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Need to pause, retrospect, and prospect!

Seven months into Covid has exposed the weakness of the Indian healthcare system. Hospitals, having had to postpone elective surgeries and suspend OPDs thereby reporting losses, had ti take drastic measures. Many smaller nursing homes had to shut down and some large corporate hospitals, facing price regulation and poor occupancy while undertaking multiple round of operational consolidation and cost-cutting measures and reporting losses in audited financial statements, har their billing practices questioned.

The revenue from COVID beds was not a patch on the revenue impertive to keep maintained and running. On a similar note, volume for non COVID-19 testing in clinical labs plummeted, while certain specialty labs had to close operations completely.In some cases ,they had to carry the added burden of short half-lives and short expiry for selected reagents and nuclear medicine.

Shifting gears, on the supply front, most MedTech equipment sellers reported an embargo on buying by the private hospitals in this period; miniscule buying bby small, new setups; and limited procurement by government hospitals having now switched to entry-models. Replacement demand was non-existent across the entire spectrum of product segments. Order that, had not been cancelled with disruption in supply chains, could not be executed in many cases.

The entire spend has been committed to COVID testing COVID test comprise 50 percent RT-PCR test, 40 percent antigen test, and 10 percent TruneNAT and CB-NAAT. the latter two being TB tests with kits validated for COVID. Take the case of molecular tests, the RT-PCR test. The regents markets in the March-September 2020 period os estimated at ~2220 core for 74.1 million tests conducted, and for October-December at ~2700 crore, with a conservative estimate of 90 million tests . This amounts to a total of ~4900 crore , for a segment that didi not exist in 2019 altogther. The leading suppliers of reagents in this segment, Roche , Thermo Fisher , and Qiagen can have nothing to complain about.

As the industry continues to navigate through these challenges, for COVID is nowhere near recording, the recntly announced National Digital Health Mission may somewhat buil out the industry-for a robust, public digital infrasture with the adoption of AI, ML and Lot, that it promise to create is long since overdue. At this point of inflection, leapfrogging to an open digital health ecosytem is perhaps the only way forward!

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