Med tech in surgery

Advanced Medtech in India

November 16, 2022

With the global human population touching eight billion and one in every six humans being Indian, it is expected that the second most populous country will be the most populous next year. Medical technology holds great untapped potential to improve efficiencies in countries like India, where the staggering numbers and the gaps in resources can be crippling both at the country and individual levels. Innovative medtech especially can play a truly transformative role through advancements in telemedicine that can bridge this demand-supply gap.

The Indian medtech industry was valued at $10.36 billion in 2020 and is anticipated to grow at a Compound Annual Growth Rate of 37% from 2020 to 2025, reaching a value of $50 billion. The market for medical technology in India is dominated by imported items, both as completed goods and raw materials, with an estimated 80% dependence on imports from foreign nations.

India has a huge opportunity to fill this vacuum through higher investment in the sector that would also help expand employment and medical tourism. The country can create a strong manufacturing ecosystem with the help of a friendly business environment, streamlined land and labor rules, improved infrastructure and logistics, and single-window clearances. Additionally, this will aid in luring international investment, cutting-edge technology, job growth, and increased exports posing India as a medtech leader in tandem with its global position as the “pharmacy of the world.”

Advancements in technology have unearthed vast potential to galvanize the Indian health care landscape. It is estimated that annually 3646 surgeries are conducted for every 100,000 Indians which would mean that for every 28 Indians one would need surgery. The advent of robotic surgery allows surgeons to perform complex surgical tasks through tiny incisions using robotic technology with more accuracy and efficiency.

Emerging Role of Robotics in Health Care

The rising capabilities of robotics are widely used in clinical and non-clinical settings to support professionals across the health care sector in their regular activities. Precision science involved in robotics means that there is qualitative improvement in tasks being performed by robots when compared to humans.

Robots can also go beyond the clinical setting. They can be used to move supplies, medications and other items around hospitals. They are also employed to carry out routine, high-volume tasks in research labs to assist technicians and scientists. In surgical settings, medical robotics offers advantages like shorter recovery time, lesser invasive procedures and improved clinical outcomes.

Robotic-assisted surgeries are procedures that are too delicate for human hands to execute and are, therefore, managed by effectively using robotic arms operated by surgeons. These gloves come equipped with sensors and offer a high degree of freedom of movement. Orthopedic and spinal surgeries are a case in point where robotics has enhanced precision and helped reduce postoperative pain, discomfort and scarring.

Robotics can also play a crucial role in the production of pharmaceuticals. Currently, dispensing, kit assembly and packing all involve robotics, and their use in the creation of pharmaceuticals will only rise. This phenomenon has been demonstrated through the COVID-19 pandemic, with several isolation wards being equipped with telepresence robots assisted the medical staff.

Socially assistive robots like PARO and therapeutic robots have improved continuously and can play an important role in aiding health care professionals in geriatric management, playing the role of companions in long-term care facilities and caregivers.

Key Barriers to Medtech in India

It is important to note that the practical adoption of robotics in health care is limited to a few surgical procedures in private hospitals and large-scale pharmaceutical production units in India due to various challenges.

The regulatory environment for medical technology in India still largely remains ambiguous, complex to navigate, and opaque for many. There is no distinct legal position in India for the sector. Until 2017, limited regulation in the form of the Drugs and Cosmetics Act, of 1940, and its amendments existed in the country, which resulted in redundant rules for medical devices and other medtech-based equipment in India.

Medical Device Rules, 2017 are a step in the right direction and have allowed for the legal introduction and registration of new medical devices. Single window clearances were introduced for new medical devices by consolidating registration certificates and import licenses into a single license that can be obtained online. It is crucial to note that critics have sounded alarms over the lack of appropriate control and expert advice over such registrations which can threaten patients’ lives.

Litigation associated with culpability arising from medical procedures involving medtech is another complex aspect that needs navigation and regulation. These issues related to safety standards and pricing for the sector are in the pipeline of matters to be addressed by Medical Technology Assessment Board.

In a resource-constrained country such as India, robotics deployment in medical sciences faces significant capital investment challenges. The deployment of robotic technology is incredibly expensive because of the high cost of importing hardware components and employee training needed to operate and maintain the technology and is met with strong resistance in India which spends only 1.4% of its GDP on the health care sector. Availability of funds remains the most pressing concern for the effective disbursement of medical technology in the country.

Additionally, there is a lack of skilled human resources to handle sophisticated robotics machinery.

Way Forward

Given the large population and gaps in the health care sector, robots offer a strong solution to India. However, the seeping of robotics in the health care sector would mean that India’s manufacturing sector would have to evolve parallelly to cater to this demand. To be both quality and cost-competitive and serve a worldwide customer base, skill and scale should be the main priorities. Otherwise, the adoption of medical technology would only be limited to private hospitals in metropolitan cities, raising equity concerns.

The high capital cost of acquiring these solutions poses a challenge for the government to adopt these technologies on a larger scale, especially in a sector like health care, on top of an already inefficient procurement framework. Strategies to reduce the direct costs involved in the use of robotics would facilitate larger uptake and this needs to be on the bedrock for creating a high volume of cases in India and consequently reducing costs.

The market for health care robots will inevitably grow even more because of investments and collaborations between robotic firms and health care providers. There is no doubt that robotic technologies will revolutionize how certain companies conduct their business, making digitally integrated robots the future of medtech in the world. For equity to be maintained in the health care system, policies will need to be designed keeping in mind the high numbers as an endowment rather than a constraint.

Medical robotics in India must balance capability and affordability to penetrate the market appropriately. Individualized selling will continue, but a versatile robot that can do a range of operations and other procedures will eventually take over the medical market in India. The value of the robot must outweigh costs like maintenance and replacement. It is preferable to use a single piece of equipment for several tasks; it should be simple to modify for various procedures and adaptable for diverse settings.

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