“Ophthalmologists are most overstretched in India, so our aim is to help them remain strain-free” Sandeep Bothra


With 15 million blinds, India is home for 50% of the world’s total blind population, according to a 2016 study by the World Health Organisation. While the status hasn’t changed much in the last two years, another most worrying fact is that the country is also one of the geographies in the world where the number of ophthalmologists in proportion to its total population is the lowest. And thus, it wasn’t a surprise that why the country was also infamous for the highest number of medical negligence in the area of eye care until recently. While the cases of negligence have significantly come down in the last few years, the credit to a great extent should go to the technology players who changed the scenario by bringing the much-needed sophistication into this field of care. Sandeep Bothra, Country Business Head- Surgical, Alcon Laboratories India, says that most of the recent technologies, those were introduced in the area of eye care in India, have visibly improved the way the diagnosis and procedures are done in the eye care setups and the emerging technologies will make the visualization and diagnosis more easier and accurate, in an interview with editor CH Unnikrishnan. Edited excerpts:

Eye care scenario in India has been quite challenging because of several factors including a shortage of ophthalmologists, lack of better training and infrastructure and accessibility issues with best technologies. Alcon has been in India for some time now and could you tell us what has been your experience so far and do you think the market has improved in terms of quality of care?

Alcon as a global leader in eye care, we always try to discover new ways to enhance sight and improve patient lives. As we have been doing this successfully in this market through innovative products, partnerships with eye care professionals and programs that create greater access to quality eye care. We identify and develop technologies that deliver better visual outcomes and address unmet patient needs, continuously improving the options that exist today. Since our research team observes surgeries and visits clinics to gain real-world insights, we also regularly meet with eye care professionals to get their feedback on our products and their future needs. So, I can confidently say that the technology and training have significantly improved the situation in the Indian eye care. Also, the customers, as well as patients, have become quite demanding as they are already aware of the latest products and procedures. It is also evident from the change that the cases of medical negligence have come down drastically in recent time. And I am proud to say that our products touch the lives of millions of people each year living with conditions like cataracts, glaucoma, retinal diseases, and refractive errors. Since we are the only company that offers the complete line of ophthalmic surgical devices, as well as a differentiated contact lens and lens care portfolio, this also gives us a premium and most trusted position in the market.

Alcon, through its social responsibility and advocacy efforts, also help to create sustainable access to eye care for patients around the world, thereby reducing the incidence of preventable blindness and visual impairment. By investing in professional education, the group help to advance the eye care industry and ultimately create better outcomes for patients and consumers.

How do you see the pricing scenario here as the government is slowly bringing cost regulation on most medical devices, implants and health equipment?

A couple of thoughts on this. No doubt, the intention of the government is noble as it wants to expand the access of healthcare to every stratum of society. But I would say, the opportunity in India for every segment is big enough for everybody. In general, I think the changes in market dynamics will ultimately depend on how these are rolled out and how agile are the companies to adapt to the changing requirements. India as a vast country with varied needs and priorities depending on the profiles of different regions, optimising the market opportunities will depend on the adaptability of the players. Still, I feel the country offers ample opportunities for both national and international companies.

As you know, India is also a very competitive as well as value conscious market with so many players, including foreign and local brands in the ophthalmic segment. So, what made you the largest and how do you maintain the leadership?

The key factor that made us the market leader is the unparalleled reach that we have in this market. We are present in every corner of the market, spanning from one end to the other in the length and breadth of the country. In addition, we have the entire portfolio of products catering to every disease and age groups. The other important factor is the quality and innovation that we maintain in every class of product knowing our partners’ needs and helping them consistently with the latest technologies, enhancing their choice of practice. That’s why the surgeons love to work with us.

What are the key challenges in this market?

In the current context, one of the challenges is how do you ensure that our products and services are available in the same quality across the country. For example, if we want to sell or service our products in Imphal or Mandya, Srinagar or Lakshadweep, I want to ensure the same quality of service that I provide in Mumbai or Delhi. But, managing the logistics of that is a big challenge in such a vast country. Just to explain the technical aspect of it, I would take the example of a cataract surgery, where there are two important equipment required—the main equipment and the library of implants. In this case, we have to reach the entire library even if the surgeon uses just one particular implant, which is decided at the surgery table. So, we need to make the stock available so that the doctor can do the surgery without compromising the quality. And this is about every geography and climatic conditions. Similarly, the doctors, though fundamentally they are the same everywhere, in India often need to balance the quality of work as well as the value proposition as the majority of the patients here still pay out of pocket. While the lack of patient awareness is a problem, the work pressure that is often faced by the overstretched surgeons in this branch of medicine is another big challenge. In India, there are only 12 to 13 ophthalmologists for a million patients, which is much below the global average. So, we aim to overcome these challenges, both at the patient side as well as the clinical side using more innovative technologies.

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