-related programmers.
• The Government has announced Rs 69,000 Crore (US$ 9.87 billion) outlay for the health sector that is inclusive of Rs 6,400 Crore (US$ 915.72 million) for PMJAY in Union Budget 2020–21.
• The Government of India aims to increase healthcare spending to 3% of the Gross Domestic Product (GDP)by 2022.
• In February 2019, the Government of India established a new All India Institute of Medical Sciences (AIIMS) at Manethi, District Rewari, Haryana at a cost of Rs1,299 Crore(US$180.04million).
• The Union Cabinet approved setting up of the National Nutrition Mission (NNM) with a three-year budget of Rs 9,046 Crore (US$ 1.29 billion) to monitor, supervise, fix targets and guide the nutrition related interventions across ministries.
• On September 23, 2018, Government of India launched Pradhan Mantri Jan Arogya Yojana (PMJAY), to provide health insurance worth Rs 500,000 (US$ 7,124.54) to over 100 million families every year.
• In August 2018, the Government of India approved Ayushman Bharat-National Health Protection Mission as a centrally sponsored scheme contributed by both center and state Government at a ratio of 60:40 for all States, 90:10 for hilly North eastern States and 60:40 for Union Territories with legislature. The center will contribute 100% for Union Territories without a legislature.
• The Government of India launched Mission Indradhanush with an aim of improving coverage of immunizations in the country. It aimed to achieve at least 90% immunization coverage by December 2018 and cover unvaccinated and partially vaccinated children in rural and urban areas of India.
• The Narendra Modi government plans to roll out a ‘One Nation, One Health System’ policy by 2030, which would integrate modern and traditional systems of medicine like allopathy, homoeopathy and Ayurveda in medical practice, education and research. Government policy aims to formulate an Integrative Health System, under which patients would get treatment from any medicinal system, depending on what ails them and their current condition. “There is a need to integrate the different forms of treatment. The government is trying to shift the focus away from the ‘-pathy’ part of medicine, which means that it should not matter if it is allopathy, homoeopathy or Ayurveda, as long as the person benefits from the treatment,” a government official said on the condition of anonymity. “If a patient comes to a hospital, they can be given allopathic treatment if their condition is serious, but they can also be given homeopathy or Ayurvedic treatment in the same hospital if their condition can be managed with those,” the official explained. The NHP recognizes the need for integrated courses for ISM (Indian systems of medicine), modern science and Ayurgenomics (a combination of Ayurveda with the study of all the genes of an organism, called genomics)”. It also talks about getting AYUSH systems to contribute to “meeting the national health goals and objectives through integrative practices''.

Achievements

Following are the achievements of the Government:

• As of July2019, around 125.7 million families enrolled as beneficiaries under Pradhan Mantri Jan Arogya Yojana (PMJAY). The scheme enrolled 16,085 hospitals, including 8,059 private hospitals and 7,980 public hospitals. It included 19 AYUSH packages in the treatment scheme. As of September 2019, about 50 lakh people received free treatment under the Ayushman Bharat-Pradhan Mantri JanArogya Yojana.
• The number of medical colleges in India increased to 529 in FY19 from 381 in FY13.
• According to Sample Registration System Bulletin-2016, India has registered a 26.9% reduction in Maternal Mortality Ratio(MMR)since 2013.

Market Size

The healthcare market can increase threefold to Rs8.6 trillion (US$133.44billion) by 2022.

MEDICAL TOURISM

Medical tourism is expected to be growing at between 25-30 percent annually. The key selling points of the medical tourism industry are its cost effectiveness and its combination with the attraction of tourism. Treatment cost is lowest in India 20 percent of the average cost incurred in the US, Singapore, Thailand, and South Africa. Besides world class medical facilities, India is also trying to promote its traditional medicine.

Indian medical tourism market is growing at 18% y-o-y and is expected to reach US$ 9 billion by2020. There is a significant scope for enhancing healthcare services considering that health care spending as a percentage of Gross Domestic Product (GDP) is rising. The Government’s expenditure on healthcare sector has grown to 1.6% of the GDP in FY20BE from 1.3% in FY16.

Health insurance is gaining momentum in India. Gross direct premium income underwritten by health insurance grew 17.16% y-o-y to Rs 51637.84 Crore (US$7.39billion) in FY20

Investment

Hospitals and diagnostic centers attracted Foreign Direct Investment (FDI) worth US$ 6.72 billion between April 2000 and March 2020, according to the data released by the Department for Promotion of Industry and Internal Trade (DPIIT). Some of the recent investments in the Indian health care industry are as follows:

• In May 2020, Jubilant Generics Ltd entered into a non-exclusive licensing agreement with US-based Gilead Sciences Inc.to manufacture and sell the potential COVID-19 drug Remdesivir in 127 countries, including India.
• In May 2020, Carlyle Group acquired 74% stake in animal health focused pharmaceutical company, Se Quent Scientific Ltd, for about Rs 1,580 Crore (US$224.15million).
• In April 2020, the first COVID-19 sample collection mobile lab of the country, namely ‘MobileBSL-3 VRDL Lab’, was launched, which can process more than 1,000 samples in a day and enhance the country's capabilities in fighting COVID-19.
• The value of merger and acquisition (M&A) deals across hospitals jumped by a record 155%to Rs7,615 Crore(US$1.09 billion)inFY19.
• In August 2019, Microsoft India and Apollo Hospitals Group entered into an agreement to set up a National Clinical Coordination Committee for AI-powered Cardiovascular Disease Risk Score API.
• Fortis Healthcare approved the demerger of its hospital business with Manipal Hospital Enterprises. TPG and Dr Ranjan Pal could invest Rs 3,900 Crore (US$ 602.41 million) in Manipal Hospital Enterprise.

Road Ahead

India is a land full of opportunities for players in the medical devices industry. The country has also become one of the leading destinations for high-end diagnostic services with tremendous capital investment for advanced diagnostic facilities, thus catering to a greater proportion of population. Besides, Indian medical service consumers have become more conscious towards their health care upkeep.

Indian healthcare sector is much diversified and is full of opportunities in every segment, whichincludesproviders,payers,andmedicaltechnology.Withtheincreaseinthecompetition,businesses are looking to explore for the latest dynamics and trends which will have positive impact on their business.ThehospitalindustryinIndiaisforecasttoincreasetoRs8.6trillion(US$ 132.84billion) by FY22 from Rs 4 trillion (US$61.79billion)inFY17ataCAGRof16–17%.

The Government of India is planning to increase public health spending to 2.5% of the country's GDP by2025.

India's competitive advantage also lies in the increased success rate of Indian companies in getting Abbreviated New Drug Application (ANDA) approvals. India also offers vast opportunities in R&D as well as medical tourism. To sum up, there are vast opportunities for investment in health care infrastructure in both urban and rural India.