Innovation in Healthcare- Focus on market access to

healthcare in emerging markets

Mukul Bagga

Business Head - Novartis

Innovation

• Improvement : Unmet need/Challenge– The power of observation

• Idea

• Implementation

Healthcare Innovation

Innovation in Healthcare

• The Unmet need – Are western Healthcare models sustainable in

a developing economy like India ?• India's expenditure on healthcare is 4% of GDP vs

other countries average of 10%• Percapita healthcare expenditure is Rs1500/• Govt expense on healthcare was 28% in 2008 –

the rest is private expenditure out of which 90% is out of pocket

• Health insurance covers approx 15% of the population

Opportunities for innovation in healthcare- The ideas?

• Funding

• Technology

• Delivery

Opportunities for innovation in healthcare- The ideas?

• Funding

• Technology

• Delivery

Innovation in Healthcare : Funding

• Public /Private partnerships : the microinsurance solution– Rashtriya Swasthya Bima Yogna (RSBY)

• April 2008• 727 surgical procedures• Cashless• Monthly premium of Rs 30 per family of 5• Total cover of approx 1 lakh • Tie up with private insurance company/Hospitals for

delivery• 25 Mn BPL population covered

Opportunities for innovation in healthcare- The ideas?

• Funding

• Technology

• Delivery

Innovation in Health care : Technology

• Innovation= research = high Cost ?• Applicability to India

– Cost– Infrastructure etc

• “Frugal engineering”– Low cost– Limited training– Local sourcing

Innovation in healthcare: Technology

• The Appaswamy /Aurolabs revolution : IOLs & ophthalmic equipments

• Serum Institute of India

Different m- Health products

Novartis Innovation to improve Patient Adherence with Technology

• Glow Caps

• Ingestible microchips

• Vaxtrac

• CML earth

• Molecular diagnostics

Opportunities for innovation in healthcare- The ideas?

• Funding

• Technology

• Delivery

Innovation in Healthcare :Delivery

• What is the issue ?– Infrastructure ?

• West : – Fully qualified staff– How to improve productivity?– The anti VEGF revolution

• India :– Dr/patient ratio: 1:2000– Rural population: Issue of access

Non adherence is a global problem

In developed countries adherence to long-term therapies in the general population is around 50% and is much lower in developing countries

WHO, Adherence to long-term therapies report

Where are we now?

16 | AMAC Spring Summit 2011 | Aunia Grogan | May 19th | Business Use Only

• 2 Mn RMPs – poorly trained but servicing rural areas• Use of telemedicine :Sky is the limit

• World health partners (WHP) sets up a franchise called Sky clinics• Pilot project at UP • Basic clinic : “Sky care”: training for basic ailments • Set up fee of Rs 40,000• 40-60% increase in turnoover• 1200 clics setup• Next level : ‘sky health center – connceted by PC /internet : 120

centers ; advanced diagnostics etc – Reaching 3.6 Mn population– Expanding to Bihar– 70Mn by 2014– Future : “Sky diagnostics”, “Sky generics”

Innovation in Healthcare : Delivery

Thank You!