Dr. Angeli Misra is Director, Lifeline Laboratory – one of the premier advanced pathology laboratories of Delhi-NCR region. She brings with her an enormous experience of technical and service expertise spanning over 34 years in clinical pathology and 26 years as chief administrator and torchbearer in raising Lifeline Laboratory to meet the highest international standards. She has exhibited exceptional proficiency in Histopathology, Cytology, Microbiology, Biochemistry, Immunology, Oncology, Hematology & Clinical Pathology.
Accurate and timely diagnostics are vital for the effective management of diseases and determining treatment modalities, in order to provide high quality healthcare services. Moreover, it is a crucial tool in preventive healthcare too.
India’s diagnostics industry is poised on the threshold of enormous growth, in keeping with recent industry trends. Currently, it stands at a whopping INR 675 billion and estimated to grow at a rapid annual rate of <10% over the n0ext 5 years, egged on by increasing wellness and healthcare awareness (due to which home testing has come into being in a much bigger way), rapid rise in lifestyle diseases like diabetes and cardiovascular diseases due to sedentary lifestyle, preventive healthcare testing, insurance services, and overall rise in the spending power of people among all strata of society. Of this INR 675 billion market, stand alone centers constitute 47% of the market, hospital labs constitute 37% and diagnostic chains constitute 16% of the market share, respectively.
Diagnostic services are broadly categorized into pathology testing (in vitro diagnostic services) and imaging diagnostics, of which pathology labs rule over 58% of the market, while imaging services constitute the remaining 42%. About 55% of the business is provided by doctors’ referrals, 35% by walk-ins and 10% from corporate houses. About 65% of the business is generated from and conducted in urban areas, while 35% of the business is generated and conducted in rural areas.
Pathology tests are further broadly categorized into 3 types: routine tests (blood- complete blood count (CBC), hemoglobin (Hb), lipid profile, fasting, post-prandial and random blood sugar test, pregnancy test, HIV/HPV, PAP smear, urine and stool, etc.); clinical tests (to diagnose and monitor various diseases and their treatments); and specialty tests (involving genetic testing, oncology tests, endocrinology tests, and immunology tests, etc.). Imaging diagnostics involve tests which are complicated and super-specialized, like computed tomography (CT) scans, magnetic resonance imaging (MRI) and positron imagery tomography scan (PET), etc.
Pan-India, diagnostic labs – organized and unorganized chains – currently number over 1 lac (of which only 1% labs are NABL approved and accredited). Diagnostic services lab chains command a share of more than 16% of the market. The major players are Dr. Lal Pathlabs, SRL Diagnostics, Metropolis Healthcare and Thyrocare Technologies, who alone dominate with more than 6% of the market share, with a wide network which works on the hub-and-spoke model, with collection centers spread far and wide. Big hospital chains like Apollo Hospitals, Max Healthcare Institute Ltd, and Fortis Healthcare also have comprehensive and well-equipped diagnostic centers. Stand alone centers operate on a smaller scale, yet command about 45-50% of the market share. Due to a lack of strict and stringent regulations, there has been a spurt in the mushrooming of small diagnostic centers, but despite that, the diagnostics market is under-penetrated and disjointed and, therefore, there is a tremendous potential and scope for growth and expansion.
Recent digital and technological innovations and advances are now integral to this industry, and are significant growth drivers, supported by India’s national health policies and programs which aim to make affordable healthcare accessible for all sections of society, including the rural population. Free Diagnostic Service Initiative (FDI) launched in 2015 under the aegis of the Government of India’s National Health Mission (NHM), to provide accessible and essential quality diagnostics in lab pathology and radiology fields at all public health centers, led to the compilation of a National Essential Diagnostics List (NEDL) in 2019 – a bouquet of the required basic and essential diagnostic tests drawn up bearing in mind the region-wise healthcare priorities. India became the first ever country to implement this initiative. This resulted in a proper assessment of the country’s disease burden, disease trends and effective collation of data, and extensive emphasis on research.
In the wake of the Covid-19 pandemic, the demand and potential for upgraded equipment got a huge boost with the awareness for implementing the latest software applications and newer testing methods which require shorter turnaround time, while stressing on increased accuracy in testing. The government too, spruced up its efforts to provide incentives for growth in the domestic medical devices industry and encouraged FDI (Foreign Direct Investment), in order to achieve a leading rank in the medical devices manufacturing industry. Furthermore, marketing communication techniques showed a huge improvement as well – e.g. health tracking applications, online consultation, highly sophisticated data collation software applications, increased awareness of diagnostic tests and health insurance services – thus boosting the demand for preventive and curative healthcare. Innovative technology like robotic process automation has emerged as a logical solution at high-end diagnostic centers, along with digitization to cover the lacunae in the area of skilled lab technicians and personnel, as well as improved precision and quicker results. To support these innovations, advanced equipment and machinery have further exhibited a hugely positive impact on the diagnostic services market. Online marketing and employing social media as a tool for building brand awareness has also caught on in a big way. The easy availability of doorstep collection, walk-in services and quick results, is a huge boost for the diagnostics industry. They have also opened the doors for enormous potential in FDI (foreign direct investment) opportunities.
However, despite the tremendous growth of India’s diagnostic services industry in recent years, there is a still a long way to go because, on an average, there is just 1 lab per million people. The industry still needs to conquer many obstacles in terms of the shortfall in supply in the face of the huge volume of demand for adequate testing services in tier-2 and tier-3 cities, as well as remote rural areas, due to the lack of adequate infrastructural support, and despite supportive national health policies and programs which aim towards making affordable healthcare accessible for all sections of society.
A significant revelation in recent market studies is that quality and brand recognition will emerge as the vital factor that will drive growth in the diagnostics industry now and in the future, along with the complete inclusion of diagnostic testing in health insurance coverage.