Indian healthtech startup Phable raises $12 million to serve patients with chronic conditions

Phable, a three-year-old healthtech startup that is serving patients with chronic illnesses in India, has raised $12 million in a new financing round as it looks to scale in the world’s second most populated nation.

Manipal Hospitals, one of the largest healthcare providers in India, led the Series A round in Phable. Existing investor New Jersey-headquartered SOSV also participated in the round.

Hundreds of millions of people in India suffer from chronic diseases. One of the biggest challenges they face is the volume of transactions they have to manage each day. There are appointments with doctors and labs for tests, purchasing of medicines, medical devices and insurance, and keeping a log of their test results.

The Bangalore-based startup has built a full-stack solution to process all these transactions. It has also developed what it claims to be the world’s largest integration with medical IoT devices.

The purpose of this is to automatically collect patients’ data so that doctors can keep a better track of their progress. The app also enables patients to share what medicine they are taking, and the frequency of the intake.

In an interview with TechCrunch, Phable co-founder Sumit Sinha explained that patients often become less disciplined about taking full dose of their medication once they start to see improvements in their conditions.

Phable has created a more transparent and real-time communication channel that allows a doctor to nudge their patients to take their medicine on time, and make any necessary changes to the lifestyle or medication cycle, or request a follow-up appointment. The app itself can be used for tele-consultation, the demand for which has skyrocketed in recent quarters as coronavirus forced people to stay indoors.

“This creates a feedback loop between the patient and the doctor even when the patient is not at the clinic or hospital and enables active interventions to get the best outcome,” he said.

Image: Phable

The startup also sells a range of medical IoT devices through its platform that patients can buy for tracking their body performance such as blood pressure and glucose levels. Sinha said that even if a patient has bought a machine from some other place, Phable’s app is compatible with most devices. (Even if it is not — as is sometimes the case with low-cost, non-branded devices — patients can manually enter their result, or take a picture of the result and through computer vision, Phable is able to understand and make a record of it.)

“The growing burden of chronic diseases in India is exacerbated by issues around compliance of patients with the treatment regime – including medication, lifestyle changes and periodic follow-ups. Phable would help to fill that gap and would enhance the quality of life for many patients. Manipal Hospitals is pleased to have this opportunity to work with the team at Phable to enhance and grow their offerings,” said Dr. Ranjan Pai, Chairman of Manipal Education and Medical Group, in a statement.

Phable, which employs 72 people, also maintains partnership with 1mg and Medlife to make it easier for patients to place orders for their medicines and get them delivered at their doorstep.

In recent quarters, millions of Indians have consulted with their doctors through their phone or computer and bought medication online for the first time. According to Frost & Sullivan, e-pharmacy market in India was estimated to be around $512 million in 2018. In a recent note to clients, analysts at Bank of America estimated this market to be worth $2.4 billion by 2022. (The preventive healthcare market, which caters to physical and mental well-being, is expected to grow to $102 billion by 2022.)

Phable today serves patients with cardiovascular and endocrinology related chronic diseases. It has already served over 220,000 patients and plans to deploy the fresh capital to scale the startup to reach 5 million patients and 35,000 doctors by the end of the year. It also plans to broaden its offering, including allowing patients to purchase insurance from within the app or website.

Currently Phable is used by over 5,000 doctors. These doctors are using the platform to stay better connected with their existing patients and are not being paid by Phable. The startup, however, also enables patients to discover more doctors. All in all, Sinha said doctors have seen their revenue grow by 20% by using Phable’s platform.

“Phable started with an uncompromising vision of connected healthcare, reimagined through leading-edge technology, and has been unrelenting in their efforts since day one. It’s been our privilege to work with the team through our accelerator MOX and to further support Phable as they go on to better millions of lives in India,” said William Bao Bean, General Partner at SOSV, in a statement.

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A startup that raised $175 million to fix primary and urgent care is still struggling with what its CEO called the 'most complex' problem in healthcare

Summary List PlacementSome of healthcare’s problems are so complex that even the most well-funded startups struggle to fix them.
Carbon Health cofounder and CEO Eren Bali found out as much as his company tried to make prices for doctor’s visits, routine procedures like blood tests, and comparative prices for diagnostic tools like MRIs and x-rays transparent for patients, a feat that sounded simple at first but quickly ballooned into a much larger, systemic problem.
In a Twitter thread posted on December 27, Bali ran through the challenges he and his team had identified in trying to create a menu of sorts for different procedures and treatments for Carbon Health patients.
In the end, he ultimately said the fix lies with insurance companies — not healthcare providers — to fix the way patients and clinics are expected to pay for healthcare in the United States.
“The problem is on the payer side,” Bali told Business Insider. “The payer systems are old and antiquated, and that’s opaque to providers. We are doing all we can on the provider side.”
Read more: $1.5 billion digital-health startup Ro wants to be your online doctor. Here’s how its coronavirus response rooted in rapid at-home testing fits into the new unicorn’s long-term strategy.
Calculating prices ahead of visits proved difficult
Carbon Health serves a wide variety of patients with its urgent and primary care services. It offers booking through an app, and also added virtual visits to any patient seeking care but hesitant or unable to go into one of its physical clinics.
Ideally, Bali said, Carbon would be able to show patients the costs of these services upfront so that the doctor and patient can decide on the best course of treatment together, but hasn’t made as much progress as he would like.
Some relatively new healthcare entrants like Walmart have similar ambitions in making shopping for healthcare just as easy as shopping for groceries. Patients can find Walmart’s cash prices online, such as a primary care visit that costs $40.
Carbon Health has developed a system that works well for patients without insurance, Bali said, because pricing is more straightforward. It created a data analysis tool that looks at different inputs such as existing conditions, Carbon’s cost of service, and other factors to provide an up-front cost to uninsured patients, Bali said. For example, Carbon charges uninsured patients $195 for a primary care sick visit and $69 for a virtual visit, according to its website.
But it was when that same system was trained for patients with insurance that things started to unravel, Bali said. The calculated costs for patients with similar backgrounds, insurance plans, and symptoms only matched 40% of the time, Bali said.
“We can’t explain the difference,” Bali said.
Insurance companies are built on out-dated systems
Part of the variance can be explained by how complex insurance plans are, Bali said. Each plan is essentially unique to the individual that has it, and coverage can range widely even among similar plans offered by the same insurance company.
That’s not something that even the most sophisticated data analytics model can fix, Bali explained. If healthcare providers like Carbon want to tell patients how much they can expect to pay for a visit and associated procedures, insurance companies need to update how they bill both patients and providers.
“It’s driven around the inadequate system,” Angela Miles, head of revenue cycle at Carbon Health, told Business Insider. “We need to rebuild that from a payer standpoint to get to a more modern standpoint.”
More complexity leads to increased costs
Startups like Oscar Health are already attempting to bring insurance companies into a more modern model, Bali said, but larger companies have yet to shift in a meaningful way.
Those that do change, albeit in a more superficial way, actually make the problem worse by making it even more complicated, Bali said, because the added complexity adds time, which adds costs.
“A lot of work that goes towards decreasing healthcare costs is making the system more complicated,” Bali said. “My theory is that things that drive increased cost in healthcare is due to increasing complexity because you can’t be transparent and compete on price.”SEE ALSO: The founder of a healthcare venture fund that just raised $200 million shares why she wants to back founders that are building businesses for their communities
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