HEALTHCARE - INDIA-OPPORTUNITIES

1 HEALTHCARE . JANUARY 2016 For updated information, please visit 1. HEALTHCARE . Executive Summary 3. Advantage india ..5. Market Overview and Trends . 7. Porters Five Forces Analysis ..15. Strategies Adopted ..17. Growth Drivers ..19. Opportunities ..35. Success Stories 39. Useful Information . 44. JANUARY 2016 For updated information, please visit 2. HEALTHCARE . EXECUTIVE SUMMARY. india is expected to rank amongst the top three HEALTHCARE markets in terms of incremental Sixth largest in the growth by 2020. world india was the sixth largest market globally in terms of size in 2014. Indian HEALTHCARE sector, one of the fastest growing industry, is expected to advance at a Impressive growth CAGR of per cent during 2015 20 to reach USD280 billion. There is immense prospects scope for enhancing HEALTHCARE services penetration in india , this presents ample opportunity for development of the HEALTHCARE industry Rising income levels, ageing population, growing health awareness and changing attitude Strong fundamentals towards preventive HEALTHCARE is expected to boost HEALTHCARE services demand in future The low cost of medical services has resulted in a rise in the country's medical tourism, Cost advantage attracting patients from across the world.

2 Moreover, india has emerged as a hub for R&D. activities for international players due to its relatively low cost of clinical research Conducive policies for encouraging FDI, tax benefits, favourable government policies Favourable investment coupled with promising growth prospects have helped the industry attract private equity, environment venture capitals and foreign players Source: Deloitte, TechSci Research JANUARY 2016 For updated information, please visit 3. HEALTHCARE . EXECUTIVE SUMMARY. The doctor-to-patient ratio for rural india , as per the Health Ministry statistics, stands at 1:30,000, well below the WHO's recommended 1:1,000. 2015. 515 organizations USD100 Billion registered for Eye HEALTHCARE Market Size Banks till 2015. Hospitals Bed for every 1050 patients in 2015.

3 2015. 189 Government medical 156926- 404 Medical Colleges for colleges till 2015. Number of Sub- MBBS till 2015. centers 196312 Number of Hospitals 215 Private medical 3601 AYUSH Hospitals colleges till 2015. in india 2760 Blood Bank till February,2015 25346 Postgraduate students per year till 2015. Source: WHO, IMH, Deloitte, EBAI, TechSci Research JANUARY 2016 For updated information, please visit 4. HEALTHCARE . ADVANTAGE india . JANUARY 2016. HEALTHCARE . ADVANTAGE india . 2015E Strong demand Growing demand Attractive opportunities 2020F. HEALTHCARE revenue in india is set Investment in HEALTHCARE Market to reach USD280 billion by 2020; infrastructure is set to rise, Market value: expenditure is likely to expand at a benefiting both hard' (hospitals) and value: CAGR of 17 per cent over 2011 soft' (R&D, education) infrastructure USD100 USD280.

4 20 india is the largest exporter of billion billion formulations with 14 per cent market Rising incomes, greater health share and ranks 12th in the world in awareness, lifestyle diseases and terms of export value. Double-digit increasing access to insurance growth is expected over the next will contribute to growth five years Advantage india Policy support Quality and The government aims to develop india affordability as a global HEALTHCARE hub Availability of a large pool of well- Policy support in the form of reduced trained medical professionals in the excise and customs duty, and country exemption in service tax Creation of new drug testing india has an advantage over its laboratories and further strengthening of peers in the West and Asia in terms the 31 existing state laboratories of cost of high-quality medical A group has been formed for services offered constituting the Mental Health Policy.

5 Source: KPMG, Deloitte, Hospital Market india by Research on india , Frost & Sullivan, LSI Financial Services, Report on HEALTHCARE , Telemedicine & Medical Tourism in india '- ASA & Associates LLP, TechSci Research Notes: R&D Research and Development, CAGR - Compound Annual Growth Rate, USD US Dollar, F Forecast, E - Estimate JANUARY 2016 For updated information, please visit 6. HEALTHCARE . MARKET OVERVIEW AND TRENDS. JANUARY 2016. HEALTHCARE . THE HEALTHCARE MARKET FUNCTIONS THROUGH FIVE SEGMENTS. Government hospitals It includes HEALTHCARE centres, district hospitals and general hospitals Hospitals Private hospitals It includes nursing homes, and mid-tier and top-tier private hospitals It includes manufacturing, extraction, processing, purification and Pharmaceutical packaging of chemical materials for use as medications for humans or animals HEALTHCARE It comprises businesses and laboratories that offer analytical or Diagnostics diagnostic services, including body fluid analysis Medical It includes establishments primarily manufacturing medical equipment and equipment and supplies, surgical, dental, orthopaedic, supplies ophthalmologic, laboratory instruments, etc It includes health insurance and medical reimbursement facility.

6 Medical covering an individual's hospitalisation expenses incurred due to insurance sickness Telemedicine has enormous potential in meeting the challenges of HEALTHCARE delivery to rural and remote areas besides several Telemedicine other applications in education, training and management in health sector Source: Hospital Market india by Research on india , TechSci Research JANUARY 2016 For updated information, please visit 8. HEALTHCARE . STRONG GROWTH IN HEALTHCARE EXPENDITURE OVER THE YEARS. HEALTHCARE has become one of india 's largest sectors both in HEALTHCARE sector growth trend (USD billion). terms of revenue and employment. The industry is growing at a tremendous pace owing to its strengthening coverage, services and increasing expenditure by public as well private players 280.

7 During 2008-20, the market is expected to record a CAGR of per cent CAGR: 160. The total industry size is expected to touch USD160 billion by 2017 and USD280 billion by 2020. 100. As per the Ministry of Health, development of 50 technologies 45 has been targeted in the FY16, for the treatment of diseases like Cancer and TB. 2008 2009 2010 2011 2012 2014 2015 2017F 2020F. Government is emphasising on the eHealth initiatives such as Mother and Child Tracking System (MCTS) and Facilitation Source: Frost & Sullivan, LSI Financial Services, Deloitte, TechSci Research Centre (MCTFC) Notes: F - Forecast JANUARY 2016 For updated information, please visit 9. HEALTHCARE . PRIVATE SECTOR HAS A STRONG PRESENCE IN india 'S HEALTHCARE SECTOR. The private sector has emerged as a vibrant force in india 's HEALTHCARE industry, lending it both national and international repute Large investments by private sector players are likely to contribute significantly to the development of india 's hospital industry, which comprises around 80 per cent of the total market In india , private HEALTHCARE accounts for almost 74 per cent of the country's total HEALTHCARE expenditure Private sector's share in hospitals and hospital beds is estimated at 74 per cent and 40 per cent, respectively The main factor contributing to rising medical tourism in india is presence of a well-educated.

8 English-speaking medical staff in state-of-the art private hospitals and diagnostic facilities Shares in HEALTHCARE spending in india , 2005 Shares in HEALTHCARE spending in india , 2015. 40%. Government 26% Government hospital hospital 34% Top tier Top tier 19%. 11% Mid tier 14% Mid tier Nursing home Nursing home 26% 30%. Source: A report on Indian Hospital Services Market Outlook' by consultancy RNCOS, Grant Thornton, LSI Financial Services, OECD, TechSci research JANUARY 2016 For updated information, please visit 10. HEALTHCARE . PER CAPITA HEALTHCARE EXPENDITURE HAS RISEN AT A FAST PACE. Per capita HEALTHCARE expenditure is estimated at a CAGR Per-capita HEALTHCARE expenditure (USD). of 5 per cent during 2008 15 to billion by 2015. This is due to rising incomes, easier access to high-quality HEALTHCARE facilities and greater awareness of personal CAGR: 5%.

9 Health and hygiene 61 61 58. Greater penetration of health insurance aided the rise in 54. HEALTHCARE spending, a trend likely to intensify in the coming decade Economic prosperity is driving the improvement in affordability for generic drugs in the market 2010 2011 2012 2013 2014 2015. Source: World Bank, BMI Report, TechSci Research JANUARY 2016 For updated information, please visit 11. HEALTHCARE . KEY PLAYERS IN THE MARKET. No of Company Presence beds*. Chennai, Madurai, Hyderabad, Karur, Karim Nagar, Mysore, Visakhapatnam, Apollo Hospitals Bilaspur, Aragonda, Kakinada, Bengaluru, Delhi, Noida, Kolkata, Ahmedabad, 9,215. Enterprise Ltd Mauritius, Pune, Raichur, Ranipet, Ranchi, Ludhiana, Indore, Bhubaneswar, Dhaka, Bacheli, Bellary, Goa, Lavasa, Nashik, Nellore, Trivuannamalai, Trichi Aravind Eye Hospitals Theni, Tirunelveli, Coimbatore, Puducherry, Madurai, Amethi, Kolkata, 3,649.

10 Dindigul, Tirupur, Salem, Tuticorin, Udumalpet CARE Hospitals Hyderabad, Vijayawada, Nagpur, Raipur, Bhubaneswar, Surat, Pune, 2,100. Visakhapatnam, Jabalpur, Raigarh Mumbai, Bengaluru, Kolkata, Mohali, Noida, Delhi, Amritsar, Raipur, Jaipur, , Ra Fortis HEALTHCARE Ltd 10,000 Chennai, Kota, Faridabad, also the company present in Singapore, Dubai, Mauritius and Sri Lanka Max Hospitals 2016 Delhi, NCR, Punjab, Uttarakhand Manipal Group of Udupi, Bengaluru, Manipal, Attavar, Mangalore, Goa, Tumkur, Vijaywada, 4,900. Hospitals Kasaragod, Visakhapatnam Ahmedabad, Bengaluru, Berhampore, Davangere, Dharwad,Durgapur, Narayana Health 7452 Guwahati, Hyderabad, Jaipur, Jamshedpur, Kolar, Kolkata, Kuppam, Mahuva, Mysore, Raipur, Shimoga, Bellary, Palanpur Source: Company websites, Fortis Red Herring Prospectus, TechSci Research Note: * No of beds include owned subsidiaries, Joint Ventures and affiliations JANUARY 2016 For updated information, please visit 12.