Vikram Vuppala, Founder & CEO, NephroPlus in an interaction with Kalyani Sharma talks about the dialysis industry in India, and more
Can you give us an overview of your company’s operations, including the number of centers and their geographical spread?
Currently, we operate 465 dialysis clinics across 280 cities in four countries: India, Nepal, the Philippines, and Uzbekistan. We’re also preparing to launch in Saudi Arabia, which should be operational by the end of this year. Across this network, we serve approximately 31,000 dialysis patients.
We started about 14.5 years ago in India, and in the last four years, we’ve expanded internationally. Our focus remains on proximity to India, targeting regions like Southeast Asia, the CIS (e.g., Uzbekistan and Kazakhstan), and the Middle East.
How has the response been in these international markets?
The response has been very encouraging. In the Philippines, for instance, we began by acquiring six clinics and have since grown to 27. We’re expanding further with both greenfield projects and additional acquisitions. The government-run PhilHealth program has appreciated our standardised care protocols, especially as we’ve established a network that serves areas beyond Metro Manila.
In Nepal, we started with one large clinic in Birgunj, expanded to Kathmandu, and now have three centers with plans to add three more shortly. The feedback has been positive, with our standardized protocols ensuring high-quality care.
Uzbekistan has been a standout success. We’re running a public-private partnership there, and data shows a 50 per cent reduction in patient mortality rates since we started. The government and patients alike have recognized the value we bring, and the Ministry of Finance has noted significant cost savings.
What’s your assessment of the dialysis industry in India? What are the major challenges?
Dialysis in India is still in its infancy. Only about 15-16 per cent of patients needing dialysis currently receive it. The primary challenges are late diagnosis and affordability.
Many patients don’t seek medical advice early, especially in rural areas, relying instead on home remedies until it’s too late. Affordability is another significant barrier, as dialysis is a chronic, recurring expense. For middle and lower-income groups, the cost combined with travel and caretaking expenses becomes unsustainable.
Kidney transplants are ideal but rare due to strict regulations and limited donor availability. Public-private partnerships and government programs like Ayushman Bharat are helping, but there’s a long way to go in building sufficient capacity.
Home dialysis is often cited as a solution for accessibility issues. What’s your perspective on its adoption in India?
Home dialysis is unlikely to gain significant traction in India for two reasons. First, it’s expensive. The cost is 2-3 times that of in-center dialysis due to dedicated resources. Second, patients generally prefer the security of a clinical setting with professional oversight.
While peritoneal dialysis offers a home-based option, it has its limitations, including a risk of infection. Most nephrologists prefer hemodialysis because it allows better monitoring and oversight. Home dialysis remains a niche solution, primarily for affluent individuals or unique cases.
Technology, especially AI, is transforming healthcare. How do you see it impacting the dialysis sector?
AI is crucial for driving efficiency and improving quality. Over the past 1.5 years, we’ve integrated AI into various aspects of our operations. For instance, our customer service is now fully AI-driven, enabling faster and more efficient patient interactions.
We’re also exploring predictive analytics to optimise patient care and operational efficiency. AI has the potential to revolutionise the dialysis sector by reducing costs, enhancing patient outcomes, and streamlining processes. Those who fail to adapt to these advancements risk falling behind.
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