Interview

Treating Technology as a Commodity to Give Service

Naveen Kulkarni

Naveen Kulkarni heads Indias first stem cell banking operation. He has seen the industry from its infancy, and feels that pricing does not play an important part in the sectors growth, he tell ENNs Rajesh K Sharma

Naveen Kulkarni

Naveen Kulkarni
heads Indias first stem cell
banking operation

Please tell us about Cryo Stemcell.
Cryo Stemcell is Indias first fully autologus stem cell bank. We started in 2003 and offer preservation of stem cells, umbilical cords and cord blood that is collected at the birth of a child.

How has stem cell banking changed since you started in 2003?
In 2003 right till 2008, people were hardly aware about stem cells and the banking concept. But after 2008, many companies, especially foreign companies entered the Indian market space. As a result, a lot of awareness about stem cell banking has come. People now are very aware about stem cell banking and today, in practically every major city, when a birth happens, the patient is aware that there is an option for stem cell banking. Awareness has grown a lot, but so has competition, as a lot of companies have come in. But the market is big enough for many more, actually.

How has the technology in stem cell banking advanced since you started?
Stem cell has two components- stem cell banking and stem cell therapy. We dont do any stem cell therapy, but support hospitals that have a need for stem cell therapy. We are the back end supporters for many such hospitals, and from the technology point of view, in stem cell banking, there is lot of process development that has happened. Percentage wise, the number of people using the stem cells is less, but in terms of absolute, we are the highest. More than 85 patients have used the stem cells that they banked with us.

What are the cities that you are active in?
We are active in South India in Chennai and Hyderabad, Trivandrum and other places. Apart from that, we are active in Mumbai and Pune, and expanding to Delhi and parts of Rajasthan as well.

How do you go about convincing people to invest in stem cell banking, and later collecting the stem cells?
We have interactions with doctors and conduct workshops with doctors about the benefits of stem cells and what their possibilities are, but the final decisions are made by parents. We do talk to parents, and many times when the parents enquire from the doctors, they refer them to us. As the due date nears, parents are made aware of the stem cell banking option. Mostly they are aware of the concept. The challenge is convincing them why they should bank with us, and what are the chances of using the stems cells. But since the application of stem cells is plausible in India also, it is not that big a hurdle.

Has stem cell banking become affordable in India?
I dont think so. So far, only one company has reduced its prices. But when you do an actual math and calculate every thing, it has not come down. People go by what is shown, without looking at the small print. The overall cost is the same. What they have done is restructure the whole financial model. Once restructured, it becomes appealing to the common man. But these are just the processing charges. There are other charges, like transportation, logistics and other charges all within one year.

Is there any chance of it becoming more affordable?
The word affordability is relative in In- dia. What is affordability? I have argued about this a lot. BMW is also affordable. Everything in India is affordable.
But reducing prices may help bring in more customers… It is about financial modeling. Most families now have two cars. But the price of cars as well as fuel is rising. But financial models like zero down payments make cars interesting. So, affordability has definitely gone up because of the options that are available. I would say that the Indian market has nothing to do with the costing.

Please tell us about the technology implemented at Cryo Stemcell.
There are many technologies that companies are working on, but at the end of the day, the value of the technology is only what it can deliver and what it can add to the patients value. Does the patient end up paying more? From a technology point of view, I would use technology as a commodity. I would to bring the best out of technology from my client. For example we have improvised our processes and brought in a technology called PRP (Platelet Rich Plasma). It is not a new technology, and is known to doctors for more than 25 years. But no company was interested in plasma and threw it away. In fact, 99.9 percent of all components in a surgery including the placenta, amniotic membrane, amniotic fluid and cord blood, can be used. Nothing should be thrown away,but everything is. We thought that the best way we can give better value to our clients would be through new features and new facilities for them when the need arose. The PRP of the cord blood is almost 15 times more potent than the regular peripheral blood plasma. It can be used not only for the child, but also for the siblings and the parents in accidents, injuries, burns etc. It can also be used for the expansion of the stem cell at the time of growth. PRP is nothing but a lot of growth factors that are useful for the body. This is technology that we are bringing in that is applied to bring greater benefit to the client at the time of need. Rather than saying that I have a particular technology, if the technology cannot deliver something valuable, it is of no use.

“I dont believe in pricing as key criteria in India at all. The whole thing is about the smartness of how you package it”

How has been the governments support to stem cell banking?
The word stem cell is a taboo. It has received bad publicity because of which, the government is wary. At the same time, many committees that are formed that comprise people from various disciplines, who give advantages to their disciplines. Like an earlier committee had an Opthalmologist who was very keen on using stem cells in corneal operations. As a result, ICMR is a recognized therapy for corneal injuries. Later, many people pushed for stem cell treatment in other fields, which is ok.

But the government is also bringing in lots of restrictions. For example, till recently, we had to pay service tax because we were not considered a medical field, but the DGCA still made licenses mandatory for all stem cell banking operators and considered stem cell banks at par with blood banks. While one government wing puts us under medical service, another says we are not and wants to take taxes from us.

Another thing is academia. Medical academic research is very low end in India. We have tied up with many hospitals and universities, where the intention of doing research is the last thing. Everyone is busy treating patients. But if you dont do research and publish it in a structured manner, you will not be at par with other companies. You will keep borrowing technologies from everywhere else.

What is the current market scenario like?
The fact that there are many players in the market says that there is a market for stem cell banking. All the companies combined havent tapped 0.5 percent of the market. A huge untapped market needs to be addressed. There is still scope for building awareness, and hospitals are building those gaps. Most companies have similar models, except a few that are working on pricing. But I dont believe in pricing as key criteria in India at all. The whole thing is about the smartness of how you package it. Smart packaging about stem cell banking helps. We too are innovative in our own ways.

A lot of stem cell banking companies entered in India a few years ago, but are now folding up and going back. They thought their experience outside would help them here, but the Indian market is different. The approach cant be same as in developed markets. Some companies have handed over their reins to Indian operators, who are primarily doctors with hospital experience. But while they can bring in the numbers initially, eventually it is a pure marketing operation.

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