Globally healthcare is on a high growth trajectory, with strong emphasis on the Asian and Middle East markets. In 2005, the global healthcare market was valued at over US $6.68 trillion and is growing at rate of 7.5 per cent, which is much higher than the global gross domestic product (GDP) growth. It is estimated that Asia currently constitutes around 34 per cent of the healthcare market. This figure is expected to increase to about 45 per cent by 2008 and projects opportunities for the Indian health care in the global pharmaceutical and diagnostic markets.
Indian diagnostics
Needless to say, Indian diagnostics, in the present scenario, will play an important role in shaping future of healthcare industry in the country. Approximately 70 per cent of treatment decisions are based on pathology results, emphasising the importance of accurate diagnostics. The Indian pathology sector, driven by price and service, is about $1 billion dollars and constitutes 2.5 per cent of the overall healthcare delivery market. It is growing at the rate of 15 per cent per year in the healthcare industry. Currently there around 40,000 labs in India, however there is a glaring apathetic attitude towards regulations and accreditations. A dismal 59 out of the 40,000 labs are accredited which is less than 1 per cent of the total labs. Out of this only 14 laboratories have CAP accreditation and over 45 laboratories have NABL accreditation. Moreover, out of the total labs, 10 per cent are inside hospitals, and only 5 have national pathology lab chains, including Metropolis across the country.
Current trends
Healthcare service providers like Metropolis Health Services provide service at international accreditation standards. The diagnostic sector has emerged as a multidisciplinary super specialty in its own right with requirement of specialists in specific areas. With the advent of modernisation of healthcare technology there is also an availability of large knowledge pool in India. The reliability and versatility of laboratory medicine has changed from "opinion based" medical care to "evidence based" medicine. There is a constant evolution of emerging branches under laboratory discipline - for example molecular pathology and molecular genetics. Integration of IT services in laboratory medicine and radiology has also made a great difference in the country.
Health care service providers are also seeing the importance of proper patient and clinician education. Preventive care is increasingly gaining acceptance as the world is growing to wellness concept. Cost-effective services have made laboratory services and radiology tools affordable. However, there is a prominent vacuum in terms of networking of diagnostic centre chains and their inherent lack of size - the top five companies comprise less than 10 per cent of revenue of the total market. Lack of health insurance causes restriction of the number of random health tests. There is a pathetic lack of regulations. If one would want to set up a diagnostic centre, there are no mandatory registrations, infrastructure norms and accreditation or qualification requirements for clinical laboratories to vouch for the authenticity of the centre.
Future
To a large extent, Indian diagnostic centres are also dependent on developed countries for quality machines and reagents. Even after all the outsourcing there is still inadequate automation and improper use of IT systems. There are numerous opportunities for the pathology sector, as India has emerged as a preferred global R&D hub. Organised players are getting consolidated and the health insurance industry is opening for privatisation. Diagnostic centres are now harbouring advanced laboratory techniques like molecular diagnostics, nanotechnology and multiplex assays using microarrays to provide better diagnosis. There is complete automation covering various laboratory segments from pre-analytics to final reporting. Healthcare has reached home with non invasive glucose monitoring and point of care testing.
Comprehensive range of tools and reliability has helped easy diagnosis. Telepathology and teleradiology are getting recognised as specialised areas of medicine rather than "support areas". Pathology industry has centralised its focus on "brands" and its convergence of with the radiology services will culminate into service of prognosis monitoring based on radiology / lab results.
There is an inherent need for an Indian pathology industry which can influence the government, provide improved standards of testing and better profit margins to be recognised like IT/ pharma around the world. The pathology industry is set to have a pan India network, providing diagnostic services to different types of customers - patients, doctors, insurance, corporate and also rural India where treatment is a priority.
(Courtesy: CII and Cygnus Research Reports)