01 — At a Glance
The Kidney Shuffle: Now Playing Globally
Nephrocare listed on NSE just 3 months ago (December 16, 2025) at ₹327/share. IPO proceeds: ₹871 crore. Today: ₹527. That’s a +61% runup in 90 days while the Nifty yawned. Q3 FY26 delivered ₹260 crore in revenue (+31.7% YoY) and ₹32.2 crore PAT (+60.3% YoY). Annualized EPS at ₹12.84. P/E of 67x on a healthcare company that runs dialysis machines like an airline runs flights. Fixed capacity. Recurring demand. Zero glamour. Maximum returns (yet).
- IPO Price (Dec 16, 2025)₹327
- Current Price (Mar 16, 2026)₹527
- IPO Return (3 months)+61.2%
- FY25 Full-Year Revenue₹756 Cr
- 9M FY26 Revenue₹733 Cr
IPO Auditor Note: Nephrocare raised ₹871 crore through IPO. Fresh issue ₹353 crore marked for capex (new clinics), debt repayment, and corporate purposes. From day 1, the market decided it was a keeper. At 67x P/E, are we pricing in dialysis as the next moonshot, or has the market simply fallen in love with a business that refuses to die? Stay tuned.
02 — Introduction: The Unglamorous Healthcare Empire
Why Nobody Talks About Kidney Dialysis (Yet Everyone Needs It)
Nephrocare Health Services Ltd is India’s largest dialysis-care provider. Not sexier. Largest. The company runs 519 dialysis clinics across India and 41+ in the Philippines, with smaller operations in Uzbekistan, Nepal, and an incoming Saudi Arabia play. It’s the 5th largest globally by annual treatments performed.
Here’s the thing: dialysis is boring until you think about it for 5 minutes. Then it’s terrifying. 8.7% of India’s population has Chronic Kidney Disease (CKD) — that’s 12.4 crore people. Only 7% are diagnosed. Even worse: only 3 lakh out of 42 lakh ESRD (End Stage Renal Disease) patients actually receive dialysis. The market gap is essentially 12x. Nephrocare is filling it. Systematically. Profitably.
The company went public because PE investors (Edoras, Bessemer, Investcorp, IFC, Quadria) had already poured capital in. They wanted an exit ramp. Instead, the IPO became a launchpad. A company that lost money for 11 years while building scale. Then in FY24, it flipped. PAT went from losses to profits. In FY25, PAT ₹67 crore. In Q3 FY26 alone, ₹32.2 crore.
Concall Insight (Feb 2026): Management stated dialysis is “capacity-constrained, reimbursement-led, scale-sensitive chronic-care utility.” Translation: think of it like airlines. Three sessions a day per machine. Four hours each. Growth = adding machines and clinics. Not software scaling. Not network effects. Just infrastructure + operations.
03 — Business Model: The Unglamorous Cash Machine
Three Models. One Thesis: Dialysis. Everywhere.
Nephrocare operates through three models: (1) Captive Clinics (65% of India business) — dialysis units inside Max, Fortis, CARE, Wockhardt hospitals on revenue-share (typically 10–18% of sessions revenue). Zero rent. Hospital keeps adjacency economics. NephroPlus runs ops, procurement, staffing. Contracts: 7–15 years. (2) PPP (Public-Private Partnership, 32% of India business) — government hospitals. Fixed reimbursement. Zero rent. Minimum guaranteed volumes. 5–10 year contracts. (3) Standalone (currently <5% but growing) — retail clinics in high-demand areas. Highest margins. Lowest volume.
The magic is in captive + PPP. No rent. Government reimbursements (60% of India revenue) mean 130-day debtor cycles, but locked-in demand. Dialysis is not optional. You need it 3 times per week. For life. That’s not recurring revenue. That’s indentured cashflow.
Internationally: Philippines (3 years, now #3 network; 23% of FY25 revenue). Uzbekistan (PPP clinics; 9% of FY25 revenue). Nepal (small, 6 clinics). Saudi Arabia (JV with Tibbiyah; “couple of quarters away” per Feb concall).
Dialysis Clinics (Global)519India: 447 | Intl: 72
Dialysis Machines5,562Up from 4,714 YoY
Patients Served36,5509M FY26: +15% YoY
Market Share (Org)~50%India dialysis market
💬 How many Indians actually know their kidney doctor’s name? You’d be surprised. But they’ll know NephroPlus. That’s the moat.
04 — Financials Overview: The Inflection Moment
Q3 FY26: The Numbers That Made Everyone Sit Up
Result type: Quarterly Results | Q3 FY26 EPS: ₹3.21 | Annualised EPS (Q3×4): ₹12.84 | Full-year FY25 EPS: ₹3.22
| Metric (₹ Cr) |
Q3 FY26
Dec 2025 |
Q3 FY25
Dec 2024 |
Q2 FY26
Sep 2025 |
YoY % |
QoQ % |
| Revenue | 260 | 197 | 246 | +31.7% | +5.7% |
| Operating Profit | 61 | 44 | 64 | +38.6% | -4.7% |
| OPM % | 23% | 22% | 26% | +100 bps | -300 bps |
| PAT | 32.2 | 20.1 | -9 | +60.3% | Recovery |
| EPS (₹) | 3.21 | 1.04 | -5.24 | +208% | Turnaround |
Concall Clarity: Management explicitly warned: “Please do not expect such kind of growth in future results too.” The 60% PAT growth is a one-time mix: (1) Philippines price increase (Oct ’24), (2) Philippines acquisitions, (3) India CGHS (Central Government Health Scheme) hike flowing through Q3. International mix is now 41% of 9M FY26 revenue (vs 12% in FY23). Higher RPT (revenue per treatment) internationally drives blended margins up. But these are lumpy. Expect volatility quarterly, consistency annualized.
05 — Valuation: The 67x Paradox
Is This Stock Expensive, Or Have We Just Been Pricing Healthcare Wrong?
