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*UPDATE FROM OCTANe’s Ophthalmology Technology Summit: Innovations in Ophthalmology

Entrepreneur innovators have catalyzed the ophthalmology industry from the get-go, starting with one of the first – Gavin Herbert, who created Allergan more than 50 years ago. Allergan evolved into a multinational pharma company that produces branded drugs and does pharmaceutical R&D. Its Irvine campus is home to its eye care commercial and R&D team, as well as its medical aesthetics and Botox therapeutics business.

So what better place to recognize Herbert than OCTANe’s Ophthalmology Technology Summit (OTS) on Friday, where he was the recipient of the second lifetime achievement award. He was recognized for his legacy of leadership. OCTANe is a life sciences and tech accelerator in Aliso Viejo.

While Herbert was at the vanguard of the industry half a century ago, the question these days is: How do large, established ophthalmology companies keep their startup attitudes fresh and vibrant, while continuing to innovate?

That was the challenge discussed among key opinion leaders at OTS on June 29. In his opening comments, OCTANe CEO Bill Carpou reported that SoCal is the No. 1 ecosystem for medical devices and ranks No. 5 for pharma nationally for ophthalmology. Additionally, the region employs 56,000 in this field, with a total labor income of $4.1 billion and a collective economic impact of $12.5 billion.

At the conference, ophthalmologists, industry leaders and investors converged to share their perspectives on innovation, practice technologies and the ever-evolving landscape of ophthalmology.

As in other realms, the technology in ophthalmology is changing so quickly that ophthalmologists have to keep up with it. And, they’re typically being asked for their opinions and assessments of new devices and therapies. Many are active investors themselves.

The 2018 summit brought together key opinion leaders from Allergan; Alcon,which has a presence in Lake Forest; Aerie Pharmaceuticals, with a presence in Irvine; J&J Vision,with HQ in Santa Ana, and under the umbrella of Johnson & Johnson; Carl Zeiss Meditec, whose global president of ophthalmic devices, Jim Mazzo, lives in OC; and OCTANe’s Visionary Ventures fund, which invests in ophthalmology startups.

Among the innovation topics they discussed were digitization/big data, miniaturization, making medical devices “smart” and gene therapy.

Big D, Little R

Data is beginning to supersede research at companies such as Allergan and J&J Vision. Since digitization and big data require new skill sets, that begs the question of how do these companies manage this transition?

Do they build their own tech? Acquire it? Use others’ tech? Or augment what they already have?

Most are finding a symbiosis of internal resources and external partnerships. Alcon, for example, did 20 deals in the past two years, a huge increase from previous years, said Laurent Attias, senior VP, corporate development strategy, BD&L and M&A.

Johnson & Johnson does half its innovation internally and gets the other half externally, said Jonathan Talamo, an ophthalmologist and chief medical officer of J&J Vision.

To that end, it established “JLabs” in 12 cities that incubate other entrepreneurs’ startups. These are no-strings-attached incubators that provide lab space and wrap-around services. No financing is offered so no equity is taken in these startups. The closest JLab to OC is in San Diego.

For the viable startups, Johnson & Johnson offers them an opportunity to move on to one of its innovation centers. These are staffed with science and financial experts to help these companies secure financing. Both the labs and innovation centers keep the parent company close to innovative science being developed externally. These labs also work collaboratively with accelerators, such as OCTANe’s LaunchPad.

“If you have an idea, pick up the phone and call me,” Talamo quipped during the panel Friday.

Going Digital

Going digital, and thereby removing the “art” from ophthalmology is not necessarily a bad thing, Attias said. But the ophthalmology industry is not quite there yet, he added.

“We need to move to the second and third (levels) of digitization and make things simpler,” he said, adding that Alcon has begun partnering with companies that do cloud computing (which enables the storage of vast amounts of data).

Harnessing the power of big data and artificial intelligence (AI) can take eye scans to a different level, with various algorithms that can help ophthalmologists seek out more specific things, said Jag Dosanjh, senior VP at Allergan Eyecare.

AI can help ophthalmology evolve by looking for patterns and turning information into insights, he added.

AI can also come in handy for data mining techniques to automate the collection of data and eventually profile patients, Talamo said.

One of the easiest places to start with AI is the continual monitoring of conditions with asynchronous symptoms, like glaucoma, said Tom Mitro, president and COO of Aerie Pharmaceuticals.

On the commercial side, how does the ophthalmology industry connect to its patients via digital marketing, asked Dosanjh.

“We need to find a better way to talk to the vast majority of the population,” he said.

Making Medical Devices Smart

How do you incorporate electronics and sensors without sacrificing comfort, in the case of contact lens, for example, asked Attias.

Wearables are coming, Talamo said, but the ophthalmology industry is not yet at the stage with wearables where cardiology is now. Wearables are electronic technologies or computers that are incorporated into items of clothing and accessories which can be worn on the body.

Delivery of Treatments

As ophthalmology treatments get more sophisticated, there’s less chemistry involved and more biology.

Something that’s needed in terms of delivery is better transparency in terms of enabling patients to quickly find the cost of any drug at several nearby pharmacies to compare and contrast, Dosanjh said.

In terms of the actual physical transport of the pharmaceuticals, the ophthalmology industry may want to consider getting into the delivery business itself, and not leave the transport of biological materials to Amazon and pharmacies, Talamo said.

“That’s the providence for us to deliver,” Talamo said. “I’m not sure Amazon would want to get into that.”

Nimbleness of a Startup

Alcon, for one, has taken on a higher degree of agility with multiple shots on goal in the same arena, Attias said.

“We need that because our initial excitement about something may not commercialize like we thought,” he said. “We need diversity and to be able to let go of some ideas. This mindset has taken time, but it’s gelling now.”

Concerns

For Mitro of Aerie, the worry is that the industry is too myopic and the “shadow that we cannot see” is looming. He’s trying to protect Aerie against that by projecting two years out, five years out, etc., he said.

Dosanjh with Allergan, is concerned that because the FDA has raised the bar in terms of getting drugs approved that there’s more of a risk in their products not meeting those higher standards.

“We have to shoot a lot higher than we used to,” he said. “Our commercial engine also has to operate at a higher level. We can’t be complacent.”

Talamo with J&J Vision, said he’s concerned that the EU has also raised the bar and changed the rules in terms of testing medical device products. The more time it takes, the more expensive it gets, he said.

Projections

Five years out, the panelists see a variety of new devices and treatments, including personalized medicine and gene therapy.

Underlying that will hopefully be a systemic way to get to the root cause of eye diseases, Talamo said.

Next year’s OTS will be June 28 at the Fashion Island Hotel in Newport Beach.

About The Author

Deirdre Newman is a long-time journalist, who's covered OC startups for a few years.

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