Courtesy: https://www.chittorgarh.com/
Review By Dilip Davda on December 6, 2025
- The company is engaged in offering comprehensive dialysis care globally.
• It is the largest dialysis provider in Asia and fifth largest global leader.
• The company marked consistent growth in its top and bottom lines for the reported periods.
• Higher finance cost dented its bottom line for H1-FY26 performance.
• Based on its recent financial data, the issue appears aggressively priced.
• However, well-informed investors may park funds for medium to long term.
ABOUT COMPANY:
Nephrocare Health Services Ltd. (NHSL) is offering comprehensive dialysis care through its network of clinics – from diagnosis to treatment and wellness programs including hemodialysis, home and mobile dialysis, supported by pharmacy. It is India’s largest dialysis service provider in terms of number of patients served, clinics, cities covered, treatments performed, revenue, and EBITDA (excluding other income) in Fiscal 2025, and it is 4.4 times the size of the next largest organized dialysis provider in India in terms of operating revenue in Fiscal 2024. (Source: F&S Report) In Fiscal 2025, the company served 29,281 patients and completed 2,885,450 treatments in India which represented approximately 10% of the total dialysis patients in India. Additionally, by September 30, 2025, the Company served 31,046 patients and completed 1,591,377 treatments in India. (Source: F&S Report)
It is also the largest dialysis service provider in Asia in 2025 and the fifth largest globally based on the number of treatments performed in Fiscal 2025. (Source: F&S Report), it is the only Indian dialysis services provider that has scaled internationally (Source: F&S Report) with a global network of 519 clinics, with 51 clinics internationally across the Philippines, Uzbekistan and Nepal, as of September 30, 2025. The company is the most widely distributed dialysis network in India with an extensive pan-India network of clinics across 288 cities, as of September 30, 2025 (Source: F&S Report) and 21 States and four Union Territories and in particular 77.35% of its clinics spread across tier II and tier III cities and towns, as of September 30, 2025.
Its endeavor is to enable people on dialysis worldwide to lead long, happy and productive lives. Dialysis is a vital, life sustaining chronic treatment, with patients typically visiting a clinic two to three times per week. Compared to most of the other acute medical conditions necessitating episodic or one-time treatment, dialysis is a recurring, life-sustaining medical service for individuals with End Stage Renal Disorder (“ESRD”). (Source: F&S Report), the company strives to ensure that patient care is accessible, high-quality, and offers value. Recognizing that dialysis patients can lead normal lives, it refers to them as ‘guests’ in its clinics as part of operations to emphasize dignity and care. Its operating philosophy focuses on three key principles: ‘Accessibility’, ‘Quality’ and ‘Value’:
The company is present across 288 cities in India, as of September 30, 2025. While approximately 90% of all the Indian dialysis facilities are in urban areas (i.e., metro cities and tier I and tier II cities) (Source: F&S Report), it has established a footprint in tier II cities and tier III cities with 128 clinics and 234 clinics, respectively, comprising in aggregate 77.35% of its clinics in India, as of September 30, 2025. NHSL enhances patient accessibility by operating its network of clinics across various formats including in-hospital, captive clinics, standalone clinics, and government-backed public private partnerships (“PPPs”) – enabling it to serve patients in private hospitals and government facilities. This flexible model has allowed it to scale rapidly while maintaining proximity to care and establish a footprint across tier II and tier III cities. It has partnered with leading hospital chains in India including Max Super Speciality Hospital, Fortis Escorts Hospitals (a unit of Fortis Hospitals Limited), Care Hospitals, Wockhardt Hospitals Limited, Paras Healthcare Private Limited, The Calcutta Medical Research Institute, Jehangir Hospital and Grand Medical Foundation (Ruby Hall) to operate certain dialysis clinics.
In addition, it has been able to expand operations internationally through various modes including arrangements with hospitals, acquisitions and public-private partnerships. The company operates a global network of 51 international clinics including 41 in the Philippines, six in Nepal and four in Uzbekistan, as of September 30, 2025 and operate the largest dialysis clinic globally in Uzbekistan. (Source: F&S Report). The company also provide holiday dialysis, dialysis on call, and dialysis on wheels services to its patients in India further ensuring easy accessibility to dialysis services.
The company operates a scalable, asset-light and capital efficient business model, which helps ensure quick clinic additions and ramp-ups with low capital expenditure, as well as a high return on capital employed, economies of scale and strong unit economics. India, despite having large number of healthcare professionals, shows lower per capita figures due to its massive population. This crunch has led to the transformation of the healthcare delivery services ecosystem by focusing on asset-light models with the need to have minimal infrastructure to increase access and lower investments. Moreover, dialysis care entails capital and operational costs, including the procurement and maintenance of equipment, recurring consumable expenses, and human resource overheads.
For many hospitals, especially those without scale, running independent dialysis units may not be financially viable in the long term. While scale plays a role in the dialysis services business, maintaining strategic focus is also important for achieving consistent margins. By partnering with specialized dialysis chains, hospitals can reduce their administrative and operational burden while ensuring cost-effective, scalable, and clinically robust care delivery for patients. (Source: F&S Report)
As of September 30, 2025, it had 3,448 employees, comprising both medical and non-medical staff, deployed across clinics and corporate office. In addition, as of September 30, 2025, the company had 2,402 contract labourers. As of September 30, 2025, 357 Enpidia-trained personnel were deployed across its clinics, contributing to the standardization of care, improved clinical outcomes, and operational scalability. Enabling cost-effective expansion into new markets with trained, protocol-compliant staff.
ISSUE DETAILS/CAPITAL HISTORY:
The company is coming out with its maiden book building route combo IPO worth Rs. 871.05 cr. (approx. 18935819 equity shares of Rs. 2 each at the upper cap). The issue comprises of fresh equity issue worth Rs. 353.41 cr. (approx. 7682717 shares at the upper cap) and an Offer for Sale (OFS) of 11253102 equity shares (worth Rs. 517.64 cr. at the upper cap). The company has announced a price band of Rs. 438 – Rs. 460 per equity shares of Rs. 2 each. The issue opens for subscription on December 10, 2025, and will close on December 12, 2025. The minimum application to be made is for 32 shares and in multiples thereon, thereafter. Post allotment, shares will be listed on BSE and NSE. The issue constitutes 18.87% of the post-IPO paid-up equity capital. From the net proceeds of the fresh equity issue, the company will utilize Rs. 129.11 cr. for capex on opening new dialysis clinics in India, Rs. 136 cr. for repayment/prepayment of certain borrowings, and the rest for general corporate purposes.
The company has reserved equity shares worth Rs. 3.50 cr. (approx. 76087 equity shares at the upper cap) for its eligible employees, and offering them a discount of Rs. 41 per share. From the rest, it has allocated not more than 50% for QIBs, not less than 15% for HNIs and not less than 35% for Retail investors.
The four Book Running Lead Managers (BRLMs) to this issue ICICI Securities Ltd., Ambit Pvt. Ltd., IIFL Capital Services Ltd., Nomura Financial Advisory and Securities (India) Pvt. Ltd., while KFin Technologies Ltd., is the registrar to the issue.
Having issued initial equity shares at par, the company has issued/converted further equity shares in the price range of Rs. 12.398 – Rs. 660.094 per share (based on FV of Rs. 2), between August 2010, and October 2025. The average cost of acquisition of shares by the promoters/selling stakeholders Rs. 0.54, Rs. 0.66, Rs. 0.94, Rs.3.03, Rs. 6.53, Rs. 7.40, Rs. 8.08, Rs. 9.90, Rs. 11.14, and Rs. 34.28 per share.
Post-IPO, its current paid-up equity capital of Rs. 18.53 cr. will stand enhanced to Rs. 20.07 cr. Based on the upper cap of the IPO price band, the company is looking for a market cap of Rs. 4615.34 cr.
FINANCIAL PERFORMANCE:
On the financial performance front, for the last three fiscals, the company has (on a consolidated basis) posted a total income/net profit/ – (loss), of Rs. 443.26 cr. / Rs. – (11.79) cr. (FY23), Rs. 574.72 cr. / Rs. 35.13 cr. (FY24), and Rs. 769.92 cr. / Rs. 67.10 cr. (FY25). For H1 of FY26 ended on September 30, 2025, it posted a net profit of Rs. 14.23 cr. on a total income of Rs. 483.97 cr. The company marked steady growth in its top line, but posted loss for FY23.
For the last three fiscals, the company has posted an average EPS of Rs. 5.40 (basic) and an average RoNW of 8.99 %. The issue is priced at a P/BV of 6.42 based on its NAV of Rs. 71.62 as of September 30, 2025, and at a P/BV of 4.39 based on its post-IPO NAV of Rs. 104.67 per share (at the upper cap).
If we attribute FY26 annualized earnings to its post-IPO fully diluted paid-up equity capital, then the asking price is at a P/E of 161.97. Based on FY25 earnings, the P/E stands at 68.76. Thus, the issue appears aggressively priced.
The company has posted PAT margins of – (2.70) % (FY23), 6.21% (FY24), 8.88% (FY25), 3% (H1-FY26), and Ro (adjusted) CE of 0.44%, 10.00%, 18.67%, 11.99%, respectively for referred periods.
DIVIDEND POLICY:
The company has not declared any dividends for the referred periods of the offer document. It has already adopted a dividend policy in July 2025, based on its financial performance and future prospects.
COMPARISON WITH LISTED PEERS:
As per the offer document, the company has shown Narayana Health, Jupiter Life, Rainbow Children, Dr. Agarwal’s, Dr Lal Path, Metropolis, Vijaya Diagnosis, as its listed peers. They are currently trading at a P/E of 46.1, 47.3, 54.1, 138, 47.5, 63.0, and 68.6 (as of December 05, 2025). However, they are not truly comparable on an apple-to-apple basis. This comparison appears to be an eyewash.
MERCHANT BANKER’S TRACK RECORD:
The four BRLMs associated with the offer have handled 104 pubic issues in the past three fiscals, out of which 28 issues closed below the offer price on the listing date.
Conclusion / Investment Strategy
NHSL is engaged in offering comprehensive dialysis care globally. It is the largest dialysis provider in Asia and fifth largest global leader. The company marked consistent growth in its top and bottom lines for the reported periods. Higher finance cost dented its bottom line for H1-FY26 performance. Based on its recent financial data, the issue appears aggressively priced. However, well-informed investors may park funds for medium to long term.
Review By Dilip Davda on December 6, 2025
Review Author
DISCLAIMER: No financial information whatsoever published anywhere here should be construed as an offer to buy or sell securities, or as advice to do so in any way whatsoever. All matter published here is purely for educational and information purposes only and under no circumstances should be used for making investment decisions. My reviews do not cover GMP market and operators game plans. Readers must consult a qualified financial advisor before making any actual investment decisions, based the on information published here. With entry barriers, SEBI wants only well-informed investors to participate in such offers. With crazy listings in the recent past, SME IPOs drew the attention of investors across the board and lead to seer madness. However, as SME issues have entry barriers and continued low preference from the broking community, any reader taking decisions based on any information published here does so entirely at their own risk. The above information is based on information available as of date coupled with market perceptions. The Author has no plans to invest in this offer.
About Dilip Davda
Dilip Davda is veteran journalist associated with stock market since 1978. He is contributing to print and electronic media on stock markets/insurance/finance since 1985.
Dilip Davda is a leading reviewer of public issues and NCDs in the primary stock market in India. The knowledge he gained over 3 decades while working in the stock market and a strong relationship with popular lead managers makes his reviews unique. His detailed fundamental and financial analysis of companies coming up with IPOs helps investors in the primary stock market. Dilip Davda has a special interest in analyzing the SME companies and writing reviews about their public issues. His reviews are regularly published online and in news papers.
(Dilip Davda -SEBI registered Research Analyst-Mumbai,
Registration no. INH000003127 (Perpetual)
Email id: dilip_davda@rediffmail.com ).
Courtesy: https://www.chittorgarh.com/
