Outsourcing & PPP model in dialysis care hold promise as patients opt for easy access: Vikram Vuppala

Nandita Vijay, BengaluruFriday, January 6, 2023, 08:00 Hrs  [IST]

The dialysis market in the country will see tremendous growth over the next several years. Pure-play dialysis networks will continue to standardize and consolidate this market. Government hospitals will continue to increasingly use the PPP and outsourcing models respectively, said Vikram Vuppala, CEO and founder, NephroPlus.

As dialysis is a chronic modality, patients are always demanding a centre close to their home rather than travelling 100 km every other day for dialysis. Quality is also continuing to increase across the country due to the growth of focused pure play dialysis networks, he added.

State governments and PSUs have realized that Public Private Partnership model (PPP) is much more efficient than delivering dialysis care themselves.

This momentum will continue to rise in 2023. All this efficient spending due to PPPs will increase access to dialysis care among the general population from 15% to 25% in 2023, he noted.

Overall dialysis market is expected to grow by more than 20% in 2023 due to the continuous rise of diabetes and hypertension diseases. The growing burden lifestyle diseases causes a significant growth in the patient population afflicted with kidney disease. This growth in the dialysis market will continue for the next 20-25 years at similar 15-20% growth rates. This large growing market presents a great opportunity for dialysis networks over the next two decades. Access to dialysis care will continue to increase especially in Tier 3 and Tier 4 cities that erstwhile did not have access to dialysis care.

Historically, dialysis was done in individual hospitals across India. Since 2010, organized dialysis networks have started growing which have built scale to achieve profitability while also focusing on clinical outcomes. Hospitals have realized that it is financially better for patients and for the hospitals if a large quality focused organized dialysis network manages the dialysis unit more efficiently. Hence the outsourcing momentum has increased, and the share of organized dialysis networks will increase from the current 20% to 35% in 2023, Vuppala told Pharmabiz.

While India is advanced in medical care across most specialties, it has a lot of ground to cover on the dialysis care front. Throughout the world, maintenance dialysis is conducted in standalone dialysis centres aged by a renal nurse and staffed by technicians. But in India, it is still primarily done in hospitals due to the resistance by nephrologists and patients to moving to a stand-alone model. Hospitals are meant to focus on clinically complicated acute tertiary care which is enriching clinically and financially for the hospitals and doctors. It is good to see that standalone are finally discussed in the government ecosystem and 2023 will be a watershed year for this standalone modality, said Vuppala.

On the challenges encountered by private nephrology care players, Vuppala said, "Many private dialysis networks have partnered with the government on PPP projects, but delayed reimbursements have been an impediment. Price inflation is inadequate considering cost inflation across equipment, consumables and human resources."

CGHS pricing for dialysis has remained the same for the last 8 years while inflation has been steep over the same period. Even Ayushman Bharat pricing for dialysis must increase keeping in mind the low baseline it started with. Rupee devaluation is also leading to significant inflation for consumables supplies, said Vuppala.