IndiaMedToday Dec 2018

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INTERVIEW IAN YOUNGMAN, UK

ARTIFICIAL INTELLIGENCE IN RADIOLOGY SYMPOSIUM SPECIAL FEATURE DEEPAK PAWAR, FICCI DALIP KUMAR CHOPRA

India’s Next Crown Jewel

MEDICAL TOURISM

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The Sunshine Industry MEDICAL TOURISM is one of the most dynamically growing industries today. Considered to be the direct impact of globalisation of healthcare, medical tourism certainly exhibits strong growth potential globally. Given India’s potential to provide both modern and traditional treatment in world-class settings at affordable costs, the value of medical tourism in India is estimated to rise to about $7-8 billion by 2020 from about $3 billion currently. Medical excellence along with international accreditation are the key factors fuelling a majority of international patient flow, eventually boosting international medical tourism.

India has the ability and opportunity to strengthen its position as a popular medical care destination, not just for value treatment but also for those with the ability to spend. We do have a sizable healthcare professional population in India. This can be leveraged to attract medical value travellers. India has 1.2 million doctors registered with the Medical Council of India and another 0.8 million doctors practicing traditional medicine such as ayurveda, unani, siddha and homoeopathy.We have 0.17 million dental surgeons. There are nearly two million registered nurses and midwives and nearly a million auxiliary nurses and midwives.

The value of medical tourism in India is estimated to rise to about $7-8 billion by 2020 from about $3 billion currentl.

With almost 5 to 6 million tourists coming to India, a simplified visa system would have a positive effect on forex earnings.Stringent documentation processes, issues related to visa approval, and limited insurance coverage are reportedly some of the most daunting factors for the detrimental growth of this segment. We must look at medical tourism as a start-up sunshine industry and facilitate the providers and entrepreneurs. Technology should bring the next wave of change for medical tourism industry..

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CONTENTS

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Twitter Facebook Linkedin

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UPFRONT 03 Editorial 06 Letters 07 News roundup 41 Event Report

INTERVIEW

India’s Next Crown Jewel MEDICAL TOURISM

Ian Youngman, UK Manish Chandra, Co-founder, Vaidam.com

SPECIAL FEATURE

SHOWCASE

COVER STORY

Insurance & Medical Value Travel Key to MVT Success

BR Life

26

A new dawn in the healthcare industry of India

Sahyadri

Opening Doors to Newer Possibilities

SHARP SIGHT GROUP of Eye Hospitals Magnus Medi

16 4

December 2018

MedTravels

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LETTERS

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t was a proud and nostalgic moment for us as our flagship Chennai hospital recently celebratedits 35th anniversary. We always had a long-term vision to nurture it into a world-class healthcareinstitution and have certainly come a long way. From a single institution in 1983 we are todaypresent in 69 locations, offering solutions across the healthcare spectrum from primary care inclinics to high-acuity care at hospitals supported by pharmacies and health insurance. The roadahead is even more exciting for us, as we will continue to leverage on global advances inmedical technology, digital health & support and consumer preferences for new formats, ratherthan choosing to rest on past achievements. We will also strongly pursue our focus onpreventive health.

Dr. Prathap C Reddy, Chairman, Apollo Hospitals Enterprise Ltd. (AHEL)

Cervical cancers are caused by infections with oncogenic HPV types. We have long used cytology to detect the precancerous lesions caused by HPV, which can then be treated before they ever progress to cervical cancer. While cytology screening has reduced the number of women who get cervical cancer, it is far from perfect because it does not always detect the precancerous lesions which develop into cancer. We have known for some time that directly screening instead for the HPV types that cause cervical cancer performs just as well if not better than cytology for screening in women below the age of 60. What was not known was whether an older woman who is HPV negative could just as safely stop screening as an older woman who tests cytology negative.

Dr Talia Malagon, Mc Gill University, Canada

UNNATI is a model forco-innovation allowing industry, startups and the civil society to jointly develop solutionsaddressing global social needs. This challenge calls for collaboration to implement early- andremote screening as well as efficient, AI-based patient management.

This is an important taskas we see the prevalence of non-communicable diseases rise globally. We are happy to partnerwith AstraZeneca India, AGNIi and Atal Innovation Mission – NITI Aayog, with a shared vision ofproviding affordable and accessible healthcare.

Carsten Grönblad, Swedish Trade Commissioner to India

diabetes in India, it is important to promote timely detection and management of the disease. Health check initiatives help in creating awareness and promoting a holistic approach towards a healthier lifestyle.

Amitesh Kumar, Joint Commissioner of Police (Traffic) Mumbai

The rise of smart devices and smart apps have made self-management of diabetes affordable. It will enable patients to be able to monitor their blood glucose levels regularly and enhance efforts towards keeping diabetes under control. This is especially important in a nation such as India which has limited doctor bandwidth, low observance to care protocols and poor access to blood glucose monitoring.

Rahul Kedia, Ad-Interim General Manager, Roche Diabetes Care India

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We want to make health a top priority for our men. Our men live a very hectic lifestyle and we want to make sure that their health is being monitored on a regular basis. Given the prevalence of

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CEO’S PERSPECTIVE DR. HARISH PILLAI, CEO – ASTER HOSPITALS & CLINICS INNOVATE PROTEMBO CEREBRAL PROTECTION SYSTEM

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HEALTHCARE INNOVATION: WHERE IS IT GOING SUNIL THAKUR, MANAGING DIRECTOR, QUADRIA CAPITAL ADVISORS

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WILL THE NEW PMA POLICY NEGATIVELY IMPACT INDIAN DEVICE MANUFACTURERS?

Lack of standardisation, fragmented training landscape and distrust relation among doctors

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15 INNOVATIONS CHANGING THE MANAGEMENT OF CARDIOVASCULAR DISEASES

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OCTOBER 2018

HOW SWITZERLAND IS LEADING INNOVATION GOING FORWARD

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NEWS ROUNDUP 1ST INTERNATIONAL PROTON THERAPY COURSE AT APOLLO Over 400 delegates from across India and Asia gathered at the 1st International PROTON Therapy Educational Programmeorganized jointly by Particle Therapy Cooperative Group (PTCOG) and Apollo Proton Cancer Centre (APCC).

Proton Therapy is the most advanced and targeted cancer treatment due to its superior dose distribution and minimal side effects that helps treat cancer more effectively and efficiently. The two day long comprehensive interactive scientific programme saw specialists from Austria, Denmark, India, Sweden, Switzerland and the US sharing their knowledge on various aspects of Proton therapy technology and treatment, to give a comprehensive overview of the application in clinical practice. The prestigious conference saw the Health Ministers from South Africa, Oman, Yemen and Sri Lanka in attendance.

Inaugurated by Dr. Motosoahae Thomas Thabane, Hon. Prime Minister of Lesotho , the conference included plenary talks from internationally recognized experts in Proton Therapy, and value adding educational sessions providing a comprehensive overview of the technology and clinical practices related to particle therapy from its origin to current day modern technologies. The highlight was

a tour of the soon-to-be-launched state-ofthe-art Apollo Proton Cancer Centre that had the delegates expressing their appreciation of the modern comprehensive facilities for organ specific cancer management.

Dr Preetha Reddy, Vice Chairperson, Apollo Hospitals said, “The 1st International PROTON Therapy Educational Programme will help physicians and oncologists understand the potential of this new technology to treat cancer. With the cancer burden in India increasing day by day, we are glad to be at the forefront in taking up the challenge of providing the best treatment option available in the world. In continuation of this legacy, we are launching this Proton therapy facility, which will be the first in South East Asia and a major milestone in our concerted focus to battle and conquer cancer.”

INDIA’S TRANSLUMINA BECOMES FIRST COMPANY IN THE WORLD TO PRESENT 10-YEAR SAFETY DATA OF DES Proving to be a major boost for the Indian medical device manufacturing industry, which is majorly dominated by US multinationals, a leading Indian producer Translumina Therapeutics LLP achieves a special feat of

Dr. Sebastian Kufnerat, Gurmit Singh Chugh, Managing Director, Translumina Therapeutics

becoming the first company in the world to demonstrate a 10-year patient safety and efficacy data of its drug eluting stent (DES) Yukon Choice PC. This is for the first time that a decade long research data has been presented for the efficacy and safety of DES since its launch in 2001, as no other research has published data of more than 5 years.

The research findings of a randomized control trial called ISAR-TEST 4 were presented by leading cardiac expert from Germany, Dr. Sebastian Kufnerat the prestigious 2018 American Heart Association Scientific Sessions at Chicago, Illinois, United States, today in the presence of leading cardiologists from all over the world.

“It was a privilege for me to present the first long-term data of Yukon Choice PC DES of 10 years efficacy and safety. This will not only prove the efficacy and safety of DES for long term, but also gives boost for the long-term success of the procedure of angioplasty after the launch of DES”, said Dr Sebastian Kufner, Associate Professor of Cardiology, German Heart Centre, Munich, Germany.

The data demonstrated that at 10 years, both Indian made ‘Yukon Choice PC’ and much used USFDA approved ‘Xience’ stents showed significantly better results than the Cypher stent regarding major adverse cardiac events, with a risk reduction of 18% and 21% and mortality risk reduction of 18% and 22%, respectively. There were no significant differences between Yukon Choice PC and Xience stents regarding these outcomes.

However, Yukon Choice PC showed the lowest rate of definite or probable stent thrombosis with a significant risk reduction than the ‘Cypher’ stent (50% reduction) and even a numerically lower rate as than the ‘Xience’ stent (29% reduction).The significance of this data has been further acknowledged by one of the most respected journals of cardiology, ‘Circulation’ that published it in its exclusive ahead-of-print online edition simultaneously.

Gurmit Singh Chugh, Managing Director, Translumina Therapeutics, who was present during the data presentation, was very excited with results and its presentation at this

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NEWS ROUNDUP prestigious forum. He stated “We are excited with this first long term data which is a new milestone and a benchmark for efficacy and safety of DES Worldwide. Yukon Choice PC showing the lowest Stent thrombosis rates compared to Xience and Cypher at 10 years creates a strong testimony that this technology is truly next generation in terms of safety.Prof Adnan Kastrati, Principal Investigator of ISAR Test 4 and the Director of Cardiac Cath Lab at German Heart Centre, Munich stated “The 10year results achieved in this trial with newgeneration DES provide a strong argument against still existing concerns about the longterm safety of DES”.

He elaborated that Yukon Choice PC uses a unique technology consisting in the combination of special surface modification and low polymeric load for controlled and optimal release kinetics of an anti-proliferative drug. The excellent results are a confirmation of the great and durable performance of this device.

Yukon Choice PC stents are manufactured at the Dehradun facility of Translumina Therapeutics, which holds around 15 per cent share of the Rs 1,500 crore stents market in India. The trial ISAR-TEST 4 compared Yukon Choice PC against Xience (manufactured by Abbott Vascular, USA) in 2603 patients in Germany for a follow-up period of 10 years.

It is interesting to note that National Pharmaceutical Pricing Authority (NPPA) had put an upper ceiling of MRP in Feb 2017 by slashing the MRP of DES by over 70%. This move proved to be extremely beneficial for domestic manufacturers to make their high end technologies available to the hospitals at a time when multinational players were withdrawing their DES citing unaffordability.

Translumina Therapeutics emerged a stronger player post price ceiling as it offered high quality and proven DES at the ceiling prices.

The DES market in the World was dominated by US multinationals for more than 15 years since the launch of DES. Most of the pivotal randomized trials of DES had a maximum follow-up for up to 5 years. With more young patients getting CAD, cardiologists from all over the world were anxious to get

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December 2018

some insights on the long-term performance of the new generation DES in terms of efficacy and safety.

“The long-term data from the ISAR-TEST 4 trial shall not only increase the confidence of Cardiologists on these new generation DES but shall also reassure patients who have received these DES for the treatment of coronary artery disease. I am pleased that one of these technologies is coming from India which shall create immense positivity and high acceptance for Indian manufactured DES world over” said Dr. Robert Byrne, Deputy Director of Cardiology at German Heart Center and Senior Author of the presented study

ROCHE TO OFFER AI BASED DIGITAL DIABETES COACHING Roche announced its partnership with the digital health company Wellthy Therapeutics to offer users of the Accu-Chek Active system an innovative artificial intelligence-based digital diabetes coaching solution. Being a leader in diabetes management solutions worldwide, Roche will expand its integrated diabetes management offering through the collaboration with Wellthy Therapeutics.

The joint offering of the two companies will encompass the trusted Accu-Chek Active blood glucose meter and the Wellthy Care app to new users. The bundle is being launched in the South and West Zones of India.

Speaking about the partnership, Rahul Kedia, Ad-Interim General Manager, Roche Diabetes Care India said, “India is home to the second largest number of people living with diabetes in the world, numbering about 73 million in 2017 as per the International Diabetes Federation. The figure is expected to almost double to 134 million by 2025.

Moreover, factors such as limited doctor bandwidth to connect with patients outside the clinic, low adherence to care protocols and poor access to blood glucose monitoring makes it crucial to support people with diabetes in their daily therapy management routines to maximize health benefits. There is a real need for those patients to be able to

monitor their blood glucose levels regularly and be supported in their efforts to keep their diabetes under control. With Wellthy’s digital diabetes health coach, new Accu-Chek Active users can log blood glucose readings into the app to receive 24/7 guidance on understanding and managing their diabetes better. We firmly believe that this joint offering will help in improving the quality of life for Indians living with type 2 diabetes.”

Wellthy Therapeutics is a digital therapeutics company that is inspiring and enabling patients to prevent, reverse and control their chronic disease. It’s first digital therapeutic for Type II diabetes has been endorsed by the RSSDI, Asia’s largest diabetes association. (RSSDI).Wellthy Therapeutics has published & presented real-world data for its diabetes therapeutic at the AADE Annual Conference in Baltimore, at the AACE 26th & 27th Annual Congresses in Austin and Boston, the ADA 77th & 78th Scientific sessions in San Diego and Orlando, the IDF Congress 2017 in Abu Dhabi, the ATTD 11th International Conference in Vienna, and the RSSDI 44th, 45th & 46th Annual Conferences in India.

The company has been featured as a thought leader in diabetes care by the American Diabetes Association.

“Roche Diabetes Care shares our vision for digital therapeutic solutions that work alongside point of care diagnostics to achieve superior patient outcomes. We are excited about this partnership, as it gives people living with diabetes access to our clinically validated diabetes therapeutic to improve and manage their health. This partnership marks an important first step, in a larger shared vision to make a meaningful difference to the lives of millions of people living with this chronic disease”, said Abhishek Shah, Co-Founder & CEO of Wellthy Therapeutics.

HCG BRINGS PRECISION CANCER CARE TO KOLKATA HealthCare Global Enterprises Ltd. (HCG), India’s largest provider of cancer care brings first Radixact® X9 – the new generation

Nand Singh Rathore, Dr. SK Sharma, EKO diagnostics, AnantKittur, Director of Projects, HCG, Dr. AyanBasu, Head, Radiation Oncology, HCG EKO Cancer Centre, Dr. Naveen Nagar, VP, Medical Services, HCG

TomoTherapy® in India to treat cancer patients.

The Radixact® System is being used at HCG EKO cancer centre, a partnership between HCG, India’s largest provider of Cancer care and EKO diagnostic centre, Kolkata, marks a major step forward in cancer treatment through precision, speed, efficiency and ease of use with the potential to provide significant clinical benefits to cancer patients in India.

An early adopter of leading-edge technology, HCG – the specialist in cancer care was among the first in India to introduce the TomoH™ System, a fully integrated 3D conformal and image-guided intensitymodulated radiation therapy (IG-IMRT) system, and the CyberKnife® Robotic Radiosurgery System, technology designed to deliver stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT).

Dr. BS Ajaikumar, Chairman & CEO, Healthcare Global Enterprises (HCG) Enterprises Ltd said, “Being at the forefront of the fight against cancer, HCG strives to offer precision treatment to cancer patients, reinforcing the ideology – the right way, the first time. The practice of adopting cuttingedge technologies like the Radixact® X9 – the new generation TomoTherapy®, along with our clinical expertise, has enabled us to move one step closer towards precise and personalized care, therefore improving the quality of life

of cancer patients. Introducing the Radixact in Kolkata is to ensure that that advance care is accessible by the patients of West Bengal and the neighboring states, and they don’t have to travel to far off locations, away from their home and close ones for cancer treatment.”

Dr. AyanBasu, Head of Radiation Oncology, HCG EKO Cancer Centre said, “Radixact now enables us to accurately deliver higher doses incorporating functional imaging like PET, improving chances of cure. The addition of India’s first Radixact® X9 – the new generation TomoTherapy® to HCG EKO gives our patients and radiotherapy team several key advantages: quick, accurate, daily CT scan guided, adaptable, highly conformal radiotherapy which gives the oncologist confidence to accurately treat all sites and cancer types. To share an instance, the inbuilt CT scan imaging in a Radixact system allows treating Bone Marrow Transplant patients accurately to the complete bone marrow instead of exposing all internal organs. One of the unique advantages of the system is for children with medulloblastoma (which constitutes one fifth of all childhood brain tumors), where the child can comfortably lie on his/her back and the radiation beam treats more than three times the length possible in regular machines in a single movement of the treatment couch. Radixact is both versatile and

comprehensive.”

Present at event, Dr. SK Sharma, CEO, EKO diagnostic centre, “The thought behind HCG EKO collaboration is the common driving force of the two entities, which is to constantly upgrade the practice with aid of new and advanced technologies. Combining the two respective specialties, that is, diagnostic services by EKO and cancer treatment and care

by HCG, the aim is to provide comprehensive facilities that cater the need for advanced cancer treatment and care all under one roof.

This is further strengthened by having a production unit of cancer detection medicine (FDG) at same premises. In the endeavour for creating a centre of excellence in cancer care, HCG EKO Kolkata proudly introduces Radixact System for the first time in India. This shall benefit thousands of cancer patients of West Bengal and rest of eastern region by providing HCG’s unparalleled expertise and accurate radiation treatment.”

According to data from the International Agency for Research on Cancer’s GLOBOCAN initiative, the number of new cases of cancer diagnosed in India will grow from approximately 1 million per year in 2012 to more than 1.5 million by 2030. As per NICPR data, West Bengal and neighboring states have the leading cases of head and neck, oral, stomach, and lung, urinary bladder cancers

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NEWS ROUNDUP due to factors like tobacco usage, air and water pollution. To address the growing demand of holistic cancer care in the region, introduction of innovative technology like Radixact will provide the patients access to comprehensive care

HMD WINS THE PRESTIGIOUS 2018 GOOD DESIGN AWARD IN JAPAN Hindustan Syringes & Medical Devices Ltd (HMD), one of the largest manufacturers of Disposable Syringes in the World and the largest for Auto Disable syringes has been awarded the prestigious ‘2018 Good Design Award’ for HMD’s Safety IV Cannula - Cathy Sipclipearning recognition in the category ofMedical Care Productsat the Good Design Award 2018 hosted by the Japan Institute of Design Promotion in Japan.

Japanese Good Design Award 2018 is an additional feather in the cap to the MDSAP (Medical Device Single Audit Plan)quality assurance certification from UL (Underwriters Laboratories, USA) and ICMED (Indian Certification for Medical Devices) certification HMD received from QCI (Quality Council of India). ICMED Certification process allowed

us to build competencies and confidence needed to strive for MDSAP and winning the Indian Design Award from DIPP helped us in winning the prestigious Japanese Good Design (G-Mark) Award - explained Mr. Rajiv Nath, Jt. Managing Director of Hindustan Syringes & Medical Devices.

HMD’s Safety IV Cannula - Cathy SiPClip, the most revolutionary technology and patented design greatly minimizes the chances of accidental needle stick injury among health workers and nursing staff when they attach IV Catheter and remove the blood infected needle from a patient which results in numerous unfortunate infections and even deaths, particularly in developing countries like India.

The auto protection technology of Safety I V Cannula Cathy SipClip is designed to provide Involuntary Activated Safety due to presence of a protection device SipClip which encapsulates the tip of the used needle, when introducer needle is extracted from the Catheter.

In India, around 40 million people are infected with hepatitis B and at least 6 million people with hepatitis C. About 184 000 people die each year of hepatitis B- and C-related complications – two times the estimated

annual number of HIV and malaria deaths together.

Mr. Rajiv Nath, a strong advocate for preventive measure of Blood borne infections like Needle stick injury by SIP (Sharps Injury Prevention) and of Injection Safety is seeking a National Swach Injection Abhiyan. He has urged the Govt. to accelerate a switch to “Auto Disable Syringes” to limit HIV and Hepatitis Epidemic. There are villages with over half the population infected with Hepatitis or HIV due to reuse of Syringes by quacks . In order to prevent reuse of syringes and contain spread of infection, it is advisable and recommended to use AD syringes specifically designed to prevent reuse. This reuse prevention has been strongly advocated by WHO.Similarly next highest risk is accidental injury from a Needle Stick and unsafe blood exposure.

Andhra Pradesh government has already taken a lead in this regard and has declared the State of Andhra Pradesh as Safety Injection Use State.

“HMD will continue pursuing excellence in user friendly intuitive innovative design and contribute towards our ongoing commitment of aiding access to affordable and safe healthcare for common people in India and other developing Countries” Added Mr. Rajiv Nath.

The Good Design Award was founded in 1957 as the Good Design Product Selection System (or G Mark System), by the Ministry of International Trade and Industry (the current Ministry of Economy, Trade and Industry). It is the only system in Japan to comprehensively evaluate and recommend design and the G-Mark carries substantial International Prestige.

STRIDES’ STRATEGIC PARTNERSHIP WITH SUDA PHARMACEUTICALS

Mr. Takashi Kobayashi from Kobayashi, Japan HMD representative collecting the Award on behalf of HMD

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December 2018

Strides Pharma Science Limited (Strides) announced that its step-down wholly owned subsidiary, Strides Pharma Global PteLimited, Singapore has entered into an exclusive product development, licensing andsupply agreement with SUDA Pharmaceuticals Ltd

(ASX: SUD) for its novel drug SUD-001H, an oral spray of sumatriptan to treat migraine headache for the US market.

Execution of Strides’ generic product pipeline for the US is nearing completion and isexpected to have 150+ ANDA filings by 2021.

The company is now focusing ondeveloping a portfolio of complex and specialty products including products filed underthe 505B (2) regulatory pathway. The company through inhouse development andpartnerships will build a portfolio of limited competition products offering exclusivity fora sustainable period. Today’s announcement of partnership with SUDA is part ofcompany’s specialty portfolio buildout for the US market.

Sumatriptan is one of the most widely used drugs for the treatment of acute migraine inadults. SUD-001H is a first-inclass mint-flavoured oral spray formulation of sumatriptan(marketed in tablet form and in a nasal spray by GlaxoSmithKline under the brand nameImitrex®). The product will be filed with the USFDA under the 505B (2) regulatorypathway and on approval is expected to be the first fast-acting oral spray of sumatriptanin the US market. The product will utilize SUDA’s recently developed proprietaryOroMist® hydrotrope technology that significantly improves the rate of absorption andthe quantity of drug that is absorbed across the mucosal membranes. A primary marketassessment on the potential for SUD-001H for the treatment of adult migraineconfirmed the need for a product that could demonstrate a faster onset of action andthe same was supported by medical practitioners.

REPORT FINDS INEQUITY MAY SLOW PROGRESS IN PREVENTING CHILD PNEUMONIA AND DIARRHEA DEATHS A new report finds health systems are falling woefully short of ensuring the most vulnerable children have access to prevention and treatment services in 15 countries that

account for 70% of global pneumonia and diarrhea deaths in children under five.

Globally, pneumonia and diarrhea led to nearly one of every four deaths in children under five years of age in 2016. Released ahead of the 10th annual World Pneumonia Day, on November 12, the 2018 Pneumonia and Diarrhea Progress Report—by the International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health—describes progress in fighting pneumonia and diarrhea in 15 countries with the greatest number of deaths from these illnesses.

This report analyzes how effectively countries are delivering 10 key interventions— breastfeeding, vaccination, access to care, use of antibiotics, oral rehydration solution (ORS), and zinc supplementation—to help protect against, prevent and treat pneumonia and diarrhea. These measures are proven to help prevent death due to these illnesses and could help achieve the UN’s Sustainable Development Goal target of reducing underfive mortality to at least as low as 25 per 1,000 live births by 2030.

The Pneumonia and Diarrhea Progress Report, issued annually for nearly a decade, finds that although countries are making progress in immunization coverage, they seriously lag in efforts to treat childhood illnesses—especially among populations that are remote, impoverished, or otherwise left behind.

“Progress to stop child deaths is hampered by persistent inequities in countries around the world,” said Kate O’Brien, MD, MPH, a professor in the Bloomberg School’s Department of International Health and IVAC’s executive director. “Addressing inequities will demand greater levels of funding, strong political commitment, accountability supported by better data, and a coordinated global effort that prioritizes the most vulnerable.”

Eight out of 15 countries assessed failed to meet the targets for any of 10 interventions to protect against and treat pneumonia and diarrhea, as outlined in the World Health Organization and UNICEF’s Integrated Global Action Plan for the Prevention and Control of

Pneumonia and Diarrhea (GAPPD). Two of the 15 countries met the 90% target coverage rate for at least four vaccines while none were able to attain a 90% level of coverage for treatment measures.

Progress in India—home to more under-five pneumonia and diarrhea deaths than any other country in 2016—has been mixed. Increasing coverage of Haemophilusinfluenzaetype b (Hib) vaccine as well as continued scaleup of rotavirus vaccines, first introduced in mid-2016, led to a bump in scoring for these interventions since last year’s report.

Introduced in 2017, the pneumococcal conjugate vaccine (PCV) has been included in only six states to-date. Further scale-up of the vaccine to all states should be considered.

India’s scores for exclusive breastfeeding, on the other hand, declined as did coverage of ORS. The proportion of children receiving important treatments remains dismally low, with barely 20% receiving ORS for diarrheal disease. For the first time, the annual report reviewed stratified national data, revealing inequities in providing life-saving interventions to children based on gender, location of residence (urban or rural), maternal education and wealth.

Yet for India, limitations in data on these subgroups make it challenging to measure how well programs are targeting the most vulnerable children.The authors conclude that in order to accelerate progress, governments must regularly collect quality data. The global community must improve access to interventions for children who are not being reached. Funders must increase support for proven solutions—or risk having progress slip away. Finally, integrating strategies related to health systems, poverty, and education may yield opportunities to improve equity.

FIRST EDITION OF ART CONCLAVE IN KURNOOL

Infertility is the inability to conceive by natural means, and is a medical condition with high prevalence affecting nearly 10 to 15% of married couples in India. Nearly 27.5 million couples who are actively seeking children

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NEWS ROUNDUP suffer from infertility. It is estimated that while female factor accounts for 40 of infertility among couples, infertility attributable to male factors is on the rise and constitutes 30-40% of infertility too.

Fundamentally there are two key factors: at play Lifestyle and clinical, Lifestyle factors such as Increasing marital age, delay in child bearing, rising alcohol and tobacco consumption and rising levels of obesity and Clinical factors such as Increasing prevalence of medical conditions such as poly-cystic ovarian syndrome (PCOS), tuberculosis, endometriosis etc.

Talking about the objective of conducting the Artificial Reproductive Techinques Conclave in association with KOGS (Kurnool obs and gynaec society) on 11th November 2018, at Hotel Sasya Pride, Kurnool.Dr Durga G Rao, Co- Founder and Medical Director of Oasis Centre for Reproductive Medicine stated that “ The key issue in infertility treatment is not just the burden of infertile couples but also the lacunae in terms of number of fertility specialist required with skill sets to treat the patients. We are conducting this ART conclave to train clinicians from across the state by the way of live workshops in the areas of management of male infertility, hands on refreshers workshop on hysteroscopy to enable the clinicians to get comprehensive knowledge from surgical perspective and a workshop in utrasonography in fertility practice” Adding more she said “At the end of it we need the participants to get empowered with knowledge and recent updates on fertility treatment aspects so that they can start treating more of infertile couples also as it is being done in association with VOGS the clinicians will be awarded 2 credit points for attending this conclave”.

Oasis specializes in dealing clients with previous failed IVF treatments. Often IVF is the last option offered to couples to conceive and its devastating to learn that at times even IVF fails.

Through advanced treatments like PGS, Vetrification, micro-TESE success rates can be improved. At Oasis we treat a lot of couples with history of failed IVF and successfully

12

December 2018

offer better pregnancy rates. Well trained experienced team with state of ART facilities have helped oasis successfully offer advance treatments all under one roof at Oasis.

HMD LAUNCHED DISPOVAN INSULIN PEN NEEDLE AT MEDICA Diabetes is one of the most prevalent diseases in the world. It has been projected that worldwide approximately over 425 million people are currently living with diabetes.

India has become one of the epicenters of the epidemic, with 74 million people suffering from diabetes today and shockingly nearly 70 per cent of Indian diabetics have uncontrolled diabetes.

The theme for World Diabetes Day 2018 - 2019 is “The Family and Diabetes” which aims to raise awareness about the impact of diabetes on the family and how to provide a support network to those who are affected by diabetes India’s disease burden is shifting. Due to pollution and unhealthy diets and lifestyle, a large number of the population is now suffering from non-communicable diseases (NCDs). Of these, diabetes is of epidemic proportions.

Speaking on World Diabetes Day, Mr Rajiv Nath, Joint Managing Director of Hindustan Syringes & Medical Devices (HMD) who is launching their Insulin Pen Needles in Europe at the Medical Forum Medica at Düsseldorf, Germany today said “We are excited to launch our DispoVan Insulin Pen Needles to provide better comfort for people with diabetes at Medica on the occasion of World Diabetes Day.” “We are particularly excited about the prospects of our latest offering which will end world monopoly of few expensive MNC brands” Added MrNath.

“With the global launch of ‘Dispovan Insulin Pen Needle’ we will contribute towards our ongoing commitment of making healthcare affordable for people worldwide” said Mr.PardeepSareen, PradeepSarin - Marketing Head of HMD.

“The Dispovan Insulin pen needle is a precision engineered, yet affordable sterile single use pen needle, which can be universally fitted on all international brands of Insulin Pens.” Explained PradeepSarin. We have had a very encouraging and excellent feedback from the India launch and now are excited to enter the global market.

For long this product segment has been dominated and access limited internationally to 2-3 expensive MNC brands from USA, Europe and Japan and now we break into this exclusive supply club. This is a very challenging and complex product to make and requires very precision engineered moulding grinding and assembling technology to ensure pain free injections.

At the same time we are aiming to make these needles competitive and affordable, so patients do not tend to reuse needles.

Re-use does not only lead to a more painful experience but can also lead to infections and complications.

Hindustan Syringes & Medical Devices (HMD) one of the largest manufacturers of Disposable Syringes in the World and the largest for Auto Disable syringes in May 2018 launched the competitive , India’s First “Made in India” Dispovan Insulin Pen Needle” to provide better comfort for people with diabetes earlier this year in India and now internationally at the Medica Exhibition in Germany.

DISCOVERY SUGGESTS NEW ROUTE TO FIGHT INFECTION, DISEASE New research reveals how a single protein interferes with the immune system when exposed to the bacterium that causes Legionnaires’ disease, findings that could have broad implications for development of medicines to fight disease and infection.

“Our immune system protects us from deadly infections, but successful pathogens have evolved many effective ways to subvert its function,” said Zhao-Qing Luo, a Purdue University professor of biological sciences and member of the Purdue Institute for Inflammation, Immunology and Infectious

Diseases, who led the research. “We have revealed an intricate mechanism of how a protein from the potentially deadly pathogen Legionella pneumophila turns off the major immune regulatory protein NF-κB, which controls numerous important cellular processes. This is important because it reveals a highly effective and specific way to turn off an immune response.”

The findings are detailed in a paper recently published in the journal Nature Microbiology.

The paper’s lead author is Purdue graduate student NinghaiGan. The researchers discovered that the bacterial enzyme MavC inhibits UBE2N, a human protein essential for the activation of NF-κB. “The inhibition by MavC is achieved by adding a small protein called ubiquitin to a position in UNE2N critical for its activity,” Luo said. “Protein modification by ubiquitin, a process termed ubiquitination, is enormously important in immune development and disease processes. “ The research suggests a route to the development of new kinds of antibiotics.

“The bacterial enzyme found in this study is important for its ability to attack the host cells, so we can develop small molecules to inhibit is activity to achieve the goal of anti-infection,” Luo said. “Further, because the bacterial enzyme effectively and highly specifically inhibits the activity of a human protein essential for immunity activation, another potential application avenue is to use it to suppress immunity for autoimmune diseases or other hyperinflammatory conditions. The major challenge in the latter application is the delivery of the genes to the patient, but the concept has been suggested by many scientists in the field.”

The paper was co-authored by Luo; Gan; Ernesto S. Nakayasu, a researcher at the Pacific Northwest National Laboratory; and Purdue biology professor Peter J. Hollenbeck.

Ubiquitination is normally catalyzed by a three-enzyme reaction cascade. However, MavC alone is able to achieve ubiquitination, which plays an essential role in numerous important cellular processes such as immunity.

Dr Naresh Trehan and Dr Surinder Bazaz with the patient

Ubiquitination is frequently hijacked by pathogens to enable the spread of infection within a host, meaning the research findings could lead to future medicines against infection.

“Because of its high specificity and efficiency against UBE2N, MavC can be further developed into agents with potential therapeutic values for the regulation of NF-κB activation in disease conditions,” he said.

Future research will include work to develop high-throughput screening strategy to identify synthetic or natural compounds capable of inhibiting MavC‘s activity. Another potential application is to use the protein to test for different immune diseases.

The work aligns with Purdue’s Giant Leaps celebration, acknowledging the university’s global advancements made in health, longevity and quality of life as part of Purdue’s 150th anniversary. This is one of the four themes of the yearlong celebration’s Ideas Festival, designed to showcase Purdue as an intellectual center solving real-world issues.

MEDANTA SETS BENCHMARK: SUCCESSFULLY OPERATES 98-YEAR-OLD CARDIAC PATIENT In an unprecedented benchmark, a 98-year-old malesuccessfully underwent coronary bypass surgery at Medanta - The Medicity. Mohammed Kadhim Saeed, from Iraq, came to India seekingtreatment for severely blocked coronary arteries causing him chest pain and discomfort.

Negotiating risks associated with heart surgery in geriatric patients, a team of cardiacsurgeons led by Dr. Naresh Trehan, Chairman and Managing Director, Medanta, performeda full coronary artery bypass surgery to relieve the patient of the serious life risk. Thepatient is believed to be the oldest person to undergo bypass surgery.

Explaining the rarity of the procedure, Dr Trehan, Chairman and Managing Director,Medanta said, “This was a case of blocked blood vessels complicated by the patient&advanced age. Four bypasses were done to reroute the blood around the blockages.

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13

NEWS ROUNDUP Post-surgery, the patient is perfectly healthy and has returned to his country.”

CARESTREAM SPOTLIGHTS NEWEST HEALTHCARE IT, MEDICAL IMAGINGTECHNOLOGY AT RSNA Carestream Health demonstrated its expanding portfolio ofsophisticated medical imaging and healthcare IT systems designed to enhance thediagnostic review of X-ray exams and expedite delivery of results to physicians and theirpatients at the annual Radiological Society of North America conference.

Radiology service providers want to tap into the expertise of subspecialists at multiplelocations, as well as optimize the quality and speed of clinical reporting.Carestream’s Clinical Collaboration Platform (see video link) addresses these needs withWorkflow Orchestrator software that supports advanced reading workflows and improves thereview process by: simultaneously prioritizing urgent medical imaging exams; routing complexcases to subspecialists or radiologists affiliated with the site where the study was performed;and logically distributing the case load among all available radiologists.

One of the largest private radiology groups in the United States has chosen WorkflowOrchestrator to manage its multi-site radiology interpretation workflow. Based on early results,the group’s radiologists expect this versatile platform to produce long-term operational andquality improvements as well as more responsive client service, optimized case assignmentand a significant return on investment.

Carestream representatives also showcased the unique benefits of the CARESTREAMOnSight 3D Extremity System (see video link) that equips hospitals, orthopaedic practices andother imaging services providers with high-resolution 3D images that offer advancedanatomical detail to help orthopaedic specialists make more accurate diagnostic andtreatment decisions.

14

December 2018

The OnSight system captures high-quality, weight-bearing imaging studies for patients witha wide range of injuries and conditions of the knee, foot, ankle and other extremities.

Unlike traditional CT technology, Carestream’s system has a large detector that easilycaptures a 3D image of the extremity in a single rotation.

A patient simply places the injuredextremity into a donut-shaped bore in the system. Since the patient’s head and body are notconfined, patients do not experience the claustrophobia that often occurs with CT systems.

Carestream focuses on delivering innovation that is life-changing—for patients, customers,employees, communities and other stakeholders—while enhancing operations for a broadrange of healthcare facilities and helping medical professionals provide quality care.

LUNG CANCER FAST TURNING INTO EPIDEMIC IN INDIA Data from Indian Council of Medical Research (ICMR) suggests that lung cancer is fast turning into an epidemic in India. It is a high-mortality cancer due to late stage at diagnosis and poor access to affordable healthcare, and today accounts for higher number of deaths in the country than colorectal cancer, prostate cancer and breast cancer. This was said by oncologists from Vikram Hospital, Bengaluru, who were speaking at a workshop to create awareness about lung cancer in the city. Worldwide, November is observed as the lung cancer awareness month.

Said Dr. NitiRaizada, Sr. Consultant Medical Oncologist and Hemato-oncologist, Vikram Hospital, Bengaluru: “Only 15 percent of cases of lung cancer are curable at the time of diagnosis. Patients with lung cancer present themselves for diagnosis at a much later stage than other cancers due to the nature of the disease. Early on, people with lung cancer have no symptoms or vague symptoms. In fact, if lung cancer is detected by chest X-ray, it is already too late for the patient. The only effective method for screening lung cancer in early stages is the Low Dose Helical Lung CT,

where high-resolution images pick up early lung lesions.”

Said Dr. SurajManjunath, Consultant Oncosurgeon, Vikram Hospital, Bengaluru: “Lung cancer has one of the highest morbidity and mortality among all cancers. It accounts for 14.5% of all cancers in men and 8.4% in women globally. It is a leading cause of cancer death in men worldwide at 22%, which means that one in five of all cancer deaths in men occur due to lung cancer. Lung cancer accounts for 5.9% of all new cancer cases diagnosed in India (both sex combined), while mortality is 8.82% of all cancers combined.”

“Smoking is the single largest contributor for lung cancer. Passive smoking, exposure to carcinogenic toxins like asbestos and radon, radiation and air pollutants are other causes, besides a small percentage of genetic cancer.

Exposure of women to smoke from the burning of charcoal for cooking is also a cause of lung cancer. Physical activity may reduce the risk of lung cancer by about 20 percent.

Exercise is known to improve lung function and reduce the danger of other diseases too.

In the West, there is a small decrease in the number of smokers. However, such trend is not seen in India yet. Moreover, the country is seeing an emerging population of women smokers. The most common age group for lung cancer is 50-59 years,” Dr. NitiRaizada said. Talking about prevention, Dr. KS Satish, Consultant Pulmonologist & Chest Physician, Vikram Hospital, Bengaluru, said: “It’s never too late for anyone to quit smoking. Quit by age 30 and you reduce the risk of smokingrelated diseases by 90 percent! Quit by age 50 and you reduce the risk of smoking-related diseases by 50 percent. Quit by age 60 and you would live longer than smokers in your age group, according to data by the National Cancer Institute in US. In fact, 15 years after one quits smoking, the risk of lung cancer become the same as that of a non-smoker. Two out of every three patients with lung cancer are over 65 years of age, so one gets enough time in life to take steps to avoid this highmortality disease.”

Said Dr. Somesh Mittal, CEO, Vikram Hospital, Bengaluru: “In India, the highest reported

(L-R)Dr. KS Satish, Consultant Pulmonologist & Chest Physician,Dr. NitiRaizada, Sr. Consultant Medical Oncologist and Hemato-oncologist,Dr. SurajManjunath, Consultant Oncosurgeon, Vikram Hospital, Bengaluru

incidence of lung cancer is from Mizoram in both males and females. Its incidence in North East India can be as high as 45 per 100,000 population. The time trends of lung cancer show a significant rise in Delhi, Chennai and Bengaluru across both sexes. The incidence and pattern of lung cancer differ as per geographic region and ethnicity, and largely reflect the prevalence and pattern of smoking.”

SMT SUCCEEDS IN BAGGING ONE MORE TENDER IN ITALY India’s leading medical device firm Sahajanand Medical Technologies (SMT) has bagged second tender through its Italian partner Eukon in Sicily region, Italy.

After the scrupulous assessment of the product quality, SMT’s Supraflex stent was amongst the top 4 out of the 20 products to win the tender. The tender is to supply more than 7000 stents to 15 public hospitals in Sicily region over the next two years from the beginning of 2019.

This is the second successive tender won

by SMT in Italy; first tender was bagged

for the Emilia Romagna region to deliver approximately 10,000 of its ‘Supraflex’ stents. SMT has successfully commercialized the Emilia tender. By qualifying for the Sicily tender SMT has successfully demonstrated its ability to compete with the best in the world for its drug-eluting coronary stents.

“We have designed a strong growth plan and we are thoroughly living it!” said GennaroBroya de Lucia, EUKON Sales Manager. “The combination of a great product like Supraflex along with an experienced and dedicated sales team has been the main driver for this market acceptance” he added. “Supraflex has proved to be a great product” he further continued, “We have seen good product appreciation from our customers and the market response has been incredible. SMT is a great partner with a responsive and structured marketing, sales and quality control team. We are proud to have partnered with SMT” Mr. GauravGoel, Head of Western Europe Operations, SMT explains, “Italy is one of the most rapidly growing market and we see it as an important territory to strengthen our presence in Europe. We are glad to know that the medical fraternity in appreciates

our product quality. Our aim is to provide holistic 360° service to our customers starting from first contact to post sales along with continuous clinical evidence generation” Supraflex, a cardiac drug eluting stent designed and manufactured in India not only proved to be at par in safety as compared to Abbott’s Xience but also 61% better in efficacy in an investigators-driven multicenter European randomized controlled study called ‘TALENT’. The findings of the TALENT trial were presented at the ‘late breaking trial session’ at TranscatheterCardiovascular Therapeutics 2018 (TCT), the largest global conference of cardiologist in San Diego, USA by a globally renowned cardiology researcher, Prof. Patrick Serruys.

Supraflex has advanced features like biodegradable polymer and ultrathin strut* (60µm) thickness. It is available in 65 countries across the world and is the largest selling drug eluting stent of SMT (Sahajanand Medical Technologies), India’s largest stent manufacturer.

The TALENT study was also presented at National Congress Italian Society of Interventional Cardiology held at Milano 2018 Mico Congress center in mid October, 2018.

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15

SPECIAL FEATURE

Key to MVT Success Deepak Pawar, FICCI

16

December 2018

MEDICAL TOURISM Market is projected to grow from US$56.333 billion in 2018 to US$136.591 billion in 2023, growing at a CAGR of 19.38% over the forecast period. Continuous rising medical costs in the U.S. and Europe with improved standards of healthcare technology in developing nations like India and China are driving the growth of medical tourism

industry. Other factors such as rising aging population worldwide, availability of affordable world-class medical facilities in emerging economies, and high medical insurance costs in developed regions are also boosting the demand for medical tourism globally.

APAC region has become the new hub for the medical tourism industry as countries in this region comprise high standards of hospitality with wide exposure to latest technology in the medical sector. Availability of low priced medical treatment options coupled with improved infrastructure in terms of healthcare facilities is making Asia Pacific an attractive location for medical tourism.

While countries such as Thailand, India, and Malaysia have already become key regions for medical tourists, several new countries like UAE and Taiwan are becoming new players in the global medical tourism industry. Growing demand for specialized surgeries such as breast augmentation, dermabrasion, and rhinoplasty and better pricing of such cosmetic surgeries in these countries will further fuel the growth of medical tourism market during the forecast period.

Medical Tourism in India is on a faster pace of growth compared to the previous years. The growth percentage is almost 25 per cent in Medical Tourism. The specialising hospitals in India also are gearing up their Patients Relations Protocols to make the patient experience comfortable. The official figure of the Ministry of Tourism suggests that there was an increase of 1,27,142 foreign patients during 2016 compare to the figures of 2015. In 2016, Medical Tourism arrivals was 3,61,060. The Indian Medical Tourism Industry is expected to grow to US$8 billion by 2020 from the US$3.9 billion of 2016.�

Opportunities for India Thus in order to emerge as preferred global destination for MVT, India needs to diversify its sources of medical tourism and offerings to create a strong value proposition Growth opportunities among regions and offerings Region

Short term

Medium term

Cardiology Orthopedics Oncology Neurology AYUSH

Treatment

Canada Eastern Europe Latin America Austrailia

US GCC Western Europe China

SAARC countries Regions of Africa Middle East*

Long term

Weight loss surgery Infertility Spine surgery

Cosmetic surgery Dentistry

*Middle East includes Oman, Iraq, Yemen

NOVEMBER 2018, VOLUME 2 ISSUE 11 `200 INDIA MED TODAY

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SPECIAL FEATURE AMERICAN ACADEMY OF EMERGENCY MEDICINE CEO’S PERSPECTIVE DR. HARISH PILLAI, CEO – ASTER HOSPITALS & CLINICS INNOVATE PROTEMBO CEREBRAL PROTECTION SYSTEM

What Ails

EMERGENCY MEDICINE in India

Lack of standardisation, fragmented training landscape and distrust relation among doctors NOVEMBER 2018

M Neelam Kachhap

In the short term, India can focus on increasing penetration in its established markets with offerings where India enjoys a clear edge.

In the medium term, India should focus on developing other regions which contribute to majority of MVT patients like US by leveraging its existing treatment capabilities. Within new offerings, India can start building its credibility in treatments like weight loss surgery, spine surgery and infertility etc. to further penetrate into its traditional patient sources.

In the long term, India needs to target remaining regions like Canada, Eastern Europe etc.; it also needs to expand footprint in offerings such as cosmetic surgery to effectively tap into these regions.

Subscribe to IndiaMedToday and get 20% discount + Extra FREE issues Indiamedtoday magazine reports on the issues and trends that are shaping the business of healthcare in India and abroad today. Each month, the print magazine discusses long-term strategies to meet the challenges posed by an evolving healthcare marketplace. In every issue, our readers discover the practical advice, analysis, and receive and insight on management trends, innovative 12 + 3 FREE issue. concepts, market strategies and real-world solutions they need to navigate the changing landscape of the business of healthcare.

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SPECIAL FEATURE

Insurance & Medical Value Travel

Dalip Kumar Chopra, President, Foundation of Healthcare and Wellness Promotion and Director, Gurdasmal Hospitality and Consultancy Services Pvt Ltd

A GROWING number of International Insurance Companies and Self – Funded Employers are exploring the idea of offering medical travel for treatment abroad as an option for their clients and employees. As healthcare costs in the U.S and Canada continue to rise, some people are seeking medical care abroad – as Medical Tourists. This type of travel insurance protects medical tourists from unexpected financial losses on a covered trip.

What makes medical tourism insurance unique A growing number of people are seeking medical care outside the borders in countries such as India, Thailand, Singapore, Malaysia, India and others. In most cases, the traveller has pre – paid for their medical treatment , but if they experience medical complications , or have to cancel their trip , this coverage will help them to recover their costs and avoid unexpected high medical expenses.

What Coverage is included in medical tourism travel insurance? a. Coverage for medical expenses due to complications that result from your treatment. b. Coverage for trip cancellations if the treatment is cancelled for a covered reason. c. Coverage for evacuations if you need evacuation to another medical facility. d. Coverage for unexpected medical costs not related to the treatment. e. Coverage for flight accidents while on a covered trip. f. Travel delays, missed connections , and lost luggage coverage are also included.

Travellers Medical Insurance differs from a

18

December 2018

normal in – land health plan or health insurance ; it is focused and designed for the medical tourist with the primary purpose of meeting the needs of the emerging industry of medical travel.Many companies and organizations in the medical tourism industry provide benefits for the people who want or need to travel in order to receive medical treatment outside their countries. If you are currently considering a medical procedure abroad , it is important for you to review the policy of your travellers insurance and coverage plans.

Why do I need Medical Travel Insurance As mentioned before, if you are travelling abroad with the intention of receiving medical treatment , standard travel insurance does not work. Its coverage is limited and you will be classified as high – risk category client. If you need cardiac surgery, dentistry, orthopaedic or cosmetic surgery, among many other categories, medical tourism to Singapore, Thailand, Colombia, Mexico, India, Cuba and Costa Rica might be of your consideration. Despite being Third World countries they offer a surprisingly high quality medical environment, but still, the risk to take is yours. It is about your health, safety and comfort.

That’s why you need special travel insurance when you travel for medical care. Some of the organizations offer or provide coverage for:  Medical complications that result in extra expenses.  Enhanced benefits in relation with complications that appear up to 6 or so months after the procedure, once you are back at home.  Complication covered for disability.

   

Complication covered for death.

Additional costs of travel.

Family coordination.

Residence modification and others.

Basic Structure of Health Insurance for Travelers Medical insurance companies offer these basic packages:  Before travel: if the patient has to cancel or delay the trip.  During travel: complications/accidents during the planned treatment, if the recovery period is longer or for postoperative complications. It includes accommodation, flights, daily allowance, consultation fees, and medication.  After travel: correction of unsuccessful surgery, including flights.

The medical travel insurance will not only boost the medical travel from developed

A growing number of people are seeking medical care outside the borders in countries such as India, Thailand, Singapore, Malaysia, India and others countries like USA and Canada to countries like India , Thailand , Singapore , Malaysia etc but also from developing regions ( Africa , Middle East , CIS and SAARC ) to countries like India , Thailand , Singapore , Malaysia with a reason that the claim cost of Medical Insurances Companies shall be reduced considerably when they are sending patients abroad to these mentioned countries without compromising the quality of medical treatment. .

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COVER STORY

MVT is one of the major growth drivers and a major source of forex earning for the Indian economy

India’s Next Crown Jewel

MEDICAL TOURISM

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21

COVER STORY

T

he broad notion of MVT is tied to the diversity and sophistication of the offerings of healthcare and wellness industry. Currently the MVT encompasses all activities related to

• Medical Treatment: curative treatment including cardiac surgery, organ transplant, hip and knee replacement etc.

• Wellness & Rejuvenation: Offerings focused on rejuvenation or for aesthetic reasons such as cosmetic surgery, stress relief, spas etc.

• Alternative Medicine: AYUSH (Ayurveda, Yoga & Naturopathy, Unani Siddha and Homeopathy) treatments According to a recent FICCI report in 2015 alone around 11 million patients traveled outside their countries to seek treatment.

Overall the estimated global MVT market was around 40 to 55 billion USD in 2015 and believed to be growing at 15 per cent annually.

Asia, has emerged as the preferred destination for these global MVT with Thailand and Malaysia attracting a larger number of MVT as compared to India.

Nevertheless, India is one the key MVT destinations in Asia with over 500,000 foreign patients driving its MVT market. According to the same report the MVT market in India was pegged at 3 billion USD in 2015 growing at a CAGR of 15 per cent.

Healthcare providers in India are quite aware of floating perceptions of medical

tourists, especially those coming from the West. Some of these negative perceptions are due to poor infrastructure, regulatory mechanisms and almost non-existent mechanism to address patient complaints or discontentment.

Additionally, there is an alarming trend of growing dissatisfaction and concerns regarding the trend perform unnecessary procedures or unnecessary investigation.

Coupled with this is the dissatisfaction of prolong length of stay from a few healthcare providers. This short term gain behavior needs to be checked as it will lead to brand erosion and can have catastrophic effects for India in a highly competitive MVT market.

The healthcare providers need to gear up to meet the global standards of quality and set their own quality benchmarks.

The best regulatory norm should be selfdriven but there are talks of a nodal agency for approval and audit of provider specific clinical outcomes; procedure specific rates and adherence to engaging with facilitators.

While these initiatives represent meaningful progress, in the end, India’s ability to achieve 9 Billion target will hinge on the success of the healthcare provider.

Continent Wise Share of Medical Travel DESTINATIONS CONTINENTS OF ORIGIN

ASIA

EUROPE

LATIN AMERICA

MIDDLE EAST

NORTH AMERICA

Africa

95%

4%

1%

-

-

Asia

93%

1%

-

-

6%

Europe

39%

10%

5%

13%

33%

Latin America

1%

-

12%

-

87%

Middle East

32%

8%

-

2%

58%

North America

45%

-

26%

2%

27%

Australia & New Zealand

99%

-

1%

-

-

22

December 2018

DR ALOK ROY Chairman, Medica Group of hospitals

W

e have about 28 thousand medical value travellers visiting our hospitals in the last year. These patients come from our neighboring countries like Bangladesh followed by Nepal, Sierra Leone etc,.Medica Hospitals hold about 6 per cent of the market share of the total 3 Billion USD medical tourism market in India.Even though medical tourism is a big market there are a number of bottlenecks and challenges. i) New Medical VISA mandate ii) Flight connectivity issues in case of certain important countries like Myanmar, Afganisthanetc iii) Language, Food and Culture to some extent

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COVER STORY

GAUTAM KHANNA Chief Executive Officer, P. D. Hinduja Hospital

W

hile Mumbai is the most populous metro in thecountry with a large number of hospitals, doctorsand medical professionals, it attracts fewer foreignpatients than Delhi and Chennai. Both privateinvestment and government policies wouldbe required to establish Mumbai as a healthcarehub. Initial steps would be capacity building andcreating an integrated framework of facilities liketransport, accommodation, information and assistanceetc. which would enable foreign patientsto come to the city and get all the services requiredwhile availing medical treatment.

NEERAJ LAL Cluster Head & Vice President-Bangalore Operations, Rainbow Children’s Hospitals

T

he government of India along with the StateGoverment must act as a regulator to institutea uniform grading and accreditation systemfor hospitals to build consumers’ trust. Italso acts as a facilitator to encourage privateinvestment in medical infrastructure andpolicy-making for improving medical tourism.

The government should actively promote FDI(Foreign direct investment) in healthcare sectoras well as also enacts conducive fiscal policies- providing low interest rate loans, reducingimport/excise duty for medical equipment. The government should reduce barriers in gettingmedical visa and institute visa-on-arrival forpatients and also can create medical attaches toIndian embassies that promote health servicesto prospective Indian visitors.

Today one of the biggest concerns in MVTis patient follow-up and postop care. Whatinterventions can help hospitals in this regard?

The post-op care is given to the patients inthe respective hospital itself.

Whereas for thefollow-up, the patients can take the consultationusing the technology like telemedicine, Skypeconsultation etc. This will help international patients to seek proper treatment from theirdoctor.

24

December 2018

Dr. Harish Pillai CEO – Aster Hospitals & Clinics, India Aster DM Healthcare

A

pproximately 18% of our total hospital volumesare contributed by MVT. These patientscome from countries from Africa and MiddleEast. Oman, Saudi Arabia, Maldives, Bangladeshand Nigeria are the major source of MVT for us. In terms of the industry, all stakeholdersneed to have a unified vision and not look atshort term gains in order to make our countryan effective Asian giant in the field of MVT. SEPC has been a pivotal agency under the Ministryof Commerce to promote MVT for thecountry. I would like to like to compliment theleadership role of Principal Secretaryof Commerce,Ms. Rita Teaotia and all the officialsof SEPC who has worked so hard for the pastthree years to promote MVT for the country.

The flagship annual event, Advantage HealthcareIndia, of which two original events werein New Delhi and one edition was in Bangalore,were a very crucial catalyst in positioning Indiaas a global hub for MVT. The portal hosted by SEPC also plays an important role. We are currentlyworking with all stake holders includingNABH to accredit healthcare facilitators so thatthe quality of services provided by accreditedagents also improves.

KEY HOSPITALS IN MEDICAL TOURISM

Fortis Memorial Research Institute, Gurgaon

Medanta Medicity, Gurgaon

Max Super Speciality Hospital, Saket, New Delhi

BLK Super Specialty Hospital, New Delhi

KEY MEDICAL TOURISM COMPANIES Jaslok Hospital, Mumbai

Medica Super speciality Hospital, Kolkata

Vaidam Magnus Medi MedTravel Tour2 India Health

Gleneagles Global Hospitals, Hyderabad

CARE Hospital, Hyderabad

Manipal Hospital, Bangalore

Indicure health Tour to India

Narayana Health, Bangalore

Apollo Hospitals, Chennai

Kaizen

Aster Medicity, Kochi

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BR LIFE

BR Life : A new dawn in the healthcare industry of India

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his is the amazing journey of a man who decided to carve his footprints in the sands of time... literally and figuratively. It was a tough expedition because land was hitherto an unexplored destinationand the risks the lone ranger took were unprecedented. But like all great men, he threw the fear of failure to the winds and never gave up till he succeeded.

This is the incredible story of a man who had the strength of the belief that he would succeed in an unknown land and also bring back that success back to his homeland.

Dr Bavaguthu Raghuram Shetty was a clinical pharmacy graduate who served as the Vice-Chairman of the Municipal Council in the small town of Udupi in Karnataka, India. He moved to the UAE in 1973 as he was in dire need of money to fund his sister’s wedding.

In UAE, he becamethe country’sfirst medical representative working for a stockist, peddling products like Nivea, Glucose and Gripe Water. This was an excruciating task because of the heat and almost non-existent roads in the region back then. But this also served as an inspiration to start his first venture, whenDr Shetty noticed the poor state of clinics and medical care in the UAE. In 1975, he set up the now famous New Medical Centre (NMC), a pharmacy cum diagnostic clinic chain. It also helped that Dr Shetty married a doctor, Mrs Chandrakumari Shetty. In partnership with her,he set up a full-fledged hospital in the region. This marked the beginning of hiscareer as a serial entrepreneur and also paved the path for his dream of giving back to his motherland later. Today, NMC is the UAE’s largest private healthcare provider and is the first healthcare company from the region to be listed on the London Stock Exchange.

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The visionary that he is, Dr Shetty realised that providing good quality medical care is only one component of the development wheel of a country. So, he went on to set up the UAE exchange, which would help Indian immigrants send money back home easily. Prior to this, they were struggling in long queues outside banks on holidays. Now the UAE exchange has 750 branches in 32 countries and now transacts over million dollars every day!

Varied businesses in his armour Dr Shetty is not the kind of man to rest on his laurels. As he establishes and stabilises one business, he is on the lookout for his next venture, which has to be an exciting and challenging one. This explains why BRS Ventures, a holding company, owned by Dr Shetty,provides innovative solutions acrossa wide range of business interests. Notable among them are healthcare, financial services (unimoni), pharmaceuticals, education, hospitality and environment.

The company is not only a well-knownpremium blue chip business group in the UAE, but also has a significant global presence through strong partnerships and multiple acquisitions.

Apart from these major ventures, Dr Shettyhas interests in areas like laundromats, consumer products andhotels. He also runsa school chain, a maintenance companyand a manpower company for the petroleum industry. All of them have achieved stupendous success.

Serving the homeland BR Life, a healthcare services brand owned and initiated by DrBR Shetty, owns superspecialty healthcare facilities in India, Nepal,

Egypt and Afghanistan. The company stands on the strong principle of giving back to the home country.

Dr Shetty, who is now all set to serve his homeland with ventures in healthcare, education, banking& financefeels that a large part of India’s population still is bereft of quality tertiary medical care which is readily accessible and affordable.

BR Life is headquartered in Bengaluru and plans to have presence across India and the Indian sub-continent soon by operating either completely owned Greenfield initiatives or Brownfield initiative under O&M model.

At present, BR Life operates4-hospitals in India—BR Life SSNMC Superspecialty Hospital (400 Beds) in Bangalore, BR Life Kalinga Superspecialty Hospital (230 Beds) in Bhubaneshwar, BR Life SUT Pattom Superspecialty Hospital (210 Beds) in Trivandrum, BRS Mother and Child Hospital (200 Beds) in Udupi.BR Life also has recently acquired 2-hospitals in Afghanistan and in the process of acquiring a few more in India, Nepal and Bangladesh.

Dr Shetty’s strong sense of philanthropy and community service has prompted him to take over an existing government hospital for mother and child in Udupi.He has constructed a new 200-bed hospital in the same premises, which offers completely free top class medical care to the underprivileged people of the region.

Currently, the group operates and manages about 1,500 beds and it plans to create a strong network of hospitals in Indian and the Indian subcontinent. BR Life has invested significantly since 2012 and is looking at additional investment to attain a critical mass of around 3,000 beds over the next two-three years; the long-term plan over the next dec-

ade or so is to have over 20,000 - 25,000 beds. This large-scale expansion plan has been motivated by the fact that India needs an additional 1.8 million beds by 2025.Dr Shetty is extremely determined to help the country reach the figure.

Ethics and safety have always been the underlying guiding philosophies for BR Life as it focuses on areas like accurate diagnosis, scientific treatment and precise delivery of healthcare services. The company also strongly believes in scientific cost accounting, standardization of procedures, proper training, and alignment with medical and non-medical professionals. These are theareas that BR Life is working on to develop the healthcare industry and enable better patient , comfort and satisfaction and in the process deliver best in care and class clinical therapy.

Rising son: Guided by his father’s experience and expertise in business and powered by the spirit of the current generation, Mr Binay Shetty is now ready to take on his father’s mantle. He has worked with different entities of BRS Ventures for more than a decade and is now the Vice Chairman and CEO of BRS Ventures.His areas of expertise arestrategic planning and corporate governance.

Mr Binay Shetty graduated from Boston University, Massachusetts, USA, with a specialization in finance and entrepreneurship.

Like his father, Binay is also a keen participant in various social, philanthropic and community activities.

Binay is determined to treadthe path that his father has taken for success—a relentless pursuit of commitment through a disciplined and ethical approach to business.

Current Facilities BR Life Group of Hospitals currently operates in the following locations in India Bangalore (SSNMC Superspecialty Hospital), Trivandrum (SUT Pattom Superspecialty Hospital and Bhubaneswar (Kalinga Superspecialty Hospital) with the flagship hospital being the one at Bangalore namely BR Life SSNMC Superspecialty Hospital.

Dr B R Shetty Founder and Chairman of NMC Healthcare, Finablr, Neopharma and BRS Ventures

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r. Shetty is a serial entrepreneur, pillar of the community and social servant.A visionary leader, who follows his heart and intuition, he has explored untapped markets and paved new pathsin his successful entrepreneurial journey in UAE. He started hisinnings in 1975 with the launch of New Medical Centre (NMC), the first private healthcare facility in UAE.His distinctivecapabilities and foresight havetransformed the healthcareindustry in the region. His commitment to providestate-of-the-art facilities enabled NMC to be listed on the London Stock Exchangeand included as a part of the coveted FTSE100 index. NMC has also been inducted into the exquisite club of MSCI Global Index.

The burgeoning expatriate population in UAE triggered the need for a formal and safe money transfer channel. Dr. Shetty sensed an opportunity in that challenge and ventured into the remittance sector by launching UAE Exchange;which is now a leading global remittance, foreign exchange and payment solutions brand. He identified an opportunity in currency exchange business and acquired Travelex, the world’s leading foreign exchange specialist. With this acquisition, he was successful in bringing two category leaders under a single umbrella. All these leading brands are now a part of the recently formed holding company – Finablr.

In a step towards backward integration into the healthcare sector, Dr. Shetty set-up Neopharma in 2003.Neopharma is a state-of-the-art manufacturing facility and has collaborations with multinational companies like Pfizer, Merck, Abbot Laboratories, Hetero Pharmaceuticals and Biocon to name a few. Recently, Neopharma has acquired an antibiotic manufacturing facility in the USA. Diversified business interests of Dr. Shetty, led him to open quality institutions in the education, hospitality, and environment sectors. He has recently acquired the Assam Tea Company in India.

As a part of the strategy to provide innovative solutions across varying verticals, Dr. Shetty has recently established BRS Ventures. The company has already earned itself the reputation as one of the leading and premium business groups in United Arab Emirates.

The company has also established a global presence with successful acquisitions and strong partnerships.

With a belief of giving back to the country, Dr. Shetty has established a leading healthcare services brand – BR Life. Headquartered in Bengaluru, Dr. Shetty currently operates multi-specialty healthcare facilities in India, Nepal, Africa and Middle East. Seven Hills Hospitals, located in Mumbai and Visakhapatnam, are the latest additions to BR Life.

Dr. B.R. Shetty’s business accomplishments and exceptional social work have earned him the “Order of Abu Dhabi”, the highest civilian honour bestowed by the Government of Abu Dhabi. He is a recipient of the prestigious Padma Shri award, one of the highest civilian honors from the Government of India. The former President of India, late Dr. APJ Abdul Kalam conferred upon him the PravasiBharatiyaSamman Award, for his outstanding contribution towards betterment of NRI community.

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BR LIFE Binay Raghuram Shetty Vice Chairman and CEO, BRS Ventures

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s the Vice Chairman and CEO of BRS Ventures, Binay Shetty embodies the best qualities of a successful entrepreneur of this generation. Guided by his visionary father, Binay is poised to take the legacy forward. He brings strong expertise of having worked with the BRS Ventures’ entities for more than a decade.

Prior to his current responsibility, he held the position of Chief Operating Officer at NMC Health, a London Stock Exchange listed healthcare provider and part of the premium FTSE 100 Index responsible for Operations, HR, Marketing, IT and Projects. He was a Board Member of NMC Health Plc. In addition to his current role, Binay also serves as the Executive Director of Finablr, a global platform for full service payments and foreign exchange underpinned by proprietary technology with network companies such as UAE Exchange, Unimoni, Travelex, Xpress Money, Ditto Bank.

He is also the Director of UAE Exchange, a leading global remittance, foreign exchange and payment solutions company as well as Travelex, a global foreign exchange provider. He is also the Vice Chairman of Alexandria NMC, a healthcare group in Egypt and BR LIFE that operates multi-specialty healthcare facilities in India.

Binay is also a board member of the Indian Business & Professional Group (IBPG) Abu Dhabi, Center for Technology and Economic Development (CTED), a research center at New York University Abu Dhabi and UAE Genetic Diseases Association. He is also managing trustee of the Dr. BR and Dr. CR Shetty Foundation.

He has 14 years of experience with a focus on strategic planning and corporate governance. He is an active participant in various social and philanthropic initiatives as well as community activities.

Binay graduated from Boston University, Massachusetts, USA, with specialization in Finance and Entrepreneurship.

BR Life SSNMC Superspecialty Hospital:The flagship hospital of BR Life Group of Hospitals, this isa ultramodern 400 bed plus state of the art facility providing advanced, accessible and affordable worldclass healthcare. The hospital, like a true multi superspecialty tertiary to quaternary care facility, has multiple Centres of Clinical Excellence (COCEs) which offers the best in care and class medical care.

These Centers of Clinical Excellence includes the following: Cardiac Sciences Center of Clinical Excellence  Orthopedic Center of Clinical Excellence  Neuro Sciences Center of Clinical Excellence  Gastroenterology Center of Clinical Excellence  Oncosciences Center of Clinical Excellence In the pipeline and very shortly the following clinical excellence centers will be added:Hemato- Onco Sciences Center of Clinical Excellence

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 Blood Related Disorders  Bone Marrow Transplant Multiorgan Transplant Center of Clinical Excellence  Liver Transplant  Kidney Transplant  Pancreas Transplant Infertility & Assisted Reproduction Center of Clinical Excellence All these centers of excellences are led by some of the finest and renowned clinical experts having worldwide experience in delivering the best in care and class clinical outcomes for patients. Besides the center of excellences, SSNMC Superspecialty Hospital also boasts of a number of disease specific clinics like: Spine Care Clinic  Heart Care Clinic  Bone & Joint Clinic  Prostrate Care Clinic  Cardio Neuro Trauma Center  Stroke Clinic with dedicated Neuro ICU  Liver Disease Clinic with dedicated Hepatic ICU

BR Life SSNMC Superspecialty Hospital pride of place is its International Patient Services wherein a dedicated team of people ensures the best in care and class diagnosis and treatment for all patients who comes seeking relief and succour from their ailments. The International Patient Services has the following facilities for patient facilitation: 24 x 7 Medical Enquiry Center  Complimentary Airport Transfers  Dedicated Lounge with Business Center  IT, FOREX and Travel Services & Counselling  24 x 7 Language Interpreter / Translation Services  Dedicated Apartment Accommodation with Self Cook Facilities As BR Life Group of Hospitals continues to strive forward on its ambitious journey of creating and providing a most advanced, accessible and affordable worldclass medical care to the people of the Indian subcontinent delivered upholding the ethos of BR Life Group i.e. “Caring and Healing with Compassion and Humaneness”, it seeks the support of the people it serves and the medical fraternity in this endeavor.

MAGNUS MEDI

Magnus Medi- NABH and IATA Accredited Medical Tourism Company, One platform for Medical travel Solutions

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agnus Medi is one of the leading Medical value travel company in India, it was established in 2010 as a tour and travels and now serves as a one-stop solution provider for Medical travel in India. We are accredited by NABH (National accreditation board for Hospital and Healthcare) organized by QCI and IATA (International Air Transport Association) is a trade association of the world’s airlines. The company takes care of all the needs from pre-treatment to post-operative phase, like getting an opinion, cost, pre-medical consultation and appointment with the doctors on ground support and local logistics.

We proudly felicitate medical tourism to our clients by associating with the best healthcare institutions across India. We closely understand the requirements and provide the most suitable array of facilities through selected healthcare bodies considering their accreditations, area of specialization, infrastructure and technology available.

“Our Vision is to Make India a world leader for treating Patients from Worldwide. We believe for better and affordable health for All Local Indians and we wish to be the leader, in helping patients getting treated in India with our technology, innovation, and information”, says Mihir Vora, CEO of Magnus Medi.

Quality of service: As we are Experience in travel industry for so long, we understand, what is required by travellers of such needs and we serve our healthcare seekers with not just conventional services but all the assistance which will required during their stay in India.

We give all required assistance to ensure

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the guests remain comfortable and hassle-free so they can focus on their treatment in best hospitals in India. As each healthcare traveller has unique needs, we customize our services as per their requirements, background and health situations.

We are associated with over 10 prestigious group of hospitals and with some very talented and renowned independent doctor’s facilities, which aggregate more than 70 hospitals across India. We are likewise connected with wellness, Alternative therapy Centers, and Dental Specialists. We arrange unique healthcare packages customized & cost-effective for full body check-ups, wellness therapy with an intention to connect with business people, and leisure tour.

Our Presence in Other country: We have a local presence in Uganda, Kenya, and Tanzania. Our initiative of having an office at each focussed country have impacted operations in a better way for both healthcare seekers as well as for us. Local presence always ensures reliability in the mind of traveller and it helps in ease of operations with respect to trust, coordination, communication and reaches. Now we have a proper team for each country which eliminates the local

language barrier as well. We are digitally connected worldwide and have dedicated in-house technology and digital team Patient relations executive and Post-treatment team has helped achieve better patient care and patient satisfaction.

“Our focus on quality, processes and unique approach made us standout from the rest” We being trusted - Our focus on quality, processes and unique approach made us standout from the rest. Additionally, our accreditations have helped us gain patients first level of trust, followed by our training and being straight forward with patients and hospitals have given us bigger success in terms of winning the trust of patient. We learn and evolve at every stage by improving on our delivery and constantly upgrading our approach and eliminating any shortcomings in cases handled.

“Our focus on quality, processes and unique approach made us standout from the rest”

MEDTRAVEL

The Dimensions of Medical Tourism

Meeting Health Needs

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ack of adequate facilities can make you question why you are adjusting with mediocre conditions and further look for alternatives.

Thus arises the concept of medical travel, a basic idea which takes people to another country or destination, where they can avail adequate medical treatment.

Such is the story of one in millions of people in underdeveloped and developing countries.

Lack of proper healthcarefacilities and providers either force them to suffer the grunt of a disease, or to shift their treatment to another country, where they at least hold the hope of recovering from their health condition. The phenomenon is largely predominant in nations like Africa, where the ratio of diseases, to the available healthcare options is drastically imbalanced. The concept is not new to developed countries either, where people often look for other medical destinations, where the treatment offered is

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better than their home country.

Thus, people expect to avail medical treatment in another country, which is equipped with advanced resources and treatment methodologies. The same can be witnessed in the case of Africa, where people are increasingly preferring India as their medical destination. It is clear from this pattern that people are highly expectant when it comes to medical facilities in their country but the lack of which, may also drive them to another popular destination, if that means better treatment options for them.

Since people in countries like Africa and the GCC, find it hard to avail adequate & quality treatment resources at an affordable price range, people, thus, are forced to explore other options for their medical needs. People expect medical travel to be a source of availing best treatment services so that they can be diagnosed and treated at the earliest, in a professional and efficient manner.

Given that, India has been rated as one of the top global healthcare destinations around the world, it is quite generic to witness the growing attraction of the world population to the country, when it comes to healthcare services. This is most likely, a fast booming sector for the country and as well as for the healthcare providers who seek to thrive and expand their scope of services. With the growing demand for Indian healthcarefacilities, it is time for medical value travel facilitators to push their operations in a fast track mode and make the most of this developing economy, not only in terms of revenue but also from the standpoint of overall experience.

What can aid the success of the Medical Tourism Industry, is an equal and warranted support from the government, in terms of its policies and contribution towards the medical sector. Playing its share of role in this scenario is Medtravels, a leading healthcare web platform, which envisions-

bridging the gap between healthcare providers and healthcare seekers. With a growing network of franchise partners, Medtravels is expanding its reach to every nook and corner of the globe to ensure that it stands by its objective of providing “Healthcare Beyond Boundaries”.

In a short span of time, Medtravels has evolved by leaps and bounds, including a vast array of local PHC’s in foreign countries, organising OPD’s and Surgical Camps, not only in India but also in other countries. It would be rightful to say that Medtravels has achieved a level of growth, which is far from being expected but which also marks the extent to which the Indian medical tourism industry has advanced. In the manner that it continues to bring more and more participants under its network, the day is not far ahead when Indian will be booming in the name of a leading healthcare destination, popular for its seamless array of services.

SHARP SIGHT GROUP

SHARP SIGHT

Group of Eye Hospitals

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ver the years, India has evolved as a premier destination for medical tourism.

It scores high over a range of factors; from highly skilled surgeons to the world-class treatments, affordable hospitalisation costs to the well-equipped hospitals with modern amenities. All this and much more makes India one of the top destinations for medical tourism. Infact, for the medical consumer, the benefits are clear.

Established in 1998, Sharp Sight Group of Eye Hospitals is among the biggest quality eye care treatment provider in DelhiNCR. Driven by the quest to protect and prevent vision loss and blindness, Sharp Sight eye hospitals have successfully conducted over 1,00,000 successful eye surgeries and have over 1000000

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satisfied patients who have been treated by us for various eye related problems from all walks of life. Our chain of hospitals are a dedicated, quality-driven, NABH accredited modern surgical centres of excellence catering to patients from all corners of the country and abroad.

At Sharp Sight Group of Eye Hospitals’ quality of health care is not just measured in terms of well-trained doctors, medical personnel or medical facilities, but it goes synonymous with compassionate patient care and minimum waiting time, thereby offering our patients an experience and not a hospital environment.

We are also NABH approved and under process of getting JCI accreditation.

Sharp Sight takes utmost pride in bringing the world-class

“Quality Ophthalmic Treatment” facilities within the reach of community. A mature and dedicated leadership, high work ethics, qualified, experienced and devoted consultants, NABH Standards, Quality and Environment, worldclass Management systems have helped us increase “cure” rates.

We have a tie-up with a hospital in Benin, Nigeria and also with a hospital in Tajikistan.

At Sharp Sight, our aim is to provide state of the art eye care facilities. Our centres are equipped with the most advanced eye care equipment’s. To compliment these machines, our doctor’s have been trained in the most prestigious institutions and they participate actively in the national and international conferences and seminars. They are amongst the finest surgeons in the

field of eye care and have performed over 1,00,000 successful surgeries, across all age groups.

At Sharp Sight, we have always believed in taking modern eye care technology to the places where there is a huge gap and adversity. Our aim is to reach out to unchartered places, both national and international, where technology does not exists and our presence can illuminate numerous lives.

Quality treatment, use of worldclass technology and cost-effective pricing are some of the key factors of our services. Infact, all our treatments and products are in par with international markets. We make sure to offer latest treatments at pocket friendly prices. Most of all, our team makes sure to offer alternate options to the patient so that he/she does not feel financial constraints. For instance, if a patient has a cataract, we offer treatments ranging from traditional cataract surgery to Femto cataract and Robotic Femto cataract surgery, etc with a wide range of intra ocular lenses to choose from. So, accordingly, patient can opt any treatment option based on their personal choice.

Our emphasis has always been on affordable pricing so that we can penetrate further to unchartered areas and reach out to the masses. But, at the same time, we have boutique services so as to cater to our elite and international clients. So, at Sharp Sight we ensure to cover the entire spectrum of population.

In terms of growth, we have witnessed many of our new hospitals coming up -both at national and international level. And, to save our patients from the agony of travelling all the way to distant lands, we provide surgical facilities and assistance to many such countries that includes Nigeria, Tajikistan, Myanmar, Mongolia, etc.

Sharp Sight has also started new innovations by way of Tele Ophthalmology to provide access to a senior and experience consultants even to patients in remote areas and those deprived of quality eye care.

Our Vision is to enhance the quality of life by reviving the joys of vision”

SAHYADRI

Opening Doors to Newer Possibilities Matchless expertise, technology and carefor patients worldwide

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ahyadri Hospitals, one of the largest chains of hospitals in India is a name synonymous with innovation, excellence and trust. With a robust network of 8 hospitals, 900 beds, 2000 clinicians and 2600 supporting staff, Sahyadri Hospitals has touched the lives of over 50 lakh patients.

Owing to the successful track-record of over 25 years, Sahyadri Hospitals is one of the most trusted hubs of quaternary care in India. With its extraordinary critical care infrastructure, utter precision in diagnosis, round-

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the-clock availability of consultants, trained critical care experts and a strong backing of tertiary healthcare services,it has emerged as a leading global referral center for many critical specialitiesand super-specialities.

The group’s expertise is internationally acclaimed especially in critical specialities like Haematology, Bone Marrow Transplant, Organ Transplant and IVF, and also in other specialities like Orthopaedics& Joint Replacement, Oncology &Oncosurgery, Urology, Paediatrics& Neonatology, Nephrology, Gastroenterology and many more.

Haematology and Bone Marrow Transplant A leading referral centre for Bone Marrow Transplant and High-end Haematology, Sahyadri Hospitals provides comprehensive services for Blood Cancer, Clotting and Bleeding Disorders, Haemophilia and Thalassemia. It has a state-of-the-art Bone Marrow Transplant unit, which has conducted over 600 transplants till date (around 50 transplants every year). Both Allogenic and Autologous stem cell bone marrow transplantations are done for various Haematological Disorders, Auto-immune Disorders and Genetic Disorders. The centre has been recognized by National Marrow Donor Programme (NMDP) USA, for doing matched, unrelated donor bone marrow transplantations in Pune.

In addition to this, it is the only 2nd DNB programme for Haematology training in India and has a busy Clinical Trial Unit as well.

The services are well-supported by services like Rehabilitation and Counselling - a vital supportive service provided by a team of expert Physiotherapists, Yoga specialists and Clinical Psychologists.

Organ Transplant The group has initiated a state-of-the-art Centre for Organ Transplant in Pune with the sole objective to make transplants affordable and accessible to all. The centre is run by a multidisciplinary team of experts trained in India and abroad and having an experience of more than 1000 liver transplants. With adept Hepatologists, Liver Oncologists, Hepatic Interventional Radiologists and proficient supportive staff, the team has conducted more than 100 liver transplants in just 2.5 years.

Fast-tracking Liver Transplants Breaking away from conventional approach, the Liver Transplant Team at Sahyadri Hospitals is making bold changes and fast-tracking patient recovery, post organ transplant, allowing patients to get discharged on the 5th day itself. In addition to faster recovery, it also costs less than the traditional liver transplant surgery. The fast-track approach is used only in carefully selected patients. In addition to faster recovery, it also helps in slashing the cost of surgery.

Sahyadri’ s IVF Center The group’s advanced Fertility Centre offers end-to-end Infertility Management. With highly accomplished IVF Specialists, Embryologists and well-trained support staff, the center follows internationally accepted IVF protocols and global practices. Having provided infertility treatment to more than 4,000 patients till date, the group’s success rate is as high as

60%. Some of the highlights of Sahyadri’sIVF center as follows: • Best success rate in previously failed IVF cycles • Parenthood delivered to over 4,000 couples • Fertility Treatments available for Ovarian Stimulation, IUI (Intra-Uterine Insemination), IVF (In-Vitro Fertilization), ICSI, Donor Insemination, Andrology, Vitrification, MESA, TESA, PESA, TESE Lab & Medical Genetics All these facilities are supported with a state-of-the-art laboratory with advanced Haematology, Endocrinology and Immunology investigative facilities. An NABL accredited laboratory, SahyadriSpeciality Lab has precision at its core ensuring excellent service and accurate diagnosis.

The group also has a high-end molecular and medical genetics unit, a unique comprehensive facility offering clinical, diagnostic and therapeutic services in genetics. This is also an NABL accredited facility.It has high-end infrastructure for cardiac electrophysiological diseases and has world-class management for patients suffering from all cardiac rhythm disorders.

Redefining medical care and raising clinical standards higher with every step, the group is a robust, well-integrated healthcare organization, which is focused at excellence. Excellence that opens the door to every possibility!

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INTERVIEW

Indian MVT Potential to Improve Ian Youngman is a UK based analyst and writer who has written about medical tourism for 12 years. He has written and published scores of reports on medical tourism, the latest being Medical Tourism Global Market and Figures 2018. Here he speaks to IMT about scope for improving MVT in India What is the difference between an international patient and a medical tourist?

Medical tourist and international patient numbers are far too often used interchangeably. But they are not the same.An international medical tourist is one who goes from where they live to another country, primarily for healthcare or health treatment. Many people make the mistake of equating “international patients” with “medical tourists”.

International patients include Medical tourists  A country’s own citizens who are not in a national health scheme  Resident expatriates  A country’s own expatriates who still have a local home  New immigrants who are not citizens  Refugees  Economic migrants  War injured patients  International students  Diplomats of foreign countries  Military personnel and their families at bases in the country  Count all nationals with dual nationality as foreigners.  Tourists who fall ill, buy legal drugs, or have an accident  Business travellers, who fall ill, buy legal

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 

drugs or have an accident Temporary workers from overseas Groups who decide not to or are not allowed being citizens.

You research medical tourism market and report on its size and growth. What according to you are the prospects of Indian healthcare industry in medical tourism?

India sees increasing numbers of medical tourists but there are problems on cost.Increased hotel costs in India are causing medical tourists from poorer countries to look at alternatives including China and Thailand. While overall numbers are up, country specific figures for 2017 warn of problems ahead. Medical tourists from Afghanistan fell from 61,231 in 2016 to 55,681 in 2017. Medical tourists from Uzbekistan declined from 9,564 in 2016 to 8,309 in 2017.

Numbers from Kenya fell from 8701 in 2016 to 7496 in 2017.And numbers from Nigeria fell from 9277 in 2016 to 5530 in 2017. Numbers from neighboring Pakistan also came down from 3,955 in 2016 to 1,785 in 2017.

The Indian tourism ministry suggests that the reason for this is that people from poorer countries are most hit by the rise in hotel prices.

The increased goods and services tax on luxury hotels in India, rose from 18 per cent to 28 per

cent contributing to overall rise in the room rent. Even Airbnb prices have risen, such that it is not affordable to poorer patients. The latest figures for the number of tourist arrivals in India on medical visas are as follows (source: Indian Home Ministry 2018) 2012 - 171,021 2013 - 236.898 2014 - 184,296 2015 - 190,000 2016 - 201,099 2017 - Awaited How do you see India as compared to other Asian countries leading the medical tourism?

India was one of the first big medical tourism destinations and has huge potential but the government and hospitals assumed that all that they had to do was offer very low prices and people would flock in.

India has potential but unless the problems are addressed, India will lose custom to countries that treat medical tourists as welcome guests. The structural problems are outside of what the local medical tourism industry can do.

As a pioneer in medical tourism India should be a market leader, but despite offering low cost treatment, it has failed for years to attract customers in numbers like rival countries have.

Thailand, Malaysia and Singapore are surging ahead, with a better medical tourism offer to foreigners, though they are costlier than India.

What according to you are the challenges limiting medical tourism in India?

India attracts customers, mostly from poorer nations, with very low costs but has problems on safety and quality of care.

Many Indian hospitals fail to market properly and think that all they have to do is say how cheap they are to attract medical tourists.

They are easily misled by phantom opportunities such as NHS hospitals sending patients to India, and US insurers sending thousands of paying customers to India. There are worries on safety; security, cleanliness and standards.

The hundreds of hospitals, clinics, doctors and agencies compete with each other. Prices ad-

vertised or quoted rarely relate to the full price.

Many still promote India as 10 per cent of EU or US price, but that compares to top of the range costs against only surgery costs in India. The real cost saving is probably only 50 to 60 per cent once all costs are factored in.

It has taken years to get the government to attempt to regulate and promote medical tourism.In fact, many hospitals, agents, wellness centres and AYUSH hospitals fail the accreditation process. This is a major deterrent for medical tourism.

The key reasons for limiting medical tourism in India are  Touting and harassment of foreign tourists create a negative perception of India  Lack of adequate infrastructure  Lack of cleanliness  Foreigners absence of trust in many of the hospitals How can India overcome these challenges to become a medical tourism leader?

India needs to focus on quality investment to be globally competitive in medical tourism.

Indian healthcare has been constantly improv-

ing and there is a huge opportunity still untapped.The bottom line is that to attract more foreign medical tourists in India, the hospital and country infrastructure both need great improvement, and the way that tourists in India are harassed on the street, is a problem. But neither problem is simple as it is more about the social and political structure of the country, than cosmetic fixes.

The notoriously slow bureaucracy of any government body in India means that promises to help promote medical tourism are not being met. Promises of accreditation and tougher standards for hospitals and wellness centres have not been met as yet, again it looks like nothing is happening. The medical tourism world may be surprised that as some competitors struggle, India is not acting quickly to promote medical tourism. But Indians, used to empty political promises, corruption, and slow state processes, just regard it as normal Indian life.

The government is supporting promotion and this will increase numbers, but it has to take hospital safety and security more seriously, and regulate the many medical tourism agents- or the efforts will be wasted.

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INTERVIEW

Technology for MVT Manish Chandra, Co-founder, Vaidam.com talks about how technology facilitates MVT MEDICAL TOURISM India is a growing sector. India maintains a stronghold as preferred destination in most countries across Africa, Middle East, Saarc and CIS. Newer countries are looking towards India as destination for quality affordable treatment. Government support, Industry events, Hospital and Facilitation companies are working favorably.

Indian cities like New Delhi - NCR, Chennai,

Mumbai and Bangalore continue to be the preferred destinations. Patients have affinity to regions because of historical context and flight connectivity. Like patients from Bangladesh prefer Kolkata or South India, Iraqis prefer New Delhi, but Omanis prefer Kerala or South India.

India remains a sought after place for Cardio, Neuro, Orthto, Cancer and Transplants. We do see many patients for Fertility, Dental, Urology and Cosmetic procedures also.

Main players The medical travel facilitation has been a fragmented space with no big player dominating the space. But this is changing now with the advent of technology and new entrepreneurs.

Internationally there has been some funding in this space. But in India we haven’t see much activity on the fund raise. It is about time we start seeing activities in this space as there is huge scope to create a medical tourism company in India of global scale.

Traditionally, in marketplace buyers and sellers come together to do transaction; keeping the idea intact, healthcare will have its flavor. Ease of Information, technology, registration of facilitators and medical service providers, standardization with respect to cost will help move the industry towards structured marketplace.

Role of technology Technology coupled with entrepreneurial skills is going to be the game changer. There are quite many variables in medical tourism industry, like - geography, language, culture, travel, etc,.

Its a heterogeneousspace. Technology can bridge this gap. Things that are important to patients like translation, curated content and advice, seamless ground operations, etc can be created using technology.

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December 2018

Artificial Intelligence (AI) in Radiology Symposium 2018 Telerad Tech and Image Core Lab (ICL), jointly conducted a symposium on ‘Artificial Intelligence (AI) in Radiology’, on November 10, 2018 in Bengaluru FOCUSED ON the benefits of AI and offering a preview of the upcoming AI products such as ‘MammoAssist’, the objective of the symposium was to firstly highlight the role of AI and deep learning in the field of radiology, and secondly, to promote the understanding of the role of AI in the healthcare industry and finally highlight the development & technology initiatives in the field. The panel discussion topics were centered on these objectives, with a balanced representation in the field through the presence of both private and government representatives. In addition, it provided a valuable networking opportunity and set the stage for further cooperation among the participants.The symposium offered an exceptional opportunity to engage with leading minds on AI – a world-changing technology.

Welcome and Keynote Address Dr. ArjunKalyanpur, CEO and Chief Radiologist, Teleradiology Solutions, inaugurated the conference with a welcome & keynote address on how Teleradiology and Artificial Intelligence hold the same synergy in the field of healthcare.

He showcased a few real-world cases and also talked about how AI is impacting and will continue to affect Radiology.

This was followed by a panel discussion on AI & the Market Dynamics of Radiology.

Moderated by AshwaniSinha, Global Head - Business Development, Telerad Tech; the panel comprised of SrikanthNadhamuni, Chief Executive Officer, Khosla Labs, PrashantAkhawat, COO, Telerad Tech, Dr. Sanjay Dhawan, Group Director – Radiology, Clearmedi Healthcare, Ravi Ramaswamy, Sr. Panel discussion 1

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EVENT REPORT Panel discussion 2

Director and Head Health Systems, Philips Innovation Campus and Nitin Krishna Mallya, GE Healthcare. The panelists mentioned that there was no iota of doubt that AI was indeed transforming the future and making an indelible impact. In fact, all the speakers pointed to the fact that Artificial Intelligence is going to help radiologists improve their productivity as well as help them perform to the best of their ability.

Dr. Nobhojit Roy, Team Lead, Health Systems Strengthening, Bihar Technical Support Programme, (Catalytic support to the Health & Social Welfare Departments of the Government of Bihar) delivered a keynote address on AI in Screening & Public Health. His talk was well received by the delegates.

This was followed by a panel discussion on AI and its Clinical Applications: Stroke, Cancer, Screening & the role of AI.This discussion was moderated by Dr. Kalyanpur, the panelists comprised of Dr. Anjali Agarwal, Senior Radiologist, Teleradiology Solutions.

AbhishekMahajan, Associate Professor, Dept of Radiodiagnosis& Imaging, Tata Memorial Hospital, Gp.Capt. (Dr.) Hirdesh Sahni, Consultant Radiology Command Hospital, Air Force, Dr. Prachi Kala, HOD – Radiology, Vydehi Institute of Medical Sciences and Research Centre and Dr. Ravi Verma, Sr. Consultant Neuroradiologist, Citi Neuro Centre. At the end of this discerning session it was evident, that AI would definitely aid in shifting the burden of radiologists by cutting down mundane tasks that theycurrently perform as part of their read process.

Mammo Assist Launch MammoAssist: AI Algorithm tool for Early Stage Breast Cancer Detection (a product of Telerad Tech) was unveiled by Guest of Honor Dr. BS Ajai Kumar, Chairman and Chief Executive Officer, HCG. MrPrashanth in his presentation explained briefly to the audience that early detection was the key in breast cancer treatment and how‘MammoAssist’, would play a significant role in this regard which willnot only help in saving lives but also make radiologists lives much easier.

The product launch was followed a keynote address by Dr. AnuragAgrawal, Director

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December 2018

CSIR – Institute of Genomics & Integrative Biology. Through his engaging and interactive presentation, he talked about how AI would impact healthcare quality and services.

The symposium witnessed a third panel discussion on Development and Validation – Approach & Challenges. The panel discussion was moderated by Kishor Joshi, Global HeadBD and Sales, Teleradiology Solutions who spoke in detail on the updates of development and validation in AI assisted radiology.

The panelists comprised of. Dr. Akhil Kumar, Head Clinical development, Aurigene, Dr. PhaneendraYalavarthy, Associate Professor of Department of Computational and Data Sciences (CDS), Indian Institute of Science (IISc); Dr. Srivatsa.D.V. V, Sr. Manager, Nexxus Social Media solutions, IQVIA, SuthirthVaidya, Chief Executive Officer, Predible Health and Dr. AbhishekMahajan, Associate Professor, Dept of Radiodiagnosis& Imaging, Tata Memorial Hospital. The panelists concluded that Artificial Intelligence was the superset of CAD, and itcan easily take on the radiologists’ routine tasks while at the same time helping to decide criteria in Clinical Trials and Drug Development.

Dr. Anjali Agrawal, Senior Radiologist, Teleradiology Solutions spoke abouthow Deep learning and AI would revolutionize the emergency room radiology.

The fourth and final panel discussion that followed, post the above key note address, was on Infrastructure, Cloud & Supercomputing. Prashant Akhawat, moderated the panel and the panelists comprised of Sundara Ramalingam Nagalingam, Head - Deep Learning Practice, Austin Cherian, Head - High Performance Computing Business, Intel Technology India, Srinivaschary T, Senior Principal Engineer, Enterprise Technologist, DellEMC

Dr. BS Ajai Kumar and Xavier Kurian, Director Solutions & Alliances, DellEMC. The panelists discussed how IT companies are gearing up on the AI front for the future. The panelists agreed that the companies are developing customized graphic processors for Neural Networks & AI and high-end imaging solutions for Radiology.

To engage the audience further, an AI Quiz was conducted as a fun activity hosted by Dr. Jayadeepa, Chief Scientific Officer, ICL, the activity brought about considerable facts and knowledge sharing about Artificial Intelligence.

The symposium concluded with a video conference by Dr. Mark Michalski, MGH & BWH Center for Clinical Data Science who explained in his presentations on how deep learning and AI is helping some radiology studies in practice.

In his closing remarks, AshwaniSinha, thanked the panelists, key speakers, participants and organizers for their enthusiasm and support in making the symposium successful.

The event concluded with a set of presentations of real-world cases describing new and noteworthy initiatives relevant to the conference theme “How AI is impacting Radiology”.