India's refurbished medical device dilemma

The issue isn’t whether refurbished systems should be used, but how they should be governed & how India can strengthen its domestic manufacturing and capabilities

- NK GANGULY

INDIA'S HEALTHCARE SYSTEM stands at a structural inflection point. While metropolitan markets are approaching capacity, the next wave of clinical expansion is shifting towards tier-II and -III cities. Demand for advanced diagnostics and tertiary care is rising rapidly in these regions, but infrastructure, capital access, and trained manpower remain unevenly distributed.

At the same time, India finds itself divided on a critical question: should refurbished medical equipment form part of this expansion?

The debate has intensified in recent months. Concerns around quality, safety, and regulatory oversight have led to calls for tighter scrutiny, and the government has constituted a committee to examine the issue. Yet a clear policy framework is still awaited. In the absence of regulatory clarity, the conversation risks becoming polarised, framed as a binary choice between patient safety and affordability.

The real issue is not whether refurbished systems should be used, but how they should be governed and how India can simultaneously strengthen its domestic manufacturing and refurbishment capabilities.

Tier 1 hospitals are increasingly overburdened, often serving as referral hubs for patients travelling long distances for imaging, dialysis, oncology care or complex procedures. The strain on urban infrastructure reflects a deeper structural imbalance in the geographic distribution of medical technology. If India is to scale healthcare responsibly, the question is not only how to build more facilities but how to equip them sustainably.

Advanced imaging platforms such as CT and MRI, catheterisation laboratories, radiation therapy systems, and high-end surgical technologies require significant capital outlay. For many providers in tier-II and -III markets, procuring brand-new systems is financially prohibitive. Expansion is frequently delayed because capital is constrained.