market research report : hb a1c testing market in india 2013

Insert Cover Image using Slide Master ViewDo not distort

HbA1c Testing Market IndiaHbA1c Testing Market – India

July 2013

Executive Summary

Market India is facing a persistent rise in its diabetic patient population and the number is estimated to grow from ‘u’ mn in 20‐‐ to ‘v’ mn in 20‐‐

HbA1c testing market in India is expected to reach INR ‘h1’ bn in 2017, growing at a CAGR of ‘ 1’ % f INR ‘b1’ b i 2012

i &

Drivers Increase in the number of diabetics

Challenges Test results can be influenced

‘x1’ % from INR ‘b1’ bn in 2012

Drivers & Challenges

Growing need for diabetes diagnosis

Increasing ageing population

Comprehensive health insurance policies covering diabetics

High price of tests

Racial and ethnic variations in HbA1c results

Technology Trends

Latex Enhanced Immunoassay Method

Enzymatic HbA1c Assay Method

High‐Performance Liquid Chromatography Method

Competitive Landscape

Major Diagnostic Service Providers

Apollo Health and Life Styles Ltd.

Dr. Lal Path Labs Pvt. Ltd.

Metropolis Healthcare Ltd.

Major HbA1c Analyzer and Bio Rad Laboratories Trivitron Healthcare

2HbA1c TESTING MARKET IN INDIA 2013.PPT

p Major HbA1c Analyzer and Reagent Manufacturers

Abbott India Ltd. Bio‐Rad Laboratories

(India) Pvt. Ltd. Trivitron Healthcare

Pvt. Ltd.

•Economic Indicators• IntroductionIntroduction•Market OverviewTestingTestingHbA1c

•Drivers & Challengesg•Diabetes Disease Trends• Technology Trends•Competitive Landscape• Strategic Recommendations


• Appendix

Healthcare system in India requires a larger public outlay due to huge population base

• According to “World Health Statistics 2011 Report, India”, healthcare comprised u% of India’s GDP in 2008 8,000

INR bn

%

Healthcare Market Size & GrowthHealthcare Industry Overview

Public and private expenditure on health as percentage of GDP was v% and w% respectively

• Favorable demographics, increase in awareness levels and better medical care are some factors that are driving the healthcare sector in India 0

2,000

4,000

6,000

,x% g

fdcba

driving the healthcare sector in India

• Segment 1 comprise the largest segment of overall healthcare market, followed by pharmacy, medical equipment, diagnostics and healthcare IT

• Gradual penetration of health insurance is stepping up

020‐‐e20‐‐e20‐‐e20‐‐e20‐‐e20‐‐

Healthcare Market‐ Segmentation

affordability of health services through increased demand for preventive and curative healthcare services

• Superior quality healthcare, coupled with low treatment costs in comparison to other countries, is b fitti I di di l t i th b d i i th

y%p%

Segment 3

Segment 2

Segment 1

benefitting Indian medical tourism, thereby driving the Indian healthcare market Treatment for major surgeries in India costs approximately 20% of that in developed countries

t%s%

r%

q%Segment 6

Segment 5

Segment 4


Diagnostics labs are witnessing healthy growth on the backdrop of huge expansion & improvement in technology

•Enhanced physician knowledge, coupled with better technology in the field of diagnostics, is causing the I di k

150

INR bn

x% gf

Diagnostic Service Market Size & GrowthDiagnostic Service – Market Overview

Indian market to grow

•Rise in lifestyle diseases has caused medical diagnostics market to grow immensely in tier II and tier III cities

• Diagnostic market is characterized by the presence of large number of labs in the unorganized sector that are 0

50

100

fd

cba

large number of labs in the unorganized sector that are not accredited

020‐‐e20‐‐e20‐‐e20‐‐e20‐‐e20‐‐

Diagnostic Service Market‐ Split Diagnostic Service Market‐ Segmentation

n%

q%

m%

p%India has more than u ‘000 labs


Category 2Category 1 Segment 2Segment 1

Rising diabetic population of India will ensure steady growth of HbA1c testing

•HbA1c market in India is expected to reach INR h1 bn in 20‐‐, growing at a CAGR of x1% from INR a1 bn in 20‐‐

•HbA1c tests can be offered exclusively or in packages with other tests by the diagnostic service providers

HbA1c – Market Overview

• Technology ‘A’ is currently the most common method adopted for conducting HbA1c tests in India

• PoCT for HbA1c testing at the household level is not available in the domestic market and hence, the laboratories and hospitals offering HbA1c tests hold 100% market share

• There is a growing level of awareness among the diabetic patient population of India about HbA1c testing which is leading them to take the test independently which in turn will suitably drive the HbA1c testing market in India Approximately u%‐v% of the HbA1c test takers come without the doctor’s recommendation

HbA1c Market Size & Growth HbA1c Tests Conducted Annually

INR bn

8

6

x1% h1g1f1d1

15

mn

x2%h2g2f2d26

4

2

0

f1d1c1b1a1

0

5

10d2c2b2a2


20‐‐e20‐‐e20‐‐e20‐‐e20‐‐e20‐‐20‐‐ 20‐‐e20‐‐e20‐‐e20‐‐e20‐‐e20‐‐20‐‐

Drivers & Challenges – Summary

Challenges

Drivers

Increase in the number of diabetics

Test results can be influenced

High price of tests

Growing need for diabetes diagnosis

Increasing ageing population

Racial and ethnic variations in HbA1c test results

Comprehensive health insurance policies covering diabetics


Rapidly growing pool of diabetic patients in the country will result in a continuous increase in the number of HbA1c tests

• India is the second largest diabetic pool in the world, after China

• Rapid urbanization and industrialization have led to lifestyle related changes that has increased

Increase in the number of diabetics Impact

the risk factors associated with diabetes High incidence of diabetes in India is mainly because of people’s sedentary lifestyles, lack of physical activity, obesity, stress and consumption of food rich in sugar, fat and calories

From one generation to the next, the prevalence of diabetes has increased six fold

Usually, u‐v% of diabetes cases are of type II and w‐z% are of type IUsually, u v% of diabetes cases are of type II and w z% are of type I

• Number of diabetic patients is expected to increase at an exponential rate through the years which will result in a steady increase in the demand for HbA1c tests

Increase in Diabetes Patients – India

60

80

mn y%hgfdcba

0

20

40


20‐‐e 20‐‐e20‐‐e20‐‐e20‐‐e20‐‐20‐‐

Note: The estimation covers diabetes in adult population between 20 years to 79 years

Diabetes Disease Trends– Summary

Diabetic Retinopathy

Cataract

Glaucoma

` Diabetic NeuropathyDiabetes Disease Trends

Cardiovascular Disease

Trends

Chronic Kidney Diseases

9

Foot Ulcers

Diabetic retinopathy has been recently declared to be the 6th most prevalent cause of blindness

Diabetic Retinopathy is a common diabetic eye disease that leads to blindness to both eyes caused by changes in the blood vessels of the retina

Common Symptoms

• People with diabetes (both type I and type II) are at risk and hence it is recommended to get a comprehensive dilated eye exam at least once a year

•During pregnancy, diabetic retinopathy may be a problem for women with diabetes

Common Symptoms

Blood vessels may swell and leak fluid

Abnormal new blood vessels grow on the surface of the retina

Diabetic Retinopathy – Prevalence among Diabetics by Age

mn

10

20

30

mn

c7

b7

a7c6

b6

a6c5

b5

a5c4

b4

a4c3

b3

a3c2

b2

a2c1

b1

a1

t‐u yearsr‐s yearsp‐q years


020‐‐e20‐‐e20‐‐e20‐‐e20‐‐e20‐‐20‐‐

Technology Trends (1/3) : Technology 1 Method

•The technology is also known as ‘Technology X’• This method for HbA1c testing is based on interactions between Particle 1 and Particle 2

• The cross‐link reaction results in changes in solution turbidity which is proportional to the amount of antigen present in samples

Latex Enhanced Immunoassay

Method

•The method has an advantage over ‘Technology A’ method in its application on general chemistry analyzerH h h d l k i i i d d d f P i l Y f i i h

Method Analysis

•However, the method lacks in precision standards and use of Particle Y often causes cuvette contamination that results in deterioration of assay precision


Market Competition – Porter’s Five Forces Analysis

Threat of New Entrants Impact

Impact Impact

Bargaining Power of Suppliers Competitive Rivalry Bargaining Power of BuyersImpact

Threat of Substitutes Impact


Competitive Benchmarking (1/4)

Key Ratios of Major Companies – Operational Basis (FY 2012) (1/3)

500

% Net MarginOperating MarginGross Margin

‐500

0

500f1d3

g2f3

f2

c2 c3

c1 d2b3b2

a3

a2a1

‐1,000

Company 6

g3

Company 5Company 4Company 3Company 2Company 1

• Company 1 recorded the highest gross margin, followed by Company 3 and Company 5

• Company 1 and Company 5 recorded similar operating margins with the former being slightly better than the latter

• Company 6 and Company 3 recorded negative operating margin and net margin


Note: Cost of Goods Sold for Dr Lal Pathlabs, S Serum and Thyrocare is N.A.

Private: Domestic Company – Company 1(1/5)Company Information Offices and Centres – India

Corporate Address

Tel No.

Fax No.

Products and Services

Website

Year of IncorporationHead OfficeHyderabad

Key People

Category Products/Services

Consultations

DiagnosticsN D i ti

Heath Check

Others

Name Designation

Person 1 CEO

Person 2 Senior VP – Marketing

Person 3 Head ‐ Operations and retails sales


Private: Domestic Company – Company 1(2/5)

Name No. of Shares held Bodies Corporate

Shareholders of the Company as on 20/06/2012 Ownership Structure

100%

Total


Note: Ownership structure corresponds to Date of AGM:20/06/2012

i i l S h K i

Private: Domestic Company – Company 1(3/5)Financial Snapshot Key Ratios

Net Profit/LossTotal Income

INR mn

400 5

INR mnc2

a2

Particulars y‐o‐y change (2012‐11)

2012 2011 2010 2009

Profitability RatiosOperating Margin

0

‐5

‐10

400

300

200

100

5

d2

d1

c1

b2

a2Net MarginProfit Before Tax MarginReturn on EquityReturn on Capital EmployedReturn on Working CapitalReturn on Assets

Financial Summary

‐150

20122011

c1

2010

b1

2009

a1Return on Fixed Assets

Cost RatiosOperating costs (% of Sales)Administration costs (% of Sales)

Interest costs (% of Sales)

• The company incurred a net profit of INR X mn in FY 20XX, as compared to net profit of INR Y mn in FY 20YY

• The company reported total Income of INR XX mn in FY 20XX, registering an increase of X per cent over FY 20YY

( )

Liquidity RatiosCurrent RatioCash Ratio

Leverage RatiosDebt to Equity RatioD bt t C it l R ti

• The company earned an operating margin of X.X per cent in FY 20XX, an increase of X.X percentage points over FY 20YY

• The company reported debt to equity ratio of X.XX in FY 20XX, a decrease of X.X per cent over FY 20YY

Debt to Capital RatioInterest Coverage Ratio

Efficiency RatiosFixed Asset TurnoverAsset TurnoverCurrent Asset Turnover


Improved Decline

Working Capital TurnoverCapital Employed Turnover

Private: Domestic Company – Company 1(4/5)Business Highlights

Description News

• Company 1 operates as a wholly owned subsidiary of the Company A

Overview

• Company 1 operates as a wholly owned subsidiary of the Company A

• It has established a large network of ‘Brand A’ across India

• ‘Brand A’ functions as an integrated model providing facilities for Specialist Consultation, Diagnostics, Preventive Health Checks and 24‐hour Pharmacy

k f h ‘ ’ li i i l ll di i l di dh d h

Diagnostics

•Has a network of more than ‘u’ clinics operational all over India, including Andhra Pradesh, Assam, Bihar, Delhi, Gujarat, Haryana, Karnataka, Kerala, Madhya Pradesh, Orissa, Srinagar, Tamil Nadu, Uttar Pradesh and West Bengal

• It has established state‐of‐the‐art Labs, which are equipped to handle diagnostics and imaging servicesservices

HbA1c• The HbA1c test is included in Product 1, which also includes Blood Sugar fasting & Post Prandial, Lipid Profile, Urine Routine, S Creatinine, BP –Ht‐Wt‐ BMI, Diet Counselling and Consultation with Diabetologist

Future Plans • Company 1 has plans of setting up similar clinics overseas in the near future


Private: Domestic Company – Company 1 – SWOT Analysis (5/5)

WS

TO


Thank you for the attentionHbA1c Testing Market – India report is part of Research on India’s Healthcare Industry Series.For any queries or customized research requirements, contact us at:

Ph 91 22 4098 7600

Follow us on:

Phone: +91 22 4098 7600E‐Mail: [email protected]

About Netscribes, Inc.Netscribes, Inc. is a knowledge‐consulting and solutions firm with clientele across the globe. The company’s expertise spans areas of , g g f g p y p p finvestment & business research, business & corporate intelligence, content‐management services, and knowledge‐software services. At its core lies a true value proposition that draws upon a vast knowledge base. Netscribes, Inc. is a one‐stop shop designed to fulfil clients’ profitability and growth objectives.

Disclaimer: This report is published for general information only Although high standards have been used in the preparation “Netscribes” is


Disclaimer: This report is published for general information only. Although high standards have been used in the preparation, Netscribes is not responsible for any loss or damage arising from use of this document. This document is the sole property of Netscribes and prior permission is required for guidelines on reproduction.

https://www.facebook.com/researchonindia

https://twitter.com/ResearchOnIndia

http://www.linkedin.com/groups?gid=3280715&trk=hb_side_g