The next big medical revolution – in digital therapeutics – is here, and its arrival has been massively accelerated by the COVID-19 pandemic.
Digital therapeutics or “DTx” combines the latest advances in biology, engineering, and data science to improve patient care. But Australia, despite having outstanding ideas and inventions in the field, is in danger of missing the wave, says a leading biotech investor.
The best Australian companies in DTx are at risk of being “cherry-picked” – particularly by cashed-up US investors – if Australia “fails to get the funding gap sorted,” says Dr. Graham Crooke, managing partner of BioScience Managers (BSM), one of Australia’s leading healthcare investment firms.
“Australia gets so many things right,” explains Dr. Crooke. “We’ve got a great healthcare system, excellent education, world-class researchers, excellent telecoms infrastructure, entrepreneurial people and governments that recognize the importance of digital. We just don’t invest enough in our own ideas and expertise.”
“Fortunately, we know what to do,” Dr. Crooke says. In 2015 Australia launched a public/private co-investment effort called the Biomedical Translation Fund (BTF) Initiative. The BTF Initiative included $250 million in federal money matched dollar for dollar by private capital – mostly from Australian superannuation funds.
“This program has been hugely successful,” continues Dr. Crooke. “We at BSM have seen the success of the BTF Initiative first hand, being one of the firms chosen in 2016 to participate in the program. BTF funds have kept biomedical companies in Australia, creating high-value jobs, expanding our healthcare ecosystem, and helping Australian companies to commercialize overseas.”
“We’re now seeing lots of exciting opportunities in DTx, but these companies are highly mobile, so we have to act quickly,” says Dr. Crooke. “Local innovations can’t and won’t stay in Australia if they’re not funded. They will have to move overseas, not to address global markets but just to get financed. In many cases, these new technologies can serve global markets just as well from Australia as from elsewhere.”
“DTx is a specialized sub-set of digital health that is simple in concept – you combine information with traditional medical products. When many people think of ‘digital health’ they think of smartwatches, remote patient monitoring, wellness apps, and patient-doctor consultations over Zoom, but DTx goes well beyond that.”
“We look at DTx as “smart” drugs, devices or diagnostics that sense, measure and collect clinically-relevant data, that then improves the product in some way, translating to better outcomes. DTx can also track data over time and use the power of artificial intelligence and machine learning to optimize treatment.”
“When the healthcare system confronted the scale of the pandemic last April, all the stars aligned for DTx very quickly,” says Dr. Crooke. “You had the traditional model of care breaking down, overwhelmed by the limitations of face-to-face care. You saw a change in mind-set – people were willing to look at new models and adopt them quickly.”
“But even when the health system gets back to some form of normal, everyone now realizes that it is still at risk of being overwhelmed a second time due to deferred and delayed treatments – or the next pandemic! The adoption of DTx will accelerate,
resulting in healthcare that is more accessible and more affordable. The logistics of patient care are complex and prone to error. This puts lots of stress on clinical staff. We think that caregivers will see that DTx can help improve outcomes for their patients.”
But local DTx companies – even those with the most promising projects – are often starved for investment.
“Part of the difficulty for Australian investors is that DTx opportunities are neither true early-stage nor true expansion-stage, which are both areas in which capital is more available in Australia. DTx doesn’t fit neatly into either of these buckets and the companies themselves also face significant clinical, regulatory, and commercialization risks. Growth capital for these companies is very limited. They are heavily reliant on friends and family or grants. We see most of them struggling.”
But US venture capital firms invested $50 billion in healthcare in 2020 and are on track to exceed that in 2021. About one-third of this $50 billion was in digital health. Also, a boom in special purpose acquisition companies (SPACs) have tens of billions of dollars to invest, says Dr Crooke. “They are more than willing to snap-up our best companies. That means the manufacturing, the jobs, the opportunities will be lost to Australia.”
Dr. Crooke cites the example of Brisbane company DoseMeRx, which developed precision dosing software for several widely-used drugs that have side effects if dosed incorrectly. Acquired in 2019 by Nasdaq-listed Tabula Rasa HealthCare, the DoseMeRx business moved to the US. “That’s the kind of opportunity that we want to keep here in Australia,” says Dr Crooke.
Since the launch of its BTF fund in December 2016, Dr. Crooke says BSM has committed a majority of the $101 million it raised, returned over $50 million to investors, and attracted significant international investment into Australian biomedical companies. The fund has invested in 9 companies and has 2-3 more investments to make. “Our return numbers are confidential, but I can say that the returns on our funds compare favorably with the best funds anywhere.”
“We know the BTF structure works – for tax-payers, for companies, and for investors,” Dr. Crooke says. “We strongly support suggestions to apply this proven model to DTx and help to make Australia the world leader in this space that it could and should be.”