Healthcare

Overview, Trends, Future
perspectives & Policy Reforms
Healthcare
Hospitals
Government
Private
Pharmaceuticals
Diagnostics
Medical
Equipment and
Supplies
Medical
Insurance
The Indian healthcare industry is valued at USD 78 bl as
of December 2013. The market is split into five segments
70%
13%
9%
4%
3%
Hospitals
Pharma
Medical
equipmen
ts
Insurance
Source: Hospital Market - India by Research on India, Aranca
Research
• 50 per cent of spending on in-patient beds
currently is for lifestyle-related diseases-
increased demand for specialised care
Shift from communicable
to lifestyle diseases
• substantial demand for high-quality and
specialty healthcare services; Gov. Support-
reduced taxes
Expansion to tier-II and
tier-III cities
• Fortis and Manipal Group are entering
management contract for additional revenue
stream
Management contracts
• A number of hospitals have adopted these
services; entered into PPP
Emergence of
telemedicine
• Health insurance is gaining momentum in
India
Increasing penetration of
health insurance
Notable trends in the Indian healthcare sector

→ Presence of world-class hospitals and skilled
medical professionals has strengthened India’s
position as a preferred destination for medical
tourism

→ The growth in the sector is underscored by the
cost advantage that India provides to the patients
from developed countries. Notably, India also
attracts medical tourists from developing nations
due to lack of advanced medical facilities in a
number of developing countries

→ Medical tourism market is expected to expand at
a CAGR of 27 per cent to reach USD3.9 billion in
2014 from USD1.9 billion in 2011

→ The major service offerings that attract medical
tourists from European nations and the Middle East
to India include yoga, meditation, ayurveda,
allopathy,
and other traditional systems of medicines.
0
1
2
3
4
5
2011 2014f
Medical tourism
market in India
Source: Ministry of Health, RNCOS, KPMG, Aranca
Research
Medical tourism: A new growth factor for India’s
healthcare sector
Indian Healthcare a $70
Bn Industry and
Growing at 15% CAGR
Source: Indian Health care, the Opportunity, PWC
Future Prospects of Indian
Healthcare
Major growth drivers:
Rising disposable incomes
Increased Accessibility
Increase in disease burden
Population growth
Insurance coverage
Others*
G
r
o
w
t
h

D
r
i
v
e
r
s

And this growth will
be fuelled by:
7.50%
4.80%
0% 50% 100%
2021
2010
Food and Beverages
Transport &
Communication
Housing and
Utilities
Apparels and
accessories
Medical Care and
Health
Education,
recreation
Healthcare expenditure to
increase from 5% to 7.5%
by end of this decade
Growth Drivers:
20
25
35
130
55
120
80
240
110
140
0 100 200 300 400 500 600
2010
2020
Gov.
Employee
insurance
Private
insurance
ESIC
RSBY
State
Insurance
Increased
Insurance
penetration-
from 45% to
26%
Source: Mckinsey report
Source: Mckinsey report
3.31%
2.80%
2.50%
1.30%
0.18%
4.91%
3.70%
2.70% 2.70%
0.20%
Coronary
Heart Disease
Diabetes Asthma Obesity Cancer
2005 2015
Rising number of lifestyle diseases
% of population suffering from lifestyle diseases
Source: National Health Council of India
In the base case scenario, all the important growth drivers will
witness robust progress.

• India’s population is expected to grow at 1.3 per cent
• prevalence of diseases such as diabetes and cancer will increase by 25 to 40
%
• GDP will grow at close to 8 %
•Rashtriya Swasthya Bima Yojana (RSBY) will cover 75 per cent of the BPL
population
• 1.9 million hospital beds will be added
• The Government will increase its spending on healthcare to 1.5% of GDP.
• Players will step up investments in consumer healthcare, biologics and
vaccines.
Moreover they will influence the patient funnel by increasing awareness and
treatment, thereby increasing the patient pool by 15 per cent.
,

Scenario picturing
On the other hand, an aggressive case scenario, spurred by
external conditions and purposeful industry actions, is
definitely possible

• GDP is expected to grow at around 8.3 per cent
•Insurance coverage would grow to cover the entire Indian population below the
poverty line
• Providers would invest in an additional 500,000 beds over and above the 1.9
million beds expected to be added in the base case
•The government’s spending in healthcare would reach 2 per cent of the GDP by
2020.

Spurred by greater affordability and infrastructure, players will intensify their
actions and would invest more aggressively to drive diagnosis and treatment rates
resulting in an additional 20 per cent increase in the patient pool.




Consequently, in this pessimistic scenario, growth would
slow down to 10%

10%
14.50%
17%
0%
5%
10%
15%
20%
Pessimistic Base Aggresive
Expected CAGR from 2010
to 2020
The expected growth
rate under different
scenarios from current
10 year CAGR of 15%
Policy and Reforms
Indian healthcare-Policy and reforms
Healthcare is a key focus area under the 12
th
Five Year Plan (2012-17)
→ The Planning Commission has allotted
USD83 billion under the 12th Five Year
Plan for healthcare spending; this is
about USD60 billion more compared to
the 11
th
Plan

→ As a result the share of healthcare in
total plan allocation is set to rise to 2.5
per cent of GDP in the 12th Plan from 0.9
per cent in the 11th


→ The National Rural Health Mission
(NRHM), introduction of district wise
pilots and setting up of more medical
institutions reflect the seriousness of
policy focus on healthcare
89%
3%
4%
4%
NRHM
District hospitals
Human resources
for health
Health insurance
under urban health
mission


Supportive policy driving FDI inflows
100 per cent FDI is permitted for all
health related
services under the automatic route

→ Demand growth, cost advantages, and
policy support
have been instrumental in attracting FDI

→ During April 2000 - September 2012,
FDI inflows in
Drug & Pharmaceuticals stood at USD9.7
billion

→ Inflows into hospitals and diagnostic
centres, and
medical appliances stood at USD1.44
billion and
USD0.6 billion respectively, during the
same period

9.7
1.44
0.6
0
2
4
6
8
10
Pharma Hospital and
Diagnostics
Medical and
Surgical
Appliances
FDI inflows (Apr 2000 - Sep
2012) into the healthcare sector
(in USD bl)

Source: Department of Industrial Policy & Promotion,
Aranca Research
Need for reform?
There has been mass improvement in healthcare p0licy- patent
reforms, RSBY, NRHM, FDI regulations

But....

•The private health sector functions practically unregulated and unaccountable
to the people or any authority.
•The healthcare expenses is much lower than that in developed country
•Quality of healthcare services are not up to the mark
•No cGMP for drug companies
•Drug Pricing not in sync with changing needs.
•More PPP needed
•Lack of infrastructure and human resources.
•Patent laws
•Research




Healthcare Industry Structure
&
Value Chain
Global Industry Overview
Healthcare
 The global health care industry is going through a period of
“glocalization” a term that combines the words
“globalization” and “localization” to describe the
adaptation of global products or services to accommodate
the needs of people in a specific locale.
 Total global health spending was expected to rise by 2.6
percent in 2013 before accelerating to an average of 5.3
percent a year over the next four years (2014-2017).

 This growth will place enormous pressure on
 Governments
 health care delivery systems
 insurers and
 consumers
 In both developed and emerging markets to deal with
issues
such as an aging population, the rising prevalence of
numerous chronic diseases, soaring costs, uneven quality,
imbalanced access to care due to workforce shortages,
infrastructure limitations and patient locations, and
disruptive technologies.
Outlook
 The outlook for global health care sector growth over the
next few years is generally positive. Emerging markets
including China, India, Indonesia, Russia, and Mexico are
expected to see spending increase quickly over the next five
years.
 Due to population growth
 Increasing consumer wealth and
 government programs to expand access to health care.
Regional perspective
 Health care spending in North America is set to rise
by an annual average of 4.4 percent from 2013-2017.
Growth will be driven partly by the expanded access to
health insurance coverage in the U.S.
 Latin American health care spending is expected to
rise by an annual average of 6.8 percent from 2013-
2017. The fastest spending growth will be in Mexico, at
more than 10 percent a year, with Brazil at 6.8 percent.
Asia Pacific
 The Asia-Pacific region’s health care spending is expected
to grow at a rate of 7.1 percent from 2013-2017.
 India has expanded its primary care policy priority and is
expected to increase spending at an average rate of 17
percent a year, followed by China at over 14 percent a year.
 Indonesia, Thailand, the Philippines, and Malaysia are also
likely to see double-digit annual growth as they expand
their health insurance systems. In Japan, health care
spending is expected to further increase due to its rapidly
aging society.
 The fastest-growing region in the coming years could be
the Middle East and Africa, where spending is expected to
rise by an average of 10 percent annually.
 Population growth which will combine with government
efforts to expand access to care.
 South Africa’s spending growth is expected to be slower, at
5.6 percent, even in light of the government’s efforts to
introduce universal health care
Brief About India Health Care
 India has been awarded a ‘Polio Free’ status by way of an
official certification presented by the World Health
Organisation (WHO).
 India is among other countries in the South East Asian
region which have been certified as being free of the polio
virus since year 2011 as per our ministry.
 Healthcare in India today provides existing and new
players with a unique opportunity to achieve innovation,
differentiation and profits.
 In the next decade, increasing consumer awareness and
demand for better facilities will redefine the country’s
second largest service sector employer.

 India's primary competitive advantage over its peers lies in
its large pool of well-trained medical professionals.
 India's cost advantage compared to peers in Asia and
Western countries is significant — cost of surgery in India
is one-tenth of that in the US or Western Europe.
 In India, the diagnostics sector has been witnessing
immense progress in innovative competencies and
credibility.
 Technological advancements and higher efficiency systems
are taking the market to new heights.

Market Size
 The healthcare sector in India is expected to grow at a
CAGR of 15 per cent to touch US$ 158.2 billion in 2017
from US$ 78.6 billion in 2012, according to a report by
Equentis Capital.(research firm)
 India being a country with a growing population, its per
capita healthcare expenditure has increased at a CAGR of
10.3 per cent from US$ 42.7 in 2008 to US$ 57.9 in 2011,
and going forward it is expected to reach US$ 88.7 by
2015.
 The factors behind the growth of the sector are
 Rising incomes
 Easier access to high-quality healthcare facilities and
 Greater awareness of personal health and hygiene.
Investment
 The private sector has emerged as a vibrant force in India's
healthcare industry, lending it both national and
international repute.
 The sector’s share in healthcare delivery is expected to
increase from 66 per cent in 2005 to 81 per cent by 2015.
 The private sector's share in hospitals and hospital beds is
estimated at 74 per cent and 40 per cent, respectively.
 According to data released by the Department of Industrial
Policy and Promotion (DIPP), hospital and diagnostic
centres attracted foreign direct investment (FDI) worth Rs
11,272.32 crore (US$ 1.87 billion) between April 2000 and
February 2014.

 Some of the major investments in the Indian healthcare industry are
as follows:
 Jaypee Group plans to diversify into healthcare by investing in excess of Rs
2,000 crore (US$ 332.68 million) over the next 3–4 years to set up a hospital
chain with a minimum capacity of 3,000 beds.
 Helion Venture Partners has invested Rs 27 crore (US$ 4.49 million) in multi-
specialty dental care chain Denty's, as demand for quality patient care
increases rapidly in India.
 Medwell Ventures Pvt Ltd has acquired Bengaluru-based Nightingales Home
Health Services, which has more than 5,000 families subscribing to its annual
care plans.
 Strand Life Sciences has partnered with the Mazumdar-Shaw Medical
Foundation (MSMF) to set up a lab that aims to bring down the cost of
detecting cancer.
 GE Healthcare and Cancer Treatment Services International have announced
plans to launch 25 cancer detection and treatment centres all over India with
an investment of Rs 720 crore (US$ 119.77 million) in the next five years.

Government Initiatives
 The Planning Commission has allocated US$ 55 billion
under the 12th Five-Year Plan to the Ministry of Health
and Family Welfare.
 The 12th Plan focuses on providing
 universal healthcare
 strengthening healthcare infrastructure
 promoting research and development (R&D) and
 enacting strong regulations for the healthcare sector.
 Some of the major initiatives taken by the government to
promote the healthcare sector in India are as follows:
 All India Institute of Medical Sciences (AIIMS) spends at
least Rs 2 million (US$ 33,271.51) annually on each faculty
member, according to a study by the institute's hospital
administration.


 The Union Cabinet has approved the proposal for setting
up of National Cancer Institute (NCI) at a cost of Rs 2,035
crore (US$ 338.51 million). NCI will be set up in the Jhajjar
campus (Haryana) of All India Institute of Medical
Sciences (AIIMS), New Delhi. The project is estimated to
be completed in 45 months.
Road Ahead
 Telemedicine is a fast emerging sector in India. In 2012, the
telemedicine market in India was valued at US$ 7.5 million, and
is expected to grow at a CAGR of 20 per cent to US$ 18.7 million
by 2017.
 India's competitive advantage also lies in the increased success
rate of Indian companies in getting Abbreviated New Drug
Application (ANDA) approvals.
 India also offers vast opportunities in R&D as well as medical
tourism.
 Reduced costs
 The availability of latest medical technologies and
 A growing compliance on international quality standards, as well as
the fact that foreigners are less likely to face a language barrier in
India.


 The Indian medical tourism industry is pegged at US$ 1 billion
per annum, growing at around 18 per cent and is expected to
touch US$ 2 billion by 2015.
 There is a significant scope for enhancing healthcare services
considering that healthcare spending as a percentage of GDP is
rising. Rural India, which accounts for over 70 per cent of the
population, is set to emerge as a potential demand source. Only
three per cent of specialist physicians cater to rural demand.
 There are vast opportunities for investment in healthcare
infrastructure in both urban and rural India. About 1.8 million
beds are required by the end of 2025. Additionally, 1.54 million
doctors and 2.4 million nurses are required to meet the growing
demand.
Value Chain In Pharmaceutical
Sector
Critical Success Factors &
Competition
Critical Success Factors

Strong mobile technology infrastructure and launch of 4G
is expected to drive mobile health initiatives in the country
• Mobile health industry in India is expected to reach $0.6 billion by 2017
Digital health knowledge resources, electronic medical
record, mobile healthcare, hospital information system are
some of the technologies gaining acceptance in the sector.
• Going forward, the healthcare sector's spending on IT products and
services is expected to rise from $53 billion in 2012 to $57 billion in 2013.
Key Growth Engines
 Health care expenditure
 Increasing population
 Rise in disposable income
 Rising literacy
 Lifestyle diseases
 Health Insurance
 Health Insurance
 Growing private Sector
 Technological Advancements
Key Growth Inhibitors
 Lack of Infrastructure and Manpower
 Inaccessibility of healthcare services
 Shortage of medical specialist
 Nursing profession
 Inefficiency of public healthcare providers

India’s Competitive Advantage
 Large pool of well-trained medical professionals in the
country.
 Cost advantage compared to peers in Asia and Western
countries is significant — cost of surgery in India is
one-tenth of that in the US or Western Europe.
 Increased success rate of Indian companies in getting
Abbreviated New Drug Application ( ANDA)
approvals.
 India offers vast opportunities in R&D as well as
medical tourism

Some of the common competition
concerns in these sectors include:
 Market failure due to information asymmetry
 International cartels such as vitamin cartels
 Collusions - vertical and horizontal collusion is
common across players in the medical supply
chain
 Abuse of dominance (IPR related) - The
ownership of an IPR grants the company
exclusive rights to produce and sell their drugs in
the market for a limited period of time. Alas,
often pharma companies engage in price
gouging.

Competition Concerns (Cont.)
 Mergers and Acquisitions and FDI – the recent controversy
over M&As and FDI in pharma where MNC acquisition
would threaten the availability of affordable generic
medicines. CCI has perhaps been given the responsibility of
regulating Pharma FDI M&As
 Absence of an adequate regulatory framework for
maintaining quality and standards of service provided
 Entry barriers and rent seeking in the medical education
sector
 Issues in medical insurance sector – lack of regulation or
control over providers’ behaviour

Health expenditure Health workers
Hospital
beds
Total Public
Out of
pocket
External
resources
Per
capita
Per
capita
Physicians
Nurses and
midwives
Community
health workers


% of
GDP
% of
total
% of
total
% of total $ PPP $
per 1,000
people
per 1,000
people
per 1,000 people
per 1,000
people
2012 2012 2012 2012 2012 2012 2007-12 2007-12 2007-12 2007-12
Brazil 9.3 46.4 31 0.1 1,056 1,109 1.8 6.4 .. 2.3
China 5.4 56 34.3 0.1 322 480 1.9 1.9 0.8 3.8
India 4 33.1 57.6 1.2 61 157 0.7 1.7 .. 0.7
Russian Federation 6.3 61 34.3 .. 887 1,474 4.3 8.5 .. ..
South Africa 8.8 47.9 7.2 1.7 645 982 0.8 4.9 .. ..
World 10.2 59.8 17.9 1.2 1,030 1,121 1.5 3.3 .. ..
Source: World Development Indicators 2014, THE WORLD BANK
World Health Indicators
Total health expenditure is the sum of public and private health
expenditures as a ratio of total population. It covers the provision
of health services (preventive and curative), family planning
activities, nutrition activities, and emergency aid designated for
health but does not include provision of water and sanitation.
Data are in U.S. dollars.
Expenses Incurred by the World & BRICS Countries
Source: World Development Indicators 2014, THE WORLD BANK
Global Perspective
Overview and Outlook
 Total global health spending was expected to rise by 2.6%
in 2013 before accelerating to an average of 5.3% a year over
the next four years (2014-2017).
 Total health care expenditures around the world was $6.15
trillion in 2013.

 Approximately $2.9 trillion in the U.S., $2.6 trillion in non-
U.S. OECD nations and $0.65 trillion elsewhere around the
world.

Health Expenditures and Services in
the U.S.:
 Total U.S. health care expenditures were estimated to be
$2.9 trillion in 2013, and are projected to soar to $3.4 trillion
in 2016.
 major categories of hospital care (about $929.0 billion),
physician and clinical services ($588.8 billion), dental
services ($116.6 billion) and prescription drugs ($262.3
billion), along with nursing home and home health ($238.6
billion).
 Health spending in the U.S., at about 18.0% of Gross
Domestic Product (GDP) in 2013, is projected to grow
steadily.
 15.4% of people in the U.S. (48.0 million) lacked health
care coverage for the entire year of 2012.
 In March 2010, President Obama signed the Patient
Protection and Affordable Care Act ("ACA")
 provide medical coverage to more than 30 million currently
uninsured Americans.
 Also in 2014, the government will begin fining citizens who
choose not to carry health insurance. The fine will start at
$95 per year or 1% of annual income (whichever is greater),
and rise to $695 per year or 2.5% of income by 2016.

Global health care sector top issues
in 2014

There are four major issues that governments, health care
providers, payers, and consumers face in 2014:
 aging population and chronic diseases;
 cost and quality;
 access to care;
 and technology
Aging population and chronic diseases
1.








Aging populations and increasing life expectancies are
anticipated to place a huge burden on the health care system in
markets such as Western Europe, Japan, and surprisingly --
China


Access to Care








 Every year in the United States, for example, 1.7 million
patients develop infections while in the hospital, and
99,000 die as a result.
Opportunities and challenges in the individual
health insurance market: Lessons from the U.S.

 India’s accelerating economic growth is transforming the
average Indian citizen into a discerning consumer with
significant disposable income.
 This growth will create a sizeable and largely urban middle
class of over 500 million people by 2025. This middle class,
will control almost 70 per cent of India’s urban
consumption power in 2025
 Five product categories—food, transportation, housing and
utilities, healthcare and personal products/services—will
account for over 80 per cent of total cumulative spending
in India over the next 20 years.
Health Insurance
 Success in a retail health insurance world requires seven
key capabilities and competencies.

Expected Sector Growth by 2020
 The slower growth in US and European markets will be
offset to some degree by expansion in emerging markets
like China and India, specifically for generic drug products.
 Healthcare will not be less innovative over the coming
decade, but rather that the focus of innovation will shift
from the product arena to healthcare delivery.
 More investment in new ways of delivering care, in part by
applying the power of information technology—long
overdue in healthcare, relative to other sectors.
 The critical question for companies will be how they can
evolve their business model and thrive in a world of
shifting profit pools.
 Contract research organizations will expand through
greater use of strategic alliances and risk-sharing
arrangements with pharmaceutical companies. Contract
manufacturing organizations will see 8% CAGR, in part
due to their expansion into China and India.

Key Challenges facing Health
Care Industry
Challenges for Life Sciences
Industry
 Transformation from Volume based model to Value
based model.
 It is no longer a physician-preference world.
 Patient advocacy groups, hospital administrators, and
other stakeholders will play a key role in product
selection and purchase.
 Companies will need to be responsive to how the
market wants to buy rather than fixating on how the
company wants to sell.
 A robust comparative effectiveness (CE) strategy and a
real-world evidence program that supports current
commercial activities, informs late-stage clinical
development and provides forward visibility of the
strategic needs to grow the business.


Challenges for Healthcare Provider
 Managing costs - Lowered reimbursement rates and increased patient
volume .
 How can providers use new transparency requirements so that
consumers and health plans really understand their costs, quality
outcomes and the value they are producing?
 Days of standalone hospitals likely are numbered.
 Horizontal integration (hospital-hospital acquisitions) and forming
much larger entities to better collaborate, prioritize programs, increase
purchasing power, consolidate services and cut costs.
 Vertical integration- Hospitals are becoming true health systems;
they are buying physician practices, ambulatory centers, diagnostic
centers, home care services, and durable medical equipment and
wellness companies.
 Providers are looking at clinical efficiency and effectiveness to both
reduce cost and prepare for the required reporting on quality.
Challenges in Health Plans Creation
 Health plans will be operating in a very complicated environment, with
Medicaid and Medicare rules, HIX rules and commercial rules.
 Managing employer and consumer expectations- Health plans will
be having lots of conversations with employers – particularly with mid-
market and small companies – about the new exchange environment
and its resulting implications.
 There will be conversations with individual consumers as well, helping
consumers to understand the value of the product they are buying and
how to use it effectively.
 Changing Business Models & Operational Strategies -
Predictability is not a word that health plans will be using in 2014.
 Determining whether their assumptions about exchanges, Medicaid
expansion and the individual market were true, and making changes to
their business models and operating strategies, if need be.
Challenges Facing Pharmaceuticals
Industry
• Successfully developing innovative drugs and enhancing R&D productivity.
• Pricing pressures and shrinking margins
• Reputation management
• Managing regulatory compliance
• Difficult to discover new molecular entities (NME’s)
• Rising customer expectations
• Poor scientific productivity
• Cultural sclerosis- Industry relies upon traditional models & strategies.

Challenges Facing India’s
Pharmaceutical Industry

Drug
Quality
• The World Health Organisation (WHO) estimates that up to 30 per cent of
branded drugs sold in developing nations are counterfeit which can have
profound implications for patients.
• Tuberculosis and Malaria counterfeits, which largely originate in India and
China, are estimated to kill some 700,000 people a year!
• Challenge of counterfeit manufacturers.
Clinical
trial quality
• Huge growth in the number of clinical trials
• Number of unethical practices such as; a lack of patient compensation for
adverse events; approval of drugs without clinical trials and lapses in informed
consent procedures.
Patent
issues
• 70 per cent of expenditure on healthcare is out-of-pocket, which has led the
government and its judiciary to take steps to promote the use of generic
products and prevent prices of lifesaving drugs being set by market forces
• In April 2013, Novartis lost a six-year legal battle after the Supreme Court ruled
that small changes to its leukemia drug Glivec would not get a new patent.
• the patent for Pfizer's cancer drug Sutent was revoked
• Roche's patent on Pegasys, a hepatitis C drug, was denied.

Pharma's incurring bigger and more frequent financial
penalties in the US
Pharma's scientific productivity has flatlined for a full
decade
Costs per approved molecule are unsustainably high
Most pharmacy companies spend a very small
percentage of their budgets on target selection and
validation
Union Budget
Announcements and expected outcome
 Broadband in rural area: Through broadband in rural area,
telemedicine will increase the accessibility of qualified doctors and
specialists.
 FDI in health insurance increased to 49%: The increased
FDI would help increase financial accessibility of the population. This
will help both patients and pharma industry.
 Opening up of 4 additional AIIMS & 12 govt. medical
colleges: It will ensure improvement in quality of medical education
and cover the shortage of doctors in India. It will enhance access to
tertiary care for the patients who have to travel from far-flung areas to
AIIMS.

Market Sharing Pie & Profitability
Trends
Market share of top five companies
in pharma sector
51%
15%
15%
11%
8%
Chart Title
Sun Pharma
Lupin
Dr. Reddy's Labs
Cipla
RanbaxyLabs
Market Share of top five
companies in hospitals
65%
25%
5%
3% 2%
Apollo Hospitals
Fortis Health
Poly medicure
Opto Circuits
Indraprastha
Key performance indicator of Sun
pharma
44808
42123
60827
84910
116880
0
20000
40000
60000
80000
100000
120000
140000
2008-09 2009-10 2010-11 2011-12 2012-13
Total income
Key performance indicator of Sun
pharma
3320
2242
3313
4449
7042
2008-09 2009-10 2010-11 2011-12 2012-13
R & D Expenditure
Key performance indicator of Sun
pharma
87.8
65.2
17.5
25.7
28.8
2008-09 2009-10 2010-11 2011-12 2012-13
Earning Per Share
Some facts about Lupin
 8
th
largest generic player globally by market
capitalization.
 2
nd
largest pharmaceutical company.
 5
th
largest and fastest growing generic company in USA
by prescription.
 7
th
largest generic player in japan.
Key performance indicator of Lupin
47736
57068
69597
94616
110866
FY10 FY11 FY12 FY13 FY14
Net Sales
Key performance indicator of Lupin
0.39
0.22
0.3
0.14
FY10 FY11 FY12 FY13
Debt-Equity Ratio
Key performance indicator of Lupin
4119
5301
5940
7708
9583
FY10 FY11 FY12 FY13 FY14
R & D Expenditure
Lupin R & D
Financial analysis of Apollo
Hospitals
2727.59
2352.27
1772.16
1541.77
1370.86
2008-09 2009-10 2010-11 2011-12 2012-13
Net Worth
Financial analysis of Apollo
Hospitals
896.04
764.12
624.11
489.79
538.05
2008-09 2009-10 2010-11 2011-12 2012-13
Investments
MileStones achieved in Apollo
Hospitals
 They have over 5300 in- house doctors.
 They have over 8700 in- house nurses.
 They have over 1500 pharmacies across 20 states.
 They have cured over 30 millions patients in 30 years.
 They have over 8300 hospital beds.


Analysis of Fortis healthcare
3205.05 3206.14
3019.25
1582.4
800.07
2008-09 2009-10 2010-11 2011-12 2012-13
Net worth
Analysis of Fortis healthcare
2405.88
2310.08
1530.82
1395.43
751.98
2008-09 2009-10 2010-11 2011-12 2012-13
Investments