#### **Overview** Shalby Limited is a leading **multi-specialty hospital chain** in India with a global reputation, particularly as the **world’s largest provider of joint replacement surgeries by volume**. Founded in 1994 by renowned orthopedic surgeon Dr. Vikram Shah, the company has evolved from a 6-bed orthopedic center into a vertically integrated healthcare ecosystem. It operates across three core verticals: **hospitals, orthopedic implant manufacturing, and franchise-based specialty centers**, creating a capital-efficient, self-reinforcing business model. Headquartered in Ahmedabad, Gujarat, Shalby is listed on both the BSE and NSE. The company has established itself as a market leader in Western and Central India, with strong presence in Northern regions, and is strategically expanding into high-growth urban centers and international markets. --- ### **Core Business Segments** #### **1. Hospital Network** - **15 multi-specialty hospitals** across 13 Indian cities, with over **2,300 beds**. - 11 are multi-specialty tertiary care facilities, and 4 are dedicated orthopedic centers under the **Shalby Orthopedic Centres of Excellence (SOCE)** franchise brand. - Performs **over 175,000 joint replacement surgeries** to date—more than any other private hospital globally—and maintains **#1 global position in arthroplasty volume**. - Clinical leadership includes **cardiac sciences, oncology, neurosciences, critical care, transplants (over 450 performed), and bariatrics**, with diversification accelerating. - **Key Acquisitions**: Strengthened footprint in North India through acquisition of Sanar International Hospital, Gurugram (130+ bed capacity), with over **60% of revenue from international patients**, primarily from the Middle East and Africa. - **Expansion Projects**: - **Greenfield 175-bed hospital in Mumbai (Santacruz)**, expected to be operational in 2027–28. - **146-bed hospital in Nashik** under brownfield development. - Strategic focus on high-income, health-conscious urban populations. #### **2. Franchise Model: Shalby Orthopedic Centres of Excellence (SOCE)** - Operates an **asset-light, scalable franchise model** to expand access to orthopedic care while minimizing capex. - **Four operational SOCE hospitals** (Lucknow, Gwalior, Udaipur, Ahmedabad), with a **planned target of 40+ centers** across India in the next 4–5 years. - Uses two models: - **FOSO (Franchise-Owned, Shalby-Operated)** – Shalby manages day-to-day clinical and operational functions. - **FOSM (Franchise-Owned, Shalby-Managed)** – Shalby provides strategic oversight, branding, training, and quality control. - **Performance**: - SOCE division generated **₹131.8 million in FY25 revenue (+28% YoY)**. - Strong momentum in franchise expansion, particularly in Gujarat, Maharashtra, Madhya Pradesh, and Uttar Pradesh. - Ensures quality and brand consistency through standardized protocols, surgeon training, and real-time performance monitoring. #### **3. Orthopedic Implant Manufacturing: Shalby MedTech (Shalby Advanced Technologies Inc.)** - Owns a **U.S.-based, FDA-approved manufacturing facility in El Dorado Hills, California**, producing knee and hip implants under the brand **"Shalby Consensus"** and **"SAT India"**. - Vertically integrates the value chain—**backward integration** allows implants for internal use, **forward integration** enables direct sales in global markets. - **Manufacturing Capabilities**: - 45,000 sq. ft. fully vertically integrated facility with machining, polishing, sterilization, and packaging. - **No product recalls in over 30 years**, a rare distinction in the medical device sector. - Production capacity exceeds **80,000 components annually** (over 4,500/month). - **Key Milestones in FY25 (FY ending March 2025)**: - Implant revenue: **₹930.6 million (+67% YoY)**. - Sold **nearly 42,000 implant components** (up from 30,000 in FY24). - COGS declined **9% YoY and 3% QoQ** due to procurement optimizations. - **Geographic Reach**: - Presence in **India, USA, Japan, Indonesia**, with entry into **4–5 new international markets** planned by FY26. - Expanding distribution in **Southeast Asia, Middle East, Africa, and CIS** via local channel partners. - **Subsidiaries**: - **Shalby Advanced Technologies Inc. (USA)** – manufacturing and R&D. - **Shalby Global Technologies (Singapore)** – global distribution and supply chain hub. #### **4. Innovation & Product Development** - **Proprietary Technology**: The **"ZERO TECHNIQUE"** in TKR surgery—developed by Dr. Vikram Shah—reduces surgery time to **22 minutes** and hospital stay to **3 days**, improving recovery and operational efficiency. - **New Product Launches**: - **Duraniom**: U.S. FDA-approved **TiNbN-coated knee implant** (only one of its kind), launched globally across India, USA, and Southeast Asia. - **TUKS (Tahoe Unicompartmental Knee)**: First launched in the U.S., with high surgeon acceptance. - **Ambition Knee Implant**: FDA-approved posterior-stabilized knee system, targeting 75–80% of knee procedures in India/SE Asia. - Upcoming pipeline includes **CKS Gold, Ambition Gold**, revision knees, and dual-mobility hip systems. - **Robotic Surgery Integration**: - Strategic partnership with **Curexo (South Korea)** to integrate advanced robotics into surgical workflows. - Robotic systems expected to **boost implant sales and generate rental income**. - Received **CDSCO approval for robotic surgeries in India** (Feb 2025). - **R&D Expansion**: - New **R&D offices in India and the U.S.** to accelerate innovation. - Hiring of **engineers and product designers**, including leadership from global med-tech giants. - Surgeons co-develop products, ensuring clinical relevance and adoption. --- ### **Strategic Growth Pillars (2025–2026 Outlook)** 1. **Expand Hospital Network** - Focus on **Mumbai, Rajkot, and Nashik** to capture high-growth urban demand. - Utilize **underutilized bed capacity (40%+ available)** to scale revenues **without major capex**. - Plans to **double hospital revenue** through improved occupancy and high-end procedures. 2. **Grow Implant Business to $100 Million Global Enterprise** - Ambitious goal: Scale Shalby MedTech into a **$100 million business** in the next 3–4 years. - **Target $8 million incremental revenue** from high-reimbursement markets: Latin America, Southeast Asia, and Russia. - Shift from **wholesale to retail (direct surgeon sales)** for higher margins. - Achieve **30% reduction in COGS** via procurement optimization, multi-vendor sourcing, supply chain resilience. 3. **Scale SOCE Franchise Network to 40+ Centers** - Asset-light expansion into Tier 2/3 cities across India. - Leverages strong **brand equity, surgeon training, and operational systems** for rapid deployment. - Enhances referral network and national footprint. 4. **Integrate Digital & Homecare Platforms** - **Homecare Services**: - Serves high-risk, post-op, and geriatric patients with **nursing, physiotherapy, diagnostics, pharmacy, and ICU-at-home**. - Growth driver due to **lower infection risk, cost efficiency, and insurance support**. - Scaled into tier-2/3 cities with a tech-integrated model. - **AI & Telemedicine**: - Developing **AI-assisted diagnostics and tele-consultation platforms** for remote access. - Digital patient records, CRM integration, and AI chatbots improving patient engagement. 5. **Global Expansion & Medical Tourism** - **70%+ revenue from international patients** at Sanar Hospital, Gurugram—key growth engine. - Foreign partnerships in UAE, Oman, Bangladesh, Nepal for **OPD services, camps, and surgeries**. - Strategic focus on **medical tourism corridors** in North Africa, Middle East, and CIS. - Regulatory approvals being pursued in **Argentina, Colombia, Malaysia**. --- ### **Financial & Operational Highlights (FY25)** | Metric | Value | |-------|-------| | **Hospital Division Revenue** | ₹8,991 million | | **Implant Business Revenue** | ₹930.6 million (+67% YoY) | | **SOCE Franchise Revenue** | ₹131.8 million (+28% YoY) | | **Total Joints Replaced (FY25)** | ~15,000+ | | **Hospital Bed Capacity** | >2,300 | | **Average Bed Occupancy** | 46% (with significant runway) | | **Organ Transplants Performed** | 450+ | | **Joint Replacement Surgeons** | 300+ (with training via Shalby Academy) | | **Global R&D & Engineering Team** | 15+ engineers hired in India/US | --- ### **Supporting Initiatives** - **Shalby Academy**: - Flagship education wing offering **allied health sciences, paramedical training, hospital management**. - **22,000+ student enrollments in FY25**, including MBA in Hospital Management, PharmD training, and AHA certifications. - Partnerships with **Kaushalya, Ganpat University, Shard College**. - Addresses skill gaps and builds internal talent pipeline. - **Sustainability & Operational Excellence**: - **Asset-light model** reduces ROCE pressure: uses **revenue-sharing O&M** instead of fixed rent. - **Centralized procurement, in-house design teams**, and **efficient OT-to-bed ratios** keep capex and opex industry-leading low. - Achieves **>20% EBITDA margins** in mature hospitals.