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Health-care For Rural India

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What are the kinds of products and therapies provided by India Medtronic Pvt Ltd?
Medtronic is the world's leading medical technology company, and offers an exceptional breadth and depth of innovative therapies worldwide. India Medtronic Pvt. Ltd. is a wholly-owned subsidiary of Medtronic Inc. responsible for all of Medtronic's businesses and therapies in India. We offer advanced therapies to treat more than 30 chronic conditions, including cardiac and vascular diseases, diabetes, chronic pain and neurological and spinal conditions.

India Medtronic's business is divided into three main groups: cardiac and vascular group, restorative therapies group and diabetes group

With a 30-year presence in India, to which extent have you been able to penetrate the market? What kind of programmes are completely India centric?

India is a very significant market for Medtronic and our focus has been to make advanced therapies more accessible and affordable to our patients. Despite a high and consistently growing incidence of non-communicable diseases (NCDs), patient access in India continues to be a challenge due to poor diagnosis, inadequate infrastructure and low insurance penetration. We still have a long way to go, and Medtronic has developed business models that help address these issues in our market.

One such programme is Healthy Heart For All(HHFA). HHFA is an innovative programme aimed at improving access to advanced cardiac care to all sections of the society. Research shows that the key barriers to patients getting the right treatment include lack of disease awareness, lack of appropriate diagnostic facilities, and lack of affordability.

HHFA partners with hospitals and tries to address all these challenges in an integrated manner.

In the pipeline is a new dialysis breakthrough technology that would make haemodialysis affordable and accessible to the increasing number of End Stage Renal Disease (ESRD) patients in India.

Medtronic has also set up therapy and procedure training centres (TPTC) in New Delhi, Mumbai, Chennai and Dhaka to train physicians in the latest medical technologies. Through these training centers, we aim to collectively train over 5,000 doctors every year, and contributed towards increasing patients' access to available therapies.

What kind of international expertise have you brought to India in the health sector?
Medtronic is committed to providing better healthcare with greater economic value through innovative solutions and cutting-edge products. We have introduced devices like the Resolute Integrity drug-eluting stent which is the only FDA approved stent for Diabetics in the world. We in India are only second to China as far as the size of diabetic population is concerned. The intention here is to bring the best products for the people who need these therapies and make these accessible as well as affordable for them.

The healthcare market in India has been witnessing a double digit growth but the majority of demand has been from the urban areas. In the current scenario, is it feasible to expand to the rural market? If yes, how would you tap the potential?

In India, it is very important for healthcare facilities to reach the rural and semi-urban areas since that is where most of the population resides. But even before we speak of the rural population, let us look at some statistics that show that the advanced technologies and tertiary care for NCDs is limited to only the metro and tier 1 towns - there are barely any specialized facilities available even in the tier 2 or 3 towns. For instance, life-saving therapies like stenting and pacing can be provided only by specialised interventional cardiologists and electro physicists in the sterilised confines of cathlabs. That said, there are less than 2000 cathlabs in the country. I believe that improving access in these tier 2 and 3 towns is the starting point for expanding access. India Medtronic aims to increase coverage significantly in tier 2/3 towns over the next few years through our different initiatives.

India's healthcare system is paradoxical -on one hand, it boasts of 'best in class' healthcare delivery attracting global medical tourists, and on the other, it is characterised by a near absence of accessible, affordable quality health services for a large part of its population. What are your plans to bridge the demand supply divide?

As I have mentioned before, Medtronic has a range of India-centric programs to address these key barriers to healthcare access and thereby, narrow this gap in demand and supply gap in the country. In addition to innovative programs like Healthy Heart for All and Shruti(our program for the underserved), we are also working towards therapy innovation like our novel dialysis therapy. At the same time, we are helping physicians in Tier 2/3 cities in setting up new cathlabs to increase capacity.

How do you plan to increase the awareness regarding medical technology in the country?
India Medtronic leads education programmes across all the businesses through 'Academia' and its therapy and product training centres with the goal of addressing capacity barriers and increasing awareness regarding medical technology.

The Academia customises curriculum for interventional cardiologists, radiologists, vascular and spine surgeons, MD physicians and endocrinologists. Programmes are also designed for non-clinical stakeholders, such as policy makers, regulatory bodies and insurance personnel, who play a critical role in making advanced medical technologies available and accessible to the people.
How big a role can government play so as to speed up the growth of medical technology?
Growing incidence of NCDs is a major concern for the government. So far, the government has focussed on regulating the industry to promote transparency. At the same time, it has allowed foreign investment in the industry to encourage growth. The government spend on healthcare is slated to triple over the next 3-5 years. This will provide the much needed impetus to healthcare and also increase the awareness and accessibility to healthcare and make it a priority.

In India, there is a need for favourable policy environment, bringing in regulatory clarity and providing incentives to increase competitiveness of medical devices companies in a transparent and healthy manner. A new Health Policy is being considered by the government and there is much hope that it will bring about the required changes.

Do you think that an ambiguous regulatory framework with no distinct legal status for the medical technology industry would help?
The medical devices currently fall under the ambit of the Drugs and Cosmetics Act with 14 categories of devices being regulated. A new, stand-alone regulatory system for medical devices will be very helpful in removing ambiguities that exist due to devices being confused with drugs.

Being a medical technology company, what have been your major innovations in the past 30 years?
In the early 80's Medtronic introduced the first implantable, programmable neurotransmitter to treat chronic pain through spinal stimulations. In the same decade Medtronic also improved the pacemaker technology in a revolutionary fashion by introducing a function that automatically adjusts the pacing rate to match a patient's level of physical activity. 

In the early 90's Medtronic made history by introducing the world's smallest pacemaker - especially designed for children and adults with light body weight. Today we have clinical studies in progress on an even smaller pacemaker called MICRA that is leadless and is implanted directly into the heart.

Another notable innovation of the 90's was when Medtronic created the Aortic stent, a minimally invasive aortic stent graft, the first new treatment for abdominal aortic aneurysms.

The VEO Insulin Pump, incidentally, also named as one of the most amazing innovations of 2013 by Times magazine is a major step as far as Diabetes management is concerned.

Progressing into the early 2000's Medtronic continued to bring innovative therapies through integration of device technology with bio materials and telecommunication. As an example, remote monitoring was introduced for our pacemakers where physicians could monitor the performance of pacemakers securely through the internet. 

Medtronic therapies impact 10.5 million patient lives every year, i.e. every 3 seconds somebody somewhere in the world benefits from our therapies.

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