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Apollo Hospitals Enterprise Ltd
Fortis Healthcare Ltd
As growing incomes give India’s millions access to First World staples such as cars and cell phones, the population is also experiencing an unpleasant byproduct of Westernized lifestyles: an epidemic of diabetes and the kidney disease it causes. While the number of Indian diabetics is predicted to hit 101 million by 2030, the cost of dialysis makes it a luxury for most patients. “There’s a huge demand for dialysis centers, but only those who can afford it get it,” says Georgi Abraham, a professor at India’s Pondicherry Institute of Medical Sciences and founder of the nonprofit Tamilnad Kidney Research Foundation that provides subsidized dialysis to the poor. “Often I find that patients just disappear. They get one or two sessions when they have some money and then stop. Within a week or two of stopping dialysis, they may just collapse and die.”
Fresenius Medical Care, the world’s No. 1 provider of kidney dialysis equipment and supplies, says sales of blood-filtering products in India have risen more than 30 percent annually since 2006. Apollo Hospitals Enterprise (APHS) and Fortis Healthcare India (FORH), the nation’s biggest private hospital operators, are opening dialysis centers nationwide. And the Indian market for kidney care may grow to $152 million next year from $97 million in 2007, forecasts researcher Global Markets Direct. Equipment makers and dialysis providers are betting that more Indians will seek treatment as incomes rise or the government picks up more of the cost. “Every major health-care provider wants a share of this market,” says Jayant Singh of consultant Frost & Sullivan’s India unit.
New Delhi-based Fortis plans to open 50 dialysis clinics over the next two years, says Varun Sethi, chief executive officer of its Renkare dialysis unit. The first opened in New Delhi last month. The service costs about 30,000 rupees ($570) a month for 12 visits, Sethi says. Such costs are prohibitive in a nation where most people get by on less than $2 a day. More than 90 percent of the 230,000 people who develop chronic kidney failure each year in India die within months because of lack of treatment, according to a 2009 study by the All India Institute of Medical Sciences and the Health Ministry.
Entry-level dialysis machines made by Gambro sell for $8,000 to $12,000 each, says Stuart Paul, the Swedish company’s president for the Americas and the Asia-Pacific region. A year of dialysis and drugs for chronic kidney disease patients in India can go from 60,000 rupees at a government-subsidized provider to more than 700,000 rupees for home-based treatment that some affluent Indians are buying, says Pondicherry Institute’s Abraham. That’s a fraction of the $30,000-plus annual cost in the U.S., but a fortune to most Indians.
The bottom line: About 52,000 patients in India are on kidney dialysis. It’s only 4 percent to 33 percent of the cost in the U.S., but too rich for most Indians.