Rapid technological advancements are helping to write a new growth story for India’s medical machining industry that thrives on precision and speed.
by Madhukar Joshi
Measure twice, cut once’, states an old English aphorism. This priceless traditional knowledge forms the fundamental footing of the entire medical machining industry in India, wherein precision machining is of utmost importance in every product cut, milled, drilled, broached, or shaped.
Medical machining involves specialised precision CNC machining of implantable devices, surgical instruments, and diagnostic equipment. A multi-tier industry, medical machining has manufacturers of CNC machines and equipment who supply their products to implant manufacturers and job-shoppers who in turn service the specific healthcare requirements of dentists, orthopaedics, and hospitals. There also are companies that offer custom components to original equipment manufacturers (OEMs) of medical equipment, along with other technology-based OEMs.
Market Structure & Scope
A highly fragmented industry, the medical device market can be classified into four broad areas: implants, equipment, consumables, and patient aids. Of this, implants and equipment are the two segments where medical machining has a dominant role to play. The products covered under the medical machining industry include, but are not limited to, multi-axes machines, orthopaedic implants, medical syringes, plastic products, IV sets, medical instruments, optometry, surgical equipment and consumables.
‘Medical implants’ constitutes the fastest growing category within this industry. Prominent procedures for implants prevalent in India are knee and hip implants, artificial joints, and dental fixtures. Although this segment is dominated by imports, many local players can be seen providing tailor-made designs to their clients in order to stay competitive.
The Indian medical device market is dominated by hundreds of small local players, who control nearly 65% of the market, as per data from the Association of Indian Medical Device Industry (AIMED). Geographically, the activity is concentrated in five industrial clusters, represented by five Indian states: Haryana, Delhi, Gujarat, Karnataka, and Tamil Nadu. The industry has evolved in these states due to their historical strengths as business hubs.
While the high availability of scientists, academicians and skilled technicians forms the strength of the Karnataka and Tamil Nadu clusters, the easy availability of skilled labour and proximity to national capital are the reasons behind the growth of the industry in Haryana and Delhi. The industry in Gujarat thrives due to the existing knowledge-base of laser technologies for diamond cutting, besides the deep-rooted entrepreneurial capability of the local communities.
According to AIMED’s forum coordinator, Rajiv Nath, “The rapidly growing Indian medical device market is currently the fourth largest medical device market in Asia, and is valued at Rs 65,000 crore.” Nath foresees a huge potential for the medical devices market due to the central government’s emphasis on domestic manufacturing through projects such as Make in India.
Trends in Medical Machining
The medical machining market has been experiencing a strong growth over the last decade or so. In the recent past, GST rollout impacted a few other segments within manufacturing, but its impact on medical machining business was short-lived due to the critical nature of this business that impacts human lives and lifestyles.
The machining technologies and techniques have undergone a series of improvements with innovative products and methods being introduced on a regular basis. These innovations are not only targeted at improving the product designs, but also enhancing the effectiveness of the life-saving procedures that products are built for. Let’s explore some of the key trends that have been driving a strong growth in the industry.
i. Products with high engineering tolerance: Surgical precision is a term commonly used to describe the high accuracy level expected of an exercise, highlighting how the world views a surgeon’s precision as the standard to follow. Imagine the level of precision that a surgeon’s tools must have. With increasing consumer awareness and an improving legal support system, there has been a growing need of high-precision equipment and tools machined for medical use.
For instance, while surgical instruments must be machined perfectly to fit into a surgeon’s hands, the implants must precisely meet a patient’s size and shape needs. Tiny variations in surface, shape, or size can have a devastating impact considering the life-saving nature of the procedures these products are used for.
“The need for high-precision equipment and implants has grown phenomenally, during the past few years, in India. Medical practitioners as well as patients see immense value in tools and implants that are machined to perfection,” observes V Nagesh, director, Cosmos Impex (India). Cosmos Impex is a leading global machine tool manufacturer with its India plant in Gujarat.
ii. Need for high-comfort implants: Procedures such as knee and hip implants, dental implants, etc. need machining of complex shapes with high tolerances. As these implants are permanently fixed in the human body, they must be precisely cut and shaped as exact fits. Their surfaces must be finely polished without leaving any grooves or roughness in order to avoid discomfort to patients. Besides the methods employed, the new materials such as stainless steel, titanium and toughened ceramic are being used today, which also require precision CNC machining along with EDM.
“Replacing natural joints with artificial joints made with complex machining is the newest trend in the orthopaedic implants space. The demand for multi-axes machines is on the rise as more patients are showing willingness to spend on implants that lend high-comfort today, more than ever before,” says Subbarayan S, CEO, SNJ Technologies. Although 5-axis machines are at a nascent stage of adoption today, their demand will grow in the near future, he says. Subbarayan, who has 20 years of experience in the industry, works as a consultant for manufacturers from verticals such as die and mould, automotive, and machine tools.
iii. Emergence of small-form factor products: There was a time when portability of many medical devices was difficult due to their large sizes. For instance, defibrillators used for patients suffering from cardiac arrest (popularly known as AED) were very cumbersome to carry, placing limitations on their use at public places. However, defibrillators of today come in small and neat portable packs. Similarly, many other medical devices are becoming tiny day-by-day. The casings of these small-form factor devices require precise machining to maintain the compactness of the whole kits. Portability of medical devices proves to be a critical feature while providing emergency care to patients at public places or remote locations.
iv. Changes in demand: During the past two decades, there has been a distinct change in the preferences of patients and medical practitioners, alike. Multiple factors including the rise in consumer awareness, availability of technologically-advanced products and procedures, rapid urbanisation of India’s tier-II and tier-III towns, and improvement in lifestyles of the country’s middle-classes have led to a new demand for advanced medical procedures.
The steadily rising disposable income of middle-class consumers in India’s top 24 cities has increased the ability of patients to spend. For instance, dental aesthetics that was once seen as a luxury of the super-rich has become an essential criterion for many patients, while selecting the type of procedure or materials today.
Coinciding with these developments, there has also been a massive growth in the health insurance sector. As today’s patients have easy access to insurance options, it has boosted their ability to access advanced treatments and procedures. The resultant growth in demand has led to procedures as well as products becoming more affordable, further fuelling the rise in demand for the medical machining industry.
The Road Ahead
Even as the industry witnesses a strong growth, technological intervention is likely to further transform it in the near future. Kazi Industries’ CEO, Feeroz Kazi, gives an example of how technology is likely to bring about a ‘massification’ of healthcare services, providing a tremendous boost to the medical machining industry. “Today, there are mobile apps available for orthopaedic hospitals, orthodontists, and many other healthcare service providers to order specific requirements of implants and other products to manufacturers and CNC machining shops. The new machines are geared to take these orders directly from the app — without human intervention — and precisely manufacture the product required within a short time,”
Kazi informs. His company is a leading supplier of precision machine components with its plant in Pune.
As more such human-machine networks become prevalent, it will enable speedy delivery of implants and other products required by medical industry. Going forward, the adoption of such technological interventions and new research happening in the areas such as 3D printing can create a massive growth for the medical machining industry, benefiting the industry, medical care providers, as well patients in a big way.