Long before Madhukar Gangadi, CEO of MedPlus, opened his first store in Hyderabad, another vision had already taken root, larger and more deeply embedded within India’s emerging private healthcare system. MedPlus may have been the disruptor, but Apollo Pharmacy was the original architect of organised pharmacy retail in India.

By the mid-to-late 1980s, Apollo had decided to diversify beyond hospital walls. The group launched Apollo Pharmacy, its first pharmacy outlet, in 1987 in Chennai. It was the beginning of what would become India’s first pharmacy chain. What started as a few Apollo storefronts offering 24/7 access to genuine medicines quickly transformed into familiar outposts in many cities by the time MedPlus started reaching these locations.

Through the 1990s and 2000s, Apollo Pharmacy remained in the shadows of Apollo Hospitals. But it continued with a steady expansion across urban India, laying the foundation for what would grow into a network exceeding 1,000 stores by the early 2010s. Between 2010 and 2014, the network scaled rapidly. The year 2014 marked a major acquisition as Apollo picked up 320 stores of Hetero Med Solutions, significantly expanding its national footprint. In the next three years, Apollo Pharmacy was integrated with Apollo’s healthcare delivery. From 2015, Ask Apollo linked over 1,500 stores with hospitals and diagnostics.

By 2019, Apollo Pharmacy had strengthened backend operations and supply chains, scaling to 3,000 outlets, positioning itself as India’s largest pharmacy chain. In 2020, the launch of Apollo 24/7 marked a shift to omnichannel care, integrating digital services with offline accessibility through a network of 3,700 pharmacies. The chain’s omnichannel strategy paved the way for Apollo HealthCo in 2021. This marked the fusion of its physical pharmacy business with Apollo 24/7, the digital healthcare arm offering teleconsultations, online ordering, diagnostics, and more.

As early as 2022, high-profile investors such as General Atlantic, SoftBank, and others reportedly held talks to invest up to $500 million in Apollo HealthCo, which was then valued at around $3 billion. In 2023, media reports indicated the group considered selling 5%-6% of Apollo HealthCo to raise around $200 million.

In April 2024, Advent International committed approximately $300 million via compulsory convertible instruments split across two tranches. This secured them 12.1% equity in the merged entity of Apollo HealthCo and Keimed, a leading pharmaceutical distributor. After the merger, it was understood that Apollo Hospitals would retain 59.2% and Keimed shareholders 25.7% in the combined entity.

In July 2025, four different pharmacy wings of Apollo Group – Apollo HealthCo, Apollo 24/7, Apollo Medicals, and Keimed – were consolidated into a new entity named NewCo. The plan approved by Apollo Group’s board of directors stipulated that Apollo Hospitals would hold 15 per cent in NewCo to ensure continued influence and integration. The new entity projected a revenue of Rs 25,000 crores by 2027 with at least a 7% EBITDA margin.

Much after Apollo and MedPlus came another pharmacy chain named Netmeds in Chennai in 2015, under the aegis of Vitalic Health Pvt. Ltd, led by second-generation pharma entrepreneur Pradeep Dadha. It, too, raised significant capital through multiple funding rounds. In 2015, it secured $50 million in Series A funding, supported by investors such as OrbiMed and the Dadha family office.14 Two years later, a $14 million Series B round was conducted with participation from Sistema Asia Fund and Tanncam Investment. This was followed in September 2018 by a $35 million Series C led by the Daun Penh Cambodia Group, along with the earlier backers. These investments fuelled Netmeds’s growth as a full-stack digital pharmacy, enabling platform development, logistics improvements, and marketing campaigns.

By 2020, Netmeds had carved out a prominent place in India’s e-pharmacy ecosystem. That August, Reliance Industries, via its subsidiary Reliance Retail Ventures Limited (RRVL), acquired a 60% majority stake in Vitalic (Netmeds’s parent company) for approximately Rs 620 crores in cash. This deal gave Reliance Retail 100% ownership of Vitalic’s subsidiaries, such as Netmeds Marketplace, Tresara Health, and Dadha Pharma Distribution. Today, NetMeds has become Reliance’s pharmacy arm, integrated into the JioMart ecosystem and backed by the promise of last-mile delivery. Yet, Reliance’s pharmacy push remained subtle and more experimental, focused on leveraging its retail infrastructure rather than dominating the digital vertical.

Even as new-age challengers like Netmeds gathered momentum, the sheer depth, reach, and trust of India’s physical pharmacy networks, led by incumbents like Apollo Pharmacy, remained formidable. Built over decades through proximity, reliability, and an entrenched supply chain, these brick-and-mortar ecosystems were not to be easily dislodged. They geared up to adapt, absorb, and converge with the digital wave, setting the stage for the next phase of competition.

In the year 2012, five young men from the Mumbai suburbs, childhood friends bound by gully cricket and college corridors in Ghatkopar, were scripting a parallel story.

Dharmil Sheth, Dr Dhaval Shah, Harsh Parekh, Hardik Dedhia, and Siddharth Shah were reimagining the space of retail pharmacies. The seed of their idea was first sown in an IIM Ahmedabad classroom, where Siddharth Shah, then a student, proposed India’s first online pharmacy as part of an academic exercise. When a professor challenged him to “Launch it, don’t just plan it”, he took it seriously. Thus, DialHealth.com was born.

But the optimism of theory soon collided with the chaos of India’s fragmented pharmaceutical supply chains. The idea continued to evolve and restructure, gradually shifting through various chemist partnership models, wrestling with last-mile logistics, and learning to navigate regulatory grey zones, before finally crystallising as PharmEasy in 2015.

What set PharmEasy apart was not flashy technology or deep-pocketed funding, but the resolve to reorganise the system from within. They bootstrapped the company using borrowed spaces and by mortgaging family homes. “We didn’t have the luxury of making mistakes,” Dharmil Sheth later said. That grit paid off. Within six months of raising their first external capital, PharmEasy’s valuation jumped from Rs 50 crores to Rs 150 crores.

Their innovation was deceptively simple: don’t replace the neighbourhood chemists; empower them. The aggregator model became PharmEasy’s signature, blending technology with trust to create a delivery network that reached deep into the city’s veins. The success of the aggregator model did not go unnoticed for long. Temasek, TPG Growth, Prosus, and others lined up, propelling PharmEasy to a $5.6 billion valuation by 2021. In just a few years, what began as a student project and a street-side dream had become the face of India’s healthtech revolution.

In June 2020, PharmEasy pulled off a strategic masterstroke by merging with Ascent Health, India’s largest offline pharma distributor. This union birthed API Holdings, a parent entity that combined B2B logistics muscle with a fast-growing, consumer-facing platform. The merger built a formidable digital–physical pharma retail hybrid.

The momentum continued. In May 2021, API Holdings acquired Medlife, one of its fiercest rivals. The consolidation sent shockwaves across the e-pharmacy ecosystem: Medlife’s customers, technology, and logistics were now absorbed, solidifying PharmEasy’s position at the top.

But the boldest move came in June 2021, when PharmEasy (read API Holdings) acquired a 66.1% stake in Thyrocare, India’s leading diagnostics brand, for Rs 4,546 crores. It was the first time a healthtech startup had taken over a listed diagnostics giant. Through Thyrocare’s deep diagnostics network, PharmEasy now offered not just doorstep medicines but also lab tests, preventive care, and health packages. It was laying the blueprint for an integrated healthcare model.

Buoyed by investor capital and emboldened by rapid growth, API Holdings filed for a Rs 6,250 crore IPO in November 2021.20 At that point, the company was reportedly valued at around $5.6 billion. But the optimism hit market headwinds. By August 2022, PharmEasy quietly withdrew its IPO plan, moving towards structured private capital and internal streamlining.

But in a short while, PharmEasy began testing offline franchise models, especially in tier-2 and tier-3 towns where local pharmacies still reigned. The stores carried PharmEasy branding, stocked inventory through its tech-integrated supply chain, and served as neighbourhood health anchors. By going back to the brick-and-mortar model, the platform was learning that even in a digital-first world, proximity and presence mattered.

PharmEasy’s meteoric rise and Reliance’s Netmeds acquisition caught the attention of India’s most trusted conglomerate: the Tata Group.

That’s how the Tata Group set its sights on an online pharmacy – 1mg.

Originally founded in 2015 by Prashant Tandon and Gaurav Agarwal, 1mg began with a simple but powerful premise – price transparency in medicine and access to authentic drugs. It grew slowly, prioritising building trust over blitzkrieg expansion. That ethos attracted Tata Digital, which soon acquired a majority stake (~55–62%) in June 2021 for $220 million–$240 million.

Now rebranded as Tata 1mg, the platform retained its core services, such as e-pharmacy, diagnostics, and e-consultation. It simultaneously began expanding on the strength of Tata Group’s credibility and deep pockets. The association brought trust, a priceless commodity in healthcare, to 1mg. Consumers began viewing 1mg as a convenient digital player and as a reliable extension of the Tata promise.

The 1mg platform also eyed omnichannel growth, testing physical stores in metros, and strengthening partnerships with labs, hospitals, and insurers. By 2023, Tata 1mg overtook PharmEasy in digital pharmacy market share, holding approximately 31% compared to PharmEasy’s 15%. The quick shift reflected its ability to gain and retain public trust, stable leadership, and operational prudence.

Other players like Amazon Pharmacy and Flipkart’s health forays (via Flipkart Health+, built through the acquisition of SastaSundar) also entered the fray, but they remained marginal challengers.

Today, the contours of India’s digital health economy are pretty clear. PharmEasy, though bruised, is evolving into a B2B2C hybrid, leveraging its diagnostics and supply chain muscle. Tata 1mg has emerged as the most trusted name in digital health, with increasing omnichannel strength and steady diagnostics growth. NetMeds and Flipkart Health+ have survived through conglomerate backing but have yet to disrupt.

What began as a grassroots disruption to democratise access to medicines and ensure last-mile delivery has slowly morphed into a global chessboard of control. The case in point here is API Holdings, PharmEasy’s parent, which has attracted significant interest from global investors like Temasek Holdings, TPG Growth, Prosus Ventures (Netherlands), and B Capital (founded by Facebook cofounder Eduardo Saverin). Behind its ambitious growth lies a steady infusion of foreign capital, each round of funding nudging the startup further away from Indian ownership and closer to the preferences of international shareholders.

Meanwhile, Tata 1mg, with its credibility anchored in the Tata name, has quietly been folded into India’s broader digital empire through Tata Digital, which itself has become a magnet for global investors. The parent conglomerate has already raised billions in overseas capital through bonds and equity placements, meaning that even Indian giants like Tata are increasingly answerable to institutional investors sitting in Singapore, New York, and London.

In the name of efficiency, scale, and reach, the digital pharmacy ecosystem has become a sandbox for foreign control. Pricing decisions, data ownership, inventory management, and even drug sourcing are affected.

The result?

What looks like a consumer victory – home delivery of medicines, discount-led diagnostics, and slick apps – masks an uncomfortable truth. As investor pressures mount, the discounts shrink. Exclusive tie-ups and algorithms begin to nudge consumers towards higher-margin drugs. Smaller pharmacies, once the backbone of Indian healthcare access in India, increasingly find themselves being squeezed out.

And the regulatory radar? It trails behind innovation, allowing data privacy risks and potential price manipulation to slip through the cracks. The consumer who once walked into the corner store and bargained with a familiar face for medicine, now scrolls through impersonal apps shaped by Silicon Valley-style incentives.

And at the end of the pipeline, it is the foreign investor, not the patient, who receives the final dose: profit.

Excerpted with permission from The Silent Syndicate: How Big Finance Is Destroying India’s Healthcare, Ameer Shahul, Hachette India.

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