salauno aims to become Mexico’s leading surgical eye care provider, performing 25,000 surgeries annually. © salauno
In 2005, Carlos Orellana and Javier Okhuysen were two aspiring entrepreneurs working as investment bankers in Madrid. Both trained as engineers but wanted to build a company that could do well by doing good. Inspired by the work of India’s Aravind Eye Care System—a non-profit organization that has made cataract surgery widely available by cutting the cost of the operation—they took the model to Mexico and transformed it into a commercial enterprise.
Mexico, as they knew, had a particularly large unmet demand for ophthalmology services as well as the highest prevalence of diabetes in the world. (All forms of diabetic eye disease have the potential to cause severe vision loss and blindness.) At the time they researched the market, public hospitals performed an estimated 67 percent of cataract surgeries. Okhuysen and Orellana felt that they could carve out a significant market share if they could drive costs down and guide patients from diagnosis to health outcome at a very large scale.
In August 2011, with close to $1 million of their personal savings, Orellana and Okhuysen opened the first salauno surgical center in Mexico City, aiming to eliminate needless blindness for patients of all income levels. In April 2014, IFC invested $2.2 million in salauno, citing the large unmet need for eye care in Mexico and the founders’ clear understanding of the market.
Since its founding, the company has grown quickly to treat more than 80,000 patients a year. Its goal is to become a top cataract surgery provider in Mexico, treating 500,000 patients and performing 25,000 surgeries each year.
Around the world, cataract surgery is the most frequently performed type of surgery, consistently producing excellent outcomes for patients. Success rates are over 95 percent and total recovery time can be less than one week, with some patients recovering vision in as quickly as a few hours.
But in Mexico, people with cataracts had few options for surgery. In 2011, public hospitals offering free cataract surgeries were unable to accommodate the volume of patients, and waiting times could be as high as a year. Patients with other pathologies—such as diabetic retinopathy and glaucoma—had even lower access to care. Private providers offered better quality and more timely services, but their prices were too high for much of the population.
salauno conducted market research to determine a price point for basic cataract surgery that would be within reach of low-income patients who had to pay out of pocket. It settled on a fixed package price for this market segment of 6,500 pesos, approximately $550 at the time. This figure, which was 50 percent below the market price, was possible because the company recovered its fixed costs through other service options and partnerships.
Providing cost-efficient, high-quality solutions to eye care in Mexico is just the start of salauno’s long-term vision. It also sees the potential to replicate its business model and open surgical hubs in more cities in Mexico.
Training and accrediting a new generation of health-care professionals were also part of salauno’s strategy. In 2012, with funding from the Inter-American Development Bank, salauno created an official accreditation program to certify ophthalmologists in cataract and refractive surgery and to give nurses specialization in eye care. The company initially attracted doctors by giving them the opportunity to learn a new surgical technique not used by other Mexican providers and to improve their skills with a high volume of surgeries.
The company’s original social mission has gained strength as the company has grown. As of 2015, more than 30 percent of its patients were from households earning less than $899 per year. Because credit is expensive in Mexico, the company sees patient financing as a growth area with potential to develop in the future.
Along with the lower cost of service came efficiencies that have enabled salauno to reduce patient wait times when compared to the wait times of its competitors. Patients can see a doctor within 60 minutes of arriving at a clinic, and if needed, they can have surgery within five days. By comparison, wait times to see a specialist at public hospitals could be up to six months, while surgery dates were booked eight to 11 months in advance.
IFC invests in companies like salauno that are working to bring best practices to health care and life sciences and that are innovating to adopt technologies and processes to control costs and serve emerging markets. Our roles include direct and indirect investments in health care and life sciences companies, sharing industry knowledge, raising management and clinical standards, informing government policy, and supporting public-private collaboration in health.
Learn more about salauno in the report Creating an Inclusive Market for Eye Care
To know more about IFC’s work in health, visit www.ifc.org/health.
Visit www.salauno.com.mx to learn more about the company.
Published in May 2017