1. The headline scenario · FY2024-25 vs FY2025-26 (provisional)

Source: DGCI&S TradeStat EIDB, commodity-wise all-countries reports, fetched per HS-8 code 5 August 2026. Basket: 148 device/consumable HS-8 lines from DPIIT's Department-of-Pharmaceuticals mapping (Guidebook on Mapping of HSN Codes, revised 16 Dec 2025), excluding drug/API lines.

The official Department of Pharmaceuticals series tabled in Lok Sabha (Unstarred Question 3451, 13 March 2026) tells the same story on its broader basket — which also counts pharma-side lines: ₹137,088 crore imports against ₹42,360 crore exports in FY2024-25, coverage of 31%, imports up 2.5× since 2014-15. Since the 2020 EEPC baseline ($6.2bn imports, $2.1bn exports, “75–80% import dependency”), the market roughly doubled and dependency did not improve — the deficit grew faster than exports.

2. Where the imports are · 17 device families, FY2025-26

Source: same TradeStat fetch as above, aggregated by HS-4 family.

The pattern is stark: India has conquered the low end (consumables, dressings, gloves, contraceptives, PPE are all net exports — the COVID-era indigenisation held) and remains 70–90% import-dependent at the technology end (lab instruments, imaging, radiotherapy, IVD).

3. Key devices for production — ranked · import value × growth × low coverage × supplier concentration

Tier 1 — largest, fastest-growing gaps

1. IVD reagents, kits & certified reference materials — ~$1.1bn imports, 9–31% coverage. India already proves capability at the bottom (malaria RDTs: $71mn exports, essentially no imports; pregnancy kits net-export). The gap is immunoassay/molecular reagents and contrast media (contrast media 60% China-sourced).
2. X-ray/CT ecosystem — $1.36bn, +27% YoY, the fastest-growing family. X-ray tube imports nearly tripled (+165% to $231mn) — a classic replacement-parts dependency: India assembles X-ray machines (and exports $142mn of tubes) but the tube/generator/ detector core is imported. CT apparatus: $181mn, 34% from China, 16% coverage.
3. Lab & analytical instruments — $2.19bn at 10% coverage: the largest single deficit family ($2.0bn). Chromatographs ($335mn, 3% coverage), mass spectrometers ($116mn, 1% coverage), gas analysers ($298mn). Quality-control demand is policy-captive (CDSCO, pharmacopoeia labs).
4. MRI apparatus — $298mn, 37% from China, 48% coverage. Imports fell 8.5% — consistent with domestic assembly starting under PLI; localisation should extend to magnets and gradient coils, not stop at assembly.

Tier 2 — high growth or high concentration

5. Oxygen-therapy & respiratory apparatus — $231mn, +30% growth, 9% coverage, top source China. The post-COVID lesson unlearned: concentrators and ventilator cores are still imported.
6. Ophthalmic surgical instruments — $252mn, +24%, 18% coverage. India leads the world in cataract-surgery volume yet imports the instruments; IOL manufacturing (Aurolab) proves the model works here.
7. Electro-diagnostic apparatus — $295mn combined, ~30% China share. India net-exports basic ECGs ($55mn, 224% coverage) — the gap is patient monitors and multi-parameter systems.
8. Orthopaedic implants: joints & other implants — $494mn combined, 44–69% coverage, sourced Switzerland/Belgium/US. Coverage is improving; the remaining gap is premium hips/knees and trauma systems.
9. Pacemakers — only $64mn, but 1% coverage and fully strategic: every implanted unit is imported (Malaysia/US/Singapore).

Tier 3 — quick wins / parts localisation

10. “Parts & accessories” residual lines (~$1.7bn combined, 14–24% coverage) — the component layer under every machine above. Localisation programmes that stop at finished-goods assembly just move the import one HS line down.
11. X-ray film ($108mn, 2% coverage, 35% Japan), dental instruments ($112mn, 34% China) and massage/wellness apparatus ($76mn, 68% China) — mid-size, technologically accessible, highly concentrated suppliers.

4. What India already does well · defend and extend

Net-export or near-parity lines, FY2025-26: catheters & cannulae (up to 10× coverage), orthopaedic/fracture appliances (136% coverage), spectacle lenses (89%), hormonal contraceptives & condoms, surgical sutures (7× coverage), syringes & needles, dialysis machines (71% coverage), endoscopes (57%), surgical blades (194%), ECGs (224%), gloves (98%), dressings (264%), PPE garments (14× coverage). These are the exact segments the 2020 EEPC deck called out — the strategy worked where it was tried.

5. Policy scaffolding already in place

• PLI for Medical Devices (₹3,420cr, 2020) — four target segments; see the companion post for full coverage-vs-gap detail.
• SMDI (Scheme for Strengthening of Medical Device Industry) — components/accessories sub-scheme window open since June 2026, the vehicle for the Tier-3 parts play.
• National Medical Devices Policy 2023 — 10–12% global-share target by 2047; four medical-device parks (Himachal Pradesh, Madhya Pradesh, Tamil Nadu, Uttar Pradesh).
• India–EU FTA (Jan 2026) — opens a $572bn EU pharma+device market; Germany and the Netherlands are simultaneously top-5 import sources and fast-growing export destinations.
• Parliamentary scrutiny is active: 122 questions on medical devices across both houses since 2019 (71 Lok Sabha, 51 Rajya Sabha).

6. Bottom line

India's medical-device trade runs a $6.2bn deficit growing at ~20%/yr, with exports flat. The winning pattern is proven: consumables went from import-dependent to net-export within a decade. The same playbook now needs to climb the value ladder — IVD reagents → X-ray/CT cores → lab/analytical instruments → MRI localisation depth → respiratory & ophthalmic devices → pacemakers — with the SMDI components window used to attack the ~$1.7bn parts layer that finished-goods PLI alone cannot reach. See the companion piece for exactly which of these PLI already addresses.

MRI access: the demand case behind the devices

India has roughly 3 MRI units per million population against a global average of 7 (the US, Korea and Japan run 28–57 per million); the installed base is only about 2,500–3,000 scanners nationally, heavily concentrated in metros and large private chains — just 14% of primary health blocks report local MRI access. Public-hospital queues run months to years: AIIMS Delhi OPD imaging dates have been issued as far out as 2027. A radiologist bottleneck compounds it — roughly 15,000 radiologists for 1.4bn+ people (about one per 93,000), with only ~1,200 new graduates a year.

That access gap is what the medical-device PLI (₹3,420 crore outlay, radiology & imaging a named target segment) and the Medical Device Parks are aimed at closing on the finished-equipment side. But an MRI scanner’s core is a superconducting magnet assembly — the same magnet-manufacturing capability this blog covered separately in the rare-earth magnets and specialty-steel PLI piece. AMTZ Vizag already hosts India’s only Superconducting Magnet Testing, Validation & Integration Centre, and indigenous cryogen-free 1.5T designs (helium-free, ~40% cheaper to build) are the clearest example yet of finished-device localisation and upstream magnet capability reinforcing each other.

Method. Each HS-8 line fetched from tradestat.commerce.gov.in EIDB (commodity-wise all-countries reports, US$ million, both directions; FY2025-26 provisional). Basket = DPIIT DoP-mapped codes in chapters 30 (device consumables), 37, 38 (IVD), 40, 62, 90, 94, 9619, excluding drug/API lines. Figures may differ from the DoP parliamentary series, which uses a broader basket including pharma lines. Additional sources: EEPC India “Indian Medical Devices — An Overview” (2020); CDSCO Notified Medical Devices E-Book, Edition 4 (to 25 Oct 2023); DPIIT Guidebook on Mapping of HSN Codes (rev. 16 Dec 2025); Lok Sabha Unstarred Question 3451 (13 Mar 2026).