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VISION 2022 ROADMAP FOR INDIAN AYURVEDA INDUSTRY
This paper analyses current positioning and highlights strategic imperatives for the industry
to transform itself and grow exponentially
CONTENTS
frost.com
Foreword...........................................................................................................................................................................3
Setting the Context.........................................................................................................................................................4
Ayurveda: Are We Missing the Point? ........................................................................................................................5
The Economic Growth Potential ................................................................................................................................6
UnlockingValue.................................................................................................................................................................9
Vision Roadmap to Achieve $9 billion by 2022.........................................................................................................10
Call to Action....................................................................................................................................................................11
Confederation of Indian Industry.................................................................................................................................19
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3All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
FOREWORD
Modern therapies have limitations to completely cure chronic and lifestyle conditions. India’s ambition to provide
universal access and quality healthcare at an affordable cost mandates a paradigm shift in adoption of Ayurveda into
mainstream healthcare system.
Ayurveda’s root cause management approach goes beyond just being a curative system of medicine to being a
preventive and promotive healthcare system as well. The industry has gained recognition both in India & developed
countries as an alternative system of medicine.
Despite having a strong advantage over modern therapies, Ayurveda industry’s growth trajectory remains subdued.
There is a burning need to prioritise focus on products and services that can jump-start modest growth and triple
industry’s market potential.
Frost & Sullivan and CII have partnered to undertake a Vision Roadmap study to identify mega pivots and growth
levers that will unlock value in key industry segments and lead to decisive action with solid implementation.
This white paper is an outcome of multiple rounds of discussions with key stakeholders in the Indian Ayurveda
Industry and CII leadership who have put an incredible effort into contributing to Vision Roadmap. We hope that this
whitepaper will catalyze further discussions during the “MINISTRY OF AYUSH and CII AYURVEDA CONCLAVE”
in achieving the objectives of the plan.
Reenita Das
Partner, Senior Vice President,
Transformational Health
Frost & Sullivan
Rajiv Vasudevan
Chairman CII Core Group on Ayurveda &
Managing Director and Chief Executive Officer
AyurVAID Hospitals
Nitin Naik
Global Vice President-Life Sciences,
Transformational Health
Frost & Sullivan
Amita Sarkar
Deputy Director General
Confederation of Indian Industry
The Mantosh Sondhi Centre
23, Lodhi Road, New Delhi-110003
Unmesh Lal
Program Manager-Life Sciences,
Transformational Health
Frost & Sullivan
Anjula Singh Solanky
Director
Confederation of Indian Industry
4 All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
SETTING THE CONTEXT
The healthcare market in India is evolving at a rapid pace. As per estimates, it is one of the fastest growing industries
with an estimated CAGR of 23% from 2015 to 2020, and is expected to be a $280 billion market by 2020 . Rising
income levels, growing geriatric population, greater penetration of health care in rural settings, increasing health
awareness with an emphasis on ‘preventative healthcare’, is expected to enhance the demand for Healthcare services.
India’s National Health Policy aims at achieving Universal Health Coverage and delivering quality healthcare to all
at an affordable cost. The policy aims at providing a comprehensive primary health package which includes major
communicable, non-communicable and chronic diseases, geriatrics, palliative and rehabilitative care.
For a vast country like India, to achieve this goal with just the modern medicine system in place is a herculean task.
Modern therapies have its own drawbacks of burgeoning costs, quality of life issues, and inability to prevent and cure
many diseases. However, Ayurveda can definitely change this outlook of healthcare delivery by getting integrated into
mainstream healthcare. As shown in Figure 1, promoting Ayurveda as a mainstream therapy approach can be used
to bridge the burgeoning gap between demand and supply by primarily focusing on secondary and tertiary prevention
of diseases. In addition, the substantial opportunity in promotive health and restoration of functional health is best
addressed by Ayurveda.
Shifts in healthcare expenditures and disease profiles provide
Ayurveda a golden opportunity to be positioned as the treatment of
choice for non-emergency medical care.
Source: AyurVAID Hospitals
Figure 1: Ayurveda’s role in Mainstream Health System
Ayurveda impact across Healthcare System
Preventive Curative
Secondary
Prevention
Acute &
Emergency
Care
Primal &
Primary
Prevention
NCDs
CDs
Tertiary
Prevention
Promotive
Health
Ayurveda can be the treatment of choice for non-emergency medical care
Disease Stage AYURVEDA ALLOPATHY
Preacute (Preventative & Curative)
Acute
(Alleviative, Preventative & Curative)
Emergency (Management)
Post-acute
(Preventative, Curative & Promotive)
Source: AyurVAID Hospitals
1 https://www.ibef.org/industry/healthcare-india.aspx
5All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
AYURVEDA: ARE WE MISSING THE POINT?
Ayurveda management is based on the concept of root-cause diagnosis and management. As shown in Figure 2,
it treats not only the physical aspects of the disease but also treats and manages the root cause of the problem,
in contrast to the prevalent practice of mere symptom management. It goes beyond just being a curative system
of medicine to being a preventive and promotive healthcare system as well. Classical Ayurveda encompasses all
attributes of a mature and complete medical science encompassing anatomy, physiology, pharmaceutics, disease
causation-evolution, and disease management. The aetio-pathogenesis of disease is established through a structured
process of compilation of disease signs and symptoms, medical history, and clinical examination. Thereafter, a whole-
body, systemic healing process attempts to restore homeostasis or good health by reversing the aetio-pathogenesis
for not only disease cure but also for sustained wellbeing in body, mind and soul dimensions. This comprehensive
therapeutic approach or ‘Chikitsa’ is uniquely personalised, and includes one or more of diet-lifestyle-medicine-
therapy. Ayurveda’s principles are universal and time tested in its application to diseases prevalent in the 21st
century,
across the world.
Figure 2: Ayurveda Industry, Treatment Approach & Services
Soul
Mind
Body
Kriya
THERAPY
Aushadha
MEDICINES
Vihara
LIFESTYLE
Ahara
DIET
External
Internal
+
+
+
Ayurveda as “Ayurveda Chikitsa” focuses on root-cause
diagnosis and management
Always includes personalised diet & lifestyle
2 Calculations based on INR-USD average exchange rate in 2016; 1 USD = 67.08 INR.
6 All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
THE ECONOMIC GROWTH POTENTIAL
The Indian Ayurveda industry can be broadly categorized into the organized and the unorganized sector. Large manufacturing product
companies, hospitals, clinics, pharmacies, authentic Ayurveda wellbeing centres constitute the organized Ayurveda sector. A large
number of organized hospitality players also include light Ayurveda therapies in their bouquet of offerings. Small manufacturing product
units, raw material cultivators, local Ayurveda vaidyas, small exporters, local Ayurveda pharmacies, extract manufacturers constitute
the unorganized sector.
Figure 3: Ayurveda Industry, Key stakeholders
						 Source: Frost & Sullivan
As per Frost
& Sullivan
estimates,
the anecdotal
evidence
conjectures
the total
Ayurveda
market to
be ~USD 3
billion2
in
2016 and
growing at
a CAGR of
15-16%.
AYURVEDA SECTOR:
KEY STAKEHOLDERS
Products
Hospitals/Clinics/
Wellbeing Centres
Government
Ministry of
AYUSH
Payors Academia/ Associations
*Non-exhaustive list of key stakeholders
CGHS
7All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
The industry can be categorized by its market offerings into two broader categories:
A) Products: Ethical, classical, OTC, personal care and beauty products
B) Services: Medical, well-being, payor and medical tourism services
Figure 4: Ayurveda Industry, Estimated Size
Total market size: ~ USD 3 billion
Services, 25%,
USD 0.75 billion
Products, 75%,
USD 2.27 billion
54%
USD 1.64
billion
Corporates
21%
USD 0.18
billion
Tourism
9%
USD 0.12
billion
Exports
(Herbs +
Finished Goods)
6%
USD 0.63
billion
Extract
Manufacturers
6%
USD 0.18
billion
Pharmacies
4%
USD 0.27
billion
Services
(Panchakarma
Hospitals)
Source: Frost & Sullivan based on the industry stakeholders’ interviews
8 All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
AYURVEDA PRODUCTS:
Ayurveda products segment (valued at ~USD 2.27 billion in 2016) has been flourishing in India for the past many
decades. Ethical products, classical Ayurveda products, FMCG and personal care products including cosmetics are
the major categories being retailed. Some of the prominent blockbuster products include Chyawanprash, Triphala
Churna, Ashwagandha, Alovera etc.
Retail franchising has provided a big push towards the launch of Ayurveda companies. In addition, e-commerce is
already playing a larger role in taking Ayurveda products to the masses. Market places such as Amazon, Flipkart and
other online pharmacies have collaborated with large corporates to retail their products to the masses.
AYURVEDA SERVICES:
Ayurveda Services segment (valued at ~USD 0.75 billion in 2016) includes two broader categories:
Medical Services: This segment constitutes clinics, hospitals, and traditional family-run vaidyasalas offering
curative services. Ayurveda is also integrated at the public health system across the country, especially at the
primary healthcare centres. However, its practice is starkly conspicuous by its absence. Ayurveda by virtues
of its philosophies and principles can play a major role in preventative, curative and promotive healthcare.
Insurance coverage is increasingly being offered for Ayurveda hospitalisation and medical care services. The
Insurance Regulatory Development Authority of India effective February 2013 has enjoined all health insurance
companies to extend cashless coverage to NABH accredited Ayurveda hospitals. Further in September 2016
the Ministry of AYUSH in consultation with the Ayurveda hospitals’ industry and major Indian health insurance
companies announced a set of standard tariffs for common medical conditions. All said, the insurance sector is
progressively increasing the share of Ayurveda coverage across Corporate as well as Retail insurance policies.
Further, there is CGHS (Central Government Health Services) coverage for Ayurveda medical care already in
place although, unfortunately, the rates have not been revised since 2008.
Well-being Services: This segment is experiencing a paradigm shift brought on by a shift in consumer
mindset - from trying to achieve physical wellness to adapting a “well-being” approach which takes into account
physical, psychological, and emotional health. The introduction of NABH accreditation standards for Ayurveda
Hospitals (effective January 2010) and Ayurveda Panchakarma Clinics (effective 2017) and separately for well-
being centres is another effective way of ensuring safety and quality of care to the patients.
Insurance coverage is increasingly being offered for Ayurveda
treatment and services; however, the coverage base is low.
There are practical difficulties in standardizing the treatment
protocols across a personalized practice approach.
9All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
UNLOCKING VALUE
Ayurveda’s rich heritage and recognition as an complementary system of medicine in developed countries provides
a good foundation to set an ambitious growth goal (tripling size) by increasing market share, customer access and
profitability in both India and global markets. Figure 5 provides insights into leveraging the industry’s strengths and
opportunities to meet the targets for 2022.
Figure 5: Ayurveda Industry, SWOT Analysis
• Root cause diagnosis and management
for effective secondary and tertiary
prevention of serious and widely
prevalent diseases
• Worldwide recognition as a source for
complementary’ medicine
• Smaller product development time
(3-4 years) as compared to conventional
Pharma drugs (10-15 years)
• Strong manufacturing base
• Lack of globally accepted standards
• Not fully integrated with
mainstream market
• Product quality variation
• Ayurveda coupled with medical
and experiential tourism (potential
for 1 billion tourists annually)
• Increased scope for innovation and
change in approach for AYUSH
therapies (leveraging mobile,
internet and Telemedicine)
• Strong thrust on promotion by the
Government
• Global consumer trend towards
herbal, organic, natural, and
wholesome health solutions.
• Geriatric care
• Rising brand recognition of
alternate medicine systems like
Chinese, Latin and South
American etc.
• Competition from Sri Lanka to
claim right to Ayurveda heritage
Weaknesses
ThreatsOpportunities
Strengths
Source: Frost & Sullivan
10 All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
VISION ROADMAP TO ACHIEVE $9 BILLION BY 2022
With the need for the Ayurveda industry to transition towards precision root-cause diagnosis and
treatment, certain key objectives need to be addressed. These include increasing the overall affordability
and accessibility of medicines, attracting private investors, promoting Ayurveda hospitals and medical
value travel, leveraging the potential of Ayurveda in preventative and curative healthcare, and creating a
well-defined network for insurance and payors.
Figure 6 provides a strategic transformation framework to capitalize on key market segments and define
growth objectives. Its success will depend on all industry stakeholders taking responsibility for the plan,
led by product manufacturers, service providers and Ministry of AYUSH.
Figure 6: Ayruveda Industry, Strategic Transformation Framework
KEY OBJECTIVES
1. Increasing Accessibility and Affordability
2. Attracting Investments to the Ayurveda Sector
3. Leveraging Potential in Preventive, Curative, and Promotive Healthcare
4. Creating Brand Ayurveda
5. Promoting Ayurveda Hospitals and Medical Value Travel
6. Structuring a Paradigm for Insurance and Payors
7. Developing an Ayurveda Dietetics Industry
8. Leverage Mobile-Internet Technologies
Products
Medical Services
Well-being
KEY SEGMENTS
This roadmap focuses on reshaping critical capabilities needed to transform the Ayurveda industry.
Achieving mega pivots and growth levers (Figure 7) is not automatic, nor will they emerge if the industry
continues on its present trajectory. Acting upon these mega pivots and growth levers will enable the
industry to realize the vision of tripling the Ayurveda market by 2022.
Figure 7: Ayurveda Industry, Mega Pivots & Growth Levers
Creating
Right Policy
and Incentive
Framework
Enabling
Insurance and
Payor
Network
Building
Capacity -
Human
Resources &
Manufacturing
Revamping
Regulatory
Requirement
for Exports
MEGA
PIVOTS
3
1 2
4
Rejuvenate
Brand
Ayurveda
Revitalise
Clinical
Evidence
Building
Embrace
Digital
3
GROWTH
LEVERS
21
Top Priorities
1.	Greater industry
and government
collaboration
will globalise
Ayurveda.
2.	Ayurveda Health
is not just a diet,
lifestyle and
medical issue.
The clinical
determinants,
social impact
and economic
benefits of
“therapy” need
to be clearly
articulated.
3.	A major goal
is to reduce
the disease
burden of three
chronic diseases
(hypertension,
diabetes and
arthritis) to
manageable
levels.
4.	Human capacity
is key: Doctors,
nurses and
community
health workers
need to be
appropriately
trained, managed
and deployed
where they are
most needed.
“There is a need
for the Ayurveda
industry to be
branded as a
precision root-
cause diagnosis and
treatment system.”
- RajivVasudevan, CEO,
AyurVaid Hospitals
11All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
CALL TO ACTION
The strategy will involve accelerating leadership in traditional “products” markets while exploring
growth opportunities in sunrise “services” markets. While the former provides double-digit growth,
the latter can offer triple-digit growth.
Mega Pivot 1 Strategic Imperatives
Creating
Right Policy
and Incentive
Framework
Policy Initiatives
•	 Formulate a comprehensive Ayurveda Industry Policy
•	 Leverage IT and Biotech sector policy frameworks &
initiatives to attract big ticket (>100 Crore) investments from
Indian and Global MNCs. Draw upon enabling inputs (monetary
and non-monetary) for the Ayurveda sector, similar to successful
precedents in IT/BT sectors.
•	 Establishment of National Ayush Mission (NAM) would
support the cultivation of increased number of medicinal plants
on farmer’s lands.
•	 Ayush Ministry to spearhead Public Private Partnerships
by opening up the Ayurveda public health infrastructure to the
private sector.
•	 Operationalize MOUs between academic institutions and
practicing hospitals/government research institutes.
•	 Establishing standard guidelines for evaluation of clinical trials
and pharmacovigilance centers for data collection and assessment of
Ayurveda medicines.
Incentives
•	 Infrastructure Upgradation by Transitioning to cGMP certified
centers and Quality control processes by means of soft loans
or grants to the industry would propel funding.
•	 Provision of liberal tax incentives, new schemes (re-activated)
and GST exemption for promotion of R&D, fund randomized
controlled trials and manufacturing automation. Encourage private
investment including incentives for large healthcare companies.
•	 Budgetary support and financial outlay to establish more tertiary
care Ayurveda Hospitals in the next 5 years.
“The government
and the stakeholders
should take initiatives
to improve
the level of awareness
about Ayurveda and
its special capabilities
among the general
public, and particularly
among the younger
generation for the
future growth of the
system.”
- Dr. P.M.Varier, Chief
Superintendent &
Additional Chief
Physician,
Arya Vaidya Sala
12 All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
Mega Pivot 2 Strategic Imperatives
Enabling
Insurance
and Payor
Networks
Insurance coverage for Ayurveda treatment practices will foster its demand and
will be instrumental to bring it into the mainstream healthcare system.
•	 Uniform inclusion of Ayurveda in 6 National Health Insurance schemes
(RSBY, ESIS, CGHS, AABY, JBY, UHIS) and other proposed schemes.
•	 Implement the Government order dated 29.10.2016 relating
to Guidelines for Insurance Coverage. Get the insurance sector to
initiate compliance with the government’s guidelines document.
•	 Showcase credible data to establish safety, efficacy, and cost
for Ayurveda treatment of major chronic diseases - hypertension,
diabetes, arthritis, etc. to enable design of new insurance products based
on full, unqualified inclusion of Ayurveda medical care.
“The current
insurance market
covers only inpatient
hospitalization.There is
a market opportunity
beyond this, which is
holistic care.”
-Vidya Hariharan,
Director-Group Strategy,
Vidal Healthcare
13All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
Mega Pivot 3 Strategic Imperatives
Building
Capacity–
Human
Resources &
Manufacturing
Appropriately integrate Ayurveda with Allopathy as primary solution to deliver
“Co-Managed Treatments” for chronic diseases and neglected (yet critical) care
pathways such as mental health, infectious diseases and antibiotic resistance
treatments. Capacity building measures should be strengthened by various training
programmes for doctors, para-medics and pharmacists.
National Medicinal Plants Board (NMPB) to:
•	 Guarantee 100% resource availability for minerals/metals/animal
bi-products/wildlife classified species/imports. Government to encourage
and support small scale cultivation of herbs in the rural regions which
would open up employment opportunities for youth.
•	 Establish a corporation for procurement and trading of medicinal plants.
This entity will
»» Cover various aspects of procurement of the genuine drug, collection,
distribution, export and research.
»» Bring the trade of medical plants under a single roof thereby
guaranteeing reasonable pricing and high quality raw materials.
•	 Align efforts of State Medicinal Plants Board and herbal
medicine manufacturers to focus on essential herbs cultivation
through the 80:20 principle.
•	 Institute a certification mechanism for raw materials, and
form a market supply system. Establishment of government-certified
raw-material supply centers in every state which would help the
manufacturers procure certified raw materials and extracts that comply
with standards of Ayurveda pharmacopoeia of India.
•	 Establish partnerships between Rashtriya Ayurveda
Vidyapeeth and MOOCs, e-learning solution providers for the
provision of certification courses in Ayurveda through for beginners,
amateurs and doctors.
National Institute of Ayurveda (NIA) to:
•	 Develop SOPs using modern pharma techniques / technology.
•	 Contribute to pharmacopoeia development.
•	 Systematic study of Traditional Chinese Medicines’ (TCM)
integration with modern medicines to incorporate its successful
practices within Ayurveda education sector.
Government to promote the Ayurveda industry by providing financial assistance
to setup the technologically sound manufacturing units, cultivation zones,
research laboratories etc. Additionally, technical education in AYUSH needs
to be promoted.
“Mass cultivation of
medicinal herbs is a
potential market in the
future.This will also
help the industry for a
sustainable collection
of raw materials. R&D
innovation should
always be encouraged
and newer dosage
forms of herbal
medicines must be
encouraged by
Ministry of AYUSH.”
- Dr.Vijendra Prakash,
General Manager,
Regulatory, Corporate
Affairs,The Himalaya
Drug Company
“The biggest promotion
of Ayurveda would
be to have many large
hospitals in urban
India demonstrating
Ayurveda to
the masses.”
– Ranjit Puranik,
CEO, Shree Dhoot
Papeshwar Ltd
14 All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
Mega Pivot 4 Strategic Imperatives
Revamping
Export
Regulatory
Guidelines
•	 Developing standard monographs for international
Pharmacopoeia (with the inclusion of modern methodologies such as
TLC, GC and PC electrophoresis) to ensure uniformity in the ingredient
usage thus avoiding variations in batches.
•	 Harmonization of drug registration requirements aimed at
maintaining quality and safety of herbal products would help promote
trade across the USA. Centralization of Drug and Cosmetics
Acts (DCA) policies would ensure GMP guidelines adherence by
all companies.
•	 Rectifying the Indian patent office “guidelines for processing
of patent applications relating to traditional knowledge and biological
material.”
“GMP WHO
standards for
manufacturing
medicines are in
place and gradually
will be absorbed
by the industry.
Similarly, clinical
trials of medicines
before introducing
in the market
should be enforced
gradually, at least for
diseases like blood
pressure, diabetes,
heart disease and
dyslipidemia, cancer
and many more.”
- Dr. Rohit Sane, Founder,
Madhavbaug Clinics
& Hospitals
15All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
“Medical tourism
in Ayurveda is
an outcome of
positioning Ayurveda
as a science of
healing.”
- Dr. Partap Chauhan,
Director, Jiva Ayurveda
“Kerala has promoted
Ayurveda in medical
tourism as an
experience and a
well-being concept.
We need to replicate
that across India,
especially across the
coastal states of Goa,
Tamil Nadu, and hilly
states, where there
is a major influx of
tourists.”
- Arjun Sharma,
Chairman of
Select Group
“Propagating Ayurveda
as a curative and
preventive system
of medicine with a
scientific basis, in
addition to its well
accepted promotive
health aspects, would
bring about a positive
change in the mind
set of people and help
expand Ayurveda and
its holistic benefits
not just in India but
across International
borders..”
Mr. Jose Dominic,
Chief Executive Officer,
CGH Earth
Growth Lever 1 Strategic Imperatives
Rejuvenate
Brand
Ayurveda
A clear brand identity for ‘Ayurveda’ is a sine qua non for building correct
awareness, market acceptance, and to propel dynamic growth across it. Since
different sub-segments constitute the larger Ayurveda sector, and with a global
spread of demand and supply of Ayurveda products and services spanning casual-
leisure applications to the most rigorous healthcare provision in hospital settings,
backed by insurance/payors, misconceptions abound about the true nature and
scope of Ayurveda. Further, Ayurveda in spite of being the mother system of
medicine of the world with its origins in the Indian heartland is yet in danger of
being arrogated by other countries in the region. Further, as in the case of Yoga,
multiple Ayurveda variants may emerge across the world, diffusing and diluting the
quintessential Indian identity of Ayurveda and the scope-quality of breakthrough
healthcare that it offers to the people of the world.
•	 The Ayurveda brand has to be systematically and scientifically
studied by a team of experts in the area (branding and domain)
constituted by the Ministry of AYUSH, Government of India and experts
from industry and academia leading to a clear articulation of brand
dimensions, followed by laying out a strategic roadmap to achieving this.
•	 An Ayurveda brand development action plan has to be
centrally conceived and governed led by the Ministry of AYUSH
with appropriate participation by industry stakeholders. By consensus,
industry stakeholders from industry, government, and NGO sectors
will be urged to comply with the recommended brand communication
guidelines.
•	 Geographical Indication protection is to be obtained for
Ayurveda as originating from India. Further, a team of legal experts
should systematically evaluate copyright protection and intellectual
property protection of Ayurveda ideas and concepts.
•	 Setting up Ayurveda Chairs at country level would help obtain
MOUs from promising markets such as Malaysia, Trinidad & Tobago,
Hungary, US etc. promoting Indian herbal medicines in foreign countries
through exhibitions and trade fairs, exchange of scholars, funding
research, and providing technical support to universities.
•	 Conforming to International Drug Regulatory requirements
to ensure strict uniformity in composition, appearance, taste and
action for all Ayurveda drugs. Upgradation of Indian Pharmacopeia
keeping the global regulators informed in order to streamline the
market access process.
•	 Accreditation of Ayurveda courses conducted by foreign
institutions to enable correct dissemination of the science across
countries and to prevent progressive dilution-degradation of Ayurveda.
16 All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
Growth Lever 2 Strategic Imperatives
Revitalise
Clinical
Evidence
Building
Evidence-based research shall support the establishment of safety and efficacy of
Ayurveda products and services both in the domestic as well as the export market.
This has been a challenge for many years now. However, the solution lies in
evidence building that is consistent with the intrinsic character of Ayurveda and yet
meets stringent scientific process expectations. Increasingly, with NABH accredited
Ayurvea hospitals and clinics abounding, thorough documentation of process, safety,
and health outcomes of Ayurveda healthcare has become a reality. Merely following
western/external imposed frameworks blindly will lead to the state of limbo
persisting. Clinical evidence even at the level of observational studies, black-box
studies, and importantly treat to target studes should be scaled up in sample size
and number of studies.
•	 Strengthen National Ayurveda clinical database thereby enabling a
cohesive pull/push of innovative research methodologies to generate right
evidence applicable for Ayurveda concepts and research.
•	 Standardise treatment protocols by means of documentation of clinical
practices throughout all Ayurveda hospitals and clinics and by systematic data
collection and compilation.
•	 Focus on research to establish safety and efficacy of Ayurveda
Chikitsa (health management comprising personalised diet-lifestyle-medicine-
treatments) and not just a discrete/single component of the total Ayurveda
intervention, to make it the treatment of choice for select diseases.
•	 Practice Based Research Networks of Ayurveda physicians adopting
standardised diagnostic processes and medical management protocols for focus
conditions shall lead to generation of large amount of standardised clinical data.
•	 Documentation of scientific evidence to support efficacy, safety profiles
will drive market authorization in US & Europe.
•	 Focus on 3 diseases on a mission basis the building of robust
evidence of safety and health outcomes.
•	 Digital-Cloud-Mobile technologies should be leveraged for recording and
storing Ayurveda clinical data generated across dispersed geographies.
•	 International Conformance with International Drug Regulatory
requirements to ensure strict uniformity in composition, appearance, taste and
action for all Ayurveda drugs.
•	 Supporting Clinical Trials (RCTs) for demand generation on well-studied
and promising Indian medicinal plants like Withania somnifera, Andrographis,
Ocimum, Emblica, Trigonella, etc. Support preparation of comprehensive
safety reviews to achieve self-affirmed GRAS status – this should
include Phase 1 clinical studies in healthy volunteers and any missing animal
toxicity studies on non-proprietary herbal preparations / products.
“The western
research methods
for traditional
medicine cannot be
blindly copied for
Ayurveda research
as the principles
and goals of therapy
are different. So
research methods
have to be modified
to fit into Ayurveda
concepts and
principles.”
- Dr. Eknath Naik,
M.D., Ph.D., FACP,
Assistant Director
and Staff Physician,
Emergency
Department,
James A Haley
Veterans Hospital
17All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
Growth Lever 3 Strategic Imperatives
Embrace
Digital
India is a global leader in IT and digital transformation. Our nation’s prowess
can be uniquely leveraged to enable the Ayurveda sector to leapfrog, to
scale exponentially to achieve its true potential- this is not an option but
an imperative. An imperative since without Ayurveda playing a larger role
India’s public health needs will not be met.
India is one of the largest smart phone markets in the world and about 1/3rd
of the population is connected digitally. This connectivity can be leveraged
to create the awareness and effectively respond to demand for Ayurveda
products and services.
•	 AyurTeleMed: Telemedicine (over Smart Phones/Laptops/Mobile
Health Vans) will enable to extend quality Ayurveda clinical expertise to
Tier 2 & 3 cities, in addition to rural areas, and address the burgeoning
demand for chronic diseases/non-communicables disease care across the
country. This can be a breakthrough initiative from the Government of
India and generate considerable employment for Ayurveda doctors.
•	 AyurClinCloud: Develop a cloud based large-scale clinical information
system that can host the lakhs of Ayurveda clinical services providers
across government and private sectors.
•	 AyurNET: Leverage digital technologies across the value chain of
Ayurveda products and services from farms/forests to factory to store
to hospitals to home to enhance quality and efficiency for benefit of all
stakeholders.
•	 E-commerce is the future of Digital India. Adoption of mobile
technologies provides “product manufacturers” a massive platform to
operate “GloRural.”
•	 Big Data Analytics will play a crucial role in transition to “high value
innovative (bio prospecting) products” and support decision making to
choose “combination therapy” (Allopathic medicine + Ayurveda).
“We need to promote
telemedicine initiatives
to bring Ayurveda
consultation and
Ayurveda products
to citizens through
collaboration with rural
CSC networks and
Anganwadis.”
- Dr. P.M.Varier, Chief
Superintendent &
Additional Chief Physician,
AryaVaidya Sala
18 All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
19All rights reserved © 2017 Frost & Sullivan and CII
Vision 2022 Roadmap for Indian Ayurveda Industry
The Confederation of Indian Industry (CII) works to create and sustain an environment
conducive to the development of India, partnering industry, Government, and civil society,
through advisory and consultative processes.
CII is a non-government, not-for-profit, industry-led and industry-managed organization,
playing a proactive role in India's development process. Founded in 1895, India's premier
business association has over 8,500 members, from the private as well as public sectors,
including SMEs and MNCs, and an indirect membership of over 200,000 enterprises from
around 250 national and regional sectoral industry bodies.
CII charts change by working closely with Government on policy issues, interfacing with
thought leaders, and enhancing efficiency, competitiveness and business opportunities for
industry through a range of specialized services and strategic global linkages. It also provides
a platform for consensus-building and networking on key issues.
Extending its agenda beyond business, CII assists industry to identify and execute corporate
citizenship programmes. Partnerships with civil society organizations carry forward corporate
initiatives for integrated and inclusive development across diverse domains including
affirmative action, healthcare, education, livelihood, diversity management, skill development,
empowerment of women, and water, to name a few.
The CII theme for 2017-18, India Together: Inclusive. Ahead. Responsible emphasizes
Industry's role in partnering Government to accelerate India's growth and development. The
focus will be on key enablers such as job creation; skill development and training; affirmative
action; women parity; new models of development; sustainability; corporate social
responsibility, governance and transparency.
With 67 offices, including 9 Centres of Excellence, in India, and 11 overseas offices in
Australia, Bahrain, China, Egypt, France, Germany, Iran, Singapore, South Africa, UK, and
USA, as well as institutional partnerships with 344 counterpart organizations in 129 countries,
CII serves as a reference point for Indian industry and the international business community.
Confederation of Indian Industry
The Mantosh Sondhi Centre
23, Institutional Area, Lodi Road, New Delhi – 110 003 (India)
T: 91 11 45771000 / 24629994-7 • F: 91 11 24626149
E: info@cii.in • W: www.cii.in
Follow us on :
facebook.com/followcii twitter.com/followcii www.mycii.in
Reach us via our Membership Helpline: 00-91-124-4592966 / 00-91-99104 46244
CII Helpline Toll free No: 1800-103-1244
877.GoFrost
myfrost@frost.com
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we have been developing growth strategies for the Global 1000, emerging businesses, the public sector and the investment community.
Is your organization prepared for the next profound wave of industry convergence, disruptive technologies, increasing competitive
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Vision 2022 Roadmap study for Indian Ayurveda Industry

  • 1. VISION 2022 ROADMAP FOR INDIAN AYURVEDA INDUSTRY This paper analyses current positioning and highlights strategic imperatives for the industry to transform itself and grow exponentially
  • 2. CONTENTS frost.com Foreword...........................................................................................................................................................................3 Setting the Context.........................................................................................................................................................4 Ayurveda: Are We Missing the Point? ........................................................................................................................5 The Economic Growth Potential ................................................................................................................................6 UnlockingValue.................................................................................................................................................................9 Vision Roadmap to Achieve $9 billion by 2022.........................................................................................................10 Call to Action....................................................................................................................................................................11 Confederation of Indian Industry.................................................................................................................................19 Copyright & Disclaimer Published by Confederation of Indian Industry (CII) and Frost & Sullivan (F&S) Without limiting the rights under the copyright reserved, this publication or any part of it may not be translated, reproduced, stored, transmitted in any form (electronic, mechanical, photocopying, audio recording or otherwise) or circulated in any binding or cover other than the cover in which it is currently published, without the prior written permission of CII and F&S.  All information,ideas,views,opinions,estimates,advice,suggestions,recommendations (hereinafter‘content’) in this publication should not be understood as professional advice in any manner or interpreted as policies, objectives, opinions or suggestions of CII and F&S. Readers are advised to use their discretion and seek professional advice before taking any action or decision,based on the contents of this publication. The content in this publication has been obtained or derived from sourcesbelieved by CII and F&S to be reliable but CII and F&S do not represent this information to be accurate or complete. CII and F&S do not assume any responsibility and disclaim any liability for any loss, damages, caused due to any reason whatsoever, towards any person (natural or legal) who uses this publication.  This publication cannot be sold for consideration, within or outside India, without express written permission of CII and F&S.Violation of this condition of sale will lead to criminal and civil prosecution.
  • 3. 3All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry FOREWORD Modern therapies have limitations to completely cure chronic and lifestyle conditions. India’s ambition to provide universal access and quality healthcare at an affordable cost mandates a paradigm shift in adoption of Ayurveda into mainstream healthcare system. Ayurveda’s root cause management approach goes beyond just being a curative system of medicine to being a preventive and promotive healthcare system as well. The industry has gained recognition both in India & developed countries as an alternative system of medicine. Despite having a strong advantage over modern therapies, Ayurveda industry’s growth trajectory remains subdued. There is a burning need to prioritise focus on products and services that can jump-start modest growth and triple industry’s market potential. Frost & Sullivan and CII have partnered to undertake a Vision Roadmap study to identify mega pivots and growth levers that will unlock value in key industry segments and lead to decisive action with solid implementation. This white paper is an outcome of multiple rounds of discussions with key stakeholders in the Indian Ayurveda Industry and CII leadership who have put an incredible effort into contributing to Vision Roadmap. We hope that this whitepaper will catalyze further discussions during the “MINISTRY OF AYUSH and CII AYURVEDA CONCLAVE” in achieving the objectives of the plan. Reenita Das Partner, Senior Vice President, Transformational Health Frost & Sullivan Rajiv Vasudevan Chairman CII Core Group on Ayurveda & Managing Director and Chief Executive Officer AyurVAID Hospitals Nitin Naik Global Vice President-Life Sciences, Transformational Health Frost & Sullivan Amita Sarkar Deputy Director General Confederation of Indian Industry The Mantosh Sondhi Centre 23, Lodhi Road, New Delhi-110003 Unmesh Lal Program Manager-Life Sciences, Transformational Health Frost & Sullivan Anjula Singh Solanky Director Confederation of Indian Industry
  • 4. 4 All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry SETTING THE CONTEXT The healthcare market in India is evolving at a rapid pace. As per estimates, it is one of the fastest growing industries with an estimated CAGR of 23% from 2015 to 2020, and is expected to be a $280 billion market by 2020 . Rising income levels, growing geriatric population, greater penetration of health care in rural settings, increasing health awareness with an emphasis on ‘preventative healthcare’, is expected to enhance the demand for Healthcare services. India’s National Health Policy aims at achieving Universal Health Coverage and delivering quality healthcare to all at an affordable cost. The policy aims at providing a comprehensive primary health package which includes major communicable, non-communicable and chronic diseases, geriatrics, palliative and rehabilitative care. For a vast country like India, to achieve this goal with just the modern medicine system in place is a herculean task. Modern therapies have its own drawbacks of burgeoning costs, quality of life issues, and inability to prevent and cure many diseases. However, Ayurveda can definitely change this outlook of healthcare delivery by getting integrated into mainstream healthcare. As shown in Figure 1, promoting Ayurveda as a mainstream therapy approach can be used to bridge the burgeoning gap between demand and supply by primarily focusing on secondary and tertiary prevention of diseases. In addition, the substantial opportunity in promotive health and restoration of functional health is best addressed by Ayurveda. Shifts in healthcare expenditures and disease profiles provide Ayurveda a golden opportunity to be positioned as the treatment of choice for non-emergency medical care. Source: AyurVAID Hospitals Figure 1: Ayurveda’s role in Mainstream Health System Ayurveda impact across Healthcare System Preventive Curative Secondary Prevention Acute & Emergency Care Primal & Primary Prevention NCDs CDs Tertiary Prevention Promotive Health Ayurveda can be the treatment of choice for non-emergency medical care Disease Stage AYURVEDA ALLOPATHY Preacute (Preventative & Curative) Acute (Alleviative, Preventative & Curative) Emergency (Management) Post-acute (Preventative, Curative & Promotive) Source: AyurVAID Hospitals 1 https://www.ibef.org/industry/healthcare-india.aspx
  • 5. 5All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry AYURVEDA: ARE WE MISSING THE POINT? Ayurveda management is based on the concept of root-cause diagnosis and management. As shown in Figure 2, it treats not only the physical aspects of the disease but also treats and manages the root cause of the problem, in contrast to the prevalent practice of mere symptom management. It goes beyond just being a curative system of medicine to being a preventive and promotive healthcare system as well. Classical Ayurveda encompasses all attributes of a mature and complete medical science encompassing anatomy, physiology, pharmaceutics, disease causation-evolution, and disease management. The aetio-pathogenesis of disease is established through a structured process of compilation of disease signs and symptoms, medical history, and clinical examination. Thereafter, a whole- body, systemic healing process attempts to restore homeostasis or good health by reversing the aetio-pathogenesis for not only disease cure but also for sustained wellbeing in body, mind and soul dimensions. This comprehensive therapeutic approach or ‘Chikitsa’ is uniquely personalised, and includes one or more of diet-lifestyle-medicine- therapy. Ayurveda’s principles are universal and time tested in its application to diseases prevalent in the 21st century, across the world. Figure 2: Ayurveda Industry, Treatment Approach & Services Soul Mind Body Kriya THERAPY Aushadha MEDICINES Vihara LIFESTYLE Ahara DIET External Internal + + + Ayurveda as “Ayurveda Chikitsa” focuses on root-cause diagnosis and management Always includes personalised diet & lifestyle 2 Calculations based on INR-USD average exchange rate in 2016; 1 USD = 67.08 INR.
  • 6. 6 All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry THE ECONOMIC GROWTH POTENTIAL The Indian Ayurveda industry can be broadly categorized into the organized and the unorganized sector. Large manufacturing product companies, hospitals, clinics, pharmacies, authentic Ayurveda wellbeing centres constitute the organized Ayurveda sector. A large number of organized hospitality players also include light Ayurveda therapies in their bouquet of offerings. Small manufacturing product units, raw material cultivators, local Ayurveda vaidyas, small exporters, local Ayurveda pharmacies, extract manufacturers constitute the unorganized sector. Figure 3: Ayurveda Industry, Key stakeholders Source: Frost & Sullivan As per Frost & Sullivan estimates, the anecdotal evidence conjectures the total Ayurveda market to be ~USD 3 billion2 in 2016 and growing at a CAGR of 15-16%. AYURVEDA SECTOR: KEY STAKEHOLDERS Products Hospitals/Clinics/ Wellbeing Centres Government Ministry of AYUSH Payors Academia/ Associations *Non-exhaustive list of key stakeholders CGHS
  • 7. 7All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry The industry can be categorized by its market offerings into two broader categories: A) Products: Ethical, classical, OTC, personal care and beauty products B) Services: Medical, well-being, payor and medical tourism services Figure 4: Ayurveda Industry, Estimated Size Total market size: ~ USD 3 billion Services, 25%, USD 0.75 billion Products, 75%, USD 2.27 billion 54% USD 1.64 billion Corporates 21% USD 0.18 billion Tourism 9% USD 0.12 billion Exports (Herbs + Finished Goods) 6% USD 0.63 billion Extract Manufacturers 6% USD 0.18 billion Pharmacies 4% USD 0.27 billion Services (Panchakarma Hospitals) Source: Frost & Sullivan based on the industry stakeholders’ interviews
  • 8. 8 All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry AYURVEDA PRODUCTS: Ayurveda products segment (valued at ~USD 2.27 billion in 2016) has been flourishing in India for the past many decades. Ethical products, classical Ayurveda products, FMCG and personal care products including cosmetics are the major categories being retailed. Some of the prominent blockbuster products include Chyawanprash, Triphala Churna, Ashwagandha, Alovera etc. Retail franchising has provided a big push towards the launch of Ayurveda companies. In addition, e-commerce is already playing a larger role in taking Ayurveda products to the masses. Market places such as Amazon, Flipkart and other online pharmacies have collaborated with large corporates to retail their products to the masses. AYURVEDA SERVICES: Ayurveda Services segment (valued at ~USD 0.75 billion in 2016) includes two broader categories: Medical Services: This segment constitutes clinics, hospitals, and traditional family-run vaidyasalas offering curative services. Ayurveda is also integrated at the public health system across the country, especially at the primary healthcare centres. However, its practice is starkly conspicuous by its absence. Ayurveda by virtues of its philosophies and principles can play a major role in preventative, curative and promotive healthcare. Insurance coverage is increasingly being offered for Ayurveda hospitalisation and medical care services. The Insurance Regulatory Development Authority of India effective February 2013 has enjoined all health insurance companies to extend cashless coverage to NABH accredited Ayurveda hospitals. Further in September 2016 the Ministry of AYUSH in consultation with the Ayurveda hospitals’ industry and major Indian health insurance companies announced a set of standard tariffs for common medical conditions. All said, the insurance sector is progressively increasing the share of Ayurveda coverage across Corporate as well as Retail insurance policies. Further, there is CGHS (Central Government Health Services) coverage for Ayurveda medical care already in place although, unfortunately, the rates have not been revised since 2008. Well-being Services: This segment is experiencing a paradigm shift brought on by a shift in consumer mindset - from trying to achieve physical wellness to adapting a “well-being” approach which takes into account physical, psychological, and emotional health. The introduction of NABH accreditation standards for Ayurveda Hospitals (effective January 2010) and Ayurveda Panchakarma Clinics (effective 2017) and separately for well- being centres is another effective way of ensuring safety and quality of care to the patients. Insurance coverage is increasingly being offered for Ayurveda treatment and services; however, the coverage base is low. There are practical difficulties in standardizing the treatment protocols across a personalized practice approach.
  • 9. 9All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry UNLOCKING VALUE Ayurveda’s rich heritage and recognition as an complementary system of medicine in developed countries provides a good foundation to set an ambitious growth goal (tripling size) by increasing market share, customer access and profitability in both India and global markets. Figure 5 provides insights into leveraging the industry’s strengths and opportunities to meet the targets for 2022. Figure 5: Ayurveda Industry, SWOT Analysis • Root cause diagnosis and management for effective secondary and tertiary prevention of serious and widely prevalent diseases • Worldwide recognition as a source for complementary’ medicine • Smaller product development time (3-4 years) as compared to conventional Pharma drugs (10-15 years) • Strong manufacturing base • Lack of globally accepted standards • Not fully integrated with mainstream market • Product quality variation • Ayurveda coupled with medical and experiential tourism (potential for 1 billion tourists annually) • Increased scope for innovation and change in approach for AYUSH therapies (leveraging mobile, internet and Telemedicine) • Strong thrust on promotion by the Government • Global consumer trend towards herbal, organic, natural, and wholesome health solutions. • Geriatric care • Rising brand recognition of alternate medicine systems like Chinese, Latin and South American etc. • Competition from Sri Lanka to claim right to Ayurveda heritage Weaknesses ThreatsOpportunities Strengths Source: Frost & Sullivan
  • 10. 10 All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry VISION ROADMAP TO ACHIEVE $9 BILLION BY 2022 With the need for the Ayurveda industry to transition towards precision root-cause diagnosis and treatment, certain key objectives need to be addressed. These include increasing the overall affordability and accessibility of medicines, attracting private investors, promoting Ayurveda hospitals and medical value travel, leveraging the potential of Ayurveda in preventative and curative healthcare, and creating a well-defined network for insurance and payors. Figure 6 provides a strategic transformation framework to capitalize on key market segments and define growth objectives. Its success will depend on all industry stakeholders taking responsibility for the plan, led by product manufacturers, service providers and Ministry of AYUSH. Figure 6: Ayruveda Industry, Strategic Transformation Framework KEY OBJECTIVES 1. Increasing Accessibility and Affordability 2. Attracting Investments to the Ayurveda Sector 3. Leveraging Potential in Preventive, Curative, and Promotive Healthcare 4. Creating Brand Ayurveda 5. Promoting Ayurveda Hospitals and Medical Value Travel 6. Structuring a Paradigm for Insurance and Payors 7. Developing an Ayurveda Dietetics Industry 8. Leverage Mobile-Internet Technologies Products Medical Services Well-being KEY SEGMENTS This roadmap focuses on reshaping critical capabilities needed to transform the Ayurveda industry. Achieving mega pivots and growth levers (Figure 7) is not automatic, nor will they emerge if the industry continues on its present trajectory. Acting upon these mega pivots and growth levers will enable the industry to realize the vision of tripling the Ayurveda market by 2022. Figure 7: Ayurveda Industry, Mega Pivots & Growth Levers Creating Right Policy and Incentive Framework Enabling Insurance and Payor Network Building Capacity - Human Resources & Manufacturing Revamping Regulatory Requirement for Exports MEGA PIVOTS 3 1 2 4 Rejuvenate Brand Ayurveda Revitalise Clinical Evidence Building Embrace Digital 3 GROWTH LEVERS 21 Top Priorities 1. Greater industry and government collaboration will globalise Ayurveda. 2. Ayurveda Health is not just a diet, lifestyle and medical issue. The clinical determinants, social impact and economic benefits of “therapy” need to be clearly articulated. 3. A major goal is to reduce the disease burden of three chronic diseases (hypertension, diabetes and arthritis) to manageable levels. 4. Human capacity is key: Doctors, nurses and community health workers need to be appropriately trained, managed and deployed where they are most needed. “There is a need for the Ayurveda industry to be branded as a precision root- cause diagnosis and treatment system.” - RajivVasudevan, CEO, AyurVaid Hospitals
  • 11. 11All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry CALL TO ACTION The strategy will involve accelerating leadership in traditional “products” markets while exploring growth opportunities in sunrise “services” markets. While the former provides double-digit growth, the latter can offer triple-digit growth. Mega Pivot 1 Strategic Imperatives Creating Right Policy and Incentive Framework Policy Initiatives • Formulate a comprehensive Ayurveda Industry Policy • Leverage IT and Biotech sector policy frameworks & initiatives to attract big ticket (>100 Crore) investments from Indian and Global MNCs. Draw upon enabling inputs (monetary and non-monetary) for the Ayurveda sector, similar to successful precedents in IT/BT sectors. • Establishment of National Ayush Mission (NAM) would support the cultivation of increased number of medicinal plants on farmer’s lands. • Ayush Ministry to spearhead Public Private Partnerships by opening up the Ayurveda public health infrastructure to the private sector. • Operationalize MOUs between academic institutions and practicing hospitals/government research institutes. • Establishing standard guidelines for evaluation of clinical trials and pharmacovigilance centers for data collection and assessment of Ayurveda medicines. Incentives • Infrastructure Upgradation by Transitioning to cGMP certified centers and Quality control processes by means of soft loans or grants to the industry would propel funding. • Provision of liberal tax incentives, new schemes (re-activated) and GST exemption for promotion of R&D, fund randomized controlled trials and manufacturing automation. Encourage private investment including incentives for large healthcare companies. • Budgetary support and financial outlay to establish more tertiary care Ayurveda Hospitals in the next 5 years. “The government and the stakeholders should take initiatives to improve the level of awareness about Ayurveda and its special capabilities among the general public, and particularly among the younger generation for the future growth of the system.” - Dr. P.M.Varier, Chief Superintendent & Additional Chief Physician, Arya Vaidya Sala
  • 12. 12 All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry Mega Pivot 2 Strategic Imperatives Enabling Insurance and Payor Networks Insurance coverage for Ayurveda treatment practices will foster its demand and will be instrumental to bring it into the mainstream healthcare system. • Uniform inclusion of Ayurveda in 6 National Health Insurance schemes (RSBY, ESIS, CGHS, AABY, JBY, UHIS) and other proposed schemes. • Implement the Government order dated 29.10.2016 relating to Guidelines for Insurance Coverage. Get the insurance sector to initiate compliance with the government’s guidelines document. • Showcase credible data to establish safety, efficacy, and cost for Ayurveda treatment of major chronic diseases - hypertension, diabetes, arthritis, etc. to enable design of new insurance products based on full, unqualified inclusion of Ayurveda medical care. “The current insurance market covers only inpatient hospitalization.There is a market opportunity beyond this, which is holistic care.” -Vidya Hariharan, Director-Group Strategy, Vidal Healthcare
  • 13. 13All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry Mega Pivot 3 Strategic Imperatives Building Capacity– Human Resources & Manufacturing Appropriately integrate Ayurveda with Allopathy as primary solution to deliver “Co-Managed Treatments” for chronic diseases and neglected (yet critical) care pathways such as mental health, infectious diseases and antibiotic resistance treatments. Capacity building measures should be strengthened by various training programmes for doctors, para-medics and pharmacists. National Medicinal Plants Board (NMPB) to: • Guarantee 100% resource availability for minerals/metals/animal bi-products/wildlife classified species/imports. Government to encourage and support small scale cultivation of herbs in the rural regions which would open up employment opportunities for youth. • Establish a corporation for procurement and trading of medicinal plants. This entity will »» Cover various aspects of procurement of the genuine drug, collection, distribution, export and research. »» Bring the trade of medical plants under a single roof thereby guaranteeing reasonable pricing and high quality raw materials. • Align efforts of State Medicinal Plants Board and herbal medicine manufacturers to focus on essential herbs cultivation through the 80:20 principle. • Institute a certification mechanism for raw materials, and form a market supply system. Establishment of government-certified raw-material supply centers in every state which would help the manufacturers procure certified raw materials and extracts that comply with standards of Ayurveda pharmacopoeia of India. • Establish partnerships between Rashtriya Ayurveda Vidyapeeth and MOOCs, e-learning solution providers for the provision of certification courses in Ayurveda through for beginners, amateurs and doctors. National Institute of Ayurveda (NIA) to: • Develop SOPs using modern pharma techniques / technology. • Contribute to pharmacopoeia development. • Systematic study of Traditional Chinese Medicines’ (TCM) integration with modern medicines to incorporate its successful practices within Ayurveda education sector. Government to promote the Ayurveda industry by providing financial assistance to setup the technologically sound manufacturing units, cultivation zones, research laboratories etc. Additionally, technical education in AYUSH needs to be promoted. “Mass cultivation of medicinal herbs is a potential market in the future.This will also help the industry for a sustainable collection of raw materials. R&D innovation should always be encouraged and newer dosage forms of herbal medicines must be encouraged by Ministry of AYUSH.” - Dr.Vijendra Prakash, General Manager, Regulatory, Corporate Affairs,The Himalaya Drug Company “The biggest promotion of Ayurveda would be to have many large hospitals in urban India demonstrating Ayurveda to the masses.” – Ranjit Puranik, CEO, Shree Dhoot Papeshwar Ltd
  • 14. 14 All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry Mega Pivot 4 Strategic Imperatives Revamping Export Regulatory Guidelines • Developing standard monographs for international Pharmacopoeia (with the inclusion of modern methodologies such as TLC, GC and PC electrophoresis) to ensure uniformity in the ingredient usage thus avoiding variations in batches. • Harmonization of drug registration requirements aimed at maintaining quality and safety of herbal products would help promote trade across the USA. Centralization of Drug and Cosmetics Acts (DCA) policies would ensure GMP guidelines adherence by all companies. • Rectifying the Indian patent office “guidelines for processing of patent applications relating to traditional knowledge and biological material.” “GMP WHO standards for manufacturing medicines are in place and gradually will be absorbed by the industry. Similarly, clinical trials of medicines before introducing in the market should be enforced gradually, at least for diseases like blood pressure, diabetes, heart disease and dyslipidemia, cancer and many more.” - Dr. Rohit Sane, Founder, Madhavbaug Clinics & Hospitals
  • 15. 15All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry “Medical tourism in Ayurveda is an outcome of positioning Ayurveda as a science of healing.” - Dr. Partap Chauhan, Director, Jiva Ayurveda “Kerala has promoted Ayurveda in medical tourism as an experience and a well-being concept. We need to replicate that across India, especially across the coastal states of Goa, Tamil Nadu, and hilly states, where there is a major influx of tourists.” - Arjun Sharma, Chairman of Select Group “Propagating Ayurveda as a curative and preventive system of medicine with a scientific basis, in addition to its well accepted promotive health aspects, would bring about a positive change in the mind set of people and help expand Ayurveda and its holistic benefits not just in India but across International borders..” Mr. Jose Dominic, Chief Executive Officer, CGH Earth Growth Lever 1 Strategic Imperatives Rejuvenate Brand Ayurveda A clear brand identity for ‘Ayurveda’ is a sine qua non for building correct awareness, market acceptance, and to propel dynamic growth across it. Since different sub-segments constitute the larger Ayurveda sector, and with a global spread of demand and supply of Ayurveda products and services spanning casual- leisure applications to the most rigorous healthcare provision in hospital settings, backed by insurance/payors, misconceptions abound about the true nature and scope of Ayurveda. Further, Ayurveda in spite of being the mother system of medicine of the world with its origins in the Indian heartland is yet in danger of being arrogated by other countries in the region. Further, as in the case of Yoga, multiple Ayurveda variants may emerge across the world, diffusing and diluting the quintessential Indian identity of Ayurveda and the scope-quality of breakthrough healthcare that it offers to the people of the world. • The Ayurveda brand has to be systematically and scientifically studied by a team of experts in the area (branding and domain) constituted by the Ministry of AYUSH, Government of India and experts from industry and academia leading to a clear articulation of brand dimensions, followed by laying out a strategic roadmap to achieving this. • An Ayurveda brand development action plan has to be centrally conceived and governed led by the Ministry of AYUSH with appropriate participation by industry stakeholders. By consensus, industry stakeholders from industry, government, and NGO sectors will be urged to comply with the recommended brand communication guidelines. • Geographical Indication protection is to be obtained for Ayurveda as originating from India. Further, a team of legal experts should systematically evaluate copyright protection and intellectual property protection of Ayurveda ideas and concepts. • Setting up Ayurveda Chairs at country level would help obtain MOUs from promising markets such as Malaysia, Trinidad & Tobago, Hungary, US etc. promoting Indian herbal medicines in foreign countries through exhibitions and trade fairs, exchange of scholars, funding research, and providing technical support to universities. • Conforming to International Drug Regulatory requirements to ensure strict uniformity in composition, appearance, taste and action for all Ayurveda drugs. Upgradation of Indian Pharmacopeia keeping the global regulators informed in order to streamline the market access process. • Accreditation of Ayurveda courses conducted by foreign institutions to enable correct dissemination of the science across countries and to prevent progressive dilution-degradation of Ayurveda.
  • 16. 16 All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry Growth Lever 2 Strategic Imperatives Revitalise Clinical Evidence Building Evidence-based research shall support the establishment of safety and efficacy of Ayurveda products and services both in the domestic as well as the export market. This has been a challenge for many years now. However, the solution lies in evidence building that is consistent with the intrinsic character of Ayurveda and yet meets stringent scientific process expectations. Increasingly, with NABH accredited Ayurvea hospitals and clinics abounding, thorough documentation of process, safety, and health outcomes of Ayurveda healthcare has become a reality. Merely following western/external imposed frameworks blindly will lead to the state of limbo persisting. Clinical evidence even at the level of observational studies, black-box studies, and importantly treat to target studes should be scaled up in sample size and number of studies. • Strengthen National Ayurveda clinical database thereby enabling a cohesive pull/push of innovative research methodologies to generate right evidence applicable for Ayurveda concepts and research. • Standardise treatment protocols by means of documentation of clinical practices throughout all Ayurveda hospitals and clinics and by systematic data collection and compilation. • Focus on research to establish safety and efficacy of Ayurveda Chikitsa (health management comprising personalised diet-lifestyle-medicine- treatments) and not just a discrete/single component of the total Ayurveda intervention, to make it the treatment of choice for select diseases. • Practice Based Research Networks of Ayurveda physicians adopting standardised diagnostic processes and medical management protocols for focus conditions shall lead to generation of large amount of standardised clinical data. • Documentation of scientific evidence to support efficacy, safety profiles will drive market authorization in US & Europe. • Focus on 3 diseases on a mission basis the building of robust evidence of safety and health outcomes. • Digital-Cloud-Mobile technologies should be leveraged for recording and storing Ayurveda clinical data generated across dispersed geographies. • International Conformance with International Drug Regulatory requirements to ensure strict uniformity in composition, appearance, taste and action for all Ayurveda drugs. • Supporting Clinical Trials (RCTs) for demand generation on well-studied and promising Indian medicinal plants like Withania somnifera, Andrographis, Ocimum, Emblica, Trigonella, etc. Support preparation of comprehensive safety reviews to achieve self-affirmed GRAS status – this should include Phase 1 clinical studies in healthy volunteers and any missing animal toxicity studies on non-proprietary herbal preparations / products. “The western research methods for traditional medicine cannot be blindly copied for Ayurveda research as the principles and goals of therapy are different. So research methods have to be modified to fit into Ayurveda concepts and principles.” - Dr. Eknath Naik, M.D., Ph.D., FACP, Assistant Director and Staff Physician, Emergency Department, James A Haley Veterans Hospital
  • 17. 17All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry Growth Lever 3 Strategic Imperatives Embrace Digital India is a global leader in IT and digital transformation. Our nation’s prowess can be uniquely leveraged to enable the Ayurveda sector to leapfrog, to scale exponentially to achieve its true potential- this is not an option but an imperative. An imperative since without Ayurveda playing a larger role India’s public health needs will not be met. India is one of the largest smart phone markets in the world and about 1/3rd of the population is connected digitally. This connectivity can be leveraged to create the awareness and effectively respond to demand for Ayurveda products and services. • AyurTeleMed: Telemedicine (over Smart Phones/Laptops/Mobile Health Vans) will enable to extend quality Ayurveda clinical expertise to Tier 2 & 3 cities, in addition to rural areas, and address the burgeoning demand for chronic diseases/non-communicables disease care across the country. This can be a breakthrough initiative from the Government of India and generate considerable employment for Ayurveda doctors. • AyurClinCloud: Develop a cloud based large-scale clinical information system that can host the lakhs of Ayurveda clinical services providers across government and private sectors. • AyurNET: Leverage digital technologies across the value chain of Ayurveda products and services from farms/forests to factory to store to hospitals to home to enhance quality and efficiency for benefit of all stakeholders. • E-commerce is the future of Digital India. Adoption of mobile technologies provides “product manufacturers” a massive platform to operate “GloRural.” • Big Data Analytics will play a crucial role in transition to “high value innovative (bio prospecting) products” and support decision making to choose “combination therapy” (Allopathic medicine + Ayurveda). “We need to promote telemedicine initiatives to bring Ayurveda consultation and Ayurveda products to citizens through collaboration with rural CSC networks and Anganwadis.” - Dr. P.M.Varier, Chief Superintendent & Additional Chief Physician, AryaVaidya Sala
  • 18. 18 All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry
  • 19. 19All rights reserved © 2017 Frost & Sullivan and CII Vision 2022 Roadmap for Indian Ayurveda Industry The Confederation of Indian Industry (CII) works to create and sustain an environment conducive to the development of India, partnering industry, Government, and civil society, through advisory and consultative processes. CII is a non-government, not-for-profit, industry-led and industry-managed organization, playing a proactive role in India's development process. Founded in 1895, India's premier business association has over 8,500 members, from the private as well as public sectors, including SMEs and MNCs, and an indirect membership of over 200,000 enterprises from around 250 national and regional sectoral industry bodies. CII charts change by working closely with Government on policy issues, interfacing with thought leaders, and enhancing efficiency, competitiveness and business opportunities for industry through a range of specialized services and strategic global linkages. It also provides a platform for consensus-building and networking on key issues. Extending its agenda beyond business, CII assists industry to identify and execute corporate citizenship programmes. Partnerships with civil society organizations carry forward corporate initiatives for integrated and inclusive development across diverse domains including affirmative action, healthcare, education, livelihood, diversity management, skill development, empowerment of women, and water, to name a few. The CII theme for 2017-18, India Together: Inclusive. Ahead. Responsible emphasizes Industry's role in partnering Government to accelerate India's growth and development. The focus will be on key enablers such as job creation; skill development and training; affirmative action; women parity; new models of development; sustainability; corporate social responsibility, governance and transparency. With 67 offices, including 9 Centres of Excellence, in India, and 11 overseas offices in Australia, Bahrain, China, Egypt, France, Germany, Iran, Singapore, South Africa, UK, and USA, as well as institutional partnerships with 344 counterpart organizations in 129 countries, CII serves as a reference point for Indian industry and the international business community. Confederation of Indian Industry The Mantosh Sondhi Centre 23, Institutional Area, Lodi Road, New Delhi – 110 003 (India) T: 91 11 45771000 / 24629994-7 • F: 91 11 24626149 E: info@cii.in • W: www.cii.in Follow us on : facebook.com/followcii twitter.com/followcii www.mycii.in Reach us via our Membership Helpline: 00-91-124-4592966 / 00-91-99104 46244 CII Helpline Toll free No: 1800-103-1244
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