Retia Medical | Marc Zemel, CEO

Marc Zemel  0:00  
Once again, I'm Mark Zemel, CEO and co founder of Retia medical, we're raising $10 million to help us take over the $4 billion hemodynamic monitoring market.

Once we got FDA clearance, one of my mentors told me go and talk to the leading academic medical centers and get their objections, get their feedback. And thankfully, not only did they buy the monitor, and now they're continuing to buy the monitors. So just two weeks ago, we signed a contract with one of these customers to buy 50 monitors. And now let me tell you a little bit about why they fall in love with this product.

So circulatory shock, is a primary cause of complications $30 billion are spent every year on these complications from high risk surgical patients and stays in the ICU. And when their blood pressure drops below 65 millimeters of mercury that circulatory shock, and it happens all the time. When it happens, clinicians have one to two minutes to prevent damage, whether it's to the brain, the heart, or the kidneys. And these are terrible outcomes for patients obviously, and very expensive to the healthcare system. So over 30 Studies show that using hemodynamic data to guide care, you can lower the rate of complications by up to 50% shorten their stay in the ICU by one to two days and save thousnads for every high risk patient. The problem is the other market monitors in this space are either too invasive, and hard to use, like the PA catheter or the esophageal Doppler where the probe moves with the pulsatility of the heart. Or they're less invasive like the Edwards A-line monitor or the Cheetah ICG impedance cardiography monitor, those are not consistently accurate. So the result is that these monitors are not routinely used on the patients that need it the most. That's where we come in. Retia provides 10 advanced hemodynamic parameters to guide care for these patients. And in head to head studies has been shown to be 50% more accurate than market leader which is Edwards in this space. It's protected by 10 patents that we licensed exclusively from MIT and Michigan State.

Here's an example of the difference. So in our FDA study, we did liver transplants and cardiac surgical patients. When you ask any anesthesiologist, they say do you work in livers, these patients, these liver transplant patients are hyperdynamic, they have high flow. And that's similar to patients with sepsis, they experience dramatic shifts in their hemodynamics through the course of the surgery. So here you can see, the blue line is the reference pulmonary artery catheter went down, right and right to correctly track that change, both indicating possibility that the patient needs an intervention. By contrast, the Edwards monitor went up suggesting the patient was fine. I said I don't need a PhD in statistics up versus down. That's the essential performance of a monitor, they got it wrong. And they get it wrong up to 50% of the time on these types of patients. Retia gets it right 90% of the time tracking those changes with the PA catheter. And that's been proven now in nine clinical studies, almost 1000 patients you're talking your your livers, cardiac heart failure, neurosurgery, major abdominal spinal, we did a 15 hour case it NIH with all sorts of complications, cancer resections, patient came out fine. And as went through rehab,

it's not enough to be accurate, you have to make it simple for the clinicians to use. So what do we do?

Every one of these patients has an arterial line for beat to beat blood pressure monitoring, right? Because you're worried about circulatory shock, right? That line is connected to the bedside monitor your GE, or your Philips or what have you. We just take one cable, just like you would plug into you know your headphones to your laptop, right? And get that blood pressure data from the multiparameter monitor, run our algorithm get you the information you need. So nursing Cleveland Clinic said it's as easy as plugging in your smartphone. So once they trust the accuracy, the clinicians fall in love with the product, right? So at Hopkins, the our champion their said his vision was to bolt our monitor to the anesthesia machine and using every cardiac OR right and that's what we did. You can see that on the right. And on the left you have in the ICU that typically mount or monitor next to all the infusion pumps so they can titrate all their medications. We track our net promoter score, how likely are you to recommend us to your friends and colleagues. It's in the 70s. Typical med tech is in the 20s and 30s. Look, everybody has one of these in their pocket, right and they show up to work. And you know, there's all these complicated buttons and all this other stuff that they don't remember, nobody reads the manual anymore, right?

Our monitor you walk up, you can figure it out instantly.

This is a $4 billion market. It's been growing at 10% or more for the past several years. We're initially focusing on the 2 million patients every year that are already being monitored with hemodynamic monitors, we don't have to do any education we come in, we give them something better, easier and cheaper. No problem, right, ultimately, with this product will serve 20 million patients every year they get an A line, they have the A line because you're worried about shock. That's why you need this monitor.

Beyond that, we have on our roadmap to go non invasive, serving the 100 million patients who are at elevated risk for complications from surgery in an ICU stays. Here's an example of how we save the hospital money. So we have two ways to go to market one is a monitor as a service, 995 per monitor per month, or they can buy the capital equipment outright, right. Primary issue is, as we all know, acute kidney injuries occurs 30 to 40% of the time after cardiac surgery, right? For every 1000 cases, you're talking almost $4 million in cost, right? Use eight of our monitors $100,000 a year right for in the ICU for the AOR right, implemented care protocols, using our data lowers that rate of AKIs hospital saving almost $2 million, it's a no brainer, when you get to the C suite CFO and the supply chain. Right. We've been focusing on academic medical centers, right, typically cardiac OR, cardiac ICU, the most knowledgeable about physiology and again, the toughest critics get us the credibility to then spread to the other ICUs and the other ORs, , right. In the meantime, we're working on getting on contracts. We're working with Vizient, Premier, and a couple others who will be in those this year. And so far, you know, sales cycle, despite COVID and everything, if they have budget, it's six to 12 months, NIH was one case, three months, we've won 95% of our evaluations. The one loss was they weren't using enough A lines, right, so it's the wrong target. With the 10 million that we're raising, we'll be driving to cashflow positive by the end of 2023 will be north of 10 million in revenue, and then continuing to grow sustainably, by 2026. Crossing 50 million in revenue. It's a 85% GP right now, with some cost reduction, we can bring that above 90, even at that point in 2026, we'll be penetrating about 10% of the total bed count for our target.

The vision with this product is not just a one algorithm and then you know run away we have other algorithms in the pipeline. And what we're trying to do is to provide connected cardio respiratory care when you think about the foundation of these patients, trying to make sure that you're managing the all the different organ functions together, right? They're on a ventilator, how do you know if their heart is ready to support the work of breathing, right when they get off the ventilator? It's very bad to have a re intimidation. And it happens all the time in the ICU, right? They use our monitor to make these decisions. Same if they're on renal replacement therapy, we work in VV ECMO. Again, it's a foundation of cardio respiratory status that helps digitally augment the care provided by the doctor. My team is outstanding lots of experience in anesthesia and patient monitoring great clinical advisors from all the top institutions. I'll just mention Jerry Korten, who was my mentor and then joined on full time he ran Versamed ventilator company brought that up to 20 million in sales sold it to GE, so we know what to do to bring this company to the next stage of its evolution.

Last year, we were part of med tech innovator, we got the CE mark, we're now selling in 14 countries built a nice pipeline, more than tripled our revenue, despite you know, COVID with two hands behind our back right terms of market access. We did just under 2 million in revenue. And as I said, we're now raising up to 10 million to help grow sales and add more algorithms. Due to the consolidation in this space. We're the only independent hemodynamic monitoring company remaining on the radar of all the strategics they know they need us in their portfolio to complete that, that that integration that I talked about to digitally augment care. So Retia means vascular network. We have a growing network of professionals and clinicians that have joined us in their vision to help us better data to save lives. I thank you for your time. Look forward to meeting you next door.