When Vikram Vuppala stumbled upon Kamal Shah’s blog in 2008, he was amazed. Shah, who had been on dialysis for well over a decade at that point, had mapped out the pain points of the entire dialysis sector in meticulous detail. Both chemical engineers by training, Vuppula, a management consultant with McKinsey in the US at the time, reached out to Shah. In 2009, the two men founded NephroPlus, a dialysis centre chain in Hyderabad.

Nine years and 149 dialysis centres later, their conversations are still the same—how to sustainably grow the business while maintaining quality of care for patients. This is no easy task in India, a fact other players in the dialysis business can attest to. While global leaders in dialysis services like DaVita are quitting on India altogether, others like Germany-headquartered Fresenius Medical Care are not expanding.

NephroPlus is a different story. It has achieved market domination—becoming India’s largest dialysis centre network in the process—while offering low-cost services and still managing profitability.

Of about 5,000 dialysis centres that are run in hospitals, dialysis chains like NephroPlus operate about 5% of them. They offer one important advantage—a highly minimised risk of patients catching infections from each other. This is a differentiator that only dialysis chains acquired by multinational companies or funded by international agencies, and a few corporate hospitals are offering in India, says Saurav Panda, co-founder of dialysis chain Sparsh Nephrocare. Dialysis equipment giant Fresenius acquired an 85% stake in Sparsh Nephrocare in 2016.

In a country without an enforcement body to ensure the Indian Society of Nephrology’s guidelines are followed, this is vital. Especially when nearly a third of patients treated for chronic kidney diseases contract a chronic disease like Hepatitis C, Hepatitis B or even HIV.

To the about 100,000 Indians on dialysis—who often have to undergo dialysis three times a week for life and constitute a mere 15 % of the patients who need dialysis—the risk is too high to ignore. Dialysis chains, therefore, are a godsend. While they do not offer a 100% assurance that diseases will not be contracted, their higher standards of care, coupled with the convenience of appointments through text message and access in all major cities gives them a leg up in a sector that is mostly unorganised. And among these chains, NephroPlus stands tallest, with the largest network of centres in the country.

Now, NephroPlus wants to take things to the next level—it wants to more than double in size, going from 149 centres to 300 by 2021. It has already raised Rs 200 crore ($27.7 million) over three funding rounds led by Bessemer Venture Partners, International Finance Corporation, and SeaLink Capital Partners, respectively.


Ruhi Kandhari

Ruhi writes on the impact of healthcare policies, trends in the healthcare sector and developments on the implementation of Electronic Health Records in India. She has an M. Sc. in Development Studies from the London School of Economics.

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