Prof. Paul Lillrank (moderator) presented his keynote by giving insights of his ideas and implementations in the organization for which he is the chairman (Aalto Health Platform). Explained how the world famous, ARAVIND EYE CARE model was chosen and implemented by his student in Finland who studied ARVIND EYE CARE in Tamil Nadu. Stressed on technology circulation instead of technology transfer, as the later is only one directional flow. He felt India is the most innovative place in the world with the land full of opportunities.

Molshree Pandey, currently working on communicable diseases and finding ways to collaborate stakeholders in a much more efficient way. Conducts and concentrate on boot camps, road shows in Denmark, presentations to many companies; connecting and opening pathway to better delivery of care in India as well as Denmark. Insisted on modification of products according to the country.

Ankit Bahl compared the way of delivering care and implementing in 2 countries Estonia of 1.2 million populations with India of 1.2 billion populations. Estonian healthcare developments:

-Have S.E.Z for Pharmaceuticals, diagnostic companies in Estonia
-Worlds first biobank which Is commercialized too!
-97% of their patient prescriptions are made online for better access for both patients as well as stakeholder handling it.

Only three things can’t be made online in Estonia 1.marriage 2. Divorce 3. Trade property. Haha!! Introduced E ambulance in Estonia! They call E-Estonia and are also working towards to achieve it!

Iris Ohrn, A kind of matchmaker and identifies companies, investors which would benefit mutually. She observed similar challenges in India as well as Sweden in terms of the cost of healthcare.

K Gopalan, Works for the betterment of healthcare ecosystem of underprivileged. India is a big corridor for the scope of solutions. The focus needs to be on Primary health care, an example is vatsalya which is trying to provide subsidized private care. Promoted SANKALP, which is a form of the network of healthcare stakeholders.

Identification of right partners and right market recognition is required. IPR (very important) during technology transfer is at-most concerned.

As GDPR in EU, likewise, we need in India too. Shared her views on DISHA Act
DISHA:
– Setting up central and state organizations
– Ensuring trust in the system
– Recognition of ‘RIGHT TO RECTIFY’ by the patients is becoming important
Differences in DISHA and GDPR should be studied,
Example: right to forget/Erase isn’t there in DISHA

GST a loan waited game changer is now about to become a reality for Indian economy. Talking about the world’s second largest population and huge health care market, the GST is going to make or mar the industry. With positive move of One Indian One Tax, the rates and procedure is going to ultimately decide the result of GST.

Introduction to Indian Taxation System

The Indian Taxation system is one of its own types in the world with numerous taxes and complex compliance system. And perhaps very few in the country actually understand the complete taxation system. While the entity has to collect and pay huge amount of taxes, what is more difficult is the compliance system of the country. The continuous efforts of various government for years has been to make the system simple and industry friendly has ultimately resulted in implementation of GST.

GST History

It all started with establishment of empowered committee headed by Asim Dasgupta in the year 2000 by the Vajpayee Government. The UPA1 and UPA2 government took it forward and finally after a very long time in 2016 again NDA government is going to implement the same.

General Expectation from GST

While manufacturers are quite optimistic about the new tax law. Commoners are not sure how it is going to impact their lives as yet. The expectation form GST is to simplify and streamline the tax structure in India.

The industry in general feels that this is a milestone for Indian economic development and will provide a huge fillip to manufacturing. This step is also expected to accelerate prime minister’s ‘Make in India’ initiative and lower prices for the consumers. The immediate impact of GST may also increase the cost of finished products in some sectors. However in the long term this would prove beneficial to the industry and consumers, and augur well for our overall economic development.

Indian Healthcare Industry

The emerging economy of India is one of the largest producers of generics. And also experiencing a boom in medical tourism which generates additional returns for the healthcare industry. Globally India’s pharmaceutical industry currently is ranking in the top 5 in terms of volume and top 15 in terms of value. To provide the required healthcare facility to the growing population of the country, the government has raised the FDI cap for Brownfield Pharmaceutical investments to 74% in June. Eventually, 100% FDI is allowed in Greenfield Pharmaceutical investments and beyond 74% under government approval in Brownfield Pharmaceutical investments. This step is expected to develop more qualified personnel and provide state-of-the-art facilities and technologies to patients.

Though the rates of GST are recently notified and item wise list is pending. It is expected to have a positive effect on the pharmaceutical sector in an overall sense. The GST is expected to simplify the tax structure, since eight different taxes are levied at state, central and municipal level in the pharmaceutical industry at the moment. GST, by

consolidating all these into one tax would increase the ease of doing business. As well as mitigate the cascading effects of multiple taxes applied on one product. Apart from this, GST will also result in operational efficiency by streamlining the supply chain which can alone add 2% to India’s pharmaceutical market size.

The pharmaceutical companies need to move to a hub-and-spoke model with primary and secondary hubs across states, besides overhauling the process of the companies used to select their warehousing network with cities like Chandigarh, Lucknow, Guwahati, and Nagpur emerging as primary hubs in addition to the metros.

GST implementation will also envisage a seamless flow of tax credit, account for improvement in overall compliance and is also expected to create a level-playing field for pharmaceutical companies in India. A big advantage for companies will be the reduction in transaction costs with the discontinuance of Central Sales Tax (CST). GST is expected to bring down the manufacturing cost. Even a 2% reduction in production or distribution cost is believed to add over 20% to profits. GST, if its rate is below the current total tax rate, will eventually help consumers by making healthcare and drugs more affordable which already is a big goal for the Indian Government.

Although, the new tax legislation is believed to bring down the manufacturing cost. It cannot be said with certainty as to how the ultimate consumer will be benefited through this as most of the medicines are available at the MRP which is inclusive of the taxes, how is the end consumer going to benefit from that? It will be ultimately the industry’s call whether to share their profit margin with their customers or not.

India’s healthcare industry is worried that the implementation of the goods and services tax (GST) may lead to higher taxes that could erode its profits, even as it hopes that the new regime will help streamline the supply chain.

GST will help companies rationalize their supply chain. However, if the overall tax cost goes up above 12% there won’t be any savings as such.

GST, once implemented, would put various sectors under the purview of service tax. The list of exempted services presently includes healthcare sector. It is expected to continue after the GST regime at least for initial period until basic cost of healthcare sector becomes affordable to the common man of the country. It is believed that levying service tax on healthcare services and facilities will be a retrograde step. An it will certainly push back the agenda to provide best in class healthcare.

Overall, the effects of GST implementation on the healthcare and pharmaceutical sector are still uncertain. However, industry experts believe that GST will set industry players and consumers in a win-win situation. In case the tax rate is set at an efficient level. The healthcare industry will benefit as GST certainly reduces complexities and removes many hurdles to the industry’s growth. The industry is on a path of promising growth and increased productivity.

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