NephroPlus plans greenfield growth in Philippines after 55 clinics

Nephrocare Health Services Limited said NephroPlus had crossed 55 clinics in the Philippines by September 2026 after adding 11 during the year, including 10 acquisitions in H1 FY27, and management said greenfield clinics would complement further consolidation in a market of about 900 facilities.

How large is NephroPlus's Philippines network now?

NephroPlus had more than 55 clinics in the Philippines at the end of September 2026, after adding 11 clinics during FY27 to that date. Of those additions, 10 were acquisitions completed in the first half of FY27, making purchases the principal route used to build the network during the period.

Management estimated that the Philippines has about 900 dialysis clinics, of which more than 500 are owned by individuals operating one or two facilities. NephroPlus said this fragmented ownership structure provides multi-year visibility for roll-ups, but it did not disclose an acquisition target, a timetable or a Philippines-specific capital budget.

The comparison between 10 acquisitions in H1 FY27 and 11 clinics added during FY27 to September shows that acquired facilities accounted for nearly all disclosed additions. Greenfield development is therefore an additional expansion mechanism rather than a replacement for consolidation, based on management's stated strategy.

Will NephroPlus build new clinics in the Philippines?

Yes, NephroPlus said its Philippines roll-up strategy will be complemented by a greenfield strategy, meaning clinics developed rather than acquired. Management did not provide the number of sites, locations, expected opening dates or capital expenditure for those planned facilities.

The company described three growth levers across its business: increasing activity at existing clinics in existing geographies, opening new clinics in existing geographies, and entering new geographies. Philippines greenfield clinics would fall under new clinics in an existing geography, while acquisitions would increase the network through consolidation of current operators.

Management said new countries may have suboptimal margins in their initial couple of years as the business makes upfront investments and builds scale. It said the operating model is designed to spread overheads across a larger revenue base over time, but it gave no Philippines-specific margin forecast for acquired or greenfield clinics.

How important is the Philippines within NephroPlus's network?

The Philippines represented most of NephroPlus's 70 international clinics at September-end, when its total network stood at 570 clinics across six countries. The company had 500 clinics in India, more than 55 in the Philippines, six in Uzbekistan, two acquired clinics in Kazakhstan and its first operational clinic in Riyadh, Saudi Arabia.

India remained the larger operating platform, with 500 clinics across 314 cities and more than 33,000 guests, around 80% of whom were in tier 2 and tier 3 towns. By comparison, the Philippines strategy disclosed on the November 4, 2026 call centred on combining purchases of small independent facilities with future greenfield development.

International operations accounted for about 47% of H1 FY27 revenue, up from 42% in FY26. Management said the higher international mix was a main driver of revenue per treatment increasing 9.7% to Rs 2,785 in H1 FY27.

NephroPlus reported H1 FY27 revenue of Rs 585 crore, up 23.6% year on year, while adjusted earnings before interest, tax, depreciation and amortisation, or EBITDA, was Rs 134 crore, up 15.3%. Q2 FY27 revenue was Rs 303 crore, up 23.5% year on year and 7.7% from Q1, while treatments grew 12% in the quarter.

How does the Philippines strategy fit NephroPlus's international plans?

The Philippines plan fits NephroPlus's stated approach of scaling its India-built dialysis platform into markets where reimbursed patient populations can support a sustainable network. Management said it assesses new geographies on the availability of government or insurance reimbursement, political stability, ability to repatriate profits, local unit economics and the potential to apply its India operating platform.

Kazakhstan became the newest market in Q2 FY27 through the acquisition of two clinics in Almaty. Management said Kazakhstan has around 12,000 dialysis patients across 150 clinics and expects approximately one year for the new operation to reach steady-state margins, while it first integrates the acquired facilities and considers acquisitions meeting its thresholds.

Saudi Arabia remained in an investment phase despite NephroPlus opening its first Riyadh clinic and starting home dialysis in Riyadh and Jeddah. The company is one of 12 technically qualified providers for a Ministry of Health tender covering about 11,720 patients across four clusters, with bids due in February 2027; management said the process will be competitive and did not assure a win.

NephroPlus also launched the NephroPlus International Dialysis Academy, or NIDA, in 2026 to train renal nurses from the Philippines and India for international markets. Management described NIDA as an early-stage initiative intended to address shortages of trained renal nurses, including in Saudi Arabia, but did not provide trainee, hiring or placement targets.

Conclusion

NephroPlus has built a Philippines network of more than 55 clinics mainly through acquisitions, with 10 purchases in H1 FY27 accounting for most of the 11 clinics added during the year to September. Management's decision to complement roll-ups with greenfield clinics broadens its route to growth in a market it estimates has about 900 dialysis facilities and more than 500 small individual operators.

The next disclosed markers are execution rather than a numerical Philippines target. Management plans to continue Philippines growth, integrate Kazakhstan's two Almaty clinics, and submit Saudi tender bids by February 2027, while its medium-term revenue-growth guidance remains 15% to 20% over three to four years.