Healthcare (R)evolution – Bionics
22 March 2018
On March 22, 2018, Parallax Advisors organized a conference about investment opportunities in healthcare.
AtonRâ Partners was one of the speakers and we presented the investment theme: Bionics.
Bionics technologies are no longer science fiction
Bionics technologies include devices that can help blind to see, give amputees new body parts and make paraplegic people walk again. But is not just this, bionics consists also in robotic surgery, artificial organs, wearable devices, DNA manipulation, 3D printing, artificial intelligence and virtual reality.
Engineering some devices that will have the same function as a natural part of the body or coordinate with natural processes is now a reality. Eyes are already in development, scientists are working on restoring the ability to create long-term memories by implanting chips in the brain, all limbs can now be replaced by artificial limbs giving hope to millions of people, transplants could become obsolete with Artificial Organs...
The future of medicine
Bionics also consists of wearable devices. These devices allow patients to keep a check on their conditions at home, like their glucose levels or their cardiac rhythm without the need to go to the physician. An example of wearable devices is the bionic pancreas. The bionic pancreas simulates the function of the real organ: regulate the blood glucose level. It is composed by two pumps, one containing the insulin and the other containing the glucagon. The insulin reduces the quantity of blood glucose and the glucagon does exactly the opposite. Then the sensor and the algorithm communicate to define the correct amount of glucagon and insulin to be injected by the pumps. This is the wearable device that better tries to simulate the pancreas.
Our modern lifestyle increases traumatic problems, pain, and joint damages. Some of today's robotic systems are collaborating with surgeons to perform complex procedures, like knee and hip surgeries, with more precision and control, giving also to the patient a better outcome, with smaller scares, a faster recovery, and less pain. The systems are robotic arms that give a feedback to the surgeon when he is doing something not in accordance with the planned surgery.
Nowadays, robotic surgery is also used for the spine, brain, and abdominal surgery. Concerning spine and brain, the robot just gives the surgeons the correct trajectory to insert the instruments.
Synthetic biology: the revolution begins...
Synthetic biology involves the transfer of genes from an organism to another to fabricate or redesign systems that do not exist in nature. We can, for example, replace defective genes with healthy ones, thus eliminating the cause of the disease. We can introduce genes that are able to inactivate defective genes and others.
This approach can be potentially used to eradicate tumors, genetic disorders, and viral infections. Today, gene editing is routinely used to introduce human genes inside bacteria to make them produce, low cost and rapidly, some medical substances like vaccines or insulin.
CAR-T cell therapy is an approach that consists of genetically modifying the immune cells, protecting us from exogenous organisms, to make cells much more receptive against some specific cancers.
But how do we replace defective genes or insert new ones? For example with CRISPR/Cas 9 system: This gene editing technology is used to make targeted changes to the genome of living cells.The CRISPR/Cas9 method can precisely modify, insert or delete disease-causing anomalies at their genetic sources. It has two components: a specific section of guide-RNA (CRISPR) and a “scissors’” enzyme that cut DNA (Cas9). When the modified guide-RNA finds the matching gene, Cas 9 cleaves the DNA at the targeted point. A strand of DNA with the desired sequence is inserted in the cut site.
This new technology has the potential to treat more than 6,000 diseases: genetic diseases, diabetes or muscular dystrophy by inserting the correct gene to produce the missing protein. It could also be used against more complex diseases, such as cancer by targeting the protein responsible for cell division or by producing killer T-cell able to destroy tumor cells.
Bionics: A real long-term investment
Our investment solution on this thematic is a long-only and actively managed certificate. We believe that Bionics benefits from long-term drivers.
When nature inspires the technology
Nature always inspired men and researchers for inventions and innovations. The dream of flying like a bird or swimming like a fish is as old as mankind itself. Leonardo Da Vinci, for example, centuries ago, attempted to exploit the principles of bird flight to design a flying machine.
This fascinating approach is motivated by the fact that evolutionary pressure typically forces living organisms to become highly optimized and efficient.
Most recent definitions of the term Bionics applied in medicine consider it simply as systems formed by merging biology, mechanics, and electronics to restore, or even enhance, the body functions.
We are living longer but not necessarily better
Today we are facing an aging population with 285 million people visually impaired, 360 million people with disabling hearing loss, 15% of the global population with a disability and more than 120,000 people in the US that are still waiting for a transplant.
The new generation is living longer but not necessarily better. They are more likely to be obese, have diabetes, or have high blood pressure than the previous generation at similar ages.
Moreover, chronic diseases and age-related degenerative diseases have increased too.
This overview gives to bionics a huge market opportunity and among all bionics technologies, synthetic biology, medical robots and wearable devices are the most interesting today considering the market size and the growth rate, and if we consider all technologies together, we are speaking about a global market of $113 billion by 2023.
Bottom line:
We believe that the Chinese biopharma sector is entering an important innovation cycle, thanks to supportive government reforms. The China FDA (CFDA) removed many clinical trial requirements and introduced a priority review designation to speed approvals. As a result, many Chinese and USA innovative drugs were approved, including Keytruda by Merck (MRK US), Repatha by Amgen (AMGNUS), or Spinraza by Biogen (BIIB US).
China also has a very competitive advantage: the sector can rely on important big data and its AI capabilities to stimulate fast-growing areas such as genomics and AI applications in healthcare.
In our biotechnology certificate, we currently have a direct exposure to the Chinese biopharma sector, albeit limited.
We are closely following the sector and may add more Chinese biopharma companies in the future.
Sources:
China Internet Network Information Center (CNNIC), https://www.yicaiglobal.co m/news/china-aims-usd146-billion-big-data-market-2020, Frost & Sullivan, Evaluate Pharma, Grandviewresearch.com, GLOBOCAN 2012: Estimated Cancer Incidence Mortality and Prevalence Worldwide in 2012, WHO, June 2017, https://www.scmp.com/sites/default/files/2014/05/30/5e8ef3511defc2f9b7963c0d172d047.jpg
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