Tackling cancer, innovatively and cost-effectively

For BS Ajaikumar, Chairman and Chief Executive of HealthCare Global Enterprises (HCG), treating cancer is life changing. But for that one person diagnosed with cancer out of 1,250 people in India, life is one of immense suffering.

While the cost of treatment continues to be a constant worry for patients, Ajaikumar says a key handicap in tackling the rising cancer incidence is the limited information on the Indian genetic make-up to develop an approach to treat the disease.

Ajaikumar heads possibly the country's only publicly-listed cancer care hospital chain. And he believes that India can leapfrog over other developed economies in adopting advanced technologies such as immunology and genomics.

Research and innovation But for that more genomic-based research needs to be done on Indians. The pharma industry-type approach of copying innovative drugs will not work, he adds. “We should invest in R&D (research and development) and in the case of genome sequencing what used to cost a million dollars can be done for ₹50,000,” he claims.

For this, doctors need to be encouraged to innovate. At HCG, he says, questions like why a patient does not respond to certain treatments (the kind of conversation that doctors get into after their daily schedule) are constantly explored.

So, how does HCG manage affordability and precision treatment? “We have devised a way to determine whether a patient can afford to pay or not by taking a counsellor approach towards understanding the lifestyle of a patient through a detailed questionnaire,” he says.

And though treatment costs run-up to lakhs of rupees with medicines adding several thousands to that, Ajaikumar counters the “high cost” perception saying that healthcare costs in India are the lowest in the world.

Cobalt treatment “One should also look at the advancements in treatments happening. Earlier, patients used to get cobalt treatment (a form of radiation treatment which got replaced by treatments like linear accelerators)," he says. Similarly, in the past, cancer recurrence was high as limited options were available. When hospitals used cobalt, people used to say that the treatment was worse than the disease. “The costs were low then, but the consequences were high. Are you okay with that?”

Explaining the economics some more, Ajaikumar points out that earlier people had to go to Delhi, Mumbai, Chennai and other metros to get treatments. “Now, we have taken it to tier II cities like Ranchi, Cuttack with technologies like PET Scan to their doorstep. Imagine the costs it can save for a person to come to a hospital in another city — stay, travel, etc.”

On a corporate level, Ajaikumar does not lose sleep over reducing HCG's debt, even as he plans to take the ₹582-crore network across the country. “Investors will take time to understand our model,” he says, of their ₹100-crore debt.

With plans to set up 23 more centres this year, Ajaikumar says, cancer is emotionally hard on the patient and family. By attempting to take treatment closer to people, in the long run, the cost will not be as harsh on their pockets, he adds.

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