Private equity (PE) investors are bullish on the largely under-penetrated health care industry, which offers high growth opportunities for companies as well as investors.
PE and venture capital firms are largely looking at opportunities in start-ups and smaller, niche companies. For instance, India is known as the diabetes capital and the prevalence of cancer is rapidly on the rise. PE investors have already invested in companies which are into eyecare, diabetes, diagnostics and oncology.
"In the last two years, healthcare has probably attracted the highest demand from PE in healthcare delivery and across segments from diagnostics, primary care to speciality surgical centres," says Vishal Bali, CEO of Fortis Healthcare.
There is a huge demand-supply gap in the healthcare services delivery with the number of beds available for patients and the diagnostics centres to identify disease not matching with the domestic demand. Chris McCahan, International Finance Corporation's Hong Kong-based chief investment officer who operates across the Asia-Pacific region in the health stream, says: "While significant capital has been going into the sector in recent years, there is still a sizable shortfall of access to affordable quality healthcare in the country and the private sector needs to continue to play an important role in extending such healthcare to more of the population."
According to a McKinsey report, infrastructure gaps continue to persist as the increase in total bed density of 1.3 per 1,000 is still significantly lower than the World Health Organization guideline of 3.5 beds for 1,000 patients.
Gupta, head (financial advisory) at Deloitte Touche Tohmatsu India, says that domestic consumption will rise and the growth in the insurance sector will support this.
Health care is recession-proof, says Ajay Kumar Vij, co-founder and CEO of Asian Healthcare Fund. According to Venture Intelligence, till August this year, there were around 32 deals attracting investments worth $465 million. Among the major deals are the $100-million investment of IFC in Fortis Healthcare in May, the $44-million deal of TA Associates and WestBridge in Dr Lal Pathlabs in February and the $42-million investment of IFC and Sabre Capital in Global Hospitals in April and the $31.9-million deal of Multiple PE in Vikram Hospital & Health Care in July. Sub-sectors such as diagnostics, eye care chains, and speciality hospitals are also getting a lot of attention from investors, says McCahan.
According to industry estimates, the Indian health care industry, which was valued at $79 billion in 2012, is growing at around 15-17 per cent every year.
Many investors who entered the hospital space between 2006 and 2008 are likely to see maturity in the next 18-24 months, says Amit Chander, partner at Baring Private Equity Partners India.
One of the major exits this year was that of Apax Partners from Apollo Hospitals with a return multiple of around 3x. Actis and Sequia Capital India exited from Paras Pharmaceuticals with a return of 3.21x and 6.82x, respectively, while Sequoia Capital India made an exit from Dr Lal's Pathlabs for 6.52x, according to Venture Intelligence data. Given the positive perception of this space, even sector-agnostic PE funds are also looking at deals in the healthcare space, says Vij.