About 4 years ago we were involved in a commercial due diligence effort related to a hemodialysis company. This time again we had the chance to validate an investment thesis, but this time it was for a company active in the home dialysis space. For years, people have been saying that Home Dialysis (HHD & PD) is the future. But it seems that there are various barriers to adoption. Some are related to the product, some to the patient population, but very often there is a market access component as well. A new therapy often does not fit established reimbursement schemes. Unfortunately for innovators, it is not enough to have a safe and efficacious therapy that is approved by the regulatory bodies and liked by the patients. If the funding is not there, everything may collapse.
The dialysis space offers a number of investment opportunities, now that consolidation is increasing. Some niche players may be interesting targets. We did a reality check of an investment thesis using primary and secondary research. It is fascinating to hear how customers have a very good view on suppliers despite the fact that they are not familiar with the business aspects "behind the scenes". Never underestimate a customer! They watch you, they judge you. They are your ideal coach. Detached and critical, but with a vested interest (the want good therapies for their patients).