Ayurveda Industry Market Size, Strength and Way Forward

Ayurveda Industry Market Size,
Strength and Way Forward
Ayurveda
Industry
Market Size,
Strength and
Way Forward
1
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Table of Contents
List of Abbreviations
List of Tables
List of Figures
List of Boxes
1. Introduction 1
1.1 Definitions and Coverage 1
1.2 Methodology Adopted 3
1.3 Governance Structure and Initiatives 4
2. Size of the Market 5

2.1 Existing Projections 5
2.2 Growth Projections: Primary Survey 7
2.3 The Drivers of Future Growth 7
3. Manufacturing and Allied Sector 8
4. Ayurveda Services 11
4.1 Medical Manpower 11
4.2 Hospitals, Dispensaries, Clinics and Pharmacies 15
4.3 Wellness Centres and Spas: Solely Ayurveda or Ayurveda as a
Major Component 21
5. Reaching out to Consumers 23

5.1 Demand Scenario and Consumer Behavior in India 23
6. International Trade and Foreign Investment 25

6.1 International Trade 25
6.2 Foreign Direct Investments 30
The Issues 32
Recommendations and Way Forward 35
References 38
Appendix A 39
List of Abbreviations
AIIA All India Institute of Ayurveda
AIIMS All India Institute of Medical Sciences
AYUSH Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy
CAGR Compound Annual Growth Rate
CCIM Central Council of Indian Medicine
CGHS Central Government Health Scheme
CII Confederation of Indian Industry
COPP Certificate of Pharmaceutical Products
DGCI&S Directorate General of Commercial Intelligence and Statistics
DIPP Department of Industrial Policy and Promotion
FDI Foreign Direct Investment
FSSAI Food Safety and Standards Authority of India
FY Financial Year
GCC Gulf Cooperation Council
GMP Good Manufacturing Practices
HS Harmonised System
IQ Institutionally Qualified
NABH National Accreditation Board for Hospitals and Healthcare Providers
NIQ Non-Institutionally Qualified
RBI Reserve Bank of India
SAARC South Asian Association for Regional Cooperation
TKDL Traditional Knowledge Digital Library
UAE United Arab Emirates
UK United Kingdom
US United States
WHO World Health Organization

List of Tables
Table 1: Market Size and Growth Across Select Sub-sectors - CII Survey of Private Sector 7
Table 2: Examples of Companies in Manufacturing 9
Table 3: Distribution of Ayurveda Hospitals and Dispensaries as per Jurisdiction

(as on April 1, 2017) 16
Table 4: Export and Import of Medicants and Medicaments during 2008-09 and 2017-18 27
Table 5: State-wise Variations in Policy Related to Purchase of Herbal products 33
Table A1: List of NABH Accredited Ayurveda Hospitals in India as of July 2018 36
List of Figures
Figure 1: Comparing Definitions of Different Wellness Products 3
Figure 2: Number of Ayurveda and AYUSH Practitioners in India during 1980-2017 12
Figure 3: State-wise and Gender wise Distribution of Total Ayurveda Practitioners as of

January 1, 2017 13
Figure 4: Distribution of Ayurveda Practitioners as per their Qualification 13
Figure 5: Number of Ayurveda Hospitals and Dispensaries in India during 1980-2017 16
Figure 6: Coverage of Ayurveda Hospitals and Dispensaries per Ten Million People 17
Figure 7: Number of Ayurveda and AYUSH System Pharmacies in India (1995-2017) 20
Figure 8: State-wise and Manufacturing Practice-wise Distribution of Ayurveda

Pharmacies in India as of April, 2017 20
Figure 9: India’s Trade in Ayurveda Products (including medicants and medicaments) 26
Figure 10a: India’s Export of Medicaments (HS30049011) 28
Figure 10a: India’s Export of Medicants (HS30039011) 28
List of Boxes
Box 1: About the Patients : Primary Survey 18
Box 2: Ayurveda - A Fresh Impetus to Medical Value Travel 30

Introduction
Ayurveda is recognised as a system of medicine indigenous to India, which includes both
medicinal products and health services. The origin of Ayurveda traces back to 5000 years
old Indian Vedic teachings based on fundamental philosophies about life, disease and
health.1 Ayurveda is regarded as one of the oldest healthcare systems in the world.2 Over
the millenniums, Ayurveda has not only sustained the changing outlook and demands for
health services due to the invasion of modern methods of treatment but, it has grown to be
renowned all across the world.
1.1 Definitions and Coverage

The World Health Organization (WHO)
adopted Traditional Medicine programme
around two decades ago. The WHO regards Ayurveda is a form of Traditional
Ayurveda as a form of Traditional Medicine. Medicine. It is a key component
According to the WHO, “traditional medicine
has a long history. It is the sum total of of India’s wellness industry and
the knowledge, skill, and practices based is now recognised as a system
on the theories, beliefs, and experiences
indigenous to different cultures, whether
of medicine globally.
explicable or not, used in the maintenance
of health as well as in the prevention, diagnosis, improvement or treatment of physical and
mental illnesses.”3 Some of the countries other than India, which are influenced by Ayurvedic
products and services, include countries in East Mediterranean region, Pakistan, Bangladesh,
Sri Lanka, Maldives, Bhutan, Myanmar and Nepal, among others.4
1 Annual Report 2017-18, Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy (AYUSH) accessible
at http://ayush.gov.in/sites/default/files/Ayush%20AR%202017-18-8.pdf (accessed on July 3, 2018).
2 See http://ayush.gov.in/About-The-Systems/Ayurveda/faq/what-origin-ayurveda and https://nccih.nih.gov/health/ayurve-
da/introduction.htm#hed3 (accessed on July 3, 2018).
3 See http://www.who.int/traditional-complementary-integrative-medicine/about/en/ (accessed on July 3, 2018).
4 See http://www.who.int/traditional-complementary-integrative-medicine/about/en/ (accessed on July 3, 2018).
1
According to the Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy
(AYUSH), “Ayurveda” is made up of two words-Ayuh and Veda. Ayuh means life and Veda
means knowledge or science. Thus “Ayurveda” in totality means ‘Science of life’. It incorporates
all aspects of life whether physical, psychological, spiritual or social.5 In India, the practice of
Ayurveda as a system of medicine has been recognized under the Indian Medicine Central
Council (IMCC) Act 19706; education of Ayurveda is regulated by a statutory body known as
Central Council of Indian Medicine (CCIM)7 and the Drugs & Cosmetics Act 19408 regulates
manufacturing and sales of Ayurveda drugs.
As per the Indian Government’s Make in India initiative (launched in September, 2014), Ayurveda
is part of the ‘Wellness’ industry. Over the years however, the Wellness industry has evolved
to include other dimensions of physical, emotional and mental well-being.9 According to the
Ministry of Statistics and Programme Implementation (MoSPI)’s National Industrial Classification
(NIC), the Government classifies Ayurveda under industries. There are two broad industry
categories under which activities related to Ayurveda fall. First category is the manufacture of
`ayurveda’ or `unani’ pharmaceutical preparation (code 21003 under division 21, manufacture
of pharmaceuticals, medicinal chemical and botanical products) and the second category
comprises of activities of Ayurveda practitioners (code 86901 under division 86, human health
activities).10
When it comes to Ayurveda products, there is confusion regarding the description and
differentiation between Ayurveda, Natural, Organic and Herbal products. While they all are largely
a part of the wellness industry, there are differences in their meaning and coverage. Certain
private companies11 have tried to bring out the different elements of each (see Figure 1).
For the purpose of this paper Ayurveda includes (a) Ayurveda product manufacturing and
allied activities and (b) services. Ayurveda services include hospitals, clinics, wellness centres
and spas; pharmacies; Ayurveda practitioners; education and research institutes; telemedicine
and online Ayurveda services; among others. Trade in Ayurveda goods includes trade of
Ayurveda products, machineries, raw materials, herbs, and intermediate products. Trade in
Ayurveda services will involve cross-country mobility of practitioners and patients; Indian
hospitals establishing presence in foreign countries and foreign hospitals establishing presence
in India, on-line Ayurveda consultancy with foreign patients, etc. Since Ayurveda is a form
of medical practice most players in this sector are organised. However, there are overlaps
5 See http://ayush.gov.in/About-The-Systems/Ayurveda/faq/what-ayurveda (accessed on July 3, 2018).

6 The text of the Act is accessible at http://ayush.gov.in/sites/default/files/The%20Indian%20Medicine%20Central%20Coun-
cil%20Act,%201970.pdf (accessed on July 3, 2018).
7 https://www.ccimindia.org/ (accessed on July 3, 2018).
8 The text of this Act is accessible at http://www.cdsco.nic.in/writereaddata/2016Drugs%20and%20Cosmetics%20Act%20
1940%20&%20Rules%201945.pdf (accessed on July 3, 2018).
9 See http://www.makeinindia.com/sector/Wellness (accessed on July 3, 2018).
10 For details see the National Industrial Classification, 2008 accessible at http://mospi.nic.in/sites/default/files/main_menu/
national_industrial_classification/nic_2008_17apr09.pdf (accessed on July 8, 2018)
11 For details see: https://www.oceanicpharmachem.com/difference-between-herbal-ayurveda-natural-and-organic-prod-
ucts/; https://www.joybynature.com/blogs/organic-recipes/45916545-understanding-the-difference-between-natural-
organic-and-ayurvedic-products; http://www.dogreen.in/green-basics/organic-products/natural-herbal-organic-difference.
html (accessed on July 12, 2018)
2
Figure 1: Comparing Definitions of Different Wellness Products




 Made from plant extracts and herbs, and mostly used for their
 Herbal medicinal properties. The herbal products may be Chemical free (if no
preservatives have been added), but pesticides may have been used in
 growing them.



 Made from plants and minerals that occur in nature and have not been
produced in a laboratory and are not man made. However, pesticides
 Natural and chemical fertilizers might have been used to enhance their growth.
 A product claiming to be natural is free of common chemicals such
as artificial fragrances, colorants, preservatives, and other synthetic
 additives. There, however, is no regulation on the word ‘natural’.

 
Also made from natural ingredients but they are grown without the use
 of chemicals or pesticides. Organic is a labelling term that indicates
Organic

that the food or other agricultural product has been produced through
 approved methods. Organic products have to be certified on the label
 ‘made with organic ingredients’, which implies the product is made with
at least 70% organic ingredients.

 
 Medicinal science which includes use of herbs as well as heavy

Ayurveda
 metals like gold, silver, copper, tin, mercury, sulphur, animal extracts,

etc. Ayurveda products may not be completely natural and may
 sometimes contain toxic levels of metals.


between the sector and other sectors, which makes it difficult to estimate the size of the

sector. For example, herbs, which are inputs into Ayurveda medicines, can also be used for

cooking and other purposes



1.2 Methodology Adopted



This report is based on secondary data analysis and a primary survey of different stakeholders

in 
the sector. Secondary data on Indian Ayurveda industry is largely available from the

Government sources, with the Ministry of AYUSH being the key repository of data. Trade data
is available from the Department of Commerce and data on foreign investments is available

from the Reserve Bank of India and Department of Industrial Policy and Promotion. Apart from

these Government sources, there are private estimates on the size of the market, employment
and growth potential, etc.
3
1.3 Governance Structure and Initiatives

The Department of Indian Systems of Medicine and Homoeopathy (ISM&H) was established
in the Ministry of Health & Family Welfare in March, 1995. It was re-named as Department of
Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy with acronym as AYUSH
in November, 2003. In keeping with the policy of the Government to lay focused thrust on
the Indian Traditional Systems of Medicine, the Department of AYUSH was granted the status
of Ministry with effect from 09.11.2014. The Ministry is responsible for policy formulation,
development and implementation of programmes for the growth, development and propagation
of AYUSH systems of Health Care. There are two statutory regulatory bodies under the Ministry
of AYUSH. They are – the CCIM and the Central Council for Homeopathy (CCH). A Drug
Control Cell is also working in the Ministry to deal with the matters pertaining to Drug Quality
Control and regulation of Ayurveda drugs under the provision of Drugs and Cosmetics Act,
1940 and Rules there under.12
The Government has been undertaking steps to promote the Indian Ayurveda industry and other
wellness services, particularly at the administrative level. Consequently, in November 2014, the
Department of Indian System of Medicine and Homeopathy was elevated to an independent
ministry. The Ministry of AYUSH was thus formed to ensure the optimal development and
propagation of AYUSH systems of health care. National Health Policy (2017)13 acknowledges
the pluralism in the Indian health sector, wherein traditional and modern medical practices co-
exist. The policy focuses on mainstreaming the potential of Indian traditional medicine, including
Ayurveda. Health is a part of 12 Champion Services Sectors identified by the Department of
Commerce, Government of India.
In addition, as per the National Health Policy, 2017, mainstreaming the potential of AYUSH
is one of the priorities of the Government. The policy ensures access to AYUSH through co-
location of public facilities. It also recognises the need to standardise and validate Ayurveda
medicines and establish a robust and effective quality control mechanism for drugs. The policy
also suggests leveraging digital tools for generating and sharing information about AYUSH
systems. Thus, Indian medicinal systems such as Ayurveda are getting a policy boost in the
country, which is likely to further accelerate the growth of the industry.
It is worth mentioning that given the emerging global and domestic demand for Ayurveda
products and healthcare services, in October 2017, theAIIA14 was established as an autonomous
organisation under the Ministry of AYUSH, Government of India. It is a centre of excellence
and is conceived as an apex institute for Ayurveda, which brings together both Ayurveda
healthcare as well as training and education for the same.
12 For details see Annual Report 2017-18, Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy (AY-
USH) accessible at http://ayush.gov.in/sites/default/files/Ayush%20AR%202017-18-8.pdf (accessed on July 3, 2018).
13 The document is accessible at http://cdsco.nic.in/writereaddata/National-Health-Policy.pdf (accessed on July 3, 2018).
14 See http://www.aiia.co.in/aboutus.html (accessed on August 12, 2018)
4
Size of the Market
2.1 Existing Projections
There are both Government and private sector estimates on the size of Indian Ayurveda industry
and wellness sector. These are largely scattered and one-time estimates of the industry size
and growth potential. Some of the estimates are as follows:
¾¾ According to Statistics MRC, the Global Ayurveda Market is accounted for USD3.428 billion
in 2015 and is expected to reach USD9.791 billion by 2022 growing at a compound annual
growth rate (CAGR) of 16.2 per cent from 2015 to 2022.15
¾¾ According to Confederation
• Accounted for USD3.428 bn in 2015
of Indian Industry ( CII) 16, Global Ayurveda • Projected to reach USD9.791 bn by 2022
in the year 2016, the total Industry • Growing at CAGR 16.2% from 2015 to 2022
estimated market size of Indian • Estimated size of USD3 bn in 2016
Ayurveda industry is USD3 Indian Ayurveda • Product market accounts for 75%, remaining
billion, which includes both Industry are services
Ayurveda products (ethical, • Projected to grow by 16% by 2021
classical, over the counter • Estimated size USD13.9 bn in FY2015
Indian Wellness • Expected to grow at CAGR of 12% over the
(OTC), personal care and
Industry next 5 years
beauty products) and services • Likely to create over 3 mn jobs
(medical, well-being, payor
and medical tourism services). The product market is larger – USD2.27 billion (75 per cent
of the total market) compared to the services market (USD0.75 billion). The industry is
envisioned to grow to reach USD9 billion by the year 2022. According to another estimate,
the Ayurveda market is expected to go from USD2.5 billion to USD8 billion by 2022.17 It
15 See https://www.reuters.com/brandfeatures/venture-capital/article?id=15602 (accessed on July 4, 2018).

16 Confederation of Indian Industry (CII) and Frost & Sullivan (F&S) (2017). Vision 2022 Roadmap for Indian Ayurveda
Industry, 2017 accessible at https://ww2.frost.com/files/4815/1487/6125/FS_WP_CII_India_Ayurveda_Industry_Road_
Map__101417_CAM-v4-Edited_Final.pdf (accessed on July 4, 2018).
17 https://qrius.com/future-group-expands-to-gain-foothold-in-ayurveda-market-but-can-it-compete-against-patanjali/ and
https://www.livemint.com/Science/w8KCgR0QlEctwAnji8BaeK/Government-expects-Ayurvedic-products-market-to-rise-to-
8-b.html (accessed on July 4, 2018).
5
is estimated that the Ayurveda products

market will grow by 16 per cent by Ayurveda practitioners
2021.18 Most private sector research
reports forecast a CAGR of 16 per
constitute the largest share
cent for the Ayurveda market by the (55.4%) in the total number of
year 2021 or 2022.19 However, there
are variations in projections across
AYUSH system practitioners.
different sub-sectors (manufacturing The number of Ayurveda
versus hospital segment), which have
practitioners has increased
been discussed in this report.
since 1980. A majority of
¾¾ There are some estimates for the size of
Indian wellness industry. During financial them are located in Bihar,
year (FY)20 2015, the Indian wellness followed by Maharashtra. Over
industry was estimated at INR850
billion (USD13.9 billion). The size of the the years, there has been an
industry is expected to grow at a CAGR increase in number and share of
of 12 per cent for the next five years.
From its current size this industry can institutionally qualified Ayurveda
achieve INR1500 billion (USD24.5 billion) practitioners.
by FY20.21 Further, the sector has a
potential to generate over 3 million job
opportunities.22 The current employment level is discussed in the next section.
Roughly, three things can be concluded. One, Ayurveda is a small but growing part of the
overall Indian wellness industry. Two, India is the largest and the most important player in
the global Ayurveda market. Three, the sector is projected to grow at a fast pace. However,
none of these studies try to provide a comprehensive estimate of the sector encompassing
both secondary data and primary survey. This report attempts to fill the lacuna and also to
layout the methodology for future data collection, which will enable to understand the size
and enormous contribution of the sector through backward and forward linkages.
18 For details see https://qrius.com/future-group-expands-to-gain-foothold-in-ayurveda-market-but-can-it-compete-against-

patanjali/ (accessed on July 4, 2018).
19 See https://www.techsciresearch.com/report/india-ayurvedic-products-market-by-product-segment-ayurvedic-health-
care-products-and-ayurvedic-personal-care-products-by-organized-vs-unorganized-competition-forecast-opportuni-
ties-2011-2021/726.html; https://globenewswire.com/news-release/2017/01/26/911080/0/en/Ayurvedic-Market-Analysis-
Trends-Report-2016-Healthcare-Products-Personal-Care-Products-Distribution-Channel-Forecast-to-2025.html; https://
www.prnewswire.com/news-releases/world-ayurvedic-market-analysis--trends-report-2016-2025---market-is-poised-to-
grow-at-a-cagr-of-around-160---research-and-markets-300397304.html (accessed on July 4, 2018).
20 Financial Year of India is from 1st April to 31st March.
21 For details see http://ficci.in/VAS-Report.pdf (accessed on July 4, 2018) – converted using average historical exchange
rate from the Reserve Bank of India (RBI) for the Financial Year 2015 of USD1 = INR61.147.
22 See https://health.economictimes.indiatimes.com/news/industry/indian-wellness-industry-rightfully-deserves-a-make-in-
india-impetus-akshar/60433250 (accessed on July 4, 2018).
6
2.2 Growth Projections: Primary Survey

The survey conducted by CII shows that growth projections vary across different sub-sectors
of Ayurveda, with an overall CAGR of 16 per cent by the year 2022. Table 1 below shows the
market size and growth projection of different sub-sector as is estimated from the CII survey. The
table also shows the variation in growth projections across different sub-sectors and markets
(domestic vis-a-vis exports). It is important to note that while CII has taken this initiative on
its own, there are data gaps, fulfilment of which will require Government support and funding.
For example, there is no official data on the size of the manufacturing sector, on employment
generation, on raw material availability, etc. While Ministry of AYUSH is coordinating with state
Government and other central Government ministries and departments to collect data, more
than 75 per cent of the business today is in private sector, and therefore engagement with
private sector is important to have a robust database.
Table 1: Market Size and Growth Across Select Sub-sectors -

CII Survey of Private Sector
Select Segments Market Size in 2017-18 Growth Projections for
Next Five-Years (CAGR in
percentage)
1. Manufacturing (75 per cent of Around INR 22,500 16
the total Ayurveda market) crores (for top 50
companies)
1.1 Ayurveda Veterinary Around INR 700 crores 12-14 (10-12 in domestic
Medicines and Feed market and 20 in exports)
Supplements (which
is a sub-component of
manufacturing)
2. Wellness Sector Not Available Products - 50
Services – 30
3. Hospitals Around INR 1000 crores Over 50
4. Day Care Treatment Centre, Around INR 5000 crores Over 50
Clinics, Dispensaries, etc.
Note: T
here are several data gaps. For example, wellness is a large and growing sector but there is no data
for this sector. This makes it difficult to estimate the size of this sector.
2.3 The Drivers of Future Growth

The ageing population with health problems and growth of young, aware, health conscious
population will drive the growth of the Ayurveda sector. The support of the Government, focus
on quality and standardization, increase in health insurance coverage and Central Government
Health Scheme (CGHS) coverage will drive the growth of this sector. The ability of the
Government to promote ayurveda at international platforms will play a big role in enhancing
the growth of this sector.
7
Manufacturing and
3.
Allied Sector
Most of the large companies in the Ayurveda sector are in manufacturing. According to the
estimates provided by the Ministry of AYUSH, there were 8667 units in AYUSH manufacturing
in 2016-17, out of which 7435 units were into Ayurveda products. Most of these companies are
small and medium sized and only around 50 companies have revenue above INR 100 crores
in 2016-17. These 50 companies account for over 85 per cent of the revenue generated by this
sector. According to Ayurvedic Drug Manufacturers Association (ADMA), which has around 9000
members, 99 per cent of their members are MSMEs (micro, small and medium enterprises).
According to industry estimates, top 50 companies (across both food and Ayurveda non-food
products) reported revenue of around INR 22,500 crores for the financial year April 2017-March
2018 from sale of Ayurveda products only. Within this, the size of the natural/Ayurveda veterinary
and feed supplement market is estimated to be INR 700 crores, with nearly INR 150 crores
of exports (around 95 per cent of exports are in herbal feed supplements while around 5 per
cent are in Ayurveda veterinary medicine according to industry estimates).
The sector is privatized and there is no official data on total production, volumes of sales
generated, and employment contribution of this sector. Some of the large product manufacturing
companies (with over INR 1000 crores turnover) include Dabur India, Himalaya Herbal
Healthcare, Baidyanath Group, Emami Group, Hindustan Unilever Limited and Patanjali Ayurved
Limited. Some companies offer both products and services (for example, Jiva Ayurveda, Kairali
Ayurvedic Group and Patanjali Ayurved Limited). For many wellness companies, 75 per cent
of the revenue is from services and around 25 per cent is from products.
A pilot survey conducted by CII shows that companies operate across different product
segments – from, medicine to food supplement and cosmetics (see Table 2)
The Ayurveda manufacturing sector contributes significantly to employment. However,

employment generation varies by the size of the companies. On an average, companies over
INR 2000 crores of revenue in 2017-18 employed around 3000 people, while those with INR
100 crores of revenue employed around 500 people.
8
Table 2: Examples of Companies in Manufacturing
Products Companies/Manufacturer
Drugs/medicine for human The Arya Vaidya Pharmacy (Coimbatore) Ltd, Arya
consumptions - Classical Ayurveda Vaidya Sala Kottakkal, SNA Oushadhasala Pvt. Ltd.,
products without any variation of Dhootapapeswar Prakashan Private Limited, Dabur India
formulae or ingredients Limited
Drugs/Medicines for Human The Arya Vaidya Pharmacy (Coimbatore) Ltd.;
Consumptions - Proprietary Arya Vaidya Sala Kottakkal
Cosmetic and Spa Products Kama Ayurveda
Kairali Ayurvedic Group
Rajah Ayurveda
The Arya Vaidya Pharmacy (Coimbatore) Limited
Himalaya Global Holdings Limited
Food Products Aravindh Herbal Labs (P) Limited, The Arya Vaidya
Pharmacy (Coimbatore) Ltd
Food Supplements Sri Sri Tattva, Dabur India Limited
Ayurveda Veterinary Medicines Ayurvet Limited, Ayursun Pharma, Himalaya Herbal
Healthcare, Vamso Biotech Private Limited, Natural
Remedies, etc.
Wellness Products Kairali Ayurvedic Group, Forest Essentials, Patanjali
Ayurved Limited
Ayurveda Agro-inputs Swaroop Agrochemical Industries, BICCO Agro Products
Private Limited
Ayurveda Machinery and AVP Treatment Equipments Enterprises [(an unit of the
Equipment Manufacturers Arya Vaidya Pharmacy (Coimbatore) Limited)],
Dhroni Ayurvedas, Poornimas Panchakarma Equipments
and Consultancy services, India Medico Instruments
Note: T
here are several data gaps. For example, wellness is a large and growing sector but there is no data
for this sector. This makes it difficult to estimate the size of this sector.
The survey highlighted that most Ayurveda products are not patented. Ayurveda is treated as
traditional knowledge and the Traditional Knowledge Digital Library (TKDL) of the Ministry of
AYUSH provide a list of around 82,90023 Ayurveda medical formulations and around 1150 herbs
registered under TKDL. According to the National Medicinal Plants Board, Ministry of AYUSH,
Ayurveda, Siddha and Unani systems of medicine have more than 90 per cent formulations
which are plant based. India has a natural advantage in manufacturing Ayurveda products as
over 7000 indigenous herbal plants grow in the country.24 However, the data on raw material
availability is outdated. According to the official data, domestic demand for medicinal plants
was estimated to be 1,95,000 MT for the year of 2014-15 and the total consumption of herbal
raw drug in the country was estimated at 5,12,000 MT. Around 22 per cent of the production
23 http://www.ayush.gov.in/traditional-knowledge-digital-library (accessed on July 4, 2018).

24 For details see https://nmpb.nic.in/content/introduction (accessed on August 10, 2018)
9
was sourced through cultivation.25 Unless recent data is collected and collated it is difficult to
estimate the raw material availability and demand.
With rise in demand for Ayurveda products, the survey found that there is a shortage of raw
materials. The Ministry of AYUSH acknowledges the need to have more robust data and in-
depth information on state-wise cultivation of different medicinal plants and identification and
prioritization of medical plants for development and cultivation through various subsidy and
other Government programmes, among others. There is a need for data and information
collection on companies’ manufacturing herbal extracts and intermediate products, list of drug
testing laboratories and R&D institutes and research centres.
While a number of companies have registered their products in India and abroad, most of the
products are registered in India. In India, food products/supplements are registered with Food
Safety and Standards Authority of India (FSSAI). Medicines are regulated by the Departments
of AYUSH. Animal feed supplements are classified based on usage and are not regulated
for licensing purposes. However, the products have to follow Legal Meteorology guidelines
pertaining to labelling and claims. Thus, there are variations across products in terms of
regulations and processes.
The pilot survey of manufacturers conducted by CII shows that many manufacturers have
developed well-known brands which are sold in domestic market and abroad. To ensure
quality, they take common certificates such as WHO-GMP (World Health Organization - Good
Manufacturing Practices), ISO 9000 and HACCAP (Hazard Analysis and Critical Control Points)
certifications. When asked about how companies decide to produce organic, natural vis-a-vis
Ayurveda products, most companies produce as per the market demand. With a growing
demand for organic products a number of manufacturers have moved into this segment.
The positioning of the product across different markets depends on various factors including
consumer choice and Government policies. For example, in most developed countries including
the United States (US) and the United Kingdom (UK) most Ayurveda products are positioned
as food supplements.
25 For details see https://www.nmpb.nic.in/content/medicinal-plants-fact-sheet (accessed on August 10, 2018)
10
Ayurveda Services
4.
The Ayurveda services sector encompasses medical manpower, hospital, dispensaries and
pharmacy, use of information communication technology, education services, wellness services,
etc. Some of these are discussed below:
4.1 Medical Manpower

4.1.1 Medical Manpower
The number of registered Ayurveda practitioners is available from the Ministry
of AYUSH. There are some private data bases26 which provide more detailed
information, but their coverage is lower than what is reported by AYUSH.
As per the Ministry of AYUSH27 as of January 1, 2017, there were 428,884
registered Ayurveda practitioners in India. The total number of AYUSH system
practitioners (including Ayurveda, Unani, Siddha, Naturopathy and Homeopathy
practitioners) on the same date was 773,668. Thus, Ayurveda practitioners
constitute 55.4 per cent of the total number of AYUSH system practitioners.
In the year 1980, there were 220,497 Ayurveda practitioners and 371,746
AYUSH system practitioners. Over the years, although the total number of
AYUSH system practitioners and Ayurveda practitioners has increased, there
was a decline in 2011 and the number started increasing again in 2014. As
shown in Figure 2, there has also been a decline in the total share of Ayurveda
practitioners in the total number of AYUSH system practitioners over the years,
since 1980. Further, there may be gaps between registered practitioners and
those that are actively practising the profession.
Focusing on the available data for practitioners per ten million people, as of
January 1, 2017, there were about 3,221 Ayurveda practitioners per ten million
26 For example, websites such as Ayurved Doctors and on-line directories such as Justdial, provide a list of doctors state-
wise and/or city-wise by illness that they treat. Patients can also get a review of the doctors from such sources.
27 http://ayush.gov.in/genericcontent/ayush-india-2017-0 (accessed on July 10, 2018).
11
Figure 2: Number of Ayurveda and AYUSH Practitioners in India during 1980-2017













                 
 


Source: Data extracted from Ministry of AYUSH, accessible at http://ayush.gov.in/genericcontent/ayush-

india-2017-0 (accessed on July 10, 2018).



people in India. While the number has increased over the last five years,
 however, if one looks back at a longer timeframe, there has been a decline

 in the number of Ayurveda practitioners perten million people in the country.

For instance, in 2009 there were 4,159 Ayurveda practitioners per ten million


people, which was lower than the year 2000 when there were 4252 Ayurveda

 practitioners per ten million people.


 
 By states, Bihar has the highest number of Ayurveda practitioners (22.6 per
 cent), followed by Maharashtra (17.8 per cent), Madhya Pradesh (10.8 per
 
cent), Uttar Pradesh (8.5 per cent) and Karnataka (7.9 per cent). The spread

of medical practitioners varies across states. States/Union Territories such
























as Manipur, Meghalaya, Mizoram, Nagaland, Sikkim, Tripura, Andaman and

Nicobar Island, Lakshadweep, Dadra and Nagar (D&N) Haveli, Puducherry,
Chandigarh, etc. have no recorded data for Ayurveda practitioners.


There are gaps in gender-wise data and information is not available from

some states. The data shared by the states show that there are more male


practitioners than female practitioners, but the gender gap in some states

 such as Karnataka and Kerala is much lower compared to the others (see
Figure 3).


There are two categories of practitioners – (a) institutionally qualified (IQ) and
(b) non-institutionally qualified (NIQ) or self-educated practitioners. Over the
years, there has been some increase in the share of institutionally qualified 

12


                 
 
Ayurveda Industry Market Size, 



Figure 3: State-wise and Gender wise Distribution of Total Ayurveda Practitioners

 as of January 1, 2017
 
 






 


 




























Note: Blue bars, namely in the case of Arunachal Pradesh, Bihar, Himachal Pradesh and Maharashtra

represent the total number of practitioners are given without the gender distribution due to unavailability

of information. There is no data for the states/union territories omitted from the chart.


 india-2017-0 (accessed on July 10, 2018).

Ayurveda practitioners (see Figure 4). Overall, in the year 2017, the share of


IQ Ayurveda practitioners is more than the NIQ Ayurveda practitioners.


Figure 4: Distribution of Ayurveda Practitioners as per their Qualification 


























      
 

Source: D ata extracted from Ministry of AYUSH, accessible at http://ayush.gov.in/genericcontent/ayush-





13




The secondary data does not provide information on remuneration of the

practitioners, their employment status, etc. Preliminary discussions with 20
Ayurveda practitioners show that they may have their own clinics or work
in a hospital, clinic or dispensary which can be Government owned, private
owned or owned by a charitable trust, among others. Some practitioners
are employed by manufacturing companies in their R&D (research and
development) divisions and by pharmacies. Some of them are also engaged
in Ayurveda education and others offer comprehensive wellness guidelines to
patients for preventive healthcare. A few practitioners (2 in our sample) are
engaged in other business activities along with Ayurveda treatment. A number
of practitioners are offering online consultancies through telephone and social
media platforms. The survey participants did not share their monthly income
or remuneration. They pointed out that remuneration depends on various
factors such as the type of illnesses treated, number of patients, socio-economy
class of the patients, location of the clinic, reach of the practitioner and his/her
reputation, etc. In general, the practitioners opined that salaries of Ayurveda
practitioners are lower than allopath practitioners.
In the past three years, there has been an increase in demand for Ayurveda
treatment, which has created a demand for medical practitioners, nurses and care
workers. There is need for more comprehensive survey to identify the demand-
supply gaps, which can help to design policies to support this sector.
4.1.2 Nurses
As regards the total number of nurses, as of December 31, 2016, there were
2,877,138 registered nurses in India, which included 841,081 auxiliary nurse
midwives (ANM), 1,979,718 registered nurses and registered midwives (RN and
RM) and 56,339 lady health visitors (LHV). Some of the states with the largest
number of nurses include Tamil Nadu, West Bengal, Andhra Pradesh, Kerala
and Karnataka. Thus, the southern states in India have greater concentration
of nurses.
There is no data on Ayurveda caregivers. With the growing adoption, importance

and spread of Ayurveda as a system of medicine in India, the National Health
Policy (2017) recognises the need for integrated courses on Indian System of
Medicine, Modern Science and Ayurgenomics to further improve the quality
of Ayurveda manpower in the country. The policy also recommends having
short courses at graduate level for improving the quality. Given the growing
global popularity of this system of medicine, quality control and training
of practitioners is crucial for sustaining demand. If India wants to promote
short-term mobility of Ayurveda practitioners and nurses to other markets,
there is need for more in-depth research on domestic demand-supply gaps,
skill availability, acceptability of the practice and degree recognition, barriers
faced, etc. This can be achieved through a survey of medical practitioners,
14
nurses, care workers, certifying agencies, quality control bodies, some foreign
Government approval’s agencies, etc.
4.2 Hospitals, Dispensaries, Clinics and Pharmacies

This section presents a statistical overview of both in-patient and out-patient Ayurveda
facilities. It includes statistical description of medical care facilities such as hospitals and
dispensaries and pharmacies. It further includes their bifurcation by state, managements,
etc. The analysis is based on the data collated from Ministry of AYUSH 28 and through
a pilot survey of chain hospitals and dispensaries.
4.2.1 Hospitals, Dispensaries and Clinics

Around 75 per cent of the hospitals, dispensaries and clinics in the Ayurveda
sector are under the private sector. There is no official system of data collection
from the private sector. In some states private hospitals are registered under
specific state Government regulations, however, there is no uniformity across
states. To ensure quality, some hospitals have taken voluntary accreditation
from the National Accreditation Board for Hospitals and Healthcare Providers
(NABH). This Accreditation Program for Ayurveda Hospitals is in association
with Department of AYUSH, Ministry of Health and Family Welfare. Accreditation
standards are based on three components - structure, process and outcome.
These standards measure the quality and safety aspects of the care delivered
to the patients. A list of NABH accredited Ayurveda hospitals is given in Table
A1 in Appendix A. This list includes hospitals which provide Ayurveda treatment
and also those which provide Ayurveda treatment along with other treatments
including Unani and Homeopathy (for example, Soukya Indian Holistic Health
Centre Pvt. Ltd., Bangalore, Karnataka). A majority of the accredited hospitals
are located in Karnataka and Kerala.
The Ministry of AYUSH collects data on hospitals and dispensaries from state
Government agencies. As of April 1, 2017, there were about 3,186 Ayurveda
hospitals and 17,416 Ayurveda dispensaries. The total number of AYUSH
hospitals on the same date was 3,943 and the number of dispensaries was
27,698. Thus, in terms of medical care facilities, Ayurveda has the highest
share among all AYUSH systems (around 80 per cent) compared to others
such as Unnani, Siddha and Homeopathy. It has increased remarkably since
the year 1980, when it was around 60 per cent of all AYUSH medical care
facilities. An increase in the share of Ayurveda facilities has been matched
by a corresponding fall in the share of Unani and Homeopathy medical care
facilities.
28 http://ayush.gov.in/genericcontent/ayush-india-2017-0 (accessed on July 10, 2018).
15
A majority of these Ayurveda facilities fall under the state Government/UT

administration (see Table 3)
Table 3: Distribution of Ayurveda Hospitals and Dispensaries as per

Jurisdiction (as on April 1, 2017)
Jurisdiction Hospitals Dispensaries
State Government/ UT Administration 3022 15972
Local Bodies 9 656

 Others 134 500
Central Government Health Scheme (CGHS) 1 33

Labour Ministry 0 172

Ministry of Coal 0 11
 Railway Ministry  0 
45

Research Councils  11 
18
  
National Institutes 9 9
  
Total 3186 17416
  
 Source: D
ata extracted from Ministry of AYUSH,
 accessible at http://ayush.gov.in/

genericcontent/ayush-india-2017-0 (accessed on July 10, 2018).
  
 The changes in number of hospitals and dispensaries
 overtime are 
presented
in Figure 5.  
  
 With the increase in the number of Ayurveda  hospitals, there has 
been an

increase in the number of hospital beds since 1991. In the year 1991, there

were 23,742 beds in Ayurveda hospitals across India. This increased to 30,653
 in the year 1996 and to 49,120 in the year 2000. There have been variations


Figure 5: Number of Ayurveda Hospitals and Dispensaries in India during 1980-2017












                 
 
Source: D
ata extracted from Ministry of AYUSH, accessible at http://ayush.gov.in/genericcontent/ayush- 




16 

in the trend since then. In 2017, there were 43,274 beds in Ayurveda hospitals
reported by the Government.29
In terms of the spatial distribution, as on April 1, 2017Ayurveda hospitals were

spread over 33 states and union territories of India. However, the spread is
not uniform. Around 66 per cent of the Ayurveda hospitals (number is 2,014)
are in Uttar Pradesh, followed by Uttarakhand (402), Karnataka (170), Kerala
(126) and Rajasthan (117). However, majority of the private healthcare facilities
are in the Southern states like Kerala and Karnataka, and this data has not

been reported in the Government database. States/Union Territories such as,

Dadra and Nagar Haveli, Lakshadweep and Puducherry have also not reported

presence of any Ayurveda hospitals.


Similarly in terms of hospital beds, Uttar Pradesh had the highest number of

hospital beds (10,054) followed by Karnataka (9,482), Maharashtra (8,026),

Kerala (3,004) and Gujarat (2,015).


In terms of Ayurveda dispensaries, Rajasthan topped the list with 3,577
Ayurveda dispensaries (around 21 per cent), followed by Uttar Pradesh


(2,104), Madhya Pradesh (1,496), Himachal Pradesh (1,150) and Bihar (1,082).
Nagaland and Manipur did not record data on any Ayurveda dispensary

during this period.


In the year 2017, the in-patient capacity of Ayurveda hospitals was 323.7

per ten million people and that of Ayurveda dispensaries was 130.26 per ten

million people in India (See Figure 6 for a trend analysis). Overall, due to

underreporting of the private sector the data seems to show a decline in the

population coverage of Ayurveda hospitals and dispensaries over time.

Figure 6: Coverage of Ayurveda Hospitals and Dispensaries per Ten Million People









               


Source: D ata extracted from Ministry of AYUSH, accessible at http://ayush.gov.in/genericcontent/ayush-



 Extracted from Ministry of AYUSH, accessible at http://ayush.gov.in/genericcontent/ayush-india-2017-0 (accessed on July
29
11, 2018). Data pertains to April 1, 2017.



 17



Discussion with the Ministry of AYUSH confirms that the above data does not
comprehensively cover private hospital and polyclinics. There is a need for
more in-depth research to know the size of the sector, revenue earned, growth
potential, infrastructure availability and requirements, type of illnesses treated,
patients profile, cost of treatment, etc. and this will require a comprehensive
survey of the available facilities. The CII survey found that most of the polyclinics
are privately-owned while dispensaries are primarily Government-owned or
supported. There were around 26,000 dispensaries as of April 2017. The
ownership and modes of operations of private hospital and clinics vary. They
can be profit making or owned by a charitable trust. There can be standalone
Ayurveda hospitals or such facilities can collocate within an allopath hospital
[for example, All India Institute of Medical Sciences (AIIMS) have an Ayurveda
centre] or with other AYUSH facilities. Recently, the All India Institute of Ayurveda
(AIIA) was set up in the lines of AIIMS, which would do R&D and treatment.
Under the National Health Mission there is a possibility of creating 20,000
co-location facilities, 646 co-location facilities in district hospitals and 510 in
public sector enterprises. The discussions further highlighted that there are
different types of clinics that are coming up. These includes on-line/tele-clinic,
mobile clinic (clinic in a mobile van), boat clinic, etc.
There are a number of well-known hospitals and clinic chains/brands in this

sector (for details see Table A1 in Appendix A). These hospitals and clinic
chains can offer treatment for a number of illnesses or they may specialise in
a particular type of illness. For example, Sreedhareeyam Ayurvedic specialises
in eye care treatment. Founded in 2006, Madhavbaug is the world’s first ISO
certified Ayurvedic Cardiac Rehabilitation Centre. Some of the well-known
brands such as Kottakkal-Ayurveda (which is a charitable trust) operate across
multiple segments including Ayurveda hospital, dispensaries, collocation
facilities, polyclinics and mobile clinics. Punarnava Ayurveda Hospital Private
Limited has three hospitals and 2 co-location facilities. Madhavbaug has two
hospitals, 158 clinics and 20 rural satellite OPDs. Another hospital chain,
AyurVaid Hospitals, have established presence across multiple states in India.
Majority of the private sector presence is in the Southern states but there
are some niche players in specific regions. For example, Jiva Ayurveda is
mostly present in the North while Madhavbaug has its major presence in the
Western part of India.
Box 1: About the Patients: Primary Survey

The number of patients that the hospital receives depends on various factors such as brand
value, size and where it is located. On an average per month, AyurVaid Hospitals with 5
hospitals (170 beds) and 1 clinic receives 1500 patients in OPD and 250-275 patients in
admission while Sreedhareeyam Ayurvedic with 9 hospitals (350 beds) and 15 dispensaries
(45 beds) receives 12,000 patients in OPD and 900 for admission. There is a huge demand
for Ayurveda treatment and as hospitals scale-up they receive more patients.
18
Box 1: About the Patients: Primary Survey

When asked about the patient profile, the distribution of Indian and foreign patients vary
across the different hospitals and clinics surveyed, but majority of the patients are Indian.
For example, 80 per cent of patients of Kottakkal-Ayurveda, 90 per cent of patients of
Sreedhareeyam Ayurvedic, 60 per cent of patients of Punarnava Ayurveda Hospital Private
Limited, 95 per cent of patients for AyurVaid Hospitals and Jiva Ayurveda are Indians while
99 per cent of patients of Madhavbaug are Indians. Most of the foreign patients are from
the neighbouring SAARC (South Asian Association for Regional Cooperation) countries
and Middle East. Of late, hospitals are getting patients from developed countries such as
the UK and the US.
The illness for which a patient comes for treatment to an Ayurveda facility varies across
hospitals and clinics. Some common illnesses for which patients seek ayurveda treatment
include different forms of bone related illnesses, arthritis, asthma, cough and allergies,
headaches and sinusitis, ophthalmology, gastrointestinal diseases, skin diseases,
gynaecological disorder, diabetics, lifestyle and metabolic disorder (obesity, thyroid, etc.),
depression and neurological disorder. The cost of treatment on an average is around INR
2800 per day in out-patient care and INR 8000-12,000 per day if the patient is admitted to
the hospital. Most of the hospitals maintain a record of patient’s illnesses and get regular
feedbacks from patients which help to improve service quality.
4.2.2 Pharmacies
Available information shows that within the overall AYUSH system of medicine,
Ayurveda pharmacies occupied the largest share (around 85 per cent). On April
1, 2017, there were about 7,698 Ayurveda pharmacies in India out of which
only 33 (0.4 per cent) were managed by the Government and the remaining
7,665 (99.6 per cent) were managed by non-Government bodies. Further, 88.9
per cent of the Ayurveda pharmacies followed good manufacturing practices
while the remaining 11.2 per cent did not.
Over the years, there has been a varied trend in the number of Ayurveda
pharmacies and the total number of AYUSH system pharmacies (see Figure
7). However, Ayurveda pharmacies have always held the highest share in the
total AYUSH system pharmacies in India, which has remained in the range
of 80-90 per cent. Rather, the share has increased from 80 per cent in 1995
to about 85 per cent in 2017.
As of April, 2017, among states, Uttar Pradesh (19.6 per cent) has the highest
number of Ayurveda pharmacies, followed by Maharashtra (10.16 per cent),
Kerala (9.69 per cent), Madhya Pradesh (8.82 per cent), Gujarat (6.88 per
cent) and Haryana (5.81 per cent), among others. In majority of the states,
most pharmacies follow good manufacturing practices (GMP). Only in a few
19









Figure 7: Number of Ayurveda and AYUSH System Pharmacies in India (1995-2017)








              
 





states/UT such as Arunachal Pradesh, Assam, Jharkhand and Puducherry, the

pharmacies following non-good manufacturing practices (non-GMP) are more

than those following GMP. There are other states such as Bihar, Jammu and


Kashmir and Maharashtra where there are either equal or slightly less than

equal number of pharmacies following non-GMP (see Figure 8).



Figure 8: State-wise and Manufacturing Practice-wise Distribution of

 Ayurveda  Pharmacies in India as of April, 2017

 
 




































 





To meet the growing demand, support and inclination towards Ayurveda

products, there is need for licensed Ayurveda pharmacies that follow good

manufacturing practices for manufacturing Ayurveda drugs.
 


20 



4.3 Wellness Centres and Spas: Solely Ayurveda or Ayurveda

as a Major Component
As regards wellness centres and spas, there is no data with the Government which
can help to understand the size of the sector, its contribution to the economy and its
growth. Wellness centres can be solely for Ayurveda treatment or they can offer other
types of treatment. The discussions with Government and industry shows that there
are around 1,50,000 wellness centres in India offering some kind of Ayurveda treatment
but only 10 per cent of them may be specific to Ayurveda form of treatment or may
meet the quality standards.
The Ministry of Tourism, Department of AYUSH and NABH has set up a process for
accreditation of wellness centres. It is a voluntary programme and a “Mark of Excellence”
is provided to the accredited centres which is expected to give confidence to the
tourists and locals that the centres are providing services as per global standards and
by credentialed staff (qualified and trained) and rights of customers are protected.30
The Government has also come with guidelines for promotion of wellness and medical
tourism.
The National Health Policy(2017), accords high importance to primary healthcare and
highlights that primary healthcare facilities, which provides a package of services
including geriatric health care, palliative care and rehabilitative care services which can
be referred to as ‘health and wellness centres’. Thus, wellness centres have received
special attention from the Government in the recent past and are largely linked to
primary care. The policy also has a vision to provide ‘health for all’ and universal health
coverage and to achieve this, the Government conceived ‘Ayushman Bharat’ (Healthy
India) scheme. Under this scheme, one of the components is to have 1.5 lakh health
and wellness centres in the country by 2022 to bring health care closer to people.
These centres will provide Comprehensive Primary Health Care (CPHC) covering both
maternal and child health services and non-communicable diseases, including free
essential drugs and diagnostic services.31 Thus, primary care, which is also an essential
component of Ayurveda in India, has received new impetus from the Government.
The survey found that some of the companies (for example, Kairali Ayurvedic Centre)
have a number of centres across multiple countries including Japan, Mauritius, United
Arab Emirates (UAE), Thailand, Bulgaria, Czech Republic under different operating
models such as Franchisee-Owned Company-Operated (FOCO) and Franchisee-Owned
Franchisee Operated (FOFO). A wellness centre with around 20 branches has around
100 full-time employees in total. The average cost of treatment is INR 2500, but the
costs vary by packages, diseases and span of treatment.
While most wellness centres do not have stay facilities a number of centres are now
creating stay facilities. The major treatment for which consumers visit wellness centres
30 Soruce: http://www.qcin.org/nabh/apwc/ ) (accessed on July 11, 2018).

31 For details see https://www.abnhpm.gov.in/about (accessed on August 3, 2018)
21
include weight management, pain management, stress management, skin care treatments
and Detox treatment. The survey found that around 95 per cent of patients in wellness
centres for day treatment are Indians while around 80 per cent of foreigners come to
stay in wellness centres from Europe, Japan, the US and rest of the world for treatments
like Panchkarma, Detox and Sukha Chikitsa (wellness treatment).
22
Reaching out to
5.
Consumers
With technological developments, the CII survey found that Ayurveda products and services are
reaching out to consumers in a variety of ways. The products can be positioned as medicines
or food supplements or food products. They can be accordingly sold through Ayurveda
specific pharmacies, general pharmacies, store and non-store (on-line and social media)
retail formats. Ayurveda products are sold through both organised/formal and unorganised/
informal retail formats. Of late, sale of Ayurveda products through e-commerce is increasing. A
manufacturer can position his/her products as Ayurveda, herbal/natural or organic depending
on the market demand. The market demand is growing for all these categories and there is
a tough competition among them.
A number of companies are using technology to provide Ayurveda services and some of them
provide both products and services. For example, although primary business of Jiva Ayurveda
is services, they also manufacture products. They have 250 doctors and 150 support staffs
and 80 physical clinics but majority of their service is through telemedicine where a patient
can call and connect with an Ayurveda practitioner. They receive calls from around 6000
patients per day out of which 75 per cent are call-back patients (i.e. those who have taken
the treatment before). A key component of their service is education services where they
digitalise Indian traditional books and literature and provide knowledge to people. They also
own facilities for Ayurveda treatment.
5.1 Demand Scenario and Consumer Behavior in India

There is no pan-India survey or official system of data collection on demand for Ayurveda
products and services. The Ministry of AYUSH is working on this data gap. A number of studies
focusing on specific companies or region or on the basis of small sample size have been
conducted by researchers to understand the demand scenario and consumer profile. These
studies show that Ayurveda and wellness sector is largely driven by the demographic and
lifestyle factors in the country. Rising population, large proportion of youth and increasing risk
of both communicable and non-communicable diseases are shaping the future of Ayurveda
23
and wellness industry in the country. Ayurveda reaches out to consumers across all income
groups. According to a report32; one in four Indians risks dying from a non-communicable
disease before reaching the age of 70 years. All these factors are leading to an increased
demand for natural therapies in the country. According to another study, Ayurveda has a
major role in Indian healthcare system and occupies a share of 70 per cent in the formal
drugs market (Bulsara and Yadav, 2018). The market is likely to grow further. According to
Deshpande (2015), the demand for herbal products worldwide has increased at an annual
rate of 8 per cent during the period of 1994–2001, and based on a WHO report, the paper
highlights that the global herbal market would be worth USD5 trillion by the year 2050. The
paper further highlights that out of the thousands of units in the sector, only around 35 have
sales of INR500 million. Thus, the demand scenario is promising.
There are various studies looking at the consumer behavior towards Ayurveda products and
services. Most of these studies focus on a particular city/district in the country. For instance,
Rajani (2016), based on a survey of 50 respondents in Palakkad district of Kerala using
structured questionnaire highlighted that a majority of the respondents consider Ayurveda as
a better system of medication over Allopathy, Homeopathy, Unani and others. Out of the total
respondents, around 96 per cent were regular customers of herbal products. Ayurveda products
were purchased due to factors such as goodness and popularised by word-of-mouth.
Based on a review of secondary literature, Bulsara and Yadav (2018) found that in Gujarat,
there is a preference for traditional medicines over allopathic treatment due to the preventive
and curative nature of medication. Further, it is highlighted that while the traditional system of
medicine takes time, it does not have any side effects. Greater awareness is being generated
about Ayurveda products.
Another study (Arya, et. al. 2012) conducted in Joginder Nagar region of Himachal Pradesh
using a structured questionnaire with 500 respondents found that 64.8 per cent of the
respondents preferred Ayurveda medicines over allopathy, homeopathy and Unani. It is also
considered reliable by majority of the respondents. Many of the respondents (around 77 per
cent) were habitual consumers of Ayurveda products for ailments like common cold, allergy
and cough, among others. Most of the consumers consume these medicines without Doctor’s
prescription and often these are consumed with allopathy and homeopathy medication. It is
worth mentioning that the region where the survey was conducted is located in the north-east
corner at an average 3,314 feet, located in the north-western ranges of the Himalayas and
thus is fairly remote.
As regards recommendation for furthering the growth of Ayurveda products, a study by Lakshmi,
et. al. (2017) conducted using semi-structured questionnaires with 202 patients in Tamil Nadu
found that most patients look for quicker response from medicines and thus, companies in the
sector should invest resources on developing Ayurveda medicines with quick response. Further,
there is a need for better visual marketing and campaigns to increase public awareness. This
will also assist in mainstreaming Ayurveda.
32 See http://economictimes.indiatimes.com/news/politics-and-nation/25-of-indians-may-die-of-lifestyle-diseases-before-
they-are-70-study/articleshow/48463055.cms (accessed on August 24, 2018)
24
International Trade
6.
and Investment Flows
6.1 International Trade
Ayurveda trade includes trade in both Ayurveda products (goods) and services.
6.1.1 Trade in Goods: Intermediaries and Final Products

As regards the trade in products/
goods, the Directorate General Difference between
of Commercial Intelligence and
Statistics (DGCI&S) compiles HS30039011 and
Foreign Trade Statistics for India. HS30049011:
Data is available at the Department
of Commerce website. Prior to 2003- HS 30039011 is a medicant
04, for the purpose of foreign trade, of Ayurveda system, which
AYUSH medicants and medicaments
were categorised in two heads
is a medicinal substance or
namely: “Ayurvedic and Unani compound. According to the
medicines” and “Homoeopathic HS classification, it is not for
medicine” only. However, 2003-
04 onwards, medicants and
retail sale and can only be used
medicaments of Ayurveda, Unani, as an input for its therapeutic
Siddha, Homoeopathic and and prophylactic use.
bio-chemic systems have been
differentiated and the import-export Compared to this, HS
data related to foreign trade in 30049011 is a medicament
respect of all these items is being
of Ayurveda systems or
recorded separately. The data is
compiled using the Harmonised medicines for retail sale.
System (HS) classification.
25
According to the HS classification, trade in Ayurveda products is covered

under the following codes:
• HS30039011: Medicants of Ayurveda Systems
• HS30049011: Medicaments of Ayurveda Systems
These two are covered under the broader heading of Pharmaceutical Products
(HS30).
India’s trade in Ayurveda products (including medicants and medicaments)

has shown a mixed trend over the last decade. From 2008-09 to 2011-12, total
trade in Ayurveda products increased. Since 2012-13 onwards it declined and
picked up again in 2015-16. India’s total trade in Ayurveda products (including
medicants and medicaments) in the year 2017-18 was USD150.96 million
(see Figure 9). Thus, compared to 2008-09, India’s total trade in Ayurveda
products (including medicants and medicaments) has increased by 10.3 per
cent approximately. The share of India’s trade in Ayurveda products (including
medicants and medicaments) in its total trade is small at 0.02 per cent.
Figure 9: India’s Trade in Ayurveda Products (including medicants and medicaments)
















         
  



Source: Compiled from Department of Commerce website accessible at http://commerce-app.gov.in/eidb/

 default.asp (accessed on September 6, 2018)


As shown in the figure, India has a trade surplus with respect to Ayurveda

products (including medicants and medicaments). In the year 2017-18, India’s

 total exports in Ayurveda products (including medicants and medicaments)
amounted to USD140.72 million while its imports were around USD10.24


million. Thus, the total trade surplus amounted to USD130.48 million.




26 


As mentioned earlier, there are two broad categories of Ayurveda products

- medicants of Ayurveda systems (HS30039011), which largely include
inputs that are not for retail sale and medicaments of Ayurveda systems
(HS30049011), which include medicines meant for retail sales. In India, the
export of medicaments (HS30049011) is much greater than the export of
medicants (HS30039011). In the year 2017-18, total export of medicants was
about USD14.22 million (around 10 per cent) while the export of medicaments
was USD126.50 million, accounting for nearly 90 per cent of total Ayurveda
exports. Thus, the export of finished products is more than the export of
raw material.A number of companies such as Arya Vaidya Pharmacy have
registered their products (medicines, health supplements and cosmetics) in
countries such as Oman, Malaysia and Latvia.
As regards imports, in the year 2017-18, Indian imported more medicants

(USD9.09 million) as opposed to medicaments (USD1.15 million) highlighting
that the import of raw material is more than the finished products when it
comes to trade in Ayurveda systems. This has been the trend throughout the
period from 2008-09 to 2017-18 (see Table 4 for details).
Table 4: Export and Import of Medicants and Medicaments during

2008-09 and 2017-18
Year Export (USD Million) Import (USD Million)

HS30039011 HS30049011 HS30039011 HS30049011
2008-09 51.07 70.22 6.68 7.46
2009-10 24.99 117.14 4 2.67
2010-11 38.02 115.52 5.98 1.21
2011-12 33.03 137.02 7.22 1.24
2012-13 22.97 132.98 6.54 0.38
2013-14 20.56 126.27 7.06 0.74
2014-15 18.02 96.75 10.18 0.6
2015-16 13.02 94.71 8.88 0.47
2016-17 15.67 105.59 5.89 1.06
2017-18 14.22 126.5 9.09 1.15
Source: Compiled from Department of Commerce website accessible at http://commerce-

app.gov.in/eidb/default.asp (accessed on September 6, 2018)
India’s major trading partners for export and import of Ayurveda products
are varied.
As regards the export of medicants (HS30039011), in the year 2017-18, the

United States (US), Nepal and the UAE , among others are India’s major
export destinations. In the same year, the top export destinations for the
27
export of medicaments were Nepal, UAE, Russia and the US, among others
(see Figures 10a and 10b).
By countries, the top import partner for import of medicants (HS30039011) in

the year 2017-18 is Nepal accounting for more than 90 per cent of the total
import. In the same year, the top import partners for the import of medicaments
(HS30049011) are Sri Lanka and Russia, together accounting for more than
  80 per cent of the total import of medicaments.
 

Figure  : India’s
10a Export of Medicants

 Figure 10b: India’s Export of


  

(HS30039011) 



Medicaments (HS30049011)
  


    
 
 


 

  
 
    

     
     
 
   
 
     
    

    
    
 
 
   
     
  
  
     
   
   
         
    
 
  
 

 

Source: 
Compiled from Department of Commerce website accessible at http://commerce-app.gov.in/eidb/


default.asp (accessed on September 6, 2018)


 


Thus, the secondary data shows that trade is still a small proportion of India’s


Ayurveda market and it is concentrated in a few export destinations and


import sources. India’s trade in Ayurveda products did slow down for a few




years, however, over the last couple of years it has picked up again. The in-


depth meetings with Ayurveda manufacturing companies highlight that only


10-15 per cent of the products or 1-2 per cent of manufacturing by volume


  is exported as Ayurveda products. Similarly, only 1-2 per cent of the products
are registered in foreign countries as drugs and sold through pharmacies.




Most products are exported as food supplements or health supplements to
markets such as the US and the UK.
 
 
28
For exports, companies follow the importing country regulations. In Canada,

for example, Natural Health Product (NHP) registration is needed and many
Ayurveda products are sold under that registration. In Georgia, Ayurveda
is under free sale certification. In Nepal and Bangladesh Certificate of
Pharmaceutical Products (COPP) is needed for exports.33
In India, there is a shortage of herbs and there are restrictions on imports of

certain herbs. However, of late there is a large informal trade in this segment
and this needs further investigation.
6.1.2 Trade in Services

India has the potential to offer Ayurveda services and this is offered in various
ways. First, a number of foreign patients come to India to avail Ayurveda
treatment and spa facilities. They are covered under the category of medical
tourism (see Box 1). The DGCI&S conducts a survey of medical value tourism
in the state of Kerala. According to the information provided by the DGCI&S
in the medical value tourism sector the state of Kerala receives tourist from
as many as 50 countries. In their study, 96 per cent of the sample Ayurveda
firms provided rejuvenation cum curative treatments; the others have only
rejuvenation/wellness treatments. The foreign clients availed both one and
two hours of massage in resorts and curative treatment. Neuro-muscular and
muscular–skeletal problems including limb and vertebral problems, obesity,
stress management, life style diseases, degenerative and old age diseases
such as rheumatic arthritis and osteoporosis, sinusitis, migraine etc. were the
most common health problems for which foreign clients came for treatment.
The survey also showed that many foreign clients (around 19 per cent) come
back for repeat visits. In 2017, the DGCI&S again conducted a survey of 70
hospitals and wellness centres which receives foreign clients.
Among the different Ayurveda companies, Jiva Ayurveda has entered into an
international partnership through education. The company has trained foreign
coaches from countries such as Japan and France who in turn spread Ayurveda
through schools such as Jiva Japan School. The Kripalu Center for Yoga &
Health is an example of how AYUSH is reaching international markets.
33 For example See; http://www.cdsco.nic.in/writereaddata/Uploading%20of%20Data%20of%20COPP%20granted%20

by%20CDSCO_July-17(1).pdf (accessed on August 24, 2018)
29
Box 2: Ayurveda - A Fresh Impetus to Medical Value Travel

Over the last few years, there has been a rise in medical tourism in India. Number of
medical tourists in India stood at around 234,000 in 2015, and 427,000 in 2016 and
495,000 in 2017. India offers affordable and high-quality healthcare systems and along
with English-speaking medical staff that has an international appeal. In the year 2018, India
had around 18 per cent of the global medical tourism market (The Hindu). In the year
2015, its medical value travel (MVT) was estimated to be USD3 billion and is projected
to grow at a compound annual growth rate of 15 per cent. It has been estimated that by
2020, India’s medical tourism industry could be worth USD9 billion, and account for 20
per cent of the global market share (FICCI and IMS Health India Report).
AYUSH, particularly Ayurveda is an important component of India’s growing medical

tourism, which has enabled India in positioning itself as the holistic destination for
alternative medicine. The practice of Ayurveda is spread across different Indian states
and it is popular in the West. Indian states such as Kerala, Tamil Nadu and Karnataka are
particularly popular among tourists for wellness treatment. With the growing focus of the
Government, there has been an increase in the AYUSH infrastructure. Moreover, with the
establishment of the All India Institute of Ayurveda, there has been a fresh impetus to the
growth and credibility of the sector. The traditional medical sector is developing Traditional
Knowledge Digital Library to prevent companies from claiming patents on such remedies
(Indian Brand Equity Foundation). This is likely to preserve the practice and enable further
growth and popularity amongst foreigners.
Source: Medical Tourists Flocking to India, The Hindu, July 23, 2018; Medical Value Travel in India: Enhancing
Value in MVT by FICCI and IMS Health India, accessible at http://www.ficci.in/Medical-Value-Travel-Report.pdf
(accessed on August 24, 2018); Indian Brand Equity Foundation.
6.2 Foreign Direct Investments

According to the Department of Industrial Policy and Promotion’s (DIPP) consolidated foreign
direct investment (FDI) policy, 100 per cent FDI is allowed through the automatic route in
the AYUSH sector and Ayurveda drug manufacturing is seen as an important investment
opportunity sector from the viewpoint of foreign investors.34 Yet, the Government does not
maintain separate data for FDI in Ayurveda industry which makes it difficult to estimate the
investment flows.35 The data provided by DIPP shows that total cumulative FDI inflow into
drugs and pharmaceutical sector during the period April 2000 to June 2018 was USD15.8
billion (4.06 per cent of total FDI in India during the period). Cumulative FDI in hospitals and
diagnostic centres during the same period was USD5.2 billion (1.35 per cent of total FDI in
India during the period).36
34 See http://www.makeinindia.com/sector/wellness (accessed on August 12, 2018)

35 For details see Response to Rajya Sabha Questions http://dipp.nic.in/sites/default/files/ru3696.pdf (accessed on August
12, 2018)
36 For detail see http://dipp.nic.in/sites/default/files/FDI_FactSheet_23August2018.pdf (accessed on August 28, 2018).
30
As regards India’s outward investments in Ayurveda industry, the data is sketchy. Data on
India’s overseas investments is available from the Reserve Bank of India (RBI) website. The
RBI publishes monthly data for broad sectors of investments, which does not explicitly mention
Ayurveda industry. However, a closer look at company-wise data reflects information for some
of the large Ayurveda companies that have made invested abroad.
Some of the top investors are – Dabur India Limited, which has invested about USD207.6 million
in UAE since July 2007; Siddhayu Ayurvedic Research Foundation, which has invested about
USD11.6 million in Indonesia and UAE since July 2007; Kerala Ayurveda Pharmacy Limited,
which has invested about USD10.7 million in the US and Germany since July 2007. Most of
the investments are made in the manufacturing sector. Other investors include companies such
as Ayurvedic Natural Healthcare Centre Private Limited, Shahnaz Ayurveda Private Limited,
Vaidya Sane Ayurved Laboratories Private Limited, Santhigram Ayurvedic and Spiritual Resort
Private Limited and Patanjali Ayurved Limited, among others.
The growth of trade and investment flows will depend on the demand for Ayurveda globally.
The CII survey found that Ayurveda can be registered and legally practiced in Gulf Cooperation
Council (GCC) countries and countries such as Mauritius. Russia and Myanmar also accept
traditional Indian medicine. It is recognised in all SAARC countries except Pakistan and
Afghanistan. In the US, where Ayurveda is yet to be recognised as a medical practice and drugs
needs FDA (Food and Drug Administration) registration, Ayurveda practices is popularised as
wellness and products are sold as food and health supplement. An US based start-up named,
Curejoy, adopted social media to spread the concept of Ayurveda by providing information
on healthy living. The company reaches out to 100 million people each month through social
media platforms and works with a set of experts, including Ayurveda doctors, nutritionists and
health coaches to promote healthy living. Around 40 per cent of their consumers are in the
US, 25 per cent in India and remaining are spread across other countries. They have setup
manufacturing units for health supplements in the US and are planning to expand to India.
Thus, companies are exploring innovative ways to spread Ayurveda in global markets.
A number of hospital chains are planning to expand to countries such as the US, Russia
and GCC. They pointed out that they need financial support from the Government to build
awareness about this form of practice. The Government may also work with other countries
to get the Ayurveda doctors registered which will allow them to practice. These are discussed
in more details in policy recommendation section.
31
The Issues
7.
• Lack of Data: The core issue faced in estimating the size of the sector, its contribution
to the GDP, employment, and its socio-economic impact is the data gap. There is no
official source of data on (a) Ayurveda manufacturing sector, (b) private hospitals, clinics,
wellness centres and spas, (c) employment generated and manpower requirements (d) raw
material availability and requirements (f) trade in Ayurveda services and (e) consumers of
Ayurveda. Unless such data is collected and collated, it is difficult to get a comprehensive
analysis of the size of the sector, project its future growth and showcase the sector in
global platforms.
• Shortage of Manpower: The survey found that there is a shortage of manpower and
skilled professionals (doctors, paramedical staff, therapists and nurses) in this field. Further,
there seems to be a lack of Government approved and/or recognized paramedical training
courses and there is no uniformity in the skill and knowledge. A number of companies
offer training to develop skills like therapists.
• Product Classification: Product classification depends on usage and the products can
be classified as Ayurveda products or food supplements. Accordingly, companies are
registered with both Ministry of AYUSH and FSSAI.
• Shortage of Quality Raw Materials: All the companies in manufacturing sector pointed
out that there is a severe shortage of certain kinds of medicinal plants/herbs, because
they are either becoming endangered or there can be lower production due to factors
such as adverse weather conditions. For example, variable production of Amla may lead
to fluctuation of rates or its non-availability. Further, there are wide variations in quality of
raw materials. There is no Government approved standards for intermediate products and
herbs and this has resulted in wide variety in standards. If pesticides are used by farmers
above the maximum residue limit specified by some markets such as the US and the
EU, the products/herbs can get rejected. As per Drugs and Cosmetics Act, raw material
should comply with the quality specifications of Ayurvedic Pharmacopeia of India, which
is a legalised document of the Government of India describing the quality, purity and
strength of selected drugs that are manufactured, distributed, and sold by the licensed
32
manufacturers in pan-India. However, as per the estimates of the survey participants,

almost 5 per cent of the raw materials fail on remediable parameters like ash value, foreign
matter, moisture content, etc., while 1-2 per cent fails on non-remediable parameters, for
example, marker compounds, assay content or TLC. The survey also found that shortages
and quality issues may also be due to factors such as non-availability of post-harvest
facilities at primary level, lack of testing laboratories, etc., in the hubs where medicinal
plants are produced, such as the North East. Moreover, extracts are not covered under
Rule 158 of Drugs and Cosmetics Act, which can lead to variable quality standards.
• Variable Quality Standards of Manufacturing Units and Services: There are wide
variations in quality standards of hospitals, manufacturing units, wellness centres. This is
a cause for concern of service providers who are trying to implement international best
practices. According to survey participants, 40 per cent of the manufacturers do not have
WHO-GMP certification.
• Product Patents and R&D Related Issues: Most Ayurveda products are not patented as
Ayurveda is treated as a traditional knowledge. This makes it difficult to have proprietary
rights on the drugs. There is limited funding for R&D in this area.
• Lack of Product Traceability: Product traceability is essential for exports and unless
traceability is implemented patients are at a risk. Unless product traceability and standards
are implemented manufactures pointed out that it is difficult for them to export.
• Variation across States in terms of Ayurveda Policy. There are variations across states
with respect to their support for Ayurveda. For example, as shown in Table 5 in some
states Animal Husbandry Departments do not include Ayurveda/Herbal products for their
purchases and only tender for chemical products.
Table 2: Distribution of Ayurveda Hospitals and Dispensaries as per

Jurisdiction (as on April 1, 2017)
S No States which Buys Herbal Products States which do not Buy Herbal Products
1 Assam Kerala
2 Arunachal Pradesh Tamil Nadu
3 Andhra Pradesh Gujarat
4 Telangana Maharashtra
5 Karnataka Madhya Pradesh
6 Haryana Rajasthan
7 Himachal Pradesh Chhattisgarh
8 Jammu & Kashmir Punjab
9 West Bengal UP
10 Jharkhand Uttarakhand
11 Goa Bihar
33
S No States which Buys Herbal Products States which do not Buy Herbal Products
12 Orissa Manipur
13 Tripura Meghalaya
14 Sikkim Mizoram
15 Pondicherry (UT) Nagaland
Source: Information provided by CII members
• Difficulties in Registering the Product as Drug in Foreign Countries: One of the

reasons that Ayurveda products are not exported as food supplements is because of
the lack of recognition of this traditional medical practice and difficulties in doing clinical
trials. In some countries Ayurveda products, especially single herb preparations can be
sold as food supplements or dietary supplements but these cannot be sold as medicines
since Ayurveda is not recognized under the healthcare system. In spite of the growing
awareness about Ayurveda globally, it is still limited. The cost of registration may be high
and companies faced issues of scientific validation and clinical trials.
• Issues in Registering Poly Herbal Formulation Abroad: In most of the countries, there
is no provision to register poly herbal (more than one herb) formulations. Most Indian
Ayurveda Products have multiple herbs. Some countries have registration rules for products
containing single herb/essential oils. This creates barriers for exports of Ayurveda animal
health products. Further, many Indian medicinal plants are not registered/approved for
use in many countries, creating barriers for product approvals.
• Non-recognition and Degree and Traditional Medical Practice: This is a major barrier
to export of Ayurveda services, especially medical practitioners. According to the survey
participants there is a huge demand for Ayurveda doctors, care givers or Ayurveda
wellness consultants outside India but most of the Indian certifications are not valid. Since,
an Ayurveda doctor can only practice as an Ayurveda consultant in most countries, it
adversely impacts their earning potential.
• Sector-specific issues: The recent natural disaster in Kerala has adversely affected
the wellness and spa sector in the state. Some hospitals, clinics and dispensaries have
pointed out that due to high demand, their ability to accommodate and treat patients is
getting saturated and there is need for funding for fast expansion.
34
Recommendations
8.
and Way Forward
The high growth of the Ayurveda sector in the recent years has been possible due to the
continued support of the Government, especially the proactive measures taken by the Ministry
of AYUSH. The industry will continue to grow if some of the concerns listed above can be
addressed. These are:
• Have a Robust System of Data Collection: To support the growth of the industry, it
is important to identify the data gaps, understand the needs and requirements of the
private sector, understand the socio-economic contribution of this sector, among others.
For promoting “brand Ayurveda” in domestic market and global platform the Ministry
of AYUSH needs to have a more robust database, which can be generated through a
comprehensive survey of all stakeholders. The Ministry needs to regularly collect data on
the growth performance of the sector, raw materials and manpower availability, barriers
faced in goods and services exports, etc. While there are shortages of certain medicinal
plants, the survey found that some species which had earlier become endangered can
now be cultivated. Data on raw materials and intermediary products will be required to
sustain future demand. Data will help the Government to take informed policy decisions.
In this regard, since majority of the sector is privatised, the Ministry of AYUSH may form a
consortium partnership with industry associations such as CII and research organizations
to collect, collate and present data on the sector.
• Formulate a Short-term and Long-term Vision Document: While the Government has
supported the industry through various initiatives, the sector will attract more investment
and create more jobs if the Government comes up with a short (five-year) and long-term
(10 year) vision document. In formulating the vision document, the Government can work
closely with the industry and industry associations to design policies that will help the
industry to become productive and competitive.
• Promote and Globalise Ayurveda: The Government can work jointly with the industry
and its associations to globalise “Brand Ayurveda” and increase awareness of this
system of practice through G20 and other multinational fora. Specifically in the G20, the
Government may work with like-minded countries to promote traditional medicines and
remove barriers to their exports.
35
• Address Shortages of Raw Materials: Various measures can be taken to address

shortages of raw materials. The survey participants pointed out that Government can
register raw material vendors, provide information on production of raw materials by
states, provide access of waste land to industry for cultivation of medicinal plants, etc. The
Government can establish an online portal where herbal products manufacturer, extract
manufacturers, etc., can register and select business partners. This will cover various
aspects of procurement from domestic and foreign markets and help to align the efforts
of different State Medicinal Plant Boards. Further, technologies such as block chains can
be used through this portal to ensure transparency and traceability. To mitigate shortages
of raw materials, these are sometimes imported through informal channels. Thus, imports
may be formalised, based on requirements and demand-supply gaps. There is need to
work closely with Customs and implement technologies, which can help to identify products
with different names, so as to avoid their entry through informal channels.
• Focus on Quality and Standards: It is important for the Government to focus on quality
and standards of the manufacturing units, service providers, treatment procedures, raw
materials used and manpower engaged in this sector. The Government needs to work
closely with the industry to design standards for raw materials. Tax incentives and other
measures may be given to help the industry in upgrading standards. The industry may be
encouraged to invest in R&D through liberal tax incentives or soft loans. The Government
may work with the industry to implement a system of product traceability. It may also
work with industry to ensure protection of traditional knowledge. It is important to draw
up a list of laboratories which meet international standards and share it with the industry.
The Government may also establish best practices or standard guidelines for evaluation
of clinical trials.
• Support Industry in Implementing Technology: Industry may be encouraged through

the right policies to invest in technologies. For example, industry can be encouraged
to use Artificial Intelligence and Machine Learning to analyse clinical data. Ayurveda
companies can use e-commerce platforms to access more clients and consumers. It
is important to develop a database and network of Ayurveda practitioners. At present,
there are some databases but they are not comprehensive. Digital supply chain using
block chain technologies can be used to ensure quality, traceability and transparency.
The initiatives in this sector and be linked to other Government initiatives such as “Digital
India” or “Start-up India” initiative.
• Promote Exports: A number of measures can be taken to promote exports. First, the
Government can support the businesses by organising promotional events, workshops,
seminar, etc. in other countries which will create awareness of Ayurveda and this will
also help to develop medical tourism in India. The Government may work with other
countries to address concerns related to registration of poly herbal (more than one
herb) formulations and come up with a process of harmonisation of drug registration
requirements. Since a number of players in this sector are small and mid-sized industry
the Government can share more information on how they can register their products or
practice in other countries. The Government can provide support for R&D and for meeting
36
quality standards for exports. In order to promote exports, COPP based on WHO-GMP
may be expanded to include non-herbal ingredients such as Bhasmas.
• Policy Uniformity across States: Policy uniformity across states and support of the state
Governments are essential for this sector to grow. The Ministry of AYUSH can identify
and share the best practices across states.
• Focus on Human Resource: As the sector grows there is a shortage of human resources
and it is important to invest in well-trained and motivated human resources. The industry
may work with Ministry of AYUSH and National Skill Development Corporation India
(NSDC) to identify the skill gaps and training needs in the sector. It is also important to
understand what requirements need to be fulfilled to make the Indian degrees acceptable
in some key countries (accordingly the curriculum may also be revised).
• Support through Insurance Policy and Coverage: Ayushman Bharat Yojana or National
Health Protection Scheme has recognised Ayurveda to be covered under insurance.
However the industry needs more clarity as to how it will be implemented. A clear guideline
may be provided in this respect.
37
References
Arya, V., Thakur, R., Kumar, S. and Kumar S. (2012), “Consumer Buying Behavior towards Ayurvedic
Medicines/Products in Joginder Nagar – A Survey”, Ayurpharm - International Journal of Ayurveda and
Allied Sciences, Vol.1, No.3 (2012) Pages 60 – 64.
Bulsara, H.P. and Yadav, N. (2018), “A Study on the Current Scenario of Consumers Buying Behavior
towards Ayurvedic Medicines in Gujarat”, IOSR Journal of Business and Management (IOSR-JBM), pp 31-
35, Presented at the 2nd International Conference on ‘Innovative Business Practices and Sustainability in
VUCA World’, Organised by GNVS Institute of Management – Mumbai in April – 2018.
Confederation of Indian Industry (CII) and Frost & Sullivan (F&S) 2017, “Vision 2022 Roadmap for Indian
Ayurveda Industry”, Prepared for Ministry of AYUSH, 2017.
Deshpande, S.M. (2015), “Study of Current Market Scenario & Marketing Prospects against Changing
Attitude of Consumers towards Buying of Ayurvedic Medicines in India”, International Journal of Business
and Management Invention, Vol. 4, Issue 6, pp. 48-54, June 2015.
Federation of Indian Chambers of Commerce and Industry (FICCI) and Ernst & Young (EY) (2016), “Value
Added Services-Wellness and Preventive Healthcare”, FICCI 9th Annual Health Insurance Conference,
December, 2016 accessible at http://ficci.in/VAS-Report.pdf (accessed on September 1, 2018).
Lakshmi, K.S., Jasim, K.M., Prabhakar, K. and Parveen S.J. (2017), “Brand Positioning of Ayurvedic
Medicine in Indian Milieu”, International Journal of Business Excellence, Vol. 11, No. 1, pp. 16-37.
Rajani, P. (2016), “Consumer Perception towards Ayurvedic Products with Special Reference to Megha’s
Herbo Care Ayurvedic Pharmacy, Varode, Palakkad”, International Journal of Commerce, Business and
Management (IJCBM), Vol. 5, No.6, pp. 7-15, Nov-Dec 2016.
Techsci Research (2016), “India Ayurvedic Products Market by Product Segment (Ayurvedic Healthcare
Products and Ayurvedic Personal Care Products), by Organized vs. Unorganized, Competition Forecast &
Opportunities, 2011 – 2021”, Techsci Research, July 2016 accessible at https://www.techsciresearch.com/
report/india-ayurvedic-products-market-by-product-segment-ayurvedic-healthcare-products-and-ayurvedic-
personal-care-products-by-organized-vs-unorganized-competition-forecast-opportunities-2011-2021/726.html
(accessed on September 1, 2018).
World Health Organization (WHO) (2010), “Benchmark for Training in Traditional/Complementary and
Alternative Medicine: Benchmark for Training in Ayurveda”, World Health Organization, 2010.
38
Appendix A
9.
Table A1: List of NABH Accredited Ayurveda Hospitals in India as of July 2018
Name Valid Upto City/District State

AyurVaid Hospital, Domlur Extension, Bangalore, 20-Oct-19 Bengaluru Karnataka
Karnataka, India
Maharishi Ayurveda Hospital, Khosla Medical Institute 01-Sep-20 New Delhi Delhi
& Research Society, New Delhi, Delhi, India
Amala Ayurvedic Hospital & Research Centre, 14-May-21 Thrissur Kerala
Thrissur, Kerala, India
Sreedhareeyam Ayurvedic Eye Hospital & Research 02-Aug-21 Ernakulam Kerala
Centre (Pvt.) Ltd , Ernakulam, Kerala, India
Soukya Indian Holistic Health Centre Pvt. Ltd., 22-Nov-18 Bengaluru Karnataka
Bangalore, Karnataka, India
AyurVaid Hospital, Ramamurthy Nagar Extn., 04-Apr-19 Bengaluru Karnataka
Bangalore, Karnataka, India
Sahaya Holistic Integrative Hospital Pvt. Ltd., 23-Jun-19 Bengaluru Karnataka
Bangalore, Karnataka, India (Accreditation Withdrawal)
Punarnava Ayurveda Hospital Pvt. Ltd., Edappally 28-Jan-20 Cochin Kerala
North, Cochin, Kerala, India
Kalari Kovilakom, Kollengode, Palakkad, Kerala, India 28-Jan-20 Palakkad Kerala
I-AIM Healthcare centre ( IHC), Bangalore, Karnataka, 06-Jul-20 Bengaluru Karnataka
India
Ashtavaidyan Thaikkattu Mooss Vaidyaratnam Nursing 16-Feb-21 Thrissur Kerala
Home, Thrissur, Kerala, India
Nagarjuna Ayurvedic Centre Ltd., Ernakulam, Kerala, 01-Sep-18 Ernakulam Kerala
India
Ahalia Ayurveda Medical College, Palakkad, Kerala, 15-Mar-19 Palakkad Kerala
India
39

Kaya Kalp, Himlayan Institute for Yoga & Naturopathy, 09-May-19 Palampur Himachal
Palampur, Himachal Pradesh, India Pradesh
KLE University 's Ayurved Hospital & Medical 02-Jul-19 Belgaum Karnataka
Research Centre, Belgaum, Karnataka, India
Kokila Siddha Hospital & Research Centre, Madurai, 06-Sep-19 Madurai Tamil Nadu
Tamil Nadu, India
Vaidyaratnam PS Varier's Arya Vaidya Sala Kottakkal 09-Nov-19 Kottakkal Kerala
Ayurvedic Hospital And Research Centre , Kottakkal,
Kerala, India
Ayurgreen Ayurveda Hospital Pvt. Ltd., Malappuram, 11-Mar-20 Malappuram Kerala
Kerala, India
Matha Ayurveda Eye Hospital (Moongode) Pvt. Ltd., 05-Jul-20 Trivandrum Kerala
Trivandrum, Kerala, India
AVN Arogya Ayurvedic Hospital, Madurai, Tamil Nadu, 05-Jul-20 Madurai Tamil Nadu
India
All India Institute of Ayurveda , Delhi, Delhi, India 05-Jul-20 Delhi Delhi
Sri. Babu Singh Jai Singh Ayurvedic Medical College 05-Aug-20 Farrukhabad Uttar
and Hospital, Farrukhabad, Uttar Pradesh, India Pradesh
National Institute of Ayurveda, Jaipur, Rajasthan, India 10-Sep-20 Jaipur Rajasthan
Patanjali Ayurved Hospital, Haridwar, Uttarakhand, 14-Nov-20 Haridwar Uttarakhand
India
Somatheeram Research Institute And Ayurveda 14-Nov-20 Thiruvanan- Kerala
Hospital, Thiruvananthapuram, Kerala, India thapuram
Sree Subramania Ayurvedic Nursing Home, Calicut, 14-Nov-20 Calicut Kerala
Kerala, India
Naiminath Homoeopathic Hospital, Agra, Uttar 14-Nov-20 Agra Uttar
Pradesh, India Pradesh
JSS Ayurveda Hospital, Mysore, Karnataka, India 14-Nov-20 Mysore Karnataka
Dhathri Ayurveda Hospital & Panchakarma Centre, 07-Jan-21 Bengaluru Karnataka
Alappuzha, Kerala, India
Shri Babu Singh Daddu Ji Ayurvedic Medical College 07-Jan-21 Pune Uttar
& Hospital, Farrukhabad, Uttar Pradesh, India Pradesh
Dr.D.Y.Patil College of Ayurved and Research Center, 07-Jan-21 Pune Maharashtra
Pune, Maharashtra, India
Maharashtra Arogya Mandal's SSAM's , Pune, 07-Jan-21 Pune Maharashtra
Maharashtra, India
Ramaiah Indic Speciality Ayuveda Restoration 07-Jan-21 Bengaluru Karnataka
Hospital, Bangalore, Karnataka, India
Major S.D. Singh P.G. Ayurvedic Medical College & 17-Feb-21 Farrukhabad Uttar
Hospital, Farrukhabad, Uttar Pradesh, India Pradesh
40

Parul Ayurved Hospital, Vadodara, Gujarat, India 21-Apr-18 Vadodara Gujarat
Dr. Saji D'Souza's K.S.A.C Hospital, Bangalore, 21-Apr-21 Bengaluru Karnataka
Karnataka, India
Shri Dhrmasthala Manjunatheshwara College of 21-Apr-21 Udupi Karnataka
Ayurveda and Hospital, Udupi, Karnataka, India
National Institute of Naturopathy, Pune, Maharashtra, 21-Apr-21 Pune Maharashtra
India
Sri Visista Super Speciality Ayurveda, Hyderabad, 12-May-21 Hyderabad Telangana
Telangana, India
Kairali Ayurvedic Health Resorts Pvt. Ltd., Kodumbu, 15-Jun-21 Palakkad Kerala
Palakkad, Kerala, India
Kalari Rasayana, Kurumandal, Perumpuzha, Paravur, 15-Jun-21 Kollam Kerala
Kollam, Kerala, India
Sitaram Beach Retreat, Thrissur, Kerala, India 15-Jun-21 Thrissur Kerala
Mahatma Gandhi Ayurved Hospital, Salod , Wardha,
Maharashtra, India 21-Jul-21 Wardha Maharashtra
Parathuvayalil Hospital , Keezhillam, Kerala, India 21-Jul-21 Keezhillam
Source: Compiled from http://www.nabh.co/frmViewAccreditedAyushHosp.aspx (accessed on August 20, 2018)
41
CII Contacts
Ms Neerja Bhattia Ms Anjula Singh Solanky

Executive Director Director
Confederation of Indian Industry (CII) Confederation of Indian Industry
The Mantosh Sondhi Center India Habitat Centre
23 Institutional Area, Lodhi Road Core IVA, 4th Floor
New Delhi 110003, India Lodi Road, New Delhi -110003 (India)
Tel : +91 11 24629994 / 45771000 Tel : +91-11-2468 2230-35
Fax : +91 11 24626149 Email : anjula.solanky@cii.in
Email : neerja.bhattia@cii.in Website : www.cii.in
Contributor
Dr Arpita Mukherjee
Professor
Indian Council for Research on International Economic
Relations (ICRIER)
Core 6A, 4th Floor,
India Habitat Centre
Lodi Road, New Delhi -110 003
Tel : 91 11 43112400,
Fax : 91 11 2462 0180
Linkedin : https://www.linkedin.com/in/drarpitamukherjee
The Confederation of Indian Industry (CII) works to create and sustain an environment
conducive to the development of India, partnering industry, Government, and civil society,
through advisory and consultative processes.
CII is a non-government, not-for-profit, industry-led and industry-managed organization,

playing a proactive role in India’s development process. Founded in 1895, India’s premier
business association has around 9000 members, from the private as well as public sectors,
including SMEs and MNCs, and an indirect membership of over 300,000 enterprises from
around 265 national and regional sectoral industry bodies.
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As a developmental institution working towards India’s overall growth with a special focus
on India@75 in 2022, the CII theme for 2018-19, India RISE: Responsible. Inclusive.
Sustainable. Entrepreneurial emphasizes Industry’s role in partnering Government to
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Ayurveda Industry Market Size,

Strength and Way Forward

2. Size of the Market 5

3. Manufacturing and Allied Sector 8

5. Reaching out to Consumers 23

6. International Trade and Foreign Investment 25

6.2 Foreign Direct Investments 30

Recommendations and Way Forward 35

AIIMS All India Institute of Medical Sciences

AYUSH Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy

CAGR Compound Annual Growth Rate

CCIM Central Council of Indian Medicine

CGHS Central Government Health Scheme

CII Confederation of Indian Industry

COPP Certificate of Pharmaceutical Products

DGCI&S Directorate General of Commercial Intelligence and Statistics

DIPP Department of Industrial Policy and Promotion

FDI Foreign Direct Investment

FSSAI Food Safety and Standards Authority of India

GCC Gulf Cooperation Council

GMP Good Manufacturing Practices

NABH National Accreditation Board for Hospitals and Healthcare Providers

NIQ Non-Institutionally Qualified

RBI Reserve Bank of India

SAARC South Asian Association for Regional Cooperation

TKDL Traditional Knowledge Digital Library

UAE United Arab Emirates

WHO World Health Organization

Table 2: Examples of Companies in Manufacturing 9

Table 3: Distribution of Ayurveda Hospitals and Dispensaries as per Jurisdiction

Table 5: State-wise Variations in Policy Related to Purchase of Herbal products 33

Figure 2: Number of Ayurveda and AYUSH Practitioners in India during 1980-2017 12

Figure 3: State-wise and Gender wise Distribution of Total Ayurveda Practitioners as of

Figure 4: Distribution of Ayurveda Practitioners as per their Qualification 13

Figure 5: Number of Ayurveda Hospitals and Dispensaries in India during 1980-2017 16

Figure 7: Number of Ayurveda and AYUSH System Pharmacies in India (1995-2017) 20

Figure 8: State-wise and Manufacturing Practice-wise Distribution of Ayurveda

Figure 9: India’s Trade in Ayurveda Products (including medicants and medicaments) 26

Figure 10a: India’s Export of Medicaments (HS30049011) 28

Figure 10a: India’s Export of Medicants (HS30039011) 28

Box 2: Ayurveda - A Fresh Impetus to Medical Value Travel 30

1.1 Definitions and Coverage

5 See http://ayush.gov.in/About-The-Systems/Ayurveda/faq/what-ayurveda (accessed on July 3, 2018).

Figure 1: Comparing Definitions of Different Wellness Products

 Medicinal science which includes use of herbs as well as heavy

1.3 Governance Structure and Initiatives

15 See https://www.reuters.com/brandfeatures/venture-capital/article?id=15602 (accessed on July 4, 2018).

is estimated that the Ayurveda products

18 For details see https://qrius.com/future-group-expands-to-gain-foothold-in-ayurveda-market-but-can-it-compete-against-

2.2 Growth Projections: Primary Survey

Table 1: Market Size and Growth Across Select Sub-sectors -

2.3 The Drivers of Future Growth

The Ayurveda manufacturing sector contributes significantly to employment. However,

Table 2: Examples of Companies in Manufacturing

23 http://www.ayush.gov.in/traditional-knowledge-digital-library (accessed on July 4, 2018).

25 For details see https://www.nmpb.nic.in/content/medicinal-plants-fact-sheet (accessed on August 10, 2018)

4.1 Medical Manpower

Figure 2: Number of Ayurveda and AYUSH Practitioners in India during 1980-2017

 practitioners per ten million people.

Source: D ata extracted from Ministry of AYUSH, accessible at http://ayush.gov.in/genericcontent/ayush-

4.3 Wellness Centres and Spas: Solely Ayurveda or Ayurveda

Source: Information provided by CII members

Source: Compiled from http://www.nabh.co/frmViewAccreditedAyushHosp.aspx (accessed on August 20, 2018)