Cardiovascular diseases (CVDs) have now become the leading cause of mortality in India. A quarter of all mortality is attributable to CVD. Ischemic heart disease and stroke are the predominant causes and are responsible for >80% of CVD deaths. The Global Burden of Disease study estimate of age-standardized CVD death rate of 272 per 100 000 population in India is higher than the global average of 235 per 100 000 population.
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PROPORTIONAL MORTALITY IN INDIA DUE TO CVD
CVDs are estimated to account for 24% of all deaths.
MARKET OVERVIEW OF CARDIOLOGY IN THE WORLD
- CVDs are the number 1 cause of death globally: more people die annually from CVDs than from any other cause.
- An estimated 17.9 million people died from CVDs in 2016, representing 31% of all global deaths. Of these deaths, 85% are due to heart attack and stroke.
- Over three quarters of CVD deaths take place in low- and middle-income countries.
- Out of the 17 million premature deaths (under the age of 70) due to non-communicable diseases in 2015, 82% are in low- and middle-income countries, and 37% are caused by CVDs.
HISTORY OF CARDIOLOGY
- 1949- Dr. Reeve Betz started the first cardiothoracic surgery department at Vellore.
- 1960- Dr. T. Thomas and Dr. Gopinath joined Dr. Betz subsequently and initiated the first open heart surgery programs.
- First ever electrocardiography (ECG) machine was used in K.E.M. Hospital, Mumbai in the late 40’s.
- 1975- First Coronary Artery Bypass Graft (CABG) surgery was carried out by Dr. K.M. Cherian at Chennai.
- First ever heterologous cardiac transplant with pig’s heart was done at K.E.M. Hospital, Mumbai by Dr. PK Sen. the patient survived for 24 hours only.
- The first electrophysiology lab was established on 5thMarch, 1975 at G.B. Pant Hospital, Delhi by Dr. M Khalilullah and almost at same time interventional cardiac catheterization labs were founded in Andhra Pradesh in 1977.
- The onset of the pharmacological intervention of acute myocardial infarction started way back in 1984. Dr. KL Chopra, Dr. HK Chopra and others used streptokinase as a thrombolytic agent for the first time in India.
- Tejas Patel has achieved global fame for popularizing the trans-radial approach for diagnostic and therapeutic interventions.
- Cardiac pacing in India dates back to late 1960s. First cardiac pacing in India was reported by the team of Dr. CC Kar and Dr. AK Basu from Institute of Post-graduate Medical Education and Research (IPGME&R), Calcutta in 1966–67.
- ML Bhatia started pacemaker implantation at AIIMS, New Delhi in 1968.
- The first ever temporary pacemaker manufactured in India was the Khalilullah-Mendez pacemaker, which was marketed in 1970.
- The first permanent pacemaker manufactured in India was from Shree Pacetronix Ltd. However, most of the components were imported.
1. BARC develops credit card-size ECG machine that will cost around Rs 4,000
It is just slightly bigger than your debit or credit card and it is a full-fledged ECG machine. A team of Bhabha Atomic Research Centre has developed a compact ECG machine, which will also be pocket friendly. The researchers claim that people will be able to afford one of these machines for their private use, just the way they use a personal blood sugar monitor or blood pressure monitor.
Also, an app will connect the device to a smartphone and the user will not have to undergo any special training to operate this little wonder. The BARC team estimates that the machine dubbed Tele-ECG would be priced around Rs 4,000. The commercial machines currently available in the market cost between Rs 40,000 and Rs 50,000.
2. Indian innovation offers cheap and effective test for heart disease
Scientists at the Healthcare Technology Innovation Centre (HTIC) in the southern Indian city of Chennai have invented a friendly device that keeps a check on artery stiffness and gives an alert when issues arise.The device, which is about the size of a digital television set top box, has been tested in three different clinical trials. All tests found the Indian machine to be on par with the commonly used imaging system.
PREVALENCE OF CORONARY HEART DISEASE IN INDIA
- Cardiovascular diseases have been gaining importance in India recently because of increased incidence of the disease. It is the first among top 5 causes of deaths in Indian population.
- In India, studies have reported increasing CHD prevalence over the last 60 years, from 1% to 9%-10% in urban populations and <1% to 4%-6% in rural populations.
- In the 30-74 age group, the overall 10-year risk of cardiovascular disease in women is 12.7%, as compared to 21.4% in men.
- CVD risk tended to be the highest in south India (including Goa), the three most northern states in the dataset (Himachal Pradesh, Punjab, and Uttarakhand), the northeastern states (except Assam), and West Bengal (particularly among males).
ECONOMIC IMPACT OF CVDS IN INDIA
- India cumulatively lost USD 236.6 billion because of heart disease, stroke, and diabetes, losing 1% off the GDP.
- In 2000, in the age group of 35 to 64, India lost 9.2 million years of productive life (PYLLs), almost six times the figure for US.
- Over a 10-year period, 20% of CVD related deaths in the 40-79 age groups can be averted by the use of a regimen of aspirin, statin and blood pressure-lowering agents. This regimen costs less than USD 3 per person per year in low and middle-income countries.
GOVERNMENT POLICIES FOR CVDS
Government has started taking measures towards prevention of heart diseases especially amongst the rural population. National Program for Prevention and Control of Cancer, Diabetes, CVDs and Stroke (NPCDCS) was introduced in July 2010 with an outlay of 500 crores for interventions on diabetes and cardiovascular diseases and stroke (out of the total outlay of ` 1231 crores). The program aims to achieve behavior change in the community and improve access to cardiac care through:
- Massive health education and mass media efforts at country level
- Opportunistic screening of persons above the age of 30 years
- Establishment of NCD clinics at CHC and district level
- Development of trained manpower and strengthening of tertiary level health facilities
- Early diagnosis and treatment
In addition, there are initiatives to include preventive healthcare check-ups under CGHS, mass screening camps for early detection amongst slum dwellers, and screening of children for congenital heart disease.
Public Private Partnerships
Government is taking initiatives of partnering with private sector hospitals which specialize in tertiary cardiac care. For instance, Government of Uttarakhand has signed a MoU with Fortis Healthcare to set up a cardiac center in a government hospital in Dehradun which will be the first comprehensive cardiac care facility in the city. Similarly, Government of Chhattisgarh has signed a MoU with Fortis (Escorts) on cardiac care and surgery and also with various pediatric cardiology centers on correction of congenital cardiac problems in children under Bal Hruday Suraksha Yojna.
GLOBAL MARKET OF CVD
- In the UK, total healthcare costs of CVD exceed $11 Billion annually, with annual economic costs of CVD exceeding $24 Billion annually.
- In the US total costs associated with CVD were estimated to be as high as $656 Billion in 2015 and could rise to as high as $1.2 trillion by 2030.
- Johnson & Johnson’s share in revenue from this drug totaled $2.3 Billion in 2016 and this is expected to increase to $3.4 Billion by 2023.
- In January 2017, Johnson & Johnson acquired Actelion and with it Uptravi and Opsumit, which together will generate $5.4 Billion by 2023, enough to secure Johnson & Johnson’s place as market leader.
INDIAN CVD MARKET
- The Indian cardiovascular device market is a meagre 1.8% of the global market.
- However, of the 17.5 million deaths due to cardiovascular diseases (CVD) in the world, approximately 2.4 million deaths occur in India.
- Considering these facts, the cardiovascular device market, valued at approximately USD 1 billion in 2015 and growing at about 15% per year.
- The death rate due to cardiovascular diseases (CVD) in India it raised by around 34 per cent from 155.7 to 209.1 deaths per one lakh population in between 1990-2016.
CVD MARKET CHALLENGES IN INDIA
- High surgical cost treatments
- Lack of accessibility, mainly for rural population
- Shortage of skilled cardiac surgeons for treatment
- Higher imports due to the increasing sophistication in cardiovascular devices
CVD MARKET DRIVERS IN INDIA
- Growing rate of heart diseases
- Increasing awareness among people about the diseases and its prevention
- Technological advancements are the main drivers of growth
MAJOR HOSPITALS IN INDIA SPECIALIZED IN CARDIOLOGY
1. Kerala Institute of Medical Sciences (KIMS)- Trivandrum
Kerala Institute of Medical Sciences or KIMS is one of Asia’s leading cardiac care hospitals. They have 600 beds (as of 2015) and are a multi-disciplinary super specialty hospital.
2. Fortis Escorts Heart Institute & Research Center
This hospital got established in 1988 and it one of the prominent cardiac hospitals in India. Apart from India it has 11 hospitals in other countries too. It has also received certifications by the JCI and NABH. Fortis has a well-qualified team of doctors and offers some of the best treatment procedures.
3. Asian Heart Institute & Research Centre- Mumbai
It got established in 2002 and its one of the private hospital in Mumbai to provide insurance scheme for the poor. It is accredited to with ISO 9001:2000, JCI and NIAHO and is well known for their cardiac treatments.
4. M. Birla Heart Research Centre- Kolkata
This is one of finest cardiac hospital with a team of highly skilled doctors and Paramedical staff.It has all facilities required for non-invasive diagnostics, nuclear medicine diagnostics, adult cardiac surgery, EP study, non-surgical intervention and many more.
5. Manipal Heart Foundation- Bangalore
Manipal Heart Foundation has the finest team of cardiologists and is well known for its world class infrastructure. It is accredited to NABH and is one most reputed hospital to be found in Bangalore.
6. Narayana Hrudayalaya- Bangalore
It was founded by Shankar Narayana Construction Company and it currently has 5000 beds.The hospital offers specialties in cardiology which includes cardiac surgery, electrophysiology and pacing, non-invasive cardiology, interventional cardiology and pediatric cardiology.
7. Rabindranath Tagore International Institute of Cardiac Sciences (RTIICS)- Kolkata
This is a super-specialty tertiary care hospital established in the year 2000. It provides service to the people of West Bengal and neighboring districts in Eastern India as well as the North Eastern states apart from countries such as Bangladesh, Nepal, Bhutan, Africa and Myanmar. RTIICS hospital is a centre of excellence in Cardiology, Cardiac Surgery & equipped with state-of-the-art operation theatres & Cath Labs.
8. M. Wadia Institute of Cardiology- Pune
It was established as a Public Charitable Trust in 1966. The N. M. Wadia Institute of Cardiology was the first non-government sector hospital in India to start a Coronary Care Unit and the first in Poona to pioneer cardiac Catheterization and Angiography.
9. Apollo Heart Hospital- Chennai
The Apollo Heart Institutes has been a pioneer in open heart surgeries and cardiac catheterization. Since its inception 33 years ago, the institute has performed over 1,55,000 cardiac surgeries. The Centers of Cardiology and Cardiothoracic Surgery at Apollo Hospitals are among the largest cardiovascular groups in the world with 14 world-class institutes, over 400 cardiologists & cardiac surgeons and 200 heart stations.
10. Medanta – The Medicity
It is one of India’s largest and most prestigious multi-super specialty medical institutes. Spread across 43 acres in Gurgaon NCR and houses 1,250 beds and over 350 critical care beds, with 45 operation theatres, the hospital was founded in 2009 by renowned cardiovascular and cardiothoracic surgeon, Dr. Naresh Trehan and is located in Gurgaon. Primarily known as an institute specializing in cardiology, presently Medanta has 32 institutions, departments and division that cater to over 20 specialties.
- CVD is a major public health problem in India, often impacting the most productive years of an individual’s life.
- The information presented in this article clearly suggests that NCDs in general and CVDs in particular are a big cause of concern for India.
- While the Indian government and other stakeholders have realized this and started some corrective action, a lot more focused and collaborative effort needs to be made to prevent a heart disease epidemic.
- Between 2011 and 2031, the number of people above 60 years of age is expected to more than double in India.
- With increasing burden of cardiovascular diseases & increasing population, India needs new Cardiac Care Units in both Public & Private sector to deal with uprising scenario.
Are you planning to build or restructure or venture in Cardiac Hospital in India? Looking for information about the major healthcare players in Government, Private diagnostic centres that are available in India? Are you looking to find out which part of the city’s is best to venture in or what all facilities are available and what all should be planned for new setup? In this article Hospaccx Healthcare Consultancy has mapped all on major players in terms of Cardiac facilities and healthcare scenario in India.
Below is the superficial and macro level survey if you need a refined market and financial feasibility or any other study related to healthcare is required you can contact Hospaccx Healthcare business consulting Pvt. ltd on [email protected] or [email protected] Or you can visit our website on www.hhbc.in