In these turbulent times, the [Indian] pharma sector has shown comparative resilience and has been relatively less impacted. There are two reasons for this: the domestic pharma market continues to experience healthy growth and the demand for generic (a biological equivalent of an originator pharmaceutical product) medicines is on the rise in international markets.
In one of the biggest cross-border deals in the education space, Manipal Education has acquired the entire shareholding of American
from New York-based Greater Caribbean Learning Resources. Manipal Education confirmed the buyout, but did not disclose the transaction size. However, sources said the company has raised $115 million debt financing from ICICI Bank in recent weeks, which will be ploughed into the buyout as well as capex requirements for ramping up the campus.
ET first reported on the potential acquisition in its edition dated October 7. The Caribbean is a well-established market for medical students
from the US mainland, where the availability of seats far outstrips demand. “We have completed the buyout, giving us control over AUA, which is among the top five medical education campuses in the Caribbean islands along with St George’s University School of Medicine
and Ross University,” Anand Sudarshan, MD & CEO, Manipal Education, told ET.
Technorati Tags: education, nearshoring, med school, India, Caribbean
- Comarow On Quality (usnews.com)
In January, Serigraph Inc., a West Bend, Wis., manufacturer, will become the first U.S. company of any size to embrace medical travel or medical tourism, offering employees the option of having certain nonemergency operations, such as joint replacement, in India. The company will pay all expenses, including travel and lodging for a companion. The incentive for employees is that they don’t have to pay a deductible—typically $1,000 to $5,000—or the hospital copay, which would be 10 percent to 20 percent of the charges.Last May, I went to India and Singapore to explore the trend of growing numbers of under- and uninsured Americans heading to both places and other foreign climes to take advantage of package prices for hip replacement, heart valve repair, spinal surgery, and other elective procedures that can be 80 percent less than the sums charged by U.S. hospitals. To cite one expensive example, heart bypass surgery can easily run up a $70,000 to $133,000 bill at a U.S. center, compared with an average of $7,000 at Indian hospitals catering to westerners. An uninsured patient I interviewed extensively in India paid a total of about $25,000 to have both hips and one knee replaced, including airfare and incidentals. He easily could have paid more than $125,000 at a U.S. hospital. And there are plenty of similar cases of huge price differences.
Technorati Tags: medical tourism
The Cost of a Long Life
November 12th, 2008 Posted in Caribbean, Health and Pharma, India, Latin America, Public Policy, Visualizations
Compelling graphic that demonstrates that throwing more money at problems does not always ensure better outcomes.
Life Expectancy around the world
The chart highlights the sharp contrast between the US and Cuba. With a life expectancy of 76.9 years, Cuba ranks 28th in the world, just behind the US. However, its spending per person on health care is one of the lowest in the world, at $186, or about 1/25 the spending of the United States. There are other cases where high life expectancies are achieved with low spending on health care.
Another reason some countries achieve high life expectancy with low health spending is that clean drinking water and preventive health care can be provided with little spending. If there is near universal clean water and preventive care, life expectancy rates can be high. In the US, however, nearly 40 million Americans lack basic health insurance, and are therefore less likely to receive preventive care. In contrast, Cuba has universal health care and one of the highest doctor-to-patient ratios in the world (See Physicians). Although Cuba has limited resources and many economic problems, it has made health care a priority. It is not alone. Sri Lanka, China and the Indian State of Kerala are considered “low-income, high well-being” countries, which have adopted policies that not only reduce inequality but also increase overall health and well-being.
Money spent at hospitals and doctors counts towards ‘economic growth’, by getting included in GDP stats, but is terrible as an indicator for human well-being.
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Implementation of this ‘health city’ idea is long overdue. With 46 million Americans without health insurance, and increasing number of them retiring baby boomers with insufficient or no insurance coverage due to preexisting medical conditions, it is only logical that the medical tourism and overseas living trend will accelerate for older Americans in the years to come. Besides health care facilities in Mexico, Central America and the Caribbean, full-fledged retirement villages can be built by Indian companies to cater to retiring Americans with lifetime savings under $200,000 and monthly pensions under $1500.
The Economic Times
Indian hospital major Narayana Hrudayalaya plans to set up a health city in Mexico that will also cater to patients from the US. “Our next project will be a health city in Mexico. We may tie up with some American hospitals for this project,” said Devi Shetty, eminent cardiologist and chairman of the Narayana Hrudayalaya group of hospitals.“The health city in Mexico will be a 3,000 to 5,000-bed facility and we are looking for joint ventures,” he said adding that the government of Mexico had requested the group to set up a large health facility.
Sources said the health city would come up either in Mexico City, the capital of Mexico or at Guadalajara, the second largest city in Mexico. Shetty said the proposed health city would also cater to the requirements of patients from America.
“We foresee healthcare delivery problems in the United States. They also have problems in undertaking a 20-hour journey to India for heart and other surgeries. As Mexico is closer to America, they will find it easy to undergo treatment there,” he said.
Technorati Tags: medical tourism
[M]ore than 490 million people (about 70 percent of the Indian population) live in rural and semi-urban areas. They are difficult to reach, especially in a country where doctors are scarce (the ratio of physicians to total population is less than one per 100,000 people, compared with about one per 160 in the United States). World-class facilities are even scarcer. Rural patients must often travel to cities for treatment, a journey of excessive cost since their family members travel with them. These constraints affect the nature of health care in unexpected ways. For example, in the United States, a customized lower-limb prosthetic may require several fittings spread over weeks. In India, it must be finished in one eight-hour sitting, so the patient and his or her family can return home before their money runs out.And yet amid all these constraints, a few health-care providers in India are establishing new global standards for cost, quality, and delivery. They do it by bypassing the conventional approaches to medical practice. For example, the Narayana Hrudayalaya cardiac care center, located in Bangalore, is one of the world’s largest providers of heart surgery and other forms of cardiac care, including care for children. A private corporation, it was founded in 2001. Only three years later, in 2004, the company performed 7,500 cardiac surgeries and treated 60,000 outpatients, including almost 2,000 telemedicine patients who received consultation and treatment at remote sites, accessing specialists through satellite- and Internet-based telecommunications links. NH makes no distinction among the quality of service delivered to different patients. Everyone is charged a fixed rate per surgery of $1,500 — one-thirtieth the $45,000 that a typical U.S. hospital might charge, and one-third of the $4,500 that a top-line hospital in India would charge.
It’s important to note that the facility and its parent company, Narayana Hrudayalaya (NH), are profitable. And NH’s cardiac care is far from the only profitable health-care innovation emerging from India. The most famous example (documented at length in my book The Fortune at the Bottom of the Pyramid) is the “Jaipur Foot,” a prosthetic foot made from rubber, intended for below-the-knee amputees, such as people injured by accidents and land mines. The JF (as it is universally called) costs about $30, a fraction of the $8,000 to $10,000 cost of a similar Western prosthesis; if a patient damages, loses, or outgrows it, he or she can simply get a new one. Since 1975, the JF has been distributed by a nonprofit, nondenominational organization called the Bhagwan Mahaveer Viklang Sahayata Samiti (BMVSS), which fits about 16,000 patients per year, with trained paramedics as the primary patient contact. BMVSS also ships artificial feet, calipers, and other aids to thousands of patients worldwide — more than 50,000 in 2004. BMVSS does not charge for its prosthetics and service; it survives on donations from satisfied patients and from philanthropists.
Another example is the Aravind Eye Care system, the world’s largest provider of cataract surgery. This company, founded in 1976, performed 240,000 surgeries in 2004 and treated 1.6 million outpatients. The founder, Dr. G. Venkataswamy, has said that his goal is to “wipe out needless blindness.” Thus, Aravind treats more than 60 percent of its patients free — and continues to operate profitably.
All three health-care innovators, NH, BMVSS, and Aravind, have been around long enough to give us confidence that these innovative health-care efforts represent sustainable businesses.
Technorati Tags: innovation, health care, india
Healthcare software provider iSoft on Thursday said that its Indian R&D team is developing a solution what it described as the world’s largest civilian IT healthcare project.The Lorenzo software application, which will link nearly two-thirds of the hospitals in the United Kingdom, will also be launched in Europe, Australia and Germany in November, iSoft executive chairman & CEO Gary Cohen said at the opening of the company’s global product development centre here.
iSoft was acquired by Australia’s IBA Health Group in 2007. Hospitals will also be connected to general practitioners, allowing patients in the UK to get themselves treated at any clinic in the country without the need for re-entering data. The solution can be extended to any part of the world, managing director S Govind said.
“The entire solution, which is for linking up all the hospitals as well operations with the hospitals is being developed and rolled out from the India development centre,” he observed.
The company is also installing solutions for the Medicity group in Gurgaon and is targetting adding 100 hospitals to its list of clients next year.
iSoft, which has 1,800 employees at its Bangalore and Chennai facilities, will hire 200 more by next year. It has grown by 50% in the last 12 months. About four-fifths of iSoft’s $500-million revenue in 2007-08 came from Europe, while Asia, Australia and New Zealand accounted for the rest.
Technorati Tags: health care, technology
Bilcare conquering new frontiers
September 22nd, 2008 Posted in Health and Pharma, India, Latin America, Profile - Individual/Company
Bilcare is one such company, which provides integrated solutions to pharma companies globally.BUSINESS:
Bilcare provides packaging products and clinical research services to pharma companies in India and abroad. It has a global footprint with operations in the US, UK, Germany, Singapore and Brazil. The company has two major business divisions — pharma packaging innovation (PPI), which contributes 83% to its total revenues, and global clinical services (GCS), which accounts for the balance part of its revenue.Under the PPI division, Bilcare quantifies the sensitivity of drugs and accordingly devises their packaging solutions. The GCS division is a faster growing high-margin business, which provides services like formulation of clinical trials, toxicology studies, batch manufacturing and randomisation.
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During a visit to India last month, I accompanied my mother to Apollo hospital in Chennai for some minor plastic surgery. This was to stitch up a ruptured ear piercing. From seeing a doctor to getting the required surgery and coming home took about 1.5 hours and cost $125. Incredible! I’ve spent more time and money on a restaurant meal. A nice touch was the morning devotional/moment of silence to wish for the speedy recovery of patients and well-being of their families.
Corporate News – livemint.com
A new study from Duke University says Indian hospitals’ innovative practices could offer valuable lessons to US policymakers and hospitals in providing low-cost and high-quality patient care.
In the study, titled “Lessons from India in Organizational Innovation”, published in the 10 September issue of Health Affairs, Duke University researchers say that while innovations are noticeable in areas such as customer service, labour practices and manufacturing in Indian hospitals, they all also reflect new organizational practices and market-oriented strategies.“Indian accomplishments thus offer lessons both on how to innovate and, more significantly, how to organize a marketplace that will foster valuable innovations,” he says.
Apollo Hospitals Group chairman Prathap C. Reddy is happy that Indian hospitals’ achievements are “finally ringing in people’s ears”. He says the achievements are a result of innovation in human efficiency, clinical care and quality management of large scale operations.
It is significant that an Indian example is being cited for the required US health care reforms as the two nations are stark opposites on this front. The size of India’s entire health sector is estimated at $20 billion (Rs90,240 crore), while the US health care sector is worth $2.3 trillion; at least 80% of the Indian health sector hinges on private resources, whereas state resources dominate the US sector, according to the study.
much of India’s success has come from its development, and constant improvement, of organizational structures.
This contrasts with the US health sector which, researchers say, “has been strikingly ossified” and has either excluded the new entrants or “crippled realistic challenges” posed by newcomers with innovative organizational forms.The authors closely studied two hospital groups in India—Hyderabad-based Care Hospitals and New Delhi-based Fortis Hospitals. They found that the application of management practices from the hotel industry helps Fortis and others tailor care according to patients’ expectations, resulting in a more focused approach than that at many US hospitals.Commercialization of local technology and “self-manufacturing” (hospitals making their own equipment)—which the authors of the study found interesting in Relisys Medical Devices Ltd, part of the Care group—is also practised at other places in India, including Aravind Eye Care System in Madurai, Tamil Nadu.While skilled labour is indeed at the centre of innovations such as lowering the cardiac surgery cost from $100,000 in the US to $2,000-6,000 in India, hospitals here are beginning to innovate on the technological front, says Vishal Bali, chief executive of the Wockhardt group of hospitals.Conscious, or awake, heart surgeries, pioneered at Wockhardt in Bangalore, are now being promoted at other group hospitals. Conscious heart surgeries reduce the length of stay in the intensive care unit as the patient is not on any life-support system. This, while lowering the cost of hospital stay, also expedites post-operative recovery and now constitutes 25-30% of Wockhardt’s heart surgeries, adds Bali.Apollo’s Dr Reddy says India can innovate further in providing medical evidence to oriental systems of medicine and integrating it with traditional hospital care.“In India, hospitals are mostly run by doctors and they hire the administrators. In the US, the administrators hire the doctors,” says Dr Shetty. “I think in 10 years, Indian hospitals will manage the Western hospitals. The writing is on the wall.”It is a scenario which the authors of the study have already visualized. “The US health sector, however, may soon resemble other innovation-intensive industries in one important respect: it may find its industry leaders displaced by Indian offerings,” the study says.
Technorati Tags: health care innovation
Indian hospital groups like Apollo, Fortis and Wockhardt should takeover hospitals in Latin America to increase outreach to US patients.
BLOG.THEMEDICALROADSHOW.COM:
Americans are living longer than ever before, but at the same time they’re facing challenges presented by out-of-control medical costs and inadequate health insurance. Increasing numbers of U.S. citizens are traveling abroad to avail themselves of Asian and Latin American hospitals and medical centers, for treatments that range from something as simple as getting your teeth whitened, to procedures as major as hip replacement surgery.
According to the most recent census data, 47 million Americans have no health insurance, and 120 million are under-insured. The Commonwealth Fund, a New York-based healthcare research organization, recently issued a report saying nearly half the working-age population of the U.S. risks being financially devastated if confronted with the need to pay for major surgery, either because they have no insurance or inadequate insurance.
Medical Destinations
Some of the major players in this niche in Asia are India, Malaysia, Singapore, Thailand and the Philippines, while destinations in Latin America that are attracting a major share of the market include Argentina, Brazil, Costa Rica, Mexico and Panama.The India Tourist Board reports that approximately 500,000 medical tourists go to Asia annually. Of this number, India receives 200,000. Medical tourism to India has been growing at 30 percent a year for the past three years, and experts estimate that, by 2012, medical tourism will be a $1 billion industry in India. Presently, the lion’s share of medical tourists traveling to India come from the Middle East, although the U.S. accounts for 10 to 15 percent of the total. It’s clear that it’s a cost-driven decision for many patients. For example, heart surgery can cost $60,000 in the U.S., but might cost $8,000 in India. When you add travel for two, and perhaps a recuperative or holiday stay, you’re still paying a fraction of what the cost would be in the U.S.
“Latin America and Mexico are extremely popular among U.S.
tourists for this form of travel simply because these regions are so close to
the U.S. border and therefore have many doctors that are U.S. certified,” says Willie Moreno, director of operations and registration for the Latin America
division of
Links:
Vacation, Adventure and Surgery
