Business snapshot of the healthcare sector in the month of January and February 2021

Medical innovations, technology and increased focus on wellness are driving the transformation in the healthcare sector at an unprecedented pace. 

In this blog, we are covering trends/key highlights in the healthcare sector in the month of January and February in terms of:

• Key investment and deals
• Sub vertical wise trends focused on:
• Healthcare delivery
• Diagnostics 
• Healthtech
• Medical devices and consumables
• Health Insurance
• Regulatory

Business snapshot of the healthcare sector in the month of January and February 2021

In the month of January and February, four key themes emerged in the healthcare sector: 

• Government increased its focus on healthcare, including wellness, disease surveillance and core infrastructure; public expenditure on healthcare likely to increase
• Government to work towards further augmenting our healthcare systems through a paradigm shift of policies and overarching programs like the Pradhan Mantri Jan Arogya Yojana and Aatmanirbhar Swasth Bharat Yojana
• Healthtech as a sector maintained high growth with huge investments in the past two months 
• Medical devices companies focused on need-based product development to increase reach in Tier-2/Tier-3 cities

Overall:

• India increased its annual healthcare budget for FY22 by 137% to US$30B (INR 2.2LCr) The Budget goes beyond direct allocations toward health and health systems to include other determinants of overall health and well-being such as nutrition and sanitation. A large part of the budget increase is because of an integrated focus on healthcare. Major contours of healthcare budget are as follows: 
• US$9.5B for the health and family welfare sector (9.7% increase over FY21)
• US$8.5B has been earmarked under “PM Atmanirbhar Swasth Bharat Yojana” to upgrade healthcare infrastructure at a primary, secondary and tertiary level over a period of six years
• US$ 4.8B for the rollout of COVID vaccines
• Government increased its focus on core public health functions like disease surveillance, testing, etc. across subcentres, primary health centres (PHCs), community health centres (CHCs) as mentioned in the report launched by the Finance Commission of India
• Economic survey of 2021, highlighted the need to increase the healthcare spend to 3% of India's GDP that comes up to be ~INR 4,03,200 Cr (GDP of India for FY20 is INR 134,40,000 Cr)

Key investments and deals: 

• Indegene raised US$ 200M from Carlyle, Brighton Park for a minority stake. Indegene wants to use it to expand its global presence and M&A activities
• Metropolis Healthcare acquired Hitech Diagnostic Centre in a cash (~US$ 70M) and stock combination deal
• MediBuddy, a digital healthcare platform raised US$ 40M in Series B funding led by India Life Sciences Fund III 
• MFine, a telemedicine and healthcare platform raised US$ 16M in a new financing round led by Heritas Capital
• Saveo Healthtech, a B2B e-commerce platform for pharmacies, raised US$ 4M in seed funding led by Matrix Partners India, RTP Global 
• Meddo, a tech-enabled clinic chain aggregator (that brings together all healthcare needs onto a single platform) raised US$ 3M in its extended Pre-Series A round led by Picus Capital and SRI capital
• Possible, a nutrition-based healthcare company raised around US$ 1M from Bollywood actor Aishwarya Rai Bachchan as part of its larger funding round
• Cure.fit acquired US-based Onyx, a fitness company focused on digital training experience, to accelerate its global expansion plans
• Phable, a Bengaluru-based healthtech platform focused on chronic disease management, raises US$ 12M Series A round funding
• Innovaccer raises Series D funding to become a unicorn company at a valuation of US$ 1.3B
• Investment of US$ 97.3M in production-linked incentive scheme in medical devices, which is expected to boost domestic manufacturing of medical devices and thus fulfilling the vision of Aatmanirbhar Bharat. Nine projects including those from Siemens Healthcare & Wipro GE Healthcare have been approved for the same

Sub-vertical wise key highlights of the month:

Healthcare delivery:

• Surgery volumes picked up, with elective surgery volumes reaching 80-85% of pre-COVID levels in January (as per the report on “Surgical volume market in India” by Praxis Global Alliance)
• Government has been de-notifying ICU bed capacity for private hospitals, releasing private capacity for other ailments
• Delhi govt. reduced the number of reserved COVID-19 ICU beds from 80% to 25%
• UP govt. denotified 241 out of 324 hospitals earmarked to treat COVID-19 cases in the state
• Kozhikode-based Meitra has launched a unique collaborative Phygital healthcare model called the Meitra Care Network. A host of healthcare professionals, doctors, public & private hospitals will join hands under the Meitra Care Network to make the best of healthcare services more accessible through technology
• The cumulative number of inoculation crossed 1.37 crore in India on the 42nd day of the COVID-19 vaccine drive
• Vaccine hesitancy in India has been dropping significantly; a nation-wide survey conducted by LocalCircles from January 16-18, found that the percentage of citizens willing to take the COVID-19 vaccine immediately has increased from 31% to 42% in a month
• 10K private hospitals are also allowed to sell vaccine shots at a fixed price
• Hospitals empanelled for state-run health insurance schemes will also be the vaccination centres in this phase of the vaccine drive

Diagnostics: 

• Diagnostics has also got an impetus under PM Atmanirbhar Swasth Bharat Yojana, a centrally sponsored scheme, which includes:
• Integrated public health labs being set-up in all districts and expansion of the Integrated Health Information Portal to all States/UTs to connect all public health labs
• Telangana Minister K.T. Rama Rao launched a diagnostics project under which 8 sample pooling points as mini hubs for diagnostic services have been set up to provide quality diagnostic and imaging services (ECG, Radiology etc) free of cost to the public
• Research and Innovation Circle of Hyderabad (RICH) extends its support to promising startups by announcing Acceleration Initiative for Diagnostics (AID) which would help promising startups and entrepreneurs to fast track their diagnostics products to reach the market

Healthtech:

• Home healthcare has been a preferred way of care during COVID-19 and it continued to pick-up in the month of January. The year 2021 will see a shift of other forms of non-COVID treatments in home environment
• Healthtech companies have increased their focus towards creating integrated care ecosystems to cater end-to-end healthcare needs of patients by providing primary and secondary care
• SS Innovations, a Medtech startup unveils robotic surgical system specializing in cardiac surgeries
• Startups like Dozee has been working for technology adoption even in government hospitals in tier 2 and tier 3 cities of India
• Innovaccer has announced to launch the Innovaccer Health Cloud. It will allow customers and partners to develop interoperable applications that improve patient engagement and operational performance. The aim to build this platform is to digitize and power the future of health 
• E-pharmacy space experienced rise in demand for online medicine delivery, hence the companies are aggressively looking to hire across all levels and functions, we will see a 20% rise in the hiring by startups

Medical device and consumables: 

• Global players are trying to increase their penetration in Tier 2 and Tier 3 cities by entering into value product segments. The challenge is to make affordable standard medical devices available to everyone buying them from across India, irrespective of their economic status.
• Further, global and domestic players are looking forward to enhance their digital maturity through digital customer acquisition, e-commerce enablement for their distributors, digital marketing for distributors/partners, etc.
• Tamil Nadu proposes to setup bulk drug and medical devices parks as a step towards fulfilment of prime minister’s vision of an Aatmanirbhar Bharat.

Health Insurance:

• The year 2020 was tough for the insurance industry but it also helped to reinvent itself like never before, procedures in health insurance were digitalized
• In the recent budget announcement, FDI limit in insurance has been hiked to 74% from 49%, opening up the way for foreign investment and M&A activity in the sector
• The Insurance Regulatory and Development Authority of India (IRDAI) has released a bill for standardization of health insurance, in which insurers were permitted to change base premium by up to +/- 5%
• Standardization of insurance products enabled the insurers to launch products with uniform features (making the policies simple to understand and easily comparable) e.g. Arogya Sanjeevani, policies for covid-19 (Corona Rakshak and Corona Kavach), etc.
• Annual budget unveiled in the month of February and lifted caps on foreigners investing in its vast insurance market
• Aditya Birla Health Insurance Company Ltd. (ABHICL) announced an industry-first initiative of up to 100 per cent health insurance premium returns and other significant product offering upgrades. Company is offering up to 100 per cent premium returns, i.e. HealthReturns^TM, rewards and up to 100 per cent reload of Sum Insured through its enhanced version of 'Activ Health' policy
• Navi General Insurance launches 2-minutes online health insurance via Navi Health app
• Customers can buy health insurance via the Navi Health Insurance app through a quick and completely paperless process that takes just 2 minutes, with the policy issued to them instantly on the app

Regulatory:

• National Digital Health Mission (NDHM) got accepted and passed in the month of January, under this every citizen will get a health card,
• This card will contain previous health data of the patient and will be accessible to the doctors on a permission basis and not all the time due to data privacy
• This is an effort from the government to connect the healthtech ecosystem into one platform seamlessly
• The Union Finance Minister Nirmala Sitharaman, announced a centrally sponsored scheme- Pradhan Mantri Aatmanirbhar Swasth Bharat Yojana under Union Budget 2021
• PM Aatmanirbhar Swasth Bharat Yojana aims at developing the capacities of the primary, secondary, and tertiary health sector
• The scheme will focus on strengthening the existing national institutions as well as create new institutions for detecting and curing new and emerging diseases. It will be an addition to NHM- National Health Mission
• The scheme will provide support for 17,788 rural and 11,024 Urban health and wellness centres
• Establishing integrated public health labs in all the districts and setting up 3,382 public health units in 11 states
• Setting up critical care hospital blocks in 12 central institutions and 602 districts
• Strengthening the National Centre for Disease Control, its 5 regional branches as well as 20 metropolitan health surveillance units
• The scheme will expand the Integrated Health Information Portal to all the UTs and states to connect all public health labs
• It will work on the operationalization of the 17 new Public Health Units. The scheme will also strengthen 33 existing Public Health Units at the Points of entry, that is at 11 seaports, 32 airports, and 7 land crossings
• Establishing 2 mobile hospitals and 15 Health Emergency Operation Centres
• Establishment of a national institution for One Health, a Regional Research Platform for Southeast Asia Region of WHO, 4 regional National Institutes for Virology, and 9 Bio-Safety Level III laboratories

Conclusion

Healthcare attracted immediate actions, and Government-aligned to this by giving attention to this sector. This resulted in an increase in the total budget and % GDP spend for healthcare in India. Past two months saw health insurance companies innovating their products to keep up with the growing technology and market demand. Schemes like PM Atmanirbhar Swasth Bharat Yojana were also launched with the aim to help in growth and adoption of remote healthcare. NDHM was also accepted which will help in connecting the Healthtech ecosystem seamlessly into one platform for the public. Preventive healthcare became a priority for everyone, which is substantiated by the fact that vaccine hesitancy dropped significantly in the past two months (over 137M people got vaccinated in a span of just 42 days of the vaccine drive). Increased focus towards one’s health will continue to be the priority in the coming months as well. 

Authored by

Aryaman Tandon, Practice Leader, Healthcare, Praxis Global Alliance

Shashikant Chaurasia, Vice President, Healthcare, Praxis Global Alliance