IE NT FIR

A T ST
P

25-27 April 2022

Venue: Dr. Ambedkar International Centre
New Delhi

TRANSFORMING
HEALTHCARE THROUGH
INNOVATION &
INTEGRATED SERVICES
 IE NT FIR
A T ST
P

25-27 April 2022

Venue: Dr. Ambedkar International Centre
New Delhi

TRANSFORMING
HEALTHCARE THROUGH
INNOVATION &
INTEGRATED SERVICES
Contents
1. About India Medical Device 2022 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2. Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
3. Articles: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
1. Understanding the value of quality medical products for better patient outcomes. . . . . . . 7
Mr Tushar Sharma
2. Health Technology Assessment in India . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Mr Indranil Mukherjee
3. India's healthcare: Self-reliant, but in a global ecosystem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Pavan Kumar Mocherla
4. Antimicrobial Resistance - The Silent Pandemic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Mr Rajan Nagar
5. "Innovate In India": A Future of Possibilities for the MedTech Sector . . . . . . . . . . . . . . . . . . . . 22
Mr Manoj Madhavan
6. Paradigm shift in healthcare. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Dr Shyam Vasudevrao
7. Introducing Digital Innovations to Train Healthcare Professionals for
Accelerating MedTech in India . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Mr Sandeep Makkar
8. Lessons learnt from the COVID-19 pandemic can help us ght the silent . . . . . . . . . . . . . . . 34
pandemic of NCDs
Mr Madan R Krishnan
9. The 500 B US$ Global Diagnostic Imaging, Critical care Space: . . . . . . . . . . . . . . . . . . . . . . . . . 37
Where are we and what's our Future?
Mr Vishwaprasad Alva
10. Cancer Care Challenges in India and Way Forward . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Mr Ashok Kakkar
11. The Power of Integration: Fueling Future Healthcare Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Dr Shravan Subramanyam
4. Pro les & Advertisements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
India Medical Device 2022

"Transforming Healthcare through innovation and integrated services".

The Department of Pharmaceuticals, Ministry of Chemicals & Fertilizers, Government of India, along with
the Federation of Indian Chambers of Commerce & Industry (FICCI) has been actively working towards
growth of Medical Device sector. Since the objective has always been to encourage and bring forward
best technology solutions and manufacturing, therefore, Department of Pharmaceuticals announced
India Medical Device series of events which is an annual activity. The 7th edition of International
Conference on Medical Device sector i.e INDIA MEDICAL DEVICE 2022 is scheduled from 25-27 April
2022.

The objective of India Pharma & India Medical Device 2022 IS to:

m Endeavor to address industry issues and to create a platform to recommend solutions

m Facilitate sharing of knowledge and best practices

m Promote India as a Manufacturing hub in the Pharmaceutical and Medical Devices Sector

m Establish India as a premier global healthcare destination and attract investments

m Provide a platform to network and collaborate

m Identify new priority areas and deliberate upon them.

The medical devices industry in India consists of large multinationals as well as small and medium
enterprises (SMEs) growing at an unprecedented scale. The current market size of the medical devices
industry in India is estimated to be nearly $11 bn.

1
The Medical device sector has been growing steadily at a CAGR of 15% over the last 3 years. 100% FDI is
allowed under the automatic route for both brownfield and greenfield setups. Strong FDI inflows reflect
the confidence of global players in the Indian market.

The Medical Device industry is highly capital intensive with a long gestation period and requires
development and induction of new technologies. It also requires continuous training of health providers
to adapt to new technologies. Most of the hi-tech innovative products originate from a well-developed
eco-system and innovation cycle which is yet to be fully developed in India.

The Government of India has taken several steps to ensure the growth of a vibrant ecosystem of medical
devices manufacturing in India over the past 5 years, states have committed to set-up dedicated
industrial parks where efficient domestic manufacturing at lower costs. The State Government of
Himachal Pradesh, Tamil Nadu, Madhya Pradesh and Uttar Pradesh have been given “in-principle”
approval to develop Medical Devices Parks & create a robust ecosystem for medical device
manufacturing in the country.

It is imperative for all the stakeholders to converge their efforts and address these challenges to provide
the required impetus that India needs in realizing its vision for “Transforming Healthcare through
innovation and integrated services”.

2
CEOs Speak

Overview
India has made significant strides in the healthcare sector in past couple of decades. This is reflected in
progress made towards achieving lower Maternal Mortality Rate (MMR), Infant Mortality Rate (IMR), Total
Fertility Rate (TFR) and other key indicators. However, with 21% of global disease burden and alarming
increase in non-communicable and lifestyle diseases, incremental changes will not be enough for
providing “quality healthcare to all”. In fact, India envisions 'Universal Healthcare' in its National Health
Policy 2017 as well as through its recently announced “Ayushman Bharat” scheme. Medical technologies
through their disruptive solutions have the potential to provide the impetus needed to make our
healthcare system more accessible, affordable and sustainable going forward.

The global medical device market, currently estimated at USD 389 billion, is expected to grow at a CAGR
of 4.4% per annum. It is a highly innovative and rapidly advancing industry¹,² that encompasses various
areas like diagnosis, treatment as well as monitoring. However, in India, most of the indigenous
manufacturing is restricted to medical consumables and technologically advanced innovation has
witnessed low levels of penetration and adoption.

It is crucial that strategies and measures adopted by the government provide clarity and assurance, not
only to the industry but also to the most important stakeholder who is the end-user of technology i.e. the
patient. “Patient-centricity”, which has evolved as the key element of an effective healthcare ecosystem
does not seem to find adequate focus in the current scenario. This will adversely affect the existing trust
deficit in the entire healthcare ecosystem. Hence, we need to be collectively mindful that the ongoing

¹ https://www.prnewswire.com/news-releases/global-medical-devices-market-2017---us-versus-international-sales-300557677.html
² https://www.visiongain.com/Press_Release/498/The-global-medical-devices-market-will-reach-398-0bn-in-2017

3
reforms help strengthen patient engagement, safeguard doctor-patient relationship and optimize
revenue in the healthcare ecosystem, which is significantly consumer and market driven.

Medical technology has the potential to create a new patient-centric business model that combines
devices with big data analytics and artificial intelligence to develop innovative and personalized
products. Devices can also provide a unique platform that helps us to consider the appropriateness of
treatment, availability of quality healthcare and reduce the pressures of financing and accessibility. It is
therefore critical to create the right environment to foster the growth of this sector by coming up with a
globally harmonised approach to the regulation of life-saving medical devices.

The CEO's speak booklet is an effort to bring the voices of the industry to the forefront and re-focus our
efforts on creating appropriate environment as well as building patient-centricity in our system. Some of
the key industry leaders have shared their viewpoints on pressing issues and presented the solutions that
can help us reshape the future of our country's healthcare landscape and development of Medical Device
Sector.

4
Articles
 Understanding the value of quality medical products for
better patient outcomes
Mr Tushar Sharma, Managing Director and GM - India & South Asia,
Abbott Vascular

A key objective for any country is to provide quality healthcare to its citizens. In tandem, the
fundamental purpose of the healthcare industry is to enable people to live longer, healthier, more
productive, and independent lives. These efforts include developing and ensuring access to
quality medicines, medical devices, and diagnostics, to help provide the best possible care for patients.
1
With the ever-increasing disease burden in India , and non-communicable diseases (NCDs) on the rise ,
1

it's clear that an important part of the solution to these challenges will be the adoption of high-quality,
innovative medical technologies.

The medical devices industry in India is estimated at $11 billion, with a compound annual growth rate
(CAGR) of 15% over the last three years. By 2025, the industry is poised for signi cant growth, with the
market size expected to reach $50 billion2. Medical devices are an essential part of the patient care
continuum for prevention, diagnosis, and treatment. Typically, this category includes any device
intended for medical purposes, such as instruments, implants, machines, software and more – ranging
from tongue depressors and blood pressure cuffs to cardiac stents and joint replacements to surgical
robots and software.

In any healthcare facility, be it hospitals, clinics, diagnostic labs, or in-house care, medical equipment
contributes signi cantly to the effectiveness and quality of services. High-quality, technology-driven
medical devices will ensure better diagnosis, desired immediate and long-term outcomes, and help
deliver better quality of care for the patient, including objectives related to effectiveness, efficiency, and
patient experience.3 The good news is that based on recent Abbott research, patients in India are more
likely than the global average to feel satis ed with their patient experience (54% vs. 40%). That being said,

7
there is more to be done overall to improve patient experience, including timely awareness of symptoms,
access to medical facilities and for those facilities to have proper technological equipment for diagnosis
and treatment, more effective communication among referring and treating physicians.

Safe and quality care are critical to any healthcare ecosystem. It is essential to use available high-quality
clinical tools to improve patient outcomes and prevent adverse events – as adverse events due to unsafe
care is one of the ten leading causes of mortality and disability in the world4.

A product is called a gold standard in the medical world when it is rated on the grounds of incredible
safety, efficacy and excellent patient outcome for both the short and long term. As such, there are
unprecedented patient, health system and sustainability bene ts from safe and quality care medical
devices.

When achieving gold standard status, patients will have a better experience across the care continuum
from intervention and beyond. From the onset, they will experience far less complications, less time in the
hospital, and a device that lasts longer, allowing for a quicker and less painful experience and the ability to
return to their daily lives quicker.

Safer medical devices also have unwavering bene ts for healthcare systems that can improve efficiency
and reduce overall cost. With high-quality medical products, there will be lower complication rates, in
turn, patients will experience a shorter length of hospital stays and are less likely to return. This will result
in lower “treatment costs,” including consumables, facilities and treatment time. Healthcare facilities can
then focus effectively on utilizing staff and improving overall equity and trust. As such, new therapies can
advance clinical trial participants from those that are signi cantly or disproportionately affected by a
disease state and ensure products meet the needs of patients who need them the most.

The environment also stands to bene t from reliable medical devices. Sustainability is an increasingly
important consideration for manufacturers, healthcare providers and patients. Many manufacturers are
assessing how their medical devices are designed, manufactured, distributed and disposed of as they
look for opportunities to reduce their carbon footprint and total environmental impact. High-quality

8
medical devices will produce less wasted products, resources and human resources – creating a healthy
environment worldwide.

The bene ts of ensuring high-quality medical care are innumerable. The global healthcare industry is
tasked with ensuring all patients are provided with the safest and highest quality of care backed by robust
clinical evidence for optimal outcomes. Here are three key ways the healthcare industry can effectively
re ne the quality of medical devices and create a collaborative ecosystem:

Medical device manufacturers: Adopt an Evidence-Based Medicine (EBM) centric approach to ensure
the usage of scienti cally proven evidence for delivering the best possible care to patients. This ensures
the highest degree of quality assurance and better long-term patient outcomes.

Healthcare providers (hospitals/ other facilities): Ensure detailed quality assessment and scrutiny of
claims made for the product bene ts with corresponding evidence while procuring medical devices will
help hospitals minimize the risks of using low-quality products. Healthcare facilities must evaluate that a
newly acquired medical device does not pose safety hazards to patients; that the device, when used in the
clinical situation, produces the desired results reliably and consistently with its intended purpose; and
that there are appropriate means of identifying performance defects. All of these measures will
contribute to long-term patient safety and holistic quality of care.

Government: Evaluating and constantly re ning the regulatory policies to align with the highest quality
assurance standards is of utmost importance to help lower the burden on health systems and societies.
Regulatory policies and processes should be based on scienti c evidence, well documented, and
understood, and are quick and cost-effective to encourage device manufacturers and technology
providers to continuously innovate and introduce new high-quality products that bene t the patient.

The government of India has begun to take measures in the last few years to maintain quality standards in
life-saving medical technologies for the betterment of the sector. This includes the introduction of the
new Medical Device Rule, a classi cation system for medical devices, and setting up a Medical Technical
Advisory Board to regularize the industry. In addition, the formation of the Indian Certi cation for Medical
Devices (ICMED) is another example of the impressive strides the government has taken.

9
 When we consider the current COVID-19 pandemic and the abundance of critical care administered via
medical devices, today more than ever, the healthcare industry must ensure that all products meet safety
standards. As India moves progressively towards assuring quality and accessible healthcare to all, we
must ensure that the basic criteria that make a medical device safe and reliable are met. Therefore, the
“Case for Quality” is of utmost importance and should be a strategic priority for the entire healthcare
ecosystem in India and beyond.

References:
1 https://www.nhp.gov.in/healthlyliving/ncd2019
1 https://www.wbhealth.gov.in/NCD/
2 https://www.investindia.gov.in/sector/medical-devices
3 https://www.who.int/health-topics/quality-of-care#tab=tab_1
4 https://www.who.int/news-room/fact-sheets/detail/patient-safety
5 Ashish Jha, BMJ Quality & Safety, Sept 2013
6 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047028/#:~:text=Medical%20device%20adverse%20events%20reported,and%20654%
20as%20non-serious
7 https://www.trade.gov/country-commercial-guides/india-healthcare-and-medical-equipment
https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.27.3.759
https://www.oecd.org/health/health-systems/Economics-of-Patient-Safety-October-2020.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6190073/
http://nhm.gov.in/New_Updates_2018/Presentation/World_Patient_Safety_Day/Priority%20in%20Patient%20safety-
%20Dr%20Subhrojyoti.pdf
https://www.researchgate.net/publication/256764438_The_Global_Burden_of_Unsafe_Medical_Care_Analytic_Modelling_of_Observatio
nal_Studies
https://qualitysafety.bmj.com/content/22/10/809
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047028/
https://www.evidera.com/the-growing-need-for-real-world-evidence-in-medical-devices/
https://www.fda.gov/medical-devices/quality-and-compliance-medical-devices/case-quality

10
 Health Technology Assessment in India
Mr Indranil Mukherjee, Managing Director – B. Braun Medical India
Pvt Ltd

L imited healthcare spending ensuing nancial toxicity in India: The Union Budget 2022-23 has
allocated Rs 86,606 crore to the health sector, which is almost similar to FY 2021-221.
Implementation of the world's largest healthcare scheme, AB–PMJAY, has been reaching
approximately 50 crore bene ciaries2. However, 63 million Indians are pushed into poverty per year
because of their inability to meet healthcare costs3.

Health Technology Assessment in India in MedTech Evaluations: To facilitate the process of transparent
and evidence informed decision making in the healthcare, Government of India has created an
institutional arrangement called the Health Technology Assessment in India (HTA In) under the
4
Department of Health Research. To date, 19 HTA studies have been completed . The ndings of study of
reuse prevention syringes (RUP) have been implemented in Punjab and Andhra Pradesh in the public and
5
private sectors . While current assessment parameters used in the Indian HTA studies, might be
appropriate for interventions directly impacting clinical outcomes (i.e., pharmaceuticals), medical
devices, usually go beyond the traditional HTA matrix. The WHO suggests that the xed cost-effectiveness
6
threshold should never be used as a standalone criterion for decision-making . A pragmatic HTA
framework inclusive of holistic measurement of costs and associated consequences (eg. overall price of
7 8 9
therapy , monetized learning curve , life cycle assessment for analyzing carbon footprint ) can lead to HTA
evaluations leveraging adaptation of innovative funding mechanisms such as Coverage with Evidence
10 11 12
Development , Outcome/Value Based Pricing and Most Economically Advantageous Tendering .

Industry as a collaborator and partner in global & regional HTA initiatives: Industry's role in HTA
varies from being an applicant, reviewer, strong collaborator to not being involved at all. The industry not

11
 only provides access to a wealth of evidence for a technology through its lifecycle, but it can also advise
based on its understanding of different markets and/or other similar technologies. As India moves
towards strengthening its HTA system, it should assess and leverage the bene ts of industry involvement.
An example of a collaborative model is Medical Technologies Evaluation Program (MTEP) from National
Institute for Health and Care Excellence (NICE) in the UK who have successfully leveraged scienti c
knowledge and expertise of all key stakeholders to develop guidelines and models for evaluation &
13
funding of several MedTech interventions . Examples from Asia include nHTA program commissioned by
The National Evidence-based healthcare Collaborating Agency (NECA) & Health Insurance Review &
Assessment Service (HIRA) in Korea for adoption of new MedTech for medical devices & in-vitro
diagnostics14, Agency for Care Effectiveness (ACE) & Health's Medical Technology Advisory Committee
(MTAC) in Singapore, China National Health Development Research Centre (CNHDRC), under the National
Health and Family Planning Commission in China & Health Intervention and Technology Assessment
Program (HITAP) which uses HTA to inform reimbursement & pricing decisions in Thailand15.

Road ahead in HTA in India: Establishment of HTA within the vast and complex Indian health system is a
signi cant step towards meeting the goal of universal healthcare. The future course could be
strengthened by the following:

i. Institutionalization of The HTA Board Act, 2019 and inclusion of MedTech industry as an active
collaborator

ii. Better utilization of HTA in Private Insurance

iii. Mandating evaluation of novel technologies using latest HTA techniques as a collaborative exercise
between industry & HTAIn for procurement

iv. Incorporating a transparent costing system for public and private hospitals for HTA evaluations

v. Increasing healthcare spending (up to 2.5% of the country's GDP).

vi. Appropriate implementation of an HTA system can bring about maximization of health and reduce
inequalities in access to healthcare in India.

12
References:
1
https://www. nancialexpress.com/budget/union-budget-2022-health-sector-allocation-up-16-new-programme-for-mental-wellbeing-
announced/2422913/
2
https://www.pib.gov.in/PressReleasePage.aspx?PRID=1738169
3
https://www.niti.gov.in/sites/default/ les/2021-03/InvestmentOpportunities_HealthcareSector_0.pdf
4
https://htain.icmr.org.in/virtual-library/hta-completed-studies
5
https://dhr.gov.in/health-technology-assessment-india-htain
6
Bull World Health Organ 2016;94:925-930. Link: https://www.who.int/bulletin/volumes/94/12/15-164418.pdf
7
https://www.medtechdive.com/news/value-based-payment-models-take-hold-in-medtech-but-barriers-slow-shift/574173/
8
Tarricone R, Torbica A, Drummond M. Challenges in the Assessment of Medical Devices: The MedtecHTA Project. Health Econ. 2017 Feb;26
Suppl 1:5-12. doi: 10.1002/hec.3469. PMID: 28139084.
9
https://www.esaic.org/uploads/2020/03/ ash-display-screen1.pdf
10
https://www.cms.gov/Medicare/Coverage/Coverage-with-Evidence-Development
11
https://www.healthaffairs.org/do/10.1377/forefront.20180326.318510
12
https://www.medtecheurope.org/wp-content/uploads/2018/01/2018_MTE_2pager_MTF-2018_project-overview_ nal.pdf
13
https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-medical-technologies-guidance
14
Lee et al., Int J Clin Res Trials 2016, 1: 110
15
https://apacmed.org/content/uploads/2020/02/The-Evolving-Health-Technology-Assessment-for-Medical-Devices-and-Diagnostics-in-
the-Asia-Paci c-Region-and-Key-Considerations-for-Value-Assessment-Frameworks.pdf

13
 India's healthcare: Self-reliant, but in a global ecosystem
Mr Pavan Mocherla, Managing Director · Becton Dickinson India Pvt Ltd

Why Indian healthcare must harmonise its standards with the rest of the
world
The common refrain in India in the aftermath of the COVID-19 pandemic was - 'to take the future of our
country's wellbeing into our own hands, we must become self-reliant in healthcare and med-tech
devices'. Consequently, a slew of measures were rolled out to encourage the journey of self-reliance.

Those that could be potential tailwinds were, a PLI (product linked incentive) schemes to invite
multinational medical device players to make in India so that they could get an incentive of 5-7% of
revenue generated from those devices. A comprehensive, forward-looking regulator, who understands
the needs of multinational players who operate in 150 plus countries and dispense with quick decisions.
And approval for setting up four medical device parks with a nancial outlay of INR 400 crore in Himachal
Pradesh, Tamil Nadu, Madhya Pradesh, and Uttar Pradesh with an objective to reduce manufacturing
cost, optimise resources, build economies of scale, and create requisite infrastructure.

However, the headwinds that were generated by various arms of the Government of India were, and are,
far greater than the tailwinds, and hamper the progress towards self-reliance. Some of these headwinds
are: Interfering measures like price capping and export restrictions discourage multinationals from
bringing new and innovative treatments or devices to India by making them economically unviable to
operate. Additional burden to adopt India speci c standards on players aspiring to use India as a
manufacturing base for global supply (thereby minimising the bene ts of operating in India). Restrictive

14
strategies like PPOs (Public Procurement Orders) that preclude multinationals from participating in state
procurement and a de-facto interpretation of 'Aatma Nirbhar' campaign as import substitution by most
of the functionaries of the Government block patients' access to modern technology.

When you consider these signals from the government, the message that gets generated becomes 'India
is not a reliable partner for the global value chain' and it then becomes very difficult for Indian
management of multinationals to make a convincing case for transformative investments in India.

This begets the question, 'why is a country with a population of 1.3 billion not an attractive market in the
rst place?' This is a million-dollar question (or shall we say a billion-dollar question) and the answer lies in
the way we pay for healthcare.

In India, the insurance penetration for in-patient care is estimated at a meagre 35%, with nearly 60% of all
healthcare expenditure paid by patients out of their own pockets. As a result, patients more often than
not choose 'just enough care'. This forces the healthcare providers (practitioners) to choose 'what is
affordable for their patients' instead of 'what is best for them'. Besides preventing patients from accessing
best-of-class healthcare, it also disincentivizes companies from bringing their most modern technologies
to the Indian market. This also explains why despite a similarly sized population, India's medtech market is
roughly 1/5th of China's.

Considering the same situation through the lens of a decision-maker sitting in an MNC HQ, if they only
have a single dollar to invest, they will choose the most optimal return location by taking into
consideration all the factors like 'price attractiveness for technology', 'growth opportunity', 'government
interference', 'ease of operations', 'insurance coverage' et al. To sum up, India already has a very small med-
tech market with practically minuscule innovation system; (only 15% of medical devices consumed are
even Made in India much less innovated in India) and in conjunction with restrictive government rules
and poor prices, we are further aggravating the situation. However, it's not an impossible task to plug this.

Few suggestions to consider based on various factors highlighted above, include – an increased focus on
strengthening the demand side equation of India's healthcare ecosystem thereby making it attractive for
both MNCs and domestic players to invest for attractive and competitive returns vis-a-vis other sectors
like FinTech, FMCG, technology to name a few.
15
 Bringing efficient metrics to evaluate government spending in healthcare. Irrespective of the size of our
healthcare spending, we need to standardize how we spend whilst standardising what we buy. We need
to move from the lowest cost to 'the best outcomes for patients' basis. This will offer economies of scale
and transparency to med-tech players. This might require the eventual moving of healthcare as a
legislative subject into the Centre's ambit, away from the state list and into the concurrent list.

Actively facilitating a culture of innovation by establishing a supportive industry ecosystem with inputs
from academia, research and government systems. The way to do this is innovation adoption by the
government health system rst which will ensure Indian innovators have a home in India rst before
looking at global markets.

Work on ensuring ease of doing business in India. The following solutions will bene t in this endeavour:
single window approvals for regulatory clearances, as opposed to multiple government bodies involved
in the due process before a license to operate, can be obtained.

One nodal officer for prompt resolution of bottlenecks working in tandem with the industry
Harmonisation of Indian standards and regulations with the rest of the world as opposed to creating a
moat around India.

As critical as healthcare is for citizens and a country, it is also a complex subject from a policy perspective.
In such a scenario, an attempt to improve access and standards of healthcare for patients through
arbitrary or excessive measures is akin to trying to t a square peg in a round hole. No amount of force or
coercion can make it work, if anything, it could do more damage than good. So, the need of the hour is a
careful, considered and collaborative approach between the government, med-tech players and other
stakeholders to mould the industry in a way it bene ts patients in the long run.

https://www.thehindubusinessline.com/specials/pulse/indias-healthcare-self-reliant-but-in-a-globalecosystem/article 64968998.ece

16
 Antimicrobial Resistance – The Silent Pandemic
Mr Rajan Nagar, Vice President and General Manager, South Asia,
BioMerieux India Pvt. Ltd.

A ntimicrobial resistance (AMR) is one of the major

threats to global health, food security and
development as it threatens the effective prevention
and treatment of infections caused by bacteria, parasites,
viruses and fungi. About 700,000 people die each year from
bacterial infections, according to the World Health
Organization (WHO).

How does AMR occurs ?

AMR occurs when bacteria, viruses, fungi and parasites change over
time and no longer respond to medicines/antibiotics making
infections harder to treat and increasing the risk of disease spread,
severe illness and death. As a result, the medicines become ineffective
and infections persist in the human body, increasing the risk of spread
to others. Microorganisms that develop antimicrobial resistance are
sometimes referred to as "superbugs".

Antibiotics are supposed to save millions of life, but today its pervasive
use is leading to increase in resistance of these lifesaving drugs. Factors
17
 such as over-prescription of antibiotics, lack of awareness amongst patients to complete the dosages,
overuse of antibiotics in livestock and sh farming, poor hygiene and infection control measures in the
society, contributes majorly towards this cause. Another area of concern is the absence of new antibiotics
development, which makes it more difficult to overcome this issue.

Impact of AMR
As per WHO data, it has been estimated that every 45 seconds someone dies from an infection caused by
a resistant bacteria. Also, it has been attributed that around 1·27 million deaths are cause due to bacterial
AMR. The number is equivalent to the deaths caused due to HIV/AIDS and Malaria together. There is also
an estimate of 10 million deaths by 2050 due to AMR.

The impact of AMR goes well beyond health as it can have serious implications on poverty reduction and
inequality, animal welfare, the environment, food safety and security. As per an estimate by The World
Bank, 28 million people could be pushed into extreme poverty every year by 2050 and overall cost to the
global economy of US$1 trillion per year.3

How COVID- 19 has accelerated the impact of AMR

The world is seeing the worst pandemic in so many years, as COVID 19 is still prevailing across the globe in
form of new variants. In 2020, when the outbreak of SARS-CoV-2 virus started, the world was unaware
about the virus behaviour and its treatments. This has led to trials of many treatment protocols which
included the overuse of antibiotics. Many hospitalized COVID-19 patients received antimicrobials, but
relatively few actually had bacterial co-infections or secondary infections. This means that many
antimicrobials may have been administered to patients unnecessarily, therefore contributing to the
spread of AMR. Some studies have shown that antibiotics have been administered to the majority of
hospitalized COVID-19 patients, and 80-100% of COVID-19 patients in the ICU.
1
Antimicrobial resistance testing, multidrug resistant organism infection | bioMérieux (biomerieux-diagnostics.com)
² Publication - GLOBAL BURDEN OF BACTERIAL ANTIMICROBIAL RESISTANCE IN 2019: A SYSTEMATIC ANALYSIS
3
Antimicrobial resistance; an emerging crisis | United Nations Development Programme (undp.org)

18
 Much remains unknown about how the pandemic is directly
impacting overall levels of antimicrobial resistance (AMR), but a
review of data from covid-19 cases, mostly in Asia, found that more
than 70% of patients received antimicrobial treatment despite less
than 10%, on average, having bacterial or fungal coinfections. The
same study also found frequent use of broad spectrum antibiotics-
designed to kill a wide range of bacteria-that can spur AMR through
overuse. Such ndings give weight to researchers' concerns that
increased antibiotic use during the pandemic could increase the
long term threat of AMR.

Act now: It's the only way we will reduce

the threat of resistance
Antimicrobial Stewardship (AMS) is critical to ght the
AMR crisis. AMS programs help ght antimicrobial
resistance by providing a framework for responsible
antibiotics prescribing and use, optimizing individual
therapy, helping reduce the spread of resistance and
raising awareness & education.

Successful antimicrobial stewardship programs

require a continued and diligent interaction between
all levels of healthcare providers, including physicians,
infectious disease specialists, infection control
p r a c t i t i o n e r s , n u r s i n g s t a ff, p h a r m a c i s t s ,
microbiologists, pathologists, lab directors and
healthcare administrators.

19
 The core elements of antimicrobial stewardship programs include:
m Implementation of national and international guidelines and clinical pathways for the diagnosis and
treatment of infectious diseases
m Limiting the use of antibiotics where not needed or not indicated
m Delivering the most appropriate antibiotic, with the correct dose established according to the type
and site of infection, patient's age, weight and clinical situation
m Switching antibiotics from parenteral to oral form as soon as possible
m Timely conversion to the most narrow antibiotic spectrum according to the organism susceptibility
m Use of the shortest effective antibiotic course and discontinuation of antibiotic courses as soon as
possible

Role of Diagnostics (Diagnostics Stewardship)

Quick and timely actions in understanding the causes of serious infections such as sepsis, pneumonia and
meningitis and starting the right antibiotic therapy is a matter of life or death of the patient. Hence, it is
important to identify the etiological pathogen and to differentiate between viral and bacterial infections,
to identify the antimicrobial resistances in microbes, and to nd out which antimicrobial agent should be
used for the cure. Thereby the unnecessary
use of antibiotics could be minimized and
the spread of antibiotic resistance better
controlled.
The microbiology laboratory therefore
plays a crucial role in identifying the
infectious agent, as well as any potential
resistance to antibiotics, in order to help
clinicians prescribe the most appropriate treatment with the shortest time delay.
Therefore, the need of the hour is to bring diagnostics closer to the general practitioners and hence to the
patient would cause a paradigm shift from empirical to evidence-based treatments of infectious diseases
in outpatient clinics. Rapid diagnostics are needed for both pathogen identi cation and resistance

20
 Adapted from Messacar et al. J. Clin. Microbiol. 2017:55:715-723

testing. The prevalence of AMR may be very PATIENT

high for some species in certain geographic Clinical Diagnosis &

Evaluation treatment
l o c a t i o n s. Ac c o rd i n g t o t h e c u r r e n t
recommendations on AST (antimicrobial
susceptibility testing), pure culture isolates DIAGNOSTIC STEWARDSHIP ANTIMICROBIAL STEWARDSHIP
are used to test the effect of antimicrobial Right test
Right patient
Health Care
Provider
Right Interpretation
Right Antimicrobial
drugs. Right time Right time

These diagnostic tools help to:

Rapid Rapid
m Identify patients who have a bacterial Diagnostic Diagnostic
Test Rapid Diagnostic test performed Result
infection which would require antibiotic Ordered Reported
treatment, MICROBIOLOGY
LABORATORY
m Identify the organism causing the
infection in order to determine the
appropriate patient management,
m Determine whether the pathogen is resistant to one or more antibiotics as a critical step to help the
clinician prescribe the most appropriate antibiotics as early as possible.

Conclusion:
Since it is well known now that AMR is major concern for the
human kind and could be the next pandemic in making, there is
a need for global coordination, especially in developing
relevant guidelines for the management of infectious diseases,
using diagnostics, novel antimicrobials & implementation of
National Antibiotics Policy. In addition, creating awareness and
increasing education amongst all stakeholders (healthcare
workers, the general public and politicians) about the dangers
associated with inappropriate use of antimicrobials should be
made mandatory.

21
 “Innovate In India”: A Future of Possibilities for the MedTech Sector
Mr Manoj Madhavan, Managing Director, Boston Scienti c India Pvt Ltd.

I ndia is well-recognized as the pharmacy of the world. Globally, the country is among the largest
producers and exporters of active pharmaceutical ingredients (API) and generics. By being at the
forefront of COVID-19 battle, the country has further cemented his position as one of the world's
biggest vaccine manufacturing hubs. At the same time, the medical devices sector in India has shown
impressive growth over the years. With the growing demand, increasing investment and policy backing,
the sunrise sector is well poised to become a global force for driving better health outcomes in a post-
pandemic world.

The sector has been growing steadily at a CAGR of 15% over the last 3 years with over 6,000 types of
medical devices in India. At present, India is among the top 20 markets for medical devices worldwide.
Furthermore, the market is expected to grow at a 37% CAGR from Rs. 75,611 crore (US $10.36 billion) in
2020 to US $50 billion in 2025. With the help of digital healthcare delivery, there is a greater emphasis on
making the med-tech supply chain resilient to healthcare crises in the future.

While giving a clarion call for 'Make in India, the Hon'ble Prime Minister had highlighted that India can
only achieve self-reliance in pharmaceuticals and medical devices by strengthening its R&D
infrastructure that would drive expansion of access to life-saving medical products and help India
become a global pharmaceuticals and medical devices hub. One of the key policy measures to achieve
this objective is to increase attention and enhance capabilities in India for R&D and innovation, which
accounts for 2/3rd of the global pharmaceutical opportunity. The total global medical technology
industry's market size is currently valued at $456.8 billion and is further projected to grow at a rate of 7.7%
to $62.0 billion in 2025.Established centers of this industry include the United States and Western Europe.

22
But industry trends show that Asia Paci c is about to play a more prominent role in the years to come.

Medical devices play a role not only in screening, diagnosing, and treating patients but also in regularly
monitoring health indicators to prevent diseases. With technological advancements, the role of medical
devices is now expanding to improve quality of care across each stage of the healthcare continuum.

If we look at the patent trends within medical devices sector in India - the last 10 years have witnessed an
average 48% increase in patent lings in the eld of medical devices. The estimation speci es the ongoing
and consistent IP awareness, indigenous innovation and the tactical strategies of the global MedTech
manufacturers to capitalise on the growing medical device market in India.

This has been made possible because of the government's focus and investment in R&D which is
instrumental to boost India's strength in the healthcare sector. Through the support of agencies like the
Department of Pharmaceuticals (DoP), Department of Biotechnology (DBT), Indian Council of Medical
Research (ICMR), Biotechnology Industry Research Assistance Council (BIRAC) etc., there is a strategic
opportunity for India to establish itself as a preferred destination for R&D followed by manufacturing of
high-quality medical devices.

Moreover, to support the scienti c acumen of the country, speci cally in the medical devices sector, the
Government of India has provided the Production Linked Incentive (PLI) Scheme of `3,420 crores
between FY21 to FY28 to boost domestic manufacturing of medical devices. To add to this, the layout and
nancial assistance associated with four medical device parks have been established to support the local
development and manufacturing of medical devices in Himachal Pradesh, Madhya Pradesh, Tamil Nadu,
and Uttar Pradesh.

Despite these achievements, one of the biggest challenges hindering the growth of R&D in India is the
dearth of talent with the requisite training, expertise and skills across the entire research and
development life cycle in the realm of the MedTech sector. To overcome this challenge, India's med-tech

1
https://innovations.bmj.com/content/3/3/167

23
 sector comprising global and domestic manufacturers have a key role to play in closing the demand-
supply gap by. Some of these ways are:

1. Integrating digital technologies to accelerate skill development through simulation-based training

2. Building quality-based competencies in the manufacturing ecosystem with interdependence

between local suppliers, manufacturers, and healthcare providers

3. Investing in IT infrastructure, logistics and upskilling distribution partners for the last mile delivery of
med-tech products into Tier II/III/rural India

4. Collaborate with partners and stakeholders under Make in India and Innovate in India schemes to
produce low-to-medium technology products to cater to the underpenetrated domestic markets
5
India spends less than one percent of its GDP on research and development, lower than most of its global
peers. One of the related aspects is the lack of acknowledgement and incentivization of incremental
innovations. At present, prices of many devices in India are either xed (by schemes like CGHS, PMJAY) or
controlled (NPPA) by Govt. By and large incremental innovations have not been rewarded with
differential pricing. This has discouraged such innovations. In most developed markets, there are well
de ned provisions like Health Technology Assessment/ Health Economics Models to reward such
innovations.

For India to evolve as the epicenter of MedTech research, it is imperative to focus on nurturing high risk
device (class C & D) innovation, incentivizing incremental innovations, upskilling talent, and
strengthening government-industry-academia partnerships while providing opportunities for
investments.

Differential pricing for incremental innovations should be adopted by policymakers. Additionally, quality
and value should drive procurement of medical devices as against the cost (L1 rule). Using a value-based
5
https://www.business-standard.com/article/economy-policy/no-jugaad-businesses-must-raise-r-d-spend-says-economic-survey-
121013000063_1.html#:~:text=India's%20gross%20expenditure%20on%20R%26D%20is%200.65%20per%20cent%20of,gross%20domesti
c%20expenditure%20on%20R%26D).

24
purchasing approach not only helps in providing the best care to the patient but also increases the
chances of innovation adoption. For instance, in many developed countries, most devices used in the
hospital setting are covered as part of an existing procedure or diagnosis-related group (DRG) code.
However, breakthrough products or innovative therapies that provide value outside of existing
procedures are likely to require separate reimbursement coverage. In this case, if such a framework is
devised, companies will engage with purchasers (e.g., physicians or hospitals) of the innovation to
understand their decision criteria for adopting the product into practice.

At Boston Scienti c, Investing in R&D and clinical science is critical to the development of medical
technologies and solutions that support patients around the world. After the success of our rst R&D
center in Gurgaon which has contributed to more than 100 patent lings since 2014, Boston Scienti c
recently launched its second R&D center in Pune and with these two R&D Centers, India has the largest
R&D footprints outside Americas for Boston Scienti c.

In addition to this, Boston Scienti c also invests in conducting skill-building workshops for young
technicians and engineers. Keeping in mind the complexity of the endoscopy procedures as an area of
intervention, in July 2021, Boston Scienti c partnered with Society of Gastrointestinal Endoscopy of India
(SGEI) and Healthcare Sector Skill Council (HSSC) to upskill GI Technicians in Endoscopy area.

The organization has also pioneered programmes like Start Up Grand Challenge in partnership with
NIPER Ahmadabad, Department of Pharmaceuticals, Invest India and Startup India to encourage start-
ups, academic institutes, and non-pro ts to develop affordable and sustainable solutions to improve
health, in India and across the globe.

The time is now right to develop breakthrough solutions to transcend from a 'Make in India' to 'Discover,
Develop and Deliver from India'. This would mean engaging with relevant stakeholders and providing
competent training to facilitate the thrust needed to achieve the vision of India as the preferred
destination for medical devices in the world.

25
 PARADIGM SHIFT IN HEALTHCARE
Dr Shyam Vasudevrao, Co-Chair, FICCI- Medical Devices Committee,
Founder and Director Forus Health, Renalyx and Rx DHP

T here is a big change in the paradigm of healthcare system in India and following the global trend
very rapidly. Preventive healthcare and wellness gaining importance and taking big market share.
Instead of patient going to hospital, hospital go to patient is another shift leading to increased
home care solutions and remote monitoring. All this is enabled by keeping the continuum of care by
digitization and Electronic medical records. Tele services are increasing access and making healthcare
more affordable and available to the population at large in remote places.

PREVENTION BETTER THAN CURE

This is an age old saying easily said than done. However, this gained more importance in the recent years
as non-communicable disease a better managed in early stages and much better if the population at risk
can prevent/delay the onset of these diseases. Environment Pollution and sedentary lifestyle has
accelerated the onset of these NCD and hence to keep NCD at bay, wellness is gaining importance.
Awareness of NCDs has drastically increased during this pandemic, people have realized how the risk
factors increases during infections if one is diabetic. Managing NCDs, which is also termed as lifestyle
diseases, requires continuous management, it is more a continuum of care which is only possible if

1. People are aware of the onset of the disease, so regular screening becomes essential

2. Digitization of healthcare continuum, EMR is key enabler

3. Tele medicine for periodic consultation and emergency handling

26
4. Intelligent systems to aid Self-management of NCDs at Home and use the doctors time very
optimally – AI/ML can play a big role in such systems

Self-management needs smart assistance and lifestyle changes need motivators. This has led to
intelligent watch, wearable gizmos, mobile apps for tness, wellness, increase in “athons”, walkathon,
swimathon, marathon etc., as never before.

As per the WHO report in 2011, the 4As to manage the mismatch in healthcare are Affordability,
Availability, Accessibility and Appropriate technology. Digital health strategy can address all these 4 As
and enable preventive, precession precision, and personalized healthcare.

SHIFT FROM INSTITUTIONAL TO HOME CARE

We see that healthcare costs are always on a raise and institutional overheads contribute a lot to these
costs. As all the healthcare resources are concentrated in the urban cities it is a double taxation for the
people in rural areas as they not only suffer from direct costs at the hospitals but also indirect costs like
travel, loss of productivity and costs not only for the patient but also for accompanying care giver. While
this is creating a rural vs urban divide, there is also a huge divide in the urban area itself between the
affordable and non-affordable category. Given the connectivity, smart self-management systems and
special connected bedside monitors or medical devices, there are several treatment and care which can
be shifted to homes.

Globally, home healthcare is preferred, encouraged, and even incentivized due to its cost effectiveness
and reach. Indian home care has also matured similarly with respect to its ability to deliver digitally
enabled, reliable, and advanced care at home. This industry is one of the fastest growing segments in

27
Globally, home healthcare is preferred, encouraged, and even incentivized due to its cost effectiveness
and reach. Indian home care has also matured similarly with respect to its ability to deliver digitally
enabled, reliable, and advanced care at home. This industry is one of the fastest growing segments in
healthcare and holds the potential to become a hyper-scaled care delivery model. This segment,
strengthened by the adoption of digital and virtual care technologies, now delivers acute and critical care
at home.

In India there are multiple home healthcare players providing healthcare across preventive, promotive,
chronic, acute rehabilitative, and palliative care in the comfort of the patient's home. Traditionally,
60–80% demand for home care has been driven by geriatric population seeking supportive long-term
care at home. In fact, the second wave of the COVID-19 pandemic in India, has highlighted Indian Home
Healthcare, as a sturdy pillar of support to the Indian Healthcare continuum, by providing advanced and
safe care at home.

Telemedicine has introduced the possibility of new avenues of care delivery to health seekers during this
pandemic, with advanced, specialized healthcare customized to their speci c needs and available on-
demand, now accessible outside institutions. The emerging health seeker segment with a higher
disposable income has the proclivity to pay for care that is personalized, less disruptive to their fast-paced
lifestyle as well as accessible at their doorstep. Technology enabled, integrated home care is emerging as
a reliable, outcome measurable, and scale-ready solution to bring high-quality healthcare to the patient's
doorstep.

The promise of home healthcare holds the key to unlock sustainable solutions to address the long-
standing global challenges of shifting disease pro les, changing population pyramid, transitioning
family structures, and the ever growing cost of care.

India is now at a similar evolutionary tipping point. We must evaluate scalable, cost-effective, and
sustainable solutions to navigate effectively through these challenges. This can only be done with newer
technologies for optimisation of care delivery and intelligent work ows.

28
DIGITISATION OF HEALTHCARE
“Harnessing the power of digital technologies is essential for achieving universal health coverage.
Ultimately, digital technologies are not ends in themselves; they are vital tools to promote health, keep
the world safe, and serve the vulnerable.” Dr Tedros Adhanom Ghebreyesus, WHO Director-General

Emergence of health technologies such as wearable tech, telemedicine, genomics, virtual reality,
arti cial intelligence and Machine learning are changing the landscape of the Indian healthcare system.
Like many other markets, India too is at the cusp of a 'digital health' revolution.

Digital health technology is a pivotal pillar in delivering value- based care across the healthcare
continuum in India. Adaptive intelligent solutions can help lower the barriers between hospitals and
patients, improving access to care and enhancing overall patient satisfaction, particularity in tier II and III
cities in India.

Increasingly we see Healthcare companies are ready to embrace innovation and emerging trends to
successfully steer new-age technologically driven business strategies by capturing consumer interest. As
the pace of digital innovation in healthcare accelerates, this is followed by the opportunities for
healthcare companies and medical devices manufacturers across India who are willing to embrace the
digital health space over the coming years.

Growth in this sector is driven by lifestyle diseases, an ageing population, rising income
levels, increasing access to insurance and growing health awareness. This rapidly increasing need and
demand for healthcare services puts immense pressure on various stakeholders to efficiently manage the
scarce human resources like clinical specialists, technicians, radiologists and inadequate infrastructure
while controlling the increasing cost burden on consumers and simultaneously providing better quality
care and increased accessibility. More from less is the right mantra for health economics as well.

29
 Introducing Digital Innovations to Upskill and Train Healthcare
Professionals in India
Mr Sandeep Makkar, Co-Chair FICCI Medical Device Committee &
Managing Director at Johnson & Johnson Medical India

Increased MedTech consumption and impact requires equitable acceleration

of infrastructure projects, adoption of innovation, and future-ready
healthcare workforce in all parts of India
Success of the MedTech sector is a lagging indicator of widely accessible, quality based, equitable, and
effective primary and tertiary health services to address the rising burden of non-communicable
diseases.
Signi cant public and private investments are underway to bolster the primary care and hospital
infrastructure projects, focused on the Tier 2-3 cities/towns, including the 22 new AIIMS hospitals. With
funding from central and state government schemes, 75 government medical college upgrades are
approved for increasing medical training and specialty/super-specialty infrastructure, primarily in these
locations . It is estimated that an additional INR 2 lakh Crore worth of private sector opportunities are
available for hospital infrastructure expansion. Government is amending regulations for increasing
public-private partnerships (via Viability Gap Funding Scheme), allowing private consortiums to
establish medical colleges, and expanding intake capacities of medical colleges. While healthcare capital
infrastructure projects and health insurance schemes are critical foundational building blocks and
leading indicators of demand generation and innovation for MedTech, the key opportunity continues to
be in building capacity, equitable distribution, and resilience of the healthcare workforce to serve this rise
in demand.
Patients' needs and expectations are fast changing, and we have both a
demand-supply capacity and knowledge gap in healthcare workers
Healthcare worker capacity building and training is still focused on the treatment of disease and delivery
of care via traditional healthcare models, when patients are increasingly seeking preventative health,

30
convenience, and personalized and connected care. Medical knowledge is growing exponentially and
doubling in less than 3 months vs. 3.5 years just over a decade ago . As diseases get more complex and
their management protocols evolve, more healthcare practitioners are feeling overwhelmed and
unprepared to meet the needs of the patients. In countries like India, this is compounded by the acute
shortage of healthcare workers to manage even the conventional delivery of care today. At an estimated
availability of 27.1 professional health workers for every 10,000 people, currently India is just halfway near
to the global standard 44.5 . Patients in Tier 2-3 locations by far are signi cantly disadvantaged in seeking
high quality specialized healthcare and must travel far to metros/Tier 1 locations adding cost, increasing
treatment times, creating economic hardship, and delaying the management of complex conditions.
Going from playing catch-up in 2022 to building a future-ready healthcare
system by 2047
We are making progress, but more must be done at a rapid pace. The Union Budget 2022 lays special focus
on the training of healthcare workforce, apart from digitization of the sector for it to become more
efficient, real-time, and swift. In addition to the hospital infrastructure expansion, India is not only
increasing the number of new healthcare workers being trained but has started to develop capacity for
implementing new healthcare models, enabled by digital programs. The undergraduate medical seats
increased by 53%, post-graduate seats by 80%, BSc. Nursing and MSc. Nursing by up to 25% when
comparing admissions between 2014 and 2020⁴. During this period, Auxiliary Nursing Midwifery (ANM)
and General Nursing and Midwifery (GNM) capacity was also developed to build preventative screening,
triage, home healthcare and post-hospitalization follow-ups—the building blocks of preventative,
personalized and connected care. More specialty technician capacity such as radiotherapy technicians
will need to be expanded fast—India has a staggering 70% and 77% shortfall of radiotherapy technicians
and medical physicists respectively for the management of cancers. Almost all capacity is in Tier 1
markets⁵.
While aspects of medical learning increasingly shifted online with hybrid learning during COVID, the last
two years also saw the acceleration of training of non-ICU healthcare workers in the training of general
ICU care including management of ICU equipment. Institutions like AIIMS implemented online training
on essentials of critical care management for ICU and non-ICU physicians and healthcare teams. Hospitals
and institutions are implementing hub and spoke tiered delivery models with partnerships to optimize
specialist resources, increase patient catchment areas and leverage technology for early disease
management and specialized care to Tier 2-3 locations. The concepts of central tele-critical care units

31
 connected to peripheral ICUs, or digitally connected supply chain networks for product ow and pricing
visibility are gaining traction.
New models such as home healthcare are being enabled with digital technology and a new cadre of
trained healthcare workers. This is resulting in not only increasing capacity but also improving clinical,
functional and economic outcomes for patients and their caregivers. Home healthcare has the potential
to replace up to 65% of unnecessary hospital visits in India and reduce hospital costs by 20%⁶.
How MedTech can participate in changing the game in healthcare workforce
skill development
Medical diagnostics, imaging, consumables, devices, and technology industry has a signi cant role to
play in accelerating skilling, upskilling and reskilling of the healthcare workforce.
Leveraging the incentives provided by state governments, companies can enter into public private
partnerships to increase screening, early detection and specialist referral and treatment capabilities in
the already existing infrastructure of over 3200 First Referral Units (over 95% have operating room and
labour room facilities), over 5600 Community Health Centres (each has required staffing of four medical
specialists) and over 30,000 Primary Healthcare Centres (each has required staffing of a medical officer
and 14 paramedical and other staff ). Recent examples are setting up E-ICUs in PHCs using central hub and
spoke models in a few districts that can be scaled widely to include over 160,000 sub-centres⁷.
Technologies such as telemedicine, remote monitoring using sensors/wearables/apps, and Augmented
Reality/Virtual Reality training tools are gradually seeing adoption in both metros and Tier 2-3 locations.
Start-ups such Synapsica, Qure.ai, Predible Health and Deeptek.ai are creating new frontiers in radiology
work ows to increase efficiency and accuracy of diagnoses across the public and private sectors.
Surgical education leaders such as Johnson & Johnson India are pioneering hybrid training technologies
for skilling surgeons and their surgical teams. Building on the xed training infrastructure of state-of-the-
art J&J Institutes in Mumbai and Chennai, and over 30 skills labs in partnerships with medical colleges,
which over the years have trained over 300,000 healthcare workers, J&J Institute has also led the way with
reaching Tier 2-3 locations with J&J Institute on Wheels and digital education. J&J Institute on Wheels has
successfully trained doctors and HCPs in over 145 towns, covering 79,329 kms by 2021. In 2021 during
COVID, J&J trained over 50,000 healthcare professionals using digital technologies such as Augmented
Reality for safe and effective use of their stapling devices in cancer surgeries, hybrid training programs for
medical students for basics in surgical suturing and integrated Virtual Reality training for orthopaedic

32
joint replacements. In addition, surgeons in Tier 2-3 locations in India were engaged and trained through
simultaneously connected hybrid programs led by renowned faculty from India, Korea, Japan, USA, UK,
and other countries. Increasing healthcare skills in all locations of India keeps us rooted to our Credo,
which is a constant moral reminder to put the needs and welfare of our patients rst.
The industry also needs to bring a greater focus on diversity and inclusion in the healthcare sector.
Women constitute a signi cant portion of the health workforce globally but are underrepresented in
India. The Global Gender Gap Report by the World Economic Forum ranked India 140 out of 156 countries,
down 28 places. As an innovative approach to increasing women representation and bridging the skill
gap, Johnson & Johnson launched the Reignite program to accommodate women who took time from
their careers to take care of their families. The program offers six-month internships, training, and
placement to women to build their con dence and skills as they re-enter the workforce.
These and many such innovative solutions across Johnson & Johnson and other companies are aligned
with Pradhan Mantri Kaushal Vikas Yojana (PMKVY) and the Skill India vision. And initiatives like these
contribute to the government's National Digital Health Mission (NDHM) that envisages an integrated
digital health infrastructure where existing gap amongst different stakeholders of the healthcare
ecosystem are met through digital highways.

References:
 http://pmssy-mohfw.nic.in
 Trans Am Clin Climatol Assoc. 2011; 122: 48-58. Peter Densen.
 WHO report: Health Workforce in India. Where, Why and How to Invest.
⁴ Pib.gov.in. 10 Aug 2021.
⁵ Indian Journal of Cancer. 2019. Radiotherapy in India: History, current scenario and proposed solutions. Anusheel Munshi, Tharmarnadar
Ganesh, Bidhu K Mohanti.
⁶ Note on Home Healthcare. Nidhi Saxena. Founder and CEO, Zoctr.com.
⁷ MoHFW. Statistics Division Report. 31 March 2019.

33
 Lessons learnt from the COVID-19 pandemic can help us fight the silent
pandemic of NCDs
Mr Madan R Krishnan, Vice President & Managing Director Medtronic

N on-Communicable diseases (NCDs) are rising globally largely due to demographic and lifestyle
changes associated with rapid industrialization and urbanization. Much before the COVID-19
pandemic, in 2016, the World Economic Forum had highlighted the need for a global action to
stem this silent Pandemic of NCDs. It was estimated that the cumulative direct and indirect costs of NCDs
over the following 15 years will be about ve times the costs triggered by the global nancial crisis in the
15 years following 2008. ⁶ Over the last three decades, India has also witnessed a sharp rise in the burden
of NCDs. The contribution of NCDs to disease burden- disability adjusted life-years (DALYs) has grown
from 30% in 1990 to 55% in 2016. Similarly, the proportion of deaths due to NCDs has increased from 37%
in 1990 to 61% in 2016. ⁷ However, majority of population doesn't have access to timely preventive and
curative care with many innovative therapies and procedures which could have reduced the morbidity
and mortality burden due to NCDs.
On the other hand, country has shown exceptional resolve and success in ghting the COVID-19
pandemic by taking leadership in ensuring wide access to vaccines, health infrastructure and other
essential supplies such as medical oxygen and personal protective equipment. Vaccine story is
particularly remarkable as it involved coming up with new vaccines and faster ways to take the vaccine to
all adult citizens. This became possible due to the proactive and open approach of the government which

⁶ The silent pandemic that threatens the global economy. World Economic Forum. Accessed at https://www.weforum.org/agenda/2016/02/the-
silent-pandemic-that-threatens-the-global-economy/
⁷ Non-Communicable Diseases. National Health Portal. Ministry of Health and Family Welfare (MoHFW), Government of India. Accessed at
https://www.nhp.gov.in/healthlyliving/ncd2019#:~:tex t=Non%2Dcommunicable%20diseases%20(NCDs),physiological%2C%20environme
ntal%20and%20behaviours%20factors.

34
enabled all stakeholders such as healthcare workers, civil society, and industry to work together for the
common goal. There are countless other examples where India has achieved excellence in the face of
adversity because of sheer determination and mission driven approach of all the stakeholders ranging
from polio elimination to many landmark projects under the space program.
Can India replicate this success in dealing with the silent pandemic of NCDs? In the past this problem may
not have been perceived with the same sense of urgency as some of the others mentioned above. Now,
we do have some of the building blocks in place. Over the last four years, nearly 1.17 lakh existing primary
health centres and sub-health centres have been upgraded to Health and Wellness Centres and their
scope has been expanded with a focus on preventive and primary care for NCDs. Pradhan Mantri Jan
Arogya Yojana (PM-JAY) has the potential to reform the health system nancing for curative care from
being focused on the supply side to being driven by demand and becoming more efficient as a result. If
implemented well, PM-JAY can address the issue of access to care for NCDs. However, utilization of the
scheme has been suboptimal. It is widely believed that the major barriers have been low
package prices under this scheme and lack of sufficient consideration given to cost variations arising due
to quality, geography, and complexity of care. This made it unattractive for private sector especially the
larger hospitals to join this scheme resulting in the current situation. The package prices may not have
been evidence based as Government had only limited capacity and resource allocation to conduct
costing studies and systematic economic evaluation and relied mainly on expert opinion and anecdotal
inputs from public sector.
Fight against COVID-19 has given a new sense of hope and con dence to India's health sector. National
health Authority (NHA) which runs the PMJAY program gave the country another success with COVID-19
vaccination by developing a COWIN application to interface with the bene ciary which has been
recognized globally for its innovative approach. It is heartening to note that recently, NHA seems to have
also understood the critical problem with PMJAY. NHA's efforts to overhaul the provider payment
mechanism and price setting methodology under the scheme with a vision to provide more value-based
care, is indeed laudable. Value-based care is much more effective as it takes a lifecycle view focused on
health outcomes vis-a-vis the episodic care prevalent currently. The new system will also be cognizant of
heterogeneity in costs due to various factors such as location and level of healthcare facilities. This should

35
help engage more hospitals and consequently reach more bene ciaries. The existing Health Technology
Assessment (HTA) agency is proposed to be complemented by another new institution so that
assessments can be done in a faster manner including through new and innovative ways such as adaptive
HTAs. NHA is also trying to develop a structured and transparent mechanism for inviting nominations for
inclusions and price negotiation of medical products to be used under the scheme. They are looking at
global best practices to create a system t for the country and keep it evolving with the times.
We could be at a critical juncture in the India's healthcare journey. We just need to learn from our
successes in dealing with COVID-19 pandemic and follow the time-tested principles of being proactive
and open so that all stakeholders could come together to achieve the common goals and make that
magic can happen again. This may revolutionize not just the healthcare regime to deal with NCDs but also
have a sustainable impact on the entire health ecosystem.

36
 The 500 B US$ Global Diagnostic Imaging, Critical care Space:
Where are we and what's our Future?
Mr Vishwaprasad Alva
Chairperson, FICCI- Medical Devices Committee,
Founder and CEO, Skanray Technologies Ltd.

I have tried to capture here the space of Diagnostics Imaging, Critical care, Surgery, Home and Geriatric
care devices where Skanray has established a strong domestic and export position in just a decade
which can be leveraged and replicated by a lot more startups, Domestic player, MNCs through Indian
investments.
This 500B US$ sector has been a forte of just the US, Germany, Netherlands, Japan, Korea, China and few
other European countries while the rest of the 180+ countries are importers. India is just emerging in the
last few years and is poised to take at least a 25% share within the next decade with a strong industry –
Govt partnership. Unlike in Pharma, Med device Consumables market, there are very few players.
System Medtech (Diagnostic Imaging, Critical care, Surgery) devices are a very complex blend of
Electromechanical systems, Specialty Plastics & Metals, Controls and automation, High end computing,
Signal processing, embedded, Imaging, User interface and Applications HW and SW covering all elds of
Engineering, Medicine, and pure Science.
That is making it special to India, Its cost structure, skills and capabilities. Unlike in Pharma, Consumer
Goods, entertainment, automobile, Communication sectors, Systems Medtech is Low Volume, High
Complexity, High Mix and quick obsolescence. The worlds developed countries and even China that is
strong in bulk manufacturing is facing challenges of escalating input costs.
Let me take you through with a speci c product example of an Advanced Surgical imaging C- Arm /
Mobile Cath lab. The typical R & D investment for this project from concept to Serial production is
between 75 and 100M US$ and 3 to 5 years. The annual volumes ranges from a thousand to around 5000
units and product obsolescence kicks in around 3 years. The amortization of the R & D, Prototyping,

37
Reliability studies, Veri cation and Validation, Safety and Regulatory costs, Pre-serials, Clinical trials,
Supply chain, parts mfg., tooling, testing capex will make up for about 25 to 40% of the product transfer
pricing. Here the Indian costs can be just about 5 to 12%. The basic raw material and metal costs are
almost the same world over, but India has a 40% cost advantage in Low volume component processing,
tooling, product engineering, installed base management, spares and service, part obsolescence and
end of life management. Overall, India can give a 60% cost and Technology out of most products in this
segment over Europe US, Japan and atleast 30% over Chinese costs.
With its English speaking professionals, access to cutting edge technologies from across the Globe, India
can make Med Tech affordable and self-funded for the country and the Globe. Currently world over the
healthcare subsidies are a huge burden on the economy. What Chinese and Indian Cell phone volumes
did to the otherwise expensive Europe/Scandinavian technology can be done to the Healthcare sector as
well.
1) Instead of incentivizing production, we need to incentivize Exports from India, Getting products to
Global safety and quality standards. We need to incentivize investments in product R & D and core
research and not assembly and screw driver technology , back-end services and low end S/W
unconnected to the applications and product. We need to build Supply Chain eco system and
Component/ Sensor/ Application skills domestically through incentives or Govt support. This sector
won't and can't grow with just customs duty, mfg., tax incentives and sops. The challenges are very
different.
2) Robust Domestic demand. No investments will come in unless there is a robust domestic demand
triggered by Public and private spending in increasing the healthcare over in urban and rural areas of
the Country. Ayushman Bharat is a very important driver for the Med Tech Self-sufficiency program.
We need to work on the execution plan, timelines and ways to overcome the healthcare retail,
insurance, delivery challenges that the country is facing today. Budgetary allocation is the rst step
but execution isn't easy.
3) Transparency in Tendering process and payments to manufacturers on time. Bring the state
procurements also under a common acceptable process to encourage domestic manufacturing
irrespective of them being an MNC, a foreign company or a domestic grown industry that invests in R
& D and Manufacturing in India.
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4) Form a task force consisting of the Pharma/MED Tech ministry, MEITY, External affairs ministry and
ministry of health to brainstorm, identify the gaps and get to execution. EAM is important to identify
and forge partnerships with countries that can be long term partners and manage the imports from
countries where we have risks of supply chain. Med Tech cuts across ministries and coordination
between ministries is always a challenge for the industry. There is no nodal agency that is active.
5) Med tech is low volume, High complexity and High Mix which is the strength of India. We will attract
investments from Europe, US and Japan that have currently invested in China and looking for a
second source. We need a Task force to enable these investments as single window agency and
speci c to med tech.
6) Rural health programs won't kick off unless we bridge the gap between retail, delivery, Technology,
Telemedicine and homecare. Rural health, Mass wellness, Homecare, Health Tourism. Med Tech and
rural health combination will drive great demand and industrial activity, Quality enhancement,
Employment generation, rural employment and prevent migration to cities.
7) China has attracted western, Japanese and American talent to bridge their med tech starting 2
decades ago. India has severe skill gaps and supply chain gaps that can be overcome in less than a
decade. Clusters, Tests labs, Simpli ed Talent immigration into India, Med Tech universities co located
with Clusters for high tech and scienti c staff is an important area of focus.
8) Semiconductor Fab, Electronics mfg. sector infrastructure is key to Med Tech. A lot has been spoken
and it's time to deliver results.
9) Certain laws like PNDT, Legal framework and simpli cation for homecare, telemedicine, Health
tourism needs to be reviewed and formalized in parallel.
The rst step is to have a work out between the Health/Pharma/ Med tech ministry, MEITY, Finance
ministry, PMO and EAM. This is long due and critical. Can we see this happen??

39
 Cancer Care Challenges in India and Way Forward
Mr Ashok Kakkar, Senior Managing Director India, Varian-A Siemens
Healthineers Company

N early 4.5 million Indians suffer from cancer and are in various stages of treatment and follow-ups,
with an average of 1.5 million cases being added every year. As per WHO's Globocan 2020, nearly
8,00,000 deaths in India are attributed to cancer. Cancer is the second largest cause of death in
our country after cardiovascular diseases. Cancer treatment is of mainly three types—surgery, radiation
therapy and chemotherapy. A facility that is equipped to provides all the three types of treatment could
be considered as Comprehensive Cancer Care (CCC) facility. Depending on the type of cancer and the
kind of patient, these options can be used either alone or in combination.
There is a constant need to support the patients and ensure that they bene t from the new technology
and changes in policies. Radiation therapy is one such therapy that has proved to be bene cial in
controlling the growth of cancer and without a radiation therapy unit a comprehensive cancer care
facility is incomplete. Radiation therapy is found to be one of the major pillars in the treatment of the
cancer diseases and almost 60% of the cancer patients need radiation therapy as a part of treatment other
than surgery, chemotherapy, immunotherapy. While 50 to 60 per cent of cancer patients require
advanced treatments such as radiotherapy, in India, less than 20 per cent end up receiving the access.
The majority of cancer care facilities are in urban areas, while 70% of the population continues to reside in
rural areas. Most developed countries have at least 4 radiation therapy units per 1 million population,
while the World Health Organization recommends at least 1 radiotherapy unit per million population for
developing nations. India has only 0.53 units per million people.⁸ Our country falls short by more than 700

⁸ Mallick S, Giridhar P. Is radiation oncology in India today ready to meet the challenge of increasing cancer incidence? India: Cancer epidemiology
and cancer control programme. Journal of Cancer Policy 2020;25: 100232

40
units. Most of the available units are present in urban areas and private institutions.⁹ Out of the 718
districts in India, radiotherapy facilities are only available in less than 100 districts. This results in only 18 to
20% of patients being able to access radiotherapy treatments. Though there has been an increase in
radiotherapy units over the past decade, 8 out of every 10 installations have been in private institutions
which are again urban-centric10. Patients from rural areas need to travel long distances to access cancer
care, affecting their livelihood and continuity of care. The skilled manpower needed to provide effective
radiation therapy is also low in India against international gures. Bridging these resource gaps will help
make cancer care affordable and accessible for patients across the country.
The other challenge is lack of awareness. Despite awareness campaigns, most patients who suspect
cancer do not reach an oncologist on time. Breast cancer, for example, is completely curable if detected at
Stage I. However, social stigma, negative perceptions of the disease and anxiety about dis gurement
prevent the patient from reaching out to their family, peers, or general practitioners. The fear of the
treatment and its cost contribute to the patient's reluctance to begin and sustain treatment. Due to their
inability to cope, patients may turn to traditional forms of treatment and when they nally reach out to an
oncologist, the disease has often progressed beyond the curable stage. This is a key concern area in a
vastly populated country
According to the National Cancer Registry Programme (2020), 1 out of 9 Indians will develop cancer
during their lifetime. Prioritising comprehensive cancer care delivery at the grassroots level will facilitate
early diagnosis and treatment. India can prepare for an increase in cancer patients by strengthening the
screening process at the rural level, while improving the facilities at district-level hospitals so patients can
receive treatment closer to home.
It is time for all healthcare stakeholders to synergise and strategize to navigate the complex maze of
cancer care to ensure delivery of affordable and equitable cancer care in India through investments in
infrastructure and access, looking at partnerships to ensure every Indian can get access to the latest and

⁹ Munshi A, Ganesh T, Mohanti BK. Radiotherapy in India: History, current scenario and proposed solutions. Indian J Cancer. 2019 Oct-
Dec;56(4):359-363.
⁰ Munshi A, Ganesh T, Mohanti BK. Radiotherapy in India: History, current scenario and proposed solutions. Indian J Cancer. 2019 Oct-
Dec;56(4):359-363.

41
most innovative healthcare that technology can deliver. Every district hospital should have the basic
infrastructure to diagnose and treat cancer.
Given that access to cancer care facilities, including radiotherapy centres, is the biggest challenge in our
country today, to address this huge gap, the public and private sectors must work in unison and come up
with innovative solutions that can provide inclusive care in the country. Setting up radiotherapy centres
in the Government Hospitals under a Public Private Partnership (PPP) could be one of the approaches. In
this model, the State is expected to provide space in their hospitals, where a private clinical service
provider will set up the radiotherapy centre to treat patients at a cost previously agreed with the State.
This will help the States to adopt this model much faster and eventually help cancer patients in their
region.
Technology could also be a great enabler to address the growing cancer burden. Cancer care is becoming
more intelligent using biomarkers, personalised drugs, precision radiotherapy, proton therapy and
targeted immunotherapy. Technology can facilitate the ow of information and remove some of the
divisions that currently exist between care specialists and primary care physicians. The use of arti cial
intelligence (AI) and machine learning (ML) to screen cases can help practitioners detect and treat early
and provide a personalised care and treatment plan.
Advanced cancer care should be available to all Indians. A holistic approach is required to provide
scalable and sustainable solutions. Collaboration of various stakeholders and especially policy
interventions could help to improve the cancer care infrastructure in the country.

42
 The Power of Integration: Fueling Future Healthcare Needs
Dr Shravan Subramanyam, Co-Chair FICCI Medical Device Committee &
Managing Director, Wipro GE Healthcare and President NATHEALTH

T he COVID 19 Pandemic was the tipping point for the world in many ways and more so for the
healthcare sector where the best in the world failed to address the fallout of the pandemic. The
need for integrated healthcare systems that supports continuum of patient centric care linking
preventive & promotive, primary, secondary and tertiary care was more evident than before.
The pandemic also made it extremely evident the critical role of medical technologies and digital
technologies in the healthcare integration through the entire patient's journey for diagnostic,
therapeutic and post care monitoring.
World Health Organization's 2030 Agenda for Sustainable Development underpins, “the spread of
information and communications technology and global interconnectedness to bridge the digital divide
and to develop societies that understand digital.”
With the digital paradigm, we are entering a new era where AI, data, and innovative tech are leading the
way— a promising response to the existing fragmented healthcare.

The Need to Integrate

While India has made great strides in bringing healthcare reforms through implementation of Ayushman
Bharat and National Digital Health Mission, there is still much desired in terms of accessibility and quality
of healthcare infrastructure particularly in rural areas where 70% of India resides. There is also limited
internal spread of modern technology and IT services in healthcare. About 44,000 secondary and primary
care centres lack state-of-the-art IT facilities, IT personnel, and high bandwidth (International
Telecommunication Union 2011).

43
Appropriate and timely implementation of National Digital Health Mission would trigger an integrated
and systematic health infrastructure that can enhance healthcare systems to reach the last mile. This will
also facilitate clinicians to efficiently access real-time health records of the patients and provide informed
decisions to nalize a logical line of care management.

The Digital Shift: Data Matters

The National Digital Health Mission (NDHM) provides the building blocks i.e. Digi Doctor, Health ID, health
facility registry and personal health records. Simply put, from a repository consisting of all health-related
information of all citizens to a comprehensive repository of all doctors practicing or teaching systems of
medicine, we already have tools to digital help patients. The next leg of this development are tech-
enabled solutions that further strengthen the integration. For instance, how are these repositories made
available to patients? Can we design systems which further use AI to help doctors to achieve greater
efficiency, improve patient outcomes and increase access to care?
Tele health or e-health got a great llip during COVID 19 pandemic as need for isolation and protection of
doctors, healthcare workers and patients became paramount. The use of chatbots and predictive
modelling tools can improve patient safety and outcomes, as well as support clinician and patient
decision-making capacity, using the electronic healthcare record (EHR) data, arti cial intelligence (AI),
and machine learning (ML) approaches.
At GE Healthcare, we are using tech to integrate and assimilate data from disparate sources. For instance,
by integrating AI into CT scan, we could reduce the RTPCR turnaround time from 48 hours to 10 minutes
thereby giving clinician the crucial advantage of golden hour to treat the patient. Through these
innovations, we are leveraging advanced algorithms to generate operational, and clinical insights.
As India rides the digital wave, we must harmonise our strategies with the global digital strategy for ease
of technology transfer and research & development collaborations. For instance, the WHO global digital
strategy underlines that health data must be classi ed as sensitive personal data and requires a high
security standard. Hence, de ning the need for strong regulatory measures to protect privacy,
con dentiality and integrity of data.

44
Collaborating through Public Private Partnerships
With launch of Ayushman Bharat and push to create a network of 1,50,000 Health and Wellness Centres
(HWCs), India will see an upgrade in the current Sub Centres (SCs) and Primary Health Centres (PHCs) and
a thrust on preventive and promotive care thus adding the crucial forth tier. That said, to realise these
programs to their full potential, an active collaboration between the government and the industry would
go a long way in addressing India's healthcare infrastructural gaps.
Recent studies have demonstrated that the number of ICU beds is disproportionately low in public and
private hospitals (MOHFW 2015) and particularly missing from most District hospitals due to shortage of
budgets, availability of appropriate infrastructure and trained manpower. Tele-ICU is another GE
Healthcare solution which is a connective, integrated piece of technology that links a critical-care team of
nurses, doctors, and intensivists from a remote hospital to a large, multispecialty facility. This system
allows the remote facility to avail the multispecialty services available in the larger hospital and ultimately
deliver quality care and better patient outcomes. Case in point is the Karnataka Government's MobileOne
initiative in collaboration with GE Healthcare and Columbia Asia Hospital to implement Tele-consulting
services at Tumkur District hospital delivering sub-specialty advice, conducting e-Rounds for ICU
patients, providing round-the-clock monitoring, and training staff on protocols and procedures.

The Determinants of Integrated Health

We live in a connected world where mechanisms for strengthening national digital health strategies and
implementing key collaborations will help us achieve the goals we are aiming at. From telemedicine to
electronic medical records, digital adoption of tech to the farthest reaches to remote monitoring systems,
the journey of integrated healthcare is unfolding.
Whether we speak of a digital revolution in healthcare or the policy changes, at the root of integration
stands digital literacy, access to equipment, strategic digital foundations within national strategies and
the dire need to work with stakeholders at every level.

45
 Profiles
&
Advertisements
 SIPCOT
State Industrial Promotion Corporation of Tamil Nadu (SIPCOT) is the lead agency of Government of Tamil
Nadu to plan, develop, promote and operate industrial infrastructure landscape in the State of Tamil
Nadu. Established in 1971 and now is in its Golden Jubilee Year, SIPCOT, has developed over 35000 acres of
industrial land spread across 24 industrial estates/parks and 6 Special Economic Zones and is
championing sustainable and equitable industrial development in the State of Tamil Nadu.
SIPCOT provides comprehensive physical infrastructure facilities including road network, stormwater
systems streetlighting, water supply system, waste management, parking infrastructure, round the clock
security etc. In addition, social infrastructure in terms of worker's hostels and other amenities are
provided on a shared basis.
SIPCOT, to transform the State Government's vision as a Trillion Dollar economy by 2030, has embarked
on a series of new initiatives to support the growth of new industries and transform the enterprises in
Tamil Nadu.
Ÿ Industrial Land Bank: SIPCOT, to cater to the future demand, is creating an additional land bank of
45000 acres for industrial purposes spread across the state.
Ÿ Transforming the Industrial Landscape of Tamil Nadu: SIPCOT is developing green eld industrial
clusters for PV Manufacturing, Furniture, Medical Devices, Electronics Manufacturing, E-Vehicles,
Future Mobility, Textiles, Leather, etc. sectors. These clusters are envisaged as comprehensive self-
contained ecosystems comprising of physical infrastructure and state-of-art common facilities, ready
build factories and social infrastructure and specialised services.
Ÿ Built Environment: SIPCOT has embarked on providing solutions for Just in-Time manufacturing
through creation of plug & play factory buildings for manufacturing and logistics.
Ÿ Supporting Innovation: SIPCOT is establishing Industrial Innovation Centres at the Sriperumbudur &
Hosur Industrial Parks. Through this initiative, SIPCOT intends to accelerate the adoption of new
technologies in the industrial landscape of Tamil Nadu.
Ÿ Sustainability: SIPCOT endeavors to promote eco-industrial parks by promoting sustainable use of
water and waste water, rejuvenation of water bodies, greening of industrial estates.
Ÿ Business- Doing Easy: SIPCOT plays a major role in doing business “Easy” through a transparent land
allotment policy.
SIPCOT through its world class industrial parks and infrastructure is an integral part of Tamil Nadu's
economic vision of transforming into a 1 trillion economy by 2030.
 Polymed
With a vision to serve people through innovative healthcare solutions, a drive was set into
motion 25 years ago when Polymed was conceived in 1997. Today, Polymed stands tall as one of
the leading medical device manufacturers & exporter from India. We have a presence in 120+
countries across the globe, with subsidiaries in Europe, the United States, and China. Currently
holding 300+ patents and a portfolio of over 150 medical devices, our products cater to a vast
range of therapeutic segments covering infusion therapy, dialysis, respiratory care, cardiology,
oncology, urology, gastroenterology, blood collection and management, anaesthesia & wound
drainage. More than 1 billion medical devices are manufactured every year in our 9 state-of-the-
art manufacturing facilities across 4 countries, which are equipped with the best innovation &
design capabilities. We are always looking to move beyond our horizons, and our acquisition of
PLAN1HEALTH, Italy has helped us to expand our portfolio of vascular access& oncology
products. The acquisition has made us one of the few companies in the world to provide a
complete solution for peripheral & central venous access. We have made it to the highly coveted
Fortune “The Next 500” list for 2022 and were also featured in the prestigious Forbes' Asia in 2021.
Polymed continues to forge ahead relentlessly and contribute towards an efficient global
healthcare ecosystem.
 Abbott
At Abbott, we're dedicated to helping people live more fully, in everything we do. We're creating
the future of healthcare through life-changing technologies and products that make you
healthier and stronger, quickly identify when you have a medical need, and treat conditions to
help you get back to doing what you love. With global headquarters in Chicago, USA, we serve
people in more than 160 countries with leading medical devices, diagnostics, nutrition products
and branded generic medicines. 113,000 of us are helping millions of people to live better and
healthier every day around the world.
In India, we've been helping people live fully for more than 100 years
 BD

BD is one of the largest global medical technology companies in the world and is
advancing the world of health by improving medical discovery, diagnostics and
the delivery of care. The company supports the heroes on the frontlines of health
care by developing innovative technology, services and solutions that help
advance both clinical therapy for patients and clinical process for health care
providers. BD and its 65,000 employees have a passion and commitment to help
improve patient outcomes, improve the safety and efficiency of clinicians' care
delivery process, enable laboratory scientists to better diagnose disease and
advance researchers' capabilities to develop the next generation of diagnostics
and therapeutics. BD has a presence in virtually every country and partners with
organizations around the world to address some of the most challenging global
health issues. BD operates in India through a wholly-owned subsidiary, BD India
Pvt. Ltd. BD has a manufacturing facility in India, a highly automated plant at Bawal,
Haryana. This facility uses manufacturing techniques of international standards
and produces products recognized around the world.
 GE Healthcare
Wipro GE Healthcare (WGE) is a Joint Venture between General Electric Company, USA and Wipro
Enterprises Limited, India. Established in 1990, it is one of the most successful and longest
running JVs in the region with operations spread across India, Bangladesh, Sri Lanka, Nepal,
Maldives and Bhutan. The company is the largest Medical Technology player in the South Asia
region.
WGE is in the business of manufacturing and distributing medical devices – from Baby Warmers,
ECGs, Anaesthesia Machines and Ultrasounds to Cath Labs, CT and MRI systems. It also provides
software services and technology solutions to GE Healthcare for products manufactured
worldwide. The Company's focus is on addressing on some of the toughest healthcare
challenges– lowering maternal and infant deaths, enabling early detection of cancer, addressing
heart diseases early and driving better outcomes for trauma patients among others.
WGE is the rst company to design and manufacture medical technologies 'In India for India and
the world', the rst company to start healthcare technology R&D in India, and is a leader in the
Healthcare PPP space in India, actively engaged in National Health Mission funded projects and
PPP projects of various state governments.
About GE Healthcare
GE Healthcare is a leading global medical technology and digital solutions innovator, enabling
clinicians make faster, more informed decisions through intelligent devices, data analytics,
applications and services, supported by its Edison intelligence platform. With over 100 years of
healthcare industry experience and around 50,000 employees globally, the company operates
at the center of an ecosystem working toward precision health, digitizing healthcare, helping
drive productivity and improve outcomes for patients, providers, health systems and
researchers around the world.
 Johnson & Johnson

Johnson & Johnson spread its root into India over 70 years ago. Since then, the company has
brought many innovative ideas, products and services to improve the health and well-being of
people in India. The company is organized into three business segments: Consumer Healthcare,
Medical Devices and Pharmaceuticals.
The medical division of Johnson & Johnson Private Limited is the largest MedTech company in
India. Johnson & Johnson Medical India (JJMI) has made signi cant contributions to surgery for
more than 60 years in India, with products dedicated to addressing unmet needs in the elds of
orthopaedics, cardiovascular, obstructive and neurovascular disease, arrhythmias, bariatric and
metabolic surgery, cancer surgery, general surgery, urologic surgery, hernia surgery and
infection prevention. We touch the lives of around 10 million patients every year in India.
Our state-of-the-art manufacturing facility in Aurangabad is focused on elevating the standard
of care and improve patient access and outcomes. JJMI is a pioneer in HCP and Non-HCP
professional education and were the rst MedTech company in India to start a dedicated training
institute for healthcare professionals (HCPs). Building on the training infrastructure of state-of-
the-art J&J Institutes in Mumbai and Chennai, we have trained over 300,000 HCPs through a
variety of medical education events.
J&J Institute has also led the way with reaching Tier 2-3 locations with J&J Institute on Wheels, a
specialized mobile surgical training center designed to upskill healthcare professionals across
India. So far, the two JJIWs successfully trained doctors and HCPs in over 145 towns, covering
79,329 kms by 2021. During COVID pandemic in 2021, J&J trained over 50,000 healthcare
professionals using digital technologies.
Guided by our J&J purpose, we continue to blend heart, science and ingenuity to change the
trajectory of health for humanity.
 Mindray
Founded in 1991, Mindray is one of the leading global providers of medical devices and
solutions. Firmly committed to our mission to “advance medical technologies to make
healthcare more accessible”, we are dedicated to innovation in the elds of Patient Monitoring &
Life Support, In-Vitro Diagnostics, and Medical Imaging System.
Mindray possesses a sound global R&D, marketing and service network. Inspired by the needs of
our customers, we adopt advanced technologies and transform them into accessible
innovation, bringing healthcare within reach. While improving the quality of care, we help
reduce its cost, making it more accessible to a larger part of humanity.
Today, Mindray's products and services can be found in healthcare facilities in over 190 countries
and regions.
 Medtronic
Medtronic began its operations in India in the year 1979. With over 1500 employees, India
Medtronic Pvt. Ltd. is a wholly owned subsidiary of Medtronic Plc. It is headquartered at Mumbai.
We have four business portfolios- Diabetes, Cardiovascular, Neuroscience, Medical Surgical.
Medtronic has two Research and Development (R&D) centers in India-
m Medtronic India Development Centre (MIDC) – the R&D facility at Bangalore focuses on
new product development for Renal Care Solutions business of Medtronic.
m Medtronic Engineering and Innovation Center (MEIC) - It is Medtronic’s largest R&D
center outside the US. The Center focuses on software and engineering solutions across
multiple product portfolios.
For training and education, Medtronic India also has two training centers-
1. Therapy and Procedure Training Center in Mumbai- The center provides hands-on
training to healthcare professionals on implanting devices for the management of cardiac
disorders, spinal surgeries, training on advanced procedures and techniques in the eld of
general surgery, respiratory and neuro interventions using Medtronic equipment and
technologies.
2. Surgical Robotics Experience Center in Gurgaon – SREC in India is 1 of 10 Medtronic
training centers across the world today where clinicians can experience and train on the
Hugo™ robotic-assisted surgery (RAS) system. † SREC provides a multi-layered curriculum for
training surgeons, assistants, and paramedical staff on the Hugo™ RAS system.

†The Medtronic Hugo™ RAS System is commercially available in certain geographies. Regulatory requirements of individual
countries and regions will determine approval, clearance, or market availability. Hugo™ RAS is pending CE mark for the EU. In the
US, the Hugo™ system is an investigational device not for sale.
 Philips India Limited (Philips)
Philips India Limited (Philips) is a subsidiary of Royal Philips of the Netherlands (Koninklijke
Philips N.V), a leading health technology company focused on improving people’s health and
enabling better outcomes across the health continuum from healthy living and prevention, to
diagnosis, treatment, and home care. Philips leverages advanced technology and deep clinical
and consumer insights to deliver integrated solutions. The company is a leader in diagnostic
imaging, image-guided therapy, patient monitoring and health informatics, as well as in
consumer health and home care.

Philips also have a Research and Development Center - Healthcare Innovation Center (HIC)
located at Maharashtra, Pune which was incorporated in the year 2010, Philips via HIC was
involved in the design and development of Mobile Surgery Equipment and Diagnostic X-Ray for
both local and global markets.

We have state of art manufacturing facility located at Chakan Pune, manufacturing Mobile C
arms, Image Guided Therapy -Catch Labs , Digital X ray ( DXR), Ultra Sound, Computed
Tomography (CT). The facility is US FDA listed state of Art facility and export to 85 + countries
Mobile C arms, Image Guided Therapy -Catch Labs.
 Stryker India
Stryker is one of the world’s leading medical technology companies and, together with our
customers, we are driven to make healthcare better. We offer innovative products and services in
Orthopaedics, Medical and Surgical, and Neurotechnology and Spine that help improve
patient and hospital outcomes.
In India, Stryker began its commercial operations in 1999, with its headquarters in Gurugram,
and regional sales offices in Mumbai, Chennai and Kolkata.
With a vision to drive global innovation and accelerate product development, we established
our Stryker Global Technology Center (SGTC) R&D in 2006 in Gurugram. The technical talent
of the center spread across in the diverse elds of systems, mechanical, software, embedded,
electronics and computer science, collaborates with the global teams to develop products and
solutions that strive to make healthcare better.
Today, our talented teams of more than 1,000 employees spread across the country are
comprised of commercial leaders, R&D engineers and IT professionals who works closely with
our customers, to understand their needs and provide innovative products and solutions that
help them deliver better patient outcomes and make healthcare better.
As an industry leader, we believe Corporate Responsibility is a strategic priority, and we invest
time and resources in the areas that are most important to our employees, customers and the
communities where we live and work.
We accomplish this by focusing on ve distinct areas.
Investing in People
Product Lifecycle Innovation
Ethics and Accountability
Resource Efficiency
Responsible Supply Chain
In India, Stryker offers an extensive portfolio in Orthopedics, Endoscopy, Craniomaxillofacial,
Patient Handling, EMS and Evacuation Equipment, Spine, Trauma and Extremities, Surgical
Navigation Software, Hospital Infrastructure, Surgical Instruments and Neurovascular
Intervention.
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 Thank You Partners
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Partners
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Session Partners Badge & Lanyard Partner Registration Desk Partner Pen Partner

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Supporting Associations
About FICCI
Established 90 years ago, FICCI is the largest and oldest apex business organization in India. Its
history is closely interwoven with India's struggle for independence, its industrialization, and its
emergence as one of the most rapidly growing global economies.
A non-government, not-for-profit organization, FICCI is the voice of India's business and industry.
From influencing policy to encouraging debate, engaging with policy makers and civil society, FICCI
articulates the views and concerns of industry, reaching out to over 2,50,000 companies. FICCI
serves its members from large (domestic and global companies) and MSME sectors as well as the
public sector, drawing its strength from diverse regional chambers of commerce and industry.
The Chamber with its presence in 14 states and 10 countries provides a platform for networking and
consensus-building within and across sectors and is the first port of call for Indian industry, policy
makers and the international business community.

FICCI Medical Devices Contact

Mr Praveen K Mittal
Senior Director, FICCI
praveen.mittal@ficci.com
Ms Pallavi Thakur
Deputy Director, FICCI
pallavi.thakur@ficci.com
Mr Sourabh Shekhawat
Senior Assistant Director, FICCI
sourabh.shekhawat@ficci.com
Ms Beena Mulani
Executive Officer, FICCI
beena.mulani@ficci.com