Internationalization Strategy for priMED into India - INTB 412

Running Head: INTERNATIONALIZATION STRATEGY PRIMED: INDIA 1

Internationalization Strategy PriMed: India

Brayden Proctor, Raymond Su, Hayley Weir, Lin Zhang, Harsh Sharma, Kirsten Tiegen

International Business 412

Michael Roberts

INTERNATIONALIZATION STRATEGY PRIMED: INDIA 2

Table of Contents:

Title Page…………………………………………………………………………………...…... 1

Table of contents…....................................................................................................................... 2

Introduction……………………………......……………………………………………………. 3

PESTEL Analysis……………………………………………………………………………….. 4

Applying PESTEL……………………………………………………………………………… 9

SWOT Analysis……………………………………………………………………………….... 9

To Go or Not to Go……………………………………………………………………………. 11

Indian Health Care System…………………………………………………………………….. 11

Competitor Information……………………………………………………………………….. 14

The Buying Process……………………………………………………………………………. 17

Mode of Entry…………………………………………………………………………………. 18

Group Purchasing Organizations……………………………………………………………… 18

Distributors…………………………………………………………………………………….. 20

Conferences……………………………………………………………………………………. 20

Conclusion……………………………………………………………………………………... 21

Appendix………………………………………………………………………………………. 22


References……………………………………………………………………………………... 27


Introduction

India is an Asian country located in the south eastern region. According to the CIA

website the population of India is almost 1.3 billion as of July, 2015. Additionally, the health

expenditure is 4% of the GDP; the GDP (purchasing power parity) of India is $8.027 trillion as

of the 2015 estimate (CIA). According to the Make in India website, India is forecasted to be the

third largest pharmaceutical market by 2020. 20% of its global exports are in generics making it

the largest provider of generic medicines worldwide. In addition, the total exports of drugs as of

2013/2014 in USD is $15,095 million with a 2.5% growth rate. The FDI policies favor 100%

ownership under the automatic route for greenfield projects. Though, FDIs are subject to

applicable laws (Make in India).

When taking a product internationally it is important to consider the possible locations

and what environment/ market be best suited for the product in question. We have been charged

with the task of creating an entry strategy for PriMED into the India market. In order to better

understand if this market is hospitable for PriMED’s product lines we have done two evaluations

on the market place. By using the SWOT and PESTEL analysis we will answer the questions:

Does India provide a hospitable environment for PriMED and their products, and is entry into

this market is a wise decision.

The PESTEL framework analysis is a means of analyzing the overall environment of a

target nation (in this case India). This framework breaks down Political, Environmental, Social,

Technological, Economic, and Legal aspects of the environment, and highlights the areas that

will have the most influence on the particular company and product. Through the use of this

model we can actually determine the areas in which we may encounter problems upon entry into

India.


Political Analysis of India

In 2014, India ranked quite high in the voice and accountability parameter which

measures the extent to which citizens are able to participate in selecting their government as well

as freedom of expression, association, and media. India ranked high on this parameter because of

its democratic principles which are deep rooted in their history (MarketLine, 2015, p. 3).

Democracy is somewhat more restricted in India than in other democratic nations however, due

to religious, linguistic, and caste differences (MarketLine, 2015, p. 15). India’s political

environment is also plagued with political violence in the form of riots and high levels of

corruption in the form of cash for votes incidents among others (MarketLine, 2015, p. 15).

Unfortunately India also has a volatile relationship with its neighbor Pakistan and is currently

threatened by terrorism because of this (MarketLine, 2015, p. 15). In terms of foreign policy,

India has undergone substantial economic liberalization and it has become closer to North

America through bilateral trade agreements. India is also in the process of developing stronger

relationships with the South-East Asian countries and oil-rich nations in order to gain trade

advantages (MarketLine, 2015, p. 15).

Economic Analysis of India

India’s economy is characterized by its large workforce, its well-educated, English-

speaking population, and its well-developed equity markets (MarketLine, 2015, p. 21). India’s

workforce is second in size only to China and is expected to increase significantly over the next

few decades. The fact that India has a large English-speaking population also gives it an

advantage in certain sectors such as IT and business process outsourcing (MarketLine, 2015, p.

21). India’s well-developed equity market has grown significantly because of regulation by SEBI

(Securities and Exchange Board of India). Because of this regulation and economic


liberalization, Indian equity markets have become some of the best in Asia (MarketLine, 2015, p.

21). Unfortunately, India’s economy has been challenged with high inflation, imbalanced

development, and poor infrastructure. These challenges are made worse by high levels of

corruption which have decreased the country’s economic growth and investment (MarketLine,

2015, p. 23). The strong presence of income disparity in India has led to the strong presence of

an informal economy which generated a significant amount of income that does not go towards

the country’s GDP (MarketLine, 2015, p. 23).

Social Analysis of India

The Indian government has had a program called National Rural Health Mission in place

for a number of years and in 2013 the government launched a New National Urban Health

Mission (MarketLine, 2015).

Literacy rates in India are considerably low compared to competing nations such as China. In

spite of India’s low literacy rates it continues to spend little on programs with a low contribution

of 3.3% of its GDP in 2013 (MarketLine, 2015).

Analysis of the Indian social system

Current strengths Current challenges Future prospects Future risks

▪ Growing proportion of young people

▪ Employment guarantee scheme

▪ Healthcare remains a major concern

▪ Rapid urbanization

▪ Low HDI rank

▪ Jan Dhan Yojana

▪ Rising life expectancy and falling infant

mortality

▪ Government’s authority challenged

▪ Employment creation


▪ Literacy level

(MarketLine, 2015, p.)

Technological Analysis of India

India is well known for its advancements in the IT sector. According to the National

Association of Software Services Companies (NASSCOM), the industry is expected to be worth

225 billion by 2020.

When it comes to product patents, India is traditionally renowned for its slowness in securing

patents; however, recently it has been improving (MarketLine, 2015)

Legal

These factors have both external and internal sides. There are certain laws that affect the

business environment in a certain country while there are certain policies that companies

maintain for themselves. Legal analysis takes into account both of these angles and then charts

out the strategies in light of these legislations. For example, consumer laws, safety standards,

labor laws etc.

Environmental: These factors include all those that influence or are determined by the

surrounding environment. This aspect of the PESTLE is crucial for certain industries particularly

for example tourism, farming, agriculture etc. Factors of a business environmental analysis

include but are not limited to climate, weather, geographical location, global changes in climate,

environmental offsets etc. (see section one of the appendix for full Comparison Chart)

Legal landscape


- According to the World Bank's 2016 Doing Business report, time to start a business,

enforcement of contracts, getting construction permits, and paying taxes are the key

constraints to doing business in India. Overall, the country has been ranked 130 out of

189 countries.

- The new Companies Act aims to improve corporate governance by introducing a more

effective legal and administrative framework; nevertheless, corporate governance is

largely driven by factors such as companies’ commitment to the principles of integrity

and transparency in business operations.

Effectiveness:

- Weak product market regulations remain a major problem for the country, curbing its

ability to procure stable financing and technology.

Vat tax

- VAT is applied at each stage of sale with a mechanism of credit for the input VAT paid.

The standard VAT rates is of 12.5% to 15% and varies among different states, with rates

reduced to as low as 1-5% in most states. The likes of petroleum products, tobacco, and

liquor attract higher VAT rates that vary between states.

Legal Requirement Standards:

Specifications developed by the American Society of Testing and Materials (ASTM)

are referenced by the FDA as the required standard in the USA. The current standard ASTM

F2100-11 (2011) specifies the performance requirements for Medical Face Masks with five basic

criteria:


1. BFE (bacterial filtration efficiency)

2. PFE (particulate filtration efficiency)

1. Fluid Resistance

2. Delta P (pressure differential)

3. Flame Spread

(See Section 2 of Appendix for full legal requirements of India and USA/ Canada)

Environmental landscape

- India is a poor performer on the Environmental Performance Index (EPI). In an EPI

study published in 2014, India was ranked 155th out of 178 countries.

- India’s dependence on thermal energy—predominantly coal-based—has resulted in a

host of environmental problems and increased India’s share of greenhouse gas emissions.

Applying PESTEL to priMED

The largest defining factors affecting entry into the Indian market are: ease of entry,

market size, existence of supporting infrastructure, competition, competition strategy,

regulations, and legal restrictions on this market segment. We see through the PESTEL analysis

that the legal restrictions and regulations on face masks in India are very similar to the

regulations in Canada and the USA (see appendix). This means that the same product can be sold

in India without the need for modifications. We also see that there is an increasing social aspect

in the health care industry. The increase in government funding shows that this market is


growing and as a result the use/ need for high quality facemasks will grow as well.

In terms of technology we know through discussion with Primed that they do not have

patents on most of their products due to the fact that this technology has been established for a

significant period of time. All though priMED prides itself in product quality and if they choose

to enter India that will be their main competitive advantage.

The largest negative influential factors we found via the PESTEL analysis are Political

and Economic. India has high levels of corruption and as such there is always instability

economically and politically; this being said, it is important to note that there is a large amount of

undocumented income in India due to the massive participation in the informal economy. As a

result GDP facts and figures will not be full representative of the actual income and expenditures

within the country.

We chose to pair the PESTEL analysis with a SWOT analysis in order to better answer

the question of whether it would be in priMED’s best interest to enter the Indian market.

SWOT Analysis of priMED India

Strengths Large healthcare industry: $1.56

billion Market growth 8% annually

(Medical Devices) Imports over half of healthcare

equipment Growing middle class: 300 million

people already Disposable equipment & supplies is

the largest component of healthcare industry in Asia Pacific (35.5%)

Disposable supplies industry is projected to increase in value by 41.9% by 2020

Weaknesses Growth is slow in public sector. (80% of

growth contributed in private sector) Health and safety rules are largely

unenforced Significant divide between rural and urban

centres: 70% of population is rural and has limited access to hospitals

Communication barrier: 15 official languages in India

Regulatory Issues: Canadian company, Chinese manufacturing, Indian market


Opportunities Untapped rural markets Huge growth in private sector of

Indian healthcare Growing demand for government

initiatives to provide healthcare to rural areas

Close proximity to China (where manufacturing takes place)

Threats Potentially over 300-500 competitors in

India already Market has high threat of new entrants Consumers may value locally made

products over foreign players

Depicted in the chart above are a vast variety of both good and bad influential factors

that will play a role in the decision of internationalization. Like stated previously I is

important to consider the fact that the GDP figures are not entirely accurate for this nation;

however, using the data available we can see that India has a vast potential. With a high

emphasis on imports of healthcare equipment it creates a product niche for foreign

manufacturers/ sellers. We also see that the disposable equipment and supplies portion of the

health care sector is considerable meaning that there is a market and it is considerable in size.

We know from the both analysis’s that there is a large swing towards increased government

expenditure in health care initiatives which will result in an increase in cash flow for medical

products. In addition a large advantage to take into consideration for selling in India is the

geographic distance form priMED’s manufacturers in China. The two nations are close to

each other which will result in ease of transportation.

The largest problem we for see with this market is the ease of entry and competition

there are already 300-500 competitors in this industry. However we have found in our

research that locally made products do not have very good product quality and as such

medical professionals tend to go for foreign brands to ensure a standard quality of products.

To Go or Not to Go


Based off of the two environmental analysis’s we have decided that entering India

would be a wise decision. This market is vast and showing steady growth, by entering India

PriMED has the potential to establish a foothold in a large growing market and gain brand

recognition. Moving forward we will delve deeper into distribution networks/ buying groups,

competition, and the market.

The Indian Health Care System

India is the seventh-largest country by size, and the second-most populous country with a

population of over 1.3 billion people, which makes India a big market for global business. There

are several well-known cities in India: Mumbai, New Delhi, Kolkata, and Bangalore, etc. New

Delhi is the capital of India, but Mumbai has the largest population and is the largest harbor of

India. Kolkata is the third largest city, and is the business center of East India. Bangalore is the

fourth largest city of India, and is the center of India’s high technology industry (Central

Intelligence Agency).

With the rapid development of economy, India has become a powerful country. However,

it is not enough to evaluate the strength of a nation based only on its wealth -- its citizens’ health

and well-being are also important. In order to improve the lives of its citizens, India has paid

great attention to building a comprehensive healthcare system. The government plays a central

role in building this healthcare system and it has promulgated the National Health Policy to deal

with health issues. India now has both public hospitals and private hospitals. Public hospitals in

India are also known as government hospitals because they are funded by the government, and it

provides free treatment for people below the poverty line. However, public healthcare services

cover just 20% of the total market in India; the rest of the market is controlled by private


healthcare services (Rajawat, 2015). There is a list of five public hospitals and five private

hospitals in the four cities mentioned above in the appendix section 3.

All these cities have many public and private hospitals, providing general healthcare

services and also specialty healthcare services like eye and heart clinics. Some hospitals in India

already have contracts with BMC Medical for purchasing masks. However, in order to protect

both doctors and patients, Indian hospitals want to increase their mask storage by placing an

order for a six-month supply of 72000 masks instead of ordering 5000 masks every fifteen days

(Porecha, 2015). With increased awareness of the health and safety benefits of wearing masks,

most Indian hospitals are looking to purchase large quantity of masks, which makes them

priMED’s target buyer group.

Another potential buyer group is India’s private cosmetic surgery centers. With the

development of technology, there are many more methods to improve people’s physical

appearance. As the demand for cosmetic surgery increases, people are no longer satisfied with

the limited range of services provided by general hospitals. They want to find facilities with

more targeted services -- hence the emergence of many private cosmetic surgery centers around

the world. India is one of the biggest cosmetic surgery market in Asia (Mann, 2010), It has a

long history of plastic surgery tracing back to the 800BC. Sushruta, an important figure in the

history of cosmetic surgery in India, has greatly improved the techniques of cosmetic surgery in

6th century BC (Dwivedi & Dwivedi, 2007). There is a list of 5 cosmetic surgery centers in the

four largest cities in the India in the appendix section 4.

In addition to allowing private healthcare provider to enter the market and opening up

specialized surgical centers, India is also trying to improve the overall healthcare system to

satisfy the health needs of its citizens by sponsoring many rural government initiatives (as


previously stated). Healthcare is an individual’s basic right, but the lack of high-quality

infrastructure, qualified medical professionals, essential drugs and medical facilities is

obstructing 60% of India’s population’s access to healthcare. Most of the 7 million people living

in the rural areas of India are now using medical facilities in deplorable condition (Gramvaani,

2013). In order to improve the level of healthcare around the country, Indian government is

implementing many welfare initiatives with a focus on rural areas.

The Indian Government has launched the National Health Mission which includes two

Sub-Missions, the National Rural Health Mission (NRHM) and the newly launched National

Urban Health Mission (NUHM) (National Health Mission). The National Rural Health Mission

was launched in 2005 to “provide accessible, affordable and quality healthcare to the rural

population” (National Health Mission). The government has also approved the launch of

National Urban Health Mission as a Sub-mission of National Health Mission in 2013, hoping to

“meet healthcare needs of the urban population with the focus on urban poor, by making

available to them essential primary healthcare services and reducing their out of pocket expenses

for treatment” (National Health Mission). This sub-mission will be accomplished by ensuring the

accessibility of the existing health care services, targeting the population living below the

poverty line and carrying out broad reforming schemes to provide cleaner drinking water, better

sanitation condition and more health-related school education.

Competitor Information

India is in a midst of a booming healthcare sector. Previously, the government’s low

spending on health care places much of the burden on patients and their families, as evidenced


by the country’s out-of-pocket (OOP) spending rate, is one of the world’s highest. According to

the World Health Organization (WHO), “just 33 percent of Indian health care expenditures in

2012 came from government sources. Of the remaining private spending, around 86 percent”

(Deloitte) was out-of-pocket expenses. The current industry needs an additional 1.54 million

doctors and 2.4 million nurses to match the global average” and the Indian government is

expected to spend 16.1% more on public healthcare (Deloitte).

Currently, there are only a few companies in India who offer non-woven masks. North

American disposable medical device/ supply companies that are usual competition to priMED

include Medline, 3M, Cardinal Health, Halyard Health (formerly Kimberly Clark Health), and

Medicom. With that being said, Medline’s Indian counterpart is mainly used for research and

development as well as IT. McKesson, Cardinal Health and Medicom currently do not operate in

India, but Medicom and Cardinal Health - generated $91 million total revenue but International

operations accounted for 4% of the total revenues in FY2014. An increase of 17.3% over

FY2013 (Marketline) - have other Asian country operations. Halyard Health - $1.7 billion in

annual net sales (Marketline) - and 3M - revenues from Europe, Middle East and Africa reached

$7,198 million in FY2014, an increase of 1.6% over FY2013 (Marketline) - are two immediate

competitors who currently operate in India with corporate offices, innovation labs, and

manufacturing (3M). Halyard Health have a wide range of supplies that match priMED’s product

lines, whereas 3M has high prices and rely on brand loyalty.

The largest competitor for priMED’s Indian market is 3M USA’s subsidiary, 3M India.

3M India’s “healthcare business segment serves markets, including multi-specialty hospitals and

small clinics, dental and orthodontic practitioners, processed food manufacturers and


pharmaceutical companies” (Marketline). The subsidiary generated approximately “$304 million

in the fiscal year ended March 2015, an increase of 5.2% over 2014” (Marketline).

Domestic brand competition would include companies like Perfect Surgical Industries

and IVcannula/ Dentex International. Both companies manufacture their procedural masks but

IVcannula/ Dentex International also exports and distributes their products. Perfect Surgical

Industries and IVCannula/ Dentex International only manufacture a single basic procedural mask

(single use package or bulk), where priMED has many variations of the procedural mask.

PriMED currently sells masks in boxes or cases, but the domestic competitors offer single use

packets which is beneficial to a “bottom of the pyramid” market. PriMED does have an

advantage in this segment because their mask has an available anti-fog which is beneficial in

hotter climates for glasses wearers, whereas the two domestic Indian companies do not offer this

type of technology. priMED’s products are ASTM approved which is North America’s

guidelines for face mask standards. Perfect Surgical Industries is ISO9001 and CE certified,

which are aimed towards business/branding rather than health and safety. priMED’s large

product line will enable Indian buyers to purchase all non-woven medical supplies in one stop.

For example, a private hospital can purchase gowns, gloves, procedural masks, surgical masks

with ties, masks with face shields in one order rather than contacting many distributors and

suppliers. This will enhance brand loyalty/ create value, and create an efficient, yet effective

buying process for purchasers.

The most popular masks in the Indian health sector would be relatable to any health

sector around the world, which would be a basic ear loop procedural mask which is used widely

from a day to day basis. All surgeries (general surgery where there’s no high risk infections and


airborne contaminants), procedural activities (like dressing changes, isolation patients that do not

have high risk infections) and cleaning for example would use a procedural mask.

Another emerging market for basic non-woven masks in India or Asia is the consumer

market. With the amount of smog and air pollutants in these emerging markets, consumers are

looking for an inexpensive way to protect their lungs. This is why the domestic Indian brands

have created a single use package for their basic procedural mask, so the mask will be sterile no

matter where they store it or sell it (convenience store, backpacks, pocket etc.).

Average Selling Prices

We contacted PriMED to find out the average selling prices for the most popular

procedural mask and the most popular surgical mask. The most popular procedural mask has an

average selling price of $0.05 to $0.07 ($CAD) per mask. The most popular surgical tie mask has

an average selling price of $0.10 to $0.12 ($CAD) per mask. These are the end-user purchase

prices, i.e. this is what the hospitals would pay for each individual mask. For procedural masks,

one case contains ten boxes and each box contains fifty masks for a total of 500 masks per case.

For the surgical tie masks one case contains six boxes each with fifty masks for a total of 300

masks per case.

Competitors of PriMED, especially American brands such as Halyard and 3m, have

similar prices for their individual masks and also sell their masks by the case. Indian companies

such as IV Cannula/ Dentex International and Perfect Surgical Industries may have lower

average selling prices for their masks because they do not seem to have to comply with any

particular regulations. They also have a cost advantage because all of their products are

manufactured locally.


The Buying Process

The buying process of disposable healthcare products in India is complicated because of

the fragmented nature of the healthcare industry as a whole. In India healthcare is a state issue

like it is in Canada, however in India there are 29 states with extremely different cultural norms

(ValueNotes Strategic Intelligence Pvt. Ltd., 2015). Another main challenge related to the

diverse Indian economy is communication. India has 15 official languages making integration

across regions extremely difficult (CIA, 2015).

One result of these factors is that most distributors are small in scope and operate in only

a limited are. (ValueNotes Strategic Intelligence Pvt. Ltd., 2015). As a result of this it is likely

most feasible for a mid-sized company such as priMED to focus on finding reputable regional

distributors to service smaller more concentrated hospital groups.

Another condition in the Indian healthcare industry is that there is a massive divide

between rural and urban centers in terms of healthcare providers. As described earlier the

majority of the Indian population lives in rural areas with limited access to hospitals. This

provides a massive opportunity for future growth, however currently most suppliers are only able

to access “metros and tier 1 & 2 cities” (ValueNotes Strategic Intelligence Pvt. Ltd., 2015). As a

result the focus in the following section will be on urban centers.

Mode of Entry

Many distributors in India also manufacture some or all of their products so an option

moving forward in India is to find a partner similar to priMED’s current manufacturer in China

to make more efficient use of the value chain. This could potentially lower costs and could build

the potential for expansion into neighboring markets such as Pakistan, Bangladesh, or Sri Lanka.

The main reason not to pursue this strategy is that priMED’s competitive advantage is in quality


of the products and using a new supplier could endanger brand image if the products

manufactured are not consistent with the standard that priMED is known for.

After considering the above alternative it seems the best mode of entry is still the one that

priMED has had success with so far, exporting. The strategy entering India will be to find local

distributors that can target Group Purchasing Organizations in the selected areas. Exporting is the

best option here because it doesn’t require a large initial investment of capital as compared to

purchasing capacity at a local factory. Also there will be no risk of compromise in product

quality.

Group Purchasing Organizations

Many of the most powerful group purchasing organizations in India are comprised

primarily of private hospitals. There are several large companies that manage hospitals all over

India. There are many more small to mid-sized hospital groups that have hospitals in different

areas in India, however many are concentrated in specific regions. Based on the locations of

hospital groups Mumbai stands out as the area to focus on. Mumbai has a massive population

and is home to several smaller hospital groups as well as to some hospitals that are part of larger

chains. Mumbai could prove to be a gateway into the rest of the Indian disposable healthcare

devices industry.

Top Priority Hospital Groups

Wockhardt Hospitals is a group of nine hospitals, three of which are located in Mumbai,

which claims to be the “market leader” in cardiac care in India. (Wockhardt Hospitals, 2016)

This company represents a potential consumer of priMED products because of its commitment to

offering high quality service and because the hospitals are clustered in West India around

Mumbai.


Platinum Hospitals is another hospital group that is a realistic potential purchaser of

priMED products. The company is smaller than Wockhardt as it is comprised of only two

institutions with its flagship 100 bed hospital is located in Mumbai and its other hospital is

located in Vasai a suburb of Mumbai. (Platinum Hospitals, 2016) Platinum offers an attractive

target as it could be easily serviced by a smaller regional distributor.

Other Important Hospital Groups

Apollo is a huge hospital group in India with 64 hospitals nationwide. (Apollo Hospitals,

2016) The issues are that the institutions are very spread out and the closest one to Mumbai is

located approximately 150 km away in Pune. Global Hospitals is also an important group in

India with seven hospitals and one located in Mumbai. (Global Hospitals, 2016) Other large

group include; Manipal Hospitals the third largest group which has its flagship hospital in

Bangalore, (Manipal Hospitals, 2016) Fortis Healthcare Limited based out of Kolkata, (Fortis

Healthcare Limited, 2016) and CARE Hospitals concentrated around Hyderabad (CARE

Hospitals, 2016).

AMRI Hospital group is an important player in Eastern India (AMRI Hospital Group,

2016) and Max Healthcare is a group of 13 hospitals centered in and around the city of New

Delhi (Max Healthcare, 2016). There are also interesting opportunities in the state of Andhra

Pradesh in southeast India. Shar Technologies Group is a group purchasing organization that

works with APNA (Andhra Pradesh Private Nursing Homes and Hospitals Association) which

has more than 5,000 members (STG, 2015). The government of Andhra Pradesh is also

renovating the city of Amaravati to become the new capital and as part of the project has

partnered with the Indo-UK Institute of Health (IUIH) to build a new 1000 bed hospital to be


completed by June 2019 (The Times of India, 2016). This hospital is set to be the headquarters of

10 new hospitals the IUIH plans to construct across India (The Times of India, 2016).

Distributors

The Distributors in the disposable healthcare device industry are, as mentioned

previously, mostly smaller regional companies. Many of these companies also manufacture at

least a portion of their products. The distributors mentioned in the following section offer

products that are similar enough that it would make sense to carry priMED products but don’t

manufacture products that are similar enough that they could manufacture the masks and gowns

themselves.

In Mumbai there are distributors that could be effective partners. One of these companies

is Nulife Triple Safety a division of MRK Healthcare is headquartered in Mumbai and operates

across Western India. Nulife manufactures and sells surgical gloves and other disposables but not

masks or gowns.

Lifecare is another distributor located in Mumbai that could be a good fit for priMED.

Lifecare started off in orthopedic surgery and dental equipment but has since moved into

disposables (Lifecare Devices, 2016). Other potential distributors located in Mumbai include;

Draeger Medical India Pvt. Ltd. (Draeger Medical, 2016) And B. Braun Medical (India) Pvt.

Ltd (B. Braun India, 2015). There are numerous other smaller distributors throughout India many

of which can be found in the 2013 India Medical Devices Manufacturers, Distributors and

Exporters Directory (Pacific Bridge Medical, 2013).

Conferences

There are opportunities to gain a deeper understanding of the Indian market through

attending conferences and events. Working with a high context culture building relationships can


be an important aspect of business and these events offer the opportunity to make connections

and begin to develop these relationships. In April 2017 New Delhi is hosting Medical Fair India

“India’s number one trade fair for hospitals, health centres and clinics” (Messe Düsseldorf North

America, 2012). Another networking opportunity is on July 23 and 24, 2016 right in Mumbai at

the Hospital Management Conference & CIMS Healthcare Excellence Awards (CIMS Medical,

2016) both of these events are annual ValueNotes Strategic Intelligence Pvt. Ltd. (2015).

Conclusion

Entry into an unfamiliar market can be taxing, expensive, time consuming, and difficult.

India will be no exception to these facts; however, as stated above India provides the potential

for a large profitable market. We have chosen an entry strategy for priMED in the form of

exportation. This strategy will prove to be the least expensive and easiest way to break into the

Indian market. By entering using a waterfall strategy, meaning the distribution in Mumbai and

expanding from that location, priMED can focus its efforts into a direct location while

simultaneously mitigating potential losses. Using the list of distributors provided it is our hope

that priMED will consider contacting some of these distribution facilities as well as hospitals and

cosmetic surgery facilities. Since priMED’s usual strategy is exportation the use of distributors

seemed to be the best fit with their current corporate culture. In addition as a high context culture

India places a great deal of importance on personal relationships; therefor it crucial to establish

relationships and network extensively in order to be as profitable as possible. Through the

information and guidelines provided it is our belief that priMED can break into the Indian market

and become established and profitable.

APPENDIX

1.


OVERALL COMPARISONLegal Canada IndiaJudicial Branch Supreme Court of Canada (judges are

appointed by the governor general on the recommendation of the prime minister); Federal Court of Canada; Federal Court of Appeal; Tax Court of Canada; Provincial/Territorial Courts (these are named variously Court of Appeal, Court of Queen's Bench, Superior Court, Supreme Court, and Court of Justice)

Supreme Court (one chief justice and 25 associate justices are appointed by the president and remain in office until they reach the age of 65 or are removed for "proved misbehavior")

Legal System common law system except in Quebec where civil law based on the French civil code prevails

common law system based on the English model; separate personal law codes apply to Muslims, Christians, and Hindus; judicial review of legislative acts

EnvirontmentalCurrent Issue air pollution and resulting acid rain

severely affecting lakes and damaging forests; metal smelting, coal-burning utilities, and vehicle emissions impacting on agricultural and forest productivity; ocean waters becoming contaminated due to agricultural, industrial, mining, and forestry activities

deforestation; soil erosion; overgrazing; desertification; air pollution from industrial effluents and vehicle emissions; water pollution from raw sewage and runoff of agricultural pesticides; tap water is not potable throughout the country; huge and growing population is overstraining natural resources

Water availability 84.51 thousand cubic metresRanked 4th. 54 times more than India

1.56 thousand cubic metresRanked 93th.

Population with improved sanitation > Urban and rural

99.81Ranked 37th. 3 times more than India

35.09Ranked 156th.

Pollution perceptions > Urban discomfort from pollution

17.52Ranked 53th.

62.3Ranked 15th. 4 times more than Canada

CO2 emissions from electricity and heat production, total >

165.62Ranked 15th.



Million metric tons

Ecological Footprint

7.66Ranked 9th. 9 times more than India

0.9Ranked 47th.

Overall air pollution 21.15Ranked 54th.


Air quality 78.85Ranked 6th. 2 times more than India

32.11Ranked 45th.

Pollution index 27.99Ranked 54th.


Climate change awareness

95%Ranked 13th. 3 times more than India

35%Ranked 113th.

International agreements > Signed but not ratified

Air Pollution-Volatile Organic Compounds, Marine Life Conservation

none of the selected agreements

2. USA FDA:

ASTM F2100-11 (2011) REQUIREMENTSFOR MEDICAL FACE MASKSTest: Low

BarrierModerateBarrier

HighBarrier

BFE (Bacterial Filtration Efficiency)at 3.0 micron ASTM F2101

≥ 95% ≥ 98% ≥ 98%

PFE (Particulate Filtration Efficiency)at 0.1 micron ASTM F2299

≥ 95% ≥ 98% ≥ 98%

Delta P (Differential Pressure)MIL-M-36954C, mm H2O/cm2

< 4.0 < 5.0 < 5.0

Fluid Resistance to synthetic bloodASTM 1862, mm Hg

80 120 160


Flame Spread16 CFR part 1610

Class 1 Class 1 Class 1

FDA regulations http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpcd/classification.cfm?id=fxx

INDIA:

India

http://jairjp.com/NOVEMBER%202013/02%20CHELLAMANI%201.pdf

3. Public and Private Hospitals List

New Delhi:

Public Hospitals:

Maulana Azad Medical College and GB Pant Hospital, All India Institute of Medical Sciences,

Bara Hindu Rao Hospital, University College of Medical Sciences and Guru Teg Bahadur

Hospital, Deen Dayal Upadhyay Hospital

Private Hospitals:

Sir Ganga Ram Hospital, Max Hospital Saket, Max Super specialty Hospital-Shalimar Bagh,

Shanti Mukund Hospital, Shri Balaji Action Medical Institute

Mumbai:

Public Hospitals:

http://jairjp.com/NOVEMBER%202013/02%20CHELLAMANI%201.pdf

http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpcd/classification.cfm?id=fxx

http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpcd/classification.cfm?id=fxx


Bombay Hospital, Hinduja National Hospital and Medical Centre, Breach Candy Hospital,

Hiranandani Hospital, Bhatia Hospital

Private Hospitals:

Jaslok Hospital and Research Centre, Jagjivan Ram Hospital, MIDC Hospital Center, Harilal

Bhagwati Mun. General Hospital, St. George Hospital

Kolkata:

Public Hospitals:

Medical College, R.G. Kar Medical College and Hospital, MR Bangur Hospital, J.B. Roy State

Ayuvedic Medical College and Hospital, SSKM Hospital

Private Hospitals:

Columbia Asia Hospital, Belle Vue Clinic, Tata Medical Centre, Rabindranath Tagore

International Institute of Cardiac Sciences, Anandalok Charitable Hospital

Bangalore:

Public Hospitals:

Fortis Hospital, Mallya Hospital, Victoria Hospitals, Manipal Hospital, Narayana Hrudayalaya

Private Hospitals:

NU Hospitals, Deepak Hospital, Sita Bhateja Speciality Hospital, Green City Hospital, Spine

Care and Ortho Care Hospital

4. Cosmetic Surgery Facilities

New Delhi:

Dr. Prabhash’s Cosmetic Surgery Clinic, Gorzeous Looks, Olmec Best Cosmetic surgery and

Hair Transplant Centre, Divine Cosmetic Surgery, Sushma Plastic And Cosmetic Surgery Clinic

Mumbai:


Cosmetic Surgery Mumbai India, Dr. Manwani’s Cosmetic Surgery Clinic, The Cosmetic

Surgery Institute, Amrit Laser and Cosmetic Surgery Clinic, Skin and Plastic Surgery Center

Kolkata:

Cosmetic Surgery Kolkata, Prem Laser and Cosmetic Surgery Clinic, Cosmetic-Therapy, Dr.

Dolly Gupta: Dermatologist, Hair Transplant and Cosmetic Surgeon

Bangalore:

New You Cosmetic Clinic, Dr. Shetty’s Cosmetic Centre, Midas Cosmetic Gynecomastia

Surgery Clinic, Contura Cosmetic Clinic, AK Clinics-Hair Transplant Bangalore

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