India’s primary market braces for surge of hospital and IVF IPOs next year

Mumbai: India's primary market is set for a heavy infusion of healthcare companies, including several in-vitro fertilisation (IVF) chains, next year, with public issues worth about ₹20,000 crore expected to hit the Street. According to investment bankers, a mix of large hospital groups and rapidly growing IVF platforms have either filed draft papers or are close to doing so. Manipal Hospitals is preparing to file for an IPO estimated at ₹8,500-9,000 crore, which will be one of the biggest issues in the healthcare space in 2026. The company runs the country's second-largest hospital chain. Another southern operator, Kauvery Hospital, is expected to raise over ₹1,500 crore through its planned offering. Asia Healthcare Holdings is preparing to tap the market. Indira IVF refiled its papers in July 2025 via the confidential route for an issue size estimated at around ₹3,500 crore. Among maternity and child-care chains, Bengaluru-based Cloudnine is said to have begun its IPO process and is expected to raise over ₹1,000 crore. 125992874 Investment bankers are of the view that a combination of stronger fundamentals and favourable valuations is prompting these companies to go public. "Hospital chains are showing steady volume growth, improving margins and greater consolidation, which gives investors better visibility," said Shirish Chikalge, who leads the pharma and healthcare practice at IIFL Capital Investment Bank. "Valuations are encouraging promoters to accelerate timing, but the underlying business momentum is clearly stronger than in previous cycles." Paras Hospitals, which had filed in September 2024 for an issue of over ₹1,000 crore, is likely to refile documents for an IPO. Hyderabad-based Yashoda Hospitals has submitted a confidential filing for a public issue pegged at around ₹4,000 crore, adding to the already sizable pipeline. Emails sent to the hospitals remained unanswered. Private equity funds are using the public markets for partial exits, but promoters are also raising fresh capital for expansion, new beds and deleveraging. "The OFS-fresh issue balance varies by company, and that's what investors should focus on," Chikalge said. Offer for sale (OFS) allows existing shareholders to sell stock. India's healthcare sector continues to be underpenetrated relative to developed and some developing economies. With big healthcare delivery companies now well-capitalised and holding substantial debt capacity, current valuations offer an attractive opportunity to raise growth capital, according to Siddharth Iyer, director - healthcare and pharma investment banking team, Equirus. Public markets have always traded at a premium to private ones, given the lower risk owing to higher liquidity.However, the current delta between the two is prompting many healthcare delivery companies to opt for a public listing, Iyer said. The sector is set for a boom, fuelled by the rapid expansion of healthcare and diagnostic chains in the country’s organised sector. Data show India lags behind peers such as Sri Lanka and Malaysia in healthcare expenditure as a percentage of GDP, which stood at 3% in 2023. On other parameters such as hospital beds per 10,000 population, India has 16 compared with 50 in China, 20 in Malaysia and 23 in Thailand. Opportunities for inclusive health have emerged with the Pradhan Mantri Jan Arogya Yojana (PMJAY), a nationwide health protection scheme that has close to 110 million families covered for medical procedures. In addition, medical tourism is spurring demand at India’s top hospitals. The medical tourism industry is expected to more than double next year from $6 billion five years ago. On average, the cost of surgical procedures in India is less than a 10th of prevailing US rates, while patients in many developed markets have to wait in queue for several years for certain operations. An investor presentation by Apollo Hospitals showed rates for hip replacement in India at $7,000, the lowest among countries such as South Korea, Singapore, and Thailand, while in the US it costs $50,000. IVF is another segment poised to see a significant surge from current levels. The infertility rate in India is pegged at about 15% but IVF or Assisted Reproductive Technology (ART) services reach only about 25% of the addressable market.