India can play bigger role if Make in India is coupled with Buy in India: Chetan Makam

The increasing demand for COVID-19 convalescent plasma highlighted the low stocks of blood products, as routine blood collection and donation was disrupted due to lockdowns. Harder hit were thalassemia and haemophilia patients, for whom regular blood transfusions are critical.

Chetan Makam, MD, Terumo Penpol, narrates how his company, which makes blood bags, donor stations and blood collection monitor and provides blood transfusion management services globally, has supported plasma banks opened by various state governments, while balancing the safety of employees, to meet the requirements of patients, both COVID and non-COVID.

While his company is prepared for “Business Un-Usual” in this financial year and he welcomes Prime Minister Modi’s vision for an ‘AtmaNirbhar Bharat’, he feels India can play a bigger role if ‘Make in India’ is coupled with ‘Buy in India’ and lists a few recommendations, in an interaction with Viveka Roychowdhury

 The COVID-19 lockdown has reduced stores of blood banks as blood donation camps could not be held and donors too kept away due to fears of infection. How has the COVID-19 situation impacted operations of Terumo Penpol?                                                                                                       

Our business concerns the timely provisioning of safe blood and blood components, which in turn are fundamental to many medical procedures. Keeping that in mind, we have safely opened our plants and at the same time maintained safe conditions for all our employees. However, the number of voluntary donors is significantly down, not just in India, but across the globe. Our plant supplies both domestic and international markets and as a result we have seen a softening in demand.

Over the past few years, we have put in place a comprehensive business continuity policy, designed to safeguard our employees around the world and at the same time maintain our ability to deliver products worldwide. We remain committed to providing consistent support to our customers and all the patients who depend on our products and services.

Convalescent plasma is a vital part of managing the COVID-19 pandemic. How has the company responded to this requirement?

In this current context that you mentioned, our products are solidly situated to cater to needs of numerous medical interventions. For example, we have our pathogen reduction technology system which is already being used extensively in several countries to add a layer of additional safety in blood transfusion processes and recently for convalescent plasma.

As well, our TRIMA and Optia devices are currently being used to collect convalescent plasma in many countries, and we have supported blood centers with plasma collection training and support. In India, we have been supporting plasma banks that have been opened by various state governments.

Since the pandemic began, Terumo Blood and Cell Technologies has shifted production to Trima kits to meet increased demand from existing and new customers;  successfully increasing production of our plasma collection kits by more than 30 per cent over pre-pandemic levels and the number of devices made are up as well. This has been achieved by investing in additional staff and overtime to keep manufacturing plants safely producing to meet customer needs.

Plasma kits have been air-freighted, in fact, despite the steep increase in shipping costs just to ensure that customers do not run out.

Blood and its components are part of non-COVID treatments as well such as haemophilia, etc. But these have taken a back seat due to lockdowns, non-availability of donors, etc. Are you seeing a pickup now that the country is cautiously unlocking? 

Patients who suffer from thalassemia and haemophilia need regular blood transfusion. They do not have the option to take a break as these are critical transfusions. In fact, as of now, these are the only collections we are seeing as the dedicated donors who make the commitments to the patients are continuing to donate. It is the voluntary donations that we are witnessing the biggest declines.

What are precautions being taken by your staff as they respond to these patient needs?  

We are taking utmost precautions in our plants and our offices to ensure safety and hygiene. All our customer facing staff globally are provided with all the PPE they require to be safe. We have set out clear guidelines for them to follow with regards to isolating and cleaning devices before using them, following the guidelines of the local governments and individual hospitals.

We are pleased to say that the customers have appreciated the diligence with which we have provided technical, clinical and product support despite the difficult situation. As the global leader for the service organisation I am proud of how our teams have conducted themselves and kept the customer and the patients they serve at the center of all that they do.

What are the efforts to make your company’s products more accessible and affordable for patients? 

Increasing the number of patients served is a goal that we hold dear, here at Terumo Blood and Cell Technologies. Over the last few years, we have continued to work together with stakeholders in various countries to get the reimbursements /insurance coverage for various treatments that we provide. Some of these treatments include plasma exchange for diseases such as Guillain-Barre syndrome, and red cell exchange for sickle cell anemia.

The thing to understand here is that the delivery of the treatments involves a much longer value chain that extends beyond the cost of just the device and disposable kit. The collection, testing, physician decisions on treatment, hospital charges etc. are all part of the overall chain of service as well as costs. Bringing down the total cost of the treatment along with enhanced reimbursements/insurance coverage will go a long way in making these procedures more affordable and accessible.

How will COVID-19 impact the revenues in this financial year? Balancing the uptick due to increased demand for convalescent plasma, were there downsides, etc? 

I would say that for this financial year, “Business Un-Usual” would be the best description. The impacts have varied depending on the product and the market. Various segments of our business in the blood centers, therapeutic treatments, cell therapy and biologics have been affected. We have seen increases and decreases in demand depending on treatments needed as well as deferred surgeries. We have seen reduced spending by customers as they adapt to the new normal as well. As with all companies, the key is to devise ways to conserve cash as it will allow for flexibility and help respond better to the constantly changing scenarios.

What are the investments, capacity expansions being planned for the next few years in India and globally?

We have already invested significantly in India over the past few years and built up additional capacity for some new products and technologies. We continue to refine our business continuity plan across our global footprint so that we can ensure uninterrupted product supply to our customers, which is even more important given the COVID-19 crisis. India is a critical part of that plan.

Where does India play into the global structure of Terumo Penpol?

Terumo Penpol is a Terumo Blood and Cell technologies manufacturing location and a key provider of value-added blood bags and medical electronics. This is a part of our larger product portfolio that spans manual to automated collections, and which is offered to customers in over 130 countries.

Because of the reliability of the local supply chain, products from our facility make their way around the globe to meet essential healthcare needs. Co-located with our factory is one of our world class R&D centers that specialises in materials and medical electronics and the product development helps deliver new medical products for India and across the world.

As a major part of the medical devices sector in India, what are your expectations from the government and policy makers?

We welcome Prime Minister Modi’s vision for an ‘AtmaNirbhar Bharat’ and India can play a bigger role in contributing to the international and domestic market if favourable policies are brought.

India can play a bigger role if we can couple Make in India with Buy in India. For example, under the existing Make in India prerequisite sourcing norms, many companies like that of Terumo Blood and Cell Technologies do not have the option of importing medical grade raw materials which are not available in India. Hence, exemption in per cent of raw material procurement for the medical device products, getting import duty exemption for those medical grade raw materials which are not available in India and GST per cent reduction or exemption for raw material procurements meeting make in India norms would be helpful.

Alongside manufacturing and investing in innovation in India, comes the need for strong, stable laws and law enforcement on Intellectual Property. IP protection for novel technology is critical for the success of global medical devices players investing outside their home market.  Further subsidy on fixed capital investment (FCI) for environmental-friendly units should be considered. Additionally, for the success of Make-in-India, the country would also need robust standardisation to ensure quality is taken care of for the domestic market. Moreover, if the products are of good quality, they will be able to clear global standards and help India capture the global market.