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SGA’s analysis on apprehensions, expectations, and alternatives Medical tourism in the USA – It’s OK to be back!

A patient’s journey in 2021- How far are you willing to travel? Mexico? Spain? or Costa Rica?

Medical Tourism in USA www.sganalytics.comwww.sganalytics.com | 1 In 2020, there have been 82 million uninsured or underinsured medical consumers or “medical refugees”, who must find a way to get their procedures (surgeries) and treatments addressed as these procedures are unaffordable in their home countries. Moreover, 2 million insured patients are expected to travel either within or to other popular destinations due to the long waiting time, there are choices and there are apprehensions but there is positivity that this market will revive.

Globally some of the popular medical tourism destinations include Costa Rica, India, Israel, Malaysia, Mexico, Singapore, South Korea, Taiwan, Thailand, Turkey, and the USA. These medical tourism destinations offer a wide range of healthcare specialties – cosmetic surgery, dentistry, cardiovascular, oncology, orthopedics, onco-surgeries, reproductive, neonatology, weight loss, health screenings, and more. The USA had been the biggest market for medical tourism until the spread of COVID-19 when international travel was put on hold.

SG Analytics looks at the same market from its supply side. This market offers patients who love to travel either within the country or abroad. Let us consider a few of the major markets and the perception amongst the potential patients who might want to travel for medical interventions in 2021. SG Analytics identifies USA as a market and its visible trends as we approach the end of 2020.

SG Analytics brings together an outlook of this market, the perceptions, and the impact of apprehensions and perception of Americans towards medical tourism in 2021.Usually the industry analyzes the medical tourism market from the service provider’s perspective.

Medical Tourism in USA www.sganalytics.com | 2 Medical Tourism in USA

The USA is one of the most interesting markets to Where will the US citizens travel for watch out in 2021. There is a large population that is treatment? expected to travel within the USA for treatment and another pool that is expected to travel outside the The USA is one of the most developed markets when it country. The market is also segmented into medical comes to complicated surgery and comprehensive care. refugees (uninsured- or underinsured) and medical Yet, many patients move abroad due to factors, such as tourists (fully insured). stringent regulations, long waiting time, and the high expense of treatment for uninsured/partially insured, while the rest look for US-based hospitals. More than 2 million US citizens were set to travel to other countries in search of cost-effective medical treatment this year; it has marked an increase of A section of the population is expected to arrive at nearly tenfold from around 250,000 medical travelers a major hospital districts due to deprivation of specialized decade ago. This could not happen because the travel care resulting from the closing of rural hospitals. They restrictions kept a lot of these eligible patients from are domestic medical tourists who are expected to take moving outside the US, which has led to an all-time low the road and travel from one state to another. As the confidence level in the market in 2020. revival plan begins, hospitals and hotels are coming together to ensure safety for patients who are expected to travel for interventions. For instance, there are plans shared by hospitality giant Hyatt to open a unit in one What will bring back the patients? of Chicago’s hospital-packed medical districts keeping Cardio-vascular surgery is one of the major segments in mind the aftermath of COVID pandemic where patients may be willing to travel within the USA or to Mexico. They usually leave the home ground Patients Beyond Borders has teamed up with Medical exclusively for two reasons, which are mentioned below. Departures in the USA (with nearly 100,000 medical 1. Easy access to experts and tourism bookings to date) and has confirmed that more 2. Assurance of higher quality of care than their home than 85% of all medical travel is expected soon and states. most of them have decided to travel to destination (countries) of their choices based on specialty services, travel time, cost and convenience.

Unfortunately, the future looks bleak,” said Trey Hulsey, a co-founder of Hayakoum, a three-year-old service that handles travel arrangements for patients from the Middle East bound for hospitals in Boston, Houston and Philadelphia. “It’s just been one blow after another.

MedicalSource: NY Tourism Times (USA) in USA www.sganalytics.com | 3 Countries where Americans are expected to travel

Barcelona Istanbul Escazú Seoul Cancun Parameters (Spain) (Turkey) (Costa Rica) (S Korea) (Mexico) Why? Ranked the world’s Best known for Ultra- World’s highest Replicated the Korea (Preference) 7th best healthcare affordable hair Americanized per-capita rate model of aesthetic nation by the transplantation; suburb of San of cosmetic treatment for World Health has more than Jose to attract treatment Americans Organization, 600 registered dental and Internationally clinics in Istanbul medical tourists accredited clinics alone and hospitals #1 choice for Dentistry Hair Transplants Cosmetic Cosmetic Elective procedures, & Ophthalmology dentistry such as surgery, including plastic implants; weight Aesthetic surgery, dentistry loss treatments and fertility besides cosmetic surgeries and aesthetic treatments Expected cost 40–75% 50–70% 40–60% 30–50% 40–70% reduction (Perception) Specialties in Ophthalmology, Vision, Dentistry, Dentistry, Non-invasive Dentistry, cosmetic demand Dentistry, Hair Transplant cosmetic surgery, strategies surgery, weight loss Cosmetic Surgery, bariatrics from Botox to surgery, pharma Orthopedics, dermal fillers travel Fertility, IVF, and from laser Pediatrics hair removal to dental veneers Direct Yes Yes Yes Fly (Time 2:50 Drive and fly Connectivity hours) (California to Cancun: 49 hours by road)

Medical Tourism in USA www.sganalytics.com | 4 Opportunity for Players, by top 3 segments in 2021

Hospitals Medical Devices Medical Tourism Agencies

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Medical tourism in 2021 Mexico – the closest neighbor to USA will play on quality and price

Heart

Procedure USA Hospitals Mexico Average Savings

Angioplasty $22,500 $11,500 50% Angiography $4,800 $1,200 70% Valve replacement $ 46,000 $16,000 60%

Bypass surgery $44,000 $24,000 50% Open Heart surgery $64,000 $24,000 66%

Medical Tourism in USA www.sganalytics.com | 5 Orthopedic

Procedure USA Hospitals Mexico Average Savings

Knee $25,000 $10,500 65% Hip Replacement $28,000 $12,500 65% Shoulder Replacement $24,500 $9,500 75%

Birmingham Resurfacing $24,000 $12,500 60%

Other Procedures

Procedure USA Hospitals Mexico Average Savings

Gastric Bypass Surgery $30,000 $11,500 70% Gastric Band Surgery $24,000 $9,500 60% Hysterectomy $14,500 $5,500 75%

Fertility Treatments $8,500 $2,650 55%

Cosmetic Procedures

Procedure USA Hospitals Mexico Average Savings

Face Lift $18,000 $4,250 68% Breast Augmentation $7,800 $3,800 55% Tummy Tuck $8,800 $4,500 50%

Liposuction (per area) $3,200 $1,150 60% Rhinoplasty (nose) $8,000 $3,200 65% Brow Lift $7,500 $2,850 70% Brazilian Buttock $10,500 $4,950 65% Neck Lift $10,000 $4,400 70% Blepharoplasty (eyelids) $5,400 $2,950 55%

Dental Procedures

Procedure USA Hospitals Mexico Average Savings

Implants - 6 teeth $18,500 $3,600 75% Porcelain crown (6 teeth) $5,200 $1,600 70% Bleaching discolored teeth $250 $50 80%

Dental Vaneers (6 teeth) $6,000 $1,800 75% Total Dentures $4,800 $1,600 70%

Medical Tourism in USA www.sganalytics.com | 6 Success does not entirely depend on patients. The typical ratio of medical tourists to other travellers is about 50-50 at the hotel, which has 80 percent occupancy, Ms. Lopez-Blázquez said. But this spring, occupancy plummeted to 30 percent, she Read! Debate! added, and almost all the guests Introspect! had a Baptist connection Published by New York Time (June 23, 2020) Interesting reads for intellectual minds! In the Bangladesh market, TAT will continue to position and promote Thailand as a Muslim friendly destination and focus on medical tourist segments

Published by International Medical Travel Journal (August 24, 2020)

Marketing Ayurveda as part of the ‘health tourism’ has brought a new definition to vacationing in India itself

Published by Economic Times (April 17, 2016)

Medical identity theft can also be an issue. Some thieves steal records in order to receive medical treatment and charge it to insurance, or to gain access to sensitive information like social security numbers

Published by Medical Tourism Magazine Medical Tourism in USA www.sganalytics.com | 7 About the Authors

Dr. Siddhartha Dutta, Practice Head, Pharmaceutical & Life Sciences Practice Dr. Siddhartha Dutta has been working in the Healthcare industry for the last 21 years. He has been involved with clinical trials, medical research, planning, and various roles in public and private healthcare domains. Besides working as a medical microbiologist, he has worked extensively in markets such as USA, Western Europe, India, Australia, Japan, Singapore, South Korea, Indonesia and has helped OEMs, VCs, banks and pharmaceutical companies expand their businesses in USA, EU and LATAM markets. Dr Dutta is an avid blogger, writer and industry speaker. His market outlooks have been published by various business magazines for the last 5 years. He has been quoted in more than 70 publications worldwide. Dr Dutta has tried to evaluate the global COVID-19 situation, and specially focused on the American businesses which might flourish or perish in these critical times. The whitepaper is relevant for all the healthcare industry stakeholders who supply medical devices or pharma products to the US market.

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