'Cancer care needs to move beyond large hospitals.' How Tata Capital-backed MOC is betting on daycare

What differentiates MOC from other cancer  centres. Where do you fit among big hospital chains and government hospitals?  

Joshi: MOC was started in 2018 to make the best cancer care affordable and accessible. Previously, patients had two options: crowded government hospitals or expensive corporate hospitals. Many had to rely on unorganised cancer care providers with inferior quality. MOC was founded to serve this majority, offering high-quality cancer care near their doorstep at an affordable cost.

Maniar: Before MOC, even in Mumbai, oncology care was either in high-end hospitals like Reliance, Hinduja and Nanavati or in government hospitals like Tata Memorial, where wait times can often be 8-12 hours, with weeks for scan appointments. More than 70 percent of the oncology space remains disorganised. Tata can only accommodate a limited number of patients, leaving many without proper care.

MOC created community cancer clinics that are small yet comprehensive, reducing the effort to access oncology care. They are not capex-heavy but ensure homogenised, standardised treatment. Historically, cancer care varied based on financial status — rich patients received different drugs than poor ones. MOC shifted this from personality-driven to process-driven care, ensuring equal access to high-quality treatment at a lower cost.

Cancer treatment, especially chemotherapy, requires frequent infusions. For example, breast cancer patients may need weekly chemotherapy for 12 weeks. Rather than visiting a large hospital every week, they can receive the same or better personalised care close to home. A country like India cannot have 200 Tata Memorial Hospitals or Apollo Hospitals catering to cancer alone but it can have 200 MOCs bridging this gap.

So, is MOC an end-to-end  centre covering consultancy, diagnostics, and treatment, or does the daycare focus only on the latter part?

Joshi: A cancer patient’s journey at MOC begins with easy walk-in OPD consultations, diagnostic tests, and lab screenings, including advanced Next-Generation Sequencing (NGS). Our onco-pharmacy ensures access to essential cancer drugs, both domestic and international. Treatments like chemotherapy, targeted therapy and immunotherapy are administered in a semi-ICU daycare setup under continuous oncologist supervision, unlike hospitals where specialists only visit.

Beyond treatment, we integrate nutritionists, physiotherapists, and psychological counsellors into care, addressing often-overlooked aspects like personalised diets and post-surgical recovery. We offer advanced tools like scalp cooling and infusion pumps at 30-40 percent lower costs than private hospitals.

Maniar: We focus on medical oncology instead of costly surgical or radiation  centres. Our hub-and-spoke model partners with nearby surgical and radiation  centres, ensuring affordable cancer care without owning those facilities.

Are there any plans to bring surgical and radiation treatments under MOC’s umbrella in the future?

Maniar: As of now, no. As I mentioned, 80 percent of a cancer patient’s journey is with the medical oncologist, and that’s where MOC’s primary focus lies. There are already ample surgical and radiation facilities available and since those treatments are often one-time or limited in frequency, patients don’t mind traveling few kilometres for them.

Instead of investing in those high-capital, infrastructure-heavy services, our priority is to expand MOC’s presence across districts, building a strong hub-and-spoke model.

What is the cost difference between a patient going to a traditional hospital and MOC, considering they may still require surgical intervention elsewhere?

Joshi: Every treatment we offer is about 30-40 percent cheaper but for certain drugs like Trastuzumab, the savings can go up to 50 percent. If you look at the cumulative cost across a patient’s entire treatment journey, the difference is significant.

Maniar: That’s because we do not charge MRP for chemotherapy drugs and our medical and infusion charges are much lower than those at large corporate hospitals. Even with funding, our investors have been supportive of this mission, allowing us to stay focussed on keeping cancer care affordable.

But is that sustainable, given that you are a for-profit organisation? 

Maniar: Yes, it is absolutely sustainable. While it does lower my EBITDA, the rate at which we are growing offsets that. It also acts as a strong USP, bringing in a higher volume of patients. The greater our patient volume, the better our negotiating power with drug suppliers, which, in turn, allows us to offer significant discounts without compromising sustainability.

This is a financially proven, frugal model that allows us to self-sustain and remain profitable. Just for context, MOC was incorporated on January 1, 2018. We are now in our seventh year of operations. For the first five and a half years, we were entirely bootstrapped. We now have 45 full-time medical oncologists, likely making us the largest medical oncology-driven business in the country. Importantly, we have never burnt money. We have remained profitable while ensuring that we provide financially accessible and sustainable oncology care for our patients.

So you broke even in the initial years itself?

Maniar: We have never lost money from the very first month. Initially, MOC was formed as an amalgamation of the existing practices of four medical oncologists, who are also the four founders of the company. Since incorporation, we have been completely self-sustained, reinvesting all our profits back into the system while maintaining steady growth at a break-even pace.

Over the first five years, we achieved a CAGR of 46 percent and we continue to see similar growth except for a brief slowdown during one and a half years of COVID when the CAGR dipped. However, even during that period, we never incurred debt.

What is the capacity of each  centre?

Maniar: Each  centre typically has a capacity of 20 to 30 beds. Across all our  centres, we have a total of 47 oncologists operating in 24 community  centres. So far, we have administered approximately 65,000 chemotherapy sessions annually and have treated 4.5 lakh cancer patients since inception.

Do you have tie-ups with financial organisations for loans or third-party financing options?

Maniar: Not yet, but we are in the process of piloting a programme with a couple of financial institutions to create sustainable financing models for cancer treatment.

So far, financing for oncology treatments has not been very successful because oncology care was not standardised. For financial models to work, we need predictability, homogeneity and a process-driven approach.

Are we seeing a trend where large hospital chains are setting up bespoke, walk-in day care  centres, similar to fertility clinics? Is this happening in cancer care as well?

Maniar: As of now, I don’t know, but I really hope it does happen because cancer care needs to move beyond large hospitals. We should keep major hospitals focused on complex, critical illnesses while shifting more process-driven treatments outside.

We’ve already seen this happen in IVF, where fertility treatments have moved outside large hospitals into dedicated  centres. Ophthalmology is also seeing a similar shift.

In oncology, this hasn’t happened yet but I believe MOC has inspired many smaller groups trying to replicate our model. We’ve even helped guide some of them to set up similar infrastructures.

So, globally, except for surgery and radiation, most oncology treatments have moved outside large hospitals. I believe India should adopt this model too.

How do you plan to deploy the newly raised funds?

Maniar: We are planning to open 18 new  centres focussed on north India — Punjab, Haryana, and Himachal Pradesh — while also expanding in and around Mumbai.

A significant part of the investment will go into technology — enhancing AI integration, improving Next-Generation Sequencing services, and making cancer care more standardised and paperless.

We’re also looking at deeper molecular research to advance our understanding of cancer. Additionally, some funds will be allocated to research projects to further improve treatment approaches.

Are there plans for international expansion?

Maniar: Yes, there’s a huge unmet need in regions like Africa. We took our first step six months ago by setting up a  centre in Tanzania. Now, we plan to expand further in East Africa, including more  centres in Tanzania.

We manage operations, technology, and pharmacy, while local oncologists lead the clinical care. This model ensures high-quality treatment while being locally sustainable and accessible.