Adam Szaronos Presents Trukera Medical at LSI USA ‘23

Transcription

Good afternoon, and thank you for the opportunity to present today. Several years ago before I joined this current organization, I had an experience that forever changed my view of the unmet need and the impact that laboratory medicine can have an up home at care. And at the time, I was working for a global manufacturer of intraocular lenses used for cataract surgery. And I'll never forget between. Before one particular post op, when I was observing with this doctor and his clinic, the staff caught him outside the door and said, Doctor, this is the patient that called really upset. She said everything was fine. She had premium bilateral surgery about a month ago, everything was fine for the first few weeks. In the last week, the vision has started to fluctuate, and she's insisting that something is wrong, the implant must have moved inside the eye regretting she spent all this money. And he looks through the chart for a moment outside the lane. And with total confidence, he turns to me, and he says, it's really good. You're actually going to see this today. Because if a patient is dissatisfied with modern cataract refractive surgery today, reasons One, two, and three are always corneal disease. And I'm going to show you how we prepare for that in advance and what that conversation looks like. And solving this problem. And I'll come back to that story in a minute, is what our company was founded for. We originally launched under the name brand tear lab in 2008. And brought to market the very first CLIA waived objective laboratory tests in eyecare. Something taken for granted if you see any specialist in any other field, there's a good chance at 90% of their decisions will be based on what laboratory results show. And that's foreign in eyecare. For good reason. There's not a lot you can learn about diseases of the eye from blood, saliva and urine. So we pioneered that concept, taking a small 50 milliliter sample and identifying disease state markers for corneal disease last year, fast forward a bit, we've done this now 25 million tests, we're obviously commercial stage organization, 25 million tests across almost 50 markets. And we rebranded we're preparing to grow beyond a one product company. This is a very high potential platform strategy when you start at the diagnostic point of a conversation and a patient journey. And so we've repositioned as Trukera Medical, a name that reflects the broader identity and goals we have to build a comprehensive cornea company. So quick company profiles here. We're growing this year expecting to do about 30% top line year over year growth, we'll probably be around 26 27 million sales. We were taken private just two years ago spent the last two years working on a new product launch. I'll show you here, refocusing our commercial efforts rebuilding. And now we have an EBITA positive core business and a healthy platform again to tack on additional expansion products as well. So here's why what we measure matters as this audience knows, salt is naturally corrosive. The human body cells work very hard to try and maintain a tight homeostasis range of osmolarity between 290 and 300 milli Osmose per leader, the cornea is no exception to that. And when exposed to elevated levels of salt ramp and cell stress and death can begin to occur. As you see here and laboratory tests we control for this on the left side, you see healthy corneal epithelial cells in a natural 290 milli Osmo range, those same cells after only 48 hours being exposed to elevated hyperosmolarity ramp and cell stress and death begins to occur. And we know the prevalence of ocular surface disease, particularly in cataract age practices is substantial. 80% of patients coming in for cataract surgery today will have at least one sign or symptom of ocular surface disease, many of which if you test for it, you'll find hyperosmolarity is the culprit. And it's not just elderly populations. In fact, last April of 2022 new study came out in the jcrs, showing laser surgery age patients typically 2030 Somethings, nearly a third of them, if you test for it will show signs of hyperosmolarity as well. And here's why it matters. And this is what the doctor that day knew he was stepping into. If a patient does have hyperosmolarity, nearly 20% of the time the fluctuations in vision can be up to a diopter or greater For those not familiar with diopters, you go to your eye care doctor and they asked what's better one or two, those are quarter diopter increments, so manage four times that are greater swings throughout the day, because you have a cellular environment on the Corneal Surface exposed to toxic hyperosmolarity. And I'll never forget how he used this information. He heard the patient out and he knew from his chart, this is what he was walking into. And he said ma'am, good news is your surgery is fine. The lens is exactly where we want it to be. But and these were the magic words I heard for the first time and I care he said but we need to talk about these lab results. something new in the automix space these lab results. Prior to surgery, we identified a high osmolarity environment on your surface we went through work to tune you up so you can get the premium lens investment you wanted. You were stable today those levels are spiking again and he has to patient, are you staying on top of your home therapy? And the patient said no, I thought I could stop after surgery. So what started as a patient ready to blame the surgery blame the lens technology turned into a patient that was reminded they have a secondary disease state that they need to manage and she left empowered and actually apologetic about it. So he's doing this in all his premium cataract refractive surgeries. And this is so substantial well known at this point only a few years ago, the ASCRS cornea committee updated their preoperative algorithm as a society recognizing osmolarity testing as essential in the preoperative cataract workup for these reasons, and the opportunity in the anterior segment space is huge. The premium cataract space continues to grow. These are cash pay transactions on top of standard cataract surgery where a patient is investing to get a targeted outcome to get out of glasses for nearsightedness, farsightedness, astigmatism presbyopia, this is a space now creating over 2 billion and incremental industry revenue annually over 12 billion and incremental provider fees. And this is our sweet spot. This is where most new osmolarity adopters today live and breathe are inside these large anterior segment surgical practices. And we're just scratching the surface of this TAM, we are today at about 25 million out of a quarter billion dollar market opportunity. But there were problems our historical product was not fit to serve this growing demand inside a cataract modern practice. So we knew we needed a solution that could keep up with the high volume demands not rerouting patients through the practice but allowed you to bring the testing to the patient. And so this quarter, we're in the process of launching. Now in market a new version of our gen two system, which is portable, practical and precise. This is the scalp pro handheld osmolarity system. It's an objective laboratory collection and analysis system fits right in the palm or in the workup Tech's pocket. And the secret sauce behind this is simple laboratory medicine is really two technologies that must work together you need a means of specimen collection, and you need a means of specimen analysis. So these are no longer separate technologies. We've integrated them into a single device. And the coefficient of variation on this is extremely precise. It's built on a 25 million tests to date of precision. Because we're somewhat alone in the space and eyecare CVs outside of our space you can see are usually a multiple of where we are consistently testing under one and a half percent CV. So this is my lovely assistant Linda, HIPAA guards, I promise you I've received consent to share her PHI I want to actually show a real life test of how this is now equipped to win and grow inside the busy premium cataract space. It's interesting just a few years ago, before COVID rapid testing in the laboratory space often meant 24 to 48 hour test turnaround. And then during COVID We got accustomed to rapid being branded as a 10 to 20 minute test. So when we say rapid and built for the high growth opportunity in cataract, we mean from collection to objective output an analysis and 15 seconds. So you'll see this here I'll speak through a couple of the beeps because it goes quick here. That's the disposable tip. And so well reimbursed test that cost about $10-11 per i reimburses about $22. That first beat recognizes the tip. There's a 50 nanoliter size collection, which is about the size of a period on a business card. And in a span of a few seconds. It does a real time temperature analysis and the osmolarity outputs available right on the screen. So Linda, here's a great example of a young cataract aged patient who would be otherwise asymptomatic, but would be a cautionary tale and a red flag where there's a secondary conversation that needs to take place before especially investing in a premium outcome about a chronic disease on the ocular surface that she'll have to manage down and stay on top of postoperatively. So with that, thank you very much for your time I look forward to the rest of the meeting.