INDUSTRIES

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MARKETSHealthcareinIndiaCHAPTER

01KeyhealthindicatorsIndia:Lifeexpectancyatbirthfrom2011to2021(inyears)LifeexpectancyinIndia20218070.4770.7170.9170.1570.1269.6469.0768.4667.8967.3667.24706050403020100201120122013201420152016201720182019202020213Description:ThestatisticshowsthelifeexpectancyatbirthinIndiafrom2011to2021.TheaveragelifeexpectancyatbirthinIndiain2021was67.24years.ReadmoreNote(s):IndiaSource(s):WorldBankIndia:Deathratefrom2011to2021(indeathsper1,000inhabitants)DeathrateinIndia20211099.4587.357.277.126.966.796.676.646.71765432106.66.59201120122013201420152016201720182019202020214Description:ThedeathrateinIndiaincreasedby2.1deathsper1,000inhabitants(+28.57percent)in2021.With9.45deathsper1,000inhabitants,thedeathratetherebyreacheditshighestvalueintheobservedperiod.

ReadmoreNote(s):India;2011to2021Source(s):WorldBankIndia:Infantmortalityratefrom2011to2021(indeathsper1,000livebirths)InfantmortalityrateinIndia2021504540353025201510542.940.938.836.93533.231.529.828.326.825.50201120122013201420152016201720182019202020215Description:In2021,theinfantmortalityrateinIndiawasatabout25.5deathsper1,000livebirths,asignificantdecreasefrompreviousyears.ReadmoreNote(s):IndiaSource(s):WorldBankFertilityrateacrossIndiafrom2011to2021(numberofchildrenbornperwoman)FertilityrateinIndia2011-20213.02.542.472.412.52.01.51.00.50.02.312.292.272.22.182.112.052.03201120122013201420152016201720182019202020216Description:ThetotalfertilityrateinIndiasawnosignificantchangesin2021incomparisontothepreviousyear2020andremainedataround2.03childrenperwoman.Yet2021sawthelowestfertilityrateinIndiawith2.03childrenperwoman.

ReadmoreNote(s):India;2011to2021Source(s):WorldBankAgingindexinIndiain2021,byregion(numberofelderlyper100children)AgingindexinIndia2021,byregionnumberofelderlyper100children01020304050496070SouthWest61.7NationalaverageNorth39.338.9Others34.934.5EastNorth-EastCentral32.827.87Description:In2021,ofallIndianregions,thesouthconsistednearly62elderlyIndiansper100children.Ontheotherhand,centralIndianstates,suchasUttarPradesh,andMadhyaPradesh,recordedthelowestagingindexthatmeasuredtimeperiod,withnearly28elderlypeopleforevery100individualsyoungerthan15yearsold.ReadmoreNote(s):India;2021;elderlyreferstopopulationover60yearsoldSource(s):InternationalInstituteforPopulationSciences;MinistryofHealthandFamilyWelfare(India);UNFPACHAPTER

02DiseaseburdenLeadingcausesofdeathsamongchildrenacrossIndiafrom2017to2019LeadingcausesofdeathinamongchildreninIndia2017-2019Shareofleadingcausesofdeath0510152025Unintentionalinjuries(excludingroadaccidents)OthersDiarrhoealdiseasesFeverofunknownoriginRoadaccidentsDigestivediseasesOtherinfectiousandparasiticdiseasesRespiratoryinfectionsNeuro-psychiatricconditionsCongenitalanomaliesMalignantandotherneoplasms9Description:UnintentionalinjuriesaretheleadingcausesofdeathamongchildrenacrossIndiabetween2017and2019.Itaccountedtoabout22.4percentofthetotaldeaths.Diarrhoealdiseaseswereothermaincauseofdeathamongchildrenbetweenfiveand14yearsold,with9.2percentduringthesametimeperiod.ReadmoreNote(s):India;2017to2019;Amongchildrenbetween5and14yearsoldSource(s):HMIS(India);IndianCensus(SampleRegistrationSystem);MinistryofHealthandFamilyWelfare(India)LeadingcausesofdeathsamongadultsacrossIndiafrom2017to2019MaincausesofdeathamongadultsinIndia2017-2019Shareofleadingcausesofdeath0510152025303540CardiovasculardiseasesOthersMalignantandotherneoplasmsDigestivediseasesRespiratorydiseasesRoadaccidentsTuberculosisGenito-urinarydiseasesDiabetesmellitusIll-definedsymptomsUnintentionalinjuries(excludingroadaccidents)10Description:Cardiovasculardiseases,malignantandotherneoplasmanddigestivediseasesweretheleadingcausesofdeathamongadultsacrossIndiabetween2017and2019.Cardiovasculardiseasesamountedtoover36percentofthetotalshare.

ReadmoreNote(s):India;2017to2019;Amongpeoplebetween30and69yearsoldSource(s):HMIS(India);IndianCensus(SampleRegistrationSystem);MinistryofHealthandFamilyWelfare(India)LeadingcausesofdeathsamongtheelderlyacrossIndiafrom2017to2019MaincausesofdeathamongtheelderlyinIndia2017-2019Shareofleadingcausesofdeath10

150520253035CardiovasculardiseasesIll-definedsymptomsRespiratorydiseasesOthersFeverofunknownoriginDiarrhoealdiseasesMalignantandotherneoplasmsRespiratoryinfectionsDiabetesmellitusUnintentionalinjuries(excludingroadaccidents)Genito-urinarydiseases11Description:CardiovasculardiseaseswereoneleadingcausesofdeathamongtheagingpopulationacrossIndiabetween2017and2019.Cardiovasculardiseasesaccountedto29percentofthetotalshare.Diabetesmellitusaccountedforoverthreepercentoftheshareofleadingcausesofdeathamongpeopleolderthan70yearsoldduringthesametimeperiod.ReadmoreNote(s):India;2017to2019;amongpeopleabove70yearsoldSource(s):HMIS(India);IndianCensus(SampleRegistrationSystem);MinistryofHealthandFamilyWelfare(India)ShareofmortalityofmajorcommunicablediseasesacrossIndiain2020ShareofmortalityofleadingcommunicablediseasesinIndia2020Encephalitis2%Malaria1%Entericfever(Typhoid)1%Others1%Viralhepatitis2%Acutediarrhoealdisease13%Acuterespiratoryinfection42%Pneumonia38%12Description:In2020,acuterespiratoryinfection(ARI)accountedforthehighestshareofmortalityat42percentinIndia.Followedbypneumoniawithashareof38percent.ARIisaninfectioncausedbybacteriaorvirusesintheupperorlowerrespiratorytractthathindersnormalbreathing.Immunocompromisedpatients,children,andgeriatricsareathigherriskofacquiringrespiratoryinfections.ReadmoreNote(s):India;2020Source(s):CBHI(India);Crisil;JupiterHospitalNumberofpeoplediagnosedwithnon-communicablediseases(NCDs)inIndiain2020,bystate(in1,000s)NumberofpeoplediagnosedwithNCDinIndia2020,bystateNumberofpeopleinthousands400

50001002003006007008009001,000WestBengalRajasthan897.54765.11MadhyaPradeshUttarPradeshTamilNaduAndhraPradeshGujarat729.75713.11540.41458.49457.45Punjab399.51391.02MaharashtraChhattisgarhHaryana273.5230.33Kerala174.88Telangana*KarnatakaGoa149.41146.2122.4813Description:Asof2020,WestBengalreportedthehighestnumberofpeoplewithnon-communicablediseases,whichwasmorethan897thousand.Incontrast,thewesternstateofGoareportedthelowestnumberofNCDcases,over22thousand.ThemostprevailingNCDsamongIndianswerechronicrespiratorydiseases,diabetes,cardiovasculardiseases,andcancers.

ReadmoreNote(s):2020;*DataforcardiovasculardiseasewasnotreportedbyTelanganastate.

DatacollectedbythesourcefromJanuarytoDecember2020.

Valueshavebeenrounded.

ReadmoreSource(s):CBHI(India);Crisil;JupiterHospitalCHAPTER

03ExpenditureSizeofthehealthcaremarketinIndiafrom2008to2020,withanestimatefor2022(inbillionU.S.dollars)SizeofthehealthcaresectorinIndia2008-20224003503002502001501003722801601101048173686052455002008200920102011201220142015201620172020202215Description:In2020,India'shealthcaresectorwasvaluedatroughly280billionU.S.dollars.Itwasexpectedtoreachabout372billiondollarsby2022,showcasingsignificantgrowthoverthepastdecade.Thesectorisoneofthelargestcontributorsintermsofrevenueandemploymentinthecountry.ReadmoreNote(s):India;2008to2020Source(s):ArancaResearch;Frost&Sullivan;Varioussources(LSIFinancialServices,Deloitte)ExpenditureonhealthcareinIndiafrom2014to2029(inmillionU.S.dollars)ExpenditureonhealthcareinIndia2014-2029200,000180,000160,000140,000120,000100,00080,00060,00040,00020,0000201420152016201720182019202020212022202320242025202620272028202916Description:ThecurrenthealthcarespendinginIndiawasforecasttocontinuouslyincreasebetween2024and2029byintotal57billionU.S.dollars(+48.03percent).Aftertheninthconsecutiveincreasingyear,thespendingisestimatedtoreach175.6billionU.S.dollarsandthereforeanewpeakin2029.ReadmoreNote(s):India;2014to2029;allvaluesareestimatesSource(s):GovernmenthealthcareexpenditureasashareofGDPinIndiafromfinancialyear2014to2023,withforecastfor2025IndiangovernmenthealthcareexpenditureasashareofGDPFY2014-20253.0%2.5%2.6%2.5%2.1%2.0%1.8%1.5%1.4%1.4%1.5%1.0%0.5%0.0%1.3%1.3%1.2%1.2%FY2014FY2015FY2016FY2017FY2018FY2019FY2020FY2021FY2022FY2023FY2025*17Description:TheIndiangovernmentspent2.6percentofthecountry'sGDPonhealthcareinfinancialyear2023.Thegovernmenthealthcarespendingislikelytobe2.5percentoftheGDPinthefinancialyear2025.ReadmoreNote(s):India;FY2014toFY2023;*Forecast.Valueshavebeenroundedforclarity.Previousreportshavebeenaccessed.

ReadmoreSource(s):IndiaBrandEquityFoundationOut-of-pocketexpenditureaspercentageofcurrenthealthexpenditureacrossIndiafrom2001to2020Shareofout-of-pockethealthexpenditureIndia2001-202080%74.1%75%70%65%60%55%50%45%73.4%

73.4%73.1%72.5%72.3%70.8%69.1%69.07%67.01%66.8%65.2%64.66%63.21%63%62.2%55.32%55.11%54.78%50.59%2001

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202018Description:In2020,Indiansspentaround50.6percentoftheirtotalhealthspendingasout-of-pocketexpenditure.Thiswasat74percentinfiscalyear2001,showingagradualdecreaseintheshareofhealthcareexpensesthatpeoplepaydirectlytotheproviders.However,Indiarankedasoneofthepoorestintermsofthisindicatorandcommonpeopleincurredheavyexpensesduetohealthcare.

ReadmoreNote(s):India;2001to2020Source(s):WorldBankTotalestimatedallocationofhealthbudgetinIndiafromfinancialyear2018to2024(inbillionIndianrupees)TotalestimatedallocationofhealthbudgetinIndiaFY2018-20241,2001,000984.61959.62914.95773.72800695.68667.34564.886004002000FY2018FY2019FY2020FY2021FY2022FY2023FY202419/statistics/1455656/india-total-health-budget-allottedInfinancialyear2024,theestimatedtotalbudgetallottedfortheIndianhealthsectoramountedtoabout985billionIndianrupees.Aconsistentincreaseintheallocationofhealthbudgethasbeenseenovertheyearssincethefinancialyear2018.ReadmoreNote(s):India;FY2018toFY2024;nominalvalueforIndianrupeesSource(s):ObserverResearchFoundation;UnionBudget(India)CHAPTER

04PublichealthprogramsTargetandachievementnumbersofAyushmanBharatHealthandWellnessCentersinIndiafromfinancialyear2019to2023(in1,000s)NumberofAyushmanBharatHWCsinIndiaFY2019-2023TargetAchievement18016014012010080154.0715074.9570604038.64017.1515200FY2019FY2020FY2021FY2023*21Description:Infinancialyear2023,therewereover154thousandAyushmanBharathHealthandWellnessCenters(AB-HWCs)acrossIndia.Therewastwicetheincreaseinthenumberofcentersascomparedtothepreviousyear.AB-HWCsprovidefreeessentialmedicineanddiagnosticservicesandteleconsultation.ReadmoreNote(s):India;FY2019toFY2023;*AsofDecember2022.India'sfinancialyearbeginsinAprilandendsinMarch.Forexample,FY2023startedinApril2022andendedinMarch2023.

ReadmoreSource(s):MinistryofHealthandFamilyWelfare(India);PIBCoverageofferedbygovernmenthealthinsuranceschemesinIndiaasofNovember2023(in1,000Indianrupees)CoverageofferedbygovernmenthealthinsuranceschemesinIndia2023CoverageinthousandIndianrupees100

2000300400500500600ChiefMinister’sComprehensiveInsuranceSchemeBhamashahSwasthyaBimaYojanaKarunyaHealthScheme500500500500YeshasviniHealthInsuranceSchemeAyushmanBharatYojanaRashtriyaSwasthyaBimaYojanaMukhyamantriAmrutamYojanaPradhanMantriSurakshaBimaYojanaMahatmaJyotibaPhuleJanArogyaYojanaAamAadmiBimaYojana30030020015075AWAZHealthInsuranceScheme1522Description:Asof2023,aboutfivegovernmenthealthinsuranceschemesprovidedcoverageof500thousandIndianrupeesinIndia.OutofwhichKarunyaHealthSchemeinKeralaprovidedhealthcaretolow-incomegroupsandseriouslyillpatientsofferingthemasuminsuredof500thousandrupeesperfamily.Meanwhile,AyushmanBharatYojanaprovideduniversalhealthcoverageforpeopleinlowsocio-economicgroups.

ReadmoreNote(s):India;asofNovember2023Source(s):ForbesNumberofprimaryhealthcarecentersinruralinIndia2022,bystateNumberofprimaryhealthcarecentersinruralIndia2022,bystateNumberofprimaryhealthcarecenters05001,0001,5002,0002,5003,0003,500UttarPradeshKarnataka2,9192,1382,133RajasthanMaharashtraBiharGujaratTamilNaduOdisha1,8531,4921,4741,4221,2881,266MadhyaPradeshAndhraPradeshAssamWestBengalJammu&Kashmir1,14292091589123Description:ThestateofUttarPradeshintheruralareasinIndiahad2919primaryhealthcarecentersasof2022.ThiswasthehighestnumberofcentersacrossIndia.Karnatakafollowedwithover2130primaryhealthcarecentersinruralIndiaduringthesametimeperiod.Theprimaryhealthcarecenter,whicharestateownedinIndia,providesessentialhealthcareservicesinrural,tribalanddesertareasacrossthecountry.

ReadmoreNote(s):India;2022Source(s):MinistryofHealthandFamilyWelfare(India)ShareofAyushmanBharathealthaccountscreatedinIndiaasofMarch2024,byageShareofAyushmanBharathealthaccountscreatedIndia2024,byage0-5years1.35%60yearsormore12.56%6-18years14.02%46-60years19.99%19-45years52.08%24Description:AsofMarch2024,over52percentofAyushmanBharathealthaccountswerecreatedforpeopleagedbetween19to45yearsoldinIndia.Incontrast,approximately20percentofthehealthaccountscreatedundertheAyushmanBharatprojectwerecreatedforindividualsagedbetween40to60yearsold.ReadmoreNote(s):India;March2024Source(s):MinistryofHealthandFamilyWelfare(India)ShareofhospitalsempanelledunderPM-JAYinIndiainfinancialyear2023,bytypeShareofhospitalsempanelledunderPM-JAYinIndiaFY2023,bytype60%56%50%40%30%20%10%0%44%PrivatePublic25Description:Infinancialyear2023,over28thousandhospitalsinIndiawereempaneledunderthePradhanMantriJanArogyaYojana(PM-JAY).Publichospitalsaccountedfor44percentofthetotalempaneledhospitals.UndertheAyushmanBharatPM-JAYscheme,thecountryprovidedsecondaryandtertiarycareforover120millionfamiliesduringthatyear.ReadmoreNote(s):India;FY2023Source(s):MinistryofHealthandFamilyWelfare(India)(NationalHealthAuthority);PIBCHAPTER

05HospitalsanddiagnosticsNumberofhospitalsinIndiafrom2014to2029NumberofhospitalsinIndia2014-202925,00022,296

22,356

22,41122,154

22,22921,979

22,07221,764

21,87721,514

21,63921,22020,92720,63320,34020,04720,00015,00010,0005,0000201420152016201720182019202020212022202320242025202620272028202927Description:ThenumberofhospitalsinIndiawasforecasttocontinuouslyincreasebetween2024and2029byintotal339hospitals(+1.54percent).Afterthefifteenthconsecutiveincreasingyear,thenumberofhospitalsisestimatedtoreach22,411hospitalsandthereforeanewpeakin2029.Notably,thenumberofhospitalsofwascontinuouslyincreasingoverthepastyears.ReadmoreNote(s):India;2014to2029;allvaluesareestimatesSource(s):LeadinghospitalsandmedicalservicescompaniesacrossIndiaasofJanuary2024,bynetsales(inbillionIndianrupees)MajorhospitalsandmedicalservicescompaniesIndia2024,bynetsalesNetsalesinbillionIndianrupees010203040506070ApolloHospitalNarayanaHrudayalaGlobalHealth65.2529.6119.5919.0517.6915.34MaxHealthcareDrParthLabAsterDMhealthKrishnaInsituteofMedicalSciencesRainbowChild11.3211.1410.9910.66IndraprasthaMetropolis28Description:Themultispecialtyhospitalchain,ApolloHospitals,hadthehighestnetsalesinthehospitalsandmedicalservicessectorinIndiaasofJanuary2024,withsalesaggregatingtoover65billionIndianrupees.Thecardiacspecialtyhospital,NarayanaHrudayalafollowedwitharound30billionrupeesworthofnetsalesinthegivenperiod.ReadmoreNote(s):India;asofJanuary2024Source(s):MoneycontrolDistributionofgovernmentandprivatehospitalsinIndiainfinancialyear2022,byregionShareofgovernmentandprivatehospitalsinIndiaFY2022,byregionGovernmenthospitalPrivatehospital120%100%80%60%40%20%0%NorthEastNorthEastSouthWest29Description:Infinancialyear2022,theshareofgovernmenthospitalsinthenortheastIndianregionwasthehighestat80percent.Ontheotherhand,theshareofprivatehospitalswasthehighestinsouthernandwesternIndiaat70percent,respectively.

ReadmoreNote(s):India;FY2022Source(s):Crisil;JupiterHospitalNumberofclinicallabsofdiagnosticcompaniesinIndiainfinancialyear2022NumberofclinicallabsofdiagnosticcompaniesinIndiainFY2022Numberoflabs200050100150250300350400450SRLDiagnosticsDrLalPathLabs426277MetropolisHealthcareThyrocareDiagnostics1712630Description:Infinancialyear2022,SRLDiagnosticshadavastnetworkof426clinicallabsandover10thousandcollectioncentersacrossIndia.Meanwhile,theDrLalPathLabshad277clinicallabsinthecountry.ReadmoreNote(s):India;FY2022Source(s):AxisCapital;Varioussources(Companiesreport)NumberoftestsofferedbyleadingdiagnosticcompaniesinIndiaasofDecember2022NumberoftestsofferedbytopdiagnosticcompaniesinIndia2022Numberoftestsoffered2,000

2,50005001,0001,5003,0003,5004,0004,5005,000DrLalPathLabsSRLDiagnosticsMetropolisHealthcareRedcliffeLabsMaxLab4,6224,5004,1003,5002,700AsterLabs2,500OrangeHealthHealthians2,0001,600ApolloDiagnostics*ThyrocareDiagnostics1mg1,20072632031Description:AsofDecember2022,DrLalPathLabsconductedabout4,622testsacrossIndia.Thecompanyhadanetworkof277clinicallabsand15thousandcollectioncenters.Inthesameperiod,SRLDiagnosticsandMetropolisHealthcareofferedoverfourtestsinIndia.ReadmoreNote(s):India;AsofDecember2022;*TestcountforChennaionly.ReadmoreSource(s):AxisCapital;Varioussources(Companiesreport)CHAPTER

06HealthinsuranceValueofhealthinsurancegrossdirectpremiumswritteninIndiafromfinancialyear2013to2023(inbillionIndianrupees)ValueofhealthinsurancegrossdirectpremiumswritteninIndiaFY2013-20231,000900800700600906.68735.98592.76521.015004003002001000459.56380.06311.64250.37206.15178.51157.3FY2013FY2014FY2015FY2016FY2017FY2018FY2019FY2020FY2021FY2022FY202333Description:Inthefinancialyear2023,Indianinsurershadunderwrittengrossdirectpremiumsamountingtoover906billionIndianrupeesunderthehealthinsurancesegment.Itwasanincreasefromthepreviousfinancialyearwhentheunderwrittenpremiumsamountedtonearly750billionIndianrupees.ReadmoreNote(s):India;FY2013toFY2023Source(s):GeneralInsuranceCouncilNumberofpeoplewithhealthinsuranceacrossIndiafromfinancialyear2016to2023,bybusinesstype(inmillions)NumberoflivescoveredunderhealthinsuranceinIndiaFY2016-2023Governmentsponsoredschemes(includingRSBY)Groupbusiness(excludingstate-owned)Individualbusiness6005004003002001000FY2016FY2017FY2018FY2019FY2020FY2021FY2022FY202334Description:Inthefiscalyearof2023,over550millionpeopleacrossIndiawerecoveredunderhealthinsuranceschemes.Ofthese,thehighestnumberofpeoplewereinsuredundergovernment-sponsoredhealthinsuranceschemes,whileindividualinsuranceplanshadthelowestnumberofpeople.ReadmoreNot