Running Head: INTERNATIONALIZATION STRATEGY PRIMED: INDIA 1
Internationalization Strategy PriMed: India
Brayden Proctor, Raymond Su, Hayley Weir, Lin Zhang, Harsh Sharma, Kirsten Tiegen
International Business 412
Michael Roberts
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 2
Table of Contents:
Title Page…………………………………………………………………………………...…... 1
Table of contents…....................................................................................................................... 2
Introduction……………………………......……………………………………………………. 3
PESTEL Analysis……………………………………………………………………………….. 4
Applying PESTEL……………………………………………………………………………… 9
SWOT Analysis……………………………………………………………………………….... 9
To Go or Not to Go……………………………………………………………………………. 11
Indian Health Care System…………………………………………………………………….. 11
Competitor Information……………………………………………………………………….. 14
The Buying Process……………………………………………………………………………. 17
Mode of Entry…………………………………………………………………………………. 18
Group Purchasing Organizations……………………………………………………………… 18
Distributors…………………………………………………………………………………….. 20
Conferences……………………………………………………………………………………. 20
Conclusion……………………………………………………………………………………... 21
Appendix………………………………………………………………………………………. 22
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 3
References……………………………………………………………………………………... 27
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 4
Introduction
India is an Asian country located in the south eastern region. According to the CIA
website the population of India is almost 1.3 billion as of July, 2015. Additionally, the health
expenditure is 4% of the GDP; the GDP (purchasing power parity) of India is $8.027 trillion as
of the 2015 estimate (CIA). According to the Make in India website, India is forecasted to be the
third largest pharmaceutical market by 2020. 20% of its global exports are in generics making it
the largest provider of generic medicines worldwide. In addition, the total exports of drugs as of
2013/2014 in USD is $15,095 million with a 2.5% growth rate. The FDI policies favor 100%
ownership under the automatic route for greenfield projects. Though, FDIs are subject to
applicable laws (Make in India).
When taking a product internationally it is important to consider the possible locations
and what environment/ market be best suited for the product in question. We have been charged
with the task of creating an entry strategy for PriMED into the India market. In order to better
understand if this market is hospitable for PriMED’s product lines we have done two evaluations
on the market place. By using the SWOT and PESTEL analysis we will answer the questions:
Does India provide a hospitable environment for PriMED and their products, and is entry into
this market is a wise decision.
The PESTEL framework analysis is a means of analyzing the overall environment of a
target nation (in this case India). This framework breaks down Political, Environmental, Social,
Technological, Economic, and Legal aspects of the environment, and highlights the areas that
will have the most influence on the particular company and product. Through the use of this
model we can actually determine the areas in which we may encounter problems upon entry into
India.
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 5
Political Analysis of India
In 2014, India ranked quite high in the voice and accountability parameter which
measures the extent to which citizens are able to participate in selecting their government as well
as freedom of expression, association, and media. India ranked high on this parameter because of
its democratic principles which are deep rooted in their history (MarketLine, 2015, p. 3).
Democracy is somewhat more restricted in India than in other democratic nations however, due
to religious, linguistic, and caste differences (MarketLine, 2015, p. 15). India’s political
environment is also plagued with political violence in the form of riots and high levels of
corruption in the form of cash for votes incidents among others (MarketLine, 2015, p. 15).
Unfortunately India also has a volatile relationship with its neighbor Pakistan and is currently
threatened by terrorism because of this (MarketLine, 2015, p. 15). In terms of foreign policy,
India has undergone substantial economic liberalization and it has become closer to North
America through bilateral trade agreements. India is also in the process of developing stronger
relationships with the South-East Asian countries and oil-rich nations in order to gain trade
advantages (MarketLine, 2015, p. 15).
Economic Analysis of India
India’s economy is characterized by its large workforce, its well-educated, English-
speaking population, and its well-developed equity markets (MarketLine, 2015, p. 21). India’s
workforce is second in size only to China and is expected to increase significantly over the next
few decades. The fact that India has a large English-speaking population also gives it an
advantage in certain sectors such as IT and business process outsourcing (MarketLine, 2015, p.
21). India’s well-developed equity market has grown significantly because of regulation by SEBI
(Securities and Exchange Board of India). Because of this regulation and economic
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 6
liberalization, Indian equity markets have become some of the best in Asia (MarketLine, 2015, p.
21). Unfortunately, India’s economy has been challenged with high inflation, imbalanced
development, and poor infrastructure. These challenges are made worse by high levels of
corruption which have decreased the country’s economic growth and investment (MarketLine,
2015, p. 23). The strong presence of income disparity in India has led to the strong presence of
an informal economy which generated a significant amount of income that does not go towards
the country’s GDP (MarketLine, 2015, p. 23).
Social Analysis of India
The Indian government has had a program called National Rural Health Mission in place
for a number of years and in 2013 the government launched a New National Urban Health
Mission (MarketLine, 2015).
Literacy rates in India are considerably low compared to competing nations such as China. In
spite of India’s low literacy rates it continues to spend little on programs with a low contribution
of 3.3% of its GDP in 2013 (MarketLine, 2015).
Analysis of the Indian social system
Current strengths Current challenges Future prospects Future risks
▪ Growing proportion of young people
▪ Employment guarantee scheme
▪ Healthcare remains a major concern
▪ Rapid urbanization
▪ Low HDI rank
▪ Jan Dhan Yojana
▪ Rising life expectancy and falling infant
mortality
▪ Government’s authority challenged
▪ Employment creation
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 7
▪ Literacy level
(MarketLine, 2015, p.)
Technological Analysis of India
India is well known for its advancements in the IT sector. According to the National
Association of Software Services Companies (NASSCOM), the industry is expected to be worth
225 billion by 2020.
When it comes to product patents, India is traditionally renowned for its slowness in securing
patents; however, recently it has been improving (MarketLine, 2015)
Legal
These factors have both external and internal sides. There are certain laws that affect the
business environment in a certain country while there are certain policies that companies
maintain for themselves. Legal analysis takes into account both of these angles and then charts
out the strategies in light of these legislations. For example, consumer laws, safety standards,
labor laws etc.
Environmental: These factors include all those that influence or are determined by the
surrounding environment. This aspect of the PESTLE is crucial for certain industries particularly
for example tourism, farming, agriculture etc. Factors of a business environmental analysis
include but are not limited to climate, weather, geographical location, global changes in climate,
environmental offsets etc. (see section one of the appendix for full Comparison Chart)
Legal landscape
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 8
- According to the World Bank's 2016 Doing Business report, time to start a business,
enforcement of contracts, getting construction permits, and paying taxes are the key
constraints to doing business in India. Overall, the country has been ranked 130 out of
189 countries.
- The new Companies Act aims to improve corporate governance by introducing a more
effective legal and administrative framework; nevertheless, corporate governance is
largely driven by factors such as companies’ commitment to the principles of integrity
and transparency in business operations.
Effectiveness:
- Weak product market regulations remain a major problem for the country, curbing its
ability to procure stable financing and technology.
Vat tax
- VAT is applied at each stage of sale with a mechanism of credit for the input VAT paid.
The standard VAT rates is of 12.5% to 15% and varies among different states, with rates
reduced to as low as 1-5% in most states. The likes of petroleum products, tobacco, and
liquor attract higher VAT rates that vary between states.
Legal Requirement Standards:
Specifications developed by the American Society of Testing and Materials (ASTM)
are referenced by the FDA as the required standard in the USA. The current standard ASTM
F2100-11 (2011) specifies the performance requirements for Medical Face Masks with five basic
criteria:
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 9
1. BFE (bacterial filtration efficiency)
2. PFE (particulate filtration efficiency)
1. Fluid Resistance
2. Delta P (pressure differential)
3. Flame Spread
(See Section 2 of Appendix for full legal requirements of India and USA/ Canada)
Environmental landscape
- India is a poor performer on the Environmental Performance Index (EPI). In an EPI
study published in 2014, India was ranked 155th out of 178 countries.
- India’s dependence on thermal energy—predominantly coal-based—has resulted in a
host of environmental problems and increased India’s share of greenhouse gas emissions.
Applying PESTEL to priMED
The largest defining factors affecting entry into the Indian market are: ease of entry,
market size, existence of supporting infrastructure, competition, competition strategy,
regulations, and legal restrictions on this market segment. We see through the PESTEL analysis
that the legal restrictions and regulations on face masks in India are very similar to the
regulations in Canada and the USA (see appendix). This means that the same product can be sold
in India without the need for modifications. We also see that there is an increasing social aspect
in the health care industry. The increase in government funding shows that this market is
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 10
growing and as a result the use/ need for high quality facemasks will grow as well.
In terms of technology we know through discussion with Primed that they do not have
patents on most of their products due to the fact that this technology has been established for a
significant period of time. All though priMED prides itself in product quality and if they choose
to enter India that will be their main competitive advantage.
The largest negative influential factors we found via the PESTEL analysis are Political
and Economic. India has high levels of corruption and as such there is always instability
economically and politically; this being said, it is important to note that there is a large amount of
undocumented income in India due to the massive participation in the informal economy. As a
result GDP facts and figures will not be full representative of the actual income and expenditures
within the country.
We chose to pair the PESTEL analysis with a SWOT analysis in order to better answer
the question of whether it would be in priMED’s best interest to enter the Indian market.
SWOT Analysis of priMED India
Strengths Large healthcare industry: $1.56
billion Market growth 8% annually
(Medical Devices) Imports over half of healthcare
equipment Growing middle class: 300 million
people already Disposable equipment & supplies is
the largest component of healthcare industry in Asia Pacific (35.5%)
Disposable supplies industry is projected to increase in value by 41.9% by 2020
Weaknesses Growth is slow in public sector. (80% of
growth contributed in private sector) Health and safety rules are largely
unenforced Significant divide between rural and urban
centres: 70% of population is rural and has limited access to hospitals
Communication barrier: 15 official languages in India
Regulatory Issues: Canadian company, Chinese manufacturing, Indian market
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 11
Opportunities Untapped rural markets Huge growth in private sector of
Indian healthcare Growing demand for government
initiatives to provide healthcare to rural areas
Close proximity to China (where manufacturing takes place)
Threats Potentially over 300-500 competitors in
India already Market has high threat of new entrants Consumers may value locally made
products over foreign players
Depicted in the chart above are a vast variety of both good and bad influential factors
that will play a role in the decision of internationalization. Like stated previously I is
important to consider the fact that the GDP figures are not entirely accurate for this nation;
however, using the data available we can see that India has a vast potential. With a high
emphasis on imports of healthcare equipment it creates a product niche for foreign
manufacturers/ sellers. We also see that the disposable equipment and supplies portion of the
health care sector is considerable meaning that there is a market and it is considerable in size.
We know from the both analysis’s that there is a large swing towards increased government
expenditure in health care initiatives which will result in an increase in cash flow for medical
products. In addition a large advantage to take into consideration for selling in India is the
geographic distance form priMED’s manufacturers in China. The two nations are close to
each other which will result in ease of transportation.
The largest problem we for see with this market is the ease of entry and competition
there are already 300-500 competitors in this industry. However we have found in our
research that locally made products do not have very good product quality and as such
medical professionals tend to go for foreign brands to ensure a standard quality of products.
To Go or Not to Go
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 12
Based off of the two environmental analysis’s we have decided that entering India
would be a wise decision. This market is vast and showing steady growth, by entering India
PriMED has the potential to establish a foothold in a large growing market and gain brand
recognition. Moving forward we will delve deeper into distribution networks/ buying groups,
competition, and the market.
The Indian Health Care System
India is the seventh-largest country by size, and the second-most populous country with a
population of over 1.3 billion people, which makes India a big market for global business. There
are several well-known cities in India: Mumbai, New Delhi, Kolkata, and Bangalore, etc. New
Delhi is the capital of India, but Mumbai has the largest population and is the largest harbor of
India. Kolkata is the third largest city, and is the business center of East India. Bangalore is the
fourth largest city of India, and is the center of India’s high technology industry (Central
Intelligence Agency).
With the rapid development of economy, India has become a powerful country. However,
it is not enough to evaluate the strength of a nation based only on its wealth -- its citizens’ health
and well-being are also important. In order to improve the lives of its citizens, India has paid
great attention to building a comprehensive healthcare system. The government plays a central
role in building this healthcare system and it has promulgated the National Health Policy to deal
with health issues. India now has both public hospitals and private hospitals. Public hospitals in
India are also known as government hospitals because they are funded by the government, and it
provides free treatment for people below the poverty line. However, public healthcare services
cover just 20% of the total market in India; the rest of the market is controlled by private
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 13
healthcare services (Rajawat, 2015). There is a list of five public hospitals and five private
hospitals in the four cities mentioned above in the appendix section 3.
All these cities have many public and private hospitals, providing general healthcare
services and also specialty healthcare services like eye and heart clinics. Some hospitals in India
already have contracts with BMC Medical for purchasing masks. However, in order to protect
both doctors and patients, Indian hospitals want to increase their mask storage by placing an
order for a six-month supply of 72000 masks instead of ordering 5000 masks every fifteen days
(Porecha, 2015). With increased awareness of the health and safety benefits of wearing masks,
most Indian hospitals are looking to purchase large quantity of masks, which makes them
priMED’s target buyer group.
Another potential buyer group is India’s private cosmetic surgery centers. With the
development of technology, there are many more methods to improve people’s physical
appearance. As the demand for cosmetic surgery increases, people are no longer satisfied with
the limited range of services provided by general hospitals. They want to find facilities with
more targeted services -- hence the emergence of many private cosmetic surgery centers around
the world. India is one of the biggest cosmetic surgery market in Asia (Mann, 2010), It has a
long history of plastic surgery tracing back to the 800BC. Sushruta, an important figure in the
history of cosmetic surgery in India, has greatly improved the techniques of cosmetic surgery in
6th century BC (Dwivedi & Dwivedi, 2007). There is a list of 5 cosmetic surgery centers in the
four largest cities in the India in the appendix section 4.
In addition to allowing private healthcare provider to enter the market and opening up
specialized surgical centers, India is also trying to improve the overall healthcare system to
satisfy the health needs of its citizens by sponsoring many rural government initiatives (as
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previously stated). Healthcare is an individual’s basic right, but the lack of high-quality
infrastructure, qualified medical professionals, essential drugs and medical facilities is
obstructing 60% of India’s population’s access to healthcare. Most of the 7 million people living
in the rural areas of India are now using medical facilities in deplorable condition (Gramvaani,
2013). In order to improve the level of healthcare around the country, Indian government is
implementing many welfare initiatives with a focus on rural areas.
The Indian Government has launched the National Health Mission which includes two
Sub-Missions, the National Rural Health Mission (NRHM) and the newly launched National
Urban Health Mission (NUHM) (National Health Mission). The National Rural Health Mission
was launched in 2005 to “provide accessible, affordable and quality healthcare to the rural
population” (National Health Mission). The government has also approved the launch of
National Urban Health Mission as a Sub-mission of National Health Mission in 2013, hoping to
“meet healthcare needs of the urban population with the focus on urban poor, by making
available to them essential primary healthcare services and reducing their out of pocket expenses
for treatment” (National Health Mission). This sub-mission will be accomplished by ensuring the
accessibility of the existing health care services, targeting the population living below the
poverty line and carrying out broad reforming schemes to provide cleaner drinking water, better
sanitation condition and more health-related school education.
Competitor Information
India is in a midst of a booming healthcare sector. Previously, the government’s low
spending on health care places much of the burden on patients and their families, as evidenced
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 15
by the country’s out-of-pocket (OOP) spending rate, is one of the world’s highest. According to
the World Health Organization (WHO), “just 33 percent of Indian health care expenditures in
2012 came from government sources. Of the remaining private spending, around 86 percent”
(Deloitte) was out-of-pocket expenses. The current industry needs an additional 1.54 million
doctors and 2.4 million nurses to match the global average” and the Indian government is
expected to spend 16.1% more on public healthcare (Deloitte).
Currently, there are only a few companies in India who offer non-woven masks. North
American disposable medical device/ supply companies that are usual competition to priMED
include Medline, 3M, Cardinal Health, Halyard Health (formerly Kimberly Clark Health), and
Medicom. With that being said, Medline’s Indian counterpart is mainly used for research and
development as well as IT. McKesson, Cardinal Health and Medicom currently do not operate in
India, but Medicom and Cardinal Health - generated $91 million total revenue but International
operations accounted for 4% of the total revenues in FY2014. An increase of 17.3% over
FY2013 (Marketline) - have other Asian country operations. Halyard Health - $1.7 billion in
annual net sales (Marketline) - and 3M - revenues from Europe, Middle East and Africa reached
$7,198 million in FY2014, an increase of 1.6% over FY2013 (Marketline) - are two immediate
competitors who currently operate in India with corporate offices, innovation labs, and
manufacturing (3M). Halyard Health have a wide range of supplies that match priMED’s product
lines, whereas 3M has high prices and rely on brand loyalty.
The largest competitor for priMED’s Indian market is 3M USA’s subsidiary, 3M India.
3M India’s “healthcare business segment serves markets, including multi-specialty hospitals and
small clinics, dental and orthodontic practitioners, processed food manufacturers and
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 16
pharmaceutical companies” (Marketline). The subsidiary generated approximately “$304 million
in the fiscal year ended March 2015, an increase of 5.2% over 2014” (Marketline).
Domestic brand competition would include companies like Perfect Surgical Industries
and IVcannula/ Dentex International. Both companies manufacture their procedural masks but
IVcannula/ Dentex International also exports and distributes their products. Perfect Surgical
Industries and IVCannula/ Dentex International only manufacture a single basic procedural mask
(single use package or bulk), where priMED has many variations of the procedural mask.
PriMED currently sells masks in boxes or cases, but the domestic competitors offer single use
packets which is beneficial to a “bottom of the pyramid” market. PriMED does have an
advantage in this segment because their mask has an available anti-fog which is beneficial in
hotter climates for glasses wearers, whereas the two domestic Indian companies do not offer this
type of technology. priMED’s products are ASTM approved which is North America’s
guidelines for face mask standards. Perfect Surgical Industries is ISO9001 and CE certified,
which are aimed towards business/branding rather than health and safety. priMED’s large
product line will enable Indian buyers to purchase all non-woven medical supplies in one stop.
For example, a private hospital can purchase gowns, gloves, procedural masks, surgical masks
with ties, masks with face shields in one order rather than contacting many distributors and
suppliers. This will enhance brand loyalty/ create value, and create an efficient, yet effective
buying process for purchasers.
The most popular masks in the Indian health sector would be relatable to any health
sector around the world, which would be a basic ear loop procedural mask which is used widely
from a day to day basis. All surgeries (general surgery where there’s no high risk infections and
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 17
airborne contaminants), procedural activities (like dressing changes, isolation patients that do not
have high risk infections) and cleaning for example would use a procedural mask.
Another emerging market for basic non-woven masks in India or Asia is the consumer
market. With the amount of smog and air pollutants in these emerging markets, consumers are
looking for an inexpensive way to protect their lungs. This is why the domestic Indian brands
have created a single use package for their basic procedural mask, so the mask will be sterile no
matter where they store it or sell it (convenience store, backpacks, pocket etc.).
Average Selling Prices
We contacted PriMED to find out the average selling prices for the most popular
procedural mask and the most popular surgical mask. The most popular procedural mask has an
average selling price of $0.05 to $0.07 ($CAD) per mask. The most popular surgical tie mask has
an average selling price of $0.10 to $0.12 ($CAD) per mask. These are the end-user purchase
prices, i.e. this is what the hospitals would pay for each individual mask. For procedural masks,
one case contains ten boxes and each box contains fifty masks for a total of 500 masks per case.
For the surgical tie masks one case contains six boxes each with fifty masks for a total of 300
masks per case.
Competitors of PriMED, especially American brands such as Halyard and 3m, have
similar prices for their individual masks and also sell their masks by the case. Indian companies
such as IV Cannula/ Dentex International and Perfect Surgical Industries may have lower
average selling prices for their masks because they do not seem to have to comply with any
particular regulations. They also have a cost advantage because all of their products are
manufactured locally.
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 18
The Buying Process
The buying process of disposable healthcare products in India is complicated because of
the fragmented nature of the healthcare industry as a whole. In India healthcare is a state issue
like it is in Canada, however in India there are 29 states with extremely different cultural norms
(ValueNotes Strategic Intelligence Pvt. Ltd., 2015). Another main challenge related to the
diverse Indian economy is communication. India has 15 official languages making integration
across regions extremely difficult (CIA, 2015).
One result of these factors is that most distributors are small in scope and operate in only
a limited are. (ValueNotes Strategic Intelligence Pvt. Ltd., 2015). As a result of this it is likely
most feasible for a mid-sized company such as priMED to focus on finding reputable regional
distributors to service smaller more concentrated hospital groups.
Another condition in the Indian healthcare industry is that there is a massive divide
between rural and urban centers in terms of healthcare providers. As described earlier the
majority of the Indian population lives in rural areas with limited access to hospitals. This
provides a massive opportunity for future growth, however currently most suppliers are only able
to access “metros and tier 1 & 2 cities” (ValueNotes Strategic Intelligence Pvt. Ltd., 2015). As a
result the focus in the following section will be on urban centers.
Mode of Entry
Many distributors in India also manufacture some or all of their products so an option
moving forward in India is to find a partner similar to priMED’s current manufacturer in China
to make more efficient use of the value chain. This could potentially lower costs and could build
the potential for expansion into neighboring markets such as Pakistan, Bangladesh, or Sri Lanka.
The main reason not to pursue this strategy is that priMED’s competitive advantage is in quality
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 19
of the products and using a new supplier could endanger brand image if the products
manufactured are not consistent with the standard that priMED is known for.
After considering the above alternative it seems the best mode of entry is still the one that
priMED has had success with so far, exporting. The strategy entering India will be to find local
distributors that can target Group Purchasing Organizations in the selected areas. Exporting is the
best option here because it doesn’t require a large initial investment of capital as compared to
purchasing capacity at a local factory. Also there will be no risk of compromise in product
quality.
Group Purchasing Organizations
Many of the most powerful group purchasing organizations in India are comprised
primarily of private hospitals. There are several large companies that manage hospitals all over
India. There are many more small to mid-sized hospital groups that have hospitals in different
areas in India, however many are concentrated in specific regions. Based on the locations of
hospital groups Mumbai stands out as the area to focus on. Mumbai has a massive population
and is home to several smaller hospital groups as well as to some hospitals that are part of larger
chains. Mumbai could prove to be a gateway into the rest of the Indian disposable healthcare
devices industry.
Top Priority Hospital Groups
Wockhardt Hospitals is a group of nine hospitals, three of which are located in Mumbai,
which claims to be the “market leader” in cardiac care in India. (Wockhardt Hospitals, 2016)
This company represents a potential consumer of priMED products because of its commitment to
offering high quality service and because the hospitals are clustered in West India around
Mumbai.
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 20
Platinum Hospitals is another hospital group that is a realistic potential purchaser of
priMED products. The company is smaller than Wockhardt as it is comprised of only two
institutions with its flagship 100 bed hospital is located in Mumbai and its other hospital is
located in Vasai a suburb of Mumbai. (Platinum Hospitals, 2016) Platinum offers an attractive
target as it could be easily serviced by a smaller regional distributor.
Other Important Hospital Groups
Apollo is a huge hospital group in India with 64 hospitals nationwide. (Apollo Hospitals,
2016) The issues are that the institutions are very spread out and the closest one to Mumbai is
located approximately 150 km away in Pune. Global Hospitals is also an important group in
India with seven hospitals and one located in Mumbai. (Global Hospitals, 2016) Other large
group include; Manipal Hospitals the third largest group which has its flagship hospital in
Bangalore, (Manipal Hospitals, 2016) Fortis Healthcare Limited based out of Kolkata, (Fortis
Healthcare Limited, 2016) and CARE Hospitals concentrated around Hyderabad (CARE
Hospitals, 2016).
AMRI Hospital group is an important player in Eastern India (AMRI Hospital Group,
2016) and Max Healthcare is a group of 13 hospitals centered in and around the city of New
Delhi (Max Healthcare, 2016). There are also interesting opportunities in the state of Andhra
Pradesh in southeast India. Shar Technologies Group is a group purchasing organization that
works with APNA (Andhra Pradesh Private Nursing Homes and Hospitals Association) which
has more than 5,000 members (STG, 2015). The government of Andhra Pradesh is also
renovating the city of Amaravati to become the new capital and as part of the project has
partnered with the Indo-UK Institute of Health (IUIH) to build a new 1000 bed hospital to be
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 21
completed by June 2019 (The Times of India, 2016). This hospital is set to be the headquarters of
10 new hospitals the IUIH plans to construct across India (The Times of India, 2016).
Distributors
The Distributors in the disposable healthcare device industry are, as mentioned
previously, mostly smaller regional companies. Many of these companies also manufacture at
least a portion of their products. The distributors mentioned in the following section offer
products that are similar enough that it would make sense to carry priMED products but don’t
manufacture products that are similar enough that they could manufacture the masks and gowns
themselves.
In Mumbai there are distributors that could be effective partners. One of these companies
is Nulife Triple Safety a division of MRK Healthcare is headquartered in Mumbai and operates
across Western India. Nulife manufactures and sells surgical gloves and other disposables but not
masks or gowns.
Lifecare is another distributor located in Mumbai that could be a good fit for priMED.
Lifecare started off in orthopedic surgery and dental equipment but has since moved into
disposables (Lifecare Devices, 2016). Other potential distributors located in Mumbai include;
Draeger Medical India Pvt. Ltd. (Draeger Medical, 2016) And B. Braun Medical (India) Pvt.
Ltd (B. Braun India, 2015). There are numerous other smaller distributors throughout India many
of which can be found in the 2013 India Medical Devices Manufacturers, Distributors and
Exporters Directory (Pacific Bridge Medical, 2013).
Conferences
There are opportunities to gain a deeper understanding of the Indian market through
attending conferences and events. Working with a high context culture building relationships can
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 22
be an important aspect of business and these events offer the opportunity to make connections
and begin to develop these relationships. In April 2017 New Delhi is hosting Medical Fair India
“India’s number one trade fair for hospitals, health centres and clinics” (Messe Düsseldorf North
America, 2012). Another networking opportunity is on July 23 and 24, 2016 right in Mumbai at
the Hospital Management Conference & CIMS Healthcare Excellence Awards (CIMS Medical,
2016) both of these events are annual ValueNotes Strategic Intelligence Pvt. Ltd. (2015).
Conclusion
Entry into an unfamiliar market can be taxing, expensive, time consuming, and difficult.
India will be no exception to these facts; however, as stated above India provides the potential
for a large profitable market. We have chosen an entry strategy for priMED in the form of
exportation. This strategy will prove to be the least expensive and easiest way to break into the
Indian market. By entering using a waterfall strategy, meaning the distribution in Mumbai and
expanding from that location, priMED can focus its efforts into a direct location while
simultaneously mitigating potential losses. Using the list of distributors provided it is our hope
that priMED will consider contacting some of these distribution facilities as well as hospitals and
cosmetic surgery facilities. Since priMED’s usual strategy is exportation the use of distributors
seemed to be the best fit with their current corporate culture. In addition as a high context culture
India places a great deal of importance on personal relationships; therefor it crucial to establish
relationships and network extensively in order to be as profitable as possible. Through the
information and guidelines provided it is our belief that priMED can break into the Indian market
and become established and profitable.
APPENDIX
1.
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 23
OVERALL COMPARISONLegal Canada IndiaJudicial Branch Supreme Court of Canada (judges are
appointed by the governor general on the recommendation of the prime minister); Federal Court of Canada; Federal Court of Appeal; Tax Court of Canada; Provincial/Territorial Courts (these are named variously Court of Appeal, Court of Queen's Bench, Superior Court, Supreme Court, and Court of Justice)
Supreme Court (one chief justice and 25 associate justices are appointed by the president and remain in office until they reach the age of 65 or are removed for "proved misbehavior")
Legal System common law system except in Quebec where civil law based on the French civil code prevails
common law system based on the English model; separate personal law codes apply to Muslims, Christians, and Hindus; judicial review of legislative acts
EnvirontmentalCurrent Issue air pollution and resulting acid rain
severely affecting lakes and damaging forests; metal smelting, coal-burning utilities, and vehicle emissions impacting on agricultural and forest productivity; ocean waters becoming contaminated due to agricultural, industrial, mining, and forestry activities
deforestation; soil erosion; overgrazing; desertification; air pollution from industrial effluents and vehicle emissions; water pollution from raw sewage and runoff of agricultural pesticides; tap water is not potable throughout the country; huge and growing population is overstraining natural resources
Water availability 84.51 thousand cubic metresRanked 4th. 54 times more than India
1.56 thousand cubic metresRanked 93th.
Population with improved sanitation > Urban and rural
99.81Ranked 37th. 3 times more than India
35.09Ranked 156th.
Pollution perceptions > Urban discomfort from pollution
17.52Ranked 53th.
62.3Ranked 15th. 4 times more than Canada
CO2 emissions from electricity and heat production, total >
165.62Ranked 15th.
963.48Ranked 5th. 6 times more than Canada
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 24
Million metric tons
Ecological Footprint
7.66Ranked 9th. 9 times more than India
0.9Ranked 47th.
Overall air pollution 21.15Ranked 54th.
67.89Ranked 15th. 3 times more than Canada
Air quality 78.85Ranked 6th. 2 times more than India
32.11Ranked 45th.
Pollution index 27.99Ranked 54th.
74.54Ranked 14th. 3 times more than Canada
Climate change awareness
95%Ranked 13th. 3 times more than India
35%Ranked 113th.
International agreements > Signed but not ratified
Air Pollution-Volatile Organic Compounds, Marine Life Conservation
none of the selected agreements
2. USA FDA:
ASTM F2100-11 (2011) REQUIREMENTSFOR MEDICAL FACE MASKSTest: Low
BarrierModerateBarrier
HighBarrier
BFE (Bacterial Filtration Efficiency)at 3.0 micron ASTM F2101
≥ 95% ≥ 98% ≥ 98%
PFE (Particulate Filtration Efficiency)at 0.1 micron ASTM F2299
≥ 95% ≥ 98% ≥ 98%
Delta P (Differential Pressure)MIL-M-36954C, mm H2O/cm2
< 4.0 < 5.0 < 5.0
Fluid Resistance to synthetic bloodASTM 1862, mm Hg
80 120 160
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 25
Flame Spread16 CFR part 1610
Class 1 Class 1 Class 1
FDA regulations http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpcd/classification.cfm?id=fxx
INDIA:
India
http://jairjp.com/NOVEMBER%202013/02%20CHELLAMANI%201.pdf
3. Public and Private Hospitals List
New Delhi:
Public Hospitals:
Maulana Azad Medical College and GB Pant Hospital, All India Institute of Medical Sciences,
Bara Hindu Rao Hospital, University College of Medical Sciences and Guru Teg Bahadur
Hospital, Deen Dayal Upadhyay Hospital
Private Hospitals:
Sir Ganga Ram Hospital, Max Hospital Saket, Max Super specialty Hospital-Shalimar Bagh,
Shanti Mukund Hospital, Shri Balaji Action Medical Institute
Mumbai:
Public Hospitals:
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 26
Bombay Hospital, Hinduja National Hospital and Medical Centre, Breach Candy Hospital,
Hiranandani Hospital, Bhatia Hospital
Private Hospitals:
Jaslok Hospital and Research Centre, Jagjivan Ram Hospital, MIDC Hospital Center, Harilal
Bhagwati Mun. General Hospital, St. George Hospital
Kolkata:
Public Hospitals:
Medical College, R.G. Kar Medical College and Hospital, MR Bangur Hospital, J.B. Roy State
Ayuvedic Medical College and Hospital, SSKM Hospital
Private Hospitals:
Columbia Asia Hospital, Belle Vue Clinic, Tata Medical Centre, Rabindranath Tagore
International Institute of Cardiac Sciences, Anandalok Charitable Hospital
Bangalore:
Public Hospitals:
Fortis Hospital, Mallya Hospital, Victoria Hospitals, Manipal Hospital, Narayana Hrudayalaya
Private Hospitals:
NU Hospitals, Deepak Hospital, Sita Bhateja Speciality Hospital, Green City Hospital, Spine
Care and Ortho Care Hospital
4. Cosmetic Surgery Facilities
New Delhi:
Dr. Prabhash’s Cosmetic Surgery Clinic, Gorzeous Looks, Olmec Best Cosmetic surgery and
Hair Transplant Centre, Divine Cosmetic Surgery, Sushma Plastic And Cosmetic Surgery Clinic
Mumbai:
INTERNATIONALIZATION STRATEGY PRIMED: INDIA 27
Cosmetic Surgery Mumbai India, Dr. Manwani’s Cosmetic Surgery Clinic, The Cosmetic
Surgery Institute, Amrit Laser and Cosmetic Surgery Clinic, Skin and Plastic Surgery Center
Kolkata:
Cosmetic Surgery Kolkata, Prem Laser and Cosmetic Surgery Clinic, Cosmetic-Therapy, Dr.
Dolly Gupta: Dermatologist, Hair Transplant and Cosmetic Surgeon
Bangalore:
New You Cosmetic Clinic, Dr. Shetty’s Cosmetic Centre, Midas Cosmetic Gynecomastia
Surgery Clinic, Contura Cosmetic Clinic, AK Clinics-Hair Transplant Bangalore
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