Silicon examines some of the latest global medtech trends through three Luxembourg scaleups: the leasing of medical devices, online booking and streamlining health data.
Trend n°1: Leasing medical devices
B Medical Systems has been developing and selling its cold chain products for over 40 years. However, an explosion in demand for cold storage and transport solutions for vaccines as a result of the pandemic has forced a reflection on how customers access its products.
Vaccines have played a pivotal role in building a collective immune response against the COVID-19 pandemic. A number of pharmaceutical companies developed successful vaccines at breakneck speed. But the race is not over. To maintain their potency, the vaccines need to be stored and transported at a constant temperature within an unbroken cold chain.
Ensuring the cold chain
For some COVID-19 vaccines, like Pfizer’s, this means keeping them at ultra-low freezing temperatures, well below what standard freezers are capable of. The Moderna vaccine also needs to be kept frozen for long-term stability. The specific requirements were an opportunity for B Medical Systems to leverage its 4 decades’ experience in cold chain products.
“It became clear that some clinics required smaller ultra-low freezer solutions to store extremely temperature-sensitive materials”B Medical Systems CEO Luc Provost
“During the fight against COVID-19, it became clear that some clinics required smaller ultra-low freezer solutions to store extremely temperature-sensitive materials,” said B Medical Systems CEO Luc Provost, adding: “Following our customer’s requests, we developed the U201, the smallest of our Ultra-Low Freezers.”
Pricing and vaccine inequity
It quickly became clear that the cost of purchasing certain cold chain products (they range from hundreds to thousands of euros) was outpricing low-income countries, further exacerbating vaccine inequity. B Medical Systems quickly pivoted to offer different leasing systems for its products, notably to India.
Provost said that the firm has successfully “executed leasing deals with some large pharmaceutical companies in the country. This provides more flexibility to the customers and avoids upfront purchase of the equipment in bulk.” The firm is now exploring further leasing opportunities.
The leasing sales model is far from a novelty in the pharmaceutical industry. According to a 2021 report on global medical device leasing opportunities from Research&Markets, “many hospitals and health systems aim to preserve cash, making them risk averse to funneling significant amounts into capital equipment that is prone to obsolescence.” This need drives new supply models such as leasing. In developed markets, leasing enables hospitals to pass on the risk of equipment downtime to vendors. And in emerging markets, leasing lowers upfront costs to providers.
The growth potential is vast. In 2021, the global medical equipment rental market size was valued at USD 53.39 billion in 2021, and it is expected to reach a value of USD 72.66 billion by 2028, according to analytics firm SkyQuest.
Mobile refrigerated vaccine solutions
Meanwhile, B Medical Systems has developed a refrigerated vaccine transport vehicle with Toyota Tsusho Corporation. The mobile solution can be used to transport large amounts of vaccine doses to the most remote areas in the world. Provost explained: “By installing our new CF850 Vaccine Refrigerator on the sturdy Toyota vehicle, vaccination campaigns in many areas worldwide have become a lot more manageable, and vaccine wastage has been reduced.”
Trend n°2: Online booking
For many, booking a doctor’s appointment online in Luxembourg has become second nature since Doctena launched in 2014. Doctena CEO Alain Fontaine talks about expanding market share and new areas for automation.
The online appointment manager for doctors was an easy sell to patients. “One can clearly say that patients love it and not only Doctena, but in all countries where you have similar offers,” Doctena CEO Alain Fontaine explains. “That’s because patients do everything online: they book flights, order pizza and movie tickets, because it’s convenient, it’s quick, and you can do it at 10 o’clock on a Saturday evening from your couch.”
The biggest challenge was and remains onboarding doctors themselves. Because of the medical environment’s “high resistance to change” and implementing new processes, Fontaine says expanding Doctena’s reach is “not a sprint, it’s a marathon”.
“I believe the biggest challenge is to remain patient enough and to just admit that it will take many years,” the CEO explains.
“I believe the biggest challenge is to remain patient enough and to just admit that it will take many years”Doctena CEO Alain Fontaine
Doctena has its biggest market share in Luxembourg, at around 35%, followed by Belgium (7%). Its share in Germany, where it is estimated that around 85% of the market of doctors and health practitioners have yet to adopt a booking platform, is considerably lower. To expand the customer base, Doctena acquired six companies in Luxembourg, Belgium, Germany and Austria in a period of two years.
10-20 years for full adoption
Fontaine believes that a renewal of medical professionals from retirements will result in an uptick in adoption. “It will take another 10-20 years to be locked in and be part of the daily operations of practice,” he says.
He is also convinced that automated booking platforms like Doctena help to make the medical profession more attractive by improving the efficiency of their daily workloads. And his team is examining automation of other technical functions to make their lives easier “like requesting a copy of the latest invoice, a sickness certificate or collecting a repeat prescription.” Starting mid-2023, Doctena will roll out software solutions to streamline these manual processes, saving the doctors time.
Doctors remain core target group
Looking ahead, its focus is on sustainable profitability growth through capitalising its presence in Belgium, Germany, Austria and Switzerland. “There’s enough to do over the coming few years,” says Fontaine.
Independent doctors remain the core target, although Doctena has examined other markets. It has completed two projects in Belgium with hospitals, a segment Fontaine says remains complex in terms of requirements and systems operability. Nevertheless, he believes that in future, hospitals will develop online booking technology for patients. The Doctena team has also examined a use case for vets. It concluded the market in Luxembourg was too small to justify developing a bespoke system.
Trend n°3: Streamlining health data
Health data play a central role in digital medicine but without standardisation and cleaning, its usefulness is limited. Andreas Kremer, co-founder and managing director of medical data services company ITTM, talks about this trend.
ITTM was founded in 2015 to meet the data management needs of the pharmaceutical industry and projects funded by the European Commission. The company ensured that data generated during preclinical and clinical studies are actionable and could be used in decision making processes. Today, ITTM is increasingly working with real world data, gathered by hospital information systems, for instance.
“The data can be molecular, demographic information etc., but always it needs to be harmonised so that one can use the data from Luxembourg, Austria, Germany or wherever and compare it directly,” Kremer explained.
A major trend in this field has been the shift away from centralising health data in data warehouses and data lakes towards a federated storage approach where data stays where it is generated. “In terms of data protection, security, and GDPR, it is sometimes easier to leave the data where it was collected,” said Kremer. With a federated approach, stakeholders can access information by sending a query that returns aggregated results. “Still, agreements need to be in place for access, but there is no loss of control regarding the data, and one has all the data protection in place, which one had before as well,” the managing director explained.
This approach is driving a trend for using real world data collected from smaller studies to create larger data sets. Federated systems of harmonized data, allow pharmaceutical companies to see what kind of data already exists and combine it to create a more complete set for their studies or trials. “A lot of trials are failing because one doesn’t get the patients one needs and/or because for whatever reason one didn’t get the numbers […]. You typically need to have big numbers to get the statistical power,” explained Kremer.
Among the challenges to streamlining clinical health data access is to ensure interoperability between different systems, be it on a technical or semantic side. Data quality and or lack of completeness is another barrier. Kremer reckoned that education about what is needed for data to be useful in the future, is key. “I think the mountain is quite big,” he admitted.
But the potential benefits of interoperable health data systems are vast. Among them will be adoption of longitudinal health management, single unified patient records composed of data from numerous sources to improve diagnosis and treatment.
In future, health apps will also supply meaningful data for these records. “Many pharmaceutical companies are including digital solutions to their portfolio,” said Kremer, adding that regulation will play a fundamental role in how soon this becomes a reality.
This article was first published in the Silicon Luxembourg magazine. Get your copy.