ISRAEL AS A LEADER IN BIOMED AND HEALTHCARE RESEARCH AND INDUSTRYAndrei Lopatenko, PhD in Computer Science,Director of Engineering, Walmartlabs, alopatenko@gmail.com

REWALK

Bionic assistance system to enable paraplegics to stand upright, walk, climb stairs

Controlled by wrist mounted remote

Approved by FDA

Distributed in Israel, USA, China

https://youtu.be/lMlp8r0tG_o?t=6m1s

ICD (IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR)

One of major achievements in cardiology of the XX century

Implantable device to perform cardioversion, defibrillation and pacing of the heart

Israeli trained Michel Mirowski is one of major contributors

EXABLATE

non-invasive medical device based on use of ultrasound for medical treatment

Approved by FDA to treat uterine fibroids, used to treat 5000 patients by 2007

Got European CE mark

Used to treat breast cancer, adenomyosis, bone metastases

clinical studies for bone metastases and brain tumors

https://youtu.be/vVLc6lYbLI0?t=8s

BRAINSWAY

“transcranial magnetic stimulation” device to treat depression

Magnetic fields stimulate targeted deep brain tissues

FDA approved

has CE Mark for 12 indications (Alzheimer’s, Parkinson, stroke)

PILL CAM

miniaturized camera inside a pill in an easy to swallow disposable capsule

pill cam colon: high accuracy of results (more than 50% accuracy to detect large polyps)

https://www.youtube.com/watch?v=rMbCB2_vCt0

CM-24

immuno-oncology, stimulating tumor-directed immune responses

first-in-class humanized anti CEACAM1 monoclonal antibody that inhibits the immunosuppressive effect of CEAC AM1, leading to an enhanced anti-tumor immune response of T and NK cells.

ccam, acquired by Merck for 605

ISRAELI HEALTHCARE SYSTEM

Israeli healthcare system is ranked 7 in the world in terms of efficiency by Bloomberg in 2014

3.3 practicing physicians per 1000 population (higher than USA)

60 hospitals and medical centers

50% of doctors are immigrants from Eastern Europe

ISRAEL HEALTHCARE SYSTEM

OECD report (advantages) : The life expectancy of Israeli males is 79.9 years, two years higher than the OECD average and the third highest on the OECD scale;

The equivalent for females is 83.6 years, 14th on the list. Japan has the longest-lived females, with an average age of 86.4%.

The infant mortality rate here is lower than average, with 3.6 per 1,000 live births compared to the OECD average of four

Israeli hospitals have many “warm beds,” as the occupancy rate here is 96.6% – the highest in the OECD – compared to the average of 75.1% and 64.4% in the US

ISRAEL HEALTHCARE SYSTEM

OECD report (deficiencies)

The ratio of Israel’s hospital beds per 1,000 residents is 3.1, compared to the OECD average of 4.9 and Japan’s 13.4. The ratio of beds in general hospitals is 1.9 per 1,000, compared to the 3.3 average and 7.9 in Japan. The ratio of psychiatric hospital beds is only 0.4 per 1,000 in Israel, lower than the 0.7 average and 2.7 in Japan.

While the ratio of physicians per 1,000 residents in Israel is 3.3., compared to 4.9 in Austria and the OECD average of 3.1, Israel’s relatively high rate is quickly disappearing, as doctors who immigrated from the former Soviet Union in the 1990s retire.

ISRAEL HEALTHCARE SYSTEM

deficiencies: As for nurses, Israel is in trouble with the second lowest ratio of 4.8 per 1,000 (only Mexico is lower) compared to the average OECD rate of 9.1 and 16.6 in Switzerland.

80.3 % of Israelis hold supplementary health insurance (beyond the regular health fund basket of services) compared to an OECD average of 34.3% and 0.2% in Iceland, where residents pay almost nothing extra for health. Israelis spend only 4.3 days annually in general hospitals, compared to the OECD average of 6.5 and 17.5 days in Japan.

Private (out of pocket) expenditures for healthcare is high in Israel, at 38.6%, compared to the 27.9% average and 52.4% in the US.

ISRAEL HEALTHCARE SYSTEM

Medical tourism:

30000 foreigners come to Israel for medical treatment (2010)

income from medical tourism is about 140M (2012)

many people from Palestinian territories came to Israel to get medical treatment because they can not get it locally. (PA spend 42M to finance medical coverage)

ISRAEL LIFE SCIENCE INDUSTRY

1000 medical device companies

$800M invested in 167 life science companies in 2014 (55% growth vs 2013)

1380 active life science companies (66% less than a decade old)

ISRAEL LIFE SCIENCE INDUSTRY

Israeli life science companies raised 1.4 Billion on the NASDAQ in 2013-2014

Out of 73 life science companies that raised on the NASDAQ in 2014, 7 are Israeli companies

62 companies were acquired in 2015 - 2014 with aggregated sum $8 billion

ISRAEL LIFE SCIENCE INDUSTRY

ISRAEL LIFE SCIENCE INDUSTRY

MEDICAL DEVICES

700 medical device companies (2013), around 1000 now

65% of them are at early stages The highest number of medical device patents per capita in the world

MEDICAL DEVICES

export 1.6 billion mostly to USA, Japan, China and Europe (global market is 322 B) 2011

Most companies are in Therapeutics (225 companies), the monitoring and diagnostics (141)

commercialization is strong in imaging sector (7 companies are bough by international giants)

out of 385 million vc investments in Israel (in 2011), 55% goes to medical device companies

MEDICAL DEVICES

brief history

1962 Mego Afek AC is founded

1972 First Israeli IPO on NASDAQ. Elscint, specializing in medical imaging

1990s due to alia from former SU, the number of companies produced medical devices increases significantly, 269 new emerge during that decade

1996-1998, General Electric (Healthcare) purchases Elbit Medical Imaging ultrasound division, Elscint NM and MRI divisions, Versamed, and uses them to found GE Healthcare Israel

MEDICAL DEVICES

2001-2010 632 new companies are established

2001 Given Imaging is listed on NASDAQ, 2004 it’s dual listed on TASE

2004-2008 MediGuide (minimally invasive navigation navigation and tracking within the body), acquired by St Jude Medical, 300M, Ventor Technologies (aortic valve technologies), acquired by Medtronic 325M (closes in 2011, development move to Ireland, manufacturing to California)

2012 superDimension (diagnosis of pulmonary diseases: cancer, tuberculosis 22000 patients in 350 hospital), acquired by Covidien for 300M

MEDICAL DEVICES

Segmentation by business stage, most companies are at early stages

65% of companies have not reached the commercial stage

out of 195 companies selling products only 30 have revenue more than 10 M

MEDICAL DEVICES

MEDICAL DEVICES

companies and technologies are frequently built by former IDF researchers: PillCam (Given Imaging) by IDF trained engineer who was working on miniaturizing of missile guiding technology

(ExAblete) InSightec is founded by IDF trained engineer working on directing missile technologies, developed MRI guided ultrasound system to treat fibroids

business friendly regulations: funding from the Chief Scientist Office, virtually tax free environment

GIVEN IMAGING

HQ is in Yokneam, founded in 1998

Revenue 178M in 2011

acquired by Covidien in 2014 which was purchased by Medtronic in 2015

PillCam family of products, Bravo pH monitoring (capsule based detecting of acid reflux)

SYNERON MEDICAL

Founded in 2000

Corporate, RD, manufacturing HQ is in Israel

Revenue 200M annual

products are mostly in medical-aesthetic applications (body contouring, wrinkle reduction)

Since 2007 markets and distributed products through Procter & Gamble

SHAMIR OPTICAL INDUSTRY

Founded in 1972

HQ in Shamir Kibbutz, Upper Galilee

1400 employees,

develops, manufactures, progressive and occupational generic lenses

in 2009 merged with French Essilor (50% for 130M)

LUMENIS

founded in 1991

HQ in Yokneam

800 employees

75 FDA clearances, present in 100 countries

medical lasers (surgical laser systems, laser links, hair removal, skin resurfacing, burn and scale healing etc)

ISRAEL PHARMACEUTICS

more than 60% of companies are in Phase 2 and 3 in mid 2013

4000 medical patents in 2013 (IATI)

annual sales ~ 8B (Israel Ministry of Economy),

50% companies are < 10 employees, 75% < 25 employees, 2/3 are founded after 2000

ISRAEL PHARMACEUTICS

Fourth largest supplied of pharmaceutical products to the USA

Pharmaceutics is 24% of Israeli export to the USA, 5.6 B in 2011

ISRAEL PHARMACEUTICS

Majority of Israeli pharmaceutics are small and medium size companies

25% drug discovery, 19% new chemical entities, 18% drug delivery

ISRAEL PHARMACEUTICS

Medical field focus: 27% cardiovascular, dermatology and aesthetics 20%, endocrinology 17%

TEVA PHARMACEUTICAL INDUSTRIES

headquartered in Petah Tikva, Israel, founded in 1901

one of the largest generic drugs manufacturers in the world

20.3 B in revenue (FY 2014)

46000+ employees

Copaxone, Azilect, Zocor

TARO PHARMACEUTICALS

headquartered in Haifa, founded in 1950

Listed in NYSE

Revenue 800+ M in 2015, 6.2 B valuation, 1300+ employees

owns 180 drugs sold to 25 countries

was on the edge of liquidation in 2006, steady growth since

NEURO DERM

Hq in Rehovot.

Clinical stage company focused in Parkinson disease and central nervous system disorders

valuation 300M

a pipeline of products for moderate and severe PD , up to Phase II

GLOBAL PHARMACEUTIC COMPANIES PRESENT IN ISRAEL

Johnson and Johnson (RD in Weizmann SP, incubator),

Perrigo (Agis),

GE Healthcare (GE in Israel since 1950),

Phillips Medical (diagnostic medical imaging 1998, Haifa),

Abbot Laboratories (acquired Starlims Technologies,, collaborates with Weizmann Institute of Science),

Merck Serono, Sanofi

ISRAEL PHARMACEUTICS

Brief history

1901 Salomon, Levin and Elstein Ltd. (SLE) was founded. currently functions as a distribution unit of Teva

1936, the Sieff Research Institute , currently the Weizmann Institute in Rehovot

1967, due to Israel geopolitical isolation local companies had to develop local solution due to lack of supply from the West

1980s, first two biotech startups are established: Bio-Technology General (BTG) and Interpharm

ISRAEL PHARMACEUTICS

1990s, a steering committee for biotechnology is founded by the government, dedicated incubators and soft funding initiatives are created

1991-2008, 17% annual increase in the number of companies, industry sales from 800M in 2000 to 6B (2013)

1990-201x, FDA approvals for drugs developed in Israel: Copaxone 1996, Exelon 1997, Rebif 2002, Doxil 2006, Erbitux 2008

Commercialization and licensing of israel developed drugs by major pharma companies, 2009 Protalix-Pfizer, 2010 Kamada-Baxter, 2013 Compugen-Bayer

REFERENCES

http://www.oecd.org/israel/israelexcellentprimaryhealthcarebuthospitalsmustimprove.htm

http://www.investinisrael.gov.il/NR/rdonlyres/8CABE501-78E8-4C81-9543-395AFD3E6C94/0/IsraelMedicalDevicesIndustryReport.pdf

http://www.iati.co.il/files/files/Life%20Sciences%20Industry%202015.pdf

http://www.swissbiotech.org/php5/aa2/UserFiles/File/31640_The%20Israeli%20Life%20Science%20Industry.pdf

REFERENCES

http://www.investinisrael.gov.il/NR/rdonlyres/5A777305-A5DB-420E-8054-E1D15D1A921F/0/IsraelBioPharmaIndustryReport.pdf

http://www.investinisrael.gov.il/NR/rdonlyres/8CABE501-78E8-4C81-9543-395AFD3E6C94/0/IsraelMedicalDevicesIndustryReport.pdf