mohan kantamaneni
Case Western Reserve University - Weatherhead School of Management
Chris Laszlo
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Forus Health is Bangalore based health care enterprise that is redefining the medical device industry in India. It is producing affordable eye care equipment at a fraction of the cost of similar products marketed by major multinationals. Their recent and most advanced innovation is 3Nethro Neo, a handheld probe that helps in diagnosis and monitoring of Retinopathy of Prematurity.
3nethra Neo is a hand held probe designed to capture the digital color images of retina of prematurely born infants to diagnose and monitor Retinopathy of Prematurity (ROP). Neo provides an unparalleled 120-degree view, enabling doctors to make an informed diagnosis.
Neo addresses three keys issues – cost, complexity and compatibility – that limited penetration of similar devices in the Indian market.
Cost - Currently a similar instrument marketed by a multinational company costs around $100,000 to $160,000 in Indian markets based on the features and configuration. This high price point makes these devices unaffordable to most practitioners and hospitals. 3Nethra Neo is available at one-sixth the price of the available diagnostic devices. This price point makes Neo more affordable to practitioners and hospitals. As more doctors and hospitals use it, efficient diagnosis of ROP can be made in initial stages and timely treatment can be offered.
Complexity – Currently the available ROP screening devices are very complex to use and carry, limiting the number of doctors using this product. Neo on the other hand weighs less than 3/4th of a pound making it easy to carry. Further it is designed to be simple and easy to operate. A doctor with minimal computer knowledge can handle Neo without any issues.
Compatibility – Neo can be operated using a laptop, which can serve as a monitor and control unit. Neo is compatible with NeoCare, a cloud based telemedicine platform through which high-resolution images can be shared for consultation with pediatric retina specialists to receive an expert opinion.
These 3 attributes make Neo a preferred choice in the management of ROP.
Forus Health is a Bangalore based healthcare venture started by a group of dedicated engineers in 2010. Its mission is to eradicate preventable blindness from India and across the globe by developing world class eye care devices and solutions. As Padmanabha Holla, Vice President of Products said, “Awareness, Availability and Affordability are the three challenging issues that prevent penetration of health care services in countries like India”.
Forus Health was born out of inspiration. The people behind Forus Health were reputed professionals in the medical devices industry. Their perceptions about the medical device industry changed after meeting the founders of Aravind Eye Care, the world’s largest eye care group. The conversations stimulated these professionals and helped them realize the need for affordable eye care screening equipment. The team decided to use their technical expertise to convert the need to a business opportunity embodying a social good. Mr. Holla said, "Prevention is better than cure – in terms of both financial and health implications”.
Ever since its inception in 2010, Forus has focused its energy and strengths to develop affordable eye care devices. In a span of 6 years, the company engineered and produced 5 innovative products at a fraction of the cost of similar products available in the market. To date, over 1,100 of these innovations have found a place in small clinics and big hospitals across 25 countries, including a few developed nations such as the USA and Canada. Through these innovations Forus has so far touched the lives of 2 million people.
Forus identified Retinopathy of Prematurity as a long neglected public health issue that was not being addressed by current technologies for multiple reasons. The World Health Organization (WHO) estimates that there are 1.4 million blind children worldwide, two-thirds of whom live in developing countries. Retinopathy of Prematurity (ROP) is the cause of blindness in about 50,000 of these children. In India, 0.2% of the childhood blindness cases are due to Retinopathy of Prematurity.
Retinopathy of Prematurity is a disease caused due to the abnormal development of blood vessel in the retina of premature babies. If not diagnosed and treated on time, ROP can potentially lead to blindness. An estimated 9 million of the 15 million premature babies born across the world every year are at risk of developing ROP. In India alone, 3.5 million premature babies are born every year but the country has less than 100 ROP specialists to screen and treat millions at need. An estimated 0.2% of the childhood blindness cases in India are attributed to Retinopathy of Prematurity.
Based on the need identified by the Forus team, they set out to create a product that can address the challenge by overcoming the current limitations. Their 4 years of hard work was paid off when they finally came up with a device that is both affordable and effective. After extensive clinical studies the product was launched recently. The product aligns very much with the organizations vision “To address health issues of the world through innovative products and solutions combined with innovation in development in an inclusive environment”. The team is very positive based on the early reviews from the initial users and is highly optimistic about future sales.
Neo was launched in the Indian market in October 2016. During its clinical validation phase, around 1,000 babies were screened. The study confirmed that the device is reliable. It has more than 94 percent sensitivity and the operators had a more than 90 percent agreement on findings.
Neo will have a profound impact on the health and the future of low birth weight children. The device makes ROP diagnosis accessible and easier. Imagine the impact this innovation can have in improving preventable blindness across the globe. In India, the device can be of significant help in screening nearly 3.5 million low-birth weight children annually. Further, Neo can make an impact in developing nations where incidence of ROP is significant higher.
The product offers several benefits to stakeholders including children, doctors and hospitals to name a few. Low birth weight children who otherwise were never screened for ROP can now be screened due to improved access and the reduced cost of care. Doctors and Hospitals will not only save thousands of dollars in fixed costs on expensive eye care equipment but also improve their business by catering to larger cohort of people.
If a disease/disorder such as ROP can be diagnosed early, it can be treated and may be completely cured at a low cost. On the other hand, if the disease is neglected, the long term repercussions haunt not only the victim but also the society. The victim may have to lead a poor quality of life. On the other hand, the governments will have to spend billions of dollars every year to offer social benefits to the affected population. So, products such as Neo will not only bring in health and economic benefits to the individuals but also to the society as a whole.
Neo adds business value to both shareholders and stakeholders. By launching Neo, Forus health has entered in to a unique league of firms that develop and manufacture complicated eye care devices. Neo also attracted national and international media attention giving visibility and improving the reputation of the firm.
3Nethra Neo was rolled out in the India market in early October, 2016. To this date, 4 units have been sold. Its order book is ticking at a fast pace. The team is expecting to sell at least 50-100 units in the first year. They have ambitious plans of marketing this product outside India over the next few years. The product is priced at $30,000 while the existing products from multinationals are priced between $100,000 to $190,000 in the India market. The low price point and the versatility of the product makes it an affordable option for doctors and hospitals.
Unlike the other inventions of Forus, which were sold to doctors and even trained non-medical professionals, Neo is and will be sold to specialist doctors and hospitals, as the price of the instrument and the expertise needed to analyze the reports are relatively high.
Since its launch in October 2016, Neo has made 3 Indian cities its home. It will be one of the very few scanning devices, if not the only one, available for screening of ROP in these cities. The instrument is bound to make a definite impact considering the high risk of incidence of ROP and huge catchment population within the territories. The number of infants who will benefit from using this device is yet to be known. It may take a while to get accurate figures and future estimations. One has to wait and watch to assess the impact this device is going to have in the field of ophthalmology.
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Mr. Padmanabha Holla, Vice President - Products
