Revenues from Bangladeshi patients have declined by 30% to 35% in 2024-2025.
Bangladesh typically accounts for 70% to 75% of all medical visas issued by India.
Political unrest in Bangladesh, the rise of a government seen as unfriendly to New Delhi, and worsening bilateral ties appear to have hit India's medical tourism sector hard.
Revenues from Bangladeshi patients have declined by 30 to 35 per cent in 2024-2025 (FY25).
Bangladesh typically accounts for 70 to 75 per cent of all medical visas issued by India, analysts said.
"Medical tourism revenues from patients in Bangladesh arriving in India for treatment are estimated to have dropped by 30 to 35 per cent in FY25 due to regime change and political unrest in Bangladesh, mainly in the first half of the year," Anuj Sethi, senior director at Crisil Ratings, told Business Standard.
Hospital chains like Apollo Hospitals Enterprise (AHEL) and Manipal Hospitals took a revenue hit due to the sharp drop in footfall from Bangladesh, especially at centres in eastern and southern India.
AHEL saw revenue from Bangladeshi patients fall steeply -- from Rs 80 crore (Rs 800 million) last year to Rs 30 crore (Rs 300 million) in the fourth quarter (Q4) of FY25.
Aashita Jain, research analyst at Nuvama Institutional Equities, said the impact on AHEL's overall revenues was around 1.5 per cent in FY25, and about 2 per cent in Q4FY25.
Manipal Hospitals also reported a marked drop in patient count from West Bengal and Bangladesh -- down nearly 75 per cent from previous levels.
"Earlier, around 10,000 medical visas were issued per month; that's now down to only 800 to 900 priority medical visas. Additionally, 19 visa centres in Bangladesh have been shut by the Indian high commission, further affecting patient inflow," said Karthik Rajagopal, group chief operating officer, Manipal Hospitals.
The steep decline matters because 70 to 75 per cent of India's medical visas go to Bangladeshi nationals, Icra observed.
Mythri Macherla, vice-president and sector head, corporate sector ratings at Icra, said international patients account for 3 to 9 per cent of revenues at most listed hospitals.
In calendar year 2024, overall medical tourist inflow to India dropped to 625,000 from 659,000 in CY 2023.
However, compared to CY 2022 (when 475,000 medical tourists visited India), the number is still 32 per cent higher, according to Bureau of Immigration data.
"There's been a sustained drop. Q4FY25 saw the steepest fall so far. We're still seeing some high-priority cases like paediatric cancer patients receive medical visas. But many others have stopped coming," said Madhu Sasidhar, president and CEO, AHEL.
Bangladesh has long been India's largest source of medical tourists, with a 48 per cent year-on-year increase bringing 449,570 patients in 2023 alone.
Over the financial year, AHEL saw a Rs 100 crore (Rs 1 billion) fall in revenue from Bangladeshi patients.
In 2023-2024, the segment brought in Rs 320 crore (Rs 3.2 billion), which dropped to around Rs 220 crore (Rs 2.2 billion) in FY25.
For AHEL, international patients make up about 6 per cent of total revenue.
Industry sources said hospitals are now seeing increased inflows from Africa and Southeast Asian countries such as Indonesia, Timor-Leste, and the Philippines, along with patients from developed economies.
One source added that Pakistani hospitals are also trying to attract Bangladeshi patients.
Still, there may be a recovery ahead. As Sethi observed, "The process of granting medical visas to patients from Bangladesh is gradually returning to normal. We expect a six- to eight-month window in 2025-2026 for full normalisation."
"Revenues from Bangladeshi medical tourists will remain under pressure this financial year."
Meanwhile, footfalls from other countries are on the rise.
"Despite the geopolitical tensions that lowered inflow from Bangladesh, some listed hospitals saw higher international patient revenues in FY25 due to increased footfall from other countries and a rise in average revenue per occupied bed," said Macherla.
Max Healthcare, for instance, recorded a 28 per cent rise in revenue from international patients in Q4, despite the drop from Bangladesh.
The country accounts for only 5 per cent of Max's international clientele.
Abhay Soi, chairman and managing director of Max Healthcare, told analysts after the results, the company has seen more than 25 per cent growth in its international medical tourism business 'for a long period', and the 28 per cent jump came 'in spite of these bottlenecks'.
Looking ahead, Icra expects the share of revenue from international patients to remain largely stable, though overall growth may slow until the current geopolitical tensions ease.
Feature Presentation: Ashish Narsale/Rediff
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