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The 'Sweet' Pill

The market for Homeopathy is poised for a steady growth with established players now even expanding globally. Nancy Singh tracks this silent transition

It is no longer Allopathy's poor cousin. Homeopathy, the third most popular method of treatment in India after Allopathy and Ayurveda, is consolidating its position in India. The Rs 12.5-billion Homeopathy market in India, growing at a phenomenal pace of 25 per cent annually, is slated to become Rs 26 billion market by 2010, states a study by The Associated Chambers of Commerce and Industry of India (ASSOCHAM). Homeopathy is also making its mark globally. The World Health Organisation (WHO) has termed Homeopathy as the second largest system of medicine. According to US-based The National Centre for Homeopathy, by 2017 the Homeopathy market will be equivalent to the alternative healthcare market, which is Rs 52,000 crore currently. Approximately 500 million people worldwide receive Homeopathic treatment and around 100 million at present use Homeopathy in India, various estimates suggest. With Homeopathy being practiced in 66 countries of the world, the world Homeopathy market is pegged at Rs 135 billion. France is a leader in this segment with its Homeopathy market pegged at Rs 45 billion. Studies reveal that in 2006-07, around five crore patients diagnosed their ailments with Homeopathy. This number is likely to exceed about 10 crore in next two-three years in view of Homeopathy's popularity and acceptability among the general masses.

Market Dynamics- India

"People are now looking out for long-term cures and because Homeopathy is safe and permanent, there is a shift from Allopathy to Homeopathy" - Dr Mukesh Batra Managing Director Dr Batra's Positive Health Clinic

"Sometimes, I get to treat five patients from five continents in a day. It's quite amazing" - Dr Rajesh Shah Managing Director Life Force Center

"Homeopathic drugs are most eco-friendly. One can treat the global population with a kilo of basic drug substance" - Dr Mahendra Kabra Homeopath Jalgaon, Maharashtra

There are over four lakh homeopaths in the country currently, with approximately 13,000 more being added every year, the highest in the world. However, the number of established players in Homeopathy in this country are few. It is rather the local clinics that are fuelling this growth story.

The corporate leader in this segment is undoubtedly Dr Batra's Positive Health Clinic which is present on a pan-India basis and most recently has gone international, For the current financial year, the company has plans to set up 10 more centres across globe. In Muscat, the group has already opened up a new centre and plans to set-up one more. In the near future, it also plans to open a clinic in London. The remaining new seven centres will be at Bangalore, Goa, Surat and Indore. "We are definitely the leaders in this market and the earliest starter in this space as we have been present for almost 30 years. Today, we are growing at a phenomenal pace of 60-80 per cent," informs Dr Akshay Batra, CFO, Dr Batra's. Critics, however, dismiss Dr Batra's as a classical 'homeopathic' clinic because they feel that the kind of services it provides are more 'cosmetic' in nature than 'curative.' Dr Batra's concentrates basically in segments like trichology, obesity, diabetes etc.

Another significant player in the Homeopathy scene is Dr Satinder Pal Singh Bakshi's 'Bakson Homeopathy' which is more prevalent in Northern India and has around six clinics across India. He is also the President of Central Council of Homeopathy (CCH). But his growth story has been marred after him being arrested by Kolkata police for allegedly mixing steroids in medicine.

Going Virtual

Not ignoring the fact that there are not many established players in the industry, Homeopathy still has quite an interesting mix of models. While Dr Batra's has been following the traditional model of standalone clinics as well as thinking about franchisee models to expand in tier II cities, interestingly the model that is a big hit is cyber clinic. In fact, Homoeopaths seem to be quite tech-savvy as most of them have exploited this medium to the core. And these doctors don't just think local, but global as well. Just by operating through their small clinics they are able to reach a huge population base.

One of the best example of this model is Dr Rajesh Shah's clinic in Mumbai whose website claims to 'Asia's largest homoeopathic clinic,' even though it's a 5,000 square- feet clinic located at Chembur in the suburbs of Mumbai. It has a team strength of nine doctors. But from that one clinic, he has successfully managed to reach an audience in around 145 countries! That's the power of cyber pace. Whilst talks of telemedicine is just doing the rounds now, Dr Shah was one of the trendsetters who set-up his cyber clinic way back in 1995 when internet just came to India. His team helps run a global clinic in an offline-online format. His clinic receives patients from countries as far as Nigeria, Japan and Sweden. He has expanded his cyber clinics to include 'askdrshah.com' that caters real-time to patient queries on a variety of ailments as well as many disease specific websites. "Sometimes, I get to treat five patients from five continents in a day. It's quite amazing," exclaims Dr Shah. Patients can even chat with doctors 24-7 on web.

The motive behind Dr Batra, starting cyber clinics was to reach out those NRI population who travel once in a while in India but are unable to follow up. Says Dr Mukesh Batra, Chairman and Managing Director, Dr Batra's, "We back up Homeopathy through online clinics. Online clinics have opened up good business opportunities. They provide us hardcore visibility in the field. We have treated patients from 86 countries." In fact, Dr Batra's has gone a step ahead and started tele-homeopathy centres across India to bring about some effective integration as well as interaction amongst the doctors present in all its clinics.

Growth Drivers

There are several factors pumping the growing Homeopathy market in India. Until recently, Homeopathy had no platform for advertising or popularity. But with players like Dr Batra's who explored this medium aggressively, the popularity of this stream soared. However, reportedly the group has been slapped with many notices for breaking advertising regulations which prevail for healthcare organisations.

The debilitating side effects of Allopathy became a boon for Homeopathy. Says Dr M Batra, "Anyone who takes an Allopathic drug always has a reaction to it at some stage or another. This is the reason why people are moving away to safer and surer alternatives. People are now looking out for long-term cures and because Homeopathy is safe and permanent, there is a shift from Allopathy to Homeopathy." In fact, research conducted by Dr Batra's four years back revealed that Homeopathy is now the first option for chronic diseases. Earlier, Homeopathy was considered the last option. Also, in the alternative segment, Ayurveda is moving neck to neck with this segment, but Homeopathy seems to have certain distinctive advantages. Practicing Homeopath as well as a research scientist in Homeopathy, Jalgoan-based Dr Mahendra Kabra who has 10 research centres in London and runs his cyber clinic gives an insight. "It is true that Ayurveda is quite popular because it's a stream that originated in the country. But, off late the rising cost of Ayurvedic medicine due to paucity of herbal plants and extinction of various species are some limitations affecting Ayurveda. On the other hand, Homeopathic drugs are most eco-friendly. One can treat the global population with a kilo of basic drug substance. It's truly 'nano."

Concurs Dr Satinder Pal Singh Bakshi, CMD, Bakson Homeopathy, "Homeopathy is an effective means of treating chronic ailments, especially hair and skin problems, respiratory problems, arthritis and other miscellaneous treatments like thyroid, bed-wetting, diabetes and obesity."

A recent ASSOCHAM's survey on 'Homeopathy adoption on rise' found that in metros like Delhi, Mumbai, Kolkata, Chennai, Bangalore and other satellite towns like Chandigarh, Hyderabad, Lucknow of nearly 5,000 patients randomly surveyed, over 55 per cent preferred Homeopathy as the treatment is safer and physiologically satisfactory with no side effects. The study also found that nearly 80 per cent of them held that Homeopathy users switch on to Allopathy only on exceptional cases and in acute emergencies, otherwise homeopaths are best to be consulted for removal of majority of physical and other aliments. Many of them also said that Homeopathy is increasingly becoming an alternate to allopathic medicines because of their fake contents and patients including doctors loosing confidence in them, the study stated. Many patients also feel that Homeopathy is a more personalised treatment, with greater one-on-one interaction between the patient and the physician.

Roadblocks

Whilst the industry has good potential to grow, it has its own set of hurdles. To add to this, the distribution of products in Homeopathy is very poor. This is because Homeopathy medicines are hardly available in 10-15 outlets in a city, compared to the reach of allopathic medicines which is accessible in almost every nook and corner. "But abroad, this is not the case. There are very few practitioners of Homeopathy, but the medicines are well distributed and hence, there is a big market in France, the UK and the US," informs Dr A Batra. The primary reason for Europe emerging as a big Homeopathy market is because of its high referral rate. France apart from being the largest OTC Homeopathy market has allopaths referring for Homeopathy treatment, which further gives a boost to this industry. The illegal practice of Homeopaths prescribing Allopathy continues to plague this branch. "Even though India produces the largest number of Homeopaths in the world, they themselves do not have enough faith in this medicine and start illegally subscribing allopathy drugs. They need to keep themselves updated with various treatment forms. Unfortunately, there is lack of complete awareness about the potential of this therapy amongst the homeopaths themselves," opines Dr Shah.

Agrees Dr Kabra, "Majority of rural healthcare is delivered by homeopaths. But it is highly unfortunate that almost all of them prescribe allopathic medicine. Another harsh reality is the fact that there are not many job opportunities in Homeopathy as there are hardly any stand alone Homeopathy institutions." Added to this is the fact that currently there is a lack of evidence-based clinical studies in Homeopathy due to non-standardisation of drugs. There is no money invested in clinical trials or on research of these medicines.

"I have treated 22,000 patients of leucoderma which can be effectively proven through clinical trials. But I have approached so many regulatory bodies like Indian Council of Medical Research (ICMR) or CCH, but to no avail. It's the problem of lack of appropriate guidelines," laments Dr Kabra. He is currently working on a project of homeopathy mobile units which will go to rural areas of Maharashtra. Avers Dr Bakshi, "There is research happening in India, but the research data is not coming to the market. There is no institution which can take samples and get into research. Most of the institutions are run by the Government." Experts also opine that in spite of formation of councils and regulatory bodies like AYUSH for alternative medicine, Homeopathy still gets a step motherly treatment and is not aggressively promoted as Ayurveda or Unani.

Leaving aside regulatory matters, successful doctors believe that Homeopaths simply lack the entrepreneurial skill. They are just happy treating their loyal population base. What adds to their woe is the fact that the doctors don't share the dose or the treatment form that they administer. There is a cloud of secrecy over what they practice.

Dr Shankar Chawala, Homepath who owns two clinics in Mumbai, sums up the lacunae that plague this industry, "Insurance companies do not have a base in this industry and additionally most corporates don't view this as a profitable sector."

Integrated Medicine-The Future

It is a matter of time that more organised players enter this market bringing in standardisation, stricter regulation and increased awareness and then it would be no surprise that India would overtake the other market leaders in the world, considering its huge population base. Experts believe that with the era of 'integrated medicine' just ushering in, wherein all the system of medicine are available under one roof, it is the consumers who will ultimately decide the fate of Homeopathy. "Homeopathy will receive a major boost only after its integration with the mainstream medicine. The patient needs to be given a choice. If everything is available under one roof, it should be left to the patient to choose a pathy which works best for him. For, the human body is not a machine but a very interesting phenomena wherein systems keep on changing and there would never be only 'one' medicine that works. Depending on his/ her body type, he/she will be able to decide as to what works best on the body. Hence, there needs to be more synergy between mainstream doctors and homeopaths who should refer all kinds of treatments for the patient, be it naturopathy, ayurveda or allopathy," believes Dr Chawala.

He also feels that it is very unfair to always compare Allopathy with Homeopathy as the basis on which the efficacy of these treatment are benchmarked are completely different.

But as far as having trust and faith in Homeopathy goes, it has left behind allopathy way back. Just that homeopaths themselves need to be confident enough of their own therapy and hone their business skills just like their clinical acumen to make it big. Until then, it will always be a mute spectator and give hope to those for whom all other doors have been closed.

nancy.singh@expressindia.com