Shalby Ltd Management Discussions

In 2024, the global economy grew by 3.3%, with advanced economies expanding modestly (1.7%) amid tight financial conditions, while EMDEs grew faster (4.2%), driven by domestic demand. However, income gaps and development challenges persisted.

Global trade grew by 3.4% but faced renewed volatility due to rising protectionism, tariff hikes, and regulatory fragmentation, which weakened trade fundamentals and impacted export-reliant nations.

FDI into EMDEs remained subdued- less than half its 2008 peak- due to geopolitical tensions, currency instability, and investor risk aversion, which slowed infrastructure and productivity gains.

Inflation averaged 2.9% in 2024, with sticky services inflation. Energy and commodity prices fell, straining fiscal balances in commodity-exporting economies.

Outlook

Global growth is expected to slow to 2.8% in 2025 and recover slightly to 3.0% in 2026. Trade growth will remain weak, and risks from policy uncertainty, conflict, and climate shocks persist. Structural reforms and global cooperation will be key to resilience and inclusive growth.

India emerged as the fastest-growing major economy in FY 2024-25, with real GDP expanding by 6.5%. Growth was broad-based, driven by strong momentum in both the manufacturing and services sectors. Industrial output benefited from rising private capital

Inflation and Price Stability:

Inflationary pressures eased significantly during the year. Headline CPI inflation dropped to 2.82% in May 2025, the lowest level recorded since February 2019. The decline was led by lower food inflation, normalisation of supply chains, and stable energy prices. Core inflation also moderated, reflecting softening input costs and well-anchored inflation expectations. The Reserve Bank of India maintained a balanced policy stance, keeping interest rates steady while ensuring adequate liquidity in the financial system. The moderation in inflation created room for household spending to recover and supported consumer confidence.

expenditure and improving capacity utilisation, while services were buoyed by double-digit growth in finance, real estate, hospitality- and communication. Domestic consumption remained resilient, supported by rural demand recovery, stable employment, and targeted

Trade and Current Account Performance:

Indias external sector delivered a strong performance in FY 2024-25. Total exports reached a record high of USD 824.9 billion, driven by robust demand for IT services, pharmaceuticals, electronics, and engineered goods. Services exports remained resilient amid global uncertainties, and Indias export diversification strategy paid dividends. On the import side, stable oil prices and moderated gold demand helped contain the trade deficit. As a result, India recorded a current account deficit of just 0.6% of GDP, and a surplus of USD 13.5 billion in Q4 FY25- the first such surplus since Q4 FY21. This improvement strengthened the countrys external position and provided further stability to the rupee.

government spending. Infrastructure investment by both the public and private sectors played a catalytic role in sustaining this momentum, while improved tax buoyancy supported fiscal consolidation efforts without compromising growth.

Foreign Investment & External Resilience:

Foreign investor sentiment remained strong during the year. Foreign Direct Investment (FDI) inflows rose by 14%, touching USD 81 billion, led by increased interest in manufacturing, renewable energy, and digital infrastructure. Indias continued structural reforms, improved ease of doing business, and geopolitical positioning as a China-plus-one alternative attracted significant long-term capital. Foreign exchange reserves rose to USD 697.9 billion, offering over 11 months of import cover and acting as a robust buffer against external shocks. The strength of the external account enabled India to navigate global financial volatility with resilience.

Outlook

India is expected to maintain its growth momentum in FY 2025-26, with the Reserve Bank of India projecting real GDP growth at 6.5%. The macroeconomic environment is likely to remain stable, supported by continued infrastructure spending, higher private investment, and strengthening global investor interest. Inflation is expected to stay within the RBIs medium-term target of 4%, as food supply conditions remain favourable and global commodity prices stay benign. The ongoing rollout of Production Linked Incentive (PLI) schemes, digital public infrastructure, and logistics reforms under the PM

Gati Shakti plan will further boost manufacturing competitiveness. While global headwinds- such as geopolitical tensions and trade fragmentation- may create short-term volatility, Indias fundamentals remain sound, positioning it for sustained, broad-based growth in the medium term.

The healthcare sector has evolved into a multi-dimensional industry that goes far beyond conventional hospital care. It encompasses a wide spectrum of services aimed at maintaining health, treating disease, and enhancing overall well-being. Broadly, the sector can be categorised into two dimensions of classification: l By Nature of Care - Preventive, Curative, Wellness l By Level of Care - Primary, Secondary, Tertiary These pillars represent the continuum of care from early-stage risk reduction to treatment and long-term health optimisation, and together define the emerging patient-centred model of modern healthcare.

As populations age, chronic diseases rise, and health awareness deepens, each of these divisions is expanding rapidly. Preventive healthcare is gaining importance through diagnostics, vaccinations and screenings; curative services remain core through hospitals and surgical interventions; and wellness is now a high-growth domain driven by self-care, fitness and mental health solutions.

I. Classification by Nature of Care

Modern healthcare is not limited to treating illnesses and focuses on the entire continuum of health, from prevention to recovery to long-term well-being. This dimension is categorised into three primary divisions:

Division	Focus area	Key components	Growth drivers
Preventive	Early detection and risk mitigation	Immunizations, routine check-ups, diagnostics, health screenings, genetic testing	Rising health awareness, wearable tech adoption, lifestyle disease burden
Curative	Diagnosis and treatment of illness or injury	Hospitals, surgical procedures, specialist clinics, acute and chronic disease management	Hospital infrastructure growth, medical technology, insurance penetration
Wellness	Holistic well-being and quality of life enhancement	Fitness, nutrition, mental health, lifestyle therapies, alternative medicine, anti- aging care	Aging population, mental health prioritization, consumer shift toward self-care

ll. Classification by Level of Care

Healthcare delivery is also categorized by the complexity and specialization of services provided, commonly segmented into Primary, Secondary and Tertiary levels of care.

Level of care	Scope & Objective	Providers	Typical services
Primary care	First point of contact; basic diagnosis, preventive advice and general treatment	General physicians, family doctors, PHCs	General consultations, vaccinations, maternal and child health, minor ailments
Secondary care	Intermediate care requiring specialist intervention	District hospitals, speciality clinics	Diagnostic tests, specialist consultations, non-complex surgeries, chronic care
Tertiary care	Advanced and highly specialized care	Multi-speciality hospitals, medical colleges	Critical care, advanced surgeries (e.g, neuro, ortho), transplants, ICU services

In 2024, healthcare systems faced rising costs, labour shortages, and growing demand for high-quality, patient-centric care. Cost containment and productivity were top priorities amid ageing populations and chronic disease burdens. Health systems accelerated investment in virtual care, AI, and automation to reduce costs and improve access.

Nearly 90% of leaders expect tech adoption to drive efficiency, aligning with strong consumer demand for digital health solutions. Spending is shifting from hospital infrastructure to asset-light digital platforms. Consumers increasingly invest in wellness products, tech-enabled tools, and preventive care, reshaping the healthcare value chain.

Transparency, data security, and regulatory compliance are now critical.

Consumers demand credible health claims, while institutions must strengthen governance to protect digital value creation.

Outlook

Healthcare is moving toward scalable, value-based, hybrid models. Systems that combine tech-driven efficiency with consumer trust are best positioned for sustainable, demand-led growth.

Indias healthcare sector maintained its strong growth momentum in FY25, reaching an estimated market value of US$638 billion. As one of the countrys most employment-intensive sectors, healthcare continues to support a workforce of over 7.5 million people, with growing demand for skilled professionals across clinical and non-clinical roles. The sectors resilience and scale underscore its critical role not only in national health security but also as a contributor to employment and economic development.

Capital Inflows & Investment Activity

The investment landscape remained buoyant in FY25, with private equity and venture capital inflows surpassing US$1 billion in the early part of the year, reflecting more than 220% growth over the previous period. Foreign Direct Investment (FDI) into key verticals such as pharmaceuticals, hospitals and diagnostics continued to accumulate steadily, crossing US$38 billion since April 2000. Strategic alliances, including hospital consolidations, technology investments, and diagnostic expansions, reflect rising investor confidence in the sectors long-term fundamentals.

Digital Health & Technology Adoption

Indias healthcare sector deepened its integration with digital solutions during FY25. The telemedicine market is estimated to reach US$ 5.4 billion, while the e-health sector has grown to approximately US$ 10.6 billion, driven by rising consumer demand for remote care, wellness tracking and AI-supported diagnostics. This transformation has also spurred job creation, with an estimated 2.7 to 3.5 million new tech-oriented healthcare roles expected to emerge, reflecting the sectors shift toward technology-led scalability and efficiency.

Workforce Expansion & Skilling Needs

Despite India achieving a doctor-to-population ratio of 1:854, the sector continues to face disparities in human resources. Nurse density remains relatively low at 1.7 per 1,000 people, highlighting the need for accelerated training and equitable distribution of healthcare workers. By CY30, the healthcare workforce is projected to expand by another 6.3 million, with targeted interventions required to meet rural and semi-urban demand.

Medical Tourism & International Demand

India reinforced its global standing in medical value travel during FY25, with the medical tourism market valued at US$7.69 billion. More than 634,000 international patients visited India for treatment, drawn by its clinical outcomes, advanced tertiary care and affordability. The sector is projected to grow to US$14.3 billion by 2029, with strong demand for orthopaedic, cardiac and oncology procedures offered by leading players.

Government Spending & Policy Support

The Union Budget 2025-26 allocated H99,858 crore (US$11.5 billion) to the healthcare sector- a 9.78% increase over the previous year. Key initiatives included a 28.8% rise in PMJAY funding, broader rollout of Tele MANAS mental health services, and enhanced support for MedTech innovation through platforms like MedTech Mitra. These policies reinforce the governments aim to elevate public health spending to 2.5% of GDP and make India a global healthcare hub.

Outlook

Looking ahead, Indias healthcare industry is poised for sustained expansion, driven by demographic shifts, income growth, and rising health consciousness. The next growth phase will be defined by technology integration, preventive care, and tier-2/3 city penetration. Providers with a blend of clinical excellence and digital adaptability stand to benefit from this transformation by aligning their strategy with emerging patient preferences and infrastructure trends.

THE HOSPITAL SECTOR

A hospital may be defined as a structured healthcare institution designed to provide comprehensive medical care, ranging from diagnosis and treatment to surgery, emergency response and rehabilitation. Unlike clinics or primary care setups, hospitals are equipped to manage both routine medical needs and complex, multi-disciplinary cases under one roof.

Level of Care	Definition	Key Services Offered
Secondary care	Hospitals that handle referrals from primary care providers; manage common illnesses requiring specialist care	General surgery, orthopaedics, gynaecology, basic diagnostics, short-term hospitalisation
Tertiary care	Advanced referral hospitals equipped with speciality and super-speciality services	Cardiology, oncology, neurology, nephrology, advanced imaging, ICU, critical care, organ transplant units
Quaternary care	Ultra-specialized centres focused on experimental medicine and advanced research	Rare surgeries, cutting-edge therapies, experimental treatments, clinical trials

In FY25, leading hospital chains posted robust financial results, with revenue growth of 12-14% and operating margins around 22–23%, as reported by ICRA. Average Revenue Per Occupied Bed (ARPOB) rose by 4-6%, supported by strong occupancy and favourable case mix.

Capacity Expansion & Infrastructure Additions

Hospital networks added around 4,000 beds in FY25, with a further 3,400 beds planned for FY26- a 23% capacity increase since FY24. Despite growth, bed density remains low (~1.6 beds per 1,000 population), especially outside metro areas, prompting continued expansion through private investment and PPPs.

infrastructure and support services, reached around US$8.2 trillion, with growth supported by ageing populations, chronic disease prevalence and expanded health insurance coverage.

Outlook

The sector is expected to grow steadily, reaching US$5.71 trillion by 2030 at a CAGR of 4.4%, with

Private Investment & Consolidation Dynamics

The hospital sector saw strong investor interest in FY25, with PE backing expansion into hospitals and med-tech. Major groups and hospital chains accelerated rollouts in Tier 2/3 markets. Single-speciality facilities are also booming, with their market size expected to more than double (~US$31 billion) in the coming years.

Technology Adoption & Efficiency Gains

Digital transformation advanced with hospitals integrating AI-driven workflows, smart diagnostics, and telehealth. ICRA highlighted that such tech investments are key to managing rising staff and compliance costs. For example, Apollo Hospitals is deploying AI to alleviate clinician workload.

the smart hospital segment alone projected to touch US$148 billion by 2029. Hospital systems will increasingly adopt hybrid care models, AI integration and value-based frameworks to manage costs and workforce constraints while enhancing care delivery.

Medical Tourism & International Influx

Indias medical tourism market strengthened in FY25, with global patient volumes up ~33% in CY23, totalling nearly 2 million. International hospital revenue reached approximately US$10 billion, projected to grow to US$13 billion by 2026, especially in specialities like orthopaedics, cardiology, and oncology.

Outlook

Looking ahead to FY26, the Indian hospital sector is positioned for sustained growth, characterised by ongoing capacity addition, digital care models, private investment and international patient flows. Providers combining scale, technology, and patient-centric infrastructure are well placed to benefit from evolving healthcare dynamics.

In 2024, the global arthroplasty market, including hip, knee, shoulder, and other joint replacements, was valued at approximately US$23.5 billion. Knee replacements accounted for the largest share (around 40-44%), followed by hip replacements. The market is expected to grow at a CAGR of 4.7-4.8%, reaching over US$31 billion by 2030. Growth is driven by the rising prevalence of osteoarthritis, ageing populations, and increased adoption of advanced implants and minimally invasive surgical techniques.

India is emerging as one of the most promising arthroplasty markets in Asia, driven by a rapidly ageing population, growing incidence of osteoarthritis, and improving access to elective surgeries. In 2024, Indias knee replacement market was estimated at US$686 million, with projections to surpass US$2.1 billion by 2035, growing at a CAGR of over 11%. Key growth drivers include tier-2 and tier-3 hospital expansion, increased insurance coverage under government schemes, and medical tourism.

Clinical Trends & Consensus

The 2024 World Expert Meeting in Arthroplasty convened over 500 surgeons from 92 countries to discuss and vote on evidence-based best practices across 64 key topics. The consensus covered areas such as dual-mobility hip implants, metal hypersensitivity in knee arthroplasty and postoperative discharge timing. The use of the Delphi method and systematic reviews helped establish global clinical benchmarks, encouraging more standardised treatment pathways worldwide.

Market Threats l High implant costs and limited reimbursement slow adoption in low- and middle-income countries l Postoperative risks such as infection, implant loosening, and revision surgeries continue to impact outcomes l Shortage of trained orthopaedic and robotic surgeons limits the scalability of advanced procedures l Regulatory challenges around AI-assisted surgeries and digital planning tools may delay approvals l Lack of long-term clinical data for newer implant materials and technologies raises safety and efficacy concerns l Uneven access to arthroplasty in non-metro areas and low insurance penetration restrict surgical volumes in public and mid-tier private hospitals

Market Opportunities l Robotic-assisted surgeries and AI-guided planning to improve precision and reduce recovery time l Same-day discharge protocols and ambulatory arthroplasty centres to reduce hospital stays and costs l Custom and sensor-enabled implants, which support better fit and postoperative tracking l Expanding demand in Asia-Pacific and other emerging regions, where procedure volumes are growing at double-digit rates l Single-speciality joint replacement centres, which offer scalable and cost-efficient delivery models l Indias cost advantage in joint replacement procedures, combined with its growing medical tourism sector, positions it as a global hub for affordable arthroplasty

The global orthopaedics market was valued at approximately US$60.8 billion in 2024, with expectations to grow to US$75.6 billion by 2030, at a CAGR of ~4.4%. This growth is driven by high surgical volumes in trauma fixation, spinal implants, orthobiologics, and sports medicine- all segments experiencing increased demand due to ageing populations, accident trauma, and the rising incidence of musculoskeletal conditions. North America remains the largest regional market, while Asia-Pacific is showing the fastest growth owing to healthcare infrastructure development and improving surgical access.

India, too, is witnessing a significant surge in orthopaedic procedures, with the market estimated at approximately US$ 2.35 billion in 2024. It is projected to double by 2033, growing at a CAGR of 8%. Key segments include trauma, spine, and joint reconstruction, supported by improving rural healthcare, expanded insurance coverage under Ayushman Bharat and rising awareness of musculoskeletal health. With the second-highest road accident burden globally, trauma-related orthopaedics is a particularly fast-growing vertical.

Clinical Trends & Consensus

Orthopaedics is shifting toward minimally invasive surgeries, biologic augmentation, and robotic integration beyond joint replacement. Global experts and recent consensus meetings in orthopaedic trauma and oncology have emphasised: l Use of navigation-assisted spinal surgeries and image-guided trauma procedures l Orthobiologics (e.g, bone graft substitutes, stem cells) as adjuncts in complex fracture healing l Early mobilization protocols in fracture and spine recovery l Growing acceptance of day-care surgery for soft tissue and sports injuries This reflects a broader movement toward standardized, protocol-based care across subspecialties.

Threats l Uneven access to trauma and spine care, particularly in rural or underserved regions l Limited availability of biologics due to high cost and regulatory constraints l Technical complexity and learning curve for newer technologies (e.g, robotics, navigation tools) l Regulatory fragmentation across geographies for orthopaedic implants and biologics l Data scarcity on long-term outcomes for newer biologic and bioresorbable products l Shortages of trained orthopaedic surgeons in public hospitals and secondary care centres constrain procedural penetration outside metros

Opportunities l Spinal implants and fusion devices are seeing rising demand, especially in degenerative disc and deformity correction markets l Orthobiologics and regenerative therapies (PRP, BMPs, stem cells) offer fast-growing potential in trauma and sports medicine l Trauma care is expanding in high-accident regions, with stronger government funding and infrastructure l Sports injury management is scaling rapidly with growth in athletic populations and early intervention programs l 3D printing, smart implants, and AI offer personalized solutions across orthopaedics- beyond arthroplasty l Indias growing medical tourism and Make-in-India push for orthopaedic devices provide scalable growth opportunities for both domestic and export-focused players

In 2024, the global oncology market was valued at approximately US$242 billion, with projections reaching US$356 billion by 2025. The market is expected to grow at a CAGR of 11-12%, reaching US$674-903 billion by 2034. Growth is driven by the rising global cancer burden, increased screening and diagnostics, and strong demand for immunotherapies and targeted treatments. North America remains the largest market, accounting for about 45-47% of global revenues, followed by Europe and the fast-growing Asia-Pacific region.

Indias oncology market is growing rapidly, supported by increasing cancer incidence, urban lifestyle changes, and improved access to screening and diagnostics. The country recorded over 1.5 million new cancer cases in 2024, with breast, lung, oral, and cervical cancers among the most prevalent. The Indian oncology drugs market was valued at over US$ 1.4 billion in 2024 and is projected to exceed US$ 2.8 billion by 2030, growing at a CAGR of ~10%. Growth is further supported by government programs like Ayushman Bharat and the rollout of more cancer care centres across tier-2 and tier-3 cities.

Clinical Trends & Consensus

The oncology field is undergoing a transformation driven by precision medicine, early diagnostics and AI integration. Key trends include: l Immunotherapy advancements (e.g. CAR-T, checkpoint inhibitors, antibody-drug conjugates) are delivering durable results in hematologic and solid tumours l Liquid biopsy and Minimal Residual Disease (MRD) testing for early relapse detection and monitoring- emerging as standard-of-care in several cancers l AI-driven platforms and digital twins are enhancing clinical decision-making by simulating treatment outcomes l A shift toward less-intensive, risk-adapted treatment regimens in cancers like Hodgkins lymphoma and ovarian cancer, optimising both survival and quality of life

Threats l Escalating treatment costs: Oncology drug spending exceeded US$223 billion in 2023 and is expected to cross US$400 billion by 2028, straining payer systems worldwide l Patent cliffs for key drugs like Keytruda threaten revenue pipelines and require rapid innovation to sustain growth

l Regulatory delays and reimbursement hurdles, especially for complex therapies like gene editing and cell therapies, can limit timely patient access l Long-term efficacy and safety data gaps for many novel therapies and diagnostics raise uncertainty among clinicians and payers l Access disparities persist- only a fraction of rural populations benefit from organised oncology infrastructure or early detection protocols

General & Cosmetics

In 2024, the global cosmetics market was valued at approximately US$ 336 billion, with forecasts indicating growth to US$ 355 billion in 2025. The market is expected to continue expanding at a CAGR of 6.0-6.6% through 2030, driven by rising consumer awareness, growing demand for premium and hybrid products, and digital transformation in the beauty industry. The Asia-Pacific region leads in market share

( 37-45%), with sustained demand from China, India, South Korea and Southeast Asia.

India represents one of the most dynamic and fastest-growing cosmetics markets globally, with its size projected to reach US$ 28-30 billion by 2025, growing at a CAGR of 9-10%. The Indian beauty and personal care sector is being driven by rising disposable incomes, deeper internet and e-commerce penetration, and growing demand for clean, gender-neutral, and Ayurvedic-inspired beauty products. Domestic brands are also scaling up rapidly, with increased VC investment and support for ‘Made-in-India product lines.

Opportunities l Next-gen immunotherapies and ADCs are expanding into previously hard-to-treat solid tumors l MRD and liquid biopsy platforms are reshaping cancer monitoring, offering multi-billion-dollar potential in both diagnosis and therapy personalization l AI and multi-omics tools are being used to match therapies to tumor profiles, predict adverse events, and reduce trial costs

Market Trends l The ongoing "skinification" of cosmetics is blurring the lines between skincare and makeup, with consumers demanding hybrid products that nourish as well as enhance l Biotech-powered beauty- lab-grown actives, microbiome-safe ingredients, and DNA-personalised formulations- is seeing rapid growth, especially in skincare and haircare l Social commerce and digital influence continue to reshape beauty purchasing behaviours, with platforms like TikTok and Instagram driving discovery and virality l Beauty tech such as AI-based skin analysers, virtual try-ons, and smart mirrors is enhancing personalisation and customer engagement, particularly in premium segments

Threats l Macroeconomic volatility may reduce discretionary spending in segments like fragrances and colour cosmetics l The industry faces intense fragmentation and rising competition, particularly from fast-growing indie and influencer-led brands l Regulatory and environmental challenges, including bans on certain ingredients, sustainable packaging mandates, and carbon l Emerging markets are investing in oncology capacity, driven by rising incidence, government policy support, and global access partnerships l De-escalation protocols and outpatient care models are creating new opportunities for value-based oncology services. l Indias oncology sector presents high-growth potential in biosimilars, low-cost chemotherapy generics and private diagnostic centres, especially in tier-2/3 cities

reduction goals, are adding compliance burdens l Consumer scepticism around product claims and green-washing may undermine brand trust, especially in developed markets l In India, regulatory ambiguity on organic and Ayurvedic labelling, along with counterfeit product concerns, pose ongoing consumer trust and safety challenges

Opportunities l Hybrid beauty products that combine skincare, SPF, hydration and pigment (e.g, tinted serums) align with the minimalist and wellness-driven beauty shift l Biotech innovation offers sustainable alternatives to natural resource-heavy actives (e.g, squalane from sugarcane vs. shark liver) l AI and personalisation tools are enabling hyper-customised beauty solutions, boosting both brand loyalty and premium pricing l Strong expansion potential in emerging markets, supported by digital access, local influencer ecosystems, and rising disposable income l Indias beauty-tech startups, Ayurveda-based cosmetics and influencer-driven D2C brands are gaining rapid traction- offering opportunities for localisation, innovation and exports

The global nephrology and urology devices market was valued at US$ 19.4 billion in 2024, with projections to reach US$ 25.96 billion by 2031, indicating a CAGR of ~7.3%. Grand View Research reported a 2022 market size of US$5.57 billion, with expectations to grow to US$9.44 billion by 2030 (CAGR ~6.8%). In Asia-Pacific, revenues grew from US$1.17 billion (2022) to an expected US$2.16 billion by 2030 (CAGR ~8%). North America remains the largest regional market, with ~32% revenue share in 2022.

In India, the nephrology and urology devices market is experiencing strong growth, driven by increasing prevalence of Chronic Kidney Disease (CKD), diabetes, hypertension and rising awareness of early urological intervention. The Indian market was estimated at H5,800 crore (~US$ 700 million) in 2024, and is projected to grow at a CAGR of over 8.5% through 2030. Government investments in dialysis care through schemes like PMNDP, coupled with the growth of private urology centres and diagnostic labs, are fueling demand for stents, PCN catheters and portable dialysis units.

Market Trends l Dialysis devices continue to dominate, projected to reach US$28.9 billion by 2030 (CAGR ~6.2%) l Minimally invasive urological procedures using PCN catheters, ureteral stents and stone retrieval devices are growing fast l Home-based dialysis, portable devices and telehealth integration are gaining traction for chronic kidney disease management l Robotic-assisted urologic surgeries, including lithotripsy and prostate interventions, are expanding globally

Threats l High device costs and irregular reimbursement in emerging countries hinder market penetration l Strict regulatory pathways across regions create long time-to-market delays l Competition from low-cost alternatives (e.g, generic disposables) pressures pricing l Rising prevalence of CKD and age-related urological conditions strains infrastructure and resource availability l Training gaps in emerging markets limit adoption of advanced techniques and technologies l Disparities in public vs. private urology access and regional imbalances in nephrologist availability remain major structural challenges

Opportunities l Asia-Pacific and Latin America offer rich growth potential, with Asia-Pacific projected to grow at 8% CAGR through 2030 l Expansion of home and portable dialysis devices, supporting decentralized care and patient autonomy l Technological advancements: Integration of AI, telehealth, and robotics to enhance precision, reduce complications, and improve access l High-growth segments such as PCN catheters, urology guidewires, and stone baskets offer rapid returns l India presents high-growth potential in localized manufacturing of urology disposables and in scaling affordable dialysis services to tier-2 and tier-3 cities

Homecare encompasses a variety of services: l Medical homecare: Includes skilled nursing, chronic disease management, post-surgical recovery, palliative care, and remote monitoring l Non-medical or supportive care: Assistance with daily activities such as bathing, dressing, medication adherence, mobility, and nutrition l Home diagnostics and therapy: Blood tests, ECGs, physiotherapy, speech therapy, and mental health counseling are increasingly available at home l Technology-enabled homecare: Includes teleconsultations, AI-enabled monitoring devices, digital health platforms, and smart wearables

The sector plays a vital role in: l Reducing hospital readmission rates l Supporting ageing-in-place for elderly patients l Improving chronic disease management outcomes l Alleviating pressure on overburdened healthcare infrastructure The global shift toward value-based care, alongside increasing consumer preference for comfort, safety and convenience, has positioned the homecare sector for sustained expansion across both developed and emerging markets.

In 2024, the global homecare (home healthcare) market- encompassing in-home medical services, remote diagnostics, and assisted living support- was valued between US$416 billion US$ 424 billion, depending on the source. North America led the market with over 42% share, followed by Europe, while Asia Pacific emerged as the fastest-growing region due to ageing populations and healthcare digitisation.

Outlook

The global homecare market is projected to expand at a CAGR of 8-10%, reaching approximately US$503-748 billion by 2030, and potentially US$476-587 billion by 2034. Key growth drivers include: l Widespread adoption of remote patient monitoring and telehealth, with telehealth alone growing at ~24% CAGR l Rising global chronic disease rates (e.g, cardiovascular, diabetes, geriatric care) l Innovations in portable diagnostic devices, smart wearables, and home infusion therapies l Policy supports promoting community-based and value-driven care

Indias homecare sector was valued at approximately US$14 billion in 2024. The growth has been driven by rising demand for post-hospitalisation care, eldercare, chronic disease management and in-home diagnostics. Major urban centres- Delhi NCR, Mumbai, Bengaluru and Hyderabad- currently dominate the formal homecare service market. The home medical equipment segment alone was estimated at around US$861.9 million in 2024, with rising adoption of oxygen concentrators, BP monitors, glucometers and mobility aids.

Outlook

The Indian homecare market is projected to grow at a CAGR of ~16.5%, reaching approximately US$64.4 billion by 2033. Demand will be driven by: l An expanding elderly population (projected to exceed 193 million by 2031) l Rising prevalence of chronic diseases such as diabetes, heart conditions and cancer l Increasing penetration of telehealth and remote patient monitoring technologies l Expanding adoption in tier-2 and tier-3 cities, aided by public-private partnerships and digital infrastructure The home medical equipment segment is expected to grow at ~6.2% CAGR, reaching US$1.38 billion by 2033, propelled by the shift toward decentralised and tech-enabled care delivery.

In 2024, the global medical technology (MedTech) market was valued at approximately US$668.2 billion, reflecting a strong recovery in elective procedures, surgical volumes and outpatient care. The sector continues to expand across diagnostics, implants, surgical instruments and connected care devices, driven by the growing burden of chronic diseases, an ageing population and increased healthcare spending across developed and emerging economies.

The market is projected to reach approximately US$694.7 billion by 2025, with steady momentum driven by growing demand for minimally invasive procedures, remote monitoring and digital health platforms. North America currently holds the largest market share, while the Asia-Pacific region is emerging as the fastest-growing region, owing to the rapid expansion of healthcare infrastructure in countries such as India, China and Indonesia.

Outlook

Looking ahead, the MedTech industry is expected to grow at a CAGR of 6-7%, potentially reaching US$955-1,147 billion by 2030-2034. Segments such as smart implants, wearable medical devices and AI-integrated diagnostics are seeing accelerated adoption. The market for connected medical devices alone is projected to double, from around US$76 billion to US$153 billion by 2030. Driving this growth are key innovations in 3D printing, robotics, surgical navigation, and telehealth integration. Additionally, the rise of value-based healthcare models and greater focus on personalised medicine are encouraging companies to invest in high-precision, patient-centric technologies.

In 2023-24, Indias MedTech industry was valued at about US$12 billion, accounting for just 1.6% of the global market. Key segments include electronic equipment (56%), disposables & consumables (26.5%), in vitro diagnostics (8.1%), implants (7.1%), and surgical instruments (2.3%).The governments ambitious target is to increase Indias global market share to 10-12% within 25 years, placing a spotlight on this transformation. Concurrently, the domestic medical device market was estimated at US$18 billion in 2024 and is expected to reach US$30.6 billion by 2033, growing at a CAGR of ~6.1%.

Indias import dependency remains substantial-imports totalled about US$8.2 billion in 2023-24, whereas exports were US$3.8 billion. However, under government initiatives like the PLI scheme, Medical Device Parks, and regulatory reforms, localisation efforts are being greatly intensified to build domestic manufacturing capacity.

Outlook

Looking ahead to 2030, the MedTech market in India is projected to grow to US$50 billion, with an anticipated CAGR of around 15%. Growth is expected to be particularly strong in diagnostics, implantables, wearables, and drug-delivery devices; the latter alone is estimated at US$6.9 billion in 2025, expanding to US$11.6 billion by 2030.Several macro and systemic trends underpin this outlook: a rapidly ageing population, a surge in chronic conditions like diabetes and cardiac disease, and increased healthcare infrastructure and insurance penetration. Additionally, foreign investment is rising, with global majors like GE Healthcare, Medtronic, Siemens and Omron setting up manufacturing and R&D hubs in India, leveraging the PLI scheme and tapping into regional supply potential.

Operational Highlights
Particulars	FY 2024-25	FY 2023-24
Bed capacity (Nos.)	2300+	2350+
Operational beds (Nos.)	1415	1390
Average Length of Stay (Days)	3.65	3.83
Occupancy (Beds)	659	633
In-patient Count (Nos.)	90,270	85,363
Out-patient Count (Nos.)	5,40,119	4,85,897

Key Financial Ratios

Ratios	Unit	FY 2024-25	FY 2023-24	%Change	Reason for variance above 25%
(Consolidated)					y-o-y
Debtors Turnover	Times	4.71	5.23	-9.92%	-
Total Debt/Equity Ratio	Times	0.09	0.11	-15.02%	-
Current Ratio	Times	3.89	3.99	-2.66%	-
Inventory Turnover	Times	12.8	12.6	1.58%	-
Net Profit Margin	%	9.6	12.52	-23.29%	-
Return on Equity	%	7.63	10.22	-25.32%	Due to decrease in net profit and increase in operating expense which mainly includes doctors payout.
Return on Capital Employed	%	10.97	12.94	-15.18%	-

INTERNAL CONTROLS

The Company has implemented a robust internal financial control framework across all key operational and reporting areas to ensure accuracy, compliance and transparency. In FY 2024–25, internal controls over financial reporting were designed and evaluated in line with the criteria outlined in the

Guidance Note on Audit of Internal Financial Controls over Financial Reporting issued by the Institute of Chartered Accountants of India (ICAI).

The senior management remains committed to upholding a strong internal control environment that ensures compliance with applicable laws and regulations protects company assets, ensures timely and reliable financial disclosures, and mitigates the risk of fraud and errors. All financial transactions are recorded in accordance with Indian Accounting Standards (Ind-AS) and the Companys approved accounting policies. An independent Internal Audit function monitors key control areas and provides strategic inputs for continuous process improvement.

BUSINESS OUTLOOK

Indias healthcare sector continues on a strong growth trajectory, supported by expanding insurance coverage, rising health awareness, and steady economic development. Demand for multi-speciality care is increasing across both urban and semi-urban regions, especially as chronic and lifestyle-related ailments gain prevalence. Simultaneously, public and private investments in healthcare infrastructure, digital health and home-based services are reshaping patient engagement and access to care.

Shalby is poised to tap into these shifts with a two-pronged approach: expanding core offerings while scaling new-age services.

The Company is strategically strengthening its presence in the implant segment, with plans to expand its international footprint and deepen domestic distribution. Focused efforts toward transitioning into a global MedTech player are underway through its U.S- based manufacturing unit and emerging market presence in India and Southeast Asia.

Domestically, the Company remains focused on Tier-I and Tier-II cities where demand continues to outpace service availability. Initiatives such as Shalby Orthopaedic Centre of Excellence (SOCE), and 24x7 homecare services are positioned for rapid expansion, with a target to operationalise 40 SOCEs across India. These efforts are supported by the Companys franchise-based, asset-light model, which allows for agile market entry and cost-efficient scaling. With a strong foundation in joint replacement and increasing contributions from emerging specialities, Shalby aims to outpace industry growth rates and strengthen its national footprint in the coming years.

REGULATIONS & SAFETY

As healthcare regulations evolve in line with global benchmarks, Shalby continues to uphold the highest standards of compliance, patient safety and corporate responsibility. The Company remains vigilant in aligning its operations with all statutory norms, ensuring transparency and accountability across clinical and business functions. Shalby maintains a robust governance framework supported by certified vendors, rigorous quality checks, and standardised equipment protocols, ensuring all medical devices and technologies meet regulatory expectations. The Companys laboratories continue to meet NABL accreditation standards, reaffirming its commitment to quality diagnostics and patient care. On the sustainability front, Shalby has embedded environmental responsibility into its operational ethos. Key initiatives include waste segregation, reduction of biomedical and plastic waste, energy-efficient infrastructure, and ongoing efforts to reduce its environmental footprint. The Company also maintains detailed compliance records and surveillance mechanisms to address emerging legal or operational risks proactively. With a patient-first approach and a compliance-led operating culture, Shalby is well-positioned to meet the future demands of Indias regulated, quality-driven healthcare environment.