While equipment manufacturers have mostly focussed on improving the quality of care and life expectancy, they also need to increase affordability so that there is a largescale impact
Successful healthcare delivery depends both on the availability of personnel and technologies. Medical devices are an important cog in the delivery system as they equip health service providers with the necessary tools to perform their job effectively. Though the country’s healthcare industry has grown significantly over the last decade, our health ecosystem is plagued by the lack of availability and affordability of quality services. In fact, India lags behind Brazil, Russia, China and South Africa and a number of other developing countries in this regard. While technological advancements have expanded to encompass almost every stage of the healthcare continuum, accessibility and democratic availability remains a hurdle. India faces a dual challenge as the rising burden of lifestyle diseases is added to the burden of communicable diseases such as tuberculosis. Non-communicable diseases are currently responsible for 61 per cent of the deaths in the country, a number that is only set to go up in the coming years. While both the Government and private participants have undertaken several measures to address the lack of quality services, these efforts have been executed in discrete silos.
In this scenario, medical appliances play a key role in offering better screening, diagnosis and treatment along with restoration and monitoring of health indicators to boost prevention. While equipment manufacturers have mostly focussed on improving the quality of care and life expectancy, they also need to increase affordability so that there is a large scale impact.
Technology has improved the complexity and accuracy of screening of diseases. Portable/point-of-care accessories have made it possible to improve diagnostic mechanisms at the primary healthcare level, provide care at home and resulted in improved health outcomes and patient satisfaction. It has also improved the access to quality care in underserved and remote regions, while also making it possible for patients to avail treatment outside traditional healthcare facilities.
Technological advancements in surgical equipment have enabled doctors to treat highly complex and critical cases and reduce the length of extended hospital stays. It has increasingly made it possible for elective and complex operations such as knee replacement and bariatric surgery to be moved to short stay/outpatient surgery centres. For example, laproscopic surgery procedures remarkably improve outcomes; reduce length of hospital stays as well as cost of treatment.
Rehabilitative centres and hospitals are making it easier for patients to recuperate and return to a relatively normal life with the help of advanced restorative and assistive devices. Advancements in curative technology have also allowed people with disabilities to lead productive lives.
Advancements in screening devices have enabled patients to monitor their condition at home, keeping a close track on all major health indicators. Furthermore, smart appliances are being increasingly used to remotely monitor patients and diagnose life-threatening conditions early, reducing the need for hospital visits and bringing down the pressure on overburdened healthcare centres. However, there is a need for a more congenial ecosystem for indigenous manufacturers as medical technology is a significant contributor to the cost of healthcare delivery. According to conservative estimates, medical equipment contributes to at least 30 per cent of the capital of setting up a secondary or tertiary care center. Moreover, diagnostics and medical devices contribute to at least 20 per cent of the cost of medical services. Unfortunately, the ecosystem is not very conducive for the sector to drive affordability and accessibility. The Goods and Services Tax (GST) on devices currently stands at 12 per cent. On the other hand, customs duty is low. This tax policy negatively impacts indigenous production and supports imports, which is counter-intuitive to the ‘Make in India’ initiative. As the inverted duty structure favors bringing in finished goods over raw material, imports constitute 75 per cent of the industry’s sales. As a result, local manufacturers make products at the lower end of the value chain.
The Government must consider revising its tax policy to help local manufacturers gain a larger share of the market. This will also help them make products at more affordable costs.
With a changing regulatory and economic environment, the medical device sector is set to grow in the future and there are a range of factors fuelling it. According to estimates, non-communicable diseases will cause 75 per cent of the deaths in the country by 2025, with an increasing number of people suffering from diabetes, heart disease and progressive lung diseases. The geriatric population is also set to increase and would require a higher need for quality healthcare and medical devices, both at homes and health facilities.
Apart from devising a more congenial tax structure, the country needs to strengthen its regulatory mechanisms and testing procedures to ensure highest standards of quality are met. According to news reports, the NITI Aayog has prepared a roadmap to ensure better regulation of medical equipment under which all devices —imported or locally manufactured — will have to be certified by the Central Drugs Standard Control Organisation (CDSCO). While improving regulation is welcome, the authorities must ensure that the process remains smooth, hassle-free and fast.
(The writer is director of a medical device marketing and distribution company)