DIABETES TEST KIT MANUFACTURING

INDUSTRY ANALYSIS

STRATEGIC MANAGEMENT 1
SECTION A | GROUP 9
IIM RAIPUR
Submitted by:
Anshoo Saini 15PGP008
Gautham Balaji 15PGP015
Isha Tayal 15PGP018
Koundinya Niggamadda 15PGP026
Piyush Gaurav 15PGP037
Shekhar Suman 15FPM009

Index
Industry Definition…………………………………………………………………………………………………………………………….2 Industry Activities 2 Similar Industries 2 Market Participants 2 Porter’s Five Forces Analysis 3 PESTEL Analysis 4 Industry Outlook 5 Products & Markets 6 Future Outlook 7 Competitive Landscapes, Success factors and Business Locations 7 Major Companies 8 Strategic Recommendations 10

Industry Analysis
Industry Definition
This industry develops and produces blood glucose meters and testing supplies that help users monitor blood glucose levels. Most manufacturers also develop other medical devices.
Industry Activities * Diabetes market research * Glucose meter monitoring research and development * Glucose meter * Glucose meter accessory
Similar Industries * Dental Laboratories * Diagnostic & Medical Laboratories * Dialysis Equipment Manufacturing * Health & Medical Insurance * Hearing Aid Manufacturing * Medical Device Manufacturing * Medical Instrument & Supply Manufacturing * Ophthalmic Instrument Manufacturing * Pacemaker Manufacturing * Robotic Surgery Equipment Manufacturing * Syringes & Injection Needle Manufacturing * TENS Machine Manufacturing * Venous Access Device Manufacturing
Market Participants * R & D * Suppliers * Manufacturers * Hospitals * Doctors * Patients * Retailers

Porter’s Five Forces Analysis

Internal Rivalry: The market is highly competitive and commoditized though it involves a considerable cost in coming up with any innovative kit. The currents products like blood glucose meter, Glucose meter test strips, lancets and Insulin pens are produced by many companies. Accu-Chek Compack Plus, One Touch Ultramini, Fora V30 etc are example of few successful products by various companies. A considerable amount of money (often running in billions) is involved in coming out with any new, more effective kit. However, most of companies are producing more or less same type of kits with little differentiation. A significant cost is involved in marketing the products, out of which advertisements take a major chunk.
New Entry: Though entry into pharmaceuticals sector involves a large cost, the cost for setting up a base for producing these kits is considerable low. Any small time pharma with little know-how can venture into these segments. Since the segment shows considerable growth projections in future, raising funds for such kits is not difficult. Designing and manufacturing of kits can also be outsourced to have competitive cost advantage. If a company develops any new method or kit, it can protect it with IPRs but that does not defer other from entering the market.
Substitutes/Complements: There are tough competitions in market for providing medication for controlling diabetes. An array of products is offered across various clans of medical area. Allopathy, Ayurveda, Homoeopathy etc have their own sets of recommendations. However, there are almost no substitutes for these kits. These kits can be personally used. A close substitute is provided by lab tests which considerably slow and does not have same position as that of these kits.
Buyer Power: Buyer have always had low bargain power in pharmaceutical and medicinal products, as there are low-to-no substitutes available but such products are very essential for them. Taking advantage of this, pharmaceuticals and medicine companies have been able to charge high prices, in order to compensate for R&D costs. The customer base for companies such kits are retail drug stores, hospitals, and government medical institutions. Though retail outlets do not have much power, hospitals and government institutes can have a bargaining stand. They may seek discounts on bulk purchase.
Supplier Power: The development of these kits is mostly outsourced and companies always have options to switch to other suppliers as switching cost is not so high. Giants can also go for horizontal integration and hence the companies have high bargain power in comparison to suppliers.
PESTEL Analysis

Political: There is increase in political pressure on healthcare industry. Since there has been considerable increase in cases of diabetes in India (prevalence rate of around 9%), government can act as a benefactor in making these basic amenities available to most. There can also pressure on pricing. There can be schemes of providing insurance to common public.
Economic: Since the diabetes is also becoming quite prevalent in middle and low income class, we may see some insurance models come in picture to handle such costs. With an increase in no. of buyers and these products being a commoditized one, the companies may be forced to cut back more prices to stay competitive. There can also M&A where small players will be bought by bigger ones.
Social/Cultural: With the aging population of India, there will be surge in diabetic cases (as diabetic is seen mostly in older people). This offers both opportunities as well as threats. Patients are becoming more informed and demanding.
Technological: There is high need of technological innovation this field. The field is lucrative in terms of returns on investment. This can lead to some new products with better accuracy. Any app or a bloodless service can also come into picture. There are also many opportunities where information and communication technologies can be used to divide the sections of patient and provide customised and cheaper service. A private consultation service may be given after each test by these test kits.
Legal: There are many legal and regularity issues in this field. However, they are quite relaxed for these kits as they do not pose severe health hazards and are not used for medication but for monitoring the glucose level only.
Environmental: There are not much of environmental ill-effects due to these kits. However, companies can be forced to find ways to effectively dispose the used test kits and elements of CSR can also come into picture.

Industry Outlook
Diabetes care market mainly consists of devices, technologies and therapeutics markets related to diabetes. Diabetes market in India is expected to reach USD 2.3 Billion by 2020 and is expected to grow at a CAGR of 6.3%.
The diabetes patient pool worldwide is expected to be 380 million by 2025. The growth rate can be mainly attributed to the increase in aging population, sedentary lifestyle, dietary patterns that are unhealthy etc. Diabetes care shares approximately 11.6% of the global healthcare expenditure. Global diabetes care product market was around USD 41 billion in 2012.
The primary market drivers for the diabetes care industry will be the large patient pool suffering from diabetes, sedentary lifestyle of people, obesity and growth in innovation technologies, more Research & Development in diabetes diagnosis and treatment and non invasive products. Moreover increase in adoption rates for diabetes care devices will be driven by growth in awareness, improved diagnosis and treatment rates and increase in need for faster, safer and effective diagnosis method and diabetes treatment.
In addition to that, ability to invest more by the market leaders and entry of new firms into this market, increase in scope of getting in untapped and emerging markets, and increase in awareness among people about diabetes care are also opening up the growth of this market. Also there has been a substantial increase in the number of diabetes cases reported globally over the past few years.
However, there are few factors that hinder the growth of the diabetes care market. They are mainly high cost associated with diagnosis and treatment, contention on reimbursement for new technologies, dearth in awareness, strict regulatory compliance, and high cost of diabetic food. Third party reimbursements are restricted to the coverage type they give to concerning devices, diagnosis and treatment of diabetes.
Products & Markets
The main products under diabetes care are the following * Blood Glucose Monitoring Devices * Testing Strips * Self-monitoring Blood Glucose Meters * Lancets * Continuous Glucose Monitors * Others * Insulin Delivery Devices * Insulin Syringes * Insulin Pens * Insulin Pumps * Insulin Jet Injectors

* Other Glucose Testing Devices * Hemoglobin A1c * Hemoglobin A1c Meters * Hemoglobin A1c Kits
Market is divided into two major segments. They are mainly glucose monitoring device market and insulin delivery device market. Glucose monitoring device is further divided into blood glucose meters, blood glucose testing strips, lancets, and CGM device. Also, Insulin delivery device is further segmented into Insulin syringes, Insulin pens, Insulin pumps and Insulin Injectors.
Global SMBG equipment market’s value has been valued to reach approximately USD 27 billion in 2022. There is an increase in availability of blood glucose meters in India but the main huddle faced by their penetration is their high priced.
The testing strips segment holds for the highest share of the blood glucose monitoring devices market and the insulin pens segment holds the largest share of the insulin delivery devices market. The greater share of the insulin pens segment is mainly because of the high adoption rate of insulin pens .The growth in taking over of insulin pens and easy accessibility of affordable insulin pens in India which was recently introduced have added to the growth of this segment. CGM systems recently became one of the fastest growing blood glucose monitoring devices market segment. Growth in this segment is mainly because of the rising adoption CGM systems by healthcare professionals to monitor real-time blood glucose levels for better care and treatment of diabetes
The usage of Continuous Glucose Monitoring devices are increased over the years but saw growth of just fewer than 20 percent in 2012.Insulin delivery device landscape will allow for strong growth and the insulin syringe patient share have a probability to decrease. The insulin pen and insulin pump patient share may see substantial growth over the next few years.
Future Outlook
One of the recent initiatives involves a glucose sensing technology, which uses tears or sweat to detect glucose levels instead of blood. A wireless device integrating the biosensor is also being developed. Continuous monitoring of glucose levels and transmission of the data to a glucose pump for a completely integrated treatment will be possible because of these innovations. A biosensor for blood glucose that involves measurement and analysis through digital means is also being developed.
Also the launch of Code-free meter by some of the companies has reduced errors in coding and has discarded the need for patients buying new box of strips each time. Higher income levels and plunge in prices of glucose meter have been playing an important role to push their widespread use. The market is expanding faster in tier-II and tier-III towns and would see a quicker growth with changing lifestyle. Although India has a bigger market size, 99.9 percent demand of Indian diabetes market is satisfied by only imports, and the government’s effort to improve local manufacturing has been still facing huddles so far.
Major Companies
Roche Diagnostics
Founded in Switzerland in 1896, Roche is a pioneer in healthcare for nearly 120 years. It has discovered innovative pharmaceuticals and diagnostics that are used by millions of patients in the world. It is the global leader in cancer treatments and leading provider of in vitro diagnostics. Roche Diagnostics currently operates from five Offices in India with the Offices at Chennai, Kolkata, Mumbai (Andheri Office) and New Delhi serving the Diagnostics while the Mumbai (Bandra office) serves pharmaceuticals.
The company has more than 35 years of experience in the area of diabetes management and serves the Patients through the product line Accu Check under which it offers products like Glucose Meters-Active and Aviva, Softclix Lancets, Meter Strips Accu-Chek-Active, Aviva and Performa. Accu Check is No.1 Brand in blood glucose monitoring systems worldwide. It sells its products through etailers like e-bay.
Johnson and Johnson
Established in 1886, with experience of over a century, Johnson and Johnson is the World’s sixth largest Consumer health company and most comprehensive medical devices business. The Medical Devices business segment produces a broad range of innovative products and solutions used primarily by health care professionals in the fields of orthopaedics, neurological disease, vision care, diabetes care, infection prevention, diagnostics, cardiovascular disease, and aesthetics. Johnson and Johnson produced the first full feature insulin pump that wirelessly communicates with a blood glucose meter-remote. The system allows a person to calculate and opt to wirelessly deliver insulin doses without touching the pump at all, giving patients more freedom, discretion, and flexibility. Johnson and Johnson OnetouchUltraeasy Glucometer is currently available in India through varies etailers with a price range of Rupees 900-1200
Abbott
Founded in 1888, by a young Chicago based physician, Dr. Wallace Calvin Abbott, the organization has been devoted to discovering new medicines, new technologies and new ways to manage health. Today, it is a worldwide broad based healthcare company whose products and technologies span the continuum of care - from diagnostics to devices, from nutrition to pharmaceutical therapies.
Headquartered in Mumbai, Abbott India Limited, a publicly listed company and a subsidiary of Abbott Laboratories, enjoys strong brand equity in multiple therapeutic categories such as Women's Health, Gastroenterology, Neurology, Thyroid, Diabetes & Urology, Pain Management, Vitamins, Anti-Infective& other therapy areas. It employs over 2,600 people and reaches customers through a network of 35 distribution points, catering to over 4,500 stockists and 150,000 retail outlets.
The company has in-house development and medical teams to undertake product and clinical development tailored to needs of the Indian market. It reaches the patients. Its key products include the XIENCE drug-eluting stent, laboratory diagnostic instruments ARCHITECT and AxSYM, and blood glucose monitoring devices for diabetes, Free Style Optium and Free Style Freedom Lite. As quoted by diabetes daily, the brand freestyle (of Abbott) is rated the best among glucose meters scoring excellent in accuracy, with a rating more than 80 out of 100.
Arkay
Established in 1960 by Mr.TadashiDoi as KDK Corporation in Kyoto, ArkayInc today operates in two business segments Development and New Business. The company has its products for Laboratory Testing, Near Patient testing, Blood Glucose Monitoring, Span Diagnostics and other products like the Blood Pressure Monitor, Insulin cool Punch etc..,
Pulsatom Healthcare
Incorporated in February 1994, with its factory and headquarters at Bengaluru, Pulsatom healthcare is the manufacturer of India’s first Indigenous Glucometer. With its goal of a Healthy India, the company specialises in point-of-care testing devices. It started manufacturing and introduced India's first indigenous Glucometer in 1995 with technology developed by National Physical Laboratory & Centre for Bio-chemical Technology, Delhi under C.S.I.R. Labs, Department of Science and Technology, Government of India. Across 20 years, it has launched over seven models to meet your need for a reliable yet economical Self Monitoring Blood Glucose Meter.
Currently the company offers RP 10 Glucometer and RP 50 Glucometer products under the Brand name ACE priced at Rs.800 and 1200 respectively where the numbers 10 and 50 specify the number of Strips in the Product. Headquartered at Bangalore, the company has its current dealer bases extend to over 100 dealers in India reaching across most major regions of the country. The company also sells its products through etailers like flipkart and Amzon in addition to its own website (https://www.pulsatom.com/estore.asp)
Other prominent products under the brand names Arkray, B.Braun, Glucocare, JSB, Diabascan, Nipro, Omron, Dr.Gene, Dr.Morepen, Besure, Beurer, Operon, RomsonsRomo, Truworth etc..,
Competitive Landscapes, Success factors and Business Locations
These are few market players in the segment working in India. In the following section we have discussed about the competitive landscapes, key success factors and business locations used by these players.

Roche
The Company is world leader in healthcare sectors of pharmaceuticals and diagnostics headquartered in Basel, Switzerland. It focuses on the strategy that aims at providing health care services for improvements in quality and survival of patient’s life. The company was founded in 1896 and since then some twenty-eight medicines developed by it have been registered in World Trade Organization Model list.
Company has expended into India with a brand name of Accu-Chek. It has its main office in Mumbai and supplies the products on pan India basis. It has an experience of 35 years on Indian soil and became a pioneer in diabetes management. It plays market penetration strategy by making its product such as lancets and glucometers widely available in the market and widely accessible by doctors and patients.
Omron
The journey began from 1933 with the founder Kazuma Tateisi and headquarters in Kyoto, Japan. It has a simple strategy that can be summed up in three stages – improving productivity, improving people’s day-to-day life and creating new relationships between machines and employees. The company strives in search of new solutions to health and safety need of the people. It commenced its operation in India in 1980 with the products such as glucometer and lancets. It presently has offices in Gurgaon, Mumbai and Bangalore. The company senses its strength in innovation of new technologies.
Pulsaton Health Care Pvt. Ltd.
The Company established in the year 1994 is headquartered in Bengaluru. This Indian based company deals in glucometer with its production unit in Bengaluru. It has collaborated with other firms to become best in the field of sales and support across India through more than 100 dealers. It has also partnerships with e-retailers such as Amazon, Flipkart, Healthkart etc.
Operon
This is a new Indian company, came into existence recently in 2008 with headquarters in Bengaluru. The company carries a workforce of experienced professionals and aim for innovation and growth in health sector od the country. The key strengths of the company are strong product line, quality products, excellent technical and customer support.
Alere
A United States based company with operations across the global is also serving India since its inception in 2001. Few strategies followed by the company are socially conscious business approach, cost effectiveness and wide availability. It commits for high quality products and services with continuous advancement in technology to sustain in the market. The Indian league of the company has offices in Manesar and Gurgaon.
JSB Health care
The biggest player in Indian market headquartered in New Delhi has experience of over 30 years in this business. Company has efficiently used its online portal for faster and free deliveries across the nation. Moreover it has tie-ups with other interesting e retailers such as Airline and Railway Catalogue, Tele shopping and corporate gifting. Among most of the Asian countries, company has also extended its business to African and European continent to have a global presence. It is a one stop shop for all the medical needs in a reasonable price.
Strategic Recommendations
The business of Self-Monitoring of Blood Glucose (SMBG) is highly competitive in nature. Without innovating on the technology used, the new entrants will find it hard to sustain and succeed in this market. The prices per unit of the glucose meter/ strips are likely to decline, adding to their troubles.
In order to sustain growth and maintain adequate profit margins, we have the following recommendations for the existing players in SMBG business: * Create better effective and economical monitoring techniques to manage diabetes and thereby focus on diagnostic development for the potentially untapped global market * Use of R&D to develop better ways of continuously monitoring glucose level in vivo * Develop technologies involving mobile phones and applications as the basic glucometer instrument to enable tech savvy consumer base to effectively monitor their glucose levels. * Partnership with insulin pumps and pens can enable automated disease management by continuous glucose monitoring. * Tight glycemic control should be focused on when educating the patient about managing diabetes.

References

* https://www.diabetesdaily.com/blog/2015/06/consumer-reports-glucose-meter-ratings-2015/) * https://www.ibisworld.com/industry/glucose-meter-manufacturing.html * http://www.medicalbuyer.co.in/index.php?option=com_content&task=view&id=4567 * http://www.diabetesmonitor.com/glucose-meters/blood-glucose-meter-trends.htm * http://www.marketresearch.com/product/sample-6921302.pdf