Cochlear trailblazes Australian medtech in India

14 June 2022

Sydney-based hearing implant pioneer, Cochlear, is paving the way for Australian medical technology in India. To date, Cochlear has worked with 21,000 patients in India. Almost 19,000 are children.

The company is set to be an early beneficiary of the signing of a new Australia-India trade deal. Once the agreement is in force, the inventor of the bionic ear will see the gradual removal of 7.5–15% tariffs on its hearing devices, parts and accessories in India.

Lower costs should help the company increase the number of children that benefit from hearing implants in India.

‘Now is a good time for Australian medtech in India,’ says Dig Howitt, President and Chief Executive Officer of Cochlear Ltd. ‘We have some great medical technology companies in Australia – in medical devices and in pharma. The market in India is underserved: there’s genuine opportunities.’

Cochlear already helps 3,000 patients per year in India

Cochlear began working in India in 1995. The company initially partnered with a distributor and Howitt says this lowered the cost of entry and helped reduce risk.

Today the company’s 80 India-based employees work directly with clinical organisations. Cochlear also works directly with large organisations that provide medical services, including the Indian Army.

To date, Cochlear has helped trained more than 300 ear nose and throat (ENT) surgeons across India. They manage an average 3,000 implants per year. This makes India Cochlear’s fourth largest market by volume.

Trade agreement makes treatment more accessible

Howitt expects the incoming trade deal – the Australian-India Economic Cooperation and Trade Agreement (AIECTA) – will increase the affordability of cochlear implants over time in India.

The complete elimination of tariffs will take 6 years. However, tariff rates on certain components will drop immediately. Howitt anticipates this will lower end-unit costs and increase accessibility for patients.

‘This is an important step forward,’ he says. ‘Our biggest barrier to helping children in India is awareness. The trade agreement will help because it will raise awareness of Australian med-tech.’

Cochlear CEO, Dig Howitt with Indian Minister of Commerce and Industry, Shri Piyush Goyal celebrating the Australia–India Economic Cooperation Trade Agreement.

Image: Cochlear CEO, Dig Howitt with Indian Minister of Commerce and Industry, Shri Piyush Goyal celebrating the Australia–India Economic Cooperation and Trade Agreement.

Howitt points out that the agreement may be expanded. In the future, he hopes that further liberalisation will make it easier for workers and professionals to move between India and Australia. This will also help Australian companies to project themselves in a complex and challenging market.

‘I think this bilateral trade agreement is important for Australia’s overall brand in India,’ he says.

Insights for Australian medtechs in India

Cochlear’s passage to India offers insights for ambitious Australian medtech companies. India is not just vast, it’s hugely diverse and the healthcare system is dominated by the public sector. Currently private care is very urbanised. There is a low level of insurance coverage among the population.

Addressing this market can be overwhelming, but Cochlear shows that patience and investment pay off.

‘It’s vital to have a target market and a clear use case,’ says Howitt. ‘Clearly there were children in India with profound congenital hearing loss. But before we could help them, we needed to upskill medical staff and find advocates for Cochlear implants.’

Besides surgeons, Cochlear has trained medical staff to conduct screening for hearing impairment. Cochlear has also trained more than 500 audiologists to support post-operative care to patients and over 2000 speech therapists to manage post-implant rehabilitation.

‘We work very closely with well-respected surgeons and they act as advocates for treatment,’ he says. ‘Partnering with medical staff helps raise awareness.’

Austrade has also helped.

‘We have worked with Austrade all over the world,’ he adds. ‘Austrade continue to support us in India to make connections and build our profile and that’s very helpful.’

Potential for Australian medtech in India

Howitt is extremely positive about prospects for medtech in India – despite the challenges. Size and rapid growth are two reasons for optimism.

‘India is a very large market and health spending is increasing,’ he says. ‘We see India as a very important market over the long run. We are committed.’

India’s government has launched the Ayushman Bharat scheme. This is the world’s largest state-funded universal healthcare program with an annual budget of A$690 billion. It will trigger opportunities in medtech, research and development (R&D) partnerships, and training and skills development.

Howitt points out several aspects to healthcare in India that should encourage Australian medtechs to give it a go.

‘English is widely spoken among medical professionals,’ he says. ‘Many doctors have trained overseas, and they are highly receptive to new medical technologies. Also there are obvious culture links with Australia.’

Private healthcare is a good entry point

Howitt points out that private healthcare is expanding. ‘As healthcare systems develop, there is likely to be increased private health insurance and Government spending,’ he says.

He stresses that Government relationships are important. And he says the Indian Government is open to new treatments when they are seen to work in the private sector.

‘We started with privately funded medical centres and sometimes with charities,’ he says. ‘After time, the government sees the effectiveness of what you are doing and wants to buy in to the treatments. That requires additional funding, so we need to work with governments to develop effective models of care.’

The importance of trust in medtech in India

For potential exporters, one element is supremely important: trust.

‘The quality of the products and people we send to India is paramount,’ says Howitt. ‘We are always careful to make sure that we act with the highest integrity to build trust. Quality builds integrity.’

Currently, Cochlear is partnering with health services in India to improve infant screening.

‘This is a hugely important endeavour,’ he comments. ‘The earlier we identify a potential patient the better the auditory outcome. Today, we are working hard to build up the infrastructure to screen infants in India – that’s something we as a company can be proud of.’

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