INDIUS Medical Solutions | Aditya Ingalhalikar, CEO

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Aditya Ingalhalikar  0:05  

Good afternoon, everyone. My name is Aditya Ingalhalikar, founder and CEO of Indius Medical Solutions. We are a spinal medical technology company developing end to end solutions from AI based diagnostics to personalized patient specific implants. spinal disorders are a large disease burden and one of the leading causes of disability all across the world, including the United States, with more than $50 billion spent every year on back and neck pain. In the US alone, more than a million surgeries are performed every year on the spine. The spinal anatomy is extremely complex with 26 bones, 74 joints, nine spinal ligaments, and 40 spinal muscles. And spine not only just allows load, bearing and motion, but it protects life and quality of life as the spinal cord nerve roots and the blood vessels traverse through the length and breadth of the spine. The complex mind disorders which is the focus of our company is a very high risk disease symptoms being pain, organ dysfunction, paralysis and even death. There are almost 71 conditions that afflict the spine. And we have categorized our problem statement into two large buckets. One is the adult spine disorders, and the other one is the pediatric spinal disorders. And within the pediatric space, we are focusing on early onset scoliosis, which is a deformity that affects in the age group of five to seven years of age, which is pre puberty, when growth is still pending in the spine. And then the other one is adolescent idiopathic scoliosis, which is post puberty so post 10 to 12 years of age. So what is the current treatment modality and workflow a busy slide over here, but the current treatment modality involves manual disease diagnosis, manual, surgical planning, manual, implant, trialing, and spinal fusion surgery, and spinal fusion surgery involves the use of implants to stabilize the spine to correct deformities of the spine, and to replace damaged tissue and to remove and eliminate motion so as to eliminate pain. On the screen. As you see over here we have pediatrics, scoliosis, deformity and spinal oncology as two examples that I have taken, and right in the center is our implants being used. Or implants being sorry, our implants being used in the center is that's our implants that are used in scoliosis deformity surgery. So that is the standard of care today. So what is the problem here? The problem is, in spite us having the best trained surgeons and best in class implants available in the United States as well as globally, the revision surgery rate in spine is 38%, as high as 38%. And the spinal surgery expenditure for Medicare and all private payers is $30 billion on a yearly basis. So imagine if that much revision surgery is there, then what is the amount of money that is being wasted because of revision surgery. So having spent time I have myself spent almost 18 years as an innovator and inventor in the spinal implant space with more than 30 patents to my credit, and what I realized that as a technologist and scientist we are keeping on innovating spinal implants, but there's no change in the surgical outcomes of the patient. So we kind of stepped back and said that you know, what, we need to address the problem differently. And what we realized is that we have addressed the mechanics and biologics, but we have not addressed the human problems. I mean, how many of you who are used to working with spine surgeons know that at any given time, a spine surgeon sees anywhere from five to 50 patients depending on which country you are in from a diagnosis bases, at the same time, three to five surgeries are performed on a daily basis, ranging from a one hour surgery to eight to 10 hours of surgery, if it is an extremely complex spine surgery, and then there is the post operative care, we all assume that he or she, the spine surgeon is a super human who is supposed to keep all this data in their head and make sure that they are completely active with their wits about during the surgery to be able to perform surgery in an accurate way. So that to us is an unmet need. We believe that that has not been addressed, we have over the last 30 years, there has been no innovation on the back end of it, which is the diagnosis side and the surgical planning side of things, though, we have done awesome things on the implant side of things. So that brings us to our solution. Our goal is to put the surgeon at the center of the offering because what we have done is we have completely forgotten the most important variable responsible for the success of the spine surgery which is the surgeon and to that end, we are developing AI driven diagnostics and surgical planning integrated with spinal implants to give personalized patient specific implants to the patient. What are the advantages of this? Now this is a busy slide over here, but what you see on the x axis are multiple parameters. So related to one surgeon work accuracy, efficiency and stress. So diagnostic inaccuracy, surgical planning, time, effort and stress And intraoperative surgery time planning and stress. The second one is hospital impact which is related to Hospital Operational costs. And then the third one is related to company distribution and sales impacts as to the inventory carrying costs and the logistics of the implant delivery and billing that is today associated, the current solution and the current workflow scores negatively high on all of these parameters. And our goal is to reduce that and to have a positive impact on all of these parameters with the goal of reducing the revision surgery rate and improving the spinal surgery outcomes. The product strategy to gain market share is to marry the AI based diagnostic platform that we are developing to our spinal implants to be able to gain market share. On the spinal implant side it is a $14 billion market growing at a 5% rate year on year. And then the second one is to address the software side of it which is a half a billion dollar market growing at 30% rate. This brings me to my next problem which is early onset scoliosis. In early onset scoliosis, it is an S shaped deformity, which affects the in the age group of five to 10 years of age. The current treatment modalities is spinal distraction done by the surgeon every six months for a period of six years, it is done either through a surgery or through magnetic distraction. Now how does the surgeon really know and today the complication and again revision surgery rate is 30%. How does the surgeon know that one kid's growth rate is different than the others? Well, they don't know the six month is a practical time point from an economics and practicality basis. And that we believe is the reason for this complication rate. We have taken a completely different approach to this, what we are saying we want to give control back to the nature we are developing a patented patient specific self actuating in finite simul natural growth driven growing rod system, which once implanted into the spine, there is no distraction that the surgeon has to do as the spine grows on a daily basis, the rod will adjust and accommodate to it. And this is the main differentiator that we are developing on the spinal early onset scoliosis side of things. Second problem in the scoliosis is adolescent idiopathic scoliosis. What you see on the screen there is the current standard of care. At 12 years of age or 10 years of age, if you have scoliosis, you are put in with spinal rods and screws, your deformity straightened and the spinal fusion spine is fused. So we're removing all the motion from the patient. And imagine it's a 18 year old child they have their entire life to lead. The disadvantages are bad quality of life, continuous pain that happens even later on and potential for revision surgery later on in the life. So what we are saying is we are developing a patient's specific motion preservation technology which is minimally invasive in nature, which once implanted, it will allow it will be motion preserving in nature, you won't have to do the fusion and it will help in reducing post operative pain from a long term standpoint. So our product strategy on the scoliosis side is again to marry the AI based software platform with our scoliosis technologies to be able to address the $1.4 billion market that is there for the scoliosis surgery implants. We have a proven leadership myself I have been in the spinal implant space for the past 18 years now I have a PhD in spine biomechanics from University of Iowa and I was the Director of Global Product Development at Globus medical. Nikhil is our is has 18 years experience in quality and supply chain and Sagar has 18 years experience in manufacturing or operations. Our AI is being delivered by Madura angle Holika, who is a scientist who spent a long time at UPenn working on brain related disorders. And Rick Barron is our board member who has extensive experience as a CFO we have a world class advisory board with prominent spinal scoliosis surgeons in the country. And our business traction we have five years FDA approvals, 11 patents in US, India, European Union and Japan our implants have been used in more than 1500 patients today and commercially, we have $1 million plus in terms of global net cumulative revenue over the last 24 months with 100% year on year growth and our implants are being used in the United States that is where we are launching currently, but we are already commercially available in India, which is a very large market financial projections. That is the growth that we are looking at, we are already revenue generating. And in terms of capital requirement, we are raising $12 million for our US commercial operations and completing the r&d and regulatory approvals for our AI platform and for our scoliosis implants. So thank you very much. And if you have any questions, my email address and phone number are there, feel free to contact me. Thank you so much.