The 5th AMCHAM Healthcare Conference was held on September 15, 2017 at Westin Mindspace, Hyderabad. Dr. Kiranmai Pendyala, Chairperson – Hyderabad Chapter, AMCHAM, welcomed the audience. She spoke on the initiation of the healthcare conference in Hyderabad and how it progressed over the years. Hyderabad is known for pharmaceutical and drug manufacturing hence healthcare is a natural topic. Thinking about the societal need intertwined with healthcare, this conference began in Hyderabad in 2013. Each year AMCHAM, with the help of a knowledge partner, created a position paper and presented it to the government.

Consul General Katherine Hadda, the guest of honor, congratulated AMCHAM on the 5th consecutive year of the conference and for the focus on such a critical sector. She emphasized that a healthy population is a critical component of a healthy economy and stable society. The access to healthcare is as important as the technology.

Dr. Balaji Utla, the CEO of Kriya Health, gave the keynote address. He found it intriguing how AMCHAM concentrated on “geo political healthcare.” Dr. Utla explained that health was a larger word compared to healthcare. What one experiences when in a critical condition with love, care and professional expertise is healthcare. There is a subtle difference between health and healthcare. He emphasized that healthcare was not a last mile problem, but the last yard, last inch, and distance is a dimension of vulnerability. All the vulnerabilities determine what quality of life a tribal group in the last inch can have. He explained that behind an opportunity is also humanity, and that it cannot be forgotten so that good corporations can become great and wonderful corporations. India needs to spend 2.5% of GDP on healthcare. There are opportunities in problems and problems in opportunities.

Dr. N.K. Singh, Frost & Sullivan was the knowledge partner for the conference, spoke on the landscape of healthcare. An interesting line from a novel said, ‘we are in the best of times and the worst of times – a time of hope and a time of despair.’ The situation of the Indian economy is similar. When there is a rise in poverty there is also increase in both communicable and non-communicable diseases. He stressed that public health is very important and must be re-focused. Dr. Singh mentioned that healthcare is changing from being curative to monitoring. He urged that the country and health system need to prepare for an aging population, the shifting burden of diseases and its comorbidities.

Session I – Innovation in Healthcare

The moderator for the session on ‘Innovation in Healthcare’ was Ms. Divya Prakash Joshi of Medtronic Hyderabad. The panelists included: Dr. Akhilesh Sharma of Dr. Reddy’s, Mr. Sujiv Nair, CEO of Telangana Academy for Skill and Knowledge (TASK) and Mr. Krishna Prasad, a clinician. To alleviate pain, restore health and extend life, healthcare is very important, especially in the changing geo-political scenario, where not only the government, hospital and even the user plays a part. Everyone is in it together to make healthcare sustainable. The discussion revolved around how the government is a facilitator and they cannot do everything. The government provides ecosystem and infrastructure and the burden remans on everyone else to innovate and bring about a change. There must be synergy.

Session II – Investment – Expectations

The moderator for the second session was Mr. Satya Gottumukkala. The panelists included Mr. Kshitij Chaudary of Invest India, Mr. M Sathya Sunder of Abbott and Dr. N.K. Singh of Frost & Sullivan.

There is a lot of interest in the India market. The world is interconnected and there has been a significant amount of investment in healthcare, especially in the technology space. Between 2010 – 2015 there was a 13.5% increase in Investment alone. It was stated that if India followed the traditional method of healing in healthcare, by 2034 India will need to invest about 250 billion dollars to take care of patients. However, if people can focus on wellness instead of treatment, the amount can be reduced by 90 billion dollars.

It was also mentioned that there was a huge trade off with the government on one side that wants to promote universal healthcare for all while the private sector was a profit maximizing agent. There is a trade off and a choice that India must make. Equity and Efficiency complement each other. Efficiency can be achieved through innovation.

In terms of price control, there are two sides to the coin. The panelists discussed, ‘What is the safe price for a drug?’ and how the to look at the situation holistically. There is a lot that the government is trying to do. There is a market, there is a demand, but government is trying to restrict pricing procedures. It was highlighted that any freedom that is abused brings about regulation.

The luncheon keynote address was given by Mr. Jayesh Ranjan, Principle Secretary – Information Technology, Industries & Commerce and Textiles – Government of Telangana. He shared on what the government was doing to promote the entire spectrum of healthcare in Telangana.

Session III – Value Based Healthcare

The third session was moderated by Dr. Ambuj Chaturvedi of Medtronic. The panelists included Ms. Joanne Sullivan of PAREXEL, Mr. Syam Adusumili of Optum Health, Arif Fahim of Abbott and Mr. Jeremy Canady of U.S. Medical Innovations.

The discussion focused on how in India, it is largely a volume based healthcare more than value based. Number of patients admitted, number of diagnostics done, number of interventions etc and even the payments are linked to the volume metrics. In more mature healthcare systems around the world there has been a movement towards looking at outcomes.

Companies must look at the value of a drug for a particular market and look at efficacy. It would aid in creating in a faster process and much better valuable outcome. The dynamics have evolved over a period of time. The speakers addressed the need to integrate into smart technology – diagnostic testing, pre-operative energy, radiation therapy etc. It was predicted that in 15 years most of the surgeries will be done via robotics.

The cost of healthcare was also discussed. In India, insurance has not truly penetrated beyond tier one cities and has only begun to reach tier two cities. Access to care matters the most because it is the velocity of care that really matters. When a patient enters the hospital, he wants to get cured fast. That is an obstacle all over the world because the faster one is treated, the less it will cost and that’s important. Accountability is a bigger problem in India than the reimbursement itself. The fundamental problem highlighted was that the doctor knows all and does not feel he has done anything wrong if things go out of hand. In rural India, it is necessary to consider looking at frugality, tele-medicine etc. Nowadays, an ultra-sound can be viewed on a smart phone and outcomes are shaping the country.

Dr. N.K. Singh gave the concluding remarks and Mr. Kalyan Chakravarthy of PAREXEL gave the vote of thanks and thanked the sponsors – American Oncology, Medtronic and PAREXEL as well as AMCHAM’s knowledge partner, Frost & Sullivan.