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medical tourism final

medical tourism final

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  • CHAPTER – 6
  • CHAPTER – 8
  • CHAPTER – 9


The key "selling points" of the medical tourism industry are its "cost effectiveness" and its
combination with the attractions of tourism. The latter also uses the ploy of selling the "exotica" of the
countries involved as well as the packaging of health care with traditional therapies and treatment

Price advantage is, of course, a major selling point. The slogan, thus is, "First World treatment at
Third World prices". The cost differential across the board is huge: only a tenth and sometimes even a
sixteenth of the cost in the West. Open-heart surgery could cost up to $70,000 in Britain and up to
$150,000 in the US; in India's best hospitals it could cost between $3,000 and $10,000. Knee surgery
(on both knees) costs 350,000 rupees ($7,700) in India; in Britain this costs £10,000 ($16,950), more
than twice as much. Dental, eye and cosmetic surgeries in Western countries cost three to four times as
much as in India.

The price advantage is however offset today for patients from the developed countries by concerns
regarding standards, insurance coverage and other infrastructure. This is where the tourism and
medical industries are trying to pool resources, and also putting pressure on the government. We shall
turn to their implications later.

The entire concept of medical tourism hangs on the efficiency, skill and competency level of the
doctors, specialists and consultants etc. World over patients and hospitals trust Indian doctors without
doubt. This is therefore an advantage for India. Patients from around the globe expect the best of
services solely based on the reputation of doctors of Indian origin. But so far the government has

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failed to realize the advantage of this important factor. This reputation and goodwill that Indian
doctors enjoy could be leveraged to attract and promote Indian medical tourism.

The other most important reason why India has not been able to attract more customers is that there is
no specific campaign which only promotes medical promotes medical tourism. The incredible India
campaign has catapulted India in the top 5 must visit unique destination for lonely planet but so far as
it goes Thailand, Bangkok and other east Asian countries are still market leaders. Therefore there is
still scope that with specific marketing, advertising and promotion campaigns considerable number of
tourists can be attracted.

In India the strong tradition of traditional systems of health care such as in Kerala, for example, is
utilised. Kerala Ayurveda centres have been established at multiple locations in various metro cities,
thus highlighting the advantages of Ayurveda in health management. The health tourism focus has
seen Kerala participate in various trade shows and expos wherein the advantages of this traditional
form of medicine are showcased.

A generic problem with medical tourism is that it reinforces the medicalised view of health care. By
promoting the notion that medical services can be bought off the shelf from the lowest priced provider
anywhere in the globe, it also takes away the pressure from the government to provide comprehensive
health care to all its citizens. It is a deepening of the whole notion of health care that is being pushed
today which emphasizes on technology and private enterprise.

The important question here is for whom the 'cost effective' services is to be provided. Clearly the
services are "cost effective" for those who can pay and in addition come from countries where medical
care costs are exorbitant - because of the failure of the government to provide affordable medical care.
It thus attracts only a small fraction that can pay for medical care and leaves out large sections that are
denied medical care but cannot afford to pay. The demand for cost effective specialized care is coming
from the developed countries where there has been a decline in public spending and rise in life
expectancy and non-communicable diseases that requires specialist services.

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Urban concentration of health care providers is a well-known fact - 59 per cent of India's practitioners
(73 per cent allopathic) are located in cities, and especially metropolitan ones. Medical tourism
promotes an "internal brain drain" with more health professionals being drawn to large urban centres,
and within them, to large corporate run specialty institutions.

Medical tourism is going to result in a number of demands and changes in the areas of
financing and regulations. There will be a greater push for encouraging private insurance tied to
systems of accreditation of private hospitals. There is a huge concern in the developed countries about
the quality of care and clinical expertise in developing countries and this will push for both insurance
and regulatory regimes. The potential for earning revenues through medical tourism will become an
important argument for private hospitals demanding more subsidies from the government in the long
run. In countries like India, the corporate private sector has already received considerable subsidies in
the form of land, reduced import duties for medical equipment etc. Medical tourism will only further
legitimise their demands and put pressure on the government to subsidise them even more. This is
worrying because the scarce resources available for health will go into subsidising the corporate
sector. It thus has serious consequences for equity and cost of services and raises a very fundamental
question: why should developing countries be subsidising the health care of developed countries?

The Golden Goal - India’s $1 billion dream:

India could earn more than $1 billion annually and create 40 million new jobs by sub-contracting work
from the British National Health Service, the head of India's largest chain of private hospitals and
other such organisations in the US and European states.

Apollo Hospitals, which provides medical tourism packages has put forth a suggestion and currently
is awaiting a reply to carry out operations at a fraction of what they would cost in the United
Kingdom. They include surgery for hip and knee replacements and coronary bypass that would slash
waiting times dramatically, reducing the queues of British patients waiting to see their doctors. They
have well equipped, state-of-the-art hospitals and can offer the same level of care as anywhere else in
the world. There is no reason why India should not become the healthcare destination of the world.

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India's healthcare industry is growing at 30 per cent annually and the Apollo group alone has so far
treated 95,000 international patients, many of whom are of Indian origin. Reddy cited two recent cases
of UK nationals who opted for private healthcare at the Apollo network.

Medical treatment in the UK is free under the NHS, but because of the long waiting times some
patients opt for expensive private care. The advantage of Reddy's offer is that is that it would reduce
pressure on the NHS and offer sub-contracted healthcare at vastly cheaper rates.

After this million people, there are thousands of expatriates. Not necessarily Indian, but expatriates
who may be given the opportunity to come and get themselves operated in India where we are
planning to give them what is called health tourism."

One of the major destinations for Medical Tourism in India is Andhra Pradesh:

Kerala is very well known for ayurvedic medicine and Andhra Pradesh is now being
recognised in the areas of Allopathy, energy therapies, alternative medicine and Mind body


Government of Andhra Pradesh is presently promoting its tourism activities in 6 major circuits viz.,
Hyderabad Circuit covering Hyderabad City and surrounding destinations like Warangal, Adilabad, etc.;
Visakhapatnam Circuit covering Visakhapatnam city, Araku Valley and surrounding destinations in
Srikakulam and Vizianagaram districts; Tirupati Circuit covering Tirumala Temple, other surrounding
temples, Horsley Hills and other nearby destinations; Krishna-Godavari Circuit covering River Cruises,
backwaters, Konaseema, Kolleru Lake area and other surrounding destinations; Vijayanagar Circuit
covering destinations in Anantapur, Kurnool, and Kadapa; and Buddhist Circuit which has two steams
viz., Lower Krishna Valley Circuit covering Nagarjuna Sagar, Amaravati and other Buddhist locations;
and North Coastal Circuit covering Buddhist locations in and around Visakhapatnam District.
Government will encourage any suitable tourism product in these circuits which serve to augment an
existing destination.

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Andhra Pradesh received 15.75 crores domestic tourists and 79.52 lakh international tourists upto
2009. Tourism provides 10% of the overall employment. Andhra Pradesh has the 1st position in the
domestic tourism. There was good growth of tourism in Tirupati and Vizag and Hyderabad.
Since tourism provides large-scale employment and there is every need to encourage it, Government
of Andhra Pradesh has taken many initiatives to promote tourism sector. Government of Andhra
Pradesh has drafted a new State Tourism Policy with an attractive package of incentives to develop
tourism in our State, on 27th

November, 2010 on the occasion of World Tourism Day, as the present
policy under implementation pertains to 1998 and there was a need for revision due to time gap and
prudent fiscal management. They have decided to promote medical tourism, film tourism, convention
tourism and heli tourism in the State by developing all tourist spots and infrastructure facilities. They
are also contemplating to develop a huge garden at Nagarjunasagar replicating the famous Brindavan
Gardens at Mysore. Government of Andhra Pradesh has requested Government of India for
introduction of Southern Splendor Luxury Tourist to cover major destinations of South India and
promote rail based tourism in our State. The Tourism Department will also be given more Police force
to start the 'Tourism Police' in all the important tourism spots to ensure security to the tourists.

An excerpt from the Indian Tourism Policy 2010:

Hyderabad, also enjoys competitive advantage over other Indian States in terms of Medical Tourism
and MICE Tourism. The presence of the best Airport in the country, the presence of the best
Convention Centre in the country, the presence of the best Exhibition facility in the country, the
presence of hotels at par with the best, very good urban infrastructure, moderate climate, and attractive
tourist destinations can help position Hyderabad as the most preferred destination for MICE Tourism.
As Hyderabad enjoys the presence of highest caliber medical specializations and expertise, it can also
be promoted as a major center for Medical Tourism.

MICE Tourism and Medical Tourism require the coming together of both the concerned Government
Agencies and the private stakeholders on a common platform. Only in such an eventuality can the
strengths of each player be synergized and maximum advantage for the city can be reaped.
Government will endeavor to create appropriate organizational structures, preferably in the form of

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societies, to establish this common platform. The constituted society can hereafter take up all the
required activities necessary for harmoniously organizing MICE Tourism and Medical Tourism
respectively. The Government will also become the main driver behind these Societies by infusing the
required capital in its corpus and by engaging experienced professionals to manage these Societies.

Andhra Pradesh launched Hyderabad Medical Tourism Promotion Society:

MEDICAL Tourism is the major focus area of the Department of Tourism, Government of
Andhra Pradesh and it is in the process of forming Hyderabad Medical Tourism Promotion
Society (HMTPS). HMTPS was launched in April 2010 for which the state tourism department
has selected stakeholders for the Society. HMTPS will work on the required norms for Medical
Tourism like maintaining standards, procedures and payment issues.
“We are currently consulting Ernst and Young to suggest a feasible model for the Society to
promote Hyderabad as a Medical Tourism destination. We are looking at having a committee of
stakeholders comprising of medical players (hospitals) and travel agents who eventually help in
smooth planning for the visiting patients,” said Jayesh Ranjan, Secretary of Andhra’s Tourism,
Archaeology and Museums departments.
Commenting on this initiative, Pradeep Thakural, Executive Director, Indian Medical Travel
Association said,
“Formation of HMTPS by the state tourism department is a positive move and this will give
much needed boost to the Medical Tourism sector, which is growing at 30-40 per cent each
year,” said Pradeep Thakural, Executive Director, Indian Medical Travel Association in

Various other Institutional arrangements are State Tourism Promotion Board (STPB) , State
Tourism Promotion Committee (STPC), District Tourism Promotion Committee (DTPC)

Therefore, Indian government is trying to develop its Medical Tourism by considering

the opportunity costs, sensitivity of patients from different economies towards price,

quality, responsivess. Apart from this Tourism Development conducts various awareness

programmes to highlight the goodwill foreign patients have upon the Indian Doctors, State

support provided to eligible tourism products like wellness centers (Spa/Yoga/.etc)

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Definition of Medical Tourism
Medical tourism can be broadly defined as provision of ‘cost effective’ private medical care in
collaboration with the tourism industry for patients needing surgical and other forms of
specialized treatment. This process is being facilitated by the corporate sector involved in
medical care as well as the tourism industry – both private and public.

Ancient History-Indian Medical Tourism
Some might have difficulty categorizing yoga retreats, Buddhist pilgrimages, and meditation
centers as medical tourism, but the unbelievable reach of India’s healing arts is not to be ignored.
Ever since yoga’s birth more than 5,000 years ago, India has enjoyed a constant influx of
medical travelers and spiritual students hoping to master and benefit from this most fundamental
and revered branch of alternative medicine. When Buddhism came along roughly 2,500 years
later, this only added fuel to the fire and helped position India as the epicenter of Eastern
cultural, spiritual, and medicinal progress. Not only is India one of the world’s oldest medical
tourism destinations, but it has now also become one of the world’s most popular ones as well.

Medical Tourism Industry Overview
The Indian healthcare market is Rs. 15 billion and growing at over 30% every year. Indian
private hospitals are increasingly finding a mention in the travel itineraries of foreigners, with the
trend of medical tourism catching up in the country. If industry estimates are to be believed, the
size of the medical tourism industry stands at Rs 1,200 – Rs 1,500 crore (Rs. 12-15 billion).A
recent CII-McKinsey study on Indian healthcare says medical tourism alone can contribute Rs
5,000- Rs 10,000 crore (Rs. 50-100 billion) additional revenue for tertiary hospitals by 2012, and
will account for 3-5% of the total healthcare delivery market. This is a huge, untapped market,
not just for therapeutic medical tourism like ayurveda, but also for curative treatment. India can
lead the world in medical and health tourism since we have a tremendous advantage with a large
pool of skilled manpower and technological edge.

Why India?
The countries where medical tourism is being actively promoted include Greece, South Africa,
Jordan, India, Malaysia, Philippines and Singapore. India is a recent entrant into medical
tourism. The Indian government predicts that India’s $17-billion-a-year health-care industry
could grow 13 per cent in each of the next six years, boosted by medical tourism, which industry

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watchers say is growing at 30 per cent annually. Price advantage is a major selling point. The
slogan, thus is, “First World treatment’ at Third World prices”.
The cost differential across the board is huge: only a tenth and sometimes even a sixteenth of the
cost in the West. India has a lot of hospitals offering world class treatments in nearly every
medical sector. For long promoted for its cultural and scenic beauty, India is now being put up
on international map as a heaven for those seeking quality and affordable healthcare. Analysts
say that as many as 150,000 medical tourists came to India in 2004. As Indian corporate
hospitals are on par, if not better than the best hospitals in Thailand, Singapore, etc there is scope
for improvement, and the country is becoming a preferred medical destination. In addition to the
increasingly top class medical care, a big draw for foreign patients is also the very minimal or
hardly any waitlist as is common in European or American hospitals.

About Hyderabad
Hyderabad is the fifth largest city in India with an ancient civilization and culture. Hyderabad
and Secunderbad are twin cities, separated by Hussain sagar which is a man made lake. A natural
and sophisticated blend of old and new, an old ‘Nawabi’ culture with a new pro-active approach
and hospitality. The teeming bazaars of the old city, in the midst of which stands the 400-year-
old Charminar, the modern shopping complexes and ultra-modern malls in the newer areas of the
city add to the charm of Hyderabad. The Golconda Fort, capital of the kingdom by that name, is
today very much part of the city, as is Cyberabad (means Cyber City), a new local area created to
keep pace with the zooming Information Technology and Tourism sector. Pearls, bangles, silks,
computer software, handicrafts and above all a delectable cuisine add to the splendor of this
great city. Hyderabad is one of the most densely populated cities in the country and is home to
about 2.2 million people. Hyderabad has a mix of Hindu-Muslim culture with a number of
monuments of historical importance, including the very famous Charminar. Hyderabad has too
many tourist attractions that would often make it difficult for a tourist to set his priorities. While
art lovers cannot defy the attraction of the huge repository of antiques displayed at the A.P.
Museum, The Nizam Museum and the Salarjung Museum would offer a delightful insight to the
rich imperial history.
Hyderabad is known worldwide for its diamond markets, glass embedded bangles and delectable
Hyderabadi cuisine. Hyderabadi Cuisine can itself be a big reason for visiting Hyderabad. The
delicious Biryanis and myriad of mutton and chicken dishes religiously followed by mouth-
watering sweets will earn the accolades from all gourmets across the world.

Advantages of Coming to Hyderabad for Medical Treatment
•Internationally accredited medical facilities using the latest technologies
•Highly qualified Physicians/Surgeons and hospital support staff
•Significant cost savings compared to domestic private healthcare
•Medical treatment costs in India are lower by at least 60-80% when compared to similar
procedures in North America and the UK
•No Wait Lists
•Fluent English speaking staff

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•Options for private room, translator, private chef, dedicated staff during your stay and
many other tailor-made services
•Can easily be combined with a holiday/business trip

Quality in Health Care
India the glorious country has found yet another way to contribute to the world through quality
health care. Now is the time when it is giving its best through quality health care and medical
tourism facilities. Increasing pressure on the medical facilities and the hike in the purchasing
capacity of the Indians and the foreigners visiting India has led to the recent development in the
quality health care and medical facilities.
The geographic conditions and the increase in the quality health care services are all conducive
to boost the medical tourism facilities in India.

Importance of Accreditation
Obviously, you want to receive the best possible care that you can. When you stick with medical
facilities that have reputable credentials and accreditation, you can be reasonably sure that they
adhere to certain standards, medical codes, and professional ethics. Having accreditation does
not necessarily mean that your doctor or dentist is a miracle worker, but it helps to weed out
undesirable medical practitioners. In addition, many insurance companies will not pay for
medical services performed at non-accredited health care facilities.

Joint Commission International ( JCI )
Joint Commission International (JCI) is the global arm of the US-based Joint Commission on the
Accreditation of Healthcare Organizations (JCAHO); the same body that certifies over 18,000
hospitals in the United States. Although JCI approval is not the only accreditation available for
medical tourism facilities, it is a fairly good benchmark to use when researching foreign

If you come across a medical tourism facility that doesn’t have JCI accreditation, there’s no need
to be alarmed. Many countries have their own accrediting bodies that put forth standards and
regulations that closely mirror (and sometimes exceed) the accrediting standards established
by JCI.

International Organization for Standardization ( ISO )
While ISO is not necessarily a health care accrediting body, it’s important that you stick with
medical tourism destinations where ISO has representation.ISO and its member organizations
help ensure that hospitals and dental clinics closely adhere to the strict international standards
that they put forth. In this way, you have a much better chance of receiving optimal medical and
dental care when you take your health vacation abroad.

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Access to Hyderabad:
By Air: Indian Airlines has flights connecting Hyderabad with all major cities in India. The
nearest airport is Shamshabad International Airport.
By Rail: The world’s second largest railway under one management the Indian Railways carries
more than ten million people every day. Main railway stations are Begumpet Station, Hyderabad
Station, Kachiguda Station and Secunderabad Station.
By Bus: The AP State Road Transport Corporation (APSRTC) has a busy district service that
connects Hyderabad to every city, town and almost all villages.

Cost Comparison: Preventive Health Checks
Preventive Health ChecksCharges in Hyderabad

Master Health Check


Executive Health Check


Cardiac Checkup


Procedure Charges In Hyderabad and USA (US $):


Cost (US$)

United StatesHyderabad

Bone Marrow Transplant2,50,000


Liver Transplant



Heart Surgery



Orthopedic Surgery



Cataract Surgery



Dental Procedure Charges between USA and Hyderabad

Dental procedure

Cost in US ($)

Cost in Hyderabad ($)

General DentistTop End DentistTop End Dentist

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Smile designing




Metal Free Bridge




Dental Implants




Porcelain Metal Bridge




Porcelain Metal Crown




Tooth impactions




Root canal Treatment




Tooth whitening




Tooth colored composite fillings200



Tooth cleaning




Cost Comparison – Hyderabad Vs United Kingdom (UK)


United Kingdom (USD)

Hyderabad (USD) Approx

Open Heart Surgery

USD 18,000

USD 4,800

Cranio-Facial surgery and skull baseUSD 13,000

USD 4,500

Neuro- surgery with Hypothermia

USD 21,000

USD 6,800

Complex spine surgery with implantsUSD 13,000

USD 4,600

Simple Spine Surgery

USD 6,500

USD 2,300

Simple Brain Tumor

USD 4,300
USD 10,000

USD 4,600

- Lesion

USD 6,500
USD 26,000

USD 2,300
USD 17,800

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Hip Replacement

USD 13,000

USD 4,500

٭ These costs are an average and may not be the actual cost to be incurred.



1.To study the factors which are attracting the International Patients to Hyderabad.
2.To study the satisfaction level of International Patients
3.To compare the cost of the treatment in Hyderabad with foreign Countries.

Data Collection
This study was conducted in a corporate multi-super specialty hospital at Hyderabad.

Primary Data – Primary Data is collected using methods such as interviews, questionnaires and
observations of the admit patients in the study hospital for the year 2007 randomly.
Secondary Data – All methods of data collection can supply quantitative data (numbers, statistics
or financial) or qualitative data (usually words or text). Quantitative data may often be presented
in tabular or graphical form. Secondary data is data that has already been collected by someone
else for a different purpose. For example-Data supplied by a marketing organization, Annual
hospital reports, Government statistics.

Sources of Data Collection – Paper-based sources, Electronic sources, Official or government
sources, Unofficial or general business sources.

Findings and Interpretations – Specialty wise International Patients Received Treatment in Study
Hospital- (2007)



No. of


Cardio-Thorasic Surgery



Plastic Surgery






Gynecology & Obstetrics09




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Surgical Gastroenterology38


Laparoscopic Surgery



Health check



Kidney Transplant Surgery00









From the above data we can say that the international patients are coming to Hyderabad to get
the world class treatment at negligible cost without any waiting time by the world class western
qualified and trained Doctors for the major health issues and tourism. There is more demand for
Orthopedics, Ophthalmology, Plastic Surgery, Cardio-thoracic and Oncology Surgeries as these
are the most expensive surgeries in their countries with more waiting time.
Nationality wise International Patients Received Treatment in Study Hospital (2007)

Nationality wise International Patients Received Treatment in Study Hospital (2007)
Sr.No.Country NameNumber Of Patients

























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From the above data we can say that the Non-Residents-Indians from the developed world and
from the Arab Countries and African Countries Hyderabad is getting good number of patients in
all specialties. Patients are paying from their own pockets to escape from the diseases and the
huge waiting time in their countries.

Satisfaction Level of International Patients Received Treatment in Study Hospital:






Medical Treatment85.52





Medical Services






Nursing Services






Patient Service






Administrative Staff83.80





Food And Beverage77.75





House Keeping






Over All Facilities87.47









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Interviews were conducted in the study hospital of the international Patients, who are treated and
those under treatment, in the conscious state of mind. This reveals that 85.68% patients rated the
services provided by the study hospital are very good, 13.49% patients rated the services
provided by the study hospital are good, 0.80% patients rated the services provided by the study
hospital are average, 0.00% patients rated the services provided by the study hospital are below

The following factors are attracting the international patients to Hyderabad-India for treatment
and tourism
1) Cost Benefit:

The prime advantage is the cost savings with respect to medical consultancy or surgeries. Many
of the Hyderabadi hospitals, serving international patients, have state-of-the-art infrastructure,
highly educated doctors and top-notch services but the figure on that price tag is a fraction of
what it would be in developed countries. Even if the patient’s insurance does not cover the costs
of treatment in India, the final bill in an Indian hospital would most probably be lower than
patient’s out-of-pocket expenses.
2) Timeliness:

Another advantage is the possibility of getting immediate medical attention. There are no waiting
lists or delays to contend with, due to insurance issues or unavailability of doctors etc.
3) Quality Health Care:

Hyderabadi doctors and paramedics are well trained and are one of the best in the world.
4) Personalized Care:

Here patients are monitored closely with a personal care of all age group.
5) Technological Sophistication:

All the corporate Hospitals in Hyderabad are having State-of-the-art equipment and
infrastructure for the best treatment and diagnosis.
6) Facilitation by Government:

The Government of India has recognized the economic potential of medical tourism. It has
facilitated travel by introducing a special visa category known as ‘medical visa’ for patients as
well as introduced tax incentives for hospitals.

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7) Ease of Travel and Communication:

Travel to Hyderabad (India) has become easier and much faster due to introduction of private
airlines. Access to Internet in Hyderabad is considered to be one of the cheapest in the world and
communication facilities are well established. Travel agencies have a great online presence and
can offer you package deals that include travel costs, boarding as well as treatment costs.
8) Easy Availability of Medicine and Drugs:

Certified drugs and medicines are easily available in Hyderabad, at comparatively lesser prices.
9) Modern &and Traditional:

Modern medical aid as well as traditional therapy, such as Ayurveda, Yoga, Naturopathy etc, is
available at different locations in Hyderabad.
10) Tourism Potential:

People, who come for relatively simple, but important procedures, can consider packing in some
travel too, with their doctor’s permission! This is an added advantage. Every part of the country
is rich in history and diverse in geography.

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