Zoya Brar
Founder and Managing Director,
CORE Diagnostics

Need For Smarter Investment To Reduce The Healthcare Disparity And Gaps

On the IVD market in India

There are two interpretations of the phrase IVD market. The first one refers to the business of instruments and consumables that are manufactured and sold by companies such as BD, Thermo Fisher, etc. to laboratories that perform diagnostic testing. The second interpretation refers to the actual clinical diagnostic testing done by the laboratories. The first interpretation refers to a product. The second interpretation refers to a service. The customers of the first interpretations are hospitals and labs. The customers of the second interpretation are the patients. The field of IVD is evolving fast, because of development of advanced technologies such as molecular diagnostics and next-generation sequencing – that make possible an entire array of genetic, genomic and proteomic testing.

According to a recently conducted study, the IVD product market is growing at a CAGR of 5.5 percent. In India, the clinical diagnostics service market is growing much faster, at over 10 percent CAGR, with the high-end testing segment growing at nearly 20 percent CAGR.  The growth in the ASEAN market is of similar magnitude. The driving factors for this growth are increased spending in the private healthcare sector and increased patient awareness. As a developing country, India is also dealing with innumerable health challenges such as high incidence rates of diabetes, cardiovascular disease, cancer, and infectious diseases. As such, emphasis on diagnostics, prognostics, and predictive techniques is critical. They are the starting point for ensuring effective treatment or cure.

On vision of Indian healthcare system what needs to be done to achieve it

Let’s first look at the state of Indian healthcare, as it stands today. India has one of the least expensive private healthcare system in the world, and yet it offers world-class clinical outcomes. For instance, a cardiac by-pass surgery, which would easily cost upwards of USD 100,000 in the US, is priced at under USD 5000 at any private hospital in India. The clinical outcomes are identical. This is a remarkable starting point.

Next, let’s talk about the future. Even if we had infinite capital available (which we do not, as a country), we will still not be able to solve the problem of skill-gap, and access. This problem can only be solved with technology. For example, Tata Trusts recently announced a broad-based initiative to address the disease burden of cancer. The program will build over one hundred cancer centers across India, connect them with a national command center from where various medical services such as radiology, pathology, treatment planning, and genetic counseling can be provided remotely. The system is intended to become financially self-sustaining in less than five years. The program has far reaching objectives such as changing in mix of early to late stage diagnosis from 30:70 to 70:30 within next ten years – through a broad-based awareness campaign and focus on screening. This is a big deal, one of a kind, and perhaps first of a kind, globally.

This is an example where India can skip a generation, much the way it did so in the telecom revolution. If you notice, the primary driver of these innovations is in the area of diagnostics. That is the vision, and the raison d’etre for CORE.

On expansion plans over the next couple of years

At present, we are offering testing services primarily in the field of cardiology, oncology, reproductive, and endocrine illnesses with a major focus in oncology. However but we are expanding our portfolio in each of these segments because we feel that the diagnostic gap is the greatest. We have also added lines of services in nephrology, transplant medicine, and neurology. Our modus operandi as a leader of next-generation diagnostics is to bring the most advanced testing diagnostic techniques and expertise to India and be the destination for all high-end diagnostic testing.

We are currently expanding in a variety of ways. From expanding our geographical territories through various partnerships with government, pharma, and health tech companies, to making preventative tests available and accessible to consumers that can be ordered directly. Also, we are adding new clinical areas enabled by latest, cutting-edge technologies in whole genome sequencing, proteomics, and more recently, metabolomics.

On planned budgetary allocation for the fiscal year 2018-19 and proportion allotted for the procurement of IVD instruments and reagents

We go through a major Capex cycle every three years of so, with each cycle comprised of USD 4-5 million.

On the areas where government should invest to make healthcare available to everyone on the go

Technology is an integral part of the modern healthcare system and increasingly bringing a difference to the diagnostics, treatments, early detection, and prevention of rare and predisposed diseases. The barriers to affordable healthcare are lack awareness about type/kinds of rare and existing diseases, insufficient diagnostics facilities, and a stringent regulatory environment.

In a country like India, there is a pressing need for smarter investment in R&D and human resources to reduce the healthcare disparity and gaps. Recently, telemedicine (often referred to as telehealth) is gaining prominence with support from the government as we have witness projects like E-sanjeevani, a web-based telemedicine software solution to remotely manage, monitor, and counsel patients. Such services help saves time, faster turn around and keeps a check on the ever-increasing hospitalization, transportation, and other miscellaneous healthcare-related costs and reaching underserved regions at the same time.

Such digital and technological innovation works the best when backed by private investors, government bodies, healthcare partners, practitioners, and health service providers. Therefore, a high priority status of health care in the budget can build positive sentiment amongst the players and the citizens. In fact, CORE has built a panel of 100 experts globally, who provide second opinions, digitally – on diagnosis and treatment. These experts are the key authority figures in their fields which is only possible through the power of digital technology.

On CORE Diagnostics vision

Diagnostics makes up or only 3 percent of the total healthcare expense, and yet determines 70 percent of the downstream expense and 100 percent of the outcome. Our vision is to impact both – the quality of clinical outcomes, and the overall cost. We are well on our way.

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