“Chaos isn’t a pit. Chaos is a ladder,” says the character you hate to love and secretly admire for his dangerous desire to rise to the top, on HBO's Game of Thrones. The story you are about to read exemplifies this quote. Humble beginnings in a small town, starting several businesses even before starting-up was cool, trundling up to the big city life and living in a one-room apartment with his new wife, innovating in a field that wasn’t his own, getting sued for millions, staging a walk-out from a company he had built, brick by brick, do not sound like the ingredients of a success story. Yet, this is how Manish Doshi, pioneer of a technology that will help drastically strengthen the odds in heart surgery, made the climb.
A textile engineer from Baroda’s M.S. University, Manish grew up in Anand at Amul housing, as his father worked at Amul. “I was determined that I will have my own business of import-export, in spite of having no knowledge of it.”
He conjured up this beautiful dream two decades before the Great Indian Startup Dream was a thing. He joined Mafatlal Fine at Navsari and worked there for five months. Looking for any trading opportunity that would provide him an entry point, he started up in Anand supplying raw materials for the paints industry. This soon turned into a chemical trading business for textile industry, which took him to Surat. Newly-wed, he lived in a one-room apartment with his wife, until things picked up. What followed were a string of other successful ventures: laser sheet metal cutting workshop and an amusement park, but Manish felt a lacking. He wished to do something more meaningful.
The wow and the vow
It was 1998 and angioplasties were gaining prominence over bypass surgeries, when Manish came across the sneaky little devices called ‘stents,’ that would go on to change his life forever. Used in surgical procedures for the heart, these stents were small spring-like components, that, bafflingly, no Indian company had manufactured till then. “I sacrificed all my other businesses and dedicated myself to this life-saving device that was disruptive and had global potential. I wanted to establish the first coronary stent manufacturing company of India,” he explains. With help from his partner in his laser business, Manish found out that though it was cheap to manufacture, stents were sold at staggeringly great margins.
Establishing a board of medical veterans, their newly floated company Sahajanand Medical was in business. The duo imported the machine to manufacture stents. With the first batch ready, they were all set to market their product at a fourth of the price of its imported counterpart, only to find doctors turning sceptics at the indigenous product, fearing a low price means inferior quality. It may shock you, but the team’s decision to rebrand and increase its price gave it a spot in the race. This enabled the company to rise to a level where the Indian stent was accepted and known for its quality over more than 40 countries.
Improvisation was the name of the game for the next few years, to progress from the bare metal stents they had started out with, whichserved the purpose of unblocking coronary arteries at that time, combating the blockage of arteries and reducing it from 30-40 percent to around 15-20 percent. Subsequently, players like Johnson &Jonhson entered the race, bringing down the percentage of blockage sharply from 40 percent to less than 10 percent and, in some cases, none at all. While J&J’s stents were made of polymers, Manish’s company invented biodegradable stents that, in a future regulation, came to be mandated in procedures, thus surviving the competitive scare.
His life’s biggest lessons
To increase acceptance among the continued skepticism from the Indian medical fraternity, they started participating in clinical trials. When they received the CE approval for their stent, they did small clinical studies in Netherlands. Then Boston Scientific and Angiotech Pharmaceuticals in the industry decided to file for patent infringement, and sued them for €25 million. The judgment was not in their favour but, fortunately, they only had to cough up only €1,400, as they hadn’t commercialised the product yet. “Although we paid less, for me, it was a €25-million lesson, which was learnt really well,” Manish says of the experience.
The day soon came when Manish, who held 10-percent equity in the company he had helped build from scratch, had to leave overnight following clashes with his business partner. He was frustrated, but knew he walked off with a robust network of veterans, influencers and opinion leaders in the medical fraternity backing him. “The Brazilian distribution company of my previous company and their founder members became my friends over the period. When I left my company, they showed their willingness to do something with me. This time I didn’t want to create just a product, but something revolutionary, which can change the way we did things. I got together with a team of scientists and started an R&D lab. And that’s how our MagicTo uch technology was born.”
The MagicTouch of startingup again
An alternative to using stents during surgery was balloon angioplasty, and just like the stents, the balloon also had to be coated with a drug that helps the body accept the implant. Under the newly christened Concept Medical , the MagicTouch technology was a sirolimus-coated balloon to treat coronary artery blockage without help of external scaffolds like stent. Supported by his Brazilian friends, Manish incorporated Concept Medical, a cardiovascular device business that advances innovation and develops next-generation products in the field, and protects technology with patents in USA, Europe and Japan.
Limus-based drug-eluting stents have been proven as more favourable compared to Paclitaxel drug-eluting stents. Currently, all drug-eluting balloons manufactured by companies like Medtronic, B Brown, Eurocore etc., use Paclitaxel. “Limus is difficult and challenging to deliver from a balloon catheter, and is difficult to coat on to the balloon. It is also very tricky to retain the drug in arterial wall for longer period to treat the disease. Many companies tried to develop this technology, but failed. So at present, we are the only company that makes this product,” Manish explains. They used nanotechnology, and the entire development was done in-house.
Learning from past mistakes, he had made sure that everything they created is not just innovative but also protected with proper IP. “Today we have 23 patents granted all over the world, many pending and many more to be coming,” he adds.
They waited three years before getting the approvals from European authorities for selling their products there. “We were the first in the world and the response, especially from Europe and Latin America was encouraging,” Manish says, adding that with patent protection, their aim is to enter the USA market next.
At present, they have procured distribution rights for 45 semi-regulated and non-regulated countries like Italy, Spain, France, UK etc., where they are enjoying monopoly. They are even offering technology to big companies for their proprietary drugs, as their technology is a core value product and its application of drug delivery can be applied to many other disease areas like oncology, peripheral vascular disease, nephrology and many more.
Funded by Manish's Brazilian partners, who act as co-founders of the company, and some childhood friends who doubled up as angels, Concept Medical will now have a formal investment round for VC money.
With no local competitor, abroad, bigger MNCs like BBRAUN, Medtronic, Boston Scientific etc. are in the industry, albeit none of them have the sirolimus variant of this technology, so far. According to a Transparency Market Research report in 2014, the global angioplasty balloons market was worth more than $1.7 billion, and by 2023, the market is expected to be valued at $2.5 billion. Between 2015 and 2023, it is projected to expand at a moderate CAGR of 3.5 percent. Concept already hit their first grand recognition at the Marico Innovation Foundation's Innovation for India Awards 2016, and is now gearing up to clock their target for the first year - $5 million, which they hope will grow by 100 to 200 percent in successive years.