BCG X B Capital DHP VF Compressed

A Digital Pill for
Revolutionizing Healthcare
OCTOBER 2023
A Digital Pill for Revolutionizing Healthcare 1

Boston Consulting Group (BCG) partners with leaders in business and society to B Capital is a multi-stage global investment firm that partners with extraordinary
tackle their most important challenges and capture their greatest opportunities. entrepreneurs to shape the future through technology. With more than $6 billion
BCG was the pioneer in business strategy when it was founded in 1963. Today, in assets under management across multiple funds, the firm focuses on seed to
we work closely with clients to embrace a transformational approach aimed at late-stage venture growth investments, primarily in the enterprise, financial
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B Capital was founded in 2015 by Eduardo Saverin and Raj Ganguly. Shortly
Our diverse, global teams bring deep industry and functional expertise and a range of thereafter, they were joined by Howard Morgan as Chair and Co-founder and
perspectives that question the status quo and spark change. BCG delivers solutions Kabir Narang joined as Founding General Partner. B Capital’s vision of providing
through leading-edge management consulting, technology and design, and corporate an unparalleled platform to help the world’s most promising startups scale and
and digital ventures. We work in a uniquely collaborative model across the firm and transform their industries could not be achieved without the guidance of
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B Capital leverages an integrated team across nine locations in the US and Asia,
as well as a strategic partnership with BCG, to provide the value-added support
entrepreneurs need to scale fast and efficiently, expand into new markets,
and build exceptional companies.
Foreword
The move towards higher spend per capita on respiratory diseases etc.) growing at 9% overtook practitioners and specialists will remain a
healthcare has emerged as a key barometer the acute disease burden in 2014. In this context, constrained resource in India for the foreseeable
of economic development and growth. This and with a growing middle class and awareness future (0.7 physicians per ‘000 people compared to
demonstrates the importance of healthcare of health, as well as increasing government WHO standard of 1). Given that these shortcomings
from a government policy perspective, as well expenditure on health (from 1.4% in 2018 to 2.2% will not be overcome in a short period of time,
as the increasing prioritization of healthcare by in 2022), we expect the overall healthcare market to leveraging technology remains the one viable way
individuals and corporates. In India, this curve has grow from $167Bn in 2022 to $458Bn in 2030. to circumvent the country’s lack of physical care
been moving upwards in recent years, driven by a infrastructure at scale. Driven by COVID, rapid
confluence of forces, from a per capita healthcare With a growing spend, Indian healthcare still digitization, increasing penetration of smartphones
spend of $45 in 2014 to $68 in 2021. However, it suffers from the classical challenges which is called and the internet, the pace of digital innovation in
very much lags the healthcare spend compared to the Iron-Triangle in healthcare – challenges of Indian healthcare is accelerating and an increasing
other large economies – thus reflecting the gap access, affordability, and quality. The healthcare number of founders are creating innovative
and potential in the sector. infrastructure in India is well below WHO platforms focused on these specific patient and
standards (1.2 beds per ‘000 people compared to doctor needs. Global and local investors have
India suffers from ‘dual disease’ burden with the WHO standard of 5). Inspite of investments helped support this trend with record levels of
acute disease burden growing at 6%, while chronic in recent years in increasing medical colleges funding since 2021.
disease burden (diabetes, cardiac diseases, and institutions, skilled professionals – general

Foreword
The government, too, has taken a series of journey. It offers a fantastic opportunity for digital- opportunities, especially at the early stage, while
progressive steps and initiatives, such as the bold native founders and incumbents to reimagine how providing an insight into where the challenges lie.
and ambitious Ayushman Bharat Digital Mission healthcare will be delivered in the future. We can These trends around technology-led innovation are
that aims to create a unified digital healthcare stack expect a transformation in how patients will seek what we envision will become the digital pill for
to promote digital health and improve healthcare and receive care. We expect a trajectory change revolutionizing healthcare in India.
outcomes. In particular, the mission aims to in how doctors and healthcare providers will seek
create a secure exchange of medical data between to give acute and chronic care. We also expect
different stakeholders in the healthcare ecosystem. the payers – i.e., health insurance companies to
Such a platform will help expand the reach of integrate into this ecosystem to create efficiency
digital health solutions while ensuring better and better patient outcomes. While it is difficult
clinical outcomes for patients across India's diverse to crystal ball gaze, our estimates suggest that
population segments. the digital health market in India can grow 10x
from $2.7Bn in 2022 to ~$37Bn by 2030. In this
Driven by the above factors, the evolution of digital report, we have outlined key drivers that will
healthcare in India is at a critical point in its lead to continued innovation and investment
Priyanka Aggarwal Karan Mohla

Managing Director & Senior Partner General Partner
Boston Consulting Group B Capital Group

Table of Contents
01 02 03
Introduction Riding the Waves Solving the Rubik's Cube

Healthcare delivery ripe for Emerging themes shaping the Winning in the
disruption in India digital health landscape digital healthcare opportunity
Page 7 Page 14 Page 68

01
Introduction
Healthcare delivery ripe for disruption in India

India is perfectly poised for growth… …in a rapidly-evolving healthcare landscape
Healthcare Healthcare
2022 2030
3% Healthcare spending % of GDP 6% Healthcare spending % of GDP
~37% Insured Households ~69% Insured Households
~55% of Healthcare spend that is OOP ~36% of Healthcare spend that is OOP
Reimbursement-guided, early disease

Prescriber-guided, late diagnosis and treatment... management, tech-enabled scale benefits

India has low health expenditure but expected to rise going forward
India lags major economies in overall healthcare Government healthcare spending in India on the rise
spending as % of GDP with aim to increase spend to 2.5% of GDP by 2025
Current Health Expenditure as a % of GDP1 India Government Health Expenditure (INR Lakh Crore)
19% 5.5
5.2
13%
12%
10% 3.2
2.7 2.7
6%
3%
India China Brazil UK Germany USA 2018 2019 2020 2021 2022
As a %
of GDP 1.4 1.4 1.6 2.2 2.2
1. Data as of 2020
Source: World Health Organization; Global Health Expenditure Database; CRISIL Research; CEIC Data

India witnessing highest healthcare inflation despite fall in COVID-related hospitalizations
YoY Medical Cost Inflation, 2021 (%)

13.8
11.6
Despite COVID-19 related
10.0 hospital admissions going
9.6 down in the recent past,
8.7 medical inflation in India
8.1 has continued to rise.
Routine surgeries have seen

their pricing go up by 8-10%.
Consumable pricing is up
17-18%. Medical inflation is
passed on to consumers.
— Business Today
Singapore Thailand Global Vietnam China India
Source: MOFSL; Mercer Marsh Benefits; Business Today

High chronic disease burden in India
Chronic diseases, such as cardio and diabetes comprise India now has the 2nd largest diabetes population,
the major disease burden in India most of them are not treated
Breakdown of Disease Breakdown of NCD Disease Type 2 Diabetes3 Prevalence (Mn Patients) –
Burden in India (%) Burden in India (%) Top 3 Countries
141
Cardiac 24%
NCDs1 58% Respiratory 11%

Diabetes &
Kidney 8%
Neoplasms 10%
74 Treated
Mental 8%
30
CDs2 31% Not Treated 32

Others 39%
44
Injuries 11%
China India USA
1. Noncommunicable Diseases; 2. Communicable Diseases; 3. T2D Diabetes Market Contributes to ~92% of Overall Diabetes Market 4. Data as of 2021
Source: Our World in Data; BCG Analysis

Healthcare is under-resourced in India
Number of Beds per 1,000 People Number of Physicians per 1,000 People Number of Nurses & Midwives per 1,000 People
15.7
-70%
5
4.3
2.6 -4%
2.9 2 2.7
-30% 2.5
2.4
1.2 1
0.7
India WHO China USA India WHO China USA India WHO China USA
Note: Data as per estimation in 2021

Source: WHO World Health Statistics; WHO Database; CRISIL Research; BCG Analysis

Unique structural challenges across Indian healthcare value chain
Healthcare
Market Entity Providers Pharmacy Diagnostics Lab Insurance1
USA ~7K ~30K ~25K 4.1%
India 70K ~800K ~100K 0.4%
Key Complexities
in the Indian Inadequate Fragmented Inadequate infrastructure
Healthcare Market Limited awareness
infrastructure supply chain in Tier 2 cities
Lack of specialist doctors Poor inventory Lack of digitization for

Lack of OPD coverage
in Tier 2+ cities management report sharing
Absence of centralized Low availability of critical Rx Dependence on Cumbersome claims

medical records drugs in Tier 2+ cities physical channels management process
1. Retail Insurance Penetration

Source: Secondary research

02
Riding the Waves

Emerging themes shaping the digital health landscape

10 Key Themes shaping the path in digital healthcare
Emerging from the Where's the Value? Show Me Omnichannel and Specialty and
Hype Cycle… the Money! Omnipresent Preventive Care
Bigger and Better
Broader adoption of Sizable value pools being Funding environment Service expansion into Increasing specialty care
digital healthcare disrupted by healthtech remains robust with adjacencies and solutions customized for
has flourished broader archetypes of vertically-integrated the Indian environment
post the pandemic business models delivery being driven by
being financed underlying unit economics
01 02 03 04 05

10 Key Themes shaping the path in digital healthcare
Asset-light – But From OOPS The Empire Ecosystem A Multipolar

Not Light Touch to SAHI Strikes Back Partnerships – World – No
A Marriage of Winner-Take-All
Convenience
New asset light Rising insurance Incumbents are ramping Greater collaboration Consolidation being led
providers are emerging penetration and OPD up digital presence and between incumbents by several deep pocketed
and gaining traction coverage to drive greater competitive intensity and digital natives players. Category
adoption of online specialists likely to
consultations continue to succeed
& patient services
06 07 08 09 10

Emerging from
the Hype Cycle...
Bigger and Better

17
Rapid tech penetration and rising consumer preference for online healthcare
delivery will catalyze adoption of digital health
Internet & smartphone adoption Preference for online consultations in the future
How likely are you to prefer taking doctor consultation

2.3x through digital for first consultation?
780
3% 6%
Number of Indian 343 11%
Internet Users (Mn) 29% 29%
2016 2022
Percentage of Percentage of
Patients (%) Patients (%)
2x
49% 36%
600 37%
Number of Smartphone 300 Metro Tier 01

Users (Mn)
2016 2022 Definitely prefer May prefer Will prefer only if offline isn't there Will not prefer
Source: Indus Valley; India Times; Live Mint; BCG Survey 2020 (conducted in June 2020 covering 400 respondents); BCG Analysis

Digital healthcare adoption has continued to grow strongly post the pandemic, irreversibly
changing consumer behavior
Usage of digital health platforms continues to grow Key factors leading to rise in usage of digital
post the pandemic healthcare adoption
Average Monthly Active Users [MAU] (Mn)
12
Pandemic-Induced Adoption
People unable to access physical outlets,
10 doctors or pharma stores offline due to
lockdown and contagion constraints
6
4
3
3
2 3 Retention Led by Price & Convenience
2
1 Users found digital platforms cheaper while
offering a wider range of options, higher
service quality and greater convenience vs.
MediBuddy Practo HealthifyMe PharmEasy physical counterparts
Tata 1mg
2019 2022
Source: App Annie; BCG Analysis

Government leading digital health initiatives to ensure healthcare accessibility and
affordability in India
Phase 1 - Battle-tested effectiveness of Phase 2 - Leveraging digital to provide access Phase 3 - Building integrated digital health
digital systems to combat COVID and affordable care to all infrastructure to improve care
COVID contact tracing, self-assessment and National telemedicine program to provide Bringing existing healthcare ecosystem
real-time advisories to citizens primary care to remote areas online via unique digital IDs and digitizing
all parts of the value chain
Aarogya Setu 218Mn+ 40 Days eSanjeevani OPD 100Mn+ 200K+

Ayushman Bharat Digital Mission
Total Reached First Patients Providers

Installs 100Mn+ Installs Served Onboarded
Easy vaccine administration - find vaccine Health insurance scheme to provide free 380Mn+ 20Mn+ 1.7Mn+
centers, book slots & receive digital certificates secondary & tertiary care for EWS
Health IDs Health Facilities Health

created Registered Professionals
INR Registered
Co-WIN 10Mn+ 2Bn+ PM-JAY 500Mn+
5Lakhs
Registered Total Vaccines Beneficiaries Insurance cover per

Citizens Administered of PM-JAY year per family
Notes: Data as on 29 April 2023

Source: Co-win, Aarogya setu, NHA, ABDM website

Government teleconsultation platform eSanjeevani already reaching 100Mn+ patients
Patients reached through eSanjeevani Consultations Impact
E-Sanjeevani Health & Wellness

Center platform rolled out as a
100Mn
doctor-to-doctor telemedicine
platform connecting rural spoke 100Mn+
centers to established Government 80Mn Patients Served
hospital hubs in larger cities
220K+
Providers
E-Sanjeevani OPD launched Onboarded 100K+
at the outset of COVID-19 as a Healthcare & Wellness
patient-to-doctor telemedicine 41Mn
platform for at-home patients
15K+ Spokes Operational
in remote locations Hubs
Established 1.1K+
18Mn OPDs Hosted
0.5Mn
6Mn
3K 49K 1Mn Daily Patient
Volume
Nov'19 May'20 Nov'20 May'21 Nov'21 May'22 Dec'22 Jan'23
Sources: eSanjeevani; MoHFW; Secondary Research

Significant Government push for integrated digital health infrastructure with Ayushman
Bharat Digital Mission (ABDM)
Implemented in Phase 1
1. Personalized Health ID 2. Standardized Healthcare Provider Registry 3. Longitudinal Patient Health Records
• Enables interoperability & sharing of data across • Enables higher quality of care & tracking of • Allows for longitudinal care & predictive solutions
providers and platforms outcomes over time • Patient to be sole owner of his/her data;
• Drives accountability across healthcare consent-enabled sharing
professionals and providers
Phase 2 and Beyond
4. Coverage and Claims Platform 5. Open Telemedicine and E-Pharmacy Network 6. Health Data Analytics
• Enables OPD insurance, reduced cost of claims • Promotes open-source models allowing inter- • Enables creation of better disease control
and higher genuineness operability and choice to users programs
• Faster and cheaper settlements for insurers would • Private players invited to build own platform • Creates new opportunities for research and
further reduce cost of insurance for customers clinical advancements
Sources: Secondary Research

Where's the Value?

Indian Healthcare value pools to expand to $450Bn+ by 2030
$450Bn+ Indian Healthcare Market Size (2030) Driven by 5 Major Trends
Total Health $167Bn $458Bn 13%

Higher focus on preventive care and health
management post COVID-19 led
13% spike in awareness
IP Delivery
71
189 15% Rising lifestyle disease prevalence with
rising urbanization
OP Delivery
12%
30
Rapidly expanding government access
Pharma1 92 initiatives and push for digitization of
healthcare infrastructure
14%
32
Diagnostics 79
Growing insurance coverage making healthcare
10 12% more accessible to larger population
29
Medtech 11 24
18% Increased digitization of unorganized
13 45
distribution and services market unlocking
Others2 scale benefits
2022 2030 CAGR
1. Pharma market size calculated basis MRP value 2. Includes fitness, alternative medicine, preventive care etc.
Source: Jefferies, RedSeer, UBS Equities, Expert Interviews, Annual Reports, BCG Analysis

Total size of heathtech market to increase to ~$35Bn by 2030
~$35Bn Digital Heath India Market Size 2030E ($Bn) Driven by 6 Major Trends
Total Digital Health 2.7 1-2% 37 7-8% Rising Digital Consumerism: ~46% smartphone
users consuming digital solutions
12-
E-Pharmacy 3-5% 15% Increasing Power of Payer: Up to ~10% digital
distribution by traditional insurers
12 30-
1.1 3-5% 35%
E-Diagnostics
New Ecosystems: With digital natives &
incumbents creating newer solutions
1-2% 3-5%
Teleconsultation 10
0.5
Beyond the Pill: Play by pharma companies
<0.5% 3 3-5% via digital disease management
Surgery Aggregation 0.4
5 12-
0.2 3-5% 15% Connected Devices: 100Mn+ wearables
Healthcare Financing shipped to India in 2022
0.3 5
<1% 3-5%
0.2 3 NDHM: Significant push to operationalize
Fitness & Specialty Care
Market Size ($Bn) % Penetration Market Size ($Bn) % Penetration
digital backbone across India
2022 2030
Sources: Jefferies, RedSeer, UBS Equities, Expert Interviews, Annual Reports, BCG Analysis

Multiple player archetype emerging in the Indian healthtech market
Diagnosis Pharma Delivery Consultation Treatment Monitoring Financing

E-Pharma
PharmEasy Tata 1mg Netmeds
01
Broad Teleconsult
Ecosystem Play
Marketplace Practo MediBuddy Visit Health
EMR-led Eka Care HealthPlix Curelink
Offline to Diagnostics Surgery Care

02
Online Healthians Orange Health Redcliffe Labs Pristyn Care Hexa Health Ayu Health
Fitness & Wellness

Cure.fit Ultrahuman HealthifyMe
03
End-to-End
Care Speciality Care
Breathe Smiles.ai Wysa Numen Sugar.Fit
Distribution Play
Plum Onsurity
04
Health
Financing Full Stack Model
Digit Kenko
05 Health SaaS Innovaccer Triomics Eluciddata Arintra Cloudphysician Carpl Redbrik AI CoverSelf

Show Me the Money!

Funding environment remains robust even post the pandemic surge; $1Bn+ flowing
into healthtech in 2022
Phase 01 Phase 02
2.5
India Healthtech VC Funding ($Bn)
Series C+
Series B/C
1.0 1.1
Series A 0.6
0.4 0.4
Seed
2017 2018 2019 2020 2021 20221

E-Pharma, teleconsultation, e-diagnostics and fitness attracted 1.0 models given a boost driven by adoption during pandemic
80-85% of healthcare spend pool
Rise of specialty care models targeting high incident health issues
such as diabetes/cardio/cancer etc.
Key Segments addressed pillars of the economy's healthcare
Highlights needs and addressed large target segments Aggregation plays catering to elective surgeries & diagnostics got
boost post COVID
Tapped into base layer of supply (pharmacies, gyms etc.) while Higher awareness post Covid-19 leading to rise of health insurance
improving delivery experience for end users distribution models and full stack plays with OPD coverage
1. 2022 till Dec-22
Source: Tracxn

New models emerging in healthtech ecosystem
Sub-Sector Total Funding Unicorns # # Companies at Comments

Series C+ stage
• Quick commerce models for pharma and rise of ONDC to

Pharma Delivery $1.5Bn+ 1 2 further boost adoption
• Rise in shopify models for doctors

Teleconsult $0.5Bn+ 0 3
• ABDM to catalyze digital medical records
Fitness & Wellness $1Bn+ 1 1 • Rise in fitness consciousness; wearables seeing adoption
• Specialty care models in chronic, critical care and elective

Specialty Care $0.2Bn+ 0 1 surgeries seeing uptick
• Offer improved the care delivery experience for patients

Aggregation Play $0.25Bn+ 1 0 and enable demand aggregation for providers
Healthcare Financing $0.1Bn+ 0 0 • Point-of-sale financing and OPD insurance emerging areas
• Rise in SaaS platforms automating workflows and data

Healthcare SaaS $0.5Bn+ 1 0 collection/storage for global providers, pharma, and payers
Source: Tracxn Emerging Segment Mature Segment

Omnichannel
and Omnipresent

30
As the healthtech market matures, we are seeing horizontal expansion and vertical
integration across the digital health ecosystem
Tele Wellness & Disease Healthcare

E-Pharmacy
E-pharmacy E-Diagnostic
E-Diagnostic Consultation Management Financing Aggregation
Aggregation Play
Play
Broadening play across Rx, Dx and teleconsultation; entry into

financing and VAHS
Omnipresent
PharmEasy Tata 1mg
Incumbent Labs Launching Launching Captive

Launching Offline
Ramping Up Digital Offline Clinics Centers
Retail Stores
Omnichannel Presence
Netmeds Dr.Lal Metropolis Proactive for Her Clinikk

Pathlabs
Building Building Building Enhancing

Vertical Private Label Reference Labs Private Label Underwriting
Integration
PharmEasy Tata 1mg PharmEasy Tata 1mg HealthKart PolicyBazaar
Digital Players Partnering with Insurance Provider-focused Expanding to Group Health Hospital Tie-ups
Plays Corporates Distribution +
B2B Focus & Bancassurance Pristyn Care
Partnerships
MediBuddy Tata 1mg Eka Care Visit Health Kenko Plum Hexa Health Ayu Health
Source: Management Information; Expert Interviews; BCG Analysis

Underpinning these moves are the unit economics of acquiring and servicing a customer
Tele Surgery
Metric Unit E-Pharmacy E-Diagnostic1 Consultation2 Specialty Care Aggregation
AOV INR 1-1.4K 1.8-2K 0.3-0.5K 1-20K3 70-80K
We decided to start
online-to-offline model
where online would
GM % 25-30% 60-80% 10-30% 50-80% 20-30%
focus on attracting
new customers and
offline would service
orders and build
CAC INR 1-1.4K ~2.5K 0.7-1.2K 1-7K 10-15K customer loyalty.
— Co-Founder,
A Large Marketplace
Company
Omnipresent Omnichannel Vertical integration B2B Focus &

Improve LTV Improve customer Improve gross Partnership
from existing acquisition at a margins through Expand customer pool
user base lower CAC private label at a lower CAC profile
1. Blended economics for marketplace and captive model 2. Captive Models generally have Fixed Rate Consultation Fees Whereas Marketplace Models Generally Pass Consultation Fees to Patient and Charge a Commission
3. Higher AOV where wearables plays involved
Source: Management Information; Expert Interviews; B Capital Group Analysis; BCG Analysis

Omnipresent
Increased horizontal expansion of E-Pharma into adjacencies such as diagnostics and

vertical integration into B2B distribution and private label
Advertisements
Marketplace2
consultation1
Distribution
E-Pharmacy
Diagnostics
Offline B2B
Pharmacies
Label Play
Solutions
Private
Offline
SAAS
B2B
Tele
In the USA, small
3P
verticals have very high
MedPlus 4-5 value pools so niche
businesses can be
sustainable whereas in
Apollo Pharmacy 2-3
India, cost structures
are too high to justify
Flipkart Health+ 4-5 the ROI in individual
value pools.
NetMeds 16-19
Owning multiple product
and service ecosystems
Tata 1mg 30-32
is critical to improve
margin structures.
PharmEasy 40-42
— Co-Founder,
Leading E-Pharmacy Player
% Market Digital Plays Supply Side Plays
Share
Current Presence - Darker Green Signaling Larger Scale Pilot Stage
1. Does not include consultations for prescription validation 2. Includes Retailio 1P and 3P GMV
Source: Target Data; Investor Presentations; Medplus DRHP; Expert Discussions; BCG Analysis

Omnichannel
Omnichannel approach
Approach
E-Pharmacies are adopting multi-channel approach to expand addressable market

by servicing acute Rx customers
Store-in-store Model with Potential to Support Online Channel Progress of E-Pharmacy players
250+ PharmEasy network of franchise pharmacies

Help improve TAT
(3-4 hrs vs. 1-2 days via Cater to greater number
warehouses/darkstores) of acute customers
1K+ Netmeds shop-in-shops within 1000+ RSPs
Fulfill larger number of Increase visibility via

online orders through branding to address
availability of SKUs larger customer base SastaSundar network of partner retailers
450+
(i.e. Health Buddies)
Online is still <5% of market so it is imperative to move offline to capture acute Rx demand, better service patients looking for immediate
fulfillment and build strong customer loyalty.
— Co-Founder, Leading E-Pharmacy Player
1. RSP = Reliance Smart Point

Source: Expert Interviews; Press Search

Vertical Integration
E-Pharmacies vertically integrating to drive higher contribution through direct

procurement and private label
• Local stockist purchase • Direct procurement • Contract manufacturing

Better margin contracts from manufacturing Private label generics
Strategy •
• Entry into distribution
•
with distributors substitution
in select geographies
Gross
25-30% 30-35% 40-50%
Margin
Scale
$50Mn $50–200Mn $200Mn+
Required
Most E-Pharma players surpassing PharmEasy seeing highest industry Private label contribution still nascent
Example scale required to negotiate Gross Margin (~31%) through building (~1-2% for pure online players, 5-8% for
better margins large B2B network for direct purchase offline retailers going online)

Vertical Integration
E-diagnostic players transitioning from marketplace model to captive labs to drive

favorable economics
Significant expansion in diagnostic presence through … driven by 15-20% higher CM realization with supply
own labs… chain ownership and higher quality control
No. of owned labs (FY 22) Metric Unit Marketplace Labs Own Labs
30-40 AOV INR 1.8-2K 1.8-2K
COGS % - 30%
Pass Through to 3P % 40-50% -
Discounts % 30-35% 40-45%

15-20
Net Margin % 10-20% 25-30%
10-15
There is a huge variation in quality across marketplace labs.

Building a company-owned lab infrastructure is imperative to
control quality and improve patient experience.
Tata 1mg Healthians PharmEasy
— Co-Founder, Leading Diagnostic Player
Source: Management Information; Expert Interviews; BCG Analysis

B2B Focus
Newer teleconsultation players like Eka Care are adopting a B2B-focused GTM approach
~70% Eka Care doctors using platform for teleconsultation,

billing, smart patient overview, offline support
~30% Eka Care Integration with Need to go

doctors using medical devices beyond only
platform for Rx and and AI-driven self teleconsultation-
Practice Management Tool
Dx digitization and assessment to have to digitize
integration services enable real-time practice, give good
EMR & Patient Vital monitoring patient experience
Integrations Tracking and build deeper
workflows
Enable smart and
Eka Care anchored around Grow practice with
marketing suite
simplified overview of 10K+ Doctors across Google
— Co-Founder,
longitudinal patient Leading
functioning as major channel business page,
history and progress Teleconsultation
for patient acquisition website review links
Patient Health Marketing Platform
Records Suite
30L+ App Downloads 7L+ Monthly Active Users 50L+ Vitals Stored 10L+ Rx Generated

Successful global teleconsultation platforms have moved across the care spectrum to offer
comprehensive solutions
Delivery Model Platform Play with Online and Offline Assets Platform Play with Pure Online Assets
Teladoc
Examples Health
KRY Ping An Good Doctor WeDoctor Doctolib Amazon Care AliHealth
Region
Preventing Care
• Information provider
• Personal health management
• Community/social care
Finding Care
• Symptom checking
• Registration service
• Appointment booking
Receiving Care
•
•
Telemedicine service
Diagnostic services
Platforms started from
telehealth offering
Continuing Care but evolved to offer
• At-home care delivery
• E-Pharmacy comprehensive solutions
• Disease mgmt. & monitor. across the patient journey
Paying for Care
• Insurance coverage
• Insurance products sales
Enabling the Journey
• IT software as a service
• Data analysis (decision support, PHM)
• El. Health Records (EHR)
• Health Information System (HIS)
Service Covered Service Not Covered

Specialty and
Preventive Care

39
Specialty care models have emerged which enable continuous monitoring of
patients’ wellness
Care Delivery Value Chain Typical Offerings Rationale
Focused on patients who need diabetes, cancer, Critical/chronic health issues require
Patients specialized care plans
cardio, dental or PCOS/sexual wellness care
Acquisition Online | Omnichannel Primary acquisition online via performance Offline channel improving patient
Channel marketing; players gradually expanding offline reach at lower CAC
Range of pricing plans with varying
Range of Care 3 Months | 6 Months | Annual Affordable monthly or annual subscription plans value prop. - allows users to choose
Packages with emphasis on delivering end outcomes plans as per needs and reduce
friction to adoption
Network of doctors specialized in particular TAs Teleconsultation added to build

Consultation Teleconsult | Offline Clinic trust and ensure outcome-based
along with offline clinics for in-person consults
monitoring
Prescription, OTC or
Medicines
Private Label Drugs
E-commerce typically offering: Players focusing on fulfillment
Tracking Connected Tracking Device • Private Label OTC Drugs services to improve AOV and
& Monitoring and Applications • Diagnostic Packages margin profile (up to ~90% revenue
• Tracking Devices (e.g., Glucose Monitors) contribution for some players)
Community Peer Learning, Q&A
Support
Patient education is very low in specialized segments and there is a high CAC involved in
conveying value proposition. Need to think beyond SEO and build differentiation
- Senior Leader, Large Marketplace Company

HealthifyMe has scaled into a holistic nutrition and fitness platform addressing multiple
consumer pain points
Timeline User Pain Points Solution Learning Impact
• No solution for daily • Calorie-tracking tailored • Simple yet frequent use- 3.0Mn
2012-2015 calorie and nutrition for Indian food case drove engagement 2016
tracking & retention 1.8Mn
• Limited at-home • Data-driven • Leveraging AI and data

nutrition support personalized nutrition to monetize engaged 9.0Mn
2016-2019 2018
• Most nutrition plans are plan at affordable rates user base 3.2Mn
generic reducing efficacy
• Growing propensity • HealthifyStudio • Expanding breadth of

to workout at home (home-based online offering to increase AOV 32.0Mn
2020-2023 owing to convenience fitness sessions) and engagement 2022
(M/T1) and lack of 6.0Mn
access (T2+)
We are doing full stack of health and wellness offerings. We started out as calorie tracker and are now Total Installed Base
expanding up the value chain to provide AI-based assistance and real coaches
Monthly Active Users
- Founder, A digital health & wellness Co

BeatO moving up the value stream through combining health insurance with existing
diabetes offerings
Overall Wellness of Customers with
Collaboration Objectives The Diabetes Total Plan
Rich Data for Sharper Offerings
Diabetic patients in India typically find it hard to BeatO partnered with Care Insurance, to
buy health insurance with adequate protection offer insurance along with a comprehensive
increase in average weekly
wellness offering 3x monitoring frequency
Health insurers face challenges in underwriting Value to customers

and pricing for diabetic patients due to
increase in engagement with
data limitations • INR 5 lakh cover 7x Doctors and coaches
• INR 20k savings per annum – due to
expense management
• Additional offerings such as BeatO connected
glucometers, strips, health coach, unlimited
BeatO targeted to address this problem through a
doctor consults through marketplace reduction in overall blood glucose
curated data backed insurance product and help 15%
their 200k+ active diabetes community levels within 3 months
Historical health and prescription

data for better claim and underwriting

Asset-Light —
But Not Light Touch

Indian hospitals are challenged with lower occupancy levels compared to global peers,
leaving room for demand fulfillment via asset-light models
India has consistently struggled with maintaining Smaller hospitals are facing even significantly lower
hospital occupancy levels compared to peers occupancy compared to larger chains
Percentage Utilization of Hospital Infrastructure in

Top 60 Indian Cities (%)
-16%
89% 90%
-54%
76%
64% 60-70%
25-30%
India OECD China UK
Smaller Chains Larger Chains
Source: OECD; Financial Express

In-patient care players like Pristyn and Hexa are delivering significant value for multiple
stakeholders in the healthcare ecosystem
Surgery Aggregation Model Unit Economic Drivers Value Add to Stakeholders
Patients • Solves for information asymmetry by providing

expert guided info
INR 70–80K • Connects patient with the right doctor based on
budget, location, etc.
Pristyn Care | Hexa Health | MedFin
• Manages end-to-end documentation including appointment
Aggregator Acquiring customer and ensuring booking, insurance coverage, post surgery care etc
end-to-end care management
• Demand generation along with concierge services managing

all documentation, appointment booking and
Network of 10-15%
Surgeons payment collection
• Provide access to Tier 1 hospitals in their network to perform
surgery which otherwise would have been hard to negotiate
Large/Small • Helps improve capacity utilization of hospitals unlocking

Hospitals 60-70%
additional revenue
Pristyn Care | Hexa Health | MedFin As India experiences larger heterogeneity in care and
15-30% inequitable distribution of care expertise in centers, we
Aggregator Insurance claim support and
post-surgery follow-up care wanted to build integrated tech platforms for India context
— Co-founder, Surgery Care Aggregator
AOV Pay-Outs Net Take Rate

Tele-diagnostics players like 5C are expanding services across diagnostics value chain
Business Model
Moving from individual tie ups with diagnostic centres and small labs to becoming a demand aggregator across
multiple platforms to capture greater market share
Started by providing pay-per-use remote tele-radiology Expanding services to digital demand aggregation
services for offline centers and fulfillment model
INR 3-4K INR 3-4K
Patients Patients
Small Hospital/Lab Digital Health Players

Demand 15-20%
Generation MEDFIN | Tata 1mg | Even
75-80%
Diagnostic Center
End-to-End Fulfillment Service 50-60%

Remote Tele-radiologist Service 5C
5C
5-10%
Network of Radiologists Partner Lab 5-10%
Service Offering Network
Service Offering 5-10%
Network of
Radiologists
15-20%
Source: Expert Interview; Lit Research; BCG Analysis AOV Pay-Outs Net Take Rate

Smart-ICU players are enabling expanded access and improved quality of care for
providers in Tier-2 regions
Smart-ICU players are targeting smaller hospitals with limited in-house

critical care capabilities to realize significant on-ground traction
58K+ India experiences a large

Patients
Patients Served Business Model heterogeneity in care and
unequitable distribution
Enable remote critical of care expertise
care delivery by across centers.
70+
Small/Medium Hospitals connecting trained
Hospitals Served Smart-ICU solutions bridge
(70% Non-Metro) healthcare personnel this gap by using advanced
to ICUs remotely. technology to improve
critical care access and
CloudPhysician 200K+ Aggregate demand streamline standard of care
Smart-ICU Player in real-time.
Clinical Workflow
Patient Days Saved around small and
Management Platform medium sized
hospitals in tier II and
— Co-Founder,
1:80 III cities through Leading Smart-ICU Player
Network of Physicians their platform
Specialist Doctor:
Patient Ratio
Source: Expert Interviews; Lit Research; BCG Analysis

From OOPS to SAHI

A quiet revolution in healthcare financing is taking place
Insurance coverage to improve from 37% today to …with increasing shift in mix towards insured coverage
69% by 2030… vs. OOP spends
% of lives covered by insurance in India OOP as a % of current health expenditure
35
46
55
69
55
65
37 54
45
2022 2025 2030 2022 2025 2030

• Improved access through Ayushman Bharat scheme
Driven • Increased penetration through digital distribution
by • Higher awareness for healthcare insurance OOP Insured
Source: IRDAI, Niti Aayog, BCG Analysis

Outpatient segment to grow faster than overall insurance
Outpatient Coverage Expected to Clock ~2x YoY Growth… …Driven by 4 Major Trends
India GDPI ($Bn) Increased coverage of OPD benefits

as digital companies make it easier for insurers to
track data and determine legitimacy of claims
CAGR
33.7 (2022-30)
+18%
28.6
Employer-driven OPD/VAHS programs
24.2 with corporates increasingly following suit of global
firms to provide employee health benefits
20.5
17.4 +15%
26.7
14.7 Traditional insurers providing OPD riders
12.5 24.9
22.3 (add-on) and digital attackers enabling
10.6 19.5
9.0 16.8 easy access & distribution
14.5
12.3
8.9 10.5
7.0 +90%
1.9 3.7
0.0 0.1 0.1 0.3 0.5 1.1 Greater consumer spend
on online OPD services with ease of access
2022 2023 2024 2025 2026 2027 2028 2029 2030 and focus on preventive care
Sub Sectors IPD OPD

Creation of digitally-administered OPD benefits picking up by both startups and
traditional insurers
OPD-Benefits-Focused Players Traditional Insurers
Key
Players Kenko Clinikk Visit Health Star Health Insurance ICICI Lombard HDFC ERGO People have realized that
conventional insurance
remains under-utilized in
• Started with OPD benefits as differentiator • Traditionally focused on surgery and accidental the long run as it doesn't
Core • Introducing new features such as “no cap coverage include OPD. Almost 70%
Offering on room rent” and “additional sum insured” • Adding standalone OPD benefits or bundled with of lifetime healthcare
across all policies IPD for the corporate segment expenses incurred are
on OPD costs and it
• Enhancing hospital coverage esp. in Tier 2+ • Large hospital coverage across India is necessary to bridge
Network • Suite of digital healthtech services • Limited digital healthtech services covered; this gap by providing
& Benefits e.g., free teleconsult, expanding offline services leveraging partnership with digital players complete financing as
well as assistance.
• Affordable monthly/annual subscription plan • Annual plans with add-ons for any additional service — Co-Founder,
Pricing • Customized pricing with AI/ML model-based OPD Benefits Player
underwriting using health data points
• Digital & user-friendly onboarding & claim • Transitioning from paper-based to digital system
User
Experience management process for onboarding & claims management
• Easy to read policy and simple terms
and conditions

The Empire
Strikes Back

As startups scale on customers and omnichannel, incumbents are ramping up digital
capabilities to capture growth and counter threat from digital natives
Payers Providers Pharma Diagnostic

Labs
Building OPD services and D2C Ramping up offline-to-online Building digital patient support Setting up digital platforms to
channels and VAHS products to presence and fulfillment services programs and platforms to enable online bookings and
compete with digital attackers to improve value capture improve patient adherence improve customer experience
Star Health Lupin

Insurance
Metropolis
HDFC Ergo Apollo Abbott
Dr. Lal Path Labs
ICICI Lombard Cipla
Institutional play is becoming large with insurance taking center stage on digital capabilities and specialty pharma ramping up their D2C
programs to meet patient demands.
— Co-Founder, Leading Digital Health Player

1
Traditional insurers are investing heavily in digital and building OPD services to improve
consumer value proposition
Star Health Insurance ICICI Lombard HDFC ERGO
• Digital enhancement of selfservice • AI for instant claim approval, • AI-based chatbots and self-service
Digital channels, telemedicine centers chatbots etc. and specialized channels and digital customer
etc. and conversational AI and digital arm to build new digital engagement and rewards program
Initiatives
image recognition products for startups (i.e. Vault)
~350Cr ~11% ~770Cr ~4% ~430Cr ~14%

Impact
Digital revenues % of digital Digital revenues % of digital Digital revenues % of digital
(H1 FY 23) contribution to (FY 22) contribution to (FY 22) contribution to
overall GDPI overall GDPI retail GWP
• Standalone Outpatient Care • Rider OPD policy (i.e. BeFit) covering • Rider OPD policy on traditional
OPD Insurance Policy launched physio, teleconsultations through health insurance products
Offerings covering Rx, Dx, physio, non- ICICI Lombard TakeCare app etc. especially for senior citizens
allopathic treatment etc. prone to frequent health issues

2
Larger providers are significantly investing in tech and leveraging existing infrastructure to
improve reach and value creation
Apollo’s Distinctive Digital Ecosystem Enabled by its Formidable
Impact Realized
Physical Network and Capabilities
4 Virtual Doctor 5K+

3 5 Consultation Daily Consultations
Condition
Management
Online
Diagnostic
Health
Predictor
Online Medicine 35K+
2 Booking 6
Delivery Daily Medicine Orders
Virtual Doctor Well-being
Companion
Consultation
Online Diagnostic 1.5K+
PHR
Booking Daily Sample Collections
Digital 1 Online
l inte
lligence p
lat Health 7
ica ted dev f
Services Medicine
nn
e c ic Insurance
or
Patient
n
Delivery
23Mn+
Cli
m
Co
es
Registrations Cumulative Registrations
5Mn+ lives
4K+ Apollo Consumer covered through
Pharmacy Apollo Munich
Stores 0.7Mn+
Active Users Daily Active Users
300+
10K+ Apollo Corporate
Doctors Tie-ups Well-being 6.3K+
30Mn+
0.5K+ 3Mn+ IPD/OPD Companion Providers Onboarded
Apollo Annual visits till
Physical Diagnostic chronic date
Centers
Network & patients
Future Launch…
Capabilities Health Insurance, Condition Management,
Well-being Companion

3
Leading domestic pharma players are instituting digital patient support programs to drive
engagement and adherence
Lupin Abbott Cipla
Lupin Digital Health Ltd. A:care platform Breathefree

Description • Wholly-owned subsidiary of Lupin Ltd. • Digital health service launched as • Mobile app to manage lung health
to provide holistic digital cardiac care part of its global A:care program and improve patient education
• Provides a digital therapeutics • Gamified health-related incentives, • Improves patient adherence through
platform linking cardiologists, coaches, tailored guidance for patients a network of certified educators and
Competitive and care managers to patients and and scientific information, virtual medication reminder features and
Advantage personalized risk management learning tools, patient progress enhances patient experience through
services for heart health review for doctors real-time query resolution via a live
chat portal
Area of
• Cardiology • Thyroid, Diabetes, Osteoarthritis • Respiratory
Focus

4
Large diagnostic players are moving towards omnichannel opportunity by setting up

digital platforms to improve customer experience
Metropolis Apollo DLPL
Online test booking for sample home collection Online test booking for free sample home WhatsApp and app based test booking and
through mobile app including test suggestions collection through mobile app including live customer chat support along with free home
based on inputs and online report downloads and chatbot support and easy access to all trend collection of sample and Apollo Life collaboration
ongoing health monitoring analyses and download of reports with Jiyo on digital wellness platform (health
tracking, well-being tips) for corporates
~INR 100 Cr (15%) revenue contribution

in FY22 targeting 33% digital
1.5K+ daily sample collections ~10-12% revenue contribution
through bookings on digital platform from digital bookings in FY21
contribution in the next 3 years
Source: Respective company websites, HBS, IIFL Securities report April 2021, Economic Times, Expert interviews

Ecosystem
Partnerships —
A Marriage of
Convenience

As the healthtech ecosystem matures, startups and incumbents bring different strengths to
create value for patient
Startups Incumbents
Strength in responding to • Deeper pools of capital

patient needs/addressing
pain points • High trust, loyalty, and
regional penetration across
Customized solutions Indian consumers
resulting in rapid customer Enhanced Patient
acquisition Value Proposition • Strategic fit of digital in
strengthening widely-
Easy user interface to drive penetrated core business
adoption and retention
• Limited focus on building
Unfavorable unit economics new capabilities for every
patient needed

Traditional insurance is driving creation of health ecosystems by partnering with
healthtech players across the value chain
Use Cases
Developing Symptoms |
Staying Healthy Obtaining Treatment Recovering | Post Care
Getting Sick
• Personalized health • AI-based timely diagnosis • Make educated decisions: • Continuous monitoring
coaching engine Access to range of hospitals,
• Doctor recommendations • On-demand medication and
doctors
• Incentives to keep healthy – home nursing service Partner ecosystem
• Medicine delivery
premium discounts, products • Cashless payments is critical for
• Access to quick & convenient driving growth
• Cloud for report storage • Instant claim process/Straight
advice e.g. tele/video calling while maintain cost
through processing
structures. We have
Insurer becomes control centre: Gatekeeps members access to solutions, introduced new
collects data along the way, can use data for predictive analysis verticals through
partnerships to
Examples of Partnerships tap into growth
opportunities.
Star Health Insurance Star Health Insurance Aditya Birla Health Care Health Insurance
— Senior Leader, A
GOQii Tata 1mg MobiKwik BeatO Large Marketplace
Company
Aditya Birla Health Niva Bupa Health Insurance Care Health Insurance
Fitbit Practo BeatO
Niva Bupa Health Insurance Niva Bupa Health Insurance
Visit Health MobiKwik

Source: Press Search; BCG Analysis

Innovative Partnerships by large Indian Pharma players
Abbott | GOQii |
Dr. Reddy's | ICICI Lombard Cipla | GoApptiv
HealthifyMe | Fitterfly
• DRL’s subsidiary Svaas is launching • Abbott has partnered with multiple • Cipla acquired 22% stake in GoApptiv,
Description cashless digital outpatient ecosystem DTx platforms for their continuous a platform to engage channel
in partnership with ICICI Lombard glucose monitoring (CGM) device partners digitally
Freestyle Libre
Area of • Multi-service cashless outpatient • Chronic therapy (diabetes) • End-to-end brand marketing
Focus services across specializations and channel engagement
delivered via application across 2-6 tier towns
• Bringing together 4 key touchpoints in • Improve patient outcomes by • Enabling wider patient reach with
Benefits the outpatient journey-consultations, developing a connected healthcare affordable and quality drugs
diagnostic services, pharmacies & ecosystem for holistic diabetes
insurance management

Global pharmas are partnering with disease management platforms to improve access and
patient adherence
Pharma Co Digital Platform Disease Area Description
• Platform is using evidence-based cognitive therapy principles and Click’s patient-

Otsuka Click Therapeutics Major Depressive Disorder engagement platform to treat patients
• Platform is allowing patients to monitor symptoms (based on ePRO) and offering cognitive
Roche/Genentech Flood Light Open CNS (Multiple Sclerosis) activities to improve patient QoL
• Ongoing registry study aims to enroll 10K MS patients
• Smartphone-based clinic is connecting patients to endocrinologists in informing lifestyle

Sanofi Onduo Diabetes and medication changes
• Patient data collection to track potential long-term complications of diabetes
• Digital wallet containing patient implant record and procedure summaries.

Breast & Other Enables real-time access of personal data and increases patient empowerment
Allergan The Aesthetic Society • Two-way doctor-patient communication tool provides safety alerts and pre & post-operative
Implants
instructions to enable greater quality of care
• Weight management and education platform to improve lives of people living with obesity
Novo Nordisk Noom Obesity • "Novo Nordisk patients using Saxenda gained significant value from the combined offering
of SaxendaCare & Noom" – Camilla Sylvest, Novo EVP of Commercial Strategy
Source: Otsuka US Press Release; Gene.com; Onduo.com; The Aesthetic Society (Surgery.org); Biospace.com

A Multipolar World —
No Winner-Take-All

63
Indian healthcare market is highly fragmented compared to peer markets overseas
Market Share of Top 3 Pharmacies Market Share of Top 3 Distributors Market Share of Top 3 Laboratories
52% 90% 50% 49%
38%
10%
5%
2% 3%
India USA China India USA China India USA China
Source: EIU; WHO; World Bank; National Statistics Agencies; BCG Analysis

Consolidation has started but is being led by deep pocketed conglomerates
which will lead to a multi-player world
Top 4 E-pharmacy players holding 85% Strong conglomerate capitalization

market share pre-pandemic driving consolidation towards 97%
market share
E-pharmacy will be a
30% Medlife multi-player game (5-6 at
PharmEasy 42% the least) due to need for
localized networks and
(Merged in 2015)
PharmEasy omnichannel. It will be
25% hard for a single player
to be omnipresent given
fragmented nature of
Tata 1mg TATA Digital 31% pharmacy and diagnostic
(Acquired By)
18% laboratory market.
12% — Co-Founder,
NetMeds Reliance 20%
(Acquired By) Leading E-pharmacy Player
15% 4%
Others Flipkart 3%
(SastaSundar Acquired By)
2019 2022
Sources: Analysis Mason Report; Lit Research; BCG Analysis

E-commerce learnings suggest as horizontal plays are being built, vertical players
can still thrive
Despite the presence of horizontal e-commerce players, Healthtech is a well-suited market for deep play
category specialists have emerged as winners by vertical players
Grocery Retail
Supply-Side Drivers
D-Mart Reliance Fresh
• Storage and delivery of pharma products requires
deep operational expertise – especially in
m/s ↣ ~30% ~10%
temperature-controlled supply chains
• Reverse logistics operations in pharma are
complex as products are to be returned
Music Streaming to the manufacturer
Gaana JioSaavn
m/s ↣ ~30% ~22% Demand-Side Drivers

• Customers value affordability, quality assurance,
ease of discovery, and high availability of specialty
Fashion E-commerce products – vertical e-commerce players are better
positioned on these parameters
Myntra Ajio • The customer journey for e-pharma is unique,
check-out procedure involves prescription
m/s ↣ 35% <5% validation and is a complex process
Sources: Jefferies; Expert Interviews; BCG Analysis

Globally, we've seen vertical players dominate digital health despite the success of
horizontal players in other e-commerce categories
India India
Goods China USA Brazil UK Germany (current) (expected)
Consumer
Electronics
Consumer
Durables
Books
Personal and
Home Care
Grocery
Apparel and
Footwear
Digital Health
Products
Ping An Good Doctor CVS Health Dr.Consulta KRY Doctolib PharmEasy
Sources: BCG Analysis Dominant Horizontal Play Dominant Vertical Play Mixed Play

03
Solving the Rubik's Cube

Winning in the digital healthcare opportunity

Solving the Rubik's Cube: Winning in the digital health opportunity
Type of Service
Pharmacy
Consultation Selection of
Diagnostic Scope of Services
Procedures
Wellness & Specialty Care
Financing
Value Proposition Service Providers

Value Size Digital Natives
Providers Selection of
Growth Rate Partners & Go-to-
Unit Economics Payers Market Approach
Differentiation Retailers
Pharmacos
Conglomerates
Service Delivery
Online Selection of Service
Delivery Mode
Omnichannel
Vertically Integrated

Key Imperatives for Startups
01 02 03 04 05
Clearly identify Sharply define your Identify tipping points Reimagine go-to-market 'Move Fast and
value pools to 'right to win' beyond and step changers in unit by exploring partnerships Break Things' approach
target as healthcare customer acquisition and economics in a clear-eyed and ecosystems to may not necessarily
spend pools increasingly experience. Define scope manner to drive business augment service delivery be applicable as
diversify beyond of services (horizontal model construct and go- capabilities keeping healthcare is a
consumer out-of-pocket vs. focused) and mode to-market approach patient centricity, multi-stakeholder
to insurance and spend of delivery (online vs. core capabilities, and system; Factor in business
mix changes from omnichannel) based service build and model how different
inpatient to outpatient on customer needs and delivery costs into stakeholders influence
organizational capabilities consideration the patient journey and
sources of funds

Key Imperatives for Incumbents
01 02 03 04 05
Integrate digital into Recognize that winning in Clearly define role Identify and monitor Reimagine go-to-
DNA as consumer trends digital requires different of digital in overall key flex points in unit market by developing
and digital adoption strategic, organizational, strategy as economics as per the partnerships and
are changing irreversibly and operational 1. Standalone digital defined role of digital in ecosystems with
and digital adoption so far capabilities and services are targeting overall strategy to drive digital natives to
has been led by natives; approach from winning in new customers sustainable adoption and augment service delivery
as natives develop physical; develop 2. Increase cross-sell growth of digital capabilities in core and
omnichannel capabilities, digital capabilities and in existing customer emerging businesses
incumbents need to approach with a ground base to boost core
develop and execute on up 'start-up' mindset business
a comprehensive digital 3. Enable a process step
strategy change in service
delivery in existing
service lines

71
Authors
BCG
Priyanka Aggarwal Kshitij Vijayvargiya Shaleen Sinha Nikhil Chari Neil Pinto Ketan Kapuria
Managing Director & Senior Partner Managing Director & Partner Managing Director Partner Consultant Senior Knowledge Analyst
Boston Consulting Group Boston Consulting Group Boston Consulting Group Boston Consulting Group Boston Consulting Group Boston Consulting Group
B Capital Group
Karan Mohla Deepanshu Pattanayak Chandan Deep Mehul Garg

General Partner Senior Associate VP, Strategy & Operations Associate, Strategy & Operations
B Capital Group B Capital Group B Capital Group B Capital Group

Contact Information & Acknowledgements
For Further Contact Acknowledgements
If you would like to discuss the themes and content of this report, please contact: This report is a joint initiative between the
Boston Consulting Group (BCG) and the
B Capital Group.
Priyanka Aggarwal Nikhil Chari Karan Mohla
Managing Director and Partner, General Partner, We thank all the participants for their valuable
Senior Partner, BCG Mumbai B Capital Group contributions through the 1-on-1 discussions
BCG Singapore Chari.Nikhil@bcg.com karan@bcapgroup.com we have had towards the enrichment of
Aggarwal.Priyanka@bcg.com the report.
Neil Pinto Deepanshu Pattanayak
Kshitij Vijayvargiya Consultant, Senior Associate, Marketing Process: India Marketing team
Managing Director BCG Mumbai B Capital Group
and Partner, Pinto.Neil@bcg.com dpattanayak@bcapgroup.com Design & Production: Jamshed Daruwalla,
BCG New Delhi Rahul Surve, Saroj Singh, Pradeep Hire, Sujatha
Vijayvargiya.Kshitij@bcg.com Ketan Kapuria Chandan Deep Moraes, Abbasali Asamdi, Saurabh Tikekar,
Senior Knowledge Analyst, VP, Strategy and Operations, Dillibabu Muthu, and Saanchi Chatwal.
Shaleen Sinha BCG New Delhi B Capital Group
Managing Director Kapuria.Ketan@bcg.com cdeep@bcapgroup.com
BCG Bengaluru
Sinha.Shaleen@bcg.com Mehul Garg
Associate, Strategy and
Operations,
B Capital Group
mgarg@bcapgroup.com

Disclaimer
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A Digital Pill for

A Digital Pill for Revolutionizing Healthcare 1

A Digital Pill for Revolutionizing Healthcare 4

Priyanka Aggarwal Karan Mohla

A Digital Pill for Revolutionizing Healthcare 5

Introduction Riding the Waves Solving the Rubik's Cube

Page 7 Page 14 Page 68

A Digital Pill for Revolutionizing Healthcare 6

A Digital Pill for Revolutionizing Healthcare 7

~37% Insured Households ~69% Insured Households

Reimbursement-guided, early disease

A Digital Pill for Revolutionizing Healthcare 8

A Digital Pill for Revolutionizing Healthcare 9

YoY Medical Cost Inflation, 2021 (%)

Routine surgeries have seen

Singapore Thailand Global Vietnam China India

Source: MOFSL; Mercer Marsh Benefits; Business Today

A Digital Pill for Revolutionizing Healthcare 10

NCDs1 58% Respiratory 11%

CDs2 31% Not Treated 32

A Digital Pill for Revolutionizing Healthcare 11

Note: Data as per estimation in 2021

A Digital Pill for Revolutionizing Healthcare 12

USA ~7K ~30K ~25K 4.1%

India 70K ~800K ~100K 0.4%

Lack of specialist doctors Poor inventory Lack of digitization for

Absence of centralized Low availability of critical Rx Dependence on Cumbersome claims

1. Retail Insurance Penetration

A Digital Pill for Revolutionizing Healthcare 13

Riding the Waves

A Digital Pill for Revolutionizing Healthcare 14

A Digital Pill for Revolutionizing Healthcare 15

Asset-light – But From OOPS The Empire Ecosystem A Multipolar

A Digital Pill for Revolutionizing Healthcare 16

A Digital Pill for Revolutionizing Healthcare 17

How likely are you to prefer taking doctor consultation

Number of Smartphone 300 Metro Tier 01

A Digital Pill for Revolutionizing Healthcare 18

Source: App Annie; BCG Analysis

A Digital Pill for Revolutionizing Healthcare 19

Aarogya Setu 218Mn+ 40 Days eSanjeevani OPD 100Mn+ 200K+

Total Reached First Patients Providers

Health IDs Health Facilities Health

Registered Total Vaccines Beneficiaries Insurance cover per

Notes: Data as on 29 April 2023

A Digital Pill for Revolutionizing Healthcare 20

Patients reached through eSanjeevani Consultations Impact

E-Sanjeevani Health & Wellness

Sources: eSanjeevani; MoHFW; Secondary Research

A Digital Pill for Revolutionizing Healthcare 21

Phase 2 and Beyond

Sources: Secondary Research

A Digital Pill for Revolutionizing Healthcare 22

A Digital Pill for Revolutionizing Healthcare 23

$450Bn+ Indian Healthcare Market Size (2030) Driven by 5 Major Trends

Total Health $167Bn $458Bn 13%

A Digital Pill for Revolutionizing Healthcare 24

A Digital Pill for Revolutionizing Healthcare 25

Diagnosis Pharma Delivery Consultation Treatment Monitoring Financing

EMR-led Eka Care HealthPlix Curelink

Offline to Diagnostics Surgery Care

Fitness & Wellness