t">

12

Vulval Lesion Excision

$ 6000

$ 1200

13

Vaginal & Perinial plastic surgery

$ 9450

$ 1890

14

Posterior Repair - Prolapse Operation

$ 9000

$ 1800

15

Salpingo-oophorectomy - Ectopic Pregnancy

$ 4950

$ 990

16

Vaginal and Vulval Warts - Removal

$ 3900

$ 780

17

Cervical Cyst

$ 3000

$ 600

18

Placement/Insertion of IUCD

$ 750

$ 150

 

India’s low-cost, world-class, affordable, top rated, healthcare facilities- accredited, certified hospitals and clinics attract and receive global patients from over 40 countries for the personalized medical care in cost effective manner. This unique blend of top class medical healthcare expertise for Gynaecology and Obstetric treatment and care procedures and other medical health care procedures at attractive and affordable prices is the most important factor in a constant annual growth rate of 30% in Medical tourism to India. There are many reasons contributing towards this huge medical healthcare cost differential and Gynaecology treatments at reduced rates, the most important of these factors are:

The discounted health care for Obstetrics and Gynaecology- surgical treatment procedures abroad in India and the low prices does not mean low on the quality of healthcare. In fact the healthcare technologies in India are at par with that provided by the healthcare facilities in any advanced country, using exactly the same advanced technology, machines and equipments as used in USA or Europe thereby delivering similar or even better success rates. Adherence to the highest quality standards of healthcare by competent board certified Gynecologists- Gynecology surgeons, Gynecology doctors, specialty surgeons for Laparoscopy Gynaecology surgery procedures with priority treatment (medical surgery treatment without wait list) and personalized attention by top Gynecologist- Gynecology surgeons, doctors and physicians- Gynecology medical surgery consultants positions India as the best alternative healthcare destination for nations with high medical care costs.

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3.2 Women care II- Cosmetics

Many of the world’s popular cosmetics brands entered the Indian market in the 1990s as the Indian market opened up to foreign companies.  The cosmetics and personal care industry has been growing at an average rate of 15-20 % for the last few years. Growth has come mainly from the low and medium-priced categories, which account for 90 % of the cosmetics market in terms of volume.


3.2.1 Market Overview

The current size of the Indian cosmetic market is approximately US$ 600 million. Of this, the fastest growing segment is color cosmetics, accounting for around US$ 60 million of the market. Industry sources estimate a rapid growth rate of 20 % per annum across different segments of the cosmetics industry reflecting an increasing demand for all kinds of beauty and personal care product. Growth has come mainly from the low and medium-priced categories that account for 90 % of the cosmetics market in terms of volume.

Even with a 20 % average growth rate, the per capita consumption of cosmetics is very low in India. Current per capita expenditure on cosmetics is approximately US$ 0.68 cents as compared to US$ 36.65 in other Asian countries. Cosmetic companies in India are placing increasing emphasis on market research and targeting new market segments such as teenagers, men and young women. Fragrances and color cosmetics constitute the high growth segments. Nail enamels and lipsticks account for around 65 % of total color cosmetic sales in India. Lakme, a brand originally introduced by the Tata group of India, now bought over by Hindustan Lever (HLL) of the Unilever group, Tips & Toes, another domestic player, and Revlon dominate the US$ 60 million color cosmetics market. Multinationals, Revlon of the U.S. and L'Oreal's Maybelline has a dominant share of the small premium lipsticks and nail enamels market. Mass-market products account for a major share, while the premium segment accounts only for a mere 9 % in lipsticks and 5 % in nail enamels. Lipsticks account for nearly a third of the market at US$ 21 million, while the market for nail enamels is estimated at around US$ 23 million. The color cosmetics segment is very competitive and has a high penetration level of 80 %. Most other cosmetic products are estimated to be used by less than 40 % of the consumers.

The prestige fragrance market, which has seen a steady influx of foreign brands, is currently estimated at US$ 20 million and is mainly bought by the affluent sections. An average annual growth rate of 15 % has been estimated for this segment for the next few years. The body spray category is the fastest growing segment within the fragrance category. The body spray market is estimated at approximately 20 million cans per annum and it is estimated to increase to 100 million cans by 2007.

The skin care market in India is estimated at US$ 180 million. Within the last decade, this segment has seen many consumers slowly shift from the mass to the premium end of the market. The penetration rate is high in the skin-care segment as compared to color cosmetics. In the skin-care segment, price and volume played an equal role in value growth. The major players in this segments are Lakme, Ponds, and Fair & Lovely of the HLL group with a 50 % market share, followed by players such as J.L. Morison that markets the Nivea range of products in India, Godrej and Revlon. The size of the hair care market in India is estimated at more than US$ 200 million, 50 % of which interestingly comes from sales of shampoo. International companies like Unilever through its subsidiary, Hindustan Lever (Sunsilk, Organics, Clinic, and Lux); and Procter & Gamble (with brands such as Pantene, Head & Shoulders) dominate the shampoo market in India with approximately 58 and 20 % market share respectively.

The Shahnaz and the Biotique brands dominate the premium herbal cosmetics segment in India, estimated at USD 100 million

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3.2.2Competition: Globalization Scope

The Indian cosmetic market, which has been traditionally a stronghold of a few major Indian players like Lakme, and Ponds has seen a lot of foreign entrants to the market within the last decade. India is a very price sensitive market and the cosmetics and personal care product companies, especially the new entrants have had to work out new innovative strategies to suit Indian preferences and budgets to establish a hold on the market and establish a niche market for themselves.

Given the price-sensitivity of the Indian consumer who do not normally prefer to fork out a large sum at one time, many cosmetic companies launched their products in smaller pack sizes to make them more affordable. HLL and Revlon were the first to introduce small pack sizes. Revlon introduced its small-range of 8 ml nail polishes and lipsticks, and was soon followed it its strategy by major Indian companies as well.

Stiff competition in the cosmetics market also saw an increase in the range of new products being introduced for newer application concepts in the last few years that provides the international companies with the scope to expand. In the skin-care segment, from just creams and moisturizers, there has been a upgrade to value-added products such as under-eye wrinkle removing creams, dark circle removing creams toners, sunscreen lotions, fairness creams, and many more. The color cosmetics market saw new products such as smudge-proof lipsticks and mascaras, liquid lip color, and long-stay lipsticks being introduced. These specialized applications led to growth in volumes and also enabled companies to price the products at a premium, driving up value growth. 

Service marketing strategies, such as point-of-sale advice and beauty counseling have shown to boosts sales of cosmetics and personal care products and driven growth in the Indian market. Beauty counselors or advisors at retails outlets have been very successful in gaining attention, creating product awareness and overcoming consumers lack of familiarity with, and fears about many cosmetics and personal care products such as home hair permanents and color cosmetics. Some companies such as Lakme have even set up exclusive Lakme beauty parlors at major cities in India through the franchisee route. Major herbal cosmetics brands such as Shahnaz Hussain and Biotique also operates chains of salons through franchisees and offer specialized training courses to customers.

L'Oreal markets its range of specialized hair care products exclusively through salons and beauty parlors. L'Oreal currently is the only company in the market that has a hair color range tailored exclusively for parlors. The company was also the first to introduce modern hair color and shampoos for colored hair in the Indian market.

A strong brand promotional campaign, good distribution network, constant product innovation and quality improvement, and the ability to provide a variety of quality products are some of the major reasons for the success of most companies. 

HLL, is currently India's largest cosmetics and personal care products producer and its brands has the dominant share (more than 50 %) in segments such as personal wash, skin care, shampoos, lipsticks and nail polish.

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3.2.3 Sales Prospects 

The growing Indian cosmetics market offers promising opportunities for international brands. The growth rate in the cosmetics market reflects an increasing demand for beauty care products in India. The most promising segments for international companies to pursue are perfumes and fragrances, and specialized/professional skin care and hair care products. The fastest growing market is however color cosmetics, which account for US$ 60 million of the total market.


 

India is the world's 2nd largest producer of food next to China, and has the potential of being the biggest with the food and agricultural sector. With India's food production likely to double in the next decade, there is an opportunity for large investments in food and food processing technologies, skills and equipment, especially in areas of Canning, Dairy and Food Processing, Specialty Processing, Packaging, Frozen Food/Refrigeration and Thermo Processing. Fruits & Vegetables, Fisheries, Milk & Milk Products, Meat & Poultry, Packaged/Convenience Foods, Alcoholic Beverages & Soft Drinks and Grains are important sub-sectors of the food processing industry. Health food and health food supplements are other rapidly rising segments of this industry.


4.1 Fruit juices and drinks

The US$ 1.80 billion carbonated drinks category are expected to face the heat of the rising competition this summer from categories falling under the health umbrella. At present, these categories are juice and juice-based drinks, energy and sports drinks, malted beverages, probiotic drinks and bottled water.

The fruit drinks segment is ripe for plucking. At US$ 300.67 million, the juice and juice drink category is among the fastest growing segments of the approximately US$ 2.38 billion packaged beverages category. While fruit drinks as a category is growing at 18-20 %, carbonated soft drinks are growing at 6-8 %.

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4.2 Foreign Direct Investment (FDI)

The key factors below have been instrumental in driving growth and investment for the Indian food industry:

  • Effective distribution network and supply chain
  • Product range that is customized to suit local market requirements
  • Superior processing technology
  • Brand building and marketing

International food brands such as Nissin Food Products Co. Ltd, Perfetti Van Melle India Cofitos, etc. have already made successful forays in India.
Other Indian initiatives and local-foreign JVs (joint ventures) include:

  • ITC Limited plans an investment of around Rs 300 crore to develop a new, integrated food processing plant during in West Bengal.

  • US-based private equity fund, New Vernon Private Equity Ltd (NVPEL), investing US$ 11.2 million in Kochi-based masala major, Eastern Condiments.

  • Hershey acquiring 51 % stake in Godrej Beverages & Foods for US$ 54 million.

  • Dabur, Blue Star and Voltas among others also have tie-ups.

4.3  Government Initiatives

The Government has declared food processing a priority introducing a number of progressive measures to set up and modernize food processing units, create infrastructure, support research and development and human resource development.

  • The national policy aims to increase the level of food processing from 2 % to 10 % in 2010 and to 25 % in 2025.

  • The level of institutional credit to be provided by banks and Financial Institutions has been increased from US$ 17.41 billion during 2003-04 to about US$ 23.76 billion in 2005-06.

  • Full repatriation of profits and capital is allowed.

  • Automatic approvals for foreign investment up to 100 %, except in few cases, and also technology transfer The government has decided to give a boost to research and development in this sector with its decision to set up the National Institute for Food Technology and Management in collaboration with Cornell University of the US.

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5. PHYSIOTHERAPY AND REHABILITATION IN INDIA
 

5.1Summary

Increasing road accidents, needs of the senior citizens, inadequate health care facilities for the poor and rural Indians, increasing health awareness by the affluent and middle income Indians, all contribute to the boom in the industry of physiotherapy and rehabilitation.  Demand for physiotherapy and rehabilitation equipments continues to increase in India with a rapid change in the life styles and work demands.  Several international firms are already present in India selling their physiotherapy and rehabilitation equipments.  Indian firms also manufacture a range of P&R equipment for both domestic and export markets. Almost all the private hospitals in India are having a separate department for P&R.  The Government of India (GOI) continues to liberalize trade regulations and currently allows the importation of all medical equipment and instruments, including P&R.  U.S. companies are encouraged to appoint technically strong agents and distributors to sell their products and technologies in India, and participate in leading trade exhibitions to create market and product exposure

The total market size of orthopedic/prosthetic goods of all types was $241 million in 2004, which is estimated to reach $252 million during the current year.  This is projected to reach $263 during 2006 and further to $302 by 2009.

A fast changing food habits, and life-styles have resulted in various types of disabilities in India.  Inadequate intake of micronutrients such as iodine, vitamins and iron, particularly in the rural areas, is another major cause of avoidable disabilities.  Large section of the poor Indians, particularly the slum dwellers and rural poor, live in unhygienic conditions without adequate medical support.  They become vulnerable to preventable disabilities, including orthopedic disabilities.  Physiotherapy treatment becomes essential to continue the fast pace of work life.

The domestic demand for healthcare services has grown from an estimated $4.8 billion in 1991 to $22.8 billion in 2002, and contributed an impressive 5.2 % to India’s GDP in 2002.  The healthcare service is expected to generate revenue of $47 billion by 2012 (accounting for an estimated 6.2 to 7.5 % of the GDP by 2012).  

The Indian population of one billion is growing at a rate of 2.5 % per year.  Of that total, about 100-150 million have the demand for, and the discretionary income to purchase, private health care services.  Many in the growing “middle income" segment look for international quality medical services in private super-specialty hospitals and this trend is likely to continue for the next five years and beyond.

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5.2 Market Trends

In the private sector, several multi-specialty hospitals perform orthopedic surgeries and treatment and these hospitals maintain a P&R unit to service its patient population.  Apollo Hospitals Group, MIOT Hospital, Chennai, Indian Spinal Injuries Centre, New Delhi, Sri Ramachandra Medical College and Research Institute, Chennai, Manipal Hospital, Bangalore  are some of the leading private sector hospitals maintaining orthopedic and P&R facilities. 

Large industrial houses, including the Tatas, Birlas, and Hindujas, have also established major multi-specialty hospitals in the country.  Several other private sector hospital projects are in various stages of development.  These developments are expected to support the demand for P&R products. 

In their efforts to stay competitive and to attract patients for treatment, many Indian private sector hospitals are going through International Standards Organization (ISO) programs to maintain and to document the service.  These ISO programs generally require the use of top-of-the-line instruments and equipment at all levels.


5.3 Competition

Aporhecaries Sundries Manufacturing Company (ASCO), Atlas Surgical Company, Kay & Company, Narang Enterprises, Wadia Group, Electrocare Systems and Services, are some of the leading manufacturers of P&R related equipment in India.  These firms are seeking new business opportunities via joint ventures.  Artificial Limbs Manufacturing Corporation (ALIMCO), Kanpur, manufactures and sells aids such as wheel chairs to disabled persons.  ALIMCO maintains four additional production facilities to increase the production capacity.   The P&R sector is at a budding stage in India and hence provides excellent opportunities for various international players to expand.


5.4 End Users

The Government of India places a high priority on the development of India's healthcare sector. The Union government, state government and private sector hospitals are the largest end-users of medical equipment and systems, including P&R. Private sector hospitals are also major end users of P&R.
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2.2 CRAMS


Contract research and manufacturing services (CRAMS) has become a promising medium for the Indian pharma industry, with India increasingly being viewed as global hub for CRAMS. Over the last 5 years the CRAMS industry has been contributing close to 8 %t of the total Indian pharmaceutical business. Developed countries are expected to further propel the CRAMS industry to grow at a CAGR of nearly 32 % from 2006 to 2013 as India offers global pharma companies both quality and cost advantage.

Contract research--including both drug discovery research and clinical research--has been growing at a phenomenal rate. While clinical trials represent 65 % of this market, new drug discovery makes up the remaining 35 %. Frost and Sullivan estimates outsourced contract research in India to reach US$ 2 billion by 2010. Similarly, according to a McKinsey report, the global clinical trial outsourcing to India in the pharmaceutical industry is estimated to be worth US$ 1.23 billion by 2010. Over 15 prominent contract research organizations (CROs) are now operating in the country which includes names such as Novartis, Johnson & Johnson, Pliva, Astra Zeneca, Bristol-Myers Squibb and GlaxoSmithKline among others.

Contract manufacturing is another new opportunity for the Indian pharmaceutical industry. Already, India has the largest number of US Food and Drug Administration (US FDA)-approved plants outside the US, with over 100 facilities. The Boston Consulting Group estimates that the contract manufacturing market for global companies in India would touch US$ 900 million by 2010.

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2.3 Generics

According to a report by global pharmaceutical market intelligence company, IMS Health the Indian generic manufacturers will grow to more than US$ 70 billion as drugs worth approximately US$ 20 billion in annual sales will face patent expiry in 2008. In fact, with nearly US$ 80 billion worth of patent-protected drugs to go off patent (including 30 of the best selling US patent-protected drugs) by 2012, Indian generic manufacturers are positioning themselves to offer generic versions of these drugs.

Already, Indian drug companies account for over 25 % of the total generic drug applications made to the FDA of US, which accounts for over half of the US$ 60 billion market. The US FDA's latest generic initiative GIVE (Generic Initiative for Value and Efficiency)-aimed at increasing the number and variety of generic medicines available to consumers and healthcare providers -- is expected to further fuel the export plans of Indian pharmaceutical companies.


2.4 Drug Master Filings (DMFs)

DMFs are confidential, proprietary assets that present to the US FDA the formulae, processes, test methodology, and other data relevant to the manufacture of products used in the composition, packaging and processing of pharmaceuticals or biologics

Indian companies like Aurobindo Pharma, Wockhardt, Ranbaxy, Dr Reddy's Lab and Sun Pharma have been in the fore-front in this segment. out of the total 187 DMFs filed with the US FDA during October-December 2007, Indian companies alone accounted for 89 DMFs, accounting for a whopping 47.6 % of the total DMFs.

While Ranbaxy filed the highest number filings with 13 DMFs, Dr Reddy’s and Aurobindo Pharma followed next with 10 DMFs each.


2.5 Nutraceuticals in India

Nutraceuticals and functional foods represent one of the fastest growing markets in the developed world. The worldwide market for these products is estimated to be about 86 billion dollars with an annual growth rate of 17 %. Considering the current trends towards healthcare cost reduction and the growing consumer interest in preventive health, it is expected that this industry will continue to exhibit strong growth rate in the coming years as well. India is relatively a new market and upcoming market in nutraceuticals. The size of the Indian industry is likely to reach about Rs. 1,000-1,200 crores in the next four years. All major pharma players are in the process of entering this market.

India is home to almost all kinds of plants ranging from tropical, sub-tropical and temperate zone plants. Also the advantage of knowledge based remedies gives India tremendous leads in finding newer applications (because of Ayurveda). Indian Scientists have been active in this field for decades; pay off period is here now!

The level of exports from India is still small, perhaps less than Rs. 750 crores if one excludes Psyllium. The major importing countries are the U.S., Europe and Japan.

India can become a big player in this industry if it develops clinical documentation and scientific basis to support claims of safety and efficacy. Companies such as Sami have succeeded because they have developed the required clinical documentation and have done clinical studies in the U.S. thus developing credibility.

India is an interesting geography for several global drug majors who are attracted by the huge talent pool, scientific skills and cheap labour that has enabled Indian companies manufacture drugs at about a third of the cost in the West.

 

2.6 Biotech Industry in India

The Indian biotech industry – accounting for 2 % of the global biotech market – has the potential to develop as a key player, generating revenues worth US$ 5 billion.
The domestic biotechnology industry is now a US$ 3 billion sector, registering 30 % growth in 2007-08 over the previous year. Furthermore, it is estimated that this sector will grow to occupy 140 million square feet by 2010, creating employment for a million by means of its products as well as its services
The Indian biotechnology sector - with its 'low cost, high value' proposition - has been growing at 35 % to 40 % annually for the last three years with over 340 companies. The domestic biotechnology industry, with growth rate of 30 % in 2007-08 over 2006-07, has grown to become a US$ 3 billion industry.
Bangalore especially has been at the helm of the country's biotech developments, what with:

Hyderabad has been a firm anchor for India's biotech industry, with the Genome Valley Project attracting foreign exchange worth US$ 1.24 billion from pharmaceuticals, biotech chemicals and allied chemicals' companies.


2.7 Investments in Biotech sector

India's biotech sector is on the threshold of a colossal growth in the coming decade with investments flowing in from all corners. Investments in this sector crossed US$ 580 million in 2006–07, with outlays from companies like Jubilant, AstraZeneca, GE Healthcare and Biocon. India is becoming one of the most favored destinations for collaborative R&D, bioinformatics, contract research and manufacturing and clinical research.

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2.8 Mergers & Acquisitions

The number of mergers and acquisitions in the recent years is testimony to the emerging growth in the Biotechnology sector:

2.9 Government Initiatives

India is among the first few countries in the developing world to have recognized the importance of biotechnology as a tool for advancing growth in the agriculture and health sectors. The Government established the Department of Biotechnology (DBT) in 1986 as the apex body to identify priority areas and evolve a long-term plan for the development of biotechnology.

The Indian government strong and committed support has been an important factor in the development and growth of this sector:


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3.1 Women care I- Gynecology and Obstetrics

There are three distinct reasons that make India the most favored and preferred destination for women care- Gynecology and Obstetrics procedures, India’s medical expertise, state-of-the-art technology at par with the best in the world, and the incredible cost-effective health care. As health care costs are increasing, the patients in the countries like U.S.A., Europe, Middle East, Canada, Japan, Europe, UK and Australia etc. are looking overseas for medical treatment and with India’s top-end, state-of-the-art healthcare facilities providing world-class healthcare for Gynecology procedures at just a small fraction (between one-fifth to one tenth) of the cost else where, India is emerging as being the most economical health Medicare destination with enormous medical healthcare cost savings on Gynecology and Obstetrics procedures like Laparoscopic Sterilization,  Caesarean Section,  Laparoscopic and general surgery Hysterectomy – Abdominal / Vaginal, Posterior Repair for Prolapse Operation,  Vaginal and Vulval Warts Removal, Gynecology cosmetic surgery procedures etc.

The cost comparison of few gynecology and obstetrics procedures between India and other western countries is as follows-

 

PROCEDURES 

Approximate cost Elsewhere-in USD 

Approximate cost in INDIA- in USD

1

Diagnostic Laparoscopy / Hysteroscopy

$ 1800

$ 360

2

Abcess - Pelvic

$ 1200

$ 240

3

Laparoscopic Colposuspension

$ 4950

$ 990

4

Bartholins Gland Marsupialisation

$ 4500

$ 900

5

Caesarean Section

$ 6000

$ 1200

6

Laparoscopic Sterilization

$ 3000

$ 600

7

Cone Biopsy of Cervix

$ 900

$ 180

8

Dilation and Curretage - D and C

$ 900

$ 180

9

Hysterectomy - Abdominal / Vaginal

$ 5250

$ 1050

10

Reversal of Sterilization

$ 6450

$ 1290

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Laparoscopic Sigmoid Colectomies

$ 6000

$ 1200