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Far From Healthy

In spite of an expanding healthcare market, prevention and wellness do not get the attention they deserve

It is a common practice for many companies to be concerned about their employees' health and offer annual or bi-annual healthcare check-up plans. Most of these are in the range of Rs 10,000-25,000, and are offered through tie-ups with corporate hospitals or diagnostics chains. However, their utility is limited.

"It is sad that most executives who come to us for basic blood tests and other sponsored health check-ups do not bother to consult a doctor or a health adviser for follow-up once they receive the reports (which in most cases indicate that all is well and indices are within the parameters). Slowly, they go back to their sedentary lifestyles and become unhealthy," says Dr Peeyush Jain, Head, Department of Preventive Cardiology, Fortis Escorts Heart Institute, New Delhi.

Moreover, such packaged tests may not reveal chronic diseases like cardio vascular disorders or cancers. Another drawback is the quality and reliability of these reports as there are numerous unorganised diagnostics facilities, says Dr Jain.

While awareness, affordability and disposable income are growing, it will be years before India transforms into a country that is focussed on safe and proper preventive healthcare, especially when compared with the levels of preventive healthcare in developed nations.

Better Than Cure

Dr Prathap Reddy, Chairman of Apollo Hospitals, which has done over 30 million health screenings of individuals in the past 40 years, says non-communicable diseases (NCDs) like cardiovascular diseases, cancers, chronic respiratory diseases and diabetes account for as much as 60 per cent of all deaths in India. About 20 per cent women and 27 per cent men aged between 30 and 70 run the risk of dying from one of the four major NCDs. A study by advisory firm Redseer reveals that the number of people with lifestyle related diseases in India will grow from 930 million in 2018 to 1,060 million by 2022. Depression (26 per cent), chronic backache (23 per cent), obesity (21 per cent), hypertension (16 per cent), Type-2 diabetes (8 per cent) and heart diseases (5 per cent) will be the main villains.

"In a country like India, a good percentage of the population cannot afford even education or other basic amenities. The idea of preventive healthcare and wellness products is gaining momentum only among the affluent population, especially middle class with disposable incomes," notes Dr Jain.

Redseer's study further estimates that India has 90 million health conscious individuals (HCIs) - defined as those who are in their 20s and 30s, affluent, living in urban areas and and aware and concerned about lifestyle-related health issues. The number of HCIs is estimated to reach 130 million by 2022 - 45 million in metros and another 25 million in Tier-1 cities. Indians are ranked fifth in the list of countries searching for fitness gadgets on the internet, observes Redseer. Cementing the trend is the per capita expense on preventive healthcare: expected to grow from $40 in 2018 to $75 by 2022.

However, it will be at least 10 years before India catches up with the level of awareness that the developed countries have, says Dr Sharvil Patel, Managing Director of Zydus Cadila and Chairman of Zydus Wellness. "Almost all of the currently available products for health and wellness by pharma and consumer goods companies are reactive products, meant to address specific diseases or correct anomalies. They are not essentially preventive medicines or therapies," he says.

Market In the Making

Preventive healthcare currently accounts for 3 per cent of the overall retail consumption in India but is growing 50 per cent faster than it. The Indian healthcare sector is expected to reach $280 billion by 2020, driven mostly by rising income levels, more awareness, increased incidence of lifestyle diseases and improved access to insurance, says an India Brand Equity Foundation (IBEF) report.

A key segment of the wellness world, nutraceuticals (supplements, Ayurvedic and herbal products, fortified foods and beverages, functional foods, probiotic foods, energy drinks, etc.) is expected to double in size in India to $4 billion by 2020 on account of strong demand for dietary supplements. This segment alone has been growing at over 16 per cent compounded annually for the past five years, according to a report by EY. The overall wellness industry is also poised to grow from Rs 85,000 crore in 2014/15 to Rs 1.5 lakh crore by 2019/20 with a CAGR of 12 per cent, but 40 per cent of that will be in beauty and not health care. The rest 60 per cent will be divided between nutritional care (27 per cent), fitness centres (16 per cent), alternative systems like Ayurveda, Yoga and Unani (15 per cent) and rejuvenation options like massage and sauna (2 per cent).

Within Rules

A rapidly expanding market also means thousands of companies coming up, which is why there is a pressing need for relevant regulations. R.B. Smarta, Chairman and Managing Director, Interlink, and Secretary of the Health Foods and Dietary Supplements Association (HADSA), says nutraceuticals are currently not regulated by the Food and Drug Association (FDA) but by the Food Safety and Standards Authority of India (FSSAI). "Each individual has the liberty to choose nutraceutical products, after becoming fully aware of the product, dosage, limitations and also the effects," he says.

At present, health check-up packages and tests that range from cancer screening to onsite, home or lab screening and costly scans are not regulated by the law. Multilevel marketing companies and e-commerce retail companies are selling food products and health monitoring devices to every customer. Health tech start-ups in India have received funding of $1.3 billion between 2011 and 2017. Of this, 55 per cent are consumer facing technologies, says the Redseer report. The proliferation of internet pharmacies has further pushed the growth of the wellness market.

In the future, telemedicine, predictive analytics and use of blockchain to create a seamless, transparent and secure health data are some of the areas that experts say will come up in the wellness market.

The preventive healthcare market in India is growing at a fast pace; appropriate regulations will make the growth healthy.