| From Tata, Ambani and Reddy to Schwarzman and now Bezos – never before have so many billionaires been so invested in my well-being. Two national diagnostic chains recently opened shop in my neighborhood, not far from a local clinic I’ve done business with for years. Also in the mix are half a dozen large digital health-care platforms, flush with cash from major league investors like Temasek, bombarding me with daily wellness messages. Now Amazon has entered this over-$16 billion market. This week, the American e-commerce giant launched at-home diagnostic services in six Indian cities, in partnership with Orange Health Labs, a company co-funded by Amazon’s venture arm. Though Amazon is investing in health care across the US, Europe and Asia, diagnostics is launching first in India. India’s health-care market is a multidecade structural opportunity, according to Jayaramakrishnan Balasubramanian, category head, Amazon Medical, India. The diagnostics service targets “a huge movement of customers rethinking healthcare from an episodic illness to overall wellness,” he said to me over email. It completes the “trifecta of digital health,” he added. Amazon Medical now offers nationwide delivery of medicines, doctor consultations and health tests via the Amazon app, making all health records available in one place. This level of integration and convenience can be a game changer, Balasubramanian said. Investors seem to think so too. The launch sent shares of Indian diagnostic companies lower on fears of heightened competition. But disrupting health-care services isn’t easy. Amazon has floundered even in its home market where it reorganized the business and laid off hundreds of employees this year. In India too, the deep-pocketed behemoth with ready access to tens of millions of customers, will face tough challenges. Diagnostics services have already been through a few transformations. A fragmented market is being consolidated by the rise of national and regional chains. They’ve invested in automation and delivery resulting in lower prices, home services and often same-day test results. Besides, reputed health-care brands like Apollo 24/7 and digital pharmacies like Tata 1mg, Netmeds and PharmEasy already offer integrated services, including financing and insurance. Profits, though, have been elusive for many. Amazon’s nationwide e-commerce infrastructure will make it difficult to beat in medicine delivery, said A Velumani, founder of leading lab chain Thyrocare, which was acquired by PharmEasy in 2021. But to win in diagnostics will require a multibillion-dollar investment in clinics and technology and national scale, he said. Curiously, Amazon has partnered with a relatively small lab chain. That will slow its market access. Wellness check-ups are just 10% of the diagnostics market. The rest is illness-related, where local doctors play an important role as an influencer in deciding what results they trust, said Ameera Shah, chairperson of Metropolis Healthcare, among India’s largest diagnostic chains. “Orange Health has to earn trust from doctors and that’s not a matter of money, it’s a matter of time,” Shah said. Balasubramanian didn’t say if Amazon will fund Orange Health to supersize its operations quickly. Or if it will consider more lab partners. He also didn’t share any timeline for a national roll-out. But my checks suggests Amazon-Orange has launched with 10% to 15% lower prices for common tests. The fight for India’s health-care services market just got more interesting. | 
