This chapter attempts to understand the medical innovation landscape of India in detail by specifically focussing on the pharmaceutical, biopharmaceutical and medical technology sectors. The first part of the chapter overviews the performance of these sectors with a special focus on research and development (R&D). The second part attempts to unearth the institutional co-production of medical R&D. This section of the chapter examines the formal and informal actors and processes in the network of production, the institutional network of funding and product development. The data presented in the chapter are drawn from secondary sources and published literature on medical innovations in India and other countries. The data on industry performance are obtained mainly from CMIE Prowess, reports of the Association of Biotechnology Led Enterprises (ABLE) and the published reports of the Department of Science and Technology, the Department of Biotechnology and the Ministry of Chemicals and Fertilisers. The data on funding are compiled from various sources including CMIE Prowess for private and public Indian and foreign companies, the Department of Science and Technology, the Biotechnology Industry Research Assistance Council (BIRAC), Government of India (GOI), for funding of research institutions and websites of the companies and service aggregators for the funding of start-ups. The data on clinical trials across companies and disease and participating hospitals are compiled from the Clinical Trial Registry of the Indian Council of Medical Research (ICMR).

The Indian pharmaceutical industry: sales, export and R&D

Studies have already shown that the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPs) regime provided an impetus for the industry to change its direction and destination and become more export oriented in its production activities (Dhar and Gopakumar 2006). Concerns were raised that imports would increase in the product patent regime and unfavourably affect the balance of trade. However, the Indian pharmaceutical industry could achieve a positive balance of trade mainly due to the export of formulations (Joseph 2009). Studies further revealed that the compound annual growth rates (CAGR) of exports of formulations are greater than those of bulk drugs in the TRIPs era, a trend opposite to one observed in pre-TRIPs era. These trends showed that imports also increased though the leading importers are multinational companies (MNCs), which was attributed to the removal of restrictions in the post-reform period.