Little did Pramod Kumar (30) expect to be told that he had an 8-cm gastric tumour when he underwent a preventive check up at Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, a couple of years ago. He was operated upon soon after and thankfully, the tumour turned out to be benign. Since then, he has made it a point to undergo the check up every year and advises his family and friends to do the same.
Kumar?s is not an isolated case. ?I got my first preventive check up in Chennai and have been following it up for almost 19 years now,? claims Sivasankari, a 60-year old author based in Bangalore. ?Although nothing serious has been detected so far, I feel reassured.?
Get the drift?
With the steep rise in lifestyle diseases and spiralling health costs, preventive care is becoming popular, especially among employees covered by corporate schemes. ?It?s decidedly a corporate phenomenon,? says Vishal Bali, CEO, Wockhardt. ?MNCs have brought in a strong component of wellness in their HR policies and gradually Indian corporates are following suit.? One estimate has it that preventive care now accounts for a-third of all patient walk-ins at any big city hospital.
Taking a cue, most leading medical service providers are getting aggressive about preventive care, offering branded packages?with discounts and freebies to boot. ?There is enough evidence to prove that baseline hypertension or endocrinal disorders can all be controlled through lifestyle modifications, only if symptoms are detected early, which is what preventive programmes are about,? says Bali.
The caseload is also interesting. Patients broadly fit into three categories. ?About 40% are employee sponsored, 20% pre-employment referral check-ups, again ordered by a corporate client, and the balance (40%) are individual walk-ins,? informs Sudarshan Mazumdar, director (marketing) at Fortis Healthcare, which runs a chain of 13 hospitals in the country.
Recently, Kailash Hospital, a multi-speciality facility in Noida, near Delhi, distributed tens of thousands of free CDs in housing complexes in the city. The CDs sell the concept of Sanjeevani, the hospital?s preventive care brand. Priced between Rs 600 and 6,000, the group runs complementary workshops for corporates to make the package more popular, informs Sankalp Bansal, the project in-charge for Kailash Hospital.
In fact, across the country, preventive care is becoming a booming business. ?In 2005, in Chennai, we registered 14,745 patients in preventive care, against 25,043 in the out-patient department (OPD). In 2006, the figures were 27,710 and 18,530; and this year, it is 22,175, against 25,615 preventive care patients. So the picture is beginning to change,? declares R Sudharsan, deputy general manager, healthcare services, Apollo Hospitals. The preventive care programme at Apollo is run across all its hospitals besides 53 out-patient clinics, where it is the main source of revenue.
?Large centres, such as Chennai, Delhi, Hyderabad and Kolkata draw a significant number from outside the respective states,? informs Dr Udhaya Balasubramanian, director, preventive medicine at Apollo. Interestingly, the patient profiling reveals they represent various age (average 40) and income groups with a male to female ratio of 60:40.
The diseases that are most common in this demographic sample are hypertension, diabetes, dyslipidemia (a disruption in the amount of lipids in the blood) etc. ?At least every third person in the health-check-up population comes with an abnormal lipid profile on any one parameter (total cholesterol, HDL, LDL, triglycerides, ratio of total/HDL cholesterol etc). Incidence of anaemia, fatty liver, gall bladder stone, renal stone, thyroid problems are also common,? reveals Balasubramanian.
She claims that the group hospital in Chennai was the first to offer all lab facilities (blood tests, ECG, X-ray, treadmill) under one roof in 1972-73. When the trend became popular in Tamil Nadu, Andhra Pradesh and Pondi-cherry, it got formally christened as Apollo Master Health Check-up Plan, that?s now available in the north Indian states, as well. ?Its popularity is natural given that there is no insurance cover for out-patient treatment,? says Sudharsan.
Most hospitals offer five to six variants under their preventive care scheme. The branded packages are generally priced between Rs 700 to 9,000, depending on the combination of tests chosen. Again, the selection depends on the age, sex and family history of the patient.
Going full throttle with marketing, Fortis follows a four-pronged strategy: selling it to the HR departments of corporates that are already on their insurance panel; selling it to corporates that are not yet empanelled; running special schemes on World Heart Day, Mother?s Day, Father?s Day, World Diabetes Day and Women?s Day and so on, and putting ads in the print medium from time to time, besides distributing leaflets and pamphlets locally.
Television is not a preferred media yet because, says a senior medical staff with Sitaram Bhartia Institute of Science & Research in Delhi, hospitals are careful not to ramp up in a jiffy putting quality of their preventive packages at stake.
In any case, the media spends on spreading awareness about these programmes are not very huge. The annual; media budget to run a promotion of this scale would be around Rs 4 crore, a major portion of which goes into print, followed by radio. The spends are increasing, as hospitals have begun to realise that preventive care is often a feeder to their OPD service.
This is particularly true of a single speciality hospital like Wockhardt that?s been in the business of preventive care for almost 13 years. ?If you are a specialist in tertiary care, you can leverage your existing facilities to provide preventive care that saves needless expenditure later, otherwise people don?t listen,? explains Wockhardt? Bali.
?Preventive care is often a patent?s first interface with a hospital,? adds Fortis? Mazumdar. ?So we are careful not to take him/her out of the value chain.? But the hospital?s ultimate plan is to take it out of the precincts of the hospital and mass- market the concept at outdoor camps as part of the group?s brand building programme.
Wockhardt?s patient volume at Lifestyle Modification Programme (the brand name for the hospital?s preventive care programme) has grown by 35% year on year and revenue growth is almost 25-28%, according to Bali. ?We are careful not to follow a mass approach on this; so our direct communication is with top corporate houses in select cities.?
The ratio of corporate to individual clients at Wockhardt is almost 50:50; out of which 60% are repeat patients, that is, they come back for a check every year. The price of the package varies from Rs 750 to Rs 4,500, depending on the tests commissioned.
Most healthcare players agree that the RoI from preventive care is much less than that from OPD attendance?since the latter is still a more volume-driven business in India. However, they are categorical that they would continue to invest in it because preventive care is a critical brand building tool and just the right vehicle to communicate a brand?s message to the consumer.