1. Meditech – A User Perspective & Requirements

2. Hospitals: Proxy for India’s healthcare boom
The Healthcare Delivery Market in India pegged at around US$ 38 billion in 2008, compared to US$ 7.7 billion Pharmaceuticals Industry and offers a huge growth opportunity
India has 17% of the world's population, but one of the poorest healthcare infrastructures among growing economies and the lowest spend on healthcare (~5% of GDP)
Demographic changes, improving income levels, changing lifestyles, and rising insurance penetration etc will result in a rise in discretionary spending on healthcare
Accessible, reliable and affordable healthcare continues to be a challenge
Opportunity in healthcare being significantly leveraged by private healthcare providers
Expected to generate employment opportunities for 9 million people by 2012
15% 2

3. Evolution of Healthcare in India
India: Per Capita Income over the last few years (USD)
Percentage share of India in world health parameters
Per capita health expenditure – $33 compared to $ 2,548 in US
Source: FICCI and Ernst & Young (2008)
Healthcare parameters per ‘000 population
Distribution of Private Healthcare Providers
US has 3.2 beds per 1,000 population and spends ~ US$ 2 trillion on healthcare
Source: FICCI and Ernst & Young (2008).
Source: FICCI and Ernst & Young (2008) 3

4. Cost of Important Procedures (US $) Key drivers for the growth
India: Potential to become the Global Healthcare destination
Overview
Cost of Important Procedures (US $)
Medical value travel is one of the most lucrative segments of the healthcare sector and is expected to grow into a US$ 1.5 billion industry by 2010
Potential to contribute US$ 1.2 – 2.4 billion additional revenue for up-market tertiary care hospitals by 2012, and will account for 3 – 5% of total healthcare market US UK
Thailand
Singapore
India
100,000
1,60,000
250,000
300,000
48,000
38,000
41,726
30,000
292,470
200,000
50,109
18,000
14,250
10,500
62,500
75,000
8,000
10,000
15,312
13,000
150,000
140,000
25,000
12,000
4,800
30,000
69,000
5,000
5,200
Heart Surgery
Heart Valve Replacement
Bone Marrow Transplant
Liver Transplant
Knee Replacement
Hip Replacement
Key drivers for the growth
Issues
Inadequate healthcare Infrastructure
Unstructured medico legal jurisdiction
Indians hospitals’ standards below par against the Global benchmarks of care
Lack of Accredited Hospitals and follow up care
Quality Healthcare at fraction of the cost
Availability of Skilled Doctors & Hospitals
Good reputation of Indian Doctors
Upsurge of Lifestyle diseases 4 4

5. Health Insurance One of the fastest growing free economy
Growing share of urban middle class households
Health insurance market size (USDm)
CAGR: 32%
Health Insurance market in India is expected to grow at a CAGR of 32% to reach a market size of Rs. 27,930 crore by FY15
One of the fastest growing free economy
Ranked 4th largest economy in the world in terms of purchasing power parity
Higher service mix, increasing urbanization
Overall penetration at 2%.
Growth driven by: a) increasing awareness, b) soaring healthcare costs and c) demographic profile of the people
Source: CRISIL Research 5 5

6. Applications of Medical Textiles
Applications range from the simple cleaning wipes to the advanced barrier fabrics used for operating rooms
New cost-effective ways to protect both hospital staff and their patients from bacteria; viruses & body fluid invasions in Operating room environments are being developed
Pre-operative & Post operative (High compression stocking, casting/splints, wound dressing)
Surgical & Operative (sutures, implants, grafts, patches, mesh, wound dressing) 6

7. Product Business division in medical textile categories September 2010
High Margin
Low volumes
Product
Commodity
Concept
Critical path
Implant
Critical Consumable
Critical disposable
Non Critical disposable
Non-critical consumable
Hygiene
Low Margin
High volumes 7

8. Business division in medical textile categories…contd.
September 2010
Business division in medical textile categories…contd.
IMPLANTS
Vascular Graft/ Endovascular Stent
Soft Tissue patch
Hernia Repair implants- Plugs/ Mesh
Sutures
Local drug delivery systems
Dura substitute
Orthopedic implants
Critical – Consumables
Vascular Support System
Compression Stocking & garments, Sequential compression Pump.
Orthopedic Support System
Casting, Knee braces, Splints neck pads, Bandages etc.
Extracorporeal Devices
Anti- Embolical Stockings, Sutures 8

9. Critical Disposable Textiles:
September 2010
Business division in medical textile categories…contd.
Product
Commodity
Concept
Critical path
Implant
Critical Consumable
CRITICAL DISPOSABLE
Non Critical disposable
Non-critical consumable
Hygiene
Critical Disposable Textiles:
OT Gowns
Drapes and Wraps
Isolation kits
Swipes
Swabs – cotton based
Wound Dressing 9

10. September 2010
Business division in medical textile categories…contd.
Product
Commodity
Concept
Critical path
Implant
Critical Consumable
Critical disposable
Non Critical disposable
Non-critical consumable
Hygiene
Commodity
Cotton Gauze
Cotton roll
Adhesive tapes (Plaster, Band-aid etc)
Cohesive tapes
Cotton balls
Surgical swabs
Tissues/ wipes
Crepe bands
Compression bands – adhesive, cohesive.
Sanitary, Nappies
Add……….
Adult Incontinence 10

11. Business division in medical textile categories…contd.
September 2010
Business division in medical textile categories…contd.
Hospital Non Critical Consumables
They form a large chunk of volume of usage. The pressure to dispose them is high but to manage such cost and logistic is a challenge.
Fabrics which are water repellant would be preferred ones for various uniforms & bed linen
Uniforms
Doctors Overcoat
Hospital Bed Assembly 11

12. September 2010
Challenges 12

13. What it means to a product Supply?
September 2010
What it means to a product Supply?
Approvals of imported products from FDA, CE marking and other agencies which assures highest quality standards
Indian hospitals aspiring for quality accreditation such as NABH / JCI
These agencies insists on Standard products – Challenge on Indigenous suppliers to match the international standards
Absence of compiled reliable data showing impact on infection control, usage of antibiotics etc.
Indian hospital Industry at loss without a local supply 13

14. Benefits of Quality Systems?
September 2010
Benefits of Quality Systems?
Benefits for Patients Accreditation results in high quality of care and patient safety. The patients are serviced by accredited medical staff. Patient’s satisfaction is regularly evaluated. Benefits for Hospitals Accreditation to a hospital stimulates continuous improvement. It enables Hospital in demonstrating commitment to quality care. It also provides opportunity to healthcare unit to benchmark with the best Benefits for Hospital Staff It improves overall professional development of Clinicians and Para Medical Staff and promotes staff safety Benefits to paying and regulatory bodies Finally, accreditation provides an objective system of empanelment by insurance and other third parties. Accreditation provides access to reliable and certified information on facilities, infrastructure and level of care
Benefits to the industry
Accreditation helps in building data on the quality of the products, pattern of infection levels, usage pattern of antibiotics etc for better understanding & confidence building 14

15. This is an opportunity loss!!!
September 2010
Impact of Quality Products / Service
The Institute of Healthcare Improvement reported that about 800,000 surgeries are complicated by infections annually, with a $9.5 billion cost to the U.S. health care system. According to a study published in Clinical Infectious Diseases, the increased length of stay following an infection is 18 days.
This is an opportunity loss!!!
Despite our best practices & using good products we are still challenged!
Therefore the need for better quality and innovative products coupled with service standards are the need of the hour. 15

16. Requirements of Hospitals in India
Quality products while keeping costs in check
New innovations to cater to growing demand
Organized market with marked presence of Indian players
Standards and certification in line with FDA/ UL/ CE
Setting up of state of the art labs for better and faster testing of various devices/ fabrics
Better logistics for improving the inventory controls of the hospitals
Building confidence of the end users 16

17. Hospitals are ready to reciprocate with….
Prices worthy of value
Carry out joint programmes to study the feasibility of the products and do a proper cost analysis
Study the pattern of infection control & monitor usage of antibiotics
A total study of the complete usage cycle would help in reducing the overall spending of the hospitals
TCO with the industry to reduce their costs for better results to hospitals and increased patient satisfaction.
Investments as partners for collaboration in terms of defining, supporting and development of indigenous products for QPD 17

18. Conclusion
Healthcare is the new sunrise sector. With emergence of private players and spread to Tier II & Tier III cities there is bound to be rapid growth.
Emergence of the insurance sector will aid growth of healthcare industry but put pressure on costs.
Gap between Quality and Cost needs to be addressed by standards, specifications and certification.
Healthcare industry is ready to collaborate with the manufacturing sector for generation of standards and conducting studies on viability and cost- effectiveness of innovative products.
Ready to invest as partners for development of new products.
A team-work between both the industries is a must for mutual strategic benefits 18

19. Fortis Healthcare Limited
THANK YOU…
Fortis Healthcare Limited 19