AUTHOR: Dr Naveen Nishchal
As Kiran Majumdar Shaw once put it-“Affordable innovation, which presents ways to innovate, be flexible, and do more with less, can help a complex and resource-constrained country like India address challenges in healthcare delivery. Such a model can ensure that healthcare is “available” and “accessible” to every citizen of the country on a sustainable basis. For this, the nation’s innovation capability needs to be enhanced through the right kind of fiscal incentives, policy support, financing mechanisms, human capital and best-in-class infrastructure”.
Affordability is the key to accessibility. In the economic reality of a developing country, cheaper drugs and medical devices and low-priced healthcare infrastructure models can work wonders. However, affordability is not simple to implement; it requires creative, out-of-the-box thinking. To deliver affordability, we require innovation—innovation in discovering drugs, medical devices, developing therapeutics and delivering healthcare. It is only by creating innovation in technology, strategies, practices and policies that we can take on local and global healthcare challenges.
New technology and its implementation will be effective if only it contributes to bringing the cost of health and medical care at a reasonable level. Affordable innovation is the only way forward, and India has a unique opportunity to deliver it to global markets by building excellence across the innovation chain from discovery to product development.
India’s contribution to affordable healthcare goes much beyond being a pharmacy of the world. It extends to affordable innovation which goes to the core of ensuring a global right to healthcare. Helped by a significantly lower cost base that supports a large talent pool of scientists and engineers, India’s research engine is now driving a new model of innovation that draws on the philosophy of affordable access.
With returns on investment plummeting to unsustainable levels in the West, companies are now rapidly leveraging India’s “affordable innovation” platform through outsourcing, risk-sharing, and co-development partnerships. GE’s Research Centre in India has developed a number of low-cost bio-medical equipment from scanners to portable electrocardiograms as has Bristol-Myers Squibb developed a number of promising novel drugs at its partnered research centre in Bangalore. Biocon, on the other hand, has not only developed insulins in India indigenously through a proprietary technology in the early 2000s, but has also developed and delivered two affordable novel biologics for the benefit of cancer and psoriasis patients in India. India is therefore proving its mettle as a “laboratory for the world” that can deliver affordable innovation and a growing number of collaborative efforts are succeeding in delivering products and services that can go a long way in ensuring that the right to healthcare becomes truly universal.
Affordability today is very important not just for emerging markets but for the global health care environment. But in the guise of affordability and much talked about affordability, one of the critical things that we have forgotten to do in health care is to figure out challenges associated with awareness, access and adoption. So today we must look beyond affordability and not ignore awareness, access and adoption.
Traditionally developing medical devices is very capital intensive with years of R&D that adds to the cost and makes it very unviable for the product to be of any commercial viability. The best way forward is to produce products that are of need by the doctors and not indulge in ambitious research programs that can take as long as 4-5 years of development time and just the research alone can cost a couple of millions of dollars. Cost of innovation is always high as it involves immense research and investment in resources with no guarantee of market share. Government establishments and Institute should come to the rescue of innovators who need hand-holding by someone for making new products commercially viable and relieving the inventor of such mental burden. Only such a marriage between innovators and non-profit establishments can ensure innovations to be introduced at reasonable price – not necessarily at a cheap rate, but affordable.
Life cycle of a medical device is not predictable as some competition may arrive in the market within six months of its launch, with additional facilities, extra benefits and probably at a cheaper cost. And there are other factors that can contribute to failure of the product despite it being very innovative and technically superior. For this, you need Curators for start-ups or need big corporate to invest in service and maintenance for new innovative products.
On the other hand, the global medical device industry is highly innovative and technology driven, changing the face of healthcare worldwide. Globally it’s a rapidly advancing industry impacting and improving aspects such as diagnosis, treatment and delivery, but in India it is still very nascent and low level of penetration and adaption. This presents an exciting opportunity to develop the industry and to play a larger role in the transformation of Indian Healthcare.
A new medical device policy is currently being developed and the Govt of India is actively engaged in discussions and consultations with various stake holders. Policy makers working collaboratively with stake holders in the healthcare ecosystem are attempting to lay down a road-map that provides consistency and productivity.
The path to realize healthcare Goals is complex, and various fundamental issues and challenges need to be addressed and solved holistically. Long-term plans need periodic policy and regulatory interventions to ensure fair conduct within the industry while providing the support needed for profitable and sustainable growth. These activity will enable the medical device industry to accelerate rapidly and play a key role in making India Healthier and stronger.