Technopak Healthcare Outlook - Vol 4.pdf

t e c h n o p a k
Company Name CONFIDENTIAL
1

healthcare
A Q u a r t e r l y R e p o r t b y T e c h n o p a k VOLUME 4
ten
industry
trends:
2008

healthcare
© Technopak Advisors Pvt. Ltd.
‘Healthcare Outlook’, a quarterly feature is an
effort by the Technopak Healthcare Team to
explore the dynamic changes that are occurring
in the healthcare industry in India today.
We at Technopak understand the need for
continuous and intensive assessment of the
world’s largest service sector industry. With
this report we have attempted to provide
insights on the trends and the opportunities in
healthcare market. During the course of this
year we will be publishing reports on various
aspects of the industry with a specific focus
on the diverse opportunities for investment.
c o n t e n t s
Overview 01
TREND 1
Academic Medical Centers
Delivering Excellence in Care, Education & Research 02
TREND 2
Healthcare Consumerism in India: Rising Awareness & Spend 03
TREND 3
Newer Formats of Healthcare Delivery:
Taking Healthcare closer to the consumer 04
TREND 4
Healthcare REITS: Addressing the Real Estate challenge 05
TREND 5
Private Equity: The Race for Value Deals 06
TREND 6
Clinical Trials: Making Inroads 07
TREND 7
Emergency Evacuation Services: Building a Network for India 08
TREND 8
Healthcare Architecture: The Business of Design 09
TREND 9
Healthcare Outsourcing: Providers focus on their core competence 10
TREND 10
Medical Device Innovation : Involving Providers and Physicians 11
About Technopak 12

01
Overview
The healthcare sector in India is at the point of inflection in transforming the
delivery setting in terms of the formats, quality of care, affordability and
geographical access. It will be requiring continous effort to take the quantum
leap and design future ready healthcare delivery multi-systems
integrated with comprehensive healthcare financing mechanism, thereby
providing access to majority of the population.
A fast growing economy, rising incomes and increased urbanization have
been instrumental in changing the perception of patients as consumers.
The present day patients are more demanding, expecting better services for
their money and exercising choice in choosing a facility for reasons other
than cost.
India needs an annual incremental addition of healthcare facilities equivalent
to almost half of what UK or France or Italy may need for their entire
population. Against a world average of 3.96 hospital beds per 1000 population,
Russia has 9.7, Brazil has 2.6, China has 2.2, and India languishes at
just over 0.7 indicating the big gap. Just to bring the availability of the beds
to 1.7 per thousand from the current levels it is required to create a million
or more new beds requiring substantial financial investment.
The financial Budget 2008 has given considerable thrust to the health and
social sector and the budget outlay has been considerably increased for
these sectors. Besides the Government has taken initiative to encourage
private sector to establish hospitals in Tier II & Tier III cities by offering 5
year tax holiday beginning fiscal year 2008. It is estimated that around US $
20 billion will be invested in Tier II & Tier III cities in healthcare facilities in the
next 5 years. Clearly indicating that the government is recognizing healthcare
as a priority for nation’s overall progress. Indian healthcare which is US
$ 40 billion industry is expeced to double in the next 5 years to US $ 80
billion.
Academic Medical Centres, AMCs in western world have played a significant
role in research of new drugs and treatments and have emerged as
centres of excellence. Although, India’s contribution to research has been
limited, the country has emerged as the favored destination for clinical trials.
We envisage that AMC in private sector will have a pan India presence and
will evolve as centres of excellence encompassing research, education and
care delivery.
Resource Need Gap in India
Physicians
Medical Colleges
Nurses
Nursing Colleges
Beds
Investments Required
993,500
600
2,510,250
1500
1.1 million
US$ 82 billion investment is required
immediately to make up for the
back-log
An additional US$ 465 billion is
needed to catch up with demographic
shifts as well as improvement
in healthcare indicators in
the next 10 years (i.e. by 2018).
Further additional US$ 500 billion
needed by meet the aging
population’s need by 2028.

Trend 1
Academic Medical Centers
Delivering Excellence in Care,Education & Research
Traditionally medical education set-ups have existed in two forms – stand
alone institutions as well as those that offer research, direct patient care &
education facilities. The latter has an edge over the former, in terms of the
‘exposure’ and ‘quality’ of education imparted. An integrated clinical setting
facilitates high quality delivery of care, better training & cutting edge
research. Such settings also help attract the best talent pool by offering
them a broader perspective to their work.
This synergy is rapidly giving rise to the Academic Medical Centers (AMC)
which are a conglomeration of Medical Research, Education and Patient
Care setting. This comprises of a group of related institutions including a
teaching hospital or hospitals, a medical school and its affiliated faculty
practice plan, and other healthcare professional schools & research
institutes. The tripartite mission of AMC- Education, Research and Patient
Care distinguishes them from peer institutions which are concerned primarily
with one of the three. This international model is now being replicated by
leading private healthcare providers in India.
Considering a huge shortfall of doctors, nurses & paramedics, the healthcare
industry is now actively seeking modifications in the norms for establishing
a medical college; e.g discontiguous use of land, allowing Medical
Collages as corporate entities etc.
• Powerhouses of research, medical education and focused patient
care.
• Enhance sharing of new & proven clinical techniques & knowledge
• Supports the interaction between fundamental and Clinical research
(from bench to bedside)
• Human Resource development
• Attraction & Retention of best talent pool
• Aids Research & Development efforts of Pharmaceutical companies/
CROs.
Leading Academic
Medical Centers
Mayo Clinic
Johns Hopkins
Patient Visits
2006
2,335,000
1,728,617
Medical Manpower
produced annually
Facts at a Glance
Staff Physicians, Medical Scientists and Clinical
Researchers =3,313
Residents, Post Docs and Fellows =2,221
Nurses and another Allied Health staff = 46.656
Medical staff = 4,741
Graduate students, Medical students &
Fellows = 2,692
Registered Nurses = 4,679
Clinical
Programs
Research
Academic
Medical
Centers
The Four Pillars of AMC
The Indian Example
Education
Care
The Manipal Group:
With its strong presence in healthcare delivery,
education & medical research, Manipal
Group is clearly one of the models close to
an AMC model in India. With its strong
academic presence across India and taking
advantage of its huge faculty base, the
group is now extending its leadership from
healthcare delivery and education to the
booming retail sector.
All India Institute of Medical Sciences
(AIIMS):
All India Institute of Medical Sciences has
earned many accolades in healthcare
delivery. Having clinical superspecialties in
the same campus as its major research
facilities makes AIIMS optimally suited for
nurturing best quality translational research
in India.

03
Trend 2
Healthcare Consumerism in India
Rising Awareness & Spend
The Indian Healthcare Consumer is more evolved and better informed
today. People have started to realize that health needs to be seen as an
important strategic asset, and given the pressures of modern life, physical
and psychological well being are imperatives to doing well at the workplace,
as well as maintaining a harmonious home life.The Healthcare market is
now a more competitive marketplace where customer satisfaction is the
watchword.
With rising income and better options to finance healthcare in terms of
health insurance policies, the citizens are catching up faster than ever to
ensure the expenditure that empowers them to choose hospitals. With this
coming into effect, incidences of planned episodes of hospitalization due to
reasons other than doctor referral & proximity in emergency are increasing.
According to India Healthcare Trends 2008, a household on an average
spends just above Rs. 4000 as annual expenditure on healthcare.
As per Technopak estimates, the average Indian consumers spent out of
wallet on healthcare will be increasing faster (from 7% in 2008 to 13% in
2028).
Main Factors for Choice of Hospitals
It was an emergency so we rushed to this hospital or nursing home
Our regular doctor/specialist/GP aksed us to go this hospital or nursing home
Rising Income
Insurance Coverage
Increasing Awareness
Quality Consciousness
Focus on Preventive Health
37
41
It is one of the hospitals or nursing home listed by the employer or company for health benefits
2
It is one of the hospital or nursing home listed by the medical insurance company
2
Other Reasons
No response
1
17
Main Factor Contributing to Other Reasons (%)
• Good Diagnostic Facilities
• Good Doctors and Specialists
• Good Nursing Care
• Good OT Facilities
• Affordable
0 10 20 30 40 50
3
3
3
2
2
Source: India healthcare treands 2008
Healthcare
Consumerism
2008
2028
Better Evaluation of Clinical &
Non clinical decisions
Enhance Accountability of Services
by Providers
Quality Improvement & standardization
New Healthcare Service Delivery
mechanism

Trend 3
Newer Formats of Healthcare Delivery
Taking Healthcare closer to the consumer
New retail healthcare formats are gaining traction in India, with affordablecost
walk-in health-care centers for common ailments at one end of the
spectrum, and highly personalized “boutique healthcare” at the other.
Traditionally healthcare has been delivered in a hospital or clinic setting
worldwide. The delivery of modern healthcare has been compartmentalised
based on speciality and location. While this system has its advantage but in
the recent past it has been severly curtailing the access to care. The inflexibity
and inconvenience inherent in obtaining healthcare from only hospital
locations severely restricts consumer choices and consumption.
With the continuing trend towards integration of health and wellness-related
products, the continued emergence and evolution of the health & wellnessconscious
consumer, there has never been a time so ripe in India for hospitals
and healthcare systems to sharpen their focus and innovate their
service offerings.
Delivery Formats
Retail Healthcare
Medical Malls
Assisted Living
Day Care Surgery Centre
Rehabilitation Centre
Boutique Health Centres
Indian Market Size
US$ Million
Functionality
Basic/primary care medical care
in retail outlets(markets/high streets/malls)
Multiple independent clinics/stores/
centres in a mall set up
Special Residential care (with Medical facilities)
meetng needs of the elderly
Diagnostic & Therapeutic stand alone
intervention centres
Restoring functionality in a convenient
environment
Focus on beauty and wellness
Service Differentiator
Accessibility and convenience
Accessibility & greater depth
of service
Planned facility enabling self
suffuciency & quality of life
Better ambience, high patient
satisfaction & cost effectiveness
Better Accessibility at a lower
cost
Personalised care in an
exclusive environmentllness
Easy Accessibility
Quality Care
DRIVERS
Convenience
Quick Service
RETAIL HEALTHCARE CLINICS are catching
on as a formula for corporate healthcare providers.
Indian Players: Apollo Clinic, Fortis Health
World, Manipal Cure & Care , Reliance
Retail, Wellspring
MEDICAL MALL: A place where all the basic
Health related problems of patients and providers
can be met under a single roof.
An ASSISTED LIVING FACILITY (ALF) are to
provide all day supervision and many other
support services with maximum levels of
privacy, space and dignity.
Indian Players: Golden Nest Senior
Commune (with Ruby Hall Clinic), Dignity
Lifestyle.
DAY CARE SURGERY is now a popular and
preferred mode of treatment for most surgical
patients, where clinically viable.
MEDICAL REHABILITATION deals with
functional restoration of a patient’s normal
physical abilities.
BOUTIQUE HEALTHCARE offers a more
comprehensive “wellness” approach to the
luxury customer.
Indian Players: Fortis Healthcare (La
Femme), Apollo Hospitals (The Cradle)

05
Trend 4
Healthcare REITS
Addressing the Real Estate challenge
Real Estate Investment Trust (REITs) are corporate, tax-advantaged entities
designed specifically to own and sometimes operate real estate, including
retail properties, apartments, office buildings, and health-care facilities.
REITs were originally formed to provide smaller investors the opportunity to
invest in diversified real estate without directly owning properties and having
to bear any management and operating costs or responsibilities.
Health care REITs specialize in health care facilities, including acute care,
rehabilitation and psychiatric hospitals, medical office buildings, nursing
homes and assisted living centers. REITs do not directly provide health
care services at the properties they own. Rather, REITs rent facilities to
licensed third-party health care providers. By supplying quality health care
facilities and expertise in property management, REITs can help reduce the
burden on providers and facilitate the delivery of medical care.
As estimated, India requires about trillion dollars over a 20 year period and
bulk of the investments would be made by the private sector. High land cost
is a deterrent to many private players investing in healthcare. REITS would
overcome this challenge by unlocking the healthcare delivery value and
would be a key financial instrument in helping healthcare providers.
Characteristics:
• REITs pay no corporate taxes but are required to distribute at least 90
percent of their net taxable income as dividends to shareholders.
• REITs offer operators up to 100 percent financing and an attractive
blended cost of capital, allowing them to fund future growth or distribute
it to shareholders.
• Derive at least 75 percent of gross income from rents or mortgage
interest.
Additional Beds
Required
Bed / 1000
Population Ratio
Floor Space
(800 sq. ft. / bed)
Land Area
(Floor Space Index 1:1)
2008
1.1 million
0.7 to 1.7
880 million sq. ft.
20,000 acres
2018
3.1 million
Anticipated concessions with regards to Healthcare REITS:
No tax on Capital Gains under IT Act, 1961
No stamp duty on leases and transfers
Rental Income to be treated on differential basis in the hands of the
recipient.
Rentals in HREITs to be free of Service Tax
HREITs to be exempt from Dividend Distribution Tax
4
2480 million sq. ft.
56,400 acres
2028
2 million
5
1600 million sq. ft.
36,400 acres
REIT
Manager
Sub Contract
Property
Manager
Uniholder
• Cornerstone
(Long Term)
Investors
• Institutional
Investors
• Retail Investors
Investment
in REIT
Units
Ownership of
Assets
Property Management Services
Health Care REIT USA, Inc. is an equity
real estate investment trust (“REIT”) that
invests across the full spectrum of
health care real estate. Founded in
1970, the company was the first REIT to
invest exclusively in health care properties.
It has gross real estate assets of
approximately $5.2 billion and a market
capitalization of approximately $6.5
billion.
Health Care REIT, USA owns:
Assisted Living
Independent Living
Skilled Care
Distributors
Debt
Specialty Care
Lenders / Debt
/ Finance
Principal and
Interest
Acts on behalf
of Uniholder
Medical Office Buildings
REIT Trustee
Net property Income
201
57
234
22
117

Trend 5
Private Equity
The Race for Value Deals
Private Equity investments in India have witnessed significant growth, the
number of deals have increased from $ 7.9 billion in 2006 to $19.03 billion
in 2007.
The healthcare sector attracted over US$ 448 million in year 2007. India
already has an active fund provider base supported by the ICICI Ventures,
one of the largest private-equities, which allocated $250 million for a
dedicated healthcare fund through I-Ven Medicare. Others include IDFC,
HSBC, JP Morgan Private Equity Fund, American International Group Inc.
(AIG), Evolvence India Life Sciences Fund, George Soros's fund Quantum
and BlueRidge. Between 2008 and 2011, the sector is expected to see
investments of around US$ 5 billion.
The healthcare sector in India is witnessing a surge of activity and the beginning
of what is seen as a rapid phase of growth. Emerging healthcare
segments like diagnostic chains, medical device manufactures as well as
hospital chains are increasingly attracting investments from a variety of
venture capitalists. At a broader level, this trend in health care is often seen
as a manifestation of the overall surge in private equity and also growing
interest among private equity funds for Indian companies.
Private equity is smart money because these investors bring more to the
table than just money. The capital and expertise of private equity act as a
catalyst for creating enterprise value.
Sector Wise Value - PE Deals by value
Private Equity Deals for Hospitals
Major Healthcare Deals
Apax Partners picked up 12 per cent stake in
Apollo Hospitals Enterprise Ltd for Rs
426.40 crore
ICICI Venture making multiple healthcare
Investments:
• Rs 40 crore in RG Stone Hospital
• Rs 140 crore in Pune's Sahyadri Hospital
• Rs 65 crore in Kolkata's Medica Synergie.
• Rs 96 crore in Mysore’s Vikram Hospital
Narayana Hrudayalaya Pvt Ltd (NHPL) has
sold a 25 per cent stake to the private equity
arms of global financial services firms
American International Group Inc. (AIG) and
JPMorgan for a total consideration of Rs 400
crore ($100 million).
IFC, the private sector arm of World Bank
invested Rs 300 crore in Max Healthcare.
India Value Fund infused around Rs 200
crore into Kochi-based DM Healthcare
Indivision India Partners, private equity fund
of Future Capital Holdings bought 25 per
cent stake in Hyderabad-based Global
Hospitals
UK-based Ashmore Investment Management
Ltd picked up a 19 per cent stake for
Rs 90 crore ($23 million) in CARE group of
hospitals.
Trivitron, received a capital infusion of US
$11 million from HSBC Private Equity (Asia)
Limited and ePlanet, a Global Venture
Capital and Private Equity firm.
MedPlus Hyderabad based Retail
pharmacy chain raised $5.2 million (Rs 23
crore) from iLabs Capital.
Blackstone Group picked up 22% stake in
VLCC at $22 million (Rs 88 crore)

07
Trend 6
Clinical Trials
Making Inroads
The size of the global clinical trials market is today estimated to be over
US$52 billion. The focus of the domestic market is on interventional
treatment trials, in the areas of bio-pharmaceuticals, life sciences & biotechnology.
Globally there are approximately 18000 trials currently being carried out by
more than 1000 contract research organizations, of which around 4 % are
being carried out in India. This is expected to rise to 15% by 2011.
Indian Healthcare delivery Provider offer attractive platforms for the Clinical
Research Organizations (CROs). CROs in India are exploring synergies to
establish partnership models with providers to make use of the huge
database, infrastructure and trained human resources. A win – win
paradigm for all stakeholders. This is also leading to a convergence wherein
both CROs & Providers seek opportunities to get into forward / backward
integration themselves. Private equity investments in both sets of organizations
are expected to create further opportunities.
Clinical Trials & Drug Development Process
Phase I trials are
performed to determine
how the drug affects the
human body, how much
medicine is safe and to
determine how the drug
should be administered.
Phase II trials provide
information about how
well a drug works, and
generate more information
on the safety and benefit
of the drug.
PHASE
2
PHASE
4
PHASE
1
PHASE
3
Drug Development
Phase III trials are
held to see if the
current practice is
the best way to treat
a patient, or if a new
drug treatment or
device provides
better treatment.
Phase IV trials are
used to continue
evaluating the drug
after the drug has
received approval to
market them
What’s driving Clinical trials in India?
Availability of highly qualified
manpower
Well established healthcare delivery
mechanism
Low Cost
Easily available and diverse ethnic
subjects for trials
Robust Healthcare Information
Technology infrastructure
Clinical Trial Phases Performed in India
Indian Clinical Trials Market
Categories of Players
Pharmaceutical Companies
Contract Research Organizations
Biotechnology Companies
Central Diagnostic Laboratories
Clinical Research Training Institutes

Trend 7
Emergency Evacuation Services
Building a Network for India
Medical studies have firmly established the importance of rapid access to
definitive care. The seriously injured patient has to be attended within one
hour of injury to minimize both mortality and morbidity.
Traditionally medical emergency ambulance services were provided by
hospitals. The range of emergency ambulances vary from land based to air
based vehicles depending upon the need. In today’s scenario many
dedicated Medical Emergency Companies have evolved.
However, in India Emergency Medical Evacuation (EME) is still in it’s
infancy.
Emergency rescue concept in India is increasingly becoming common.
With the concept coming into vogue, constructing a hospital structure with
provision for a helipad in compliance with air safety norms will be an essential
part of new projects.
An air ambulance is an absolute necessty in remote locations and geographies
where there is no access to trauma & speciallsed care facilities.
An increasing number of health insurance plans now cover Emergency
Evacuation Services. This is expected to further fuel the growth of the
sector.
International Players...
National Emergency Number Association (NENA)
United States
Provides nationwide Emergency Number & Promotes 9-1-1
research, planning, training and education. It covers about 99% of
the US population. Receives an estimated 240 million calls are
made to 9-1-1 in the U.S. each year.
The Royal Flying Doctor Service - The first and one of the largest
aero medical organisation in the world.
International SOS - Provider of air ambulance evacuation &
repatriation services across five continents having facilities in
more than 70 countries, including 27 alarm centers and 26 International
SOS clinics.
Medical Emergency Aviation
Air Methods
Indian Players...
Emergency Medical Research Institute (EMRI)
India
Vision is to establish Emergency Research Centre of Excellence by
2010 and is set up in India along similar lines as NENA, with Emergency
Service number: 1-0-8. Till date it has tie-up with more than 400
hospitals across 50 towns, serving 8 Crore population in States AP,
Gujarat, MP. It is set to expand across India by 2010 and employ 1 lakh
people at its proposed 22 emergency response centres operating
through 10,500 ambulances.
East West Rescue
Meera Rescue
Vibha Lifesavers
Trauma constitutes the highest share of
ambulance usage (55%)
Road Accidents
~ 4,40,000 cases
Critical Cases
~ 1,30,000
Deaths
~ 43,800

09
Healthcare Architecture
The Business of Design
Healthcare delivery settings worldwide are undergoing an accelarated rate
of change with newer emerging trends such as shift to ambulatory care,
development of integrated diagnostic & treatment platforms. In addition,
patients of today can be better seen as consumers who are literally shopping
for healthcare. To respond to this changing health seeking behaviour,
an attendant change in healthcare delivery climate is called for. Facilities
planning and design is one such area that can help achieve new institutional
goals.
Facility design not only helps define patient experience but also improves
the clinical & financial performance of healthcare institutions. It is therefore
imperative to understand the quantifiable benefits of good design. Evidence
based design is an emerging concept which uses measurable delivery
outcomes to create environments that are therapeutic, supportive of family
involvement, efficient for staff performance and restorative for workers in
addition to supporting a sustainable design. It is seen, for instance, that
single room inpatient accommodation leads to faster recovery and
improved clinical performance. Given these indirect benefits, the added
expenditure in creating 100% single rooms is insignificant as illustrated
below.
A well designed facility may require a higher initial outlay, however, there are
significant compensatory savings & cost avoidance in the long run making
good design a sound business proposition.
Single Room vs. Multi bed : Cost Dynamics
Assumptions:
Increase in floor area/bed = 50 sq. ft
For 300 bed hospital = 15,000 sq. feet
Cost of construction @ Rs. 3000/sq ft
Increase in Capital expenditure = 4.5 crore
This results in a maxmim 5 % increase in overall capital expenditure
Advantages
of EBD
Trend 8
Clinical Outcome
Financial Outcome
Other Benefits
Parameters
Architectural Responses
• Acuity adaptable single rooms
• Separation of Inpatient and Outpatient
•Decentralized design
•Patient room layout
•Equipment integration
•Decentralized logistical support
•HEPA filters
•Adequate hand-washing facilities
•Provision for family stay/involvement in
care delivery
•Value added services
For Patients For Institutions For Community
Reduced Patient Falls
Reduced Medical Errors
Reduced Nosocomial Infections
Increased Market share
Attracts more philanthropic donations
Reduced staff turnover
Reduced use of drugs
Reduced Length of patient stays
Enhanced staff productivity & performance
•Daylight, art, landscape, music
•Adaptable services planning
Physical Design
Human Resource
Re engineering
Better quality of life
DRIVERS
Operations
Re engineering
Logistics System
Design

Healthcare Outsourcing
Providers focus on their core competence
With changing Healthcare market dynamics, the providers are under greater
pressure to provide cost effective quality services. In an effort to do so, they
prefer to focus focus on their core domain of Medical delivery. This has led
to a plethora of outsourcing companies which focus on the support services
in a hospital.
Due to an increasing inclination of providers towards organized contractors,
the current estimated market size of more than US$ 1 billion is expected to
grow at a CAGR of 20%.
The main reasons for outsourcing of services include functional and industry
specialization, cost & technology consideration. The outsourcing providers
are today offering a wide array of highly sophisticated speciallsed
services at an affordable cost to the provider. In turn the contractors get a
larger market share making the arrangement mutually beneficial.
Components
Cost Centre
Revenue Centre
Both
Trend 9
Various Models of Outsourcing
Market Distribution
Model
Fixed Cost +
Incentive
Profit Sharing;
Revenue Sharing
Fixed Cost +
Profit Share +
Incentive
Example
Housekeeping, Security, Laundry
Food & Beverages, Parking, Transportation
Radiology & Pathology Services
Source: India Healthcare Treands 2008
Hospital Outsourcing Market
Major Consideration for Outsourcing
•Make vs. Buy – Own vs. Rent –
Manage vs. Outsource…
•Unique Skill Sets
•Complex Processes
•Technology Limitation
•Cost Benefit Analysis
Emerging Areas of Outsourcing
• Information Technology
• Food & Beverages
• Recruitment & Training of Manpower
• Hospital Management
• Financial Accounting
• Ambulance Services
• Facility Management
• Biomedical Equipment Maintenance
Cost
Non-Core
Areas
Technology
Healthcare
Outsourcing
Market
Competition
Vendor Specialized
Services
Labor
Problems

11
Trend 10
Medical Device Innovation
Involving Providers and Physicians
India is seen as a worldwide hub for technology innovations on the similar
lines of automobile manufacturing industry. Medical Device Innovation
starts with an idea followed by applied research to validate the idea. The
next stage is the development of a new medical device starting with a
patent, followed by prototyping, clinical trials & Food & Drug Administration
(FDA) approval.
Research & Development plays a very significant role in Medical device
innovation and Physicians & Providers play a crucial role in this process.
Role of Providers & Physicians- Major Highlights
• Medical technology innovation typically consists of incremental improve
ments to existing technologies. Such innovation takes place everyday,
through interaction amongst companies, physicians, patients and others.
• The medical technology innovation process is interactive and involves
significant collaboration with physicians and other end users. Real-world
experiences with a product, both positive and negative, are critical to the
design of the next generation of a given technology.
• Clinical outcomes, patient and physician preferences and other after-
market data are collected continually by medical technology firms to
improve the next generation of a device.
Medical Device Innovation Process
Applied
Research
Targeted
Development
Product Patent
& Prototyping
Clinical Trials &
FDA Approval
Manufacturing
& Marketing
Adoption
& Use
Medical technology & Pharmaceutical Companies
spend 12% of their revenue on
Research & Development, which is significantly
higher than other industry.
Medical Device Clinical Trials in India
India provides a suitable destination for
medical device companies. The two
major factors responsible for supporting
clinical trial studies in India are:
• The cost of conducting clinical trials in
India is about 40-60% less than in
western countries.
• Recruitment of patients for clinical trials
results in reduced time to market a new
device.
Medical Device Companies & Healthcare Providers Presently doing Medical Device Clinical Trials in India
Abbott Apollo Hospitals
Johnson & Johnson EHIRC
Aurolab Fortis Healthcare
Medtronics Max Healthcare
Codman & Shurtliff AIIMS
Pro Top & Mediking Aravind Eye Hospital
Global Medical Device R&D Market
Source: www.clinical trials.gov

About Technopak
With a team of established domain experts at work, Technopak builds and
enhances business capabilities for leading Indian and international companies
by offering end-to-end services that are unique thanks to our rich experience,
strong industry relationships and a global footprint.
Technopak’s services are built around offering integrated strategy, process
and technology deployment solutions to clients. Our key sectors of focus
include Textile & Apparel, Retail & Consumer Goods, Consumer Insights,
Healthcare and Hospitality.
The healthcare practice is uniquely positioned to advice clients based on its
expertise in the Indian Scenario, insight into consumer behavior in India and
its access to the best international practices.
The Healthcare Practice provides the whole gamut of services from concept
to commissioning for the healthcare delivery chain.
Strategic & Business Consulting
Facility Planning & Architectural Design
Medical Equipment Planning
Human Resource Management
Operations Optimization
Quality & Accreditation support
Marketing & Branding
Information Technology
Health Education & Training
Public Health
Mergers & Acquisition Support
CONTACTS
Dr. Rana Mehta
Vice President, Healthcare
rana.mehta@technopak.com
Gulshan Baweja
Principal Consultant, Healthcare
gulshan.baweja@technopak.com
Monika Kejriwal
Principal Consultant, Healthcare
monika.kejriwal@technopak.com
Abhishek Pratap Singh
Principal Consultant, Healthcare
abhishek.singh@technopak.com
Healthcare Practice
Technopak Advisors Pvt. Ltd.
4th Floor, Tower A
Building-8
DLF Cyber City, Phase-II
Gurgaon-122002
(National Capital Region of Delhi)
India
T: +91 124 4541111
F: +91 124 4511198/99
Email: healthcare@technopak.com
Website: www.technopak.com

Head Office
4th Floor, Tower A, Building 8, DLF Cyber City, Phase II,
Gurgaon 122 002, (National Capital Region of Delhi)
T: +91-124-454 1111, F: +91-124-454 1199
Bangalore
11A, 11th Floor, Canberra Block, U B City
24, Vittal Mallya Road, Bangalore 560 001
T: +91-80-4034 8600, F: +91-80-4034 8699
Mumbai
101-105, 2nd Floor, Sunjana Tower,
Sun Magnetica Service Road,
Luis Wadi, Thane West,
Mumbai 400 602
T: +91-22-2583 2222, F: +91-22-2583 8408
healthcare
For further details, please contact:
Dr. Rana Mehta
Vice President, Healthcare
rana.mehta@technopak.com

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