Ahead of the budget, the HEALTH PIONEER catches up with the stakeholders in the Indian Pharma/Health sectors to get a glimpse of their wishlist. The Interim Budget will be presented on February 1, 2024.

Expectations from the healthcare sector in a budget are significant, particularly in the context of public health and well-being. Industry players share some common expectations:

DR ANIL GULATI, Chairman & CEO, Pharmazz

The pharmaceutical industry in India has seen unprecedented growth in recent years and has to be prepared for increased growth in the coming years. It will be necessary to improve manufacturing quality while reducing costs. Innovation is essential to industry growth; therefore, developing novel technologies to discover drugs from new chemical entities needs to be incentivized. In this upcoming budget, the government could advance policies that promote improved drug manufacturing quality and modernize regulations to aid new drug discoveries.

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DR ANSHUL GUPTA, Director of Medical & Haemto-Oncology, Medanta Hospital, Lucknow

In 2023-24, the Union Health Ministry had allocated Rs 89,155 crore. This was an increase of 13% over revised estimates for 2022-23. So it is but natural that in the current fiscal, we expect the Government to further increase the health budget allocation to improve healthcare facilities in the country. The proposed areas where this budget allocation should be done are:

• The health insurance coverage under the Ayushman Bharat scheme should be revised/increased for cancer patients as the cancer care including cancer drugs and supportive care is expensive and the patients despite being the scheme’s beneficiaries could not afford the anti-cancer care.
• For patients with health insurance, additional benefits (over and above existing) under section 80 C should be given.
• Non-Governmental organizations including private hospitals and institutes should also be made eligible for Government funding for research projects.
• Artificial Intelligence-based software should be installed in the areas of paramedical services such as pathology, radiology, etc.
• Separate budgetary allocation should be made for organ transplant patients across the country as transplant is a niche area where Government financial assistance is meager.

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DR MAYANK SOMANI, CEO & Managing Director, Apollomedic

As we look ahead to the 2024 Budget, we foresee major advancements in fortifying the hospital industry. The Budget is not merely a fiscal plan but an opportunity to shape a robust, inclusive, and technologically advanced healthcare system. The healthcare ecosystem anticipates increased funding for healthcare and pharma, emphasizing innovation, R&D, and digitalization. Expectations include favorable policies, reduced taxes on high-end equipment, and incentives for Public-Private Partnership (PPP) model hospitals which will help leverage the private sector expertise to improve public health services. Encouragement for health insurance promotion is sought, with a focus on extending benefits to non-metro areas through strategic hospital projects. The industry looks forward to comprehensive measures supporting advancements, accessibility, and sustainability in healthcare delivery.

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CHANDRA GANJOO, Group Chief Executive Officer, Trivitron Healthcare

The MedTech industry in India holds high expectations from the Budget. With an alarming 80-85% dependence on imports, resulting in a massive import bill of over Rs 63,200 crore, the government must catalyze domestic manufacturing. This not only reduces the financial strain but also propels India towards self-reliance in medical technology. 

The industry advocates for a comprehensive strategy: incentivizing R&D and indigenous production, streamlining regulatory processes for faster product approvals, and enhancing infrastructure and skills. Tax incentives for investment in advanced technology, streamlining bureaucratic procedures, and fostering industry-academia collaboration can stimulate domestic manufacturing. This approach should align with global standards and ensure a stable regulatory environment to attract investments.

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RAJIV NATH, Forum Coordinator, Association of Indian Medical Device Industry (AIMeD)

As per GTRI report of August 2023, the Indian medical devices industry can expand from USD 12 billion to USD 50 billion by 2030, reducing import reliance to 35% and boosting exports to USD 18 billion. Supporting policies are needed so that the Indian Medical Devices Industry can make quality healthcare accessible and affordable for the common masses, aim to place India among the top five medical devices manufacturing hubs worldwide, and help end the 80-85 per cent import dependence forced upon us and an ever-increasing import bill of over 63,200 Crore.

We have the following Budget recommendations to cut down the ever-increasing import bill:

• Increase in Custom Duty to a nominal 10%-15% Duty and a predictable tariff policy 
• Correction of Inverted Duty by levying a Health Cess of 5% customs duty on balance Medical Devices (this was not earlier applied to all HS Codes). Cess is used for Ayushman Bharat.
• Trade Margin Capping by monitoring MRP of Imports (if over 10 - 20 times of CIF)
• Income Tax benefits for project investments in Medical Devices Manufacturing.

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PAVAN CHOUDARY, Chairman, Medical Technology Association of India (MTai)

In recent years, the Medical Device industry has benefited hugely due to noteworthy initiatives by the government, such as the National Medical Device Policy (NMDP), the Promotion of Research & Innovation in the Pharma-MedTech sector (PRIP) scheme, the establishment of medical device parks and elevation of branding and promotional strategies for the growth of the sector.

That said we must also be cognizant of the nuances of the medical device sector which comprises mechanical and engineering complexities. Unlike other sectors, most medical devices have a high value but are produced in low volumes.

It may therefore not be economically viable to manufacture all devices in a single geographical area. Even countries with highly developed medical manufacturing hubs like the USA, Japan, Germany, etc. also rely on imports to cater to the healthcare needs of their country.

India’s current tariff duty structure on medical device imports is very high. This high customs duty regime adversely impacts the costs of medical devices which contradicts the government’s efforts to provide low-cost healthcare available to the masses through schemes like the Ayushman Bharat program (PMJAY). Therefore, we request the government that for products where the ability to import substitutes is still some time away, the customs duty rate should be reduced.

KEY DEMANDS

NATHEALTH: The Healthcare Federation of India, an organisation that involves leading healthcare service providers, medical technology providers (devices & equipment), diagnostic service providers and other stakeholders is seeking:

INCREASING HEALTH BUDGET ALLOCATION: India’s public healthcare spending remains low, at only around 1.6-1.8 % of GDP, insufficient to tackle the magnitude of healthcare challenges. NATHEALTH recommends increasing budget allocation to 2.5% of GDP to augment the social insurance schemes, boosting healthcare reforms and infrastructure, and fast-tracking digital health services across India.

RATIONALIZATION OF GST: Although increased budget allocation has been a longstanding request from the sector, there remains another persistent issue concerning the healthcare credit chain through GST. Indirect taxation and lack of input credit for providers pose a significant challenge for the healthcare industry. NATHEALTH strongly recommends outlining a reform agenda in the Finance Bill to restructure the healthcare GST framework.

BOOSTING THE VALUE CHAIN: The focus should remain on augmenting local capabilities to extend care to the most remote areas, while concurrently emphasizing the localization of the value chain. Additionally, harmonizing global best practices necessitates integrated budget allocations for effective execution as well as safeguards for quality and patient safety.

BOOSTING MEDICAL VALUE TRAVEL: Medical value-added services and Travel are expected to be USD 10 billion. To further aid the growth of this segment the issue of MAT credit needs immediate government attention. Individuals must benefit from exports. This move will allow them to offset it. It will create a more significant value proposition to focus on MVTs and boost capacity.

SEPARATE BUDGET ALLOCATION FOR SKILLING AND CAPACITY BUILDING OF HEALTHCARE WORKERS: While the government announced the establishment of 157 new nursing colleges in the previous budget, strengthening the health workforce situation in India is one such area that needs continuous government and policy focus. India’s doctor-to-patient ratio is lower than the WHO-recommended threshold. NATHEALTH recommends that the government should allocate funds for training and development programs for doctors, nurses, and allied healthcare workers, putting special emphasis on digital learning stack and smart certification standards.