The Future of MedTech in India: Meeting Tier-2 and Tier-3 Needs

In an exclusive interaction with Thiruamuthan, Assistant Editor at India Pharma Outlook, Shishir Agarwal, President and Managing Director, Terumo India, discusses how MedTech companies are adapting their products and strategies to meet the growing demand in India’s Tier-2 and Tier-3 cities by focusing on affordability, accessibility, and innovation, while leveraging digital technologies, partnerships, and government initiatives for sustainable healthcare solutions.

How are MedTech companies adapting their product offerings and distribution strategies to meet the growing demand in India’s Tier-2 and Tier-3 cities?

Healthcare demand in India has reached a tipping point with Tier-2 and Tier-3 cities emerging as the next growth engine. This shift is fueled by rising incomes, wider insurance coverage, and increasing awareness of quality care. MedTech companies are rethinking both their product offerings and the way they reach these markets to respond effectively.

Products are being adapted to local realities, designed to be affordable, reliable, and easy to use, ensuring that clinical outcomes even in smaller cities match global standards. At the same time, innovation continues across the portfolio, from high-volume essentials to advanced technologies. There is a clear shift towards value-based solutions rather than scale alone.

Equally important is strengthening distribution through deeper regional partnerships, closer engagement with local hospitals, and robust service and training support for the healthcare professionals.

At Terumo India, this is not a new trend and has been our core since inception. As we remain committed to delivering clinical value, building capabilities through training, and working closely with healthcare providers to ensure vascular and critical care solutions are accessible, sustainable, and relevant to patient needs, despite geography.

What role do telemedicine and remote monitoring technologies play in expanding access to healthcare in underserved regions of India?

Telemedicine and remote monitoring are making a real difference in how healthcare reaches underserved parts of India. In many Tier-2, Tier-3, and rural areas, the issue isn’t only infrastructure but also access to the therapies. Digital care models help bridge that gap by linking patients at local centres with expertise from larger hospitals, cutting down the need for long, expensive travel and enabling timely care closer to home.

The hub-and-spoke model has been particularly effective, where primary care centres or community clinics are digitally linked to tertiary hospitals. This allows patients to receive specialist consultations, follow-ups, and even emergency guidance.

While physical infrastructure is growing, the real bottleneck in underserved regions is often the shortage of specialized skills. We leverage digital connectivity to bring high-end surgical expertise to Tier-2 and Tier-3 cities. Through our Terumo India Skill Lab (TISL), we use advanced AV systems to livestream complex procedures in real-time. This allows a specialist in a metro to virtually 'proctor' and train a local physician, ensuring that life-saving vascular or cardiac procedures can be performed safely at the local level.

From a broader perspective, digital technologies support more equitable care delivery and allow clinicians to focus on outcomes rather than geography. When combined with training and on-ground support, telemedicine becomes a powerful enabler of accessible, sustainable healthcare across India.

Also Read: How to Bridge the Healthcare Gap in Emerging Markets with MedTech

Given the infrastructure challenges in Tier-2 and Tier-3 cities, how are MedTech companies ensuring their products are accessible and cost-effective for local populations?

Infrastructure challenges in Tier-2 and Tier-3 cities require MedTech companies to look beyond just selling products and focus on how those products are used in real clinical settings. Accessibility and cost-effectiveness come from designing solutions that are reliable, easy to adopt, and deliver consistent clinical outcomes, even in resource-constrained environments. It’s also about reducing the overall cost of care by enabling safer, minimally invasive procedures and improving workflow efficiency for hospitals.

Strong distribution and service networks are critical, as is investing in clinician training, so that the technologies are used optimally and sustainably. Digital tools and health IT further support this by helping hospitals improve utilisation and reduce unnecessary strain on infrastructure.

At Terumo India, the focus is firmly on value-led access. By offering clinically proven vascular, infusion, and critical care solutions, backed by continuous education and close collaboration with healthcare providers, the aim is to help hospitals deliver high-quality care that is both scalable and cost-effective for local populations, well beyond metro cities.

With the rise of government initiatives like Ayushman Bharat, how are MedTech companies aligning their products to support affordable healthcare in smaller cities?

Government initiatives like Ayushman Bharat (PM-JAY) have fundamentally shifted how affordability and access are approached, particularly in Tier-2 and Tier-3 cities. With defined reimbursement structures under PM-JAY and the growing role of the Ayushman Bharat Digital Mission, the focus has clearly moved toward care models that are practical, scalable, and outcome-driven.

For the MedTech industry, this has shifted the conversation from 'price' to 'total value.' Newer approaches to medical care, such as minimally invasive procedures, improved procedural efficiency, and shortened recovery time, help hospitals manage costs and post-operative complications, which is critical for the high-volume, efficiency-driven model that Ayushman Bharat encourages. Digital enablement and a strong focus on clinician training through platforms like the Terumo India Skill Lab further strengthen this ecosystem by supporting continuity of care and better use of existing infrastructure.

How are partnerships between local healthcare providers and MedTech companies evolving to improve healthcare delivery in Tier-2 and Tier-3 regions?

Partnerships between MedTech companies and healthcare providers in Tier-2 and Tier-3 regions are evolving from transactional vendor relationships into strategic, long-term collaborations focused on strengthening care delivery. This emphasizes clinician training, workflow optimisation, and digital adoption, enabling hospitals to maximise limited infrastructure and resources.

We recognize that infrastructure is only as good as the expertise behind it. Through our eTISL (electronic Terumo India Skill Lab) platform, we have created a hybrid learning model. We provide hands-on simulation training alongside digital colloquiums, allowing regional doctors to master complex cardiovascular and interventional procedures locally. This 'bench-to-bedside' approach ensures that cutting-edge techniques are adopted quickly and safely.

By tailoring affordable and scalable solutions and supporting the care continuum from procedure planning to post-procedure outcomes, MedTech companies are helping smaller hospitals build capability, improve patient outcomes, and deliver quality care closer to home in a more sustainable manner.

Also Read: India's Path to Billion-Dollar Drugs: Building a Strong Ecosystem

Looking ahead, what technological advancements in MedTech do you foresee as crucial for addressing the unique healthcare needs of India’s Tier-2 and Tier-3 cities over the next decade?

Looking ahead, several technological advancements will be critical in addressing the unique healthcare needs of Tier-2 and Tier-3 cities. In cardiac and vascular care, minimally invasive techniques and smarter intervention tools that reduce procedure time and hospital stay will be game changers, especially where infrastructure is limited. In radiology, AI-assisted imaging and cloud-enabled diagnostics can significantly improve throughput and accuracy, enabling smaller centres to tap into specialist expertise remotely.

Beyond specific clinical technologies, digital platforms that support teleconsultations and real-time monitoring will help bridge gaps in specialist availability and follow-up care.

Overall, the focus will be on technologies that are value-driven, scalable, and responsive to local needs, enabling high-quality care that is both affordable and sustainable across emerging healthcare markets.

How do you foresee the government's support for domestic manufacturing as highlighted in the Union Budget 2026, specifically benefiting MedTech companies in terms of production incentives, tax relief, or regulatory changes?

The Union Budget 2026–27 reflects a clear intent to strengthen India’s domestic MedTech manufacturing ecosystem. Measures such as production-linked incentives and targeted tax relief will reduce the cost of manufacturing advanced medical devices, directly improve affordability and expand access, particularly in Tier-2 and Tier-3 markets.

Equally encouraging is the focus on building a strong biopharma and innovation ecosystem through initiatives like Biopharma SHAKTI. Investments in clinical trial infrastructure, regulatory capacity, and specialised talent will make India more attractive for global R&D collaborations, while training allied health professionals and caregivers ensures advanced technologies are used safely and effectively.

From a trade standpoint, developments like the India–EU trade agreement enhance export competitiveness through tariff elimination. With aligned standards and simplified compliance, these steps can support MSMEs, attract investment, and position India as a globally trusted MedTech manufacturing hub delivering high-quality, value-driven solutions.