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April2009
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2/30
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MarketOverview
Rules&Regulationsfor
Competition
ey
eve opmen s
3MEDICALDIAGNOSTICS INDIA.PPT
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Indiandiagnosticsmarketiswitnessingsignificantgrowthwith
majorcontributionfromtheInVitroDiagnostic(IVD)segment
Indiandiagnosticmarketcomprisesof
Diagnostictestservicesmarket
MarketOverview Diagnostic
Test
Services
Market
37.940
+20%INRbn
Diagnosticproducts/instrumentsmarket
Diagnosticmarketaccountsfor10%ofhealthcare
sector
Indiacurrentlyhasover11,500hospitalsand40,000
.
26.3
10
20
30
In2008,
IVD
servicesmarket
wasINR36bn
About70%ofthetreatmentsinIndiaarebasedonlab
diagnostictests
IVDInstruments&ReagentMarketIVDTestSegments(2008)
2006 2007 2008
Marketsizeestimationisdifficultasdiagnosticmarketishighlyunorganized
5%
6%
4%
3%
37%
BioChemistry
Immunology
Haematology15.8
12.815
20 +18%
INRbn
7% Criticalcare
UrineRoutine
Others
Microbiology
14%
.
0
5
10
4MEDICALDIAGNOSTICS INDIA.PPT
24%oagu a on
2006 2007 2008
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Technologicaldevelopmentshasledtothediagnosisofawide
spectrumofinfectiousdiseases
Diagnostics Consumption&
trends Type
of
testing CAGR
%
(2004
08)
InfectiousDisease
Tuberculosis Increasing ELISA90%;Rapid10% 11.0
HIV Increasing ELISA65%;Rapid35% 10.6
Malaria Increasing Immunodiagnosticm 9.4
HepatitisB Steady ELISA65%;Rapid34%Agglutinationmethods1% 7.7
HepatitisC Steady ELISA80%;Rapid20% 7.7
engue tea y ; ap .
Syphilis Steady ELISA65%;Rapid35% 5.7
Typhoid Steady ELISA65%;Rapid35% 5.6
Hormones
Reproductivehormones Increasing ofLH35%,FSHandprolactinkits65% 8.6
Thyroid Increasing ELISA90%,RIAandChemiluminescence10% 7.7
Others
BloodGroupingreagents Steady Haemagglutination 5.7
Pregnancydiagnosis Steady Immunochromatography/Latex 5.7
CancerMarkers Steady Fluorescence,ELISA,Chemiluminescence 5.7
MolecularDiagnosticsNascentmarket.MaximumpenetrationobservedonlyinPolymeraseChainReaction(PCR)basedtechnologies.
Companiesofferingimmunodiagnosticshavebeenlargelyimportingequipments
5MEDICALDIAGNOSTICS INDIA.PPT
Thisshows
that
the
market
for
diagnostic
tests
has
been
rising
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MarketOverview
Rules&Regulationsfor
Competition
ey
eve opmen s
6MEDICALDIAGNOSTICS INDIA.PPT
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Drivers&Challenges
Drivers
Increaseinlifestylerelateddiseases
Changingdemographics
Growth
in
medical
outsourcing
Differenceinimportdutyon
diagnostickitsforpublicandprivate
sector
formedicaltourism
Increasingpenetrationofmedical
insurance
Lackofaccreditation certificationof
diagnosticcenters
RisingPE/VCinvestments
7MEDICALDIAGNOSTICS INDIA.PPT
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Mountinginstancesoflifestylediseasesinurbanareasandthe
demandforqualitydiagnosis
Increasinginstancesoflifestylediseasesisanurbanphenomenon,especiallyamongtheyoung
andworkingclassinmetropolitanareas
Growthin
lifestyle
related
diseases Impact
Lifestylediseasessuchascardiacailments,diabetesetc.requireexpensivediagnostictests
makingthissegmentincreasinglylucrativeforplayers
54.91% 2005
2015% of Population
500USD/Treatment
reva enceo c ron c es y e seases n n a agnos c es s os ompar son
1
2
3
4 3.31%2.80%
3.70%
280
150
100
200
300
400
0
Cardiac Diabetes
. .
Cancer
50
HepatitisA
Thyroid Cardiac Diabetes Cancer
8MEDICALDIAGNOSTICS INDIA.PPT
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ChangingdemographicscenarioinIndiaisexpectedtodrive
demand
Increaseinaveragelifeexpectancyandgrowthinelderlypopulationisexpectedtoboost
demand
Changingdemographics Impact
Largescalemovementofruralpopulationtourbancenterswillalsooptfortheseservices
AverageLife
Expectancy Population
(Age
65
years
and
above)
66.065.163.3
50
1005.85.3
4.7
2
4
6
2000-04 2005-09 2006-10 2000 2005 2010
9MEDICALDIAGNOSTICS INDIA.PPT
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Strongoutsourcingopportunitiesduetotechnological
enhancementsandcostbenefits
Diagnosticsoutsourcinghasbeengrowingduetotechnologicalupgradationofequipmentin
Indianlaboratoriesmeetinginternationalstandards
Growthin
outsourcing
Impact
Costbenefitshavealsoplayedamajorrole
Specializedtestslikemoleculardiagnosticsorhormonerelatedtestscost7080%lessinIndia
thanin
US
MedicalinstitutionsfromUSandUKhavebeenoutsourcingabulkoftests
OutsourcingopportunityspecificallyfromtheUK,inhealthcaresector,ispeggedataroundUSD800mn
Indiaprovidescostarbitrage:
Tests Costin
US/UK
(USD) Cost
in
India
(USD) %
Difference
Blood tests Xra s and ultrasounds 574 84 583
Magneticresonanceimaging(MRI)scan 700 60 1067
Thyroidprofilebloodtest 3050 5 500900
Note:Theratesareindicative
10MEDICALDIAGNOSTICS INDIA.PPT
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Medicaltourismisprovidingsupplementalrevenuesforthe
diagnosticmarket
Inadditiontogrowingdomesticdemand, medicaltourismisgeneratingadditionalrevenuefor
diagnosticsservices
Medicaltourism
in
India Impact
Medicaltourismhasbeengrowingat30%andisexpectedtobecomeatUSD2bnindustryby
2010
Somepart
of
medical
tourism
market
is
expected
to
accrue
to
the
diagnostics
market,
primarily
benefiting thehospitalswithdiagnosticcenters
a n r versan c a enges orme ca our smare
Drivers Challenges
Significantsavings
Worldclassfacilities
Inadequateair
connectivity
Visare uirementsfrommostcountries
Qualityandexperienceofmedicalprofessionals
Minimalwaitingtime
Largemarketofuninsuredindevelopedcountries
Medicolegaljurisdictions
Countryspecificrestrictions
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Growingpenetrationratesofhealthinsurancehasmadequality
diagnosticservicesmoreaffordable
InIndia,penetrationofhealthinsuranceisverylowbutgrowing:
Morefamiliesfrommiddleclassarenowpurchasinghealthinsurance
Risinghealth
insurance
levels Impact
20%ofpopulationislikelytohavemedicalinsuranceby2015comparedtocurrent2%
Additionally,
many
companies
are
providing
health
insurance
coverage
to
employees
therebydrivingpenetration
Increasin insurancecovera e rovideadditionalrevenuetothedia nosticscentres
Insurancecompaniestieupwithdiagnosticcentrestoprovidebetterhealthassessment
services(medicalscreening,diagnostictesting)tolifeinsurancecandidates
Birla
Sun
Life
Insurance
Company
Ltd
entered
into
a
partnership
with
Quest
Diagnostics
India
Private
Ltd.
ICICILombardenteredintoaninsurancepartnershipwithManipal,FortisandApolloGroup
HealthInsurancePremium
INRbn
212
47
500
1,000+35%
12MEDICALDIAGNOSTICS INDIA.PPT
2008 2013 2018
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LargescaleinvestmentsfromPE/VCfirmstowardscapitalizing
onthegrowthprospectsinthemarket
PrivateequityplayersarebullishonthehealthcareindustryinIndia
In2008,thehealthcaresectoraccountedfor13%oftotalinvestmentsamountingtoUSD
Increasedfocus
of
PE/VC
firms Impact
5570.48mn
Apartfromhospitalsandpharma,privateequityplayersarealsoshowinginterestindiagnostic
centersin
India
% Amounta e nves or arge
Stake USDmn
Nov2007ePlanetVenturesandHSBC
PrivateEquity
(Asia)
Ltd
Trivitron n.a. 11
. .
Jun2006 Bennett,ColemanandCo. Thyrocare n.a. n.a.
May2006 ICICIVentures MetropolisHealthServicesLtd n.a. 8
2005 Se uoiaCa ital
India
Dr
Lal
PathLabs 26 6
13MEDICALDIAGNOSTICS INDIA.PPT
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Biasedgovernmentregulationandthelackofaccreditation
affectingtheofqualityservicesarethemajorbarriers
Theimportstructurehasbeensoformulatedthatitfavorsthepublicsector
Privatesectorisfacedwiththeissueofprovidingservicesatcompetitivepricesacrossincome
Differencein
import
duty
on
diagnostic
kits
for
public
and
private
sector Impact
groupsandareoftenreducedtoprovidingservicesonlytoanichemarket
Public Private
Inordertoimportequipmentsandreagents
Forimportingdiagnosticequipmentsadutyof19.8
21.7%islevied
license;adutyof5%islevied
Equipmentandsuppliesareprocuredthrough
tenderswithpricebeingtheforemostbasisof
decisionmaking
Equipmentsandsuppliesareprocuredbasedon
qualityandprice,leading tocostescalations
Lackof
accreditation
or
certification
has
led
to
alarge
pool
of
medical
centers
with
minimal
Lackofaccreditation/certification ofdiagnosticcenters Impact
focusonthequality,whichisincontrasttomandatoryrequirementsforotheraspectsof
healthcaresuchashospitals,doctors,nursesandevenpharmacies
Lessthan1%ofthetotallaboratoriesareaccredited
14haveCollegeofAmericanPathologists(CAP)accreditation
14MEDICALDIAGNOSTICS INDIA.PPT
45
have
National
Accreditation
Board
of
Laboratories
(NABL)
accreditation
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Market
Overview
Rules&Regulationsfor
Competition
ey
eve opmen s
15MEDICALDIAGNOSTICS INDIA.PPT
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Diagnosticequipmentmanufacturersarehighlyregulatedbythe
centralandstategovernmentbodies
Majorgoverning
bodies
GovernmentAuthorities Operation
TheDirectorateGeneralofHealthServices
StandardControlOrganization(CDSCO)
FDAand
CDSCO Regulates
the
manufacture
of
all
diagnostic
kits
and
reagents
as
it
belongs
to
the
categoryofdrugs
Responsibleforapprovaloflicensesofspecifiedcategoriesofdrugsanddiagnostics
Segmentationofproducts
products
Statedrugoffices/StateFDAsTheymonitorthequalityofdrugsanddiagnosticsproductsthataremanufacturedby
respectiveStateunitsandthosemarketedintheState
CriticalDevices
Productsusedforthe
diagnosisofHIV,HBsAg,
HCV, Bloodgrouping
reagents,malariatests
NonCriticalDevices Otherdiagnosticsproducts
16MEDICALDIAGNOSTICS INDIA.PPT
Alldiagnostics
products
manufactured
or
sold
in
India
requires
alicense
h diff i l i f i i l d i i l
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Thedifferenceinregulationsforcriticalandnoncritical
diagnosticsdeviceshasledtolackofqualitycontrol
Regulatoryprocess
for
diagnostics
equipments Quality
checksare
conducted
b
Manufact
uring
CriticalDevices
pp ca on s
submittedtothe
DrugsController
GeneralofIndia
National
Instituteof
cense
granted
afteran
auditof
36monthsble
disease
manufact
uringunit
NonCriticalDevices
Testmanufacturinglicenseortestbatchevaluationisnotrequired
Noinspectionsneedstobecarriedoutbythecentralauthorities
17MEDICALDIAGNOSTICS INDIA.PPT
Lackof
sufficient
quality
control
measures
has
led
to
substantial
number
of
questionable
products
in
the
market
M f d i li d d i i
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Manufacturersneedanimportlicenseandproductregistration
certificatefromthe CentralDrugsStandardControl
RegulationsRelated
to
Imports
CDSCOisresponsibleforqualitycontrolofimportedproductsaswellasthelicensingofnewproducts
RegistrationCertificate:Applicationinrespectofthe
premisesandthedevicestobeimported
Documentation
Form9istobeforwardedbythemanufacturerandshouldbe
RegistrationCertificate ImportLicense
Submission: TheapplicationisreviewedbytheDrugs
ControllerGeneral
Registrationfee:USD1000perproducttoberegistered
OtherDocuments:
Bank
slips
showing
requisite
fee
paid,
Form
40PowerofAttorneytotheIndianAgent/Officeanddossiers
attestedbytheIndianEmbassyinthemanufacturerscountry
GMP(GoodManufacturingPractices)certificate
CompanyRegistrationcertificate
FreeSales
Certificate
in
the
country
of
manufacture
Manufacturin License Duration:Theregistrationprocesstakes9months
Forwardedbythemanufacturer,importerortheagentin
India
CountryofOriginCertificate
Listofcountrieswheretheproductisalreadybeingexported
ISO/TUV/CEcertificate
BatchReleaseCertificate(foranyonebatch)
QCcertificates(foranyonebatch)
Otherrequirementsforimportedmedicaldiagnosticequipmentsare
Abatchreleasecertificateforthespecificgoodsthathavebeenimported
Shelflifecertificatewhichmuststatethatthe oodshaveashelflifeofmorethan60%atthetimeoflandin
18MEDICALDIAGNOSTICS INDIA.PPT
Certificateof
Analysis
for
the
products
supplied
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Customdutyisleviedonthediagnosticequipmentsimported
Importduty
structure
TheGovernmenthasbeenfocusingonenhancingprivatesectorparticipationbyreducingthe
customsdutyleviedonimportsofdiagnostickitandreagentsimportedbytheprivateplayers
34.4 34.5
30
40
Pregnancy confirmation reagents/Reagents for diagnosing
%
21.719.8
0
10
20 Diagnostic reagents designed to be administered to thepatient/Blood grouping reagents
Feb 2009Jan 2008
19MEDICALDIAGNOSTICS INDIA.PPT
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Market
Overview
Rules&Regulationsfor
Competition
ey
eve opmen s
20MEDICALDIAGNOSTICS INDIA.PPT
O i d thl b idl di i th h b d
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Organizedpathlabsarerapidlyexpandingusingthehubandspokemodel,includingsmall,independentlabsinthenetwork
CC CC
DiagnosticTesting
Market
Structure Hub
and
Spoke
Model
Highlyfragmentedwith~40,000laboratories:
Hospitals:43%
Reference
Lab
CC CC Independentlabs:52%
AmongthelabsinIndia
Automated 5%
Semi Automated 38%
CC CC CC CC
Laba e e
Lab
Organizedplayersaccountfor10%ofmarketand
expandingwithhubandspokemodel:
Referencelabs
act
as
regional
hubs
and
are
usually
located
inlargemetros
Collectioncentresarelocatedinhospitals,nursinghomes,
pathologylabs,doctorsclinicsetc.
Satellitelabsandcollectioncentresareeitherownedor
franchised
Referencelabs:Hubwithcomprehensiveorspecializedtesting
capability
,
,
independentlabsare:
Becomingfranchiseesinthehubandspokemodel
Partneringwithlargechainsonreferralbasis
Gettingacquiredbylargechains,whichlowersthecostof
Collectioncentres(CC):Collectsamplesforforwardingto
eitherasatellitelaborreferencelab
Avariationinthismodelistheabsenceofsatellitelabsand
theexistenceofonlyreferencelabsandcollectioncentres
21MEDICALDIAGNOSTICS INDIA.PPT
expansionandstartuptimeforthelatter
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MajorPlayers DiagnosticTestServicesMarket(1/2)
Company Overview BusinessOutlook
ApolloHospitals Startedin1983
DiagnosticfacilitiesintheirsubsidiaryApolloClinics
EnteredintoaJVwithAmcareLabs,an
affiliateofJohnsHopkinsInternationalof
theUS,tosetupadiagnosticlaboratoryin, ,
ClinicalPathology,Microbiology,Xray,UltrasoundwithColor
Doppler,ECG,EchoCardiographyandTreadmill
HyderabadataninvestmentofUSD2.2mn
DrLalPathLabs Startedin1977
40labsand500samplecollectioncenters
Establishedaninternationalalliancewith
QuestDiagnosticsNicholasInstitutefor
Accreditation:NABL,CAP Planningtosetup50labsand1000
collectioncentersby2012
Expandoperationsinsouthernandwestern
regionsinvestingINR600mn
P anningtoinvestINR100mnin ran
building
MetropolisHealth
Services
Startedin1981
10000laboratoriesacross125citiesglobally,13laboratoriesin
India,350
collection
centers
Growinginorganically
Itislookingatoverseasexpansionaswellas
outsourcin
o ortunities Capabilitytocarryover3600routineinvestigationswithover
100technologies e.g.biochip,DNAsequencing,pathology,
radiology
ICICIVenturesowns18%ofthecompany
Plansonincreasingtheirportfolioto9more
labs
TargetedrevenueofINR5bnby2010
In2008,acquiredtwolabsinNorthIndia
22MEDICALDIAGNOSTICS INDIA.PPT
,
DiagnosticLaboratory
Note:Thislistisnotexhaustive
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MajorPlayers DiagnosticTestServicesMarket(2/2)
Company Overview BusinessOutlook
PiramalDiagnostics
/Wellspring
Startedin1988
104diagnosticcentersin48cities,300collectioncenters
PlanningtoinvestINR2.5bntoexpandits
diagnosticchainin75urbancentersby2010
Ac uiredMinradInternationalIncforUSD
Accreditation:NABL,CAP40mn
SuperReligare
Laboratories
Limited SRL
Startedin
1996
35labs,800collectioncentersdistributedin400townsacross
thecountryand7franchiseelab
Tieups
with
UK
based
organizations
for
outsourcing
Plansondeveloping23reference
Ranbaxy Catersto25000doctors,650hospitalsand~1000smallerpathologylabsandcarriesout34000tests/daybasedon95
technologies
Accreditation:CAP,
NABL,
CLSI,
GCLP
Re ortedtotalrevenuesofINR804mninFY2007
laboratoriesin2009
ExpansionbudgetispeggedatINR1.5bn
In2008,acquiredDubaibasedMena
Healthcarefor
USD
20
mn
Thyrocare Startedin1995
Carriesout30000test/day,over600franchisedcollection
centers
Accreditation:CAP,NABL
Centralizedoperationsthroughasingle
laboratorymodel,locatedinNaviMumabi
Onlyplayerexpandingthrougha100%
franchiseemodel
23MEDICALDIAGNOSTICS INDIA.PPT
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Manufacturers IVDProducts/InstrumentsMarket
TheIVDproductsmarketinIndiaisprimarily
dominatedbyforeigncompanies
Playersin
the
market IVD
Products
Market
Share
(2008)
GlobalIVDcompanieslikeRocheDiagnostics,
Abbott,J&J,
Siemens
Healthcare
Diagnostics,
BeckmanCoulterhavestrongpresenceinthe36%
n anmar e
Domesticplayershaveforayedintothemarket
and
are
establishing
themselves
by
producing
costeffectiveand ualit oods
64%
60%ofdiagnosticmedicalequipmentand
suppliesisimported
Lowcostreagentkitsarebeingimportedfrom
ForeignPlayers
DomesticPlayers
China,Taiwan,andKorea
24MEDICALDIAGNOSTICS INDIA.PPT
Major Domestic Players Diagnostic Equipment Manufacturing
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MajorDomesticPlayers DiagnosticEquipmentManufacturingMarket(1/3)
Company Overview BusinessOutlook
AgappeDiagnostics Reagents:Clinicalchemistry,SyReBiochemistry),SyRe(Immunoturbidimetry), Controls/Calibrators,serology,
hemoscreen,coagulation,Urinalanalyzer,infectiousrapidcard
Focusingontheexportmarketswithplans
ofestablishingasubsidiaryinDubaiunder
AgappeMiddleEastLLC
test,infectiousELISA,hepatitismarkers,torchpanel,
Glucometer
Instruments:Clinical
Chemistry
Analyzer,
Hematology
Analyzer,
CoagulationAnalyzer,Sodium&PotassiumAnalyzer
AlsoplanstoexpandoperationstoAfrica
andEurope
LaunchedBiolis
12i
,afully
automatic
analyseraswellasCystatinC,amore
sensitiveinstrumentfortheestimationof
GlomurularFiltrationRate
J.Mitra Rapidtestkits:HIVrange,HCVrange,HBVrange,Malariarange
ELISAtest
kits:
HIV
range,
HCV
range,
HBV
range,
Dengue
FocusesonPointofCare(POC)for
infectiousdiseaseslikeHIVandmalaria
Massproduction
at
affordable
prices
, ,
ConfirmatoryTests,BloodGroupingRange
MarketleaderinHIVdiagnosisequipment
OrchidBiomedical
Systems(Tulip
Fertilityrange,Infectiousdiseasesrange, Parasitologyrange FocusesonPOCsforinfectiousdiseases
Massproductionataffordableprices
25MEDICALDIAGNOSTICS INDIA.PPT
Note:Thislistisnotexhaustive
Major Domestic Players Diagnostic Equipment Manufacturing
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MajorDomesticPlayers DiagnosticEquipmentManufacturingMarket(2/3)
Company Overview BusinessOutlook
RFCL IVD,animalhealthcare,laboratorysolutionsandcustomsynthesis
Adoptedaninorganicgrowthpath
InApril2008,acquiredBremerPharma
InSeptember2008,acquiredUSbased
MallinckrodtBakerforUSD340mn
InJanuary2008,acquiredGodrejMedical
DiagnosticsandAlvedPharma&Foods
InJuly,2007acquiredWiproBiomedical
TargetedrevenueofINR5bnby2010
SpanDiagnostics
Ltd.
Diagnosticreagents&kits:Bloodbankingproducts,clinical
chemicalreagents,hematology,infectiousdiseasesserology,
histopathology,antibioticdiscs
Instruments:Biochemistry,
ELISA,
Hematology,
Chemiluminescence
ItisaleaderinSphilisandthyroiddiagnosis
equipment
TransasiaBio
Medicals
Relatedtobiochemistry,hematology,urineanalysis,
coagulation,ESR,immunology,liquidhandlingsystem
Plansto expanditsexistingproductrange
andventureintomicrobiologyand
veterinaryscience
TulipGroup ImmunologyReagents,CardiacMarkers,CancerMarkers, Itisoneoftheleadersinsyphilis,typhoid,
Instruments Coagulometers,ELISAreader&washer
,
,
groupingreagents,cancermarkers and
tuberculosisdiagnosticequipment
26MEDICALDIAGNOSTICS INDIA.PPT
Note:Thislistisnotexhaustive
Major Domestic Players Diagnostic Equipment Manufacturing
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MajorDomesticPlayers DiagnosticEquipmentManufacturingMarket(3/3)
Company Overview BusinessOutlook
Xcyton Immunodiagnostickits:HIVCheXandHEPCheXC,JEVCheX,CYSTI CheX,Dengue CheX
Moleculardia nostickits
StrategicpartnershipwithQualigensfine
chemicalsinordertomarkettheirHIV
andhe atitisdia nostickits
YashrajBiotech Antigens:Customizedmonoclonalandpolyclonalantibodies Focusingonreducingcostsofmoleculardia nostics throu h innovative technolo
OtherPlayer: AccurexBiomedical,BhatBiotech,MedsourceOzoneBiomedicalsPvt.Ltd.,Trivitron
27MEDICALDIAGNOSTICS INDIA.PPT
Note:Thislistisnotexhaustive
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KeyDevelopments
Date Development
17Mar09 RocheDiagnostics,aswissbasedcompany,plansonconsolidatingtheir positionintheIndianmarketin2009.TheyplanonexpandingtheirreachthroughinnovativediagnostictestssuchastheNTproBNPandKRASmutationtestsrelatedtocolorectalcancer.
10Feb09 AlokaTrivitronMedicalTechnologies,amedicalequipmentmanufacturingJVofAloka,JapanandTrivitronhealthcarebegan
productionofAlokaSSD500,portableultrasoundscannerfromitsfacilityatPoonamalleeinChennai.Itplansondeveloping
highquality
products
on
acost
effective
basis
catering
primarily
to
the
developing
nations.
06Oct08 WiproanITgianthasenteredthemedicaldiagnosticsmarketthroughitssubsidiaryWiproBiomed.Theyhavetiedupwith .
telemedicine,especiallyinthediagnosticradiology.
10Mar08 SnehaDiagnosticsplansondeveloping10stateoftheartmedicaldiagnosticscentresacrossAndhraPradeshby2009.AcapitalinvestmentofINR50mnisexpectedtowardsthisexpansionventure.
09Jan08 RFCLLimited,anICICIventurecompanyacquiredGodrejMedicalDiagnostics.ThisledtopartnershipswithQBCDiagnostics,, , , .
29MEDICALDIAGNOSTICS INDIA.PPT
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