India Healthcare
Healthcare has emerged as one of Indias largest sectors in terms of both revenue and employment, driven by expanding coverage, improved service delivery, and increasing expenditure by both public and private players. The industry continues to grow at a remarkable pace, supported by rising health awareness, government initiatives, and strong private-sector participation.
In 2023, the overall healthcare market was estimated at approximately USD 372 billion , reflecting steady growth from USD 110 billion in 2016 and projected to reach USD 638 billion by FY25 . This growth is underpinned by rising per capita incomes, urbanization, a growing burden of non-communicable diseases, and greater health awareness across the population.
Government programs such as Ayushman Bharat are expanding insurance coverage and strengthening healthcare delivery infrastructure, particularly for vulnerable sections of society. The private sector is simultaneously investing in capacity expansion, advanced technology adoption, and service quality improvement. Infrastructure development remains a priority?€” according to the National Health Profile 2022, India has about 849,206 government hospital beds , while industry estimates suggest an additional 1.18 million private hospital beds , translating to approximately 1.41 beds per 1,000 population , well below the WHO-recommended threshold and indicating significant capacity enhancement potential.
is emerging as a key growth driver ?€” the Indian digital health market reached an estimated USD 14.33 billion in 2024 , while the e-health market is projected to reach USD 10.6 billion by 2025 . The telemedicine segment alone was valued at USD 6.28 billion , underscoring the rapid adoption of remote care solutions.
We are also witnessing notable targeted investments in specialized healthcare services. DNA Wellness announced a 200 crore (USD 23.98 million) investment to establish over 100 cervical cancer screening laboratories across India by FY27. Holding exclusive rights to the CERViSure DNA Ploidy Test , a quick and non-invasive cancer detection method, DNA Wellness inaugurated its first laboratory in Ahmedabad, with additional facilities planned in Vadodara, Rajkot, and Surat by October 2024. This initiative addresses a critical public health challenge, with approximately 130,000 new cervical cancer cases and 80,000 related deaths reported annually in India.
Looking ahead, the sector is poised for strong medium-term growth, supported by deeper penetration of health insurance, expanding digital healthcare solutions, and continued public?€” private collaboration. However, challenges persist, including workforce shortages, uneven access to quality care between urban and rural regions, and the need for robust data governance as digital adoption accelerates. Addressing these gaps will be essential to building a robust, inclusive, and technology-enabled healthcare ecosystem in India.
The health-tech segment is set for significant expansion, with hiring expected to rise by 15-20% in FY24, reflecting increasing demand for innovative healthcare solutions and the integration of advanced technology into medical services. Digital health
Healthcare Sector Growth Trend
(US$ billion)
Healthcare Segments
Indias healthcare sector encompasses hospital infrastructure, medical devices and equipment, health insurance, clinical trials, telemedicine, and medical tourism. With an ageing population and an expanding middle class, these segments are poised to diversify further, driven by a rising preference for preventive healthcare.
Private hospitals account for roughly 70% of Indias healthcare market, maintaining a dominant position due to their extensive network, advanced infrastructure, and higher adoption of modern medical technologies. This dominance is supported by increasing investments from corporate hospital chains and private equity players. The remaining market share is distributed among pharmaceuticals, medical devices, diagnostics, insurance, and other allied healthcare services, each playing a crucial role in supporting the broader healthcare ecosystem and driving innovation, accessibility, and affordability.
Share of Market Segments of the Healthcare Sector in India in FY 2021
Healthcare Market Distribution India 2019-2030*, by Provider Type (in %)
Indias Hospital Industry - Growth and Opportunities
Indias hospital industry is on track for steady, long-term expansion, powered by two primary growth drivers: rising domestic demand for quality healthcare and the nations growing reputation as a global hub for medical tourism. Major metropolitan cities such as Delhi, Mumbai, Chennai, and Kolkata continue to lead the sector, hosting established superspecialty hospitals with advanced treatment capabilities and world-class infrastructure.
However, the industry is undergoing a notable shift. Healthcare providers are increasingly focusing on Tier-2 and Tier-3 cities to bridge gaps in healthcare access. This move caters to emerging urban populations seeking modern medical facilities closer to home, reducing the need to travel to larger cities for treatment.
From an investment perspective, the hospital segment offers high potential for both domestic and international players .
The sector is supported by favorable government policies that encourage foreign participation in both greenfield (new) and brownfield (existing) projects. With a supportive regulatory framework, a steadily expanding patient base, and growing opportunities for infrastructure development outside traditional metropolitan hubs, hospitals remain one of the most attractive sub-segments of Indias broader healthcare ecosystem.
According to the National Health Profile 2022 , India has approximately 849,206 government hospital beds . Industry estimates add around 1.18 million private hospital beds ,
bringing the total to roughly 2.03 million across the country. This equates to about 1.41 beds per 1,000 people , based on the 2023 estimated population of 1.44 billion . Notably, the distribution is heavily skewed toward the private sector in urban areas , while rural regions continue to face significant shortfalls in healthcare infrastructure.
Key Transformations in Indias Healthcare Landscape
?€? Shift from communicable to lifestyle diseases - Indias disease profile is undergoing a significant transition, with lifestyle-related ailments such as high cholesterol, hypertension, obesity, and alcohol-related disorders becoming more prevalent. This shift is driven by urbanization, sedentary work environments, and changing dietary patterns, requiring a stronger focus on preventive healthcare and chronic disease management.
?€? Expansion into Tier-2 and Tier-3 cities - Healthcare providers are increasingly moving beyond metropolitan hubs to establish hospitals, clinics, and diagnostic centers in emerging cities such as Nashik, Mohali, and Dehradun. This expansion addresses underserved populations, improves accessibility to quality healthcare, and taps into rising demand from growing middle-class communities.
?€? Emergence of telemedicine - Virtual healthcare services are becoming mainstream, enabling patients to consult doctors remotely through video calls, mobile apps, and online platforms. Telemedicine not only bridges the urban-rural healthcare gap but also offers cost savings, convenience, and faster access to medical advice, particularly in remote areas.
?€? Rising adoption of artificial intelligence (AI) - AI technologies are increasingly being used in diagnostics, predictive analytics, personalized treatment plans, and hospital operations. From interpreting medical imaging with greater accuracy to forecasting patient needs, AI is transforming the efficiency, accuracy, and reach of healthcare services.
?€? Increasing penetration of health insurance - More
individuals are securing health coverage, driven by growing awareness, government initiatives, and innovative insurance products. This trend enhances affordability of medical services, reduces out-of-pocket expenses, and encourages people to seek timely medical care.
?€? Focus on universal immunization programs (UIP) -
The government continues to strengthen nationwide immunization efforts, aiming to protect all children
and vulnerable groups from preventable diseases. This initiative plays a critical role in improving public health indicators, reducing mortality rates, and ensuring equitable healthcare access across regions
?€? Digital Transformation in Healthcare- Digital
transformation has profoundly reshaped Indias healthcare sector, fundamentally altering how medical services are accessed and delivered. At the heart of this transformation lies the Ayushman Bharat Digital Mission (ABDM) , which under the broader umbrella of the National Digital Health Mission, is creating a unified digital health ecosystem . As of April 2023, this ecosystem includes over 380 million Ayushman Bharat Health Accounts (ABHA IDs) and more than 262 million linked health records , laying the groundwork for seamless, interconnected healthcare access across the country. 1
?€? Telemedicine- Telemedicine has emerged as a critical pillar of this digital shift, notably accelerated during and after the COVID-19 pandemic. Indias national platform, eSanjeevani , launched in April 2020, has become the worlds largest
telemedicine implementation within primary healthcare, serving over 311.9 million consultations to date. 2 Other figures suggest it has totaled upwards of 276 million consultations , with a staggering 300,000 conducted daily. 3 In states like Telangana, telemedicine uptake has been particularly impressive?€”rising from 5.3 million users in 2022-23 to 7.8 million in 2023-24 , and projected to reach 8.7 million by March 2025. 4
?€? Market projections further underscore telemedicines expansive growth trajectory. The sector was valued at USD 3.10 billion in 2024 , with forecasts suggesting it could surge to USD 19.90 billion by 2033 , reflecting an estimated CAGR of 20.5% during 2025-33.
Government Policies shaping Indias health system Enhanced oversight of health insurance claims
The government is shifting the National Health Claims Exchange under the purview of the Finance Ministry and IRDAI. This aims to curb hospital overcharging, stabilize insurance premiums, and reinforce fair pricing practices. 6
Expansion and reform of Ayushman Bharat (PM-JAY)
?€? Coverage has been significantly widened to include all senior citizens aged 70 and above via the Ayushman Vay Vandana card. 7
?€? Decades of data reveal that the scheme has reduced out- of-pocket spending from 62% to 38%, while approximately 8 crore people have benefited. The number of medical colleges has also more than doubled from 307 in 2014 to 730 in 2024. 8
Upgrading primary care and urban health facilities
Seventeen health centers in Delhi are being converted into modern Ayushman Arogya Mandir clinics, bringing preventive, curative, rehabilitative, and palliative services closer to communities. 9
Strengthening workforce and health infrastructure under NHM
?€? The National Health Mission (NHM) has deployed over 5 lakh additional healthcare professionals between FY2021-24 and enabled wide-scale implementation of quality standards and 24x7 primary services. 10
1 https://www.imarcgroup.com/india-telemedicine-market
2 https://www.fortuneindia.com/macro/economic-survev-avushman-bharat-telemedicine-diaital-health-transformina-healthcare-in-india/120277
3 https://pmc.ncbi.nlm.nih.gov/articles/PMC11422547/
4 https://timesofindia.indiatimes.com/citv/hvderabad/telemedicine-services-expand-rapidlv-in-telanaana/articleshow/121195350.cms
5 https://www.imarcgroup.com/india-telemedicine-marke
6 http.s://www?– reuter.S?– Com/hu.sine.s.s/healthcare-pharmaceutical.s/india-plan.s-tiahten-over.siaht-claim.s-portal-curh-ri.sina-healthcare-co.st.s-.source-707.5-07-1
7 https://www.linkedin.com/pulse/access-healthcare-india-reforms-proaress-outlook-2030i-medici-andre-rvwz
8 http.s://time.sofindia?– indiatime.s?– com/city/lucknow/ayu.shman-hharat-a-aame-chanaer-in-health-.sector-rainath/article.show/171300464?– cm.s
9 https://timesofindia.indiatimes.com/citv/delhi/17-health-facilities-to-be-uparaded-across-delhi-tenders-floated/articleshow/123119824.cms
10 http.s://www?– leaality.simplified?– com/improvement.s-in-india.s-puhlic-health/?utm
?€? Infrastructure expansion outcomes: Ayushman Arogya Mandir centers now exceed 1.7 lakh; 7,998 public facilities have national quality certifications. 11
Modernizing drug regulation and export processes
Indias drug regulator is simplifying export approvals and licensing for unapproved drugs, aiming to reduce administrative burdens. Investment in digital systems and guidelines for advanced therapies like gene and cell treatments is also underway. 12
Reforms to Central Government Health Scheme (CGHS)
CGHS now uses PAN-based IDs, auto-verifies approvals through Bharat Kosh, enables online medical device requests (e.g., oxygen concentrators), and offers SMS/email updates along with a mobile app. 13
Maternal and child health initiatives in aspirational regions
NITI Aayog highlighted "Project BLOOM" from Lunglei, Mizoram, as a model public health practice. It integrates health, nutrition, transportation, and behavioral outreach to improve maternal and child outcomes in remote areas.
India Scenario
Cancer is on the rise in India, a pattern that is coinciding with the overall rise in non-communicable diseases (NCDs). Cancer cases are estimated to touch 20 lakhs by 2040, up from about
11.6 lakh in 2018. In 2018, it was reported that Indias cancer prevalence has more than doubled in comparison to the previous 26 years.
While lung, throat, stomach, and esophageal cancers are most common among men, breast and cervix uteri cancers are on the rise among women in India. Incidences of breast cancer have also touched alarming proportions. It continues to affect a larger proportion of women in metropolitan cities such as Hyderabad, Chennai, Bengaluru and Delhi, than in other parts of the country.
In 2022, around 19-20 lakh new cancer cases were estimated to be reported in India. However, real incidence of cancer is conservatively estimated to be 1.5-3 times higher than the reported incidence from cancer registries.
Increasing Cancer Incidences in India
ONCOLOGY INDIA AND GLOBAL OVERVIEW
Global Scenario
Cancer remains one of the most significant health challenges worldwide. According to the World Health Organization (WHO) , it is the second leading cause of death globally , responsible for almost 10 million deaths annually , or one in every six deaths . The rising cancer burden is closely linked to a combination of modifiable lifestyle risk factors ?€”including tobacco and alcohol consumption, unhealthy diets, obesity, and sedentary lifestyles?€”and non-modifiable factors like ageing. With the global population growing and life expectancy increasing, the absolute number of cancer cases is projected to rise sharply, further straining healthcare systems.
The oncology therapeutics market has expanded rapidly in recent years, growing at a CAGR of 9.8% between 2015 and 2019, reaching USD 167.9 billion . However, the COVID-19 pandemic caused a temporary setback in 2020, with the market contracting by about 11% to USD 149.9 billion , due largely to disruptions in diagnosis, treatment access, and clinical trials. Despite this dip, post-pandemic recovery has been strong, supported by advances in immunotherapy, targeted therapy, and precision oncology . As of 2024, analysts project the global oncology market to exceed USD 250 billion by 2030 , driven by innovations in cancer immunotherapy, early diagnostics, and AI-powered care models .
https://www.drishtiias.com/current-affairs-news-analvsis-editorials/news-editorials/09-06-9095
12 https://www.reuters.com/business/healthcare-pharmaceuticals/indias-drua-reaulator-streamline-export-process-reduce-workload-2025-02-27
13 http.s:/feconomictime.s.indiatime.s.com/wealthfcave/7-maior-channe.s-in-cnh.s-you-.should-know-pan-ha.sed-id-to-fa.ster-medical-reque.st-approval.s/
articleshow/122022927.cms
Ageing Population
Population over the age of 50 years is expected to rise in India
Exposure to Risk Factors
Lifestyle changes like tobacco use, alcohol consumption, processed food, pollution etc
Affordability
Active roll out of government schemes, increased insurance penetration
Rising Awareness
Growing awareness and greater public emphasis on screening
Cancer Incidence Across Countries
India faces a grave challenge of high cancer incidence which is growing at a faster pace as compared to other developing countries.
According to the 2020 WHO ranking on cancer burden, India ranks at the 3rd position after China & USA, respectively, in terms of new yearly cancer incidence being reported.
Based on the historical growth in reported cancer incidence (CAGR of 5% between 2012-16), Indias cancer incidence crude rate is estimated to be 122 per lakh population and age specific incidence (ASR-W*) rate is estimated to be 116 per lakh population in 2020. While the estimated age-specific incidence rate (ASR rate) for India is lower compared to other geographies, Indias real ASR rate is expected to be higher than Thailand and Indonesia, and comparable with China and Brazil (refer Chart below)
Despite the crude rate of incidence not being amongst the highest in India compared to other geographies, the total incidence burden is high due to the large population size of the country. Considering growth in population and crude rate, Indias cancer incidence is estimated to be growing at a CAGR of 6.8% (2015 to 2020) which is significantly higher than other developing countries such as China (1.3%) (which has a comparable population size), Brazil (4.5%) and Indonesia (4.8%) as well as developed countries such as UK (4.4%).
In 2022, around 19 to 20 lakh new cancer cases were estimated to be reported in India. However, the real incidence of cancer is conservatively estimated to be 1.5 to 3 times higher than the reported incidence from cancer registries.
Source: Globacan 2018, ICMR, Industry Reports
| 122 ft | 182-242 i | 279 ft | 273 ft | 145 m | 316 a |
| 116 ft | 174-22 a | 215 ft | 164 m | 141 | 205 ft |
689 675
Source: NCRP 2020 Annual report, Global cancer observatory for Brazil, Thailand, US, UK, China and Indonesia
#Estimated incidence considering only population growth and crude rate CACR, without considering impact of changes in risk factors and improvement in diagnosis *ASR-W is a weighted mean of the age-specific incidence rates. The weights are taken from the population distribution of the "world Standard Population defined by WHO, and the estimated incidence rate is expressed per lakh population for comparisons between different geographies.
*CAGR: Compound annual growth rate, measures the annual growth over multiple years by compounding over the period.
| Estimated# | Real | |||||||||
| India | Brazil | Thailand | Indonesia | China | US | UK | ||||
| Overall new cases (In 000s) | 1,714 | 2,570 -3,430 | 475 | 131 | 397 | 4,569 | 2,282 | 458 | ||
| Overall new cases (In 000s) | o | 6.8% | 4.5% | 7.8% | 4.8% | 1.3% | 6.6% | 4.4% | ||
Within India, out of the 17 states covered by population-based cancer registries (PBCRs), 13 states exhibit a rising cancer burden
Among all states and UTs covered by population-based cancer registries (PBCRs), Kerala, Mizoram, Tamil Nadu, Karnataka, Punjab, and Assam report the highest overall crude incidence rates of cancers (above 130 cases per lakh population) and have 23% share of the total cancer burden of the country.
Tamil Nadu, Karnataka, Punjab, and Maharashtra are the states where the crude incidence rate among females is significantly higher than male cancer incidence. Conversely, for Assam, Meghalaya & Nagaland, the crude incidence among males is much higher than female cancer incidence.
Key state wise projected crude incidence per lakh population (2020) and CAGR trend
| State/UT (No. of Registries) | Crude rate per lakh population | |||||
| Overall | Male | Female | ||||
| Kerala (2) | * | 181.6 | * | 188.7 | * | 175.4 |
| Karnataka (1) | 151.7 | 132.3 | 172.6 | |||
| Tamil Nadu (1) | * | 148.6 | * | 135.4 | * | 161.5 |
| Punjab (1) | 144.0 | 126.4 | 163.7 | |||
| Mizoram (1) | * | 141.7 | 1 | 143.5 | * | 139.9 |
| Assam (3) | 138.6 | 151.6 | 125.8 | |||
| Delhi (1) | 1 | 113.5 | 111.7 | 1 | 115.5 | |
| Maharashtra (6) | 97.2 | 88.8 | 106.2 | |||
| Arunachal Pradesh (2) | 1 | 94.1 | 91.0 | 1 | 97.1 | |
| West Bengal (1) | 1 | 87.9 | 1 | 94.1 | 81.4 | |
| Madhya Pradesh (1) | 87.8 | 85.3 | * | 90.4 | ||
| Gujarat (1) | * | 85.8 | 92.6 | * | 78.2 | |
| Meghalaya (1) | 79.5 | 100.7 | 58.4 | |||
| Sikkim (1) | 1 | 70.5 | 1 | 67.8 | 1 | 73.5 |
| Tripura (1) | 68.5 | 76.7 | 60.0 | |||
| Nagaland (1) | * | 68.2 | 1 | 74.1 | 61.9 | |
| Manipur (1) | 1 | 56.2 | 1 | 50.8 | 1 | 61.6 |
The challenge of rising disease burden is further compounded by poor outcomes compared to global counterparts across all major organ types
There is a significant gap in access to quality cancer treatment in India due to limited and uneven distribution of cancer care centers (CCCs), radiotherapy (RT) equipment, and diagnostic tools:
?€? CCCs are present in only 175 districts, each serving ~3 million people, mostly located in metros and Southern/Western India.
?€? RT equipment is severely lacking, with only 0.4 units per million people versus the WHO recommendation of at least 1 (targeting 2 by 2030).
?€? Diagnostic tools are underpenetrated:
?€? CT: 5 units per million (vs. 40 in high-income countries)
?€? PET-CT: 0.25 per million (vs. 3 in the West)
?€? Mammography: 1.7 per million (vs. 50+ in developed countries)
Penetration of CCCs and RT equipment across major states in India
Significant demand supply gap exists in oncology specific medical infrastructure and workforce
| 1.3X | 2.1X | 2.6X | 1.4X | 1.0X | 1.4X |
Advancements in cancer treatment in India
With the rising incidence of cancer in recent years, India has significantly improved the processes for cancer diagnosis and treatment. Recent advancements have also transformed cancer care and has given hope to millions of people.
?€? Genomic guided Immunotherapy: Immunotherapy, also known as biologic therapy, is widely used for cancer care and cure. It boosts the bodys natural defence to help combat the disease. The treatment promises much better outcome for the cancer patients.
?€? Liquid biopsy: The sampling and examination of non-solid biological tissue, usually blood, is known as liquid biopsy or fluid phase biopsy. Its a ground-breaking method for detecting cancer at an early stage and determining the effectiveness of chemotherapy.
?€? Artificial Intelligence (AI): Recent advancements in artificial intelligence have largely enhanced the efficacy of various treatment methods. AI has helped medical practitioners to predict the effectiveness of cancer
immunotherapy and is extremely useful for the diagnosis of different types of cancer.
?€? Adaptive Radiation Therapy: Through this new technology the treatment is adapted to account for internal anatomical changes as some organs in the body that require radiation therapy can change in size and shape over the days and weeks that a course of treatment can take.
?€? Multiparametric-magnetic resonance imaging (MP-MRI) and Fluorescence lifetime imaging (FLI): These imaging techniques aid in breast cancer detection. The scan shows signs of proteins that aid the growth of cancer cells and allows doctors to quickly diagnose and decide a clear path for treatment.
India, therefore, stands at the cusp of offering remarkable cancer care through numerous innovative and patient centric treatments. The country has achieved important breakthroughs in cancer research that help better care and treatment of cancer patients. Besides, the use of advanced technology has enabled caregivers to rely on innovative pathways for cancer detection
| 1.3X | 2.1X | 2.6X 1.4X | 1.0X | 1.4X |
| \u2022 Only 175 of 500+ districts covering 40% 45% of population have CCC \u2022 40% of CCC are concentrated in metros/ state | \u2022 RT per million population of 0.4 vis-a-vis WHO recommendation of 1 RT per million population | \u2022 Incidence per clinical oncologist (medical and radiation oncologist) at 315 compared to 120 in China and 137 in the US | \u2022 Demand supply gap in medical physicists while being acute currently is further expected to widen by 130 every year |
Fertility
India is the second-most populous country in the world accounting for 17.7% of the worlds population. However, over the past few years, fertility rates have severely declined in India. The fertility rate in 2019 was 2.22 births per woman, a 0.89% fall from 2018. In 2020, the fertility rate further reduced to 2.2 births per woman, a fall of 0.9% from 2019.
Infertility is among the most prominent health issues faced by many young couples around the world. In India too, it has become a grave problem in recent years. Sedentary lives with little or no physical exercise, increasing stress levels, erratic sleep patterns and unhealthy lifestyle choices are some of the major factors causing infertility. As a result, artificial methods of conception have become quite popular in large metros as well as small towns.
Risk factors leading to high prevalence of infertility
?€? PCOS incidence in India reported to range between 4% to 23%
?€? Mean global prevalence rate of 5% to 10%
?€? Endometrial TB causes endometrial and tubal damage resulting in infertility
?€? Prevalence is estimated to be ~18% among infertile women in reproductive age in India vis-a-vis 1% in the USA
?€? Prevalence of obesity in men has increased from 18.9% (2015) to 22.9% (2019)
?€? Increased from 20.6% (2015) to 24% (2019) in women as per NFHS-5 15
?€? Tobacco prevalence in India estimated at 38% for Men & 8.9% for Women
?€? Overall alcohol consumption per capita increased from 4.3 litres in 2010 to 5.7 litres in 2016 16
?€? High prevalence of STDs
?€? Estimated to range between 10-34%
The growing prominence of advanced research has opened new avenues for infertility treatment in India. It has provided patients with safe and secure solutions including IUI (intrauterine insemination), IVF (in vitro fertilisation), and ICSI (Intracytoplasmic sperm injection). In India, the most common method of treatment is in-vitro fertilization and IVF clinics continue to report a very high number of successful conceptions.
The future of infertility treatment in India relies largely on the adoption of digital methods of treatment. With growing importance of artificial intelligence and machine learning in the field of medicine, infertility treatments are also expected to be remodelled in the coming years. The incorporation of AI in therapeutic Assisted Reproductive Technology (ART) opens promising possibilities in this field. It is not only expected to offer high efficacy rates but is also anticipated to reduce treatment costs considerably. By processing and analysing more data accurately and in greater detail, AI is anticipated to distinguish high-quality embryos from chromosomally defective ones, a method that is intended to save healthcare practitioners enormous time and effort.
India is witnessing a high burden of infertility, with an estimated 32 to 34 Mn couples in the reproductive age suffering from lifetime infertility in 2021
15 https://mohfw.gov.in/sites/default/files/NFHS-5 Phase-II 0.pdf 16 18105 Global status report on alcohol and health 7018 For Web
Prevalence of Lifetime Infertility in India, 2021
(Population in Mn.)
In 2020, an increase in the proportion of women in the reproductive age (20-44 years), coupled with a skew towards those aged between 30-44 years has resulted in an increase in infertility prevalence
?€? In 2018, ~70% of live births occurred among married women in the age-group between 20-29 vis-avis 83% in 2012
?€? Fertility rates in women aged 30-49 are significantly lower than that of women aged 20-29 years
?€? The increase in the proportion of women is skewed towards those aged 30-44 years and is forecast to increase by ~20% between 2010 to 2020. This shift is likely to increase the burden of infertility in India by 2020.
?€? Assuming the marital rate in 2021 is similar to the decadal growth rate observed between 2001 and 2011, the number of couples in reproductive age group (20-44 years) has increased from 193 Mn in 2011 to 231 Mn by 2021 (Source: Census data)
Percentage of live births per age-group (based on age-specific marital fertility rate, 2018)
?€? Demographic changes in the population are forecast to
increase the percentage of women in the reproductive age Age in years. women
(20-44 years) by ~14% between 2010 to 2020 Source: Sample registration survey 2018
Current Infertility market in India (No. of fresh cycles)
Current Infertility market in India (No. of fresh cycles): Current market for infertility is estimated at ~2,50,000 in-vitro fertilization (IVF) cycles with a 2% penetration rate which is low when compared to other countries
CAGR of 20% when compared to 1,00,000 cycles in
12%-15%
prevalence of infertility in India
2%
of the total infertile couples currently seek infertility treatment
20%-25%
of the total couples registering at an infertility centre undergo IVF
~1.5
IVF cycles performed per couple (80% couples go for 2 cycles)
4-9%
couples coming forward for treatment annually as observed in developed nations, IVF cycles would be 2X-4X higher than current levels
Potential IVF market in 2027: With more infertile couples coming forward for treatment, the IVF market is estimated to grow by ~10-15% to 5-6 lac cycles by 2027. Between FY15 to FY22, share of organized players (corporate IVF chains and large doctor setups) has grown from 25% to ~45-50%; shift in share from un-organized to organized players expected to continue largely driven by increased regularisation of the sector with implementation of ART bill as well as shift in patient preference towards organised players post COVID
Key Challenges and Opportunities
?€? Challenges:
* Late-stage diagnosis due to low awareness and limited screening infrastructure
* Urban-rural healthcare access gap
* High treatment costs and limited insurance penetration
* Shortage of trained oncologists and oncology nurses
?€? Opportunities:
* Scaling up Ayushman Bharat coverage for oncology treatments
* Expanding molecular diagnostics and AI-based cancer screening
* Boosting tele-oncology to improve access in Tier-2 and Tier-3 cities
* Strengthening palliative care services alongside curative approaches
Growth in Cancer Incidence - India vs Global Peers
Between 2012 and 2016, the reported cancer incidence in India grew at a CAGR of ~5%, and between 2015 and 2020, the pace accelerated to 6.8% annually?€”outstripping several countries. By comparison, the growth rates during the same period were:
* China: 1.3% (similar population size but much
slower growth)
* Brazil: 4.5%
* Indonesia: 4.8%
* UK (developed country): 4.4%
Indias crude incidence rate in 2020 was estimated at 122 cases per lakh population, and the age-standardized incidence rate (ASR-W) at 116 per lakh population. While these rates appear lower than those of several high-income nations, the real ASR?€” once accounting for under-reporting?€”is likely comparable to China and Brazil and higher than Thailand or Indonesia.
Reported vs Real Incidence
In 2022, an estimated 19-20 lakh new cancer cases were reported in India. However, experts suggest that the real incidence is 1.5-3 times higher than registry data due to:
* Under-reporting in rural and semi-urban areas
* Limited cancer registry coverage
* Lack of access to diagnostics in early stages
* Social stigma and low health-seeking behaviour
This means the actual annual cancer case load could be closer to 30-40 lakh cases, placing enormous strain on Indias healthcare infrastructure.
Key Drivers of Rising Incidence
1. Population Growth & Ageing - Indias population over age 50 is expected to grow substantially, and cancer risk increases sharply with age.
2. Lifestyle Risk Factors - Tobacco use (both smoking and smokeless), alcohol consumption, processed foods, obesity, and air pollution contribute to a growing share of cancer cases.
3. Increased Awareness & Screening - Public health campaigns, celebrity advocacy, and greater access to diagnostics are identifying more cases than before.
4. Affordability & Access - Expansion of government health schemes such as Ayushman Bharat, along with increased insurance penetration, is enabling more people to seek diagnosis and treatment.
5. Relapse-driven Cases - Improvements in survival rates mean more patients are living longer, but some face cancer recurrence, adding to the burden.
Projected Market Growth
Indias cancer care industry?€”covering diagnostics, treatment, and supportive care?€”is poised for rapid expansion. The industry is projected to grow at a CAGR of ~12%, driven by:
?€? Rising patient volumes
?€? Advances in targeted therapy and immuno-oncology
?€? Growing private sector participation
?€? Public-private partnerships in tertiary care
Despite the relatively moderate crude incidence rate, the sheer scale of Indias population means its cancer burden is already one of the largest globally and is expected to rise sharply over the next decade unless preventive strategies, early detection programs, and affordable care models are significantly strengthened.
Our business
Oncology
H 6
adding Life to years
The Company is the largest provider of cancer care in India under the "HCG" brand. It owns and operates comprehensive cancer diagnosis and treatment services (through radiation therapy, medical oncology and surgery). As of March 31, 2025, our HCG network consisted of 22 comprehensive cancer centres, including 1 centre in Africa. Each of our comprehensive cancer centres offers, at a single location, comprehensive cancer diagnosis and treatment services including radiation, medical oncology and multidisciplinary approach to cancer care across our HCG network, wherein specialist physicians from various disciplines collaborate to provide the best course of treatment for each patient. Our freestanding diagnostic centres and our day care chemotherapy centre offer diagnosis and medical oncology services, respectively.
We follow a multidisciplinary approach to cancer care across our HCG network, wherein specialist physicians from various disciplines collaborate to provide the best course of treatment for each patient. This allows us to share and develop best practices, build clinical expertise and adopt standardized protocols for diagnosis and treatment, thereby improving the quality of our cancer care services. We believe that as a result, we can better serve our patients and ensure consistent clinical outcomes.
In our HCG network, our specialist physicians adopt a technology- focused approach to diagnosis and treatment. For instance, we use advanced technologies, including molecular pathology and molecular imaging for accurate diagnosis and staging of cancer, which enable us to decide upon the appropriate course of treatment for each patient. We believe that owing to the relationships we enjoy with such medical technology vendors and pharmaceutical and biotechnology companies and our involvement with them in the areas of research and development, we have been able to introduce in India and adopt across our HCG network the latest advances in technology relatively early.
For instance, we were among the first healthcare providers in India to standardize molecular diagnostics technologies, including genomic testing and molecular imaging, including 128 slice PET-CT scans in the diagnosis and staging of cancer, as well as to introduce high intensity flattening filter free mode radiotherapy, stereotactic and radiosurgery and robotic radiosurgery, in the treatment of cancer in India. We were also the first healthcare provider in India to perform computer assisted tumour navigation surgery. We believe this gives us a distinct advantage relative to our competitors in delivering high quality and standardized cancer care to our patients. We also utilize targeted nuclear medicine therapies as well as advanced radiation treatments to minimize side effects and improve the outcome of treatments. By ensuring that we adopt these diagnostic and treatment technologies throughout our HCG network, we can provide consistent quality of care to all patients.
Given the large number of patient cases treated across our HCG network, we believe that we can efficiently utilize our equipment, technologies and human resources, thereby deriving economies of scale. Furthermore, efficiently utilise our equipment, technologies and human resources, thereby deriving economies of scale.
Through the adoption of a centralised drug and consumables formulary, we can lower the overall cost of drugs and consumables. We believe that our business model is scalable and when combined with efficient utilisation of resources, it enables us to operate within a competitive cost structure.
HCG key differentiators:
1) Clinical outcomes a major driver in selecting doctor/ hospital; survival rate a lead indicator of clinical outcome: A Patient chooses a hospital based on clinical outcomes which are different in different hospitals based on the indepth practice (specialization, sub-specialisation), research, machines, technology, tools, knowledge sharing, domain expertise and various such factors. One does not decide hospital on basis of multi-speciality or single speciality.
HCG is the largest oncology focused hospital which does extensive research on cancer care which allows it to stay one step ahead compared to other hospitals. Based on the sheer volume that HCG caters our belief is that the clinical outcomes at HCG should be far superior compared to other hospitals when it comes to oncology and has higher success ratio/survival rate matters in case of oncology which is one of the major driving forces when it comes to selecting HCG.
2) Sub-specialization is need of the hour: With ever increasing complexity of cancer and need for accurate treatment there are various sub-specializations which have emerged. There are over 50 different types and subtypes of cancer each requiring unique treatment & knowhow. HCG has highest number of oncologists (400+) in the country with various sub-specialist oncologists which is a determining factor to choose hospital.
3) Largest tumour-board in India: Tumour board is a unique approach whereby group of oncologists meets every week to discuss critical case and decide what treatment needs to be given to a particular patient considering various factors. This helps in enhancing the accuracy level and outcome levels are far better. HCG has the largest tumour board in India which is a key differentiating factor.
4) Pioneers of research in India: Very few institutes like HCG and Tata memorial in India are focused on R&D and academics. HCG has been at the forefront of Research and Development when it comes to cancer research. HCG till date has published close to 970 research papers.
5) All modalities under one roof: Most of the multi-speciality hospitals have one department for oncology but they lack comprehensive cancer care centres. HCG has dedicated 21 comprehensive cancer care centres in India and 01 in Kenya which provides all modalities (diagnostics, radiotherapy, medical, surgical oncology) under one roof.
6) Largest gene sequencing in the country (Genomics Lab): HCG has taken a leadership role in genomics-driven tumour boards and gene-profiling. This has given insights into patient-centric approach, particularly for advanced and recurring tumours, not only from India, but from Africa and Middle East, making HCG a destination for cancer care. This approach helps in better outcome and indirect more patient referrals.
BACC Healthcare Private Limited, our wholly owned subsidiary, is the leading provider of fertility treatment under the brand "Milann". It owns and operates comprehensive reproductive medicine services including assisted reproduction, gynaecological endoscopy and fertility preservation. Milann has been Ranked No. 1 in India and first in the South India region continuously for 3 years in the fertility segment in the Times Health All India Critical Care Hospital Ranking Survey 2018. (Source: All India Critical Care Hospital Ranking Survey 2017, All India Critical Care Hospital Ranking Survey 2017, published on Times Health, Times of India on December 16, 2016).
Milann is led by a team of qualified and experienced fertility specialists with successful track record of providing fertility treatments. Our Milann fertility centres provide comprehensive reproductive medicine services, including assisted reproduction, gynaecological endoscopy and fertility preservation; and follow a multidisciplinary and technology focused approach to diagnosis and treatment. Our Milann network also operates on a model like our HCG network, wherein the various Milann fertility centres aim to provide medical services following established protocols with a focus on quality medical care across diagnosis and treatment.
Precision Diagnostics
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Triesta Sciences is an integrated speciality diagnostics vertical of HCG with end-to-end capabilities in precision medicine through proprietary analytics, clinical research, genomic technologies, assay development and validation and a network of laboratories offering a broad menu of tests.
Triesta Sciences is a one- stop solution for oncology diagnostics, Genomics (Next Generation sequencing based diagnostics), biomarker and translational research, laboratory services, and clinical research services for several hospitals across India with a focus on innovation, quality and accuracy for better diagnosis and prognosis of Cancer.
Triesta offers proprietary data analytical engines for research and clinical applications for genomic testing and offers hospital laboratory management services by way of establishing and operating laboratory within the hospital premises. It also provides clinical reference laboratory services in India with specialization in oncology, rare diseases and reproductive health and its offerings include molecular diagnostic services and genomic testing. Triesta central reference laboratory is in Bengaluru and is accredited by NABL in India, as well as by CAP for quality assurance of laboratory tests performed. Additionally, Triesta offers research and development services to pharmaceutical and biotechnology companies in the areas of clinical trial management and biomarker discovery and validation and is led by a team of specialist onychopathologies, molecular biologists and clinical researchers.
As part of clinical diagnostics, Triesta offers precision tests like Inherited Cancer Risk Analysis, Tumour Mutation Analysis
for Precision Treatment, Liquid Biopsy Analysis for Precision Treatment, Response Monitoring, and Early Detection of Relapse, in addition to an entire gambit of traditional tests.
Multi-speciality
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HCG operates three multi-speciality hospitals, under "HCG" brand in Ahmedabad, and Rajkot, in the state of Gujarat and one in Hubli in the state of Karnataka.
HCG Multispecialty in Ahmedabad, Rajkot and Hubli are tertiary care hospitals with 103, 82 and 118 beds respectively, as of March 31, 2025. These hospitals provide comprehensive inpatient and outpatient treatments. Their key specialties include cardiology, neurology, orthopaedics, gastroenterology, urology, internal medicine and pulmonary and critical care. Suchirayu Health Care Solutions Limited, in Hubli, is a multi- speciality quarternary hospital. With 118 operational beds and capacity to go to 250 beds, the hospital offers state of the art facilities and infrastructure in the region.
Hospital Network
Existing HCG cancer centres in India
As of March 31, 2025, we operate a network of 22 comprehensive cancer centres across ten states in India and 1 centre in Nairobi, Kenya. All of these centres are owned and operated by the Company, with some of the centres in joint- venture with oncologists or healthcare groups where majority ownership is with the Company. The following table sets out our existing comprehensive cancer centres as on the date of this report and their facilities and service offerings:
| Commencement | Facilities and service | s | ||||
| cancer centre | of operation (calendar year) | Number of beds 3 | Number of RT-LINAC 6 | Number of operation theatres 7 | Number of PET -CT scanners | Laboratory |
| Karnataka Cluster | ||||||
| Bengaluru \u2014 double road | 1989 | 47 | 1 | 3 | Yes | |
| Shimoga 1 | 2003 | 48 | 2 | 3 | Yes8 | |
| Bengaluru- Kalinga Rao road 2 | 2006 | 220 | 3 | 5 | 3 | Yes |
| Hubli | 2008 | 40 | 1 | 2 | 1 4 | Yes8 |
| Gulbarga | 2016 | 45 | 1 | 2 | Yes | |
| Gujrat cluster | ||||||
| Ahmedabad 1 | 2012 | 118 | 2 | 7 | 1 | Yes |
| Baroda 1 | 2016 | 99 | 1 | 5 | 1 | Yes |
| Bhavnagar | 2018 | 96 | 1 | 3 | Yes | |
| East India cluster | ||||||
| Ranchi | 2008 | 80 | 2 | 3 | 1 | Yes |
| Cuttack | 2008 | 126 | 2 | 3 | 1 | Yes |
| Kolkata 1 | 2019 | 74 | 2 | 3 | 1 4 | Yes |
| Maharashtra cluster | ||||||
| Nashik 1 | 2007 | 97 | 1 | 4 | Yes | |
| Borivalil | 2017 | 69 | 2 | 5 | 1 | Yes |
| Nagpur* | 2017 | 74 | 2 | 4 | 1 | Yes |
| South Mumbai | 2019 | 29 | 2 | 2 | 1 | Yes |
| Nashik Phase II 1 | 2018 | 75 | 2 | 5 | 1 | Yes |
| Andhra Pradesh cluster | ||||||
| Vijayawada | 2009 | 905 | 2 | 4 | 1 4 | Yes |
| Ongole | 2012 | 325 | 1 | 2 | Yes | |
| Vishakhapatnam | 2016 | 815 | 2 | 5 | 1 | Yes |
| MGCHRI 1 | 2024 | 139 | 2 | 4 | 1 | Yes |
| Others | ||||||
| Indore | 2023 | 44 | 1 | 3 | ||
| Jaipur | 2018 | 100 | 3 | 2 | 1 | Yes |
| Kenya 1 | 2016 | 1 | 1 |
Notes
1. Operated through our Subsidiary.
2. Our comprehensive cancer centre located at Kalinga Rao Road in Bengaluru is our centre of excellence.
3. Number of beds includes ICU beds (as applicable).
4. We utilize PET-CT of our partner.
5. In addition, we have self-care beds of 70, 40, 55 and 57 at our centres - Vjayawada, Ongole Vizag and MGCHRI respectively.
6. Includes a WBRRS system and Cyber Knife.
7. Includes major and minor operation theatres. Major operation theatres are used to perform complex surgeries and minor operation theatres are used to perform minor surgical procedures.
8. Lab services by Partner
As of March 31, 2025, we also have a freestanding diagnostic centre in Chennai equipped with PET-CT scanners.
HCG cancer centres under development in India New Centres
As on the date of this report we are in the process of establishing 2 state-of-the-art cancer care facility in Bangalore which is an extension to our Centre of Excellence and would primarily cater for cancer diagnostics, day-care radiation, chemotherapy services and surgical services.
The table below sets out details of our cancer Centre under development in India as on the date of this report and their facilities and service offerings:
| Location of new cancer care centres under development | Facilities and services | ||||
| Number of beds | Number of RT- LINACs | Number of operation theatres | Number of PET-CT scanners | Laboratory | |
| Bangalore (Whitefield) | 22 | 1 | 2 | 1 | Yes |
| North Bangalore | 97 | 1 | 5 | 1 | Yes |
Milann centres
The following table sets out our existing Milann fertility centres as of March 31, 2025 and their facilities and service offerings:
| Units | Year | Beds | IVF | Endo OT | Embryo Lab | Neonatal ICU |
| Kumarpark | 1989 | 25 | Y | Y | Y | Y |
| JP Nagar | 2010 | 24 | Y | Y | Y | Y |
| HSR | 2023 | 4 | Y | N | Y | N |
| Indiranagar | 2012 | 6 | Y | Y | Y | Y |
| Whitfield | 2018 | 10 | Y | Y | Y | Y |
| Chandigarh | 2016 | 8 | Y | Y | Y | Y |
In FY25, Milann closed its MSR and Sarjapur units. The MSR unit was shut down following a strategic decision to exit the shop-in shop-out model, while the Sarjapur unit was closed to enhance operational efficiency by redirecting patient flow to the HSR unit.
Risks and concerns
Risks are integral part of any enterprise. Efficient management of business risks is a key factor that determines growth, profitability and at times, even survival. In the last few years, the healthcare industry in India has been witnessing increased consolidation even among the larger players. Further, Government intervention, by way of an active regulatory regime, be it in terms of price control or capping of margins on medicines has been stepped up. State and Central Healthcare coverage schemes are also impacting industry margins. The risks that might impact our business, prospects, financial condition and results of operations, inter-alia includes:
(a) Our results of operations in any given period can be influenced by a number of factors, many of which are outside of our control and may be difficult to predict, including political and economic conditions, the timing of opening and the number of new centres, changes in the competitive landscape in which we operate, government policies which may affect the pricing of our medical services, the operation of medical equipments, the licensing and operation of our centres and hospitals and the licensing of our medical staff, delays in executing our growth strategies due to a number of factors, delays in project execution resulting in significant time and cost overruns, delays or failure in receiving government approvals, unavailability of
human and capital resources, or any other risks that we may or may not have foreseen etc.
(b) The success of our business is dependent on our ability to maintain our relationships with our partners, to identify suitable partners and acquisitions targets and to undertake new partnership arrangements and acquisitions. We may be unable to continue to operate our centres and hospitals if there are any conflicts or disputes with our partners or if our partnership arrangements are not renewed at the end of their respective terms.
(c) Our patients include patients who pay for their medical expenses themselves and patients who are beneficiaries of third-party payer agreements. If we do not receive payments on time from our payers, our financial condition, cash flows and results of operations may be materially and adversely affected. We make provisions for disallowances and doubtful trade receivables in our financial statements on account of the probability of not being able to collect the amounts billed to third party payers, based on our actual experience of disallowances and collection from each category of payers. Provisions for disallowances reduce our revenue from operations and provisions for doubtful trade receivables increase our expenses and thus reduce our profitability.
(d) We face intense competition from other healthcare facilities. If we are unable to compete effectively, our business and results of operations may be materially and adversely affected. Our ability to effectively compete with our competitors is dependent on our ability to
achieve high success rates in diagnosis and treatment and reduce risks and side effects in providing cancer care and fertility treatment, enhance the brand image and marketability of our "HCG" and "Milann" brands, increase new patient registrations across our HCG network, attract and retain specialist physicians, physicians and other skilled persons etc.
(e) We are highly dependent on our promoters, key clinicians, partners and the members of our senior management team, including some who have been with us since the establishment of the first cancer centre in our HCG network, to manage our current operations and to meet future business challenges. The loss of the services of our senior management or key management personnel, including our senior specialist physicians and physicians, or if we are unable to find a suitable replacement for them, could seriously impair our ability to continue to manage and expand our business.
(f) We may not realise the value of our goodwill or other intangible assets. We expect to engage in additional transactions that will result in our recognition of additional goodwill or other intangible assets. We evaluate on a regular basis whether events and circumstances have occurred that indicate that all or a portion of the carrying amount of goodwill or other intangible assets may no longer be recoverable and is therefore impaired. Under the current accounting rules, any determination that impairment has occurred, would require us to write off the impaired portion of our goodwill or the unamortised portion of our intangible assets, resulting in a charge to our earnings. We have written off goodwill in the past, and any future write off could have a material adverse effect on our financial condition and results of operations.
(g) Currently, our Company conducts a portion of its operations through its subsidiaries. Further, a portion of our Companys assets is held by, and a part of its earnings and cash flows is attributable to, our subsidiaries. If earnings from our subsidiaries were to decline, our Companys earnings and cash flows would be materially and adversely affected. We cannot assure you that our subsidiaries will generate sufficient earnings and cash flows to pay dividends or otherwise distribute sufficient funds to enable our Company to meet its obligations, pay interest and expenses or declare dividends.
(h) We rely on the financing arrangements with various banks and financial institutions to bridge the gap between cash flow from operating activities and investing activities (including put options of the partners). We cannot assure that the banks and financial institutions would fund us as per the planned timelines, and this could adversely affect our results of operations and financial condition.
The above risks can be considered as potential threats to the business of the Company. For information on opportunities, please refer to Industry section of the Management Discussion and Analysis Report.
We have revitalised our Risk Management framework with a detailed exercise aimed at a better and updated understanding of all our operational, financial, regulatory and strategic risks. Please refer to the section on Enterprise Risk Management forming part of the Management Discussion and Analysis Report to read more on the Risk Management framework.
Financial and operating highlights Overview
HCG (the Company) stepped into the Financial Year 2024-25 ("Fiscal Year" or "FY"), after completing some key acquisitions and consolidating stake holding in some of the subsidiaries in the FY 24-25. Along with continued efforts to improve operational efficiency and drive better margins, increased occupancy levels and better capacity utilisation, revenue for FY 2025 grew at 17% over FY 2024 and the EBITDA grew by 22%.
Overview of key regions Karnataka cluster
Karnataka cluster had operated 5 Cancer centres and 1 multispeciality centres operating through-out the year. Revenue from Karnataka cluster increased to INR 6,398 million in FY 2025 from INR 6,014 million in FY 2024 with a 6% YoY growth. Oncology centres registered a growth of 7%, with centre of excellence growing at 13%. Multispecialty centre registered a growth of 3%. Share of Karnataka region as a percentage of total revenues for HCG Centres (excluding Fertility) was at 30% in FY 2025 with only a marginal reduction by 3% from FY 2024.
Gujarat cluster
During the year, Gujarat cluster had 5 operational centres. At a cluster level, revenue grew by 10% from INR 4,784 million in FY 2024 to INR 5,275 million in FY 2025. Oncology centres grew at 15% and multispecialty centres de grown by 1%. Share of Gujarat region as a percentage of total revenues for HCG Centres (excluding Fertility) remains at 24%.
East India cluster
East India cluster had 3 operational centres during the year and revenue increased by 21% in FY 2025 to INR 2,551 million from INR 2,106 million in FY 2024, with Kolkata growing at 47% driven by medical oncology.
Andhra Pradesh cluster
During the year under review, Andhra Pradesh cluster had 3 operational centres. The revenues of the cluster have shown an increase of 49% to INR 2,054 million in FY 2025 from INR 1,378 million in FY 2024. We continue to strengthen our position in state of Andhra Pradesh, with continuing focus on improving revenue mix.
During the year, the Company has acquired 51% equity shares of Vizag Hospital And Cancer Research Centre Private Limited (VHCRPL) on 01 October 2024 for a consideration of Rs.
2,063.2 millions and acquired the control of VHCRPL from 02 October 2024. Consequently, revenues of INR 501.74 million and EBITDA of INR 101.08 million from VHCRPL have been consolidated into the financial performance for the year.
Maharashtra
Our centres in Borivali in Mumbai and in Nagpur, both amongst the largest new centres launched in the last few years, are continuing to ramp up in volumes and revenues. We also added another LINAC at Borivali during the year. South Mumbai centre was fully operationalised in FY 2021 and is one of the most advanced new cancer centres with substantial investment in radiation technology.
Overall Maharashtra cluster clocked revenue of INR 3,592 million during FY 2025 as against revenue of INR 2,871 million in FY 2024 registering a year-on-year growth of 25%. We continue to strengthen our position and scale, remain extremely positive about this region.
North India
North India revenue grew by 23% from INR 846 million in FY 2024 to INR 1,044 million in FY 2025.
Milann Centres
Milann continues to be one of the leading IVF brands in India with strong focus on clinical excellence, training and education as well. Milann revenue de-grown by 14% from INR 674 million in FY 2024 to INR 577 million in FY 2025.
Financial Performance
The financial statements of HealthCare Global Enterprises Limited and its subsidiaries (collectively referred to as "HCG" or the Group) and its joint venture are prepared in compliance with the Indian Accounting Standards ("Ind AS") as prescribed under section 133 of the Companies Act, 2013 read with the Companies (Indian Accounting Standards) Rules as amended from time to time.
The discussions herein below relate to consolidated statement of profit and loss for the year ended March 31, 2025, consolidated balance sheet as of March 31, 2025, and the consolidated cash flow statement for the year ended March 31, 2025. The consolidated results are more relevant for understanding the performance of HCG.
In accordance with the Companies (Indian Accounting Standards), Rules, 2015 of the Companies Act, 2013, HCG adopted Indian Accounting Standards (Ind AS) for preparation of its financial statements from April 1, 2016.
Significant material accounting policies used for the preparation of the financial statements are disclosed in the notes to the consolidated financial statements for the year ended 31 March 2025.
Operating revenue *
| Location of new cancer care centres under development | For the fi | Growth vis- a-vis FY2024 | For the fiscal year ended March 31, 2024 | ||||||
| (INR In million) | In % | (INR In million) | % of Revenue | ||||||
| REVENUE | |||||||||
| Revenue from operations | |||||||||
| Income from medical services | 20,563.17 | 92.70% | 14.48% | 17,961.47 | 94.14% | ||||
| Income from sale of medical and non- | 1,445.27 | 6.52% | 54.14% | 937.61 | 4.91% | ||||
| medical items | |||||||||
| Other operating revenues | 172.92 | 0.78% | -3.74% | 179.63 | 0.94% | ||||
| Total Revenue from Operations | 22,181.36 | 100.00% | 16.26% | 19,078.71 | 100.00% | ||||
| Income from government grant | 47.14 | 0.21% | 10.97% | 42.48 | 0.22% | ||||
| Other income | 348.14 | 1.54% | 105.49% | 169.42 | 0.88% | ||||
| Total Revenue | 22,576.64 | 100.00% | 17.03% | 19,290.61 | 100.00% | ||||
| Location of new cancer care centres under development | Growth vis- a-vis FY2024 | For the fiscal year ended March 31, 2024 | |||||||
| (INR In million) | % of Revenue | In % | (INR In million) | % of Revenue | |||||
| EXPENSES | |||||||||
| Purchases of stock in trade | 5,902.16 | 26.55% | 23.12% | 4,793.66 | 25.07% | ||||
| (Increase)/ decrease in stock-in-trade | -96.17 | -0.43% | 143.53% | (39.49) | -0.21% | ||||
| Employee benefits expense | 3,534.75 | 15.90% | 14.67% | 3,082.42 | 16.12% | ||||
| Finance costs | 1,545.61 | 6.95% | 42.14% | 1,087.36 | 5.69% | ||||
| Depreciation and amortization expense | 2,113.44 | 9.51% | 21.21% | 1,743.56 | 9.12% | ||||
| Other expenses | 9,014.92 | 40.56% | 12.85% | 7,988.74 | 41.78% | ||||
| Total Expenses | 22,014.71 | 99.04% | 18.00% | 18,656.25 | 97.57% | ||||
| Profit/ (loss) before tax and exceptional items and share of loss of an associate/ joint venture | 561.93 | 2.53% | -11.42% | 634.36 | 3.32% | ||||
| Exceptional Items | 0 | 0.00% | -100.00% | 39.05 | 0.20% | ||||
| Share of profit/(loss) of equity accounted investees | 7.71 | 0.03% | 98.71% | 3.88 | 0.02% | ||||
| Profit/ (loss) before tax | 569.64 | 2.56% | -15.89% | 677.29 | 3.54% | ||||
| TAX EXPENSE | |||||||||
| (1) Current tax | 286.63 | 1.29% | -16.47% | 343.15 | 1.79% | ||||
| (2) Deferred tax | -205.33 | -0.92% | 159.26% | -79.20 | -0.41% | ||||
| Net tax expense/ (credit) | 81.30 | 0.37% | -69.20% | 263.95 | 1.38% | ||||
| Profit/ (loss) for the year | 488.34 | 2.20% | 18.14% | 413.34 | 2.16% | ||||
| Share of loss of minority interest | 44.24 | 0.20% | -164.86% | (68.21) | -0.36% | ||||
| Net Profit/ (loss) for the year | 444.10 | 2.00% | -7.78% | 481.55 | 2.52% | ||||
* Excluding other income
Revenue
Revenue from operations
The revenue from operations (other than revenue from government grants) increased by INR 3,102.65 million, or by 16.26%, from INR 19,078.71 million in Fiscal Year 2024 to INR 22,181.36 million in Fiscal Year 2025. The increase is primarily attributable to increased patient footfalls addition of beds, addition of radiation and robotic machines resulting in increased capacity in Fiscal Year 2025.
During the Fiscal Year 2025, Our, Karnataka, Gujarat, Maharashtra, East India, Andhra Pradesh, North India and Tamil Nadu clusters contributed to a revenue of: (a) Karnataka: INR 6,398 million, (b) Gujarat: INR 5,275 million, (c) MH: INR 3,592 million, (d) East India: INR 2,551 million; (e) Andhra Pradesh: INR 2,054 million (f) North India INR 1,044 million and (g) Tamil Nadu INR 305 million respectively. All the centres registered year on year growth in revenues.
Established cancer centres registered a year-on-year growth of 22%, emerging centres registered a year-on-year growth of 32%.
Income from government grants
Income from government grants represents amortized deferred income earned from availing export promotion capital goods scheme ("EPCG"). It stood at INR 47.14 million in FY 2025 against INR 42.28 million in FY 2024.
Other income
Our other income increased by INR 178.72 million, from INR 169.42 million in Fiscal Year 2024 to INR 348.14 million in Fiscal Year 2025. Increase in other income was primarily on account of Miscellaneous income of 137.06 million and interest on bank deposits of 37.92 million.
Expenses
Our total expenses increased by INR 3,358.46 million, or by 18.00%, from INR 18,656.25 million in Fiscal Year 2024 to INR 22,014.71 million in Fiscal Year 2025. Increase in cost of consumption, employment cost and other operating expenses is in line with increase in revenue and operations.
Cost of consumption
Cost of consumption comprises of our expenses related to purchases of medical and non-medical items and changes in inventories of medical and non-medical items. Cost of consumption related to usage of drugs, medical and nonmedical consumable items increased by INR 1,051.82 million and stood at INR 5,805.99 million in Fiscal Year 2025 up from INR 4,754.17 million in Fiscal Year 2024.
Cost of consumption as a percentage of our total revenue including government grant & other income is 25.72% and 24.64% for Fiscal Year 2025 and Fiscal Year 2024, respectively.
Employee benefits expense
Our employee benefits expense increased by INR 452.33 million, or by 14.67%, from INR 3,082.42 million in Fiscal Year 2024 to INR 3,534.75 million in Fiscal Year 2025. This increase in Fiscal Year 2025 is attributed to increase in head count due to increase in volume of operations, increments during the year, additional insurance cover for employees and revision in Minimum wages.
Finance costs
Our finance costs increased by INR 458.25 million, or by 42.14%, from INR 1,087.36 million in Fiscal Year 2024 to INR 1,545.61 million in Fiscal Year 2025. This increase is primarily due to
increased rate of interest on term loans and bank Overdrafts as compared to previous year and incremental debt taken.
Depreciation and amortisation expense
Our depreciation and amortisation expense increased by INR 369.88 million, or by 21.21%, from INR 1,743.56 million in Fiscal Year 2024 to INR 2,113.44 million in Fiscal Year 2025.
Depreciation on PPE and intangible assets increased by Rs. 237.34 million and right of use assets during current and previous year by Rs. 132.54 million. This includes depreciation of INR 26.82 million attributable to the Vizag acquisition.
Other expenses
Our other expenses increased by INR 1,026.18 million, or by 12.85%, from INR 7,988.74 million in Fiscal Year 2024 to INR 9,014.92 million in Fiscal Year 2025. Increase in other expenses is mainly on account of medical consultancy charges marginal increase is due to higher fixed consultant costs pursuant to investment in new doctors in Mumbai, Kolkata and multi-speciality and in line with increase in revenue and operations, increase in usage of Radiation equipment which is on pay per use basis, expenses towards health camps, hoarding, marketing online and print media, etc have been increased QoQ and trade receivables that are written off during the year .Overall, the other expenses constituted approx. 41% of total revenue for both the Fiscal Years.
Profit / (loss) before tax and exceptional items and share of loss of associate/joint venture
Our profit before tax and exceptional items and share of loss of associate/joint venture was INR 561.93 million in Fiscal Year 2025 as compared to a profit before tax amounting to INR
634.36 million in Fiscal Year 2024, The decrease was primarily due to higher depreciation expenses arising from asset additions through the Vizag acquisition, as well as increased finance costs.
Share of (loss) of equity accounted investees
Share of Profit / (loss) from Joint Venture represents the share from a Joint Venture in Kenya.
Tax expense
We recorded current tax of INR 286.63 million and deferred tax of INR -205.33 million in Fiscal Year 2025 because of which total tax expense for FY 2025 was INR 81.30 million. We recorded current tax of 343.15 million and deferred tax of INR -79.2 million in Fiscal Year 2024 because of which total tax expenses for FY 2024 was INR 263.95 million.
Profit / Loss for the year
Our profit after tax before share of profit of non-controlling interest was INR 488.34 million in Fiscal Year 2025 as compared to a profit of INR 413.34 million in Fiscal Year 2024.
Share of profit/ (loss) of non-controlling interest
Non-controlling interests share of profit was INR 44.24 million in Fiscal year 2025 as compared to a loss of INR -68.21 million in Fiscal year 2024.
Profit/loss for the year attributable to owners of the Company
As a result of the foregoing, our net profit for the year attributable to owners of the Company was INR 444.10 million in Fiscal year 2025 as compared to a net profit attributable to owners of the Company amounting to INR 481.55 million in Fiscal Year 2024.
Assets
| Particulars | As of 31 March | ||||
| 2025 | 2024 | ||||
| Non-current assets | |||||
| (a) Property, plant and equipment | 12,689.18 | 10,146.94 | |||
| (b) Capital work-in-progress | 247.56 | 831.84 | |||
| (c) Right-of-use assets | 6,941.12 | 4,906.61 | |||
| (d) Goodwill | 4,299.50 | 2,229.35 | |||
| (e) Other intangible assets | 489.07 | 298.71 | |||
| (f) investments in equity accounted investee | 43.09 | 33.60 | |||
| (g) Financial assets | |||||
| (i) Investments | 70.03 | 69.65 | |||
| (ii) Other financial assets | 704.69 | 486.15 | |||
| (h) Deferred tax assets (net) | 249.93 | 70.58 | |||
| (i) Other tax assets (net) | 855.38 | 769.69 | |||
| (j) Other non-current assets | 404.84 | 433.34 | |||
| Total non-current assets | 26,994.39 | 20,276.46 | |||
| Particulars | As of 31 March | ||||
| 2025 | 2024 | ||||
| Current assets | |||||
| (a) Inventories | 530.23 | 426.68 | |||
| (b) Financial assets | |||||
| (i) Trade receivables | 4,008.96 | 2,940.26 | |||
| (ii) Cash and cash equivalents | 2,358.71 | 2,726.13 | |||
| (iii) Bank balance other than cash and cash equivalents above | 1,118.26 | 304.60 | |||
| (iv) Loans | 26.96 | 19.43 | |||
| (v) Other financial assets | 49.84 | 67.80 | |||
| (c) Other current assets | 345.01 | 313.62 | |||
| Total current assets | 8,437.97 | 6,798.52 | |||
| TOTAL ASSETS | 35,432.36 | 27,074.98 | |||
We had property, plant and equipment amounting to INR 12,689.18 million as of March 31, 2025, and INR 10,146.94 million as of March 31, 2024. Our property, plant and equipment assets primarily consist of medical equipment, buildings, land, leasehold improvements, furniture and fixtures and vehicles.
Increase in our property, plant and equipment assets is on account of net additions of INR 3,367.44 million which is offset by depreciation charge of INR 825.20 million during the fiscal year 2025.
Our Capital Work-in-progress, which was INR 831.84 million as of March 31, 2024, has decreased to INR 247.56 million as of 31 March 2025. This reduction is primarily attributable to the capitalisation of assets pertaining to the Ahmedabad Cancer Centre project during the year.
The Right-of use assets increased by INR 2,838.56 million on account of new leases during the year ended March 31, 2025 and, increased by INR 9.73 million due to acquisition through business combination. The Right-of use assets decreased by INR 563.95 million on account of depreciation (net) and further decreased by INR 249.83 million due to termination of lease and foreign currency translation adjustments.
We had goodwill amounting to INR 4,299.50 million as of March 31, 2025, and INR 2,229.35 million as of March 31, 2024. Our goodwill primarily arises from the acquisition of Milann Fertility Centres, the City Cancer Centre in Vijayawada, and the diagnostic business acquired from Strand Life Sciences. Additionally, it includes goodwill resulting from our acquisition of a controlling interest in Suchirayu Health Care Solutions Limited and the Cancer Care Centre in Indore. We had acquired the controlling interest in Vizag Hospital And Cancer Research Centre Private Limited and the goodwill has increased by INR 2,070.14 million during the current fiscal year.
Increase in our other intangible assets from INR 298.71 million as of March 31, 2024 to INR 489.07 million as of March 31, 2025 was mainly on account of additions of INR 290.00 million (relating to Vizag acquisition), additions during the year - INR 24.28 million and amortisation of INR 128.64 million.
Investments in equity accounted investee relate to investment made in Joint Venture - Advanced Molecular Imaging Limited, Kenya. We had non-current investments of INR 43.09 million as of March 31, 2025, and INR 33.60 million as of March 31, 2024.
We had other non-current financial assets of INR 704.69 million as of March 31, 2025, and INR 486.15 million as of March 31, 2024. This primarily comprises of Term Deposits and security deposits.
Our Deferred Tax Assets increased from INR 70.58 million as of March 31, 2024, to INR 249.93 million as of March 31, 2025. Our other tax (income tax) assets increased from INR 769.69 million as of March 31, 2024, to INR 855.38 million as of March 31, 2025, which is primarily on account of Advance tax and Tax Deducted at Source by our customers, net of tax provisions pending assessments and refunds in our holding company and our subsidiaries.
We had other non-current assets amounting to INR 404.84 million and INR 433.34 million as on 31 March 2025 and 2024 respectively. The decrease is primarily attributable to the absence of an advance payment of INR 20.00 million made in the previous year towards the acquisition of a business.
We had inventories of INR 530.23 million and INR 426.68 million as of March 31, 2025, and 2024 respectively. Our net trade receivables increased from INR 2,940.26 million as of March 31, 2024, to INR 4,008.96 million March 31, 2025. Our trade receivables comprise receivables from government payors, corporate bodies, insurers, and patients who pay directly to us.
We had other current financial assets (including Bank balance other than cash and cash equivalents) of INR 1,168.10 million as of March 31, 2025, and INR 372.40 million as of March 31, 2024.
We had other current assets of INR 345.01 million as of March 31, 2025, and INR 313.62 million as of March 31, 2024, which primarily comprised of prepaid expenses, advances to vendors, taxes paid under protest and receivable from revenue authorities.
Liabilities and Indebtedness
Liabilities
The following table sets forth the principal components of our liabilities as at March 31, 2025, and 2024: Liabilities
| Particulars | As of 31 March | |
| 2025 | 2024 | |
| Non-current liabilities | ||
| (a) Financial liabilities | ||
| (i) Borrowings | 6,045.84 | 4,853.01 |
| (ii) Lease liabilities | 7,750.86 | 5,588.16 |
| (iii) Other financial liabilities | 634.00 | - |
| (b) Provisions | 214.34 | 156.62 |
| (c) Deferred tax liabilities (net) | 35.35 | 60.75 |
| (d) Other non-current liabilities | 387.33 | 328.21 |
| Total non-current liabilities | 15,067.72 | 10,986.75 |
| Current liabilities | ||
| (a) Financial Liabilities | ||
| (i) Borrowings | 3,976.47 | 1,874.56 |
| (ii) Lease liabilities | 599.04 | 427.87 |
| (iii) Trade payables | ||
| Total outstanding dues of micro enterprises and small enterprises | 41.38 | 62.12 |
| Total outstanding dues of creditors other than micro enterprises and small enterprises | 3,301.21 | 2,748.53 |
| (iv) Other financial liabilities | 1,959.20 | 1,636.51 |
| (b) Other current liabilities | 366.97 | 482.62 |
| (c) Provisions | 193.54 | 182.86 |
| (d) Current tax liabilities (net) | 26.37 | 21.98 |
| Total current liabilities | 10,464.18 | 7,437.05 |
| Total liabilities | 25,531.90 | 18,423.80 |
A significant portion of our liabilities comprise of non-current borrowings and lease labilities. We had non-current borrowings amounting to INR 6,045.84 million and INR 4,853.01 million as of March 31, 2025, and 2024 respectively. Non-current lease liabilities amounted to INR 7,750.86 million and INR 5,588.16 million as of March 31, 2025, and 2024 respectively.
Other non-current financial liabilities amounting to INR 634.00 million as of 31 March 2025 and INR Nil million as of 31 March 2024.
Our other non-current liabilities primarily comprise of Deferred Government grant of INR 387.33 million as of 31 March 2025 and INR 328.21 million as of 31 March 2024.
We had outstanding trade payables amounting to INR 3,342.59 million and INR 2,810.65 million as of March 31, 2025, and 2024 respectively. This primarily comprised of payables towards purchase of drugs, consumables, various services
including medical consultancy charges, legal and professional fees, housekeeping charges and security charges.
We had other current financial liabilities amounting to INR 1,959.20 million and INR 1,636.51 million as of March 31, 2025, and 2024 respectively. These primarily comprised of liability on put options amounting to INR 1,401.34 million and accrued salaries and benefits amounting to INR 428.09 million.
Our other current liabilities amounted to INR 366.97 million and INR 482.62 million as of March 31, 2025, and 2024 respectively. This primarily comprised of advance from customers amounting to INR 167.58 million and 181.87 million and statutory dues amounting to INR 140.69 million and INR 107.83 million as at March 31, 2025, and 2024 respectively. We also had a contingency provision for custom duty amounting to INR 3.19 million as on March 31, 2025, as against INR 155.84 million as on March 31, 2024.
Liabilities - borrowings
| Particulars | As of 31 March | |
| 2025 | 2024 | |
| Secured loans | ||
| - Term loans from banks | 6,791.84 | 5,320.31 |
| - Term loans from other parties | - | - |
| - Vehicle Loans | - | - |
| - Working capital loans (bank overdraft) | 2,829.34 | 1,065.95 |
| Total secured loans | 9,621.18 | 6,386.26 |
| Unsecured loans | ||
| - Deferred payment liabilities | 288.16 | 303.34 |
| - From Other parties | 112.97 | 37.97 |
| Total unsecured loans | 401.13 | 341.31 |
| Total borrowings | 10,022.31 | 6,727.57 |
To fund our working capital and capital expenditure requirements, we have entered into various loans and facility agreements with various financial institutions. All our indebtedness outstanding as of March 31, 2025, was denominated in Indian Rupees except for INR 214.34 million (US$ and Euro denominated loans) outstanding loans taken from various equipment vendors and Working capital and term loan taken in Kenya.
Summary of cash flow statement:
| Particulars | For the fiscal year ended | |
| 31-Mar-25 | 31-Mar-24 | |
| Net cash generated from operating activities | 3,171.09 | 2,845.79 |
| Net cash generated from / (used in) investing activities | (4,877.52) | (2,257.27) |
| Net cash (used in) financing activities | (424.38) | (640.16) |
| Net cash flows generated for the year | (2,130.81) | (51.64) |
Cash generated from operating activities
For the fiscal year ended March 31, 2025, we had profit before tax of INR 569.64 million and our operating profit before working capital changes was INR 4,254.87 million. Our cash generated from operations after adjusting for changes in working capital was INR 3,489.91 million.
After adjusting for changes in working capital and net income taxes paid amounting to INR 318.82 million, our net cashflow generated from operating activities was INR 3,171.09 million for the fiscal year ended in March 2025.
Cash used in investing activities
For the fiscal year ended March 31, 2025, our net cash outflow in investing activities was INR 4,877.52 million, mainly relating to acquisition of property, plant and equipment aggregating INR 2,088.67 million. Substantial additions to these relate to plant and medical equipment.
Cash used in financing activities
For the fiscal year ended March 31, 2025, our net cash outflow in financing activities was INR 424.38 million. This includes repayment of lease liabilities and interest thereon aggregating to INR 1,081.59 million and proceeds from long term borrowings, net of repayment of borrowing and interest thereon, aggregating to INR 683.61 million.
| Particulars | For the fiscal year ended March 31 | ||||
| 2025 | 2024 | ||||
| Ratio Leverage | |||||
| Debt/Equity | 1.09 | 0.81 | |||
| EBIDTA/interest * | 2.74 | 3.19 | |||
| Ratio Profitability | |||||
| Operating Profit Margin % ** | 18.60% | 17.96% | |||
| Net Profit Margin% | 1.97% | 2.50% | |||
| Return on equity % | 5.08% | 5.70% | |||
| RoCE % | 7.66% | 8.40% | |||
| Return on Net Worth | 5.3% | 4.9% | |||
| Particulars | For the fiscal year ended March 31 | ||||
| 2025 | 2024 | ||||
| Ratios Operations | |||||
| Inventory Turnover Ratio | 12.13 | 11.70 | |||
| Current Ratio | 0.81 | 0.90 | |||
| Ratio - Per Share | |||||
| EPS | 3.14 | 3.43 | |||
| P/E*** | 169.94 | 98.22 | |||
| Market Capitalisation/Total Revenue *** | 3.35 | 2.43 | |||
*EBITDA includes other income
**Operating profits includes other income and income from govt. grants ***Based on closing share price as on 28 March 2025 on NSE
Notes to key ratio:
(i) Return on Equity: PAT/Average Shareholders Equity
(ii) RoCE: EBIT/Capital Employed
(iii) Inventory Turnover Ratio: COGS/ Average Inventory (of FY 25 and FY 24)
(iv) Current Ratio: Current Assets/ Current Liabilities
(v) EPS: PAT post minority interest/ Nos. of diluted shares outstanding
(vi) P/E: Closing share price as on 31 March 2025, on NSE/EPS
(vii) EBIDTA/Interest: Interest includes Interests on lease liability.
(viii) Net profit margin: Profit / (loss) for the year/ Revenue from operations,
(ix) Return on Net Worth: PAT/Average Total Equity
The Return on Net worth is in line with last year.
Please refer to Note 49 of standalone financial statements for other relevant ratios and explanatory notes.
Disclosure of Accounting Treatment
The financial statements of the Company have been prepared in accordance with the Indian Accounting Standards (Ind- AS) notified under the Companies (Indian Accounting Standards) Rules, 2015 and Companies (Indian Accounting Standards) (Amendment) Rules, 2016 read with Section 133 of the Companies Act, 2013.
Credit Rating
The long-term credit rating of HCG for FY 25 is retained at A (+) by ICRA. (Associate of Moodys Investors services) A Rating for Instruments signifies adequate degree of safety regarding timely servicing of financial obligations. The outlook on the longterm rating is Stable.
Internal Control System and Their Adequacy
At HCG, management has the overall responsibility to design, implement and monitor an effective process and control environment that is aligned to the inherent risk profile of the organization. Management is responsible for the identification, evaluation and management of significant risks. The Company
has institutionalized a framework to focus on key risks that might impact achievement of business objectives. The framework entails a structured process to identify, assess and monitor the risks and initiate suitable mitigation strategies for effective risk management. The Board monitors exposure to these risks with the assistance of various committees and senior management.
The internal control framework is designed to manage and mitigate the risks faced by the Company. The company has designed and implemented an entity level control framework setting the control philosophy and principles which guide the organization policy and operating process framework.
The organizational role, responsibility and accountability structures with appropriate performance oversight processes are defined and aligned to provide an enabling environment to the business units and functions to operate as per the design control environment. Review and oversight procedures are designed to monitor effective adherence as per design.
The internal control system commensurate with the nature of business, size and complexity of operations and has been designed to provide reasonable assurance on the achievement of objectives in effectiveness and efficiency of operations, reliability of financial reporting and compliance with applicable laws and regulations.
As a part of overall governance mechanism around financial reporting and as stipulated under the Companies Act, 2013, Internal Controls over Financial Reporting (ICoFR) framework have been institutionalized. The adequacy and operating effectiveness of the internal controls affecting financial reporting is assessed by the management.
The internal control framework is supplemented with an internal audit program that provides an independent view of the efficacy and effectiveness of the process and control environment and supports a continuous improvement program. The internal audit program is managed by an Internal Audit function with direct reporting to the Audit and Risk Management Committee of the Board.
The scope and authority of the Internal Audit Function is derived from the Audit Charter approved by the Audit Committee of the Board. The Internal Audit function develops an internal audit plan to assess control design and operating effectiveness, as per the risk assessment methodology
The Internal Audit function provides assurance to the Board and management that a system of internal control is designed and deployed to manage key business risks and is operating effectively
Management provides action plans to address the observations noted from the internal audit reviews and action plans are monitored towards resolution under the supervision and guidance of the Audit Committee.
The Audit Committee reviews the adequacy and effectiveness of the Companys internal control environment and monitors the implementation of internal audit observations
Enterprise Risk Management
HCG operates in a business environment that is characterized by increasing competition and market uncertainties. It is exposed to a number of risks in ordinary course of business. This is inevitable, as there can be no entrepreneurial activity without the acceptance of risks and associated profit opportunities.
Accordingly, risk management activities at HCG are not aimed at eliminating all risks in their entirety, but rather at helping to identify and assess the risks the company encounters in its daily business. This allows the company to manage the risks in an efficient manner to take informed decisions, to exploit the opportunities available and thereby enhance the value of the company and its stake holders.
Risk Management Framework:
The Risk Management framework has been developed and approved by senior management in accordance with the business strategy.
The key elements of the framework include Risk Strategy, Risk Structure, Risk Portfolio, Risk Measuring & Monitoring and Risk Optimizing. The implementation of the framework is supported through criteria for risk assessment and categorization, risk escalation matrix, Risk forms & MIS.
The overall objective of risk management process is to optimize the risk-reward relationship.
Risk Categorization:
Risk Categorization into different buckets help to prioritize risks, within an entity. It assists management in ensuring that they have captured all categories of organizational risks, not just traditional, financial hazards.
The Risk Management Committee of the Board considers a number of factors for risk categorization during risk identification and assessment.
Risk Measuring and Monitoring
A risk review involves the re- examination of all risks recorded on the risk assessment repository to ensure that the current assessments remain valid and review the progress of risk reduction actions.
Risk Communication and Escalation need to be embedded in the culture of an organization to make it effective. At HCG, the Board of Directors drive the Risk Management Process through its Risk Management Committee by adopting the following communication and escalation procedure: Employees continuously identify needs to update / modify the risks and escalate them to their respective Unit / Functional Head.
The respective Unit/ Functional Head or designated personnel collate the identified risks/ modifications and forward the same to the respective Risk Coordinator for collation and escalation to Risk Management Committee. Standard forms for identification/ modification/ deletion of risks are used for this purpose.
The Risk Coordinator collates the risks and forwards the same to the Risk Management Committee on a periodic basis. The Risk Management and Steering Committee (RMSC) is responsible for reviewing and validating the risks/ modifications for all departments. The RMSC categorizes and rates the risks (using the risk appetite). Risk Owners for each risk are identified and approved by RMSC.
Risk Owners may be at any level in the organization depending on the nature and categorization (e.g. strategic, operational, compliance or reporting) of the risk.
Designated Risk Coordinator updates the Risk Assessment Repository on the basis of the approvals obtained from the RMSC.
RSMC, through the Chief Risk Officer, provides half yearly updates to the Chairman & Board of Directors for key risks, their assessment and status of action plans for mitigating these risks.
The escalation of key risk information will assist in ensuring that significant risks identified at the line level are available for consideration in the context of the overall operations of the business.
Risk Management Organization
A robust organizational structure for managing and reporting risks is a prerequisite for an effective risk management process. The organization structure needs to be supported by clearly defined non - overlapping roles and responsibilities which are communicated and understood.
In order to ensure that this policy is followed in letter and spirit, a Risk Management and Steering Committee (RMSC) is constituted comprising of Key personnel nominated from the following departments:
?€? Operations
?€? Finance
?€? Compliance
?€? Legal
?€? Procurement & Pharmacy
?€? IT
?€? HR
?€? Quality Control and Audit
Monitoring the quality of our patient care is one of our prominent focuses. We take action to identify and eliminate the recurrence of any expected or adverse incidents. As part of that, we embrace patient feedback, self-examination and peer review. We use these benchmarks to help us deliver high quality patient care in a safe environment and look at ways to continually improve our patient experience.
We review and publish our inpatient services performance against a number of important measures including hygiene, infection rate and patient satisfaction. We use these benchmarks to help us deliver high quality patient care in a safe environment and look at ways to continually improve our patient experience.
We are subject to various internal and external audits, incident reporting and feedback monitoring processes. Internal audits are carried out by members of our staff at each cancer centre on a half-yearly basis. Our internal audits are based on standard requirements set out by NABH and may impose corrective and preventive actions, as necessary, for any non-compliance with such requirements. The quality department of each cancer centre reviews all feedback received from patients daily and takes measures to appropriately address such feedback. Incident reports are collected and analysed by the quality departments weekly and appropriate remedial measures are undertaken.
External audits are carried out by NABH at our centre of excellence in Bengaluru and at HMS. External audits by NABL and CAP had been carried out at Triesta central reference laboratory. External audits by NABH, NABL and CAP are based on the standards set out by these bodies and are voluntary. The external accrediting bodies also set out certain quality standards, which are monitored by our internal quality departments and a monthly report of quality indicators is presented to our corporate quality team, which oversees the quality functions of our Company. Further, our internal quality teams document the policies and procedures mandated by the accrediting bodies. The accrediting bodies verify these policies and procedures. Our corporate quality team also develops specific quality indicators to monitor clinical outcomes based on documented clinical procedures.
In addition to the above, HCG has also developed case specific clinical protocols for the majority of the oncology cases that we see in the HCG Network. This standardization has helped
us in achieving optimum level of care in all units without having to compromise.
Each cancer centre also has other committees which are responsible for quality control, such as hospital infection control committees, pharmacy and therapeutics committees, employee grievances committees and ethics committees.
From time to time, AERB also conducts audits at our cancer centres relating to quality assurance of radiation equipment, radiation safety measures taken by our cancer centres, any changes in the representations made by our cancer centres while obtaining the AERB approval and the adequacy of the skills and number of manpower and resources at each cancer centre.
We also have a quality management system structured as per the ISO9001:2008 guidelines for quality management systems across our Milann fertility centres. The key quality assurance practices at our Milann fertility centres include standardised treatment and management protocols, service delivery by experts in reproductive medicine, globally accepted medical equipment, regular calibration and maintenance of key equipment, quality control processes such as standardised processes for tests and audits.
Our Milann fertility centres undertake weekly clinical audits aimed at enhancing clinical outcomes, patient safety and care. The clinical audit process reviews and evaluates medical management in line with clinical and scientific best practice standards, clinical success rates, possible causes and courses of action for unsuccessful outcomes, quality metrics for clinical, embryology and laboratory outcomes and policies and action plans for continuous quality improvement.
Employee surveys are carried out twice a year by the human resource departments of each cancer centre and the results of such surveys are shared with the quality departments and the management team of each cancer centre for remedial measures.
Clinical Excellence
Clinical excellence is the core premise around which our healthcare operations are structured. Our Group continues to deliver the highest standards of clinical outcomes across all our business verticals. Our standardised clinical protocols for diagnosis and treatment of cancer patients have allowed us to manage the large volume of patient cases across our HCG network with successful clinical outcomes. The five-year survival rate for breast cancer patients at our HCG network is comparable to U.S. benchmarks. We believe that we are able to attract and retain highly skilled specialist physicians due to our reputation for clinical excellence, our technology-focused approach, the exposure and experience we provide in relation to clinical best practices and the training programmes we offer for their ongoing development. We believe that the abilities and expertise of our team of specialist physicians differentiate us relative to our competitors.
Department of Clinical excellence at HCG has been instrumental in synergizing the clinical functions at all HCG hospitals. This department under quality and strategy aims to improve the quality of clinical care and usher in uniform standards
of care across all HCG centres. This has been facilitated through a systematic change in people, process, and function. Credentialing and privileging have been synergized with the functions and quality indicators of each department thereby ushering a sense of accountability. Identifying training needs and skill development has ensured improvement at the people level. At the process level upgradation of medical record departments, registry, implementation of uniform documentation practices across centres, clinical audits and deficiency monitoring has helped set high standards of clinical practice. Mapping our own clinical outcomes and constantly evolving HCG treatment guidelines has paved way for standardization of clinical pathways and improvement in the functioning of the departments. Research leveraged with genomics has ushered in an era of precision medicine at HCG. Biorepository specimens and the accompanying clinical repository is a treasure trove for novel drug targets and discovery. The department of clinical excellence strives towards an improvement in clinical care and health of the patients transcending beyond oncology. The vision is to make peoples lives better than what they had before a cancer diagnosis using caring hands, clinical expertise, and high-end technology.
The Department of Clinical Excellence facilitates:
?€? Implementation of Uniform documentation standards
?€? Implementation of Uniform treatment protocols and clinical pathways
?€? Centralized Cancer registry
?€? Centralized Biorepository
?€? R&D activities and Investigator
?€? Centralized Clinical repository
?€? Initiated Trials
?€? Documentation of outcomes
?€? Development of clinical audit standards across departments
?€? Developments of clinical forms
Human Resources
The Human Resources (HR) department at HCG is driven by the mission to help HCGians realize their potential - to develop, grow and achieve their purpose, build the right culture and capabilities to enable us to serve our patients and to make HCG the best place to work for passionate, innovative people who want to make a difference. As on March 31, 2025, the number of people employed are 6,736 (Permanent).
We believe that we are able to attract and retain highly skilled specialist physicians due to our reputation for clinical excellence, our technology - focused approach, the exposure and experience we provide in relation to clinical best practices and the training programmes we offer for their ongoing development. We believe that the abilities and expertise of our team of specialist physicians differentiate us relative to our competitors. Several of our specialist physicians have received accolades and awards in recognition of their contribution to their respective fields of medicine.
Our senior management team has extensive experience in the management of healthcare businesses. We believe the experience, depth and diversity of our management team, complemented by the clinical expertise and relationship base of our physician Promoter, is a distinct competitive advantage in the complex and rapidly evolving healthcare industry in which we operate.
In order to maintain the quality of care we offer to our patients; our physicians and other medical staff must pursue a rigorous programme of continuing education. We offer a wide range of health education sessions and seminars on-site at our centres and hospitals to our physicians and medical staff, as well as to healthcare professionals outside our network of centres and hospitals. The sessions are led by expert physicians and other healthcare professionals from our network of centres and hospitals, who have first- hand knowledge of the latest clinical developments and research. We believe that these sessions provide an important forum to discuss recent developments to improve patient care and teach our physicians and medical staff new skills. In addition, we believe that they also provide an important opportunity for us to showcase the capabilities of our centres, hospitals and physicians and allow our physicians to grow their referral networks.
We also offer physicians the opportunity to consult with each other on challenging cases and treatments. For example, at our weekly tumour board discussions, we discuss selected complex cases from across our HCG network. This allows knowledge sharing and enables us to develop best practices and protocols which are implemented across our HCG network. We also evaluate the clinical activities of each centre and hospital as part of our annual evaluations to ensure that high quality treatments or services are provided to patients.
Furthermore, we have a dedicated learning and development department, which continuously monitors the learning and development activities and ensures that a high quality of service is provided to our patients, thereby improving patient satisfaction. Our learning and development department provides continuing education for quality improvement to our employees. It identifies areas in which training is required, and develops an employee development plan for each employee, pursuant to which employees are provided various skill enhancement trainings.
At our centre of excellence in Bengaluru, we offer a Diplomate of National Board medical residency programme for radiation oncology, medical oncology and pathology, in affiliation with the National Board of Examination.
In addition, we offer various certificate medical and nursing courses on oncology, a paramedical course on advanced radiotherapy technology, a laboratory research course and various other medical and non-medical courses for our employees.
Our Milann fertility centres also offer a post-graduate fellowship programme in reproductive medicine services to fertility specialists, in affiliation with the National Board of Examination. Additionally, our Milann fertility centres offer training programmes in IVF for fertility specialists and embryologists.
We believe that these education and training programmes are critical capabilities that we have and these enable us to develop an in house trained team of specialist physicians.
Forward Looking Statement
Except for the historical information contained herein, statements in this discussion contain/contains certain "forwardlooking statements". These forward-looking statements generally can be identified by words or phrases such as "aim", "anticipate", "believe", "expect", "estimate", "intend", "objective", "plan", "project", "will", "will continue", "will pursue" or other words or phrases of similar import. Similarly, statements that
describe our Companys strategies, objectives, plans or goals are also forward-looking statements. These forward-looking statements involve a number of risks, uncertainties and other factors that could cause actual results to differ materially from those suggested by the forward-looking statements. These risks and uncertainties include, but are not limited to, our ability to successfully implement our strategy, future business plans, our growth and expansion in business, the impact of any acquisitions, our financial capabilities, technological implementation and changes, the actual growth in demand for our services, cash flow projections, our exposure to market risks as well as other general risks applicable to the business or industry.
The Company undertakes no obligation to update forward looking statements to reflect events or circumstances after the date thereof. These discussions and analysis should be read in conjunction with the Companys financial Statements included herein and the notes thereto.
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