The document provides an overview of the Indian healthcare system, including key trends, growth drivers, and challenges. It notes that the size of the Indian healthcare industry is $35 billion and growing at 17% annually, faster than any other country. The industry employs over 4% of the population and includes 229 medical colleges, 600,000 doctors, and over 800,000 hospital beds. However, healthcare infrastructure and access remains inadequate, with 80% of healthcare spending being out-of-pocket. The government is taking steps to improve access through initiatives like the National Rural Health Mission and increasing healthcare spending.

1. Prof. (Dr.) Prashant Mehta©
M.Sc, Ph.D. (Chemistry), MBA, Ph.D. (Management)
National Law University, Jodhpur
DECODING THE INDIAN HEALTHCARE SYSTEM
Emerging Prospects

2. My Talk Today
•News Makers
•Healthcare Industry
•Key Growth Engines
•Key Inhibitors
•Market Challenges
•Healthcare (Bio-medical & Hospital
)Wastes
•Constitutional Provisions
•Landmark Cases
•Regulatory Framework
•Bio-medical Waste Handling Rules, 1998,
Amended Rules 2008, Draft Rules 2011
•Handling of Bio-medical Wastes
•Conclusions
•Snap Shots
•References

3. INDIAN HEALTHCARE LANDSCAPE
“The growing demand for quality healthcare in INDIA and
the absence of matching delivery mechanisms pose a great challenge
to all stake holders and an even greater opportunity for different
service providers.

14. Trends
• Indian economy is growing at 5.6 percent despite negative
global economic conditions.
• Size of the Indian Healthcare Industry is nearly US$ 35 billion
• It contributes over 5 percent to GDP of the country
• It offers employment to over 4 percent population
• Indian Healthcare Industry is growing at rapid pace of 17
percent year on year basis. It is fastest growth in the world.
• Healthcare Infrastructure and Resources in India includes:
229 medical colleges, 6,00,000 practicing doctors, 18,000 new
doctors qualifying every year, 15,000 hospitals, 875,000
hospital beds, 737,000 nurses, 3,50,000 retail pharmacies,
50,000 pathology laboratories and other facilities.
Source: Industry Focus, 2012

16. Growing INDIAN Economy
GDP GROWTH RATE GLOBAL SHARE – INDIA GDP (%)
Source: International Monetary Fund, World Economic Outlook (2010)

17. Ever Growing Clinical Statistics: India
• Cancer: 3 million
• Diabetes: 34 million
• HIV: 8-10 million
• Epilepsy: 8 million
• Hypertension: 150 million
• Schizophrenia: 1 million
• Asthma: 40 million
• Alzheimer's: 1.5 million
• Cardiac-Related Deaths: 2 million
• Tuberculosis related Deaths – 0.3 million
• Malaria related Deaths – 0.2 million
• Pharmaceutical – US$10 billion growing at 12% despite global
economic pressures
• Hospitals/Nursing Homes – $12 billion – growing at 20%
• Medical Equipment – $2 billion, growing at 15%
• Clinical Lab Diagnostics –US$2 billion – growing at 30%
• Imaging Diagnostics – US$1 billion – growing at 30%
• Other Services (includes Training and Education; Aesthetics and
Weight loss; US$2 billion – growing at 40%
• Retail Pharmacy; etc.– US$2 billion – growing at 40%
Source: Industry Focus, 2012

18. Growth Trends, Allocation and Spending : India
Source: Planning Commission
Rs. In Crores

19. Main Growth Engines: Indian Healthcare
Source: Business Standard, Economic Times, Health site

20. Components of Healthcare Industry: India
Source: Hospital Market India By Research on India
US $78.6 billion, 2012

21. Indian Healthcare Sector - Benefitted By
Source: Health Ministry, Government of India

22. Pharmaceuticals Market: India
Growing and
Ageing
Population
Growing Sick
Population
Rising Incidence
of Non
Communicable
and Infectious
Disease
Improved Access
to Healthcare
Higher
Affordability
Source: Business Standard, IMS Health, 2010Source: PWC Analysis, 2010/India

23. Healthcare Expenditure: Growth and Share
Source: Business Standard, Hospital Market Research on India, World Bank, Business Monitor Report

24. Healthcare Expenditure: Projections
Source: Economic Times, 2013

25. Indian Health Expenditure vs. Major Economies
Source: World Health Statistics, 2013, WHO, ICMR, Aranca Analysis

26. Medical Equipments Technology Sector: India
• The medical technology sector, which plays a vital role in the
delivery of healthcare services in India was valued at 2.75
billion USD in 2008 (National Institute of Pharmaceutical
Education and Research, Ahmedabad).
• It is expected to reach 14 billion USD in 2020 at a
compounded annual growth rate of approximately 15%.
• The medical equipment segment forms the largest share of
the medical technology sector with over 55% of the total size
of the market.
• The medical implants segment constitutes the next biggest
segment with over 25% of the market.
Source: PWC Analysis, NIPER - Ahmedabad

27. Diagnostics Sector: India
• In India, the in-vitro segment of the industry
accrued revenues of US $463.50 million in 2012,
which is estimated to touch US $1,254 million by
2018 growing over the last 5 years at an estimated
CAGR of 20%.
• The principal areas of growth include haematology,
biochemistry, complex molecular diagnostics, and
specialty diagnostics.
• The increase in the number of hospitals, healthcare
facilities, development of healthcare infrastructure,
the advancement of medical equipment, and
complexity of diseases has propelled the growth of
this industry.
• With 40,000 independent pathology laboratories in
the country, the industry is highly competitive and
price driven
• Presently, the lab testing market is largely serviced by
small unorganized players and hospitals
• By 2010, two million patients are expected for clinical
trials in India; translating into 20 million tests

28. Insurance Growth and Penetration: India
Source: ISI Analytics, Healthcare Industry, 2010, General Insurance Council of India, 2010
The Indian economy is growing and will
continue to provide conducive macro-
environment for the industry. The
government is increasing its spend on
healthcare.
The Indian healthcare insurance industry
is currently very small and limited, but is
expected to grow at a CAGR of 15%.
Around 80% of healthcare expenditure is
financed out of pocket. Insurance
penetration will go up dramatically as out
of pocket payment for medication is not a
model anywhere in the world.

29. Traditional Medicinal Care: India
Source: Ministry of Health, RNCOS, KPMG, Aranca Research
Noticeable Trends
The traditional medical sector is developing Traditional Knowledge Digital Library to prevent companies from claiming patents on such remedies. There is growing
interest from numerous private equity firms in the traditional healthcare sector in India
Leading Brands And Players
Vicks VapoRub, Amrutanjan Balm, Zandu Balm, Moov Pain Cream and Halls Lozenges are among the leading ayurvedic brands in India. Many big players such as
Apollo, VLCC and Manipal Group are also setting up wellness centres across India, with traditional healthcare remedies as the focus of their offerings
Services Offered
Ayurvedic medicines offer traditional Indian health remedies based on natural and herbal ingredients. The sector has broadened its offerings and now
includes services on diet and nutrition, yoga, herbal medicine, humor therapy, and spa services
Market Size
The traditional (ayurvedic) medical care market in India was valued at about US $1.4 billion in 2010, and this is expected to rise at a CAGR of 20 per
cent over 2011–15

30. Policy Support: By Government of India
•The benefit of section 10(23G) of IT-Act has been extended to
provide long-term capital to hospitals with 100 beds or more.
Government is encouraging the PPP model to improve
availability of healthcare services provide financing.
Encouraging Private
Sector
•The benefit of section 80-1B has been extended to new
hospitals with 100 beds or more that are set up in rural areas,
such hospitals are entitled for 100 percent deduction on
profits for five years.
Encouraging
Investment in Rural
areas
•Incentives and tax holidays are being offered to hospitals
providing healthcare travel facilities.
Incentives for
Medical Tourism
•Allocation of US $5.6 billion, an increase of 20 percent from
FY12. Hospitals with at least 100 beds are eligible for 150%
deduction from capital expenditure, and exemption on
service tax. In 12th Plan US $83 billion was allocated by
Planning commission.
Union Budget FY 13
•Custom duty on life-saving equipment has been reduced to 5%
from 25%, and exempted from countervailing duty. Import
duty on medical equipment has been reduced by 75%, high
depreciation on prices of life saving equipment upto 40%..
Tax Incentives
•NHRM was set in 2005-2012 to ensure provisions of effective
healthcare to the country’s rural population. This initiative has
helped in reduction of Infant Mortality Rate (IMR), Maternal
Mortality Rate (MMR), and Total Fertility Rate (TFR).
National Rural
Health Mission
(NHRM)
•To cater to the healthcare needs of slum dwellers ban Health
Mission (NUHM), 2005 across urban India. This initiative caters
to nearly 42.6 million slum developers spread across 640 towns
and cities in India
National Urban
Health Mission
(NUHM)
•Scotland is extending assistance to Indian pharmaceutical and
biotech companies. The country intends to partner with India
in stem cell research, clinical trials, regenerative medicine, and
affordable healthcare.
International
Co-operations
•Indian government has extended support for improving the
quality of healthcare delivery. In line with this, the Union
Cabinet approved USD333.61 million to set up the National
Cancer Institute.
Establishment
of Facilities
Source: Union Budget FY 2013, Health Ministry, planning Commission, RBI, Deloitt, Livemint

31. FDI In Healthcare Sector: India
Source: Business Today, Planning Commission of India, Department of Industrial Policy and Promotion
The Indian Pharmaceutical industry has
attracted US $1707.52 million worth of FDI in
the period between April 2000 and April 2010.
This FDI is exclusive of investments in shares of
Indian firms. Acquisitions of local players by
large MNCs illustrate the increasing level of
interest shown in the Indian market.

32. Advantage India
Strong Demand
Healthcare revenue in India is set to reach US $280 billion by
2020 and expenditure is likely to expand at a CAGR of 12%
over 2012-2015
Attractive Opportunities
Investment in healthcare infrastructure both hard (hospitals) and soft
(R&D, Education ) is set to rise, medical tourism is emerging as one of
the most lucrative area
Quality and Affordability
There is a large pool of well trained medical professionals in the
country. Compared to peers it has a comparative advantage in the
cost of offering high quality medical services.
Policy Support
To develop India as global hub for healthcare, policy support in form
of reduced excise, customs duty, service tax exemption, and NHRM
program to boost rural healthcare
Market Size
US $72 billion, 2011
Expected to be US $280 billion, 2020
Source: KPMG, Hospital Market India by Research on India Aranca Research

34. References
CORPORATE RESEARCH REPORTS:
• HEALTHCARE IN INDIA: A REPORT BY BOSTON ANALYTICS, JANUARY 2009
• GLOBAL INFRASTRUCTURE: TREND MONITOR INDIAN HEALTHCARE EDITION: OUTLOOK 2009 –2013 BY
KPMG
• STRATEGIES FOR PROVIDING EQUITABLE HEALTHCARE, BY ECS LIMITED, MARCH 2008
• PHARMACEUTICAL OFFSHORING LANDSCAPE, ZINNOV MANAGEMENT CONSULTING, SEPTEMBER 2008
• INDIAN PHARMACEUTICAL INDUSTRY ON COURSE OF GLOBALIZATION, DEUTSCHE BANK RESEARCH,
APRIL 2008
• HEALTHCARE IN INDIA: EMERGING MARKET REPORT 2007 BY: PRICEWATERHOUSE AND COOPERS (PWC)
• HEALTHCARE OUTLOOK, TEN INDUSTRY TRENDS 2007, A QUARTERLY REPORT BY TECHNOPAK, FEBRUARY
07 / VOLUME 1
• HEALTHCARE OUTLOOK, NEW PARADIGMS IN HEALTHCARE DELIVERY 2007, A QUARTERLY REPORT BY
TECHNOPAK, FEBRUARY 07 / VOLUME 2
• HEALTHCARE OUTLOOK, TRENDS IN HEALTHCARE DESIGN 2007, A QUARTERLY REPORT BY TECHNOPAK,
FEBRUARY 07 / VOLUME 3
• HEALTHCARE, MARKET OVERVIEW, INDIA BRAND EQUITY FOUNDATION (IBEF) OCTOBER 2007
• OVERVIEW OF THE HEALTHCARE INDUSTRY IN INDIA, THE INDO ITALIAN CHAMBER OF COMMERCE AND
INDUSTRY, APRIL 2007
• HEALTHCARE REPORT: BY ERNST & YOUNG, INDIAN BRAND EQUITY FOUNDATION (IBEF), 2006
• BOOMING CLINICAL TRIAL MARKET IN INDIA: RNCOS REPORT, NOVEMBER 2007
• DRAFT NATIONAL PHARMACEUTICALS POLICY, 2006, PART - A (CONTAINS ISSUES OTHER THAN
STATUTORY PRICE CONTROL), DEPARTMENT OF CHEMICALS AND PETROCHEMICALS, GOVERNMENT OF
INDIA, DECEMBER 28, 2005
• HEALTH ATTAINMENTS AND DEMOGRAPHIC CONCERNS: NATIONAL HUMAN DEVELOPMENT REPORT,
2001: CHAPTER 5
• THE STATE OF HUMAN DEVELOPMENT: NATIONAL HUMAN DEVELOPMENT REPORT, 2001: CHAPTER 1
• HEALTHCARE IN INDIA, CARING FOR MORE THAN A BILLION: BY SRIVATHSAN APARAJITHAN Y, MATHUR
SHANTHI, MOUNIB EDGAR L., NAKHOODA FARHANA, PAI ADITYA AND BASKARAN LIBI, IBM INSTITUTE
OF BUSINESS VALUE, IBM GLOBAL BUSINESS SERVICES
• CASE STUDY ON MANIPLE CURE & CARE: INDEGENEOUS CONCEPT THAT COMBINES HEALTHCARE AND
RETAIL IN A SINGLE FORMAT: BY PRICE WATER HOUSE AND COOPERS(PWC) AND DYNAMIC VERTICAL
SOLUTIONS
• INDIAN PHARMACEUTICAL INDUSTRY: ISSUES AND OPPORTUNITIES: RESEARCH AND MARKETS REPORT (
http://www.researchandmarkets.com/reports/35229)
SUMMARIES:
• INADEQUATE REGULATIONS UNDERMINE INDIA'S HEALTHCARE: BY: MUDUR GANPATI: BMJ 2004;
328;124- DOI:10.1136/BMJ.328.7432.124-A
• HEALTH CARE IN INDIA: LEARNING FROM EXPERIENCE: BY THE WORLD BANK GROUP
• HEALTHCARE INDICATORS: BY MS. MUKHERJI SRIMOTI, COMMERCIAL SPECIALIST, THE U.S.
COMMERCIAL SERVICE IN INDIA, THE AMERICAN CENTER, NEW DELHI
• INDIA’S NATIONAL HEALTH SYSTEM PROFILE: WHO
• OPPORTUNITIES IN HEALTHCARE: “DESTINATION INDIA”: FICCI AND ERNST & YOUNG.
• RURAL HEALTH CARE SYSTEM: THE STRUCTURE AND CURRENT SCENARIO
• INTRODUCTION TO NURSING AND HEALTH CARE DELIVERY SYSTEM IN INDIA
• A POLICY FRAMEWORK FOR REFORMS IN HEALTH CARE, PERSPECTIVES ON HEALTH CARE IN INDIA: BY
PRIME MINISTER’S COUNCIL ON TRADE AND INDUSTRY
• FAILURE OF PUBLIC HEALTHCARE SYSTEM: CJ: BY SINGH CHANDRA SHEKAR, FEBURARY, 2008
• FINANCING THE HEALTH CARE SECTOR IN INDIA: BLOG BY DR SINGH HARMEET, MBA (BIRMINGHAM)
• IN CHINA, INDIA, HEALTH CARE BURDEN SHIFTS TO POOR, GROUND-LEVEL IMPLEMENTATION 'IS SIMPLY
NOT THERE': BY POWELL ALVIN, HARVARD NEWS OFFICE
• STRENGTHEN THE INDIAN HEALTHCARE INDUSTRY (RECOMMENDATIONS): MODE 1 GATS REPORT INDIA
PAGE 83, 84
• ROLE OF PRIVATE SECTOR IN HEALTH CARE IN INDIA CHALLENGES, OPPORTUNITIES & STARTEGIES: BY
LATH G K, CEO, APOLLO HOSPITAL BILASPUR, MP
• UNHEALTHY PRESCRIPTIONS: THE NEED FOR HEALTH SECTOR REFORM IN INDIA: BY SUNIL NANDRAJ,
INFORMING REFORMING, THE NEWSLETTER OF THE INTERNATIONAL CLEARING HOUSE OF HEALTH
SYSTEM REFORM INITIATIVES ICHSRI, APRIL-JUNE 1997, PP. 7-11.
• MEDICAL TOURISM IN INDIA: ISSUES AND CHALLENGES: BY CHACKO PHEBA, THE ICFAI UNIVERSITY
PRESS.
• HEALTH INSURANCE IN INDIA: OPPORTUNITIES, CHALLENGES AND CONCERNS: BY MAVALANKAR DILEEP
AND BHAT RAMESH, IIM AHMEDABAD
• INDIA BRAND EQUITY FOUNDATION (IBEF), MARCH 2013, AUGUST 2013 REPORT (WWW.IBEF.ORG)
• HEALTHCARE INDIA SECTOR NOTES, MAY 2014, (WWW.IIMJOBS.COM)
• INDIAN HEALTHCARE SYSTEM – OVERVIEW AND QUALITY IMPROVEMENTS, DIRECT RESPONSE, 2013:04,
SWEDISH AGENCY FOR GROWTH POLICY ANALYSIS , WWW.GROWTHANALYSIS.SE
• INDIAN PHARMA, INC.: CAPITALIZING ON INDIA’S GROWTH POTENTIAL, www.pwc.com/India
• INDIAN PHARMA INC. CARING FUP OR NEXT LELVEL OF GROWTH, www.pwc.com/India

35. References
Websites:
• www.technopak.com
• www.kpmg.com/infrastructure
• www.ibef.org
• www.dbresearch.com
• www.dynamicverticals.com
• www.bostonanalytics.com
• www.ibm.com/healthcare/hc2015
• www.pwc.com/globalhealthcare
• www.wikepedia.com/healthcare
• www.ficci.com
• www.timeswellness.com
• www.fortishealthworld.com
• www.whoindia.org
• www.who.int
• www.mohfw.nic.in
• www.crisil.com
• www.pharmabiz.com
• www.pharma.org
Journals
• JOURNAL OF THE ACADEMY OF HOSPITAL ADMINISTRATION
• INDIAN JOURNAL FOR THE PRACTICING DOCTOR
• JOURNAL OF HEALTHCARE AND MEDICAL TECHNOLOGY AND MANAGEMENT
• INDIAN JOURNAL OF MEDICAL ETHICS
• THE PHARMA REVIEW AND PHARMA TIMES
• JOURNAL OF HOSPITAL PHARMACY
Other Publications:
• MINISTRY OF HEALTH, GOVERNMENT OF INDIA
• INDIAN MEDICAL COUNCIL & INDIAN DENTAL COUNCIL
• EXPRESS HEALTHCARE MANAGEMENT
• INDIAN HEALTHCARE FEDERATION
• MEDICA: PHARMACEUTICAL INDUSTRY PUBLICATIONS
• MEDICA: HEALTHCARE SERVICES PUBLICATIONS
Chapters:
• COMPETITION CONCERNS: THE PHARMACEUTICAL INDUSTRY BY CUTS INTERNATIONAL
• CHAPTER 10: DRUG PRICE DIFFERENTIALS ACROSS DIFFERENT RETAIL MARKET SETTINGS: AN ANALYSIS
OF RETAIL PRICES OF 12 COMMONLY USED DRUGS: BY GODWIN S K AND VARATHARAJAN D., HEALTH
ADMINISTRATOR VOL: XIX NUMBER 1: 41-47
• HEALTHCARE POLICY AND ADMINISTRATION IN INDIA: BY SAPRU R K, STERLING PUBLICATION, II
EDITION, CHAPTER 15, PAGES 228-249.
My Books:
• Indian Health Sector and Healthcare System: A critical Insight, LAP Lambert Academic Publishing,
Germany, 2012, ISBN-10: 3659268895, ISBN-13: 978-3659268892, Prashant Mehta
• Indian Retail Analytics: An In-depth Study of Indian Retail Market, its Dimensions, Opportunities,
Problems, and Prospects, LAP Lambert Academic Publishing, Germany, 2012, ISBN-10: 3659147303,
ISBN-13: 978-3659147302 Prashant Mehta
My Publications:
• Legal Provisions and Management Perspectives of Biomedical and Hospital Waste in India. Journal
Club for Management Studies (JCMS),1(II), 11-36 (2014).Dr. Prashant Mehta. ISSN No : 2394 - 3033, V –
1, I – 2, 2014
• Biomedical Waste Disposal: Indian Perspective: Scholasticus, Journal of National Law University,
Jodhpur Vol. 5 No. 1, September 2007, Prashant Mehta, ISBN: 0975-1157, Indexed