Young and fit dropping dead: A sector comes into focus

Economic Times

01-07-2025

The recent death of Shefali Jariwala, best known for the 2002 chartbuster 'Kaanta Laga', due to cardiac arrest, has again brought to light the increasing trend of young, healthy and fit Indians suddenly dying of heart attack. In the past few years, several celebrities, such as Sidharth Shukla and Puneeth Rajkumar, have died due to cardiac issues. Heart attack incidents which used to affect mainly older adults now appear with increasing frequency among people under 50 years of age.
The epidemic of cardiovascular diseases in India has created a lot of awareness about timely diagnosis among people which puts the focus on an emerging segment in India's healthcare sector -- diagnostics. India's diagnostics sector is undergoing a significant transformation, shifting from a fragmented business to a structured and tech-driven industry. Recently, Amazon announced its foray into the diagnostics space, marking a defining moment in this evolution. With an estimated market size of $25 billion and rapid growth, diagnostics is emerging as one of the most promising segments in Indian healthcare. But what triggered this boom? What forces are shaping its future? And is there a link to the rise in sudden heart attacks among India's young population?
The COVID-19 pandemic was a catalyst that brought diagnostics to the forefront of healthcare. Once seen as a backend service, diagnostic testing has now become integral to proactive health management. More Indians are choosing routine screenings and preventive tests over symptomatic treatment. The shift in mindset, from illness-based to wellness-based healthcare, has been profound. This behavioral transformation laid the groundwork for diagnostics to flourish across urban and semi-urban India.During the pandemic, diagnostic players were overloaded with work. Their bottom lines were getting better every single quarter. Between FY20 and FY22 – in just two years – literally all the companies saw a growth of more than 50% in absolute revenue numbers, as per a recent ET report. Once the pandemic ended, the workload returned to normal. The cash generated during Covid was utilized by different companies in different ways. Some used it to reduce their debt burden, others used it for expansion, using the cash for mergers that turned them from regional to national players. Post-pandemic, the demand for diagnostic services has surged, not only because of higher health awareness but also due to the lingering effects of the virus, which prompted many to seek tests related to heart health, respiratory function, and immune markers.
India's recent diagnostics growth is also closely linked to the rising incidence of non-communicable diseases (NCDs). Conditions such as cardiovascular diseases (CVD), diabetes, hypertension and cancer are being detected at younger ages and are increasingly prevalent even in tier-2 and tier-3 cities. This has naturally escalated the demand for laboratory tests and imaging services. There has been a noted increase in sudden heart attacks among young and seemingly fit Indians, especially post-COVID. While there is no direct data attributing this to the boom in diagnostics, the phenomenon has contributed to an increase in cardiovascular screenings such as lipid profiles, ECGs and stress tests. As more individuals seek to understand their cardiac risk, diagnostics have become a proactive tool for early detection.
The Indian diagnostics sector is transitioning rapidly from unorganised, standalone labs to structured, pan-India diagnostic chains. Organised players such as Dr Lal PathLabs, Metropolis, Thyrocare and SRL Diagnostics are increasing their footprints through franchise models and acquisitions. Organised diagnostic labs currently command around 15% market share but this is rising steadily, according to a recent report by PhillipCapital. The market is characterized by a high degree of fragmentation, with hospital-based labs holding a 37% share and unorganized standalone labs controlling the remaining 48%.
Amazon India's recent launch of its diagnostics service in collaboration with Orange Health Labs is a significant milestone for the sector. The service, currently available in six major cities and 450+ PIN codes, offers over 800 tests with home sample collection in under 60 minutes and reports delivered within six hours.This entry not only validates the sector's growth potential but also intensifies competition. Following Amazon's announcement, shares of major diagnostic players like Dr Lal PathLabs and Metropolis fell by up to 3%, reflecting market concerns about pricing pressures and customer retention. Amazon brings scale, tech infrastructure and a convenience-first model, which could redefine customer expectations in diagnostics, especially in urban centers.
One of the most promising aspects of the diagnostics sector is its expansion beyond metros. Non-metro cities are witnessing an annual growth rate of 20–25% in diagnostics demand, compared to 10% in metro cities. Rising health awareness, increasing affluence, and better insurance penetration are enabling residents in smaller towns to opt for preventive testing. Organised players are aggressively entering these markets, setting up franchise labs, mobile collection centers and even partnering with local clinics to provide high-quality testing services. The demand surge from rural and semi-urban areas is expected to play a pivotal role in the sector's growth trajectory over the next five years. Recently, Suraksha Diagnostics said it will invest Rs 200 crore to set up over 20 advanced imaging centres across eastern India. The plan, which will be executed in collaboration with United Imaging, is aimed at expanding access to advanced diagnostic services in tier 2 and tier 3 cities, enhancing both affordability and healthcare quality in smaller towns and semi-urban regions, it said. The Indian government's healthcare initiatives, particularly Ayushman Bharat, have improved access to diagnostics for a broader population. Additionally, state-level Public-Private Partnership models in radiology, such as the Punjab government's tie-up with private players for operating MRI and CT scan centers, are helping bridge infrastructure gaps.Health insurance is also becoming more inclusive of diagnostics, covering pre-emptive testing and annual health checks. As out-of-pocket expenses decline, more individuals are accessing regular testing services, further supporting sectoral growth.India's diagnostics sector remains under-penetrated compared to global standards. When measured by the number of tests conducted per person each year, India lags far behind other developing nations such as Brazil and Saudi Arabia--even though India has the largest population in the world. This indicates that there is still a huge untapped demand for diagnostics services in the country, as per the PhillipCapital report. The diagnostic sector in India is expected to grow at a compound annual growth rate (CAGR) of around 14% through FY2028, according to the PhillipCapital report. Radiology services alone are projected to expand from $7.1 billion in FY2025 to $13.5 billion by FY2030. The expansion will be led by increased adoption of AI in medical imaging, growth in home-based testing and broader genomic and personalised medicine offerings.However, challenges remain. Pricing pressures from new entrants like Amazon, quality standardisation in smaller labs and the need for improved regulation and accreditation are ongoing issues. The government and industry will need to work in tandem to ensure that growth does not compromise accuracy or ethics.The Indian diagnostics sector is no longer an auxiliary healthcare service. It is becoming a central pillar of the country's healthcare ecosystem. Driven by lifestyle changes, epidemiological shifts, digital innovation, and consumer demand, the sector is poised for sustained expansion. Amazon's entry marks a shift from traditional models to a more consumer-focused, tech-enabled and scalable diagnostic future. While the rise in sudden heart attacks among the young has brought cardiovascular diagnostics into focus, the sector's momentum is supported by a much broader wave of preventive health consciousness sweeping the nation. Diagnostics in India is not just booming; it is evolving and preparing to redefine how 1.4 billion people manage their health.