Successful healthcare delivery depends both on the availability of medical personnel and health technologies. Medical devices are an important cog in the healthcare delivery system. They equip health service providers with the necessary tools to perform their job of providing quality healthcare effectively. The Indian healthcare industry has grown significantly over the last decade. However, our health ecosystem is plagued by lack of availability and affordability of quality healthcare services. In fact, India lags behind the BRICs nations and a number of other developing countries in this regard. While technological advancements have expanded to encompass almost every stage of the healthcare continuum, accessibility and democratic availability remain a hurdle.

India faces a dual healthcare challenge as the rising burden of lifestyle diseases is added to the burden of communicable diseases such as Tuberculosis. Non-communicable diseases are currently responsible for 61 per cent of deaths in the country, a number that is only set to go up in the coming years. While both the government and private participants have undertaken several measures to address the lack of quality healthcare services, these efforts have been executed in discrete silos.

The importance of medical device manufacturers In the continuum of care

In this scenario, medical devices hold a key role in offering better screening, diagnosis and treatment of diseases along with restoration and monitoring of health indicators to boost prevention. While medical device manufacturers have mostly focused on improving the quality of care and life expectancy, we also need to increase the affordability of devices so that there is a large scale impact.

Testing and diagnosis – Technology has improved the complexity and accuracy of screening. Portable/point-of-care devices have made it possible to improve diagnostic mechanisms at the primary healthcare level, provide care at home and resulted in improved health outcomes and patient satisfaction. It has also improved the access to quality healthcare in underserved and remote regions, while also making it possible for patients to avail treatment outside traditional healthcare facilities.

Treatment and care – Technological advancements in surgical equipment have enabled doctors to treat highly complex and critical cases and reduce the length of extended hospital stays. It has increasingly made it possible to perform elective and complex surgeries such as knee replacement, bariatric surgery, pain management to be moved to short stay/outpatient surgery centres. For example, laparoscopic surgery procedures remarkably improve outcomes, reduce the length of hospital stays as well as costs of treatment.

Restoration – Rehabilitative centres and hospitals are making it easier for patients to recuperate and return to a relatively normal life with the help of advanced rehabilitative and assistive devices. Advancements in rehabilitative technology have also allowed people with disabilities to lead productive lives and fulfil their dreams.

Monitoring – Advancements in health screening devices have enabled patients to monitor their health condition at home, keeping a close track on all major health indicators. Furthermore, smart devices are being increasingly used to remotely monitor patients and diagnose life-threatening conditions early, reducing the need for hospital visits and bringing down the pressure on the over-burdened healthcare centres.

Need for a more congenial ecosystem for indigenous manufacturers

Medical technology is a significant contributor to the cost of healthcare delivery. According to conservative estimates, medical devices contribute to at least 30 per cent of the capital of setting up a secondary or tertiary care centre. Moreover, diagnostics and medical devices contribute to at least 20 per cent of the cost of medical services.

The medical devices sector plays a crucial role in improving access to healthcare in the country. Unfortunately, the ecosystem is not very conducive for the sector to drive affordability and accessibility. GST on devices currently stands at 12 per cent. On the other hand, customs duty is low. This tax policy negatively impacts indigenous production and supports imports, which is counter-intuitive to the Make in India initiative. The inverted duty structure favours the import of finished goods over raw material. Resultantly, the medical industry largely relies on imports and the local manufacturers produce products in the lower end of the value chain. Imports constitute 75 per cent of the industry sales of medical devices in the country. The government must consider revising its tax policy for devices to lower the GST while increasing the customs duty to help local manufacturers gain a larger share of the market. This will also help them manufacture products at more affordable costs.

The road ahead

With a changing regulatory and economic environment, the medical device sector is set to grow in the future, and there is a range of factors fueling it. Non-communicable diseases are estimated to be responsible for 75 per cent of deaths in the country by 2025, with an increasing number of people suffering from diabetes, heart disease and COPD. The geriatric population is also set to increase and would require a higher need for quality healthcare and medical devices, both at homes and health facilities.

Apart from devising a more congenial tax structure, India also needs to strengthen its regulatory mechanisms and quality testing procedures to ensure the highest standards of quality are met. According to news reports, the NITI Ayog has prepared a roadmap on ensuring better regulation of medical devices under which all devices – imported or locally manufactured – will have to be certified by the Central Drugs Standard Control Organization (CDSCO). While improving regulation is welcome, the authorities must ensure that the regulatory process remains smooth, hassle-free and fast.