How is CORE Diagnostics has different from other diagnostic chains? How has it helped the company grow and progress?
The inception of Core was based on a simple observation: while the ‘delivery system’ of healthcare services had caught up with the Western standards, clinical diagnostics lagged behind the developed markets by almost a decade. There are a handful of large players and local small labs. Neither of them had either the skills or the incentives to move away from ‘routine diagnostics.’ We saw a ‘white space’ in high-end diagnostics. We created Core to bridge this gap by making advanced diagnostics procedures available, affordable and accessible in India. Our unique strategy is perpetual innovation – in everything we do.
If you look at our product portfolio. Nearly a third of our tests are unique to us. No one else offers them in the Indian market. A globally renowned oncologist at AIIMS is on record having told a patient – if Core doesn’t offer this test, no one else would. Fortunately for the patient, we did. Further, we are the only one in the market that offers a second opinion on every test we do – provided digitally, over the cloud, by a subject matter expert from our panel based in the US. In the customer satisfaction survey, we ask only one question: will you recommend us to a family member? Think about how powerful that statement is – as an indicator of customer delight. And we score in the high 90s in percent net promoter score.
I truly believe Core is the first successful experiment, at least in healthcare, in defining a new generation work culture – transparent, flat, candid and dialog-driven. We believe that the purpose of a debate is progress, not victory. Debate and healthy conflict is a key ingredient in all of our staff meetings. Artificial harmony only breeds mediocrity. Innovative work culture has no place for that. CORE is constantly introducing innovation – in all aspects of service delivery – to sustain the competitive advantage. This includes hiring, training, office design, compensation structure, product portfolio, marketing, sales, and service delivery. We are also focusing on scientific breakthroughs in three general areas –genomics, informatics, and cost reductions.
On the diagnostic side of things, we have brought in innovation in two dimensions: clinical specialties, and platform technologies. Specifically, we have the broadest menu of high-end molecular and genomic diagnostics in cardiology, oncology, nephrology and reproductive medicine. In order to support innovation in these specialties, we have led scientific breakthroughs in three areas – genomics, informatics, and cost reduction. In doing so, we have worked with the belief that we cannot go about it in isolation, it requires extensive collaboration with academia, big pharma and other innovators in diagnostics, globally.
What also makes us stand apart is that we offer a second opinion on every test through a world class panel of organ experts from the US and other countries. To make this happen, we make extensive use of communication technology and digital imaging. CORE has been using digital pathology for remote reading routinely for the past 36 months. The platform includes the capability of parallel sharing images and live video-collaboration. As a corollary, we also have the shortest turn-around time of any test in the industry. This inspires confidence in our customers and us.
Brief us about CORE Diagnostics’ global partners?
Innovation is never static! we are constantly looking ahead and making our inroads into this niche space year-on-year. In this recent year, CORE partnered with Promega Biotech, a US-based innovator in the life sciences industry focusing on the implementation of the Microsatellite Instability (MSI) technology especially for advanced solid tumors.
The technology plays a crucial role in selecting the most effective clinical intervention for detecting DNA mismatch-repair deficiency which further determines whether a cancer patient is potentially eligible for immuno-oncology therapy.
Later in this year, CORE and Guardant Health AMEA joined hands to bring their most widely used and accepted liquid biopsy test to India. The concept of liquid biopsies is new and acts as an alternative option for patients who are unable to undergo surgical (invasive) tumor tissue biopsies. We are thrilled to be able to offer Guardant360 to the Indian market and hope to enable more oncologists to tailor cancer treatment for advanced stage cancer patients. Guardant360 can help reduce complications, errors and delays of invasive biopsies through a simple blood draw. Through these and other partnerships, we hope to transform the way critical and chronic lifestyle diseases are diagnosed and treated in India.
How is the medical diagnostics market in India?
Diagnostics sector is highly un-organised and fragmented. It is mostly comprised of labs that are focused on routine or generic tests. This, along with lack of specialised clinical expertise that’s central for molecular and genomic testing is a continuous challenge. We are continuously focused on building the right kind of talent and training them stay perpetually current in their knowledge. With several thousand new clinical publications coming out each day, this is a formidable task.
Awareness amongst the clinicians, especially outside the big metros – regarding the importance of diagnostic, prognostics, and predictive tests is another key challenge. It is one thing to offer a customer what they need. It is entirely different task to make them aware of what they need. Finally, I believe regulatory headwinds will remain a challenge for healthcare for next several years.
How do you position yourself?
Today, CORE is the de facto destination for innovative, high-end diagnostics and trusted by thousands of clinicians across India. In just a short span of time, CORE has established its brand as the clear innovation leader as the fastest growing lab, with a current five per cent MoM growth. It has the broadest geographical coverage – with sales and service presence in 180 cities in India and 12 international markets – all served out of our NABL accredited central laboratory in the NCR.
Some of the pharma compnaies’ CORE has tied up with are Astra Zenenca, Merck, Natco, Pfizer and ten others. CORE is also working closely with all leading hospital providers such as Max, Artemis, Apollo, Columbia Asia, Medanta, Manipal and 200 others.
How cost effective are your tests and how do you balance quality and affordable price?
CORE offers services free of cost to those who most need them. The company is also going beyond national boundaries to make a difference at an international level with our global movement of ‘pathologists without borders’ programme. With an aim to give back to the society, CORE is enhancing the learning experience at medical educational institutions by sharing its infrastructure, technical know-how, and soon to become happen, the world’s largest digital library of pathology cases. Partnering with the best scientific minds globally and publishing our research for the greater good the network continues to expand.
What are the latest technologies, next generation diagnostics techniques adopted by CORE Diagnostics?
We see our way forward very broadly: to re-shape the diagnostic industry – in a manner that it gets viewed as the central function of healthcare delivery. This requires a full gamut of initiatives – from expanding our geographical territories through various partnerships with government, pharma, and health tech companies, to making preventative tests available and accessible to consumers that can be ordered directly. In order to ensure that, we are adding new clinical areas enabled by latest, cutting-edge technologies in whole-genome sequencing, proteomics, and more recently, metabolomics. We want CORE to remain the partner-of-choice for any Pharma company in conducting clinical trials. At present, we are offering testing services primarily in the field of cardiology, oncology, reproductive, and endocrine illnesses with a major focus in oncology. We have also added lines of services in nephrology, transplant medicine, and neurology.
What is your opinion on Ayushman Bharatwhich offers free diagnostics facilities?
The much-needed provisions and plans under the Ayushman Bharat scheme are in fact, COREs vision-to enhance the diagnostic process for critical and life burdening diseases. However, the need of the hour is to put more weight on the equitable accessibility and availability of quality diagnostics since we are already dealing with complicated healthcare issues like incorrect, unnecessary, misleading or over diagnosis and treatment. The scheme will not only increase the penetration of diagnostics but also encourage citizens to make their health plans in conjunction with retirement plans. It is a chance to foster innovation in a coordinated manner for private players like us to devise low-cost new diagnostics solutions and customize the existing ones for the greater.
What is your take on PPPs in diagnostics market space?
I believe that no healthcare player can operate in isolation, as it requires extensive collaboration with academia, big pharma and other innovators in diagnostics, both locally and globally. CORE strongly believes in promoting a sustainable collaboration between public and private players to serve the unmet needs, quality and accessibility in diagnostics space. The government has a crucial role to play by supporting private care providers to deliver more efficiently. We are already working with the Punjab government on a Hepatitis C eradication program through preemptive screening.
What is the market potential for high-end diagnostics in India? What are your expansion plans?
Diagnostics market is just over $3billion in India, and growing to $6 billion by the year 2020. Majority of this growth is going to come from the high-end sector, which amounts to a mere $100 million today. While growth prospects make the diagnostics industry interesting, there is an important attribute which make this industry really unique. In most of the developed healthcare systems across the world, Diagnostic Medicine makes up approximately 3-4 per cent of the total healthcare cost, but it impacts approximately 70 per cent of the total (downstream) cost. Due to this “leverage”, diagnostic medicine is receiving increasing attention on healthcare agenda – across the globe. India is no exception. That’s what makes the diagnostics segment both – important for the patient, and interesting for the entrepreneur.
What re the learnings from the seven years since inception?
Setting up a start-up is a mammoth task to begin with, add on top of that, an industry that hasn’t yet seen a leader under the age of 35, a work culture that doesn’t allow for any silicon valley like innovation, a service where the consequences are literally life and death, and there you have it – the perfect place to set up Core Diagnostics! CORE, as Eric Lander puts it was a “lucky accident”. I simply put myself in a “place surrounded by smart and wonderful people” and was unafraid to follow the accident where it led me.