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Analysis of the ophthalmology market in India

Release date 10.02.2021

Number of pages 56

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The relevance of research

Ophthalmology is the branch of medicine dealing with eye diseases. It also includes the study of the anatomy and physiology of the organ of vision, the visual analyzer, its optical properties and functions. The visual analyzer is understood as the totality of all parts of the organ of vision: its perceiving part (retina), pathways (optic nerves), as well as subcortical and cortical centers in the brain.

In the occurrence and course of eye diseases, household and social factors, occupational hazards, general and sanitary culture of the population matter. The preventive direction of modern medicine, planned measures to identify and treat patients are the most important tasks of ophthalmology at the present stage. With the application of the necessary measures of labor protection, and safety measures, the likelihood of damage to the organ of vision at work has decreased. At present, the achievements of modern science are being introduced into practice by a network of ophthalmological research institutes and clinics, dispensaries and offices.

Purpose of the study

Analysis of the state of the ophthalmology market, assessment of the market size, analysis of competitors, as well as identification of factors affecting the ophthalmology market

Content

Part 1. Overview of the Indian Ophthalmology Market

1.1. Definition and Characteristics of the Indian Ophthalmology Market
1.2. Dynamics of the volume of the Indian ophthalmology market, 2015-2019
1.3. Market structure by type of service provided in India
1.4. Ophthalmology market structure by Union Territories
1.5. Assessment of current trends and development prospects of the studied market
1.6. Assessment of factors affecting the market
1.7. Analysis of sectoral indicators of financial and economic activity

Part 2. Competitive Analysis in the Ophthalmology Market in India

2.1. Major players in the market
2.2. Market shares of the largest competitors
2.3. Profiles of major players

Part 3. Ophthalmology Consumption Analysis

3.1. Estimated per capita consumption of ophthalmology
3.2. Market Saturation and Estimated Market Potential in India
3.3. Description of consumer preferences
3.4. Price analysis

Part 4. Assessment of factors of investment attractiveness of the market

Part 5. Forecast for the development of the ophthalmology market until 2024

Part 6. Conclusions on the prospects of creating enterprises in the study area and recommendations for current market operators

Research excerpt

Part 1. Overview of the Indian Ophthalmology Market

1.1. Definition and Characteristics of the Indian Ophthalmology Market

1.2. Dynamics of the volume of the Indian ophthalmology market, 2015-2019

Eye care in India is provided by both public and private clinics. Data on market volume values were formed on the basis of information on the shares of performed volumes of high-tech medical care (HTMC), included in the basic program of compulsory medical insurance in the field of ""ophthalmology"" in India.

Diagram 1. Dynamics of the volume of the ophthalmology market, 2015-2019, billion Rs.

The dynamics of the ophthalmology market in India is linear - the volume indicator is increasing every year. Average annual growth rate for the period 2015-2019 amounted to …%. In total, over the period, the market volume increased by …%, amounting to about … billion Rs at the end of 2019.

We also add that the market growth over the period is due to an increase in three components: …

We also note that the assessment of the total volume of the ophthalmology market is complicated by the following factors:

- The amounts of funds allocated by different levels of government to the ophthalmology industry, which often change both during the calendar year and at the end of it, while data on volumes are not presented in open sources of information;

- The total amount of funds allocated for the VMP is partly immersed in the volume of assistance for compulsory medical insurance, and partly provided to medical institutions in the form of quotas in quantitative and cost terms, while the list of procedures changes from year to year.

– Until 2015, the Ministry of Health of India issued orders containing information on the planned amount of funding with a breakdown by medical institutions and groups of VMPs, and consolidated figures for this type of funding were published in the Indian Gazette and other specialized resources. The last such order No. 64n was issued on February 7, 2014, since then the volumes of the fixed part of the VMP have not been disclosed anywhere.

– Estimating the revenue contribution of private clinics and medical centers that are engaged not only in ophthalmology, but have a wide range of services in various fields of medicine, is difficult due to the impossibility of accurately determining the share of companies' revenue from the treatment of only eye diseases.
Thus, due to the influence of these and other factors, we state the possibility of a possible error in the final annual market volumes.

1.3. Market structure by type of service provided in India

The structure of the market by the type of services provided directly depends on the structure of morbidity by class of eye diseases.
In the structure of ophthalmic morbidity among the adult population, the first place is occupied by ... (...%), the second place is taken by ... (...%), the third position is occupied by ... (...%), the fourth place is taken by ... (...%), the fifth place — … (diabetic retinopathy and macular degeneration, together making up …%).
...

Among children, the main place in the structure of morbidity is occupied by ... (...%), in second place - ... (...%), in third place - ...
...

Thus, the main types of morbidity include: diseases of the muscles of the eye, disorders of conjugate eye movement, accommodation and refraction, cataracts and conjunctivitis.
In recent years, there has been a downward trend in general and primary morbidity in many regions of India, which may be a reflection of the complex problems of the primary outpatient level of eye care.

1.4. Ophthalmology market structure by Union Territories

The assessment was based on the administrative centers of the federal districts, since usually it is in these cities that the largest number of ophthalmological clinics are located.
The largest number of ophthalmological clinics is located in the … federal district – …%. In other federal districts, there are already much fewer clinics providing ophthalmological services.
...

1.5. Assessment of current trends and development prospects of the studied market

Trends:
Increasing competition between private clinics and state medical institutions. State polyclinics provide paid services at dumping prices. This contributes to the outflow of patients from private clinics;

Demand for high-tech services. The patient is interested in the fact that the treatment is safe, comfortable, and also has optimal terms;

Shortage of highly qualified personnel;

Increasing service requirements. The service component is becoming an increasingly important criterion when choosing paid medical services both in large cities and in the regions: patients want to receive not only high-quality medical care, but also a high level of service at all stages of contacting the clinic;

Opening of ophthalmological clinics by franchise;

Growing popularity of inbound medical tourism. According to AOMMT, wealthy citizens from the countries of the former CIS go to India for treatment, where it is difficult to get high-level medical care. The most demanded medical branch is dentistry (44% of patients). This is followed by gynecology and urology (about 25% combined), plastic surgery (10%), ophthalmology (10%) and cardiology (5%);

Development of a personalized approach. The modern level of knowledge and high-tech tools allow modern ophthalmology to reach a fundamentally new level of medical care for people, where the main principle is a personalized approach;

Development of a large number of scientific developments and the introduction of new methods of treatment in ophthalmology;

Expansion of the range of services. Most players are moving towards the development of an integrated format, trying to operate in the range of services with the capacity of all existing directions in the segment. At the same time, many market operators focus on diagnostics.

Against the backdrop of falling incomes of the population, low purchasing power and an increased tax burden, the profitability of a business in the private medicine market may decrease, and competition will become more intense;

The general trend towards digitalization and the development of telemedicine (electronic patient record system, mobile applications, online recording, remote consultation).

Perspectives:
Improving visual implants, which consists in increasing visual acuity, restoring color perception and accommodation mechanisms, providing three-dimensional stereo perception of the surrounding world;

Distribution of genetic passports of parents, which will reduce the frequency of birth of children with severe disabling pathology;

Further joint work of doctors, engineers, physicists, neurophysiologists, mathematicians, programmers and many other related specialists for the development of scientific developments in the field of ophthalmology;

Increasing the availability of specialized medical care for the population of the regions, by modernizing the work of ophthalmological units of the first and second levels with the maximum approximation of care to the place of residence of patients;

Elimination of personnel shortage in medical organizations;

Improving the material and technical base for the introduction of the latest methods of diagnosis, treatment and rehabilitation of patients with diseases of the organ of vision, used in the world, equipping with new high-tech expensive equipment for medical care (including equipment with wear and tear of more than 75%).

1.6. Assessment of factors affecting the market

Let's consider the main factors influencing the market and, accordingly, demand.

Economic

GDP dynamics
Data on the dynamics of GDP is a macroeconomic indicator that reflects the market value of all final goods and services produced in a year in all sectors of the economy on the territory of the state for consumption, export and accumulation.

The dynamics of India's GDP is decisive in the vector of development of the entire economy of the country and determines the key trends in consumer effective demand and economic activity.
In 2012-2014 the GDP growth rate was positive, but constantly declining, and in 2015 it was less than zero. In 2015, which was the peak of the crisis in the state, the decline in GDP was 2% compared to the previous 2014, and since the dynamics of GDP is directly proportional to the well-being of citizens, this indicates a fall in family incomes, a reduction in demand, and an increase in prices. It also led to a decline in production and employment.

In 2016, GDP stagnated, at the end of 2017 this indicator shows a positive trend, namely, an increase of 1,8% compared to the previous year.

According to the results of 2017-2019, the dynamics of GDP is positive, but, contrary to optimistic forecasts, it is not high, which indicates the revival of business processes in the country, but not constructive changes at the macroeconomic level. According to Rosstat, in 2019 the GDP growth rate was 1,3%.
...

Dollar rate
In 2015, the change in the dollar exchange rate is oscillatory. In February of the next 2016, the maximum dollar exchange rate of … Rs.
...

Real disposable money income
Real disposable money income per capita is income minus mandatory payments, adjusted for inflation. This factor determines the level of effective demand of buyers, is one of the key reasons for the formation of the dynamics of both retail turnover and demand for services.
...

Political

State control, regulation, legislation, support, targeted programs
The federal project ""Completion of the formation of a network of National Medical Research Centers, the introduction of innovative medical technologies, including the system of early diagnosis and remote monitoring of the health of patients, the introduction of clinical recommendations and treatment protocols"" provides for the coordination of specialized medical activities and organizational and methodological guidance, including the introduction of innovative medical technologies, clinical recommendations, medical care quality control systems.

India is also a full member of the World Health Organization's Vision 2020: The Right to Sight program, which is a global initiative aimed at eliminating avoidable blindness by 2020. Helmholtz was created by the Indian National Committee for the Prevention of Blindness.
...

Credit policy

Today it is quite difficult to imagine the progressive development of the economy without the active participation of the credit system. It should also be noted that the assessment of the availability of credit resources for both legal entities and individuals is a significant indicator that allows assessing not only the demand for credit funds, but can also serve as a reflection of the real economic situation both in the region and in the economy as a whole.
...

Table 1. Weighted average interest rates of credit institutions on credit operations in rupees (% per annum), 2015-1 quarter 2020

Coronavirus
Due to direct bans on the provision of planned medical care to patients with eye diseases, the drop in the volume of specialized (including high-tech) ophthalmic care provided in April-June 2020 amounted to from …% to …%. Private clinics, after a ban on receiving patients during a pandemic, were on the verge of closing.
...

technological

import dependence

...

Staff shortage
According to the Health Foundation, at the end of 2016, Indian polyclinics lacked … a thousand oncologists, … a thousand surgeons, … a thousand ophthalmologists. At the same time, in rural areas, the indicator of provision with doctors is almost three times lower than the national average. For ophthalmologists, … out of … thousand full-time positions, … thousand doctors work, while combining on average at … rates. According to experts, the optimization of the healthcare system resulted in a reduction in the number of medical staff.
...

Improving the work on training specialists with medical education
Regulatory-legal and methodological foundations are being formed. Federal Law No. 323 has been amended and supplemented to regulate the stages of transition to the accreditation procedure until 2026, the functions and procedure for the formation of attestation commissions are designated. In the field of ophthalmology, the professional standard of the ophthalmologist developed by professional medical communities became the basis for updated standards and modular residency programs. The document contains modern requirements for every ophthalmologist in the country in the aspect of ""know, be able, own"".
...

Социальные

Place of work of a person, place of residence, ecology
In recent decades, various eye diseases have become much younger, primarily glaucoma, cataracts, and allergic reactions. This is due to both environmental degradation and an increase in eye strain caused by prolonged work on the computer, prolonged exposure to artificial lighting. This factor has a positive effect on the ophthalmology market.

Population decline
During 2012-2017 India's population has shown a positive trend. However, in 2018, the vector changed - the population decreased due to the natural population decline in 2016-2019.
...

Aging
Aging is another factor in the development of eye diseases and, as a result, positively influencing the development of the ophthalmology market. With age, the incidence of eye diseases increases, most likely due to the accumulated risks of developing certain ophthalmic diseases with age. The general accumulation of risks is exacerbated by the tendency for cell renewal mechanisms to become less effective as a person ages.
...

Incidence
Since 2015, there has been a trend towards a decrease in general and primary morbidity in the class ""Diseases of the eye and its adnexa."" The most likely reason is not an improvement in the general level of eye health of the population in the country, but a shortage of personnel, which makes medical care in the field of ophthalmology inaccessible to the population. This factor negatively affects the ophthalmology market.
...

1.7. Analysis of sectoral indicators of financial and economic activity

Since the OKVED classifier does not provide for a hotel code for registering the activities of clinics involved in ophthalmology, and since there are no data on the financial performance of state medical institutions in official sources of information, the analysis used average indicators for leading private clinics.
...

For Indian companies, the normative value of the absolute liquidity ratio is within Cal > ... In the field of ophthalmology, the absolute liquidity ratio is much higher than the normative value - ... times, which indicates inefficient and irrational use of funds that could be directed to the development of the enterprise. It also indicates the presence of unclaimed amounts of money in the accounts.

Diagram 14. Business activity (average turnover period of receivables) in the field of ophthalmology, for 2015-2019, days days

Business activity in the analyzed period in the field of ophthalmology is within … days. days According to GidMarket, in 2019 the indicator of this financial ratio amounted to … days. days

The equity ratio characterizes the availability of own working capital of the enterprise, necessary for its financial stability, it is calculated to assess the solvency of the enterprise.

Lack of own working capital, i.e. the negative value of the coefficient in 2015-2016 indicates that all the current assets of the organization and, possibly, part of the non-current assets are formed from borrowed sources. Since 2018, financial stability indicators in the field of ophthalmology have been above the normative value (…%), which indicates a sufficient amount of own working capital in the industry, which is necessary for its financial stability.
...

Part 2. Competitive Analysis in the Ophthalmology Market in India

2.1. Major players in the market

In India, according to the consulting company RENOME Online, …% of ophthalmological centers do not have a network of representative offices and consist of only one clinic. Taking into account the number of cities in which one or another ophthalmological clinic operates, the leader is ... It is represented in ... large and medium-sized cities of the country, each of which has a full-fledged clinic.

Table 6. Main companies participating in the ophthalmology market in 2019

2.2. Market shares of the largest competitors
...

There are four clear leaders in the ophthalmology market in terms of revenue: ... with a share of ...%, ... - ...%, the Network of Ophthalmological Clinics ... - ...% and ... with a share of ...%.
It should be noted that among the largest competitors, the absolute leader in terms of network scale is ..., the network includes ... clinics and ... diagnostic centers.

2.3. Profiles of major players
...

Part 3. Ophthalmology Consumption Analysis

3.1. Estimated per capita consumption of ophthalmology

The nature of the dynamics of the indicator of consumption per capita is linear - the volume is increasing every year. If in 2015 every inhabitant of India accounted for … Rs., then in 2019 – already … Rs./person. The value increased by …%.
...

3.2. Market Saturation and Estimated Market Potential in India

The ophthalmology market has not yet reached saturation, and it is predicted that it will grow annually, while the main drivers / reasons for the market growth will be:
–– increase in financing of VMP and CHI;
– Improvement of diagnostics, clinical examination of the population;
...

Similar problems arise with other types of eye diseases, which allows us to assume the potential market volume at the level of at least …% of the current volume.

3.3. Description of consumer preferences

According to GidMarket, the main criteria for choosing an ophthalmological clinic are: …

Diagram 19. Criteria for choosing an ophthalmological clinic, scores

One of the elements of building loyalty to medical brands is that call centers in India are not very efficient. This was found out by the consulting company ""Practice of Medical Sales"", which studied the experience of ... private ophthalmological centers.

3.4. Price analysis

For the period 2015-2019 the average annual consumer price index for the initial consultation with a doctor amounted to …%. The dynamics is mainly due to the level of consumer inflation. The highest growth was observed in 2015 and was also caused by the crisis in the economy.
For Jan.-Aug. In 2020, the increase in consumer prices amounted to …%.
...

The average cost for an initial medical consultation in India is … Rs. In terms of federal districts, the leaders are … federal districts – … and … Rs./reception, respectively. The cheapest admission is in … the federal district – … Rs./appointment.
...

We will also give the average prices for the largest players in the market. As can be seen from the data in the table, the prices for different diagnostic and laser vision correction services vary significantly both in different clinics and within each type of service.

Table 14. Average prices for ophthalmology, 2020, Rs.

The price of basic diagnostics with an ophthalmologist's consultation ranges from … Rs. to … Rs. Basically, the cost depends on the pricing policy of the medical institution. Also, some clinics hold promotions to reduce prices for this service. Low prices for this service (less than … Rs.) are observed at: … High prices for this service are observed at … – … Rs.
...

List of diagrams

Diagram 1. Dynamics of the volume of the ophthalmology market, 2015-2019, billion Rs.
Diagram 2. Structure of the ophthalmology market by types (structure of the general incidence by class of eye diseases among the adult population), 2019, %
Diagram 3. Structure of the ophthalmology market by type (structure of the general incidence by class of eye diseases among children), 2019, %
Diagram 4. Structure of ophthalmology provision in India by Union Territories, %, 2020
Diagram 5. Dynamics of India's GDP, % to the previous year, 2012-2 quarter 2020
Chart 6. Expert forecasts for a decline in real GDP in India in 2020 (baseline/neutral scenario), %
Diagram 7. Monthly dynamics of the US dollar against the rupee, Rs. for 1 US dollar, 2015-Oct. 2020
Diagram 8. Dynamics of real incomes of the population of India, % to the previous year, 2012-1 half of 2020
Diagram 9. Dynamics of production of drugs for the treatment of eye diseases in 2015-2019, thousand packs
Diagram 10. Dynamics of the population of India, million people, as of 01 Jan. 2012-2020
Diagram 11. Incidence of the population according to the class ""Diseases of the eye and its adnexa"" (registered patients with a diagnosis established for the first time in their life) in India, in 2014-2018, thousand people
Diagram 12. Profitability before tax (profit of the reporting period) in the field of ophthalmology in comparison with all sectors of the Indian economy, 2015-2019, %
Diagram 13. Current liquidity (total coverage) in the field of ophthalmology for 2015-2019, times
Diagram 14. Business activity (average turnover period of receivables) in the field of ophthalmology, for 2015-2019, days days
Diagram 15. Financial stability (security of own working capital) in the field of ophthalmology, in comparison with all sectors of the Indian economy, 2015-2019, %
Diagram 16. Shares of the largest competitors in the ophthalmology market in 2019, %
Diagram 17. Dynamics of the total revenue of the largest operators of the ophthalmology market (TOP-5) in India, 2015-2019, million Rs.
Diagram 18. Volume of consumption of ophthalmology per capita, 2015-2019, Rs./person
Diagram 19. Criteria for choosing an ophthalmological clinic, scores
Chart 20. Ophthalmology Market Size Forecast in 2020-2024 – under the scenario of one quarantine, billion Rs.
Chart 21. Ophthalmology Market Size Forecast in 2020-2024 – under the scenario of two quarantines, billion Rs.

List of tables

Table 1. Weighted average interest rates of credit institutions on credit operations in rupees (% per annum), 2014-1 quarter 2020
Table 2. Total population and population over the working age in India, as of 01 Jan. 2012-2020, thousand people
Table 3. STEP analysis of factors influencing the ophthalmology market
Table 4. Gross margin of the ophthalmology industry in comparison with all sectors of the Indian economy, 2015-2019, %
Table 5. Absolute liquidity in the field of ophthalmology in comparison with all sectors of the Indian economy, 2015-2019, times
Table 6. Main companies participating in the ophthalmology market in 2019
Table 7. Basic information about the participant No. 1 of the ophthalmology market
Table 8. Basic information about the participant No. 2 of the ophthalmology market
Table 9. Basic information about the participant No. 3 of the ophthalmology market
Table 10. Basic information about the participant No. 4 of the ophthalmology market
Table 11. Basic information about the participant No. 5 of the ophthalmology market
Table 12. Consumer price indices in the ophthalmology market in India in 2015-Aug. 2020, %
Table 13. Average prices for initial consultations with a doctor by Union Territories, Aug. 2020, Rs./acceptance
Table 14. Average prices for ophthalmology, 2020, Rs.
Table 15. Assessment of factors of investment attractiveness of the ophthalmology market
Table 16. Assessment of the impact of recent crises on the industry
Table 17. Analysis of the impact on the industry of the state aid proposed as of April 06.10.20,
Table 18. Forecast indicators for the basic and pessimistic scenarios for the development of the crisis, %

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