ET BureauAfter two decades of running a textile business, Vasanth Kumar and his partners were itching to diversify. Their company in Tirupur, Shakthi Knitting, was already one of the largest fabric and garments manufacturers in the country. A quick market study was enough to convince them that healthcare was a good business to attempt. The Indian healthcare market was rapidly expanding, and there was no devices industry in the country to speak of. Kumar and his co-founders chose this field without hesitation, and quickly formed a subsidiary, SKL Medtech.
As a garment manufacturer, Shakti Knitting was already dealing with antimicrobial garments, mainly as a means to prevent odour. This wasn’t sophisticated technology, but it made them aware of the problems of anti-microbials. Scientists around the world were waging a losing battle with microbes, as they were gaining resistance to every new antibiotic.
SKL, with its founders being primarily engineers, was the last company to look for a next generation anti-microbial. But being engineers, their minds were not working like those of scientists. "We were looking at a textile-based solution," says Kumar. SKL’s first product, a wound dressing called Theruptor, works in a way no other product in the market does. It attracts nearby bacteria using electric charge and pierces their cell walls using molecular needles. No biochemical process, no meddling with bacterial metabolism, and so little chances of resistance ever.
The product worked well in animal trials, and SKL is now developing it into a medical device to be sold all over the world. Being a class-II device (medium risk), it will take just four months of them to get it through the mandatory regulatory clearance. If it goes well, SKL would have a foot into the $6 billion global wound-care market.
Forget the future of this device for a moment. A few years ago, it would have been hard to find a company like SKL Medtech, a manufacturing company diversifying into medical devices. But now medical technology seems to have caught the imagination of entrepreneurs and engineers in the country, and a large number of them have ventured into this difficult terrain. Some of them are attracted by the complete absence of medical products for rural areas but their inventions seem to be good enough to get them a global presence. They could be building a substantial industry over the decade.
The Biggies Check in
So far, India has had no presence in the global medical device market, and most of the devices used in the country — with some exceptions like cardiac stents — are imported. Now, we can see the first stirrings of a major industry, as multinationals have started designing several products for the country, and Indian startups and established companies are joining them. Supporting them are design and engineering centres sprouting in R&D institutions, and the large amount of money the government is spending on medical technology development.
Also building expertise in the country are IT services companies like Wipro, who are trying to work with the large number of device manufacturers around the world. The Indian medical electronics market is growing too. According to Frost and Sullivan, a consultancy, it will grow from $6.5 billion (about Rs 40,000 crore) now to $11.5 billion (about Rs 70,000 crore) in 2017, a compounded annual growth rate of 16 per cent.
Since rural areas are not serviced enough by large players, it is a largely untapped market available for anyone willing to innovate. Says Shyam Vasudev, president and chief technology officer of Forus Health, an ophthalmology device startup: "Entrepreneurs these days are very excited about healthcare devices."
Vasudev himself is one of the prime movers of this industry. He has been eying this market since 2002, when he understood the potential of healthcare devices while working as an engineer for Ericsson in Stockholm. When he moved to India and Philips R&D, he mooted the idea of making products for rural areas within his company.
That was seven years ago, when medical devices were considered for the rich, and no one had taken the rural market seriously. But things changed quickly, as General Electric and Philips themselves started unleashing a revolution, and a complete change of mindset. In some ways, CK Prahlad’s paper ‘Fortune at the Bottom of the Pyramid’ was instrumental in driving this change of mindset.
Philips changed its approach and has launched a few products in recent times that look at healthcare devices from a different perspective. Among other things, it asked this question: how can you identify chronic diseases at the point of occurrence? About 730 million — of the 1.2 billion in the country — live in rural areas, and the nature of chronic diseases is not very different there. Yet people are not diagnosed early enough because they need to go to towns for their health check-ups.
The solution is to shrink devices, make them easy to use, and take them to rural areas. As all the multinationals discovered, this shrinking needed complete reengineering. In the last few years, Philips has launched several products that attempted to make devices portable. Examples include an ECG device, an ultrasound device and infant warmers. Other multinationals too came up with similar ideas, the most prominent of which was GE.
The Ecosystem Builds
GE set up its John F Welch Technology Centre in Bangalore in 2002. Healthcare technology was one of its focus areas right from the beginning, but the mindset change became visible around 2008. GE launched its first product for the country, a portable ECG system. So far it has launched 25 products, most of them engineered from scratch specifically for rural India and, by extension, for the rest of the developing world. During the last six years, GE engineers also learned a lot about rural India, and how people think and work there.
More than anything else, it learnt that it was important to work with customers right from the beginning. So, a few months ago, it built its first co-creation lab, called E Cube. Potential customers come from around the country and work with GE designers in the lab. Its first few products are about to be launched.
One of them is a baby warmer. A completely new PET/CT scanner is another device, for which oncologists in India spent two full days at the centre. Over the next few years, this lab could be the birth place of a large number of GE products for India. Says Shyam Rajan, chief technology officer, India, of GE Healthcare: "There has been a tremendous improvement in the ecosystem in the last few years."
He identifies several aspects to this change. For example, doctors and engineers have now begun to work together.
This is also driven by the urge for innovation, especially from R&D institutions. But the ecosystem is far from complete. Since India is in the early stages of this industry, a large number of components of the ecosystem are yet to fall in place.
In a recent study, InnAccel, a Bangalorebased accelerator, identified five challenges specific to this sector: access to physical infrastructure, technical expertise and resources, lack of product engineering expertise, team members and access to capital.
"It is very difficult for engineers to get into the emergency room or the operation theatre," says Siraj Dhanani, cofounder of InnAccel. "Through our programmes, product engineers can now get into these settings within two to three days."
The Incubators…
Vigorous government programmes are addressing some of these challenges. The Government of India has funded some centres for healthcare devices, the two most prominent ones being at IIT Madras, and at All Indian Institute of Medical Sciences (AIIMS) and IIT Delhi. The IIT Madras centre, cal led Healthcare T e c h n o l o g y Innovation Centre (HTIC), has helped some companies design products, apart from developing new products of its own. The AIIMS-IIT Delhi centre, in collaboration with Stanford University, trains people to develop healthcare devices. In two years, it has already spawned seven companies.
HTIC was funded by the department of biotechnology to develop competence within the country in healthcare technology. Set up in 2011, it has so far spent Rs 25 crore, two-thirds of which was from the department and the rest from private companies.
Now, the majority of its funding comes from projects sponsored by private companies. GE, for example, is sponsoring a technology development project there. But it also develops technology of its own, some of which has penetrated the Indian market already. One of its early products, a mobile eye surgical unit, has finished 1,000 surgeries so far. Its second product, a software platform called Eye-PAC, was used as an image-processing platform by 3Netra of Forus Healthcare. 3Netra, a revolutionary product that could diagnose five major eye diseases automatically, is now going through several advancements.
Its third device could be equally revolutionary when it comes to the market. It is a cardiovascular screening device that measures the stiffness of the arteries and gives a read-out without an image. "We are trying to build a disruptive device," says Mohan Sivaprakasam, assistant professor at IIT Madras and head of HTIC. "We are attempting to make a device for early cardiovascular screening at a few hundred rupees."
…And Startups Follow
HTIC would soon need an industrial partner to take this forward. The other project funded by the department of biotechnology, in collaboration with the Department of Science and Technology and Stanford University and others, is creating products and companies rapidly. So far, in its short existence of four years, it has transferred seven technologies, a record for a government-funded programme.
It works through a completely novel method. It funds four fellows every year — a doctor, a mechanical engineer, a designer and a business person — for a six-month training programme at Stanford University. "There isn’t enough interaction in India between engineers and doctors," says Rajiv Doshi, consulting associated professor medicine at Stanford University and head of the Stanford-India Biodesign.
The fellows can come back and do what they want, but a majority of them have started companies together based on the ideas they have worked on while at Stanford. They have so far resulted in 22 devices, some of which are novel ideas for products that do not exist anywhere in the world.
These include a limb immobiliser after traffic accidents, a method to screen newborn babies for hearing loss, a device for neonatal resuscitation, and a liver-biopsy device. The limb immobiliser and the hearing-loss screening devices are in the market. The others are under development. The liver-biopsy device, made by the Bangalore startup IndioLabs, is an extremely high-tech product that tries to go beyond incumbents in the market, and not just in portability and cost. Liver biopsies are necessary to diagnose cirrhosis of the liver correctly, but they are extremely risky as the procedure can precipitate bleeding. So, it is rarely done in rural areas, as the equipment is expensive and expertise is not available. Yet, liver disease is extremely common in India, and goes undiagnosed and thus untreated till it is too late. IndioLabs is attempting to bridge this gap in rural healthcare.
Its portable device, currently under preclinical trials, does several things at the same time. It pierces the tissue on its own. It delivers an anti-haemorrhagic agent to the tissue while it is being cut, therefore reducing chances of bleeding. It places the tissue inside the container without being touched by the hand, thereby eliminating contamination and risk of infection to the healthcare provider. Says Siraj Bhagwan, a Stanford-India Biodesign fellow and founder of IndioLabs: "Our device is one of a kind." Liver biopsies cost 40 per cent less using it. IndioLabs is looking for a commercial launch next year. It is worth watching.
Shot in the arm for Medical Devices
Indian companies are developing state-of-the-art medical devices that require substantial innovation. Here are a few samples of some products that are set to enter the market in a year or two.
Eye imaging system for premature babies
Premature babies normally do not have well-developed eyes, but it is often not diagnosed and they become blind quickly. A portable eye imaging system being developed by Forus Healthcare an help diagnose poor retina development in premature infants.
Cardiac Imaging System
Measuring arterial stiffness is an important method to diagnose cardiovascular disease, but it is difficult and dependent on expert help. IIT Madras is developing a low-cost device that will measure arterial stiffness non-invasively.
Low-cost Liver Biopsy Device
Liver biopsies are the gold standard for liver disease diagnosis, but they are risky and expensive. A startup called IndioLabs has made a portable device that makes the procedure less risky and cheaper.
Antibiotic Wound Dressing
Wounds are not easy to manage, as there are multiple factors that need to work well together for quick healing. SKL Medtech, a Tirupur-based startup, has developed an advanced wound dressing that can kill microbes as well as provide a good healing environment.
With inputs from Krithika Krishnamurthy
As a garment manufacturer, Shakti Knitting was already dealing with antimicrobial garments, mainly as a means to prevent odour. This wasn’t sophisticated technology, but it made them aware of the problems of anti-microbials. Scientists around the world were waging a losing battle with microbes, as they were gaining resistance to every new antibiotic.
SKL, with its founders being primarily engineers, was the last company to look for a next generation anti-microbial. But being engineers, their minds were not working like those of scientists. "We were looking at a textile-based solution," says Kumar. SKL’s first product, a wound dressing called Theruptor, works in a way no other product in the market does. It attracts nearby bacteria using electric charge and pierces their cell walls using molecular needles. No biochemical process, no meddling with bacterial metabolism, and so little chances of resistance ever.
The product worked well in animal trials, and SKL is now developing it into a medical device to be sold all over the world. Being a class-II device (medium risk), it will take just four months of them to get it through the mandatory regulatory clearance. If it goes well, SKL would have a foot into the $6 billion global wound-care market.
Forget the future of this device for a moment. A few years ago, it would have been hard to find a company like SKL Medtech, a manufacturing company diversifying into medical devices. But now medical technology seems to have caught the imagination of entrepreneurs and engineers in the country, and a large number of them have ventured into this difficult terrain. Some of them are attracted by the complete absence of medical products for rural areas but their inventions seem to be good enough to get them a global presence. They could be building a substantial industry over the decade.
The Biggies Check in
So far, India has had no presence in the global medical device market, and most of the devices used in the country — with some exceptions like cardiac stents — are imported. Now, we can see the first stirrings of a major industry, as multinationals have started designing several products for the country, and Indian startups and established companies are joining them. Supporting them are design and engineering centres sprouting in R&D institutions, and the large amount of money the government is spending on medical technology development.
Also building expertise in the country are IT services companies like Wipro, who are trying to work with the large number of device manufacturers around the world. The Indian medical electronics market is growing too. According to Frost and Sullivan, a consultancy, it will grow from $6.5 billion (about Rs 40,000 crore) now to $11.5 billion (about Rs 70,000 crore) in 2017, a compounded annual growth rate of 16 per cent.
Since rural areas are not serviced enough by large players, it is a largely untapped market available for anyone willing to innovate. Says Shyam Vasudev, president and chief technology officer of Forus Health, an ophthalmology device startup: "Entrepreneurs these days are very excited about healthcare devices."
Vasudev himself is one of the prime movers of this industry. He has been eying this market since 2002, when he understood the potential of healthcare devices while working as an engineer for Ericsson in Stockholm. When he moved to India and Philips R&D, he mooted the idea of making products for rural areas within his company.
That was seven years ago, when medical devices were considered for the rich, and no one had taken the rural market seriously. But things changed quickly, as General Electric and Philips themselves started unleashing a revolution, and a complete change of mindset. In some ways, CK Prahlad’s paper ‘Fortune at the Bottom of the Pyramid’ was instrumental in driving this change of mindset.
Philips changed its approach and has launched a few products in recent times that look at healthcare devices from a different perspective. Among other things, it asked this question: how can you identify chronic diseases at the point of occurrence? About 730 million — of the 1.2 billion in the country — live in rural areas, and the nature of chronic diseases is not very different there. Yet people are not diagnosed early enough because they need to go to towns for their health check-ups.
The solution is to shrink devices, make them easy to use, and take them to rural areas. As all the multinationals discovered, this shrinking needed complete reengineering. In the last few years, Philips has launched several products that attempted to make devices portable. Examples include an ECG device, an ultrasound device and infant warmers. Other multinationals too came up with similar ideas, the most prominent of which was GE.
The Ecosystem Builds
GE set up its John F Welch Technology Centre in Bangalore in 2002. Healthcare technology was one of its focus areas right from the beginning, but the mindset change became visible around 2008. GE launched its first product for the country, a portable ECG system. So far it has launched 25 products, most of them engineered from scratch specifically for rural India and, by extension, for the rest of the developing world. During the last six years, GE engineers also learned a lot about rural India, and how people think and work there.
More than anything else, it learnt that it was important to work with customers right from the beginning. So, a few months ago, it built its first co-creation lab, called E Cube. Potential customers come from around the country and work with GE designers in the lab. Its first few products are about to be launched.
One of them is a baby warmer. A completely new PET/CT scanner is another device, for which oncologists in India spent two full days at the centre. Over the next few years, this lab could be the birth place of a large number of GE products for India. Says Shyam Rajan, chief technology officer, India, of GE Healthcare: "There has been a tremendous improvement in the ecosystem in the last few years."
He identifies several aspects to this change. For example, doctors and engineers have now begun to work together.
This is also driven by the urge for innovation, especially from R&D institutions. But the ecosystem is far from complete. Since India is in the early stages of this industry, a large number of components of the ecosystem are yet to fall in place.
In a recent study, InnAccel, a Bangalorebased accelerator, identified five challenges specific to this sector: access to physical infrastructure, technical expertise and resources, lack of product engineering expertise, team members and access to capital.
"It is very difficult for engineers to get into the emergency room or the operation theatre," says Siraj Dhanani, cofounder of InnAccel. "Through our programmes, product engineers can now get into these settings within two to three days."
The Incubators…
Vigorous government programmes are addressing some of these challenges. The Government of India has funded some centres for healthcare devices, the two most prominent ones being at IIT Madras, and at All Indian Institute of Medical Sciences (AIIMS) and IIT Delhi. The IIT Madras centre, cal led Healthcare T e c h n o l o g y Innovation Centre (HTIC), has helped some companies design products, apart from developing new products of its own. The AIIMS-IIT Delhi centre, in collaboration with Stanford University, trains people to develop healthcare devices. In two years, it has already spawned seven companies.
HTIC was funded by the department of biotechnology to develop competence within the country in healthcare technology. Set up in 2011, it has so far spent Rs 25 crore, two-thirds of which was from the department and the rest from private companies.
Now, the majority of its funding comes from projects sponsored by private companies. GE, for example, is sponsoring a technology development project there. But it also develops technology of its own, some of which has penetrated the Indian market already. One of its early products, a mobile eye surgical unit, has finished 1,000 surgeries so far. Its second product, a software platform called Eye-PAC, was used as an image-processing platform by 3Netra of Forus Healthcare. 3Netra, a revolutionary product that could diagnose five major eye diseases automatically, is now going through several advancements.
 |
Its third device could be equally revolutionary when it comes to the market. It is a cardiovascular screening device that measures the stiffness of the arteries and gives a read-out without an image. "We are trying to build a disruptive device," says Mohan Sivaprakasam, assistant professor at IIT Madras and head of HTIC. "We are attempting to make a device for early cardiovascular screening at a few hundred rupees."
…And Startups Follow
HTIC would soon need an industrial partner to take this forward. The other project funded by the department of biotechnology, in collaboration with the Department of Science and Technology and Stanford University and others, is creating products and companies rapidly. So far, in its short existence of four years, it has transferred seven technologies, a record for a government-funded programme.
It works through a completely novel method. It funds four fellows every year — a doctor, a mechanical engineer, a designer and a business person — for a six-month training programme at Stanford University. "There isn’t enough interaction in India between engineers and doctors," says Rajiv Doshi, consulting associated professor medicine at Stanford University and head of the Stanford-India Biodesign.
The fellows can come back and do what they want, but a majority of them have started companies together based on the ideas they have worked on while at Stanford. They have so far resulted in 22 devices, some of which are novel ideas for products that do not exist anywhere in the world.
These include a limb immobiliser after traffic accidents, a method to screen newborn babies for hearing loss, a device for neonatal resuscitation, and a liver-biopsy device. The limb immobiliser and the hearing-loss screening devices are in the market. The others are under development. The liver-biopsy device, made by the Bangalore startup IndioLabs, is an extremely high-tech product that tries to go beyond incumbents in the market, and not just in portability and cost. Liver biopsies are necessary to diagnose cirrhosis of the liver correctly, but they are extremely risky as the procedure can precipitate bleeding. So, it is rarely done in rural areas, as the equipment is expensive and expertise is not available. Yet, liver disease is extremely common in India, and goes undiagnosed and thus untreated till it is too late. IndioLabs is attempting to bridge this gap in rural healthcare.
Its portable device, currently under preclinical trials, does several things at the same time. It pierces the tissue on its own. It delivers an anti-haemorrhagic agent to the tissue while it is being cut, therefore reducing chances of bleeding. It places the tissue inside the container without being touched by the hand, thereby eliminating contamination and risk of infection to the healthcare provider. Says Siraj Bhagwan, a Stanford-India Biodesign fellow and founder of IndioLabs: "Our device is one of a kind." Liver biopsies cost 40 per cent less using it. IndioLabs is looking for a commercial launch next year. It is worth watching.
|
|
Shot in the arm for Medical Devices
Indian companies are developing state-of-the-art medical devices that require substantial innovation. Here are a few samples of some products that are set to enter the market in a year or two.
Eye imaging system for premature babies
Premature babies normally do not have well-developed eyes, but it is often not diagnosed and they become blind quickly. A portable eye imaging system being developed by Forus Healthcare an help diagnose poor retina development in premature infants.
Cardiac Imaging System
Measuring arterial stiffness is an important method to diagnose cardiovascular disease, but it is difficult and dependent on expert help. IIT Madras is developing a low-cost device that will measure arterial stiffness non-invasively.
Low-cost Liver Biopsy Device
Liver biopsies are the gold standard for liver disease diagnosis, but they are risky and expensive. A startup called IndioLabs has made a portable device that makes the procedure less risky and cheaper.
Antibiotic Wound Dressing
Wounds are not easy to manage, as there are multiple factors that need to work well together for quick healing. SKL Medtech, a Tirupur-based startup, has developed an advanced wound dressing that can kill microbes as well as provide a good healing environment.
With inputs from Krithika Krishnamurthy
(Catch all the Business News, Breaking News Budget 2024 News, Budget 2024 Live Coverage, Events and Latest News Updates on The Economic Times.)
...moreDownload The Economic Times News App to get Daily Market Updates & Live Business News.
Read More News on
(Catch all the Business News, Breaking News Budget 2024 News, Budget 2024 Live Coverage, Events and Latest News Updates on The Economic Times.)
...moreDownload The Economic Times News App to get Daily Market Updates & Live Business News.
Get Unlimited Access to The Economic Times
