NephroPlus: Treating renal disorders innovatively

There are currently more than 70 lakh patients suffering from kidney failure and other kidney-related ailments in India who require dialysis every two or three days to survive. But the state of renal care in India is abysmal, and only about 75,000 patients have access to any sort of treatment.

Shocking statistics reveal that almost one-third of those suffering from renal disorders get infected by HIV, Hepatitis C or Hepatitis B during dialysis. NephroPlus, a kidney-care clinic chain has been built to cater to the demand for world-class specialised dialysis services across India’s metros, is tackling this problem in an innovative way. Founded by 36-year-old Vikram Vuppala, Kamal Shah and Sandeep Gudibanda in 2009, NephroPlus now has three standalone and 10 in-hospital centres across major Indian cities, with plans to open 30 centres by the end of the year. Former software developer and one of the co-founders of NephroPlus, 37-year-old Kamal Shah spent most of his adult life literally experimenting with various dialysis methods. He has even suffered a failed kidney transplant. So when one of his doctors suggested a daily self-dialysis procedure which he could perform in the confines of his home every night, Kamal was a relieved man. "When my doctor suggested it, I found there was pretty much nobody else in India doing this daily nocturnal home hemo. I decided I should go for this, as it would give me really good quality of life. So, we bought the machine and it up set up at home. For the last seven years I have been doing daily nocturnal home hemo dialysis, and I get dialysis every night for about seven hours," he says. Kamal wrote about this return to normalcy on his much-followed blog. This attracted the attention of Vikram Vuppala, a US-based healthcare strategy consultant with McKinsey, who at the time was studying the Indian dialysis space. Spotting an opportunity, he returned to India and along with Sandeep Gudibanda, an Indian School of Business graduate who Vikram had met at a cancer care workshop and Kamal Shah, Vikram launched NephroPlus in 2009 in Hyderabad. Vuppala adds,"This is NephroPlus’ standalone unit where all the guests of Hyderabad are able to get highest quality dialysis in the country." _PAGEBREAK_ Initial funds for the venture came from Vikram’s savings and multiple angel investments upwards of Rs 1 crore. These funds helped the team set up their first clinic in Hyderabad in 2010. NephroPlus today runs 13 centres across India in Hyderabad, Secunderabad, Bangalore, Chennai and Agra and have carried out more than 50,000 dialysis sessions since inception. Explaining the functioning of the clinic, Vuppala says, "We have a manager of clinical affairs for every state, who is a dialysis patient, and counsels the patients not only on the clinical or psychological standpoint. We make it a point to counsel each of the patients to lead a normal life, even when on dialysis." While the annual 250 percent growth in its patient base is a testament to the need NephroPlus is plugging in in the marketplace, a validation of the business model came in the form of a successful Series A funding from private equity player Bessemer Venture Partners in 2011. This funding allowed the initial investors to exit with handsome returns. Growing at 200 percent year-on-year, NephroPlus has 250 employees including clinical and administrative staff, and has applied for patents for its innovations that prevent cross infections in dialysis. The game-changer for NephroPlus was tying up with hospitals to manage their loss-making and often poorly-equipped dialysis centres. Bringing the advantage of economies of scale in sourcing consumables as well as skilled talent, NephroPlus today manages 10 such in-hospital units across the country and charges anywhere between Rs 1,380-2,800 per session. The team now plans to launch four more centres including one at the reputed Max Hospital within the next quarter. This centre in Employees’ State Insurance Corporation (ESIC) Hyderabad is their first government tie-up. But going forward, NephroPlus is exploring the possibility of working on more such public-private partnerships.Vikram Vuppala says, “Here the unique thing is the central government entity is giving us only space, electricity and water. We have setup the entire infrastructure, including the medical equipment, beds, doctors, paramedical staff etc. The government pays us a nominal amount for each of the dialysis sessions. We believe in trying to address the Below Poverty Line (BPL) patients as well. But we understand that they cannot individually pay Rs 1,300-1,400 that is required for each sitting, so we are trying to come up with innovative ways to partner with the government so that many of the BPL patients across the country can benefit from this scheme. They are now committed to fully bridging the demand-supply mismatch. With plans to setup over a 100 centres by 2015, they should be able to close their second round of funding by the end of this year.