Q: How do you describe the state of affairs in kidney disease from Indian perspective?

Kidney related disease has been a neglected field till now mainly due to the lack of awareness and poor affordability in India. In India on an average there are around 1.5 lakh new End Stage Renal Disease (ESRD) patients annually out of which only 10 percent of them are able to avail proper dialysis and some 6,000 patients get transplants. The cost of dialysis is high as compared to the per capita income if we look at the monthly sessions (i.e. 10-12 session per month at Rs 1,500 to 3,000 per session). There is also the problem of unavailability of dialysis units in their demography with most of the dialysis units confined to the Metros.

Kidney disease is a lifestyle disease as ultimately somebody who is coming for ESRD and coming on dialysis its mainly due to their lifestyle problems, if they had adjusted their lifestyle and had they taken a proper precautions then this thing would have never happened for most of the patients.

Almost 75-85 percent of the cases are due to hypertension and diabetes. The scenario is now changing as more and more centers are emerging and more awareness is reaching both at the patient level and at the physician level because of which people are able to take better care of themselves, insurance have started covering this so the affordability factor is also slowly and steadily taking care of itself. Having said that it's an emerging market so, we are hoping that all regulatory factors would come in to play and will have much better service offerings going forward.

Q: Please tell us about DCDC Kidney Care's operations in brief and also your growth plans/strategy in the coming financial year?

We intend to take our tally of center to 50 by the end of this financial year. We are already present in key locations and are looking for a pan India presence. Medical tourism is also a key area in our expansion strategy. We recently signed a contract with a Jaipur hospital and are also in talks with various hospitals at Jodhpur, Udaipur, and Agra. This will give us a good reach to patients who are travelling from abroad or internally to these locations. One should not miss out on leisure because of dialysis. We support and promote health and happy lifestyle. We are also looking to tie up with cruise companies to offer dialysis cruises as holiday option, a first for India.

DCDC Kidney Care also is in talks to open centres at international locations like Nigeria and Mongolia.

Q: What are the challenges ahead for dialysis industry?

Dialysis industry face many challenges today like there is a need for the policy for kidney patients to avail dialysis at a minimum cost. Many VC/PE players are already investing in this type of setup however, the approach is still a very cautious one, as the awareness levels are low both in the patients and the doctors community. Nephrologists are still waking up to this concept, they have this fear of the unknown and how these type of units will help them in their careers. We have seen in the past even patients taking dialysis as a specialty treatment and would prefer to go to a hospital than a standalone center, so we tied up with hospitals and over took their units.

We do see skilled manpower as a very big hurdle in future, as all the private players are aiming to open up 100 units each in coming years. As we all are trying to create an industry, our perception is that the best service provider will create the most share and retain it. Hence, skilled staff will be a thing to look at to grow strength by strength.

We also have an in-house program for the people who want to make their career in dialysis as nurses and technicians, we are willing to train them for two years at a basic fee and after one year they will get on ground training at our centers with stipend which will also help them to earn back their fee with experience.

Q: What is the current industry size and latest trends/new developments?

Dialysis services industry is at a very nascent stage of around 700 crore in turnover and is expected to grow by 25-30 percent annually. The sector comprises of both organized and non-organized players. We can foresee a huge growth in organized sector in the coming years as they have either got funding or are in the process from various VC/PE players. This will witness a whole new level of hygiene, service, quality and comfort in dialysis delivery.

Q: What is the outlook and way forward for dialysis industry in India?

For dialysis industry to flourish and reach out to common man, many regulatory hurdles need to be checked. Services like nocturnal dialysis, dialysis at home, and dialysis on the go are the future for this industry. This industry needs lots of awareness and affordability to reach its peak in India.

We are also quite happy to see the steps government has taken to provide free dialysis for the under privileged strata of the society and as a private player we do have programs in place for these patients who can avail our services at a minimum cost.