Technologies in Development at Medtech Startups, November 2015

Below is a list of the technologies under development at new medtech companies and recently added to the Medtech Startups Database.

  • Devices to assist pulmonary function.
  • Technologies to improve performance of orthopedic implantation.
  • Treatments for conditions associated with spinal cord injury and disease.
  • Technologies for the preservation and transport of organs and biologicals.
  • Interventional technologies for the treatment of neurovascular technologies.
  • Spinal fusion technologies
  • Orthopedic implants, including a prosthetic meniscus for placement in the knee joint.
  • Women’s health products including low risk device to measure cervical dilation.
  • Medical device to rapidly and accurately diagnose otitis media.
  • Bioabsorbable heart valve.
  • Electro-hydraulic generated shockwave for cosmetic, medical applications.

For a historical listing of technologies at medtech startups, see link.

 

Technologies Gaining Nearly $600M Fundings in Medtech for October 2015

Fundings for medical technology reached $594 million for the month of October 2015. These are the technologies gaining funding In October 2015:

  • Tissue engineering in blood vessels, including for acellular vessels use for vascular access in ESRD
  • Magnetically adjustable spinal bracing system
  • Technologies to reduce the risk of stroke in transcarotid artery revascularization
  • Technologies to treat hearing loss
  • Surgical adhesives and sealants
  • Drug-device for novel treatment of urologic diseases
  • Drug delivery device technology
  • Minimally invasive device for the treatment of acute decompensated heart failure
  • Diagnostics for acute kidney injury
  • Catheter-based, minimally invasive treatment of endovascular arteriovenous fistula
  • Minimally invasive, non-surgical technology for circulatory support
  • Endovascular aortic aneurysm repair
  • Non-invasive intracranial pressure measurement
  • Implantable pump technology for fluid management
  • Intraoperative imaging and navigation
  • Devices for dry eye, glaucoma, others.
  • Nonsurgical device for the treatment of chronic nasal obstruction
  • Focused ultrasonic surgical devices for hemostasis, cauterization, and ablation
  • Technology for drug delivery to brain
  • Technologies for robotically-assisted minimally invasive surgery
  • Catheter based therapeutic devices for the treatment of cerebral aneurysms
  • Neuromodulation technologies
  • Renal denervation
  • Device to provide rapid allergy relief and device to monitor neonatal end-tidal carbon monoxide

For details on these, including the companies and their funding amounts, see link.

Medtech Startups, 2010-2015

From 2010 to present (Oct 2015), as included in the Medtech Startups Database, MedMarket Diligence identified 442 new (under one year old) medical technology startups whose businesses encompass, alone or in combination, medical devices, diagnostics, biomaterials, and the subset of both biotech and pharma that is in direct competition with medical devices, including tissue engineering and cell therapy. Of these, 74% were founded in the U.S., 5% were founded in Israel, and the rest were founded in 18 other countries.

Companies in the database have been categorized by clinical and/or technology area of focus, with multiple categories possible (e.g., minimally invasive and orthomusculoskeletal and surgery). Below is the composition of the companies identified from Jan. 2010 to Oct. 2015.

Screen Shot 2015-10-06 at 4.50.10 PM

Source: Medtech Startups Database

Below is a graphic on the companies by country. The U.S. (not shown) led with 327 companies.

Screen Shot 2015-10-06 at 4.17.30 PM

Source: Medtech Startups Database

In the U.S., the breakdown by state, other than California and its 466 companies (excluded only to show states with significantly lower numbers), is as follows:

Screen Shot 2015-10-06 at 5.13.08 PM

Source: Medtech Startups Database

 

New Medical Technologies at Startups, May 2015

Below is the list of technologies under development at medical technology companies identified in May 2015 and included in the Medtech Startups Database.

  • Nanotechnology-based diagnostic
  • Bone fixation devices, including for post-sternotomy closure
  • Devices and materials for bone lengthening
  • Nanopolymer drug delivery
  • Developing an artificial pancreas; combined blood glucose monitor and insulin pump
  • Terahertz radiation-based measurement of blood glucose
  • Patient-specific orthopedic implants
  • Undisclosed medical technology
  • Novel energy delivery-based medical technology
  • Device for early detection of cardiovascular disease based on endothelial dysfunction
  • Facet joint surgical instruments
  • Neuromodulation technology
  • Electric stimulation in wound healing
  • Mesenchymal stem cell treatment in cardiology, transplantation, and autoimmunity
  • Integrated blood glucose monitor, insulin dosing
  • Surgical instrumentation

For a historical listing of technologies at medtech startups, see link.

 

New technologies at medtech startups, October 2014

Below is a list of the technologies under development at medical technology startups recently identified and included in the Medtech Startups Database.

  • Prosthetic disc nucleus in spine surgery.
  • Device and non-device technologies based on dynamics of blood flow.
  • Magnetic and fluorescent technology point-of-care device to detect heart attack.
  • Technologies for tissue reconstruction.
  • Adult stem cell therapy in orthopedics, aesthetics, and chronic diseases (diabetes, COPD, heart disease, multiple sclerosis, stroke/cerebrovascular disease).
  • Vagus nerve stimulation for neuromodulation treatment of various inflammatory autoimmune diseases.
  • Surgical devices including for endoscopic access closure.
  • Device to measure sympathetic nerve activity and produce ECG.
  • Simultaneously track electrical measures that indicate brain, heart, optical and musculoskeletal activity.
  • Needle-free pediatric withdrawal of blood.
  • Ventilation systems for improved delivery of gas, moisture and nebulized medication.
  • Broadly focused medical technology company active in osteoarthritis, cardiovascular, stroke, diabetes, infection control and spine surgery.

For a historical listing of technologies at medtech startups, see link.

Medical technologies and recently identified startups (June 2014)

New medical technologies under development at recently identified startups span ophthalmology, gastroenterology, cardiology, spine surgery, orthopedics, patient monitoring and surgical instrumentation.  Below are the technologies at the recently identified medtech startups that have been included in the Medtech Startups Database.

  • Intraocular lens for presbyopia.
  • Portable, wireless EKG device.
  • Tissue engineering in peripheral and central nervous system injury.
  • Micro transtympanic drug delivery to the ear.
  • Diagnosis of functional GI disorders.
  • Spinal implants and instrumentation systems.
  • Surgical suction devices.
  • Calcium phosphate bioceramic implants for bone defects.
  • Intervertebral fusion cage.
  • Monitoring of neural activity during sedation.
  • Surgical instrument positioning systems for minimally invasive and robotic surgery.
  • Critical care monitoring technologies.

For a historical listing of medical technologies under development at startups, see link.

Glucose monitoring research drives more promises than answers

If I had a nickel for every headline like this that ultimately failed, like the technology, to actually achieve the promise, I would be on a tropical beach sipping pina coladas:

“Glucose monitoring for diabetes made easy with a blood-less method” (link)

Technologies in development for less-invasive or non-invasive glucose monitoring are legion, and many are very promising, but you can’t fill out a deposit slip with these promises. Frequently, such alternatives are based on the premise of quantifying blood glucose by sensitively detecting glucose in other fluids (interstitial fluid, tears, saliva, urine, etc.) that do not require the use of lancets to draw blood. However, despite their sensitivity and other sophistication in detecting minute quantities of glucose, their “arm’s length” to actual blood glucose compounds the challenge by requiring that the test reproducibly correlate the sample values with actual, current blood glucose levels.

The challenge stands unanswered, while the burgeoning population of endlessly finger-pricked diabetics remains painfully unsatisfied.

As a practical reality, continuous blood glucose monitors like those from Dexcom and Medtronic offer far more to the diabetic population, not only by avoiding finger pricks but also by revealing the patterns in blood glucose levels over time as a result of activity, carbohydrate intake, insulin bolus, insulin basal rate, stress and countless other patient-specific determinants.

Medtech fundings for June 2014

Fundings in medical technology for the month of June totaled $445 million, led by fundings of Benvenue Medical ($64 million) and InSightec ($50 million).

Below are the top fundings in the month.

Company fundingProduct/technology
Benvenue Medical, Inc., has raised $64 million in a round of funding according to the companyMinimally invasive implants for spine surgery
InSightec, Inc., has raised $50 million in a Series D round of funding according to the companyMR-guided focused ultrasound
Pixium Vision has raised $46.7 million in an initial public offering according to press reportsImplants to treat blindness
OrthoPediatrics Corp. has raised $39 million in a round of funding according to a regulatory filingOrthopedic implant technologies designed for pediatric use
Cheetah Medical, Inc., has raised $33.85 million in a round of funding according to a regulatory filingNon-invasive hemodynamic monitoring
Spinal Kinetics, Inc., has raised $33.85 million of a planned $34.77 million round of funding according to a regulatory filingMotion preservation systems, including artificial discs, for degenerative disc disease

For a complete list of medtech fundings in June 2014, see link.

For a full list of the fundings in medtech, by month, since 2009, see link.

Technologies at Medtech Startups, May 2014

Below is a list of the new medical technologies under development at startups we identified in May 2014 and added to the Medtech Startups Database.

  • Patient positioning system for use in hip replacement and other orthopedic procedures.
  • Instrumentation to facilitate hip replacement surgery and other orthopedic instrumentation.
  • Drug-coated stent-valve designed to inhibit stenosis, obstruction or calcification of the valve.
  • Implants for the treatment of aneurysm.
  • Orthopedic implant technologies including a force sensor to measure performance of an orthopedic articular joint.
  • Insulin patch pump for treatment of insulin-dependent type 2 diabetes.
  • Undisclosed tissue vascular technology
  • Rapid, accurate, inexpensive diagnostic devices initially focused on malaria.
  • Device for diagnosis and management of diabetic retinopathy.
  • Tumor-targeted drug delivery.
  • Near infrared technology for blood glucose monitoring in diabetes.
  • Non-resorbable films for anti-adhesion.
  • Angioplasty double balloon for treatment of peripheral vascular disease.
  • Device to reduce the risk of ventilator-associated pneumonia.
  • Trocar, sleeve and tip for minimally invasive endoscopic surgery.

For a historical listing of the technologies at medtech startups, see link.

Where will medicine be in 20 years?

(This question was originally posed to me on Quora.com. I initially answered this in mid 2014 and am revisiting and updating the answers now, in mid 2015.)

An important determinant of “where medicine will be” in 2035 is the set of dynamics and forces behind healthcare delivery systems, including primarily the payment method, especially regarding reimbursement. It is clear that some form of reform in healthcare will result in a consolidation of the infrastructure paying for and managing patient populations. The infrastructure is bloated and expensive, unnecessarily adding to costs that neither the federal government nor individuals can sustain. This is not to say that I predict movement to a single payer system — that is just one perceived solution to the problem. There are far too many costs in healthcare that offer no benefits in terms of quality; indeed, such costs are a true impediment to quality. Funds that go to infrastructure (insurance companies and other intermediaries) and the demands they put on healthcare delivery work directly against quality of care. So, whether it is Obamacare, a single payer system, state administered healthcare (exchanges) or some other as-yet-unidentified form, there will be change in how healthcare is delivered from a cost/management perspective.

From the clinical practice and technology side, there will be enormous changes to healthcare. Here are examples of what I see from tracking trends in clinical practice and medical technology development:

  • Cancer 5 year survival rates will, for many cancers, be well over 90%. Cancer will largely be transformed in most cases to chronic disease that can be effectively managed by surgery, immunology, chemotherapy and other interventions.
    [View Aug. 2015: Cancer has been a tenacious foe, and remains one we will be fighting for a long time, but the fight will have changed from virtually incapacitating the patient to following protocols that keep cancer in check, if not cure/prevent it.] 
  • Diabetes Type 1 (juvenile onset) will be managed in most patients by an “artificial pancreas”, a closed loop glucometer and insulin pump that will self-regulate blood glucose levels. OR, stem cell or other cell therapies may well achieve success in restoring normal insulin production and glucose metabolism in Type 1 patients. The odds are better that a practical, affordable artificial pancreas will developed than stem or other cell therapy, but both technologies are moving aggressively and will gain dramatic successes within 20 years.
    [View Aug. 2015: Developments in the field of the “artificial pancreas” have recently gathered considerable pace, such that, by 2035, type 1 blood glucose management may be no more onerous than a house thermostat due to the sophistication and ease-of-use made possible with the closed loop, biofeedback capabilities of the integrated glucometer, insulin pump and the algorithms that drive it, but that will not be the end of the development of better options for type 1 diabetics. Cell therapy for type 1 diabetes, which may be readily achieved by one or more of a wide variety of cellular approaches and product forms (including cell/device hybrids) may well have progressed by 2035 to become another viable alternative for type 1 diabetics.] 
  • Diabetes Type 2 (adult onset) will be a significant problem governed by different dynamics than Type 1. A large body of evidence will exist that shows dramatically reduced incidence of Type 2 associated with obesity management (gastric bypass, satiety drugs, etc.) that will mitigate the growing prevalence of Type 2, but research into pharmacologic or other therapies may at best achieve only modest advances. The problem will reside in the complexity of different Type 2 manifestation, the late onset of the condition in patients who are resistant to the necessary changes in lifestyle and the global epidemic that will challenge dissemination of new technologies and clinical practices to third world populations.
    [View Aug. 2015: Despite increasing levels of attention being raised to the burden of type 2 worldwide, including all its sequellae (vascular, retinal, kidney and other diseases), the pace of growth globally in type 2 is still such that it will represent a problem and target for pharma, biotech, medical device, and other disciplines.] 
  • Cell therapy and tissue engineering will offer an enormous number of solutions for conditions currently treated inadequately, if at all. Below is an illustration of the range of applications currently available or in development, a list that will expand (along with successes in each) over the next 20 years.

    [View Aug. 2015: Cell therapy will have deeply penetrated virtually every medical specialty by 2035. Most advanced will be those that target less complex tissues: bone, muscle, skin, and select internal organ tissues (e.g., bioengineered bladder, others). However, development will have also followed the money. Currently, development and use of conventional technologies in areas like cardiology, vascular, and neurology entails high expenditure that creates enormous investment incentive that will drive steady development of cell therapy and tissue engineering over the next 20 years, with the goal of better, long-term and/or less costly solutions.] 

  • Gene therapy will be an option for a majority of genetically-based diseases (especially inherited diseases) and will offer clinical options for non-inherited conditions. Advances in the analysis of inheritance and expression of genes will also enable advanced interventions to either ameliorate or actually preempt the onset of genetic disease.
    [View Aug. 2015: It’s a double-edged sword with the human genome. As the human blueprint, It is the potential mother lode for the future of medicine, but it remains a complex set of plans to elucidate and exploit for the development of therapies. While genetically-based diseases may readily be addressed by gene therapies in 2035, the host of other diseases that do not have obvious genetic components will resist giving up easy gene therapy solutions. Then again, within 20 years a number of reasonable advances in understanding and intervention could open the gate to widespread “gene therapy” (in some sense) for a breadth of diseases and conditions.] 
  • Drug development will be dramatically more sophisticated, reducing the development time and cost while resulting in drugs that are far more clinically effective (and less prone to side effects). This arises from drug candidates being evaluated via distributed processing systems (or quantum computer systems) that can predict efficacy and side effect without need of expensive and exhaustive animal or human testing.
    [View Aug. 2015: The development of effective drugs will have been accelerated by both modeling systems and increases in our understanding of disease and trauma. It may not as readily follow that the costs will be reduced, something that may only happen as a result of policy decisions.] 
  • Most surgical procedures will achieve the ability to be virtually non-invasive. Natural orifice transluminal endoscopic surgery (NOTES) will enable highly sophisticated surgery without ever making an abdominal or other (external) incision. Technologies like “gamma knife” and similar will have the ability to destroy tumors or ablate pathological tissue via completely external, energy-based systems.
    [View Aug. 2015: By 2035, technologies such as these will have measurably reduced inpatient stays, on a per capita basis, since a significant reason for overnight stays is the trauma requiring recovery, and eliminating trauma is a major goal and advantage of the NOTES technology platform. A wide range of technologies across multiple categories (device, biotech, pharma) will also have emerged and succeeded in the market by producing therapeutic benefit without collateral damage.] 
  • Information technology will radically improve patient management. Very sophisticated electronic patient records will dramatically improve patient care via reduction of contraindications, predictive systems to proactively manage disease and disease risk, and greatly improve the decision-making of physicians tasked with diagnosing and treating patients.
    [View Aug. 2015: There are few technical hurdles to the advancement of information technology in medicine, but even in 2035, infotech is very likely to still be facing real hurdles in its use as a result of the reluctance in healthcare to give up legacy systems and the inertia against change, despite the benefits.]
  • Systems biology will underlie the biology of most future medical advances in the next 20 years. Systems biology is a discipline focused on an integrated understanding of cell biology, physiology, genetics, chemistry, and a wide range of other individual medical and scientific disciplines. It represents an implicit recognition of an organism as an embodiment of multiple, interdependent organ systems and its processes, such that both pathology and wellness are understood from the perspective of the sum total of both the problem and the impact of possible solutions.
    [View Aug. 2015: This orientation will be intrinsic to the development of medical technologies, and will increasingly be represented by clinical trials that throw a much wider and longer-term net around relevant data, staff expertise encompassing more medical/scientific disciplines, and unforeseen solutions that present themselves as a result of this approach.]

There will be many more unforeseen medical advances achieved within 20 years, many arising from research that may not even be imagined yet. However, the above advances are based on actual research and/or the advances that have already arisen from that research.