Patient is last beneficiary of cancer treatment; Accel & IDG-backed startup Onco.com aims to change thisDipti Nair
Onco.com is an online platform that helps cancer patients get scientific treatment advice as per the latest international guidelines through its network of world-class oncologists in the US and India.
At a Glance
Founders: Rashie Jain, Dr Amit Jotwani
Year it was founded: 2017
Where is it based: Bengaluru
The problem it solves: A virtual cancer hospital for middle-income countries
Funding raised: Pre-series A funding from Accel and IDG Ventures
The patient, if at all, is the last beneficiary of cancer treatment.
Shocking as this may sound, ask anyone who has lost a loved one to cancer, and they will nod in agreement. The horrible truth about cancer treatment is that the patient is the least worry of the system.
Consider this scenario. A family finds out that the chronic backache of a member is, in fact, an indication of the last stages of cancer. Their doctors do not tell them what cancer it is. Relatives and friends advise them to go to a particular hospital that is most probably located in another city.
FDs are broken and life is disrupted. A few lakhs and hours of chemo and surgery later, the family returns to their hometown empty-handed.
“It is very important that each patient gets the right treatment plan, only then will we have the right results,” says Dr Amit Jotwani, Co-founder of Onco.com. He adds,
“We believe that the right treatment plan is as important as the treatment itself.”
Rising burden of cancer
Founded in 2017, by two passionate individuals as different from each other as chalk and cheese, Onco.com is aiming to fix the broken chain of cancer treatment in developing countries.
“We founded this company with the philosophy that every patient has the right to know what is the best treatment for them. Cancer is a very complex disease. It requires a multi-disciplinary approach. Unfortunately, in developing countries, they do not get this. Patients often just go to one specialist who decides what is best for them. What we want to bring in is a multi-disciplinary approach to treatment planning. We want to empower patients with the best treatment plan they can have for the best outcomes possible,” adds Dr Amit, who is himself an oncologist.
Let’s look at the rising cancer burden in India. Indian Council of Medical Research (ICMR) in its study earlier projected 1.7 million incidences of new cancer cases by 2035. But the incidence grew faster than projected, and 14 lakh (1.4 million) new cases were reported in 2016 in India.
Now, ICMR states that we could see 17 lakh (1.7 million) new cases of cancer in India in 2020 itself (instead of the earlier estimated 2035).
The World Health Organisation states that “cancer is one of the leading causes of morbidity and mortality worldwide, with approximately 14 million new cases in 2012. The number of new cases is expected to rise by about 70 percent over the next two decades”.
Rashie Jain, the dynamic CEO and Co-founder of Onco.com, states that they are attempting to build a virtual cancer hospital for middle-income countries. “On our online platform, we provide quality counselling from the world’s best oncologists at every stage of the disease. Today, 50 percent of cancer patients reside in developing countries, but 70 percent of cancer deaths happen in these countries. This is because of lack of access to good oncologists and poor quality of counsels that they get. We are solving this huge problem through our online platform,” says Rashie.
Virtual tumour boards
Onco.com recently raised a pre-Series A funding round with Accel and IDG Ventures. Ranjith Menon from IDG says, “Fourteen to 15 million people discover they have cancer every year globally. This is a traumatic experience. A platform that can help people navigate their disease better was our inspiration behind backing the team at Onco.com.”
Adds Barath Shankar Subramanian of Accel, "In India, and in several middle-income countries, the doctor-to-patient ratio is severely poor. For seven lakh new cancer cases every year, there are only 2,000 oncologists in the country. During our diligence efforts, we believed that there was tremendous work to be done in cancer care delivery, and the need to fill the gap in analysing medical information and prognosis provided to patients. Onco.com enables patients to access the best cancer specialists in the country and outside, and identify the optimum treatment in the comforts of their homes."
According to Rashie, they plan to use the capital to expand their operations in more geographies, especially in Africa and build a solid team.
Globally, there are a few online doctors-on-demand platforms like cancerdocs.com and Driver.xyz, where patients can go for a second opinion.
What sets Onco.com apart, as Rashie claims, are its unique virtual tumour boards and its network of oncologists. “Our oncologists are getting used to providing opinions in a certain way through the structures we have put in place, which allow them to deliver their opinions in 15 minutes as opposed to say two hours. That’s the IP of the company. We are working with doctors who are getting used to that. Secondly, we have to create value for the doctors themselves. They respect the virtual tumour board that allows them to share knowledge with their peers. It is not just a random WhatsApp group,” she says, adding that it is not easy to replicate this network. “We are not a brokerage firm. We control everything.”
As part of its virtual tumour board service, Onco.com builds a multi-disciplinary panel of global specialists for patients to get collaborative and relevant advice as per latest scientific advancements for their cancer. Empowered with the right information, the patients can then choose to get the treatment delivered at their preferred geography/hospital in a more cost-effective manner.
Since inception, Onco.com has served thousands of cancer patients from more than 13 countries around the world. The network has empaneled over 150 senior site-specific cancer specialists from both India and the US.
Rashie says to make themselves a patient-first platform, they had to go B2C. They make money directly from consumers. “We charge a flat fee. But hopefully, in future we can partner with insurance companies,” she says.
Consultations with Indian doctors is at Rs 7,000 for a panel, while for US doctors it is $850. “We have a revenue share with doctors. We are also looking to a B2B strategy for Africa for now so that we can empower the local ecosystem in the countries there,” adds Rashie adds.
An IIT Kanpur alumnus, Rashie has a Btech degree and a short but rewarding career in heathcare till she decided to set up Onco.com. “I worked in JP Morgan’s equity research division that focuses on biotech startups in the US. It was fascinating to work closely with companies making cutting-edge drugs,” she says. This brought her an opportunity to work in Biocon as the project manager of a biosimilar breast cancer drug. Thereafter, she went on to pursue her MBA at Wharton and major in healthcare management and entrepreneurial management.
At Wharton, she shared her idea of setting up an online platform for cancer consultation with her professor Stephen Sammut. The professor, who also taught at Indian School of Business (ISB) in Hyderabad, pitched her idea to his class at ISB that included Dr Amit.
Dr Amit, who interestingly was studying healthcare management, warmed up to Rashie’s idea. He is a radiation oncologist with over 12 years of clinical experience.
“We did not know each other, but six months down the line so much started to make sense,” Rashie recalls. “We had achieved our proof of concept, we had started generating revenue, we learnt so much about how we will build this company. Two things became very clear: it has to be B2C company. We have to make it patient-centric. The second thing was, we also wanted to be a medical company, so we have to be very responsible how we provide the medical opinion. It cannot be just some substandard document you are giving to patients.”
This meant spending a lot of time building protocols around latest research in the field and documenting the templates, and Dr Amit became the best person to do that as Onco.com’s Chief of Medical Affairs. “As part of his job, he was also taking care of templatising all the repository that we had. What kind of questions patients have, what kind of treatment is available, and also became responsible for onboarding doctors. I was responsible for our marketing efforts and operations,” Rashie adds.
Today, they are a 15-member team.
Dr Amit says that before his professor shared Rashie’s idea, he was also thinking on similar lines but more on the domestic cancer patients' front and had even bought website domains like 'indiacancerguide.com' and scancelp.com' to plan something around helping patients get the right treatment with the right doctors.
“Later, when I met Rashie I realised we had a common philosophy that each cancer patient should get the right treatment guidance from Indian or US oncologists. That's when we joined hands and started working on this project,” he says.
According to Dr Shankar, Senior Consulting Oncologist, HCG hospitals, Mumbai (trained at MD Anderson, Tata Memorial), there are several centres available to serve cancer patients, but most of them do not provide a comprehensive review for the patient, which many times results in inaccurate treatment.
“Cancer treatment requires a comprehensive review of patient's clinical condition by a team of experienced oncologists in light of available scientific protocols. The part I like about Onco.com’s approach is that the process rests exclusively on evidence-based collaborative approach by experienced clinicians who are specialised into specific domain practices, which makes it a patient-centric approach for better therapeutic outcomes,” he adds.
Rashie says as a result of their consultations, nine out of 10 times patients have been advised not to travel to bigger cities. “Most of the time it is an issue of medication,” she says, adding,
“The issue of procuring medicines will eventually solve, but what will remain is the dearth of specialists. So if you can create a platform and bring all specialists on that platform for patients to access internationally, you have created value.”
Talking about the future of healthcare, Rashie says, “Treatment planning will be on the cloud and treatment delivery at the spoke. This will ensure it is cost effective. There are diagnostic centres coming up in smaller towns. Other startups are bringing in cost-effective service providers. In the US, there are chemo centres in small towns, and patients talk to their specialists on apps. We need to have that here in India as well.”
With healthcare in India and other developing nations itself in need of an intensive care unit, efforts like Onco.com bring in much-needed respite to cure the system. And hopefully, put the focus of cancer treatment back on the patient.
(Pictures by Vincent Arthur)