Medical tourism has, in recent years, become a major growth sector for the Asian travel and tourism sectors.
This does not really come as a surprise, given how travellers have made their way to the region over the centuries to seek out cures for a variety of maladies.
In the context of the 21st century, Asia has gained greater popularity as a destination for aesthetic medicine and cosmetic surgery, thanks mostly to surgical innovations offered in India and Thailand, as well as pharmaceutical advances from Japan and South Korea.
But medical tourism in the region goes far beyond the cosmetic and well into more specialised, life-saving specialisations like cardiology, oncology, pulmonary care, and even reproductive and fertility care.
In today’s feature, we take a closer look at the state of medical tourism within the Asia-Pacific, who the current key players are, and what the sector stands to evolve into.
Per Grand View Research's 2023 report, ENT surgery took up the lion's share of the medical tourism market in asia, followed by neurosurgery and oncology
Why the world comes to Asia for medical care
Admittedly, cost is the biggest factor that has been driving patients, especially those from western nations, to make their way to Asia for consultations and treatments.
Going by a 2024 report from Healthcare Asia, the cost of comprehensive treatments (which is to say consultation + procedure + recovery / post-surgical therapy) could drop by up to 80 percent if done in Malaysia, 40 percent in Singapore, and 75 percent in Thailand depending on the modalities chosen for the patient.
Thanks to this, the size of the Asia Pacific medical tourism market stood at US$10.32 billion as of end-2023 and is expected to grow at a rate of around 26.4 percent per annum till 2030.
Aside from cost, Grand View Research pointed out that patients also appreciate the greater availability of skilled medical professionals as well as specialised treatments on offer at highly competent and well-equipped facilities throughout the region.
The patient influx is further fuelled by the way numerous hospitals and healthcare facilities throughout Asia have teamed up with their peers overseas to boost their respective capabilities, enabling them all to work with a much wider clientele base.
Likewise, such partnerships entail exchange of knowledge, technology, and best practices, improving overall competence across the board.
By consolidating resources and expertise, organizations can enhance their market presence and competitive advantage.
It has also helped that governments throughout the region have been implementing policies supporting the medical tourism sector, though the framework tends to differ between nations.
Any regulations implemented by government agencies are usually centred on compliance with global quality standards, patient safety, and ethical practices in the medical tourism industry.
It is interesting to note at this point that the most common procedures that draw foreign patients to the region are those involving ear, nose, and throat (ENT) surgery, oncological treatments for cancer and pre-cancerous conditions, and neurosurgery.
Key players in the Asia-Pacific medical tourism sector
According to the research site Mordor Intelligence, while many medical organisations throughout the region are engaged in the practice of medical tourism, there are five in particular that stand out.
These are as follows:
- Apollo Hospitals Enterprise Ltd (India) Based in Chennai, the company currently operates a network of 71 owned and managed hospitals, and has been around since 1983. It has excelled in the management of lifestyle diseases such as coronary issues and diabetes; pediatric and women's care, as well as modalities for improving fertility. Apollo likewise prides itself on pharmaceutical innovation;
- Bumrungrad International Hospital (Thailand) Since it first opened in 1980, Bumrungrad has since grown into Southeast Asia's largest privately-owned hospital and has made its reputation as a go-to institution for medical tourism. The hospital's areas of specialisation run the gamut from allergy treatment and gynaecological issues to holistic care and various disciplines of cardiology. According to Bumrungrad's website, the hospital treats an average of 550,000 local and foreign patients a year, with foreigners coming in from 190 countries;
- Fortis Healthcare Ltd (India) Headquartered at the Fortis Memorial Research Institute in Gurgaon, Fortis has the distinction of having more than 20 understandings with the health departments of governments around the world. On average, it treats over 200,000 foreign patients from 175 countries a year, doing treatments and procedures at its 27 hospitals throughout India. Fortis is a leading destination for cancer treatment as its primary field of specialisation is oncology, more specifically cancers of the endocrine and circulatory systems;
- KPJ Healthcare Berhad (Malaysia) Located in Kuala Lumpur, KPJ Healthcare prides itself on a "start to finish" approach with regard to medical tourism, helping patients, their families, and primary care providers throughout the process from getting necessary visas and other permits to post-procedural care. KPJ's dedicated International Patient Centre provides ample guidance to foreign patients as to what to expect from their treatment along with any socio-cultural matters they may encounter throughout their stay in Malaysia. The company's core competencies revolve around cardiology, oncology, and orthopaedic surgery; and
- Raffles Medical Group (Singapore) It is interesting to note that over 35 percent of Raffles' patients are from overseas, hailing from more than 100 nations worldwide. Offering an extensive range of state-of-the-art modalities at its facilities, the company offers comprehensive care packages for potential patients, placing them in the hands of its team of globally-competent experts. The Raffles International Patient Centre likewise ensures personalised care for each patient, making them feel safe and cared for in a foreign land. Aside from cardiology, oncology, and orthopaedics, Raffles has also gained acclaim for fertility treatments.
The downside is...
However, despite the great economic benefit of medical tourism to the region, along with the recognition it accords to the medical professionals operating within, the sector does have a serious downside to it.
Writing for the site News Medical in 2022, Dr Tomislav Meštrović, MD, PhD pointed out that medical tourism poses a number of risks for patients flying overseas for treatments and procedures.
With regard to patient risks, Meštrović pointed out the potential for nosocomial infections, more commonly known as hospital-acquired infections, especially if patients are being treated in developing nations wherein the standards for medical hygiene may not be at par with those overseas.
Seeking treatment in developing nations also poses the risk of patients getting infected by multiresistant organisms, particularly noroviruses which commonly cause acute gastroenteritis, as well as mycobacterial infections following cosmetic surgical procedures.
At the same time, foreign patients may be exposed to infections that they would not normally encounter in their part of the world, thus posing a public health risk when they return home as they unwittingly become carriers of contagion.
Another cause for concern is tissue rejection among patients who go to the Asia-Pacific for organ transplants, leading to greater expense due to secondary procedures and an extended convalescence period.
On the other hand, nations that have become leading venues for medical tourism also face a number of issues.
In a recent article for Medical Tourism Magazine, medical researcher Dr Prem Jagyasi explained that those travelling overseas for medical procedures, as stated above, stand to carry the potential of contagion into their home countries, bringing in hitherto unknown strains of infectious microorganisms like bacteria, fungi, and viruses.
As such, there is the risk of outbreak and epidemic involved, especially if a significant volume of travellers makes their way back from a country with ongoing health issues among its people.
At the same time, citizens of countries involved in medical tourism may find themselves shunted to a corner, especially by private hospitals and medical facilities that may opt to give priority to foreign patients who are willing and ready to pay premium prices for treatment.
Medical tourism in this context also runs the risk of medical professionals giving more of their time and ability to visiting patients as opposed to their core local clientele.
An influx of foreign nationals into a country’s medical tourism sector runs the same risks as conventional overtourism: a strain on available resources, inconvenience for local populations, as well as a greater effluvium when it comes to environmental waste.
Taking all these into consideration, what the World Medical Association (WMA) declared at its 69th General Assembly in 2018 still holds water at this point:
If not regulated appropriately, medical tourism may have medico-legal and ethical ramifications and negative implications, including but not limited to: internal brain drain, establishment of a two-tiered health system, and the spread of antimicrobial resistance. Therefore, it is imperative that there are clear rules and regulation to govern this growing phenomenon.
How Asia can do even better
Despite the fact that the WMA made its recommendations in 2018, a good two years before the pandemic hit, the bulk of these suggestions continue to have practical value in the contemporary practice of medical tourism.
First of all, governments need to to carefully consider all the implications of medical tourism to the healthcare system of a country by developing comprehensive, coordinated national protocols and legislation for medical tourism in consultation and cooperation with all relevant stakeholders.
Per the recommendations, these protocols should assess the possibilities of each country to receive medical tourists, to agree on necessary procedures, and to prevent negative impacts to the country´s health care system.
Second, governments and service providers need to ensure that medical tourism does not negatively affect the proper use of limited health care resources or the availability of appropriate care for local residents in hosting countries.
In this context, special attention ought to be paid to treatments with long waiting times or involving scarce medical resources.
Also, medical tourism must not promote unethical or illegal practices, such as organ trafficking; thus relevant authorities, including governments, should be able to stop elective medical tourism where it is endangering the ability to treat the local population.
Finally, welcoming foreigners in as medical tourists should never be allowed to distort the normal assessment of clinical need and, where appropriate, the development of waiting lists, or priority lists for treatment.
Once accepted to treatment by a health care provider, medical tourists should be treated in accordance with the urgency of their medical condition.
Whenever possible patients should be referred to institutions that have been approved by national authorities or accredited by appropriately recognised accreditation bodies.
