Indian hospital chains, which saw their medical tourism business decline after the government tightened visas to Bangladesh nationals, are looking at international patients from other geographies such as the Middle East, Africa and Central Asian countries.
Hospital executives told Moneycontrol that there is a partial recovery in the number of medical visas issued to Bangladesh, even as they have stepped up targeted marketing and outreach efforts and introduced transparent packages to attract patients from other countries.
"While there has been a short-term decline from markets like Bangladesh, we are seeing rising demand for healthcare and medical value tourism from multiple countries in Africa and the Commonwealth of Independent States, among others," Dr Madhu Sasidhar, CEO, Apollo Hospitals, said.
Bangladesh earlier accounted for around 45 percent of all medical visas issued by India. However, in 2024, these visas declined by 28.2 percent as India restricted visas to Bangladeshis following the ouster of the Sheikh Hasina government, subsequent political unrest, and rising anti-India sentiment.
The number of medical visas issued by India reached an all-time high of 597,196 in 2023, but Bangladesh, along with Yemen and Somalia pulled down that number to 463,725 in 2024.
The most hit
The hospitals based in East and South India that attract a higher number of Bangladeshi patients were impacted more.
In the third quarter of FY25, the drop in Bangladesh patients resulted in a 1.5 percent revenue loss for Apollo, whose Chennai and Kolkata hospitals get a bulk of Bangladeshi patients.
Sasidhar said that despite the Bangladesh impact, the number of international patients continues to grow at a healthy pace.
"The 19 percent YoY increase in international revenue (excluding Bangladesh) underscores the trust patients place in our clinical expertise,” he said.
Apollo, India's largest healthcare provider, generates about 7 percent of its revenue from international patients, but some of its regional flagship hospitals in Chennai and Delhi see standalone revenues of up to 20 percent from the segment.
International patients are much sought after by hospitals, as they pay 15-20 percent premiums and spends are largely out-of-pocket. They come to India to avail advanced tertiary care like organ transplants, bypass surgeries, joint replacements, among others. Along with accessing healthcare, the patients and their attendant family members also spend money on accommodation, travel and other purchases, helping the economy indirectly.
For instance, Apollo performs an average of 1,200 transplants a year; it conducted 1,769 in FY24, with about 30 percent of these for international patients.
Anil Vinayak, Fortis Healthcare's Group Chief Operating Officer said the situation is gradually improving after the drop following last year's regime change in Bangladesh.
"After a previous 40-50 percent drop in patient arrivals and revenue from Bangladesh, the recent easing of visa regulations has led to a recovery of 15-20 percent in patient arrivals," Vinayak said.
He added that the resumption of freight train services between the two countries signals further potential recovery in medical tourism.
Overseas patients contribute approximately 9 percent to Fortis’ total revenue.
"We cater to a diverse international patient base, including individuals from the Middle East, CIS nations, African countries, the Pacific Islands, and SAARC nations, utilising our advanced medical infrastructure and expertise. Currently, our medical value travel revenues are almost at par with the levels seen before the Covid-19 pandemic," Vinayak said.
Gradual recovery
Medical tourism is recovering from major disruptions caused by the Covid-19. Before the pandemic, it accounted for about 8-10 percent of the revenues of large hospital chains. Geopolitics is now also affecting medical travel, with India yet to see the return of Afghan patients following the Taliban takeover in August 2021, which led to visa restrictions. India had issued around 20,000 visas annually to Afghans in the preceding years.
On the bright side, in 2024, medical visas to Iraq grew 8 percent year on year to 30,877.
Hospitals are confident that India continues to be an attractive destination given the quality and affordability of healthcare services.
The market for medical tourism, valued at $2.89 billion in 2020, is projected to reach $13.42 billion by 2026, according to government figures.
Dr Alok Roy, founder of Kolkata-based Medica Group of Hospitals, now owned by Manipal Hospitals, expressed optimism that Bangladesh patients will return to India as the alternative destinations remain expensive.
"The rich Bangladesh patients can access care in Thailand, Singapore or Malaysia, but for average middle classes and poor, India remains the most compelling option given the affordability and quality of healthcare, along with cheaper travel and accommodation," Roy added.
Roy cautioned that Thailand is rapidly emerging as a major alternative to India for medical tourism, as it is not far from Bangladesh and is becoming cost-competitive.
"The impact of Bangladesh patients goes beyond hospitals, it is impacting sales of drugs and diagnostics, especially in Kolkata," he added.
Vinayak of Fortis said the government could do more by further streamlining visa processes, creating dedicated medical tourism hubs, increasing global awareness of specialised treatments, and establishing aftercare networks.
"While the e-visa system has improved access, it requires further refinement in processing times and online support to fully meet the needs of medical tourists," Vinayak added.
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