A neurosurgery simulation device from Synaptive Medical. (Synaptive Medical)
Research into life sciences is not an instant-return kind of investment. A decade and a half after the MaRS Discovery District opened its doors in Toronto, the city’s promised health-care ecosystem is at last starting to emerge. As technologies years in the making finally weave their way to market, Toronto could be set to rival Boston as a life sciences research and innovation centre.
As in so many other areas of the economy, technological innovation promises to disrupt and improve the way health care is provided. But modifying the procedures and best practices of doctors and hospitals is not as simple as, say, building an app to hail a taxi. Public health-care models such as Canada’s are particularly difficult to crack. Widespread adoption “requires a very rigorous economic and clinical analysis,” says Armen Bakirtzian, CEO and co-founder of Intellijoint Surgical, which makes a miniature surgical-grade tracking system that allows surgeons to select and align implants more accurately.
New life sciences technologies must be approved by Health Canada, but that doesn’t automatically translate into broad acceptance. Zayna Khayat, senior adviser for Health System Innovation at MaRS, uses the analogy of pharmaceutical companies’ armies of salespeople. “If they didn’t have [them], no pills would ever be used,” she says. “Every pill gets approved based on very rigorous outcomes and clinical analysis, but it doesn’t mean it gets bought—doctors make the decision, and they have to be convinced.” Products like Intellijoint’s total hip replacement surgery solution or Synaptive Medical’s suite of surgical technologies face similar hurdles. So three years ago, MaRS tapped Khayat to lead a newly created market-opener program called Excite to help health-care startups get their technology through the approval and adoption process.
Excite works with the Ontario health care system, the country’s largest. (The GTA also hosts more than half of the country’s life sciences firms, according to economic development agency Invest Toronto.) The program helps companies with promising early data—often obtained overseas, because of the high cost of medical testing in Canada—design and execute the key study provincial authorities need to see to sign off. “We’re helping [companies] use Ontario’s academic and clinical infrastructure to build an incredible dossier or package of evidence that they can now use to walk into any other major player,” says Khayat. Successful companies will also have a hefty reference from a very influential customer—the $50-billion Ontario health system, which buys the technology at a system level if regulators deem it to be sufficiently effective and economical. Excite has no success stories to tell just yet—Khayat says it takes at least a year to design the study and two or more years to evaluate it in the field. But BresoDX, a self-administered home test for sleep apnea, developed by Toronto-based company Bresotec, is likely to complete the study portion of the process in early 2016.
The meticulous process of medical market entry in Canada can be a leg up for companies that survive it, says Cameron Piron, CEO and co-founder of Synaptive Medical. “If you have a product that can show value, it certainly has great opportunity to scale outward very rapidly,” he says. But too-high barriers could stifle truly innovative technologies, or drive their inventors away. That remains a lofty hurdle in a field where it can take decades of research and development before a team can enrol its first study participant. “If that home market is also very difficult to enter commercially, that’s an additional challenge for startups in Canada,” warns Piron.
Khayat agrees: “If they can’t get a beachhead in their local market, it’s very hard for them to justify keeping their local operations here.”
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