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Rewinding 2023

Rewinding 2023

2023 has proven to be a milestone year for the Indian healthcare landscape. From groundbreaking therapies to  transformative technologies, the Indian healthcare sector is at the cusp of a resounding revolution A profoundly promising sector, the Indian healthcare sector is rising at a dizzying pace. This sunrise sector has taken the Indian industry by storm and 2023 is proving to be a landmark year in many ways. One of the largest sectors in the Indian market, the healthcare domain which comprises hospitals, pharmaceuticals, diagnostics, life sciences, health technology, health insurance and clinical trials is growing at a tremendous pace. As Per the Economic survey carried out in the year 2022-23, the Indian public expenditure on healthcare touched 2.1 per cent of the GDP in FY 2023. Driven by the heightened demand for quality healthcare, the healthcare sector has held the bull by the horns and risen to meet the growing need for a robust healthcare framework and infrastructure. Identified globally as a promising sector, investors are eyeing this segment. According to a Grant Thornton Bharat report, the Indian healthcare sector has attracted investments worth $4.4 billion in H1 of 2023. The numbers clearly show that this segment is pivoted to grow from strength to strength. The growth of this dynamic sector has been catalysed by technology integration, digitisation and innovation, with patient-centricity being at the epicentre of the disruption. The industry has been ever-evolving, seeing groundbreaking therapies coming to the forefront ushered in by advancements in the R&D segment of the industry. Primarily driven by digital transformation the healthcare sector is forecasted to grow tenfold. A Boston Consulting Group (BCG) report states that the market is estimated to touch a whooping figure of $37 billion by 2030.
[caption id="attachment_25551" align="alignright" width="300"] Arvind Vaishnav, Head of Clinical Partnerships, Growth Region and Philips Innovation Campus, Bangalore[/caption]   What we have been witnessing in the healthcare industry over the past few decades is a groundswell of  technologies that ends up in additional administration and regulation, which is pulling healthcare workers away  from their purpose of patient care. Ask anyone in healthcare and it is common to hear about that ‘one more thing,’ in their daily work irrespective of how best it fits into their overall  workflow and experience. As a result, most of them now spend more time away from actually caring for patients. That is why I think it is incredibly important for everyone in the industry ecosystem to rethink how healthcare workers can be reconnected to their primary  purpose of patient care. This implies thinking of people before technology, asking what it means for a healthcare professional to interact with a certain technology, and how it can complement their workflow. It also means we need to find better ways of tracking and highlighting the value that healthcare workers deliver to the patient.  
[caption id="attachment_25552" align="alignright" width="300"] Aniruddha Sen, Co-founder, Kenko Health[/caption]   Traversing the landscape of healthcare finance with the vision of Health for All has left a mark in 2023. The surge  in telemedicine, addressing the need for safe and convenient healthcare, is gearing up for further expansion in 2024. This transformative shift is reshaping healthcare, notably with the growing use of online consultations and remote services. In 2023, Artificial Intelligence (AI) played a crucial role and is set to gain even more prominence.  The use of AI for precise diagnostics, a standout trend, is projected for substantial growth in 2024. AI’s pivotal role in streamlining insurance processes, detecting fraud, and enhancing healthcare system efficiency remains crucial. The integration of digital health solutions into daily life is steadfast, seamlessly embedding healthcare technology.  The success of remote patient monitoring, a cost-effective solution for reducing hospitalisation expenses, is poised for further refinement, promising enhanced accessibility to healthcare services. A notable shift towards preventive care was observed in 2023, marking a departure from reactive health  management. The proliferation of wellness apps, fitness wearables, and incentivised programmes from insurance providers is guiding individuals towards healthier lifestyles. Rooted firmly in 2023, this trend is set to solidify in  2024, fostering a holistic approach to well-being. Crucially, there is a heightened focus on preventive health financing. Anticipated innovations from insurance  providers are expected to introduce policies incentivising proactive health measures. This aligns with the industry’s commitment to providing accessible, cost-effective healthcare, centered around individual and community well-being.
[caption id="attachment_25553" align="alignright" width="300"] Suresh Ramu, Co-founder and CEO, Cytecare Hospitals[/caption]   With investments in the Indian healthcare sector reaching an impressive $4 billion this year, the industry has experienced a profound transformation, especially in the hospital segment - a response to proactive government initiatives. This achievement marks a significant milestone, with the sector witnessing billion-dollar investments for two consecutive years now. The upsurge in individuals seeking healthcare services, driven by Ayushman Bharat initiatives, underscores the necessity to address the healthcare needs of a broader demographic. The industry’s shift towards standardised services and infrastructure, spearheaded by branded and organised players, positions it for scalability and  enhanced service delivery. This positive evolution aligns seamlessly with changing patient expectations, demonstrating a steadfast commitment to meeting diverse healthcare needs across the country. Aligned with the government’s vision for an upgraded healthcare infrastructure, investments in Indian hospitals not only address immediate needs but also strategically position the country for a robust healthcare future. Private equity players play a pivotal role in this transformation, contributing capital and strategic guidance to foster innovation and operational excellence. These investments, measured in both the number of deals and their overall value, signify a promising paradigm shift in the industry. The Indian healthcare sector is indeed at the forefront of change, shaping a more resilient and progressive future.
  [caption id="attachment_25554" align="alignright" width="300"] AIS Bedi, Managing Director, Torque Pharmaceuticals[/caption] The Indian pharmaceutical industry is undergoing dynamic changes, driven by several key trends that are shaping its trajectory. Presently, the Indian pharma industry stands as the third largest by volume. Globally, that is driven by factors such as - cost competitive manufacturing, ensuring accessibility to affordable drugs, growing government support, and the surge in R&D investments. In 2024, the pharma sector will strive to comply with the  government’s Vision Pharma 2047, which will sustainably focus on affordability and innovation. The ongoing digital transformation and technology upgrades are set to facilitate seamless communication with the public and swift delivery of services and products. By strategically addressing economic barriers, reinforcing infrastructure,  and embracing innovative healthcare solutions, India can move closer to the goal of providing every individual with an equal opportunity to achieve optimal health.
[caption id="attachment_25555" align="alignright" width="300"] Mudit Dandwate, CEO and Co-Founder, Dozee[/caption] In the landscape of healthcare startups throughout 2023, India’s challenges, such as scarcity of healthcare resources for its vast population, were met with substantial progress driven by technological advancements, particularly in artificial intelligence (AI). With approximately 10,000 health tech startups and significant investments, the sector’s growth trajectory is poised for exponential expansion, potentially reaching a market value of ~$35 billion by the decade’s end. While the start-up space across the globe is suffering through the ‘funding winter’, owing to the economic turbulence that this year has consistently witnessed, innovative start-ups continue to persevere. Leveraging AI, which was, indubitably, the currency of 2023—, and backed by government schemes such as the Ayushman Bharat Digital Mission (ABDM), the health tech landscape of the country has remarkably sustained itself. The relentless march of digital innovation in healthcare, aimed at enhancing service delivery, has inadvertently paved the way for a disturbing surge in cybercrime. As the curtains fall in 2023, the healthcare industry stands at the threshold of a transformative era, defined by  impactful policy interventions, groundbreaking innovations, and an unwavering commitment to patient-centricity. Embracing digital and AI-driven solutions on a broader scale has ushered in a new era where the synergy of medical expertise and cutting-edge technologies propels us toward unparalleled enhancements in patient care. This confluence paints an optimistic horizon, promising a relentless evolution of medical practices that adapt seamlessly to the dynamic needs of individuals and communities, marking 2023 as a pivotal chapter in the relentless pursuit of healthcare excellence.
[caption id="attachment_25556" align="alignright" width="300"] Saransh Chaudhary, President, Global Critical Care, Venus Remedies & CEO, Venus Medicine Research Centre[/caption]   The year 2023 has been transformative for the pharmaceutical sector in India, which has witnessed an upward  trajectory in terms of business performance. The pivotal role played by the Indian government, particularly its focus on innovation and technology, has been instrumental in shaping the fortunes of pharmaceutical businesses. In terms of figures, industry reports state that in FY23, the Indian pharma market saw a year-on-year growth of  nearly 5 per cent to reach a market size of $49.78 billion. The growth trajectory in 2023 has been marked by a strategic move to complement volume-based generics with value-based products driven by a surge in R&D initiatives. The recent introduction of the Rs 5,000-crore research-linked-incentive (RLI) scheme and the setting up of Centres of Excellence in collaboration with the Indian Council of Medical Research is expected to strengthen research infrastructure and promote industry-academia linkages for research and development (R&D). These initiatives are likely to propel pharmaceutical organisations towards research-driven excellence in the coming years. The production-linked incentive (PLI) scheme is set to further catalyse growth, particularly in high-value products across the global supply chain. As the pharmaceutical sector enters 2024, the lessons from 2023 set the stage for a promising future. The industry’s focus on innovation, diversification and collaborative efforts with the government has put the pharma sector in sync with market trends. The integration of transformative technologies, the emphasis on generic  medicines and the commitment to ESG principles showcase a forward-thinking approach. Crucially, the sector’s dedicated pursuit of collaborative economic models to address antibiotic resistance reflects a strong commitment to overcoming challenges in research and development. This collaborative stance, particularly seeking support from regulatory bodies, is important to sustain antibiotic research efforts and  effectively combat antibiotic resistance. The pharmaceutical sector’s performance in 2023 has propelled it towards greater success, marked by innovation, collaboration and a commitment towards shaping a healthier world.
[caption id="attachment_25558" align="alignright" width="300"] Satish Kannan, Co-founder and CEO, MediBuddy[/caption] Driven by factors such as rising demand for innovative healthcare services, rapid technological advancements, government initiatives, and a growing middle class, the Indian health tech industry is projected to reach a staggering $5.5 billion by 2025. Recent years have witnessed a notable shift in the Indian healthcare sector towards prioritising preventive healthcare and wellness. This shift has fuelled innovation and disruption, with numerous healthcare startups entering the market to address this evolving landscape. Leveraging cutting-edge technologies like artificial intelligence (AI), machine learning (ML), and genomics, these startups are developing innovative solutions to address critical healthcare needs. India’s large pool of highly skilled engineers and scientists well-versed in cutting-edge technology will also be a key factor in building  innovative health tech startups. Indian healthcare startups have demonstrated remarkable resilience and innovation in 2023. These startups are addressing critical healthcare needs, making healthcare more accessible, affordable, and personalised. As the sector continues to grow, Indian healthcare startups are poised to play an increasingly important role in shaping the future of healthcare delivery.
[caption id="attachment_25559" align="alignright" width="300"] Surajit Chakrabartty, CFO, MedGenome[/caption] Over the past one to two years, genomics as a diagnostic tool has witnessed an unprecedented surge in  adoption, primarily evident in larger cities and tertiary care settings. Notably, this growth is now extending its roots into Tier II and III cities and secondary care centres, due to reduced costs of diagnostic tests and a rise in disposable incomes. The aftermath of the pandemic has seen a heightened focus on preventing future health crises, fostering a health-conscious society seeking preventive wellness measures and early disease screening. This shift has led to the emergence of genomic wellness companies, launching tests to capitalise on the growing trend of  understanding genetic predisposition, environmental factors, and other contributors to overall health. A robust regulatory framework is also crucial, addressing partnerships, data storage, usage protocols, consumer protection, de-identification methods, potential discoveries, and outcome distribution. Despite increased awareness, the genetic testing sector is still in its early stages, tapping into less than 10-15 per cent of its total potential. This leaves ample room for further growth and exciting developments in this field in the coming years. As the industry continues to evolve, the integration of genomics into healthcare is poised to play a pivotal role in shaping the future of diagnostics, ultimately contributing to better healthcare outcomes for individuals across the nation.  
[caption id="attachment_25560" align="alignright" width="299"] Nikhil Chopra, CEO & Whole Time Director, JB Pharma[/caption]   The Indian pharmaceutical sector has delivered an impressive performance throughout the year, surpassing  expectations set by credit rating agencies, in a challenging year. Post the challenge posed by the COVID-19 pandemic and its successful containment of it, the healthcare industry underwent a gradual transformation to  adapt itself to changing and unmet needs. This shift in dynamics revealed emerging issues related to the affordability of drugs and access to medications, presenting hurdles that required adept and timely solutions. In 2023, chronic therapies, contributing 38 – 40 per cent of the pharmaceutical industry, have consistently outpaced  the growth of other therapies. The industry also witnessed an increase in the number of companies diversifying their product portfolio and investing in wellness and OTC products like probiotics. The increasing burden of diseases and growing awareness of the importance of healthcare is expected to fuel the demand for quality pharmaceutical products. Regulations and changes from the government are channelled in the right direction towards curbing spurious and ‘not of standard quality’ drugs, which has already garnered noticeable results like drastic improvements in quality measures, manufacturing facilities, processes and quality  assurance and control mechanisms. The second half of 2023 has seen a growing interest in private equity investments in hospitals and diagnostics. These strategic alliances, mergers and acquisitions are a welcome change as this will only enhance the accessibility of hospital and diagnostic services to the Indian population, even in the remotest parts of the country. Moreover, the industry recognised the significance of collaborations and partnerships with healthcare entities, investment companies etc working closely to improve the accessibility and cost-effectiveness of medications.
[caption id="attachment_25561" align="alignright" width="299"] Dr Kiran Sharma, Professor-Marketing & International Business, KJ Somaiya Institute of Management[/caption] The COVID-19 pandemic has brought about fast and drastic changes in the pharmaceutical industry. The  healthcare and pharmaceutical industry has seen quick growth. However, this financially prosperous time for pharma companies has left leaders and stakeholders wondering what the future of healthcare entails. Decoding future diseases and potential treatments is imperative to distinguish between a worthy investment or financing an industry fad. The pharmaceutical industry is forecasted to see an upward trend since the COVID-19 pandemic phase. The latest trend of economic grouping seen among the countries has increased post-COVID era. Big data is providing pharmaceutical companies with predictive, prescriptive, and diagnostic analytics that have led to new drug discoveries and developments. In 2023, both pharmaceutical companies and governments continued to  diversify their supply sources by outsourcing production to neighbouring countries or outsourcing to the market of sale. Pharmaceutical companies are expected to face challenges in the global market due to the adoption of cost-control policies and the tightening of rules by governments in key markets.  
[caption id="attachment_25562" align="alignright" width="299"] Lalit Mistry, Partner and Co-Head, Healthcare, KPMG in India[/caption] The healthcare sector is presently transforming at an unprecedented pace, and various key factors are at the helm of this ongoing metamorphosis. Technology has permeated every aspect of the healthcare sector and is now being accepted, adopted, and leveraged by multiple stakeholders. This has resulted in a shift towards remote healthcare delivery, collection and utilisation of healthcare data, enhanced accessibility, operational efficiency,  and personalised care. Another key factor driving the change in the industry is the evolving role of patients in the healthcare ecosystem. From dormant participants with limited power and awareness, patients of today are active stakeholders who are driving the trends in the industry. In addition to these factors, the systemic issues prevalent  in the country continue to shape the trends of the industry. Some of these factors include demographic shifts, changes in disease burden, healthcare infrastructure, healthcare workforce availability, high out- of-pocket expenditure (OOPEs), and rural-urban divide. While these variables continue to interact with each other, collectively, they are emerging as the guiding forces  that are reshaping the healthcare industry and resulting in the emergence of new-age delivery models. These models are revolutionising India’s entire healthcare value chain, ushering in an era of innovative, patient- centric, and accessible healthcare approaches. It is also understood that the new-age healthcare models are not just about technology, but a paradigm shift in how healthcare is conceptualised, delivered, and experienced. At the  core of this shift lies the recognition that healthcare is not a one-size-fits-all proposition. Individualised care, tailored to the specific needs and circumstances of each patient, is the cornerstone.  
[caption id="attachment_25563" align="alignright" width="299"] Nishith M Desai, Nishith Desai Associates[/caption] The first half of 2023 has brought about some significant developments for the Indian healthcare industry. The trend has been to regulate previously unregulated or under-regulated activities, enactment of new regimes for healthcare professionals, and operationalise laws that were notified in the past few years. There have been significant developments for both the medical and dental fraternity; the laws that govern fertility services and surrogacy have been fully operationalised etc. Discussions are being held about bringing hair transplant centres  and cosmetology clinics under the ambit of the Clinical Establishments Act. The focus remains on ensuring patient welfare and safety. Not only are healthcare professionals being brought  under either revised or entirely new legal regimes, but the past few years have also seen a shift towards regulating clinical establishments that offer specific categories of healthcare services. In addition to issuing the NMC Code, the NMC has also been actively reforming the regulatory framework for medical education in India, to ensure more holistic and competent medical professionals in the future, which will improve the overall healthcare delivery system in India. Some of the key developments that have taken place in the first half of 2023 are:
  • New code of conduct for doctors
  • Establishment of the National Medical Register
  • Legal framework for dentists
  • Mandatory registration of fertility and surrogacy clinics
  • Extension granted to state governments to constitute state allied and healthcare councils
  • Accessibility standards for healthcare facilities