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Wireless endoscopy versus Pillcam – how competing medical innovations demand different business models?

Posted by evolvingwheel on January 27, 2008

Here, I would like to talk about two medical diagnosis innovations (worth mentioning) and how the two competing methods would demand different considerations for successful commercialization of one over the other.

First comes the Pillcam. This device had been developed more than 7 years back and had received FDA approval. Currently, Pillcam is a market status quo and delivers a distinctively amazing method of imaging our GI tract in a non-invasive manner. When I first read it a year back, I was enthralled by the opportunity of getting one’s endoscopy done without going to the doctor and staying in the clinic for several hours, sedated, and undergoing a complex procedure of camera insertion. The PillCam SB video capsule measures 11 mm x 26 mm and weighs less than 4 grams. It contains an imaging device and light-source on one-side and transmits images at a rate of 2 images per second generating more than 50,000 pictures over an 8-hour period. It works simple too. You just fast overnight, reach the doctor’s office in the morning, swallow the capsule and put a recording belt on the waist, come back after the workday and deposit the recording device with all the images. The pill goes out naturally with a bowel movement later. For more detail, read[here].

Now, recently, Eric Seibel, a University of Washington research associate professor of mechanical engineering along with other researchers, has developed a scanning endoscope that consists of just a single optical fiber for illumination and six fibers for collecting light, all encased in a pill. The traditional endoscopes have a long wire 9 mm wide with a camera and requires sedation for the width of the wire. The new design from UW has a camera in a small capsule (smaller than the size of a vitamin tablet) tethered by a 1.4 mm wire (not a cable but more like a very thin string) that is very easy to swallow and doesn’t produce any discomfort that requires sedation. Now, that is definitely a market winner over conventional endoscopy. uw_camera_capsule.jpg

But how about competing with Pillcam? Well, this capsule is half the size of Pillcam and can be made smaller. Besides, the UW device takes 15 color pictures per second. The resolution is better than 100 microns, or more than 500 lines per inch. One advantage it has over the Pillcam is that being tethered, it is not just a fly-by view of the GI tract. The physician can move the small pill back and forth by using the thin tether – that allows more critical imaging of any specific location. Read more [here].

So what are the competing options? –

  • While one is a fly-by capsule with no tether, the other has a negligibly thin wire but allows more control over diagnosis. The consideration will be what degree of even minute irritation that tether might have on a huge sample of patients and how enhanced is the diagnosis?
  • One requires the capsule to be in the system for more than 8 hours (still reasonable since it doesn’t feel anything) with a device belt around the stomach all day. The other requires a small visit and one clinician to get the imaging done swiftly. In fact, UW inventor demands that it is as simple as getting it done in shopping mall. So there is opportunity of kiosk based diagnosis.
  • UW has a better image resolution than Pillcam. However, if Pillcam can innovate fast and implement a camera with 30-40 images per second, then it can stay as the market leader and create a higher barrier of entry.
  • One interesting aspect is to realize how large customer base Pillcam has. Awareness and marketing are the key features. On one hand, UW device can be delivered using the conventional clinic/diagnose center infrastructure along with kiosk based delivery model in the near future. On the other hand, Pillcam has the benefit of total remote testing. However, you still have to enter the clinic, swallow the pill, and put the belt on. So you still have to make the visit and wait in a line, etc. However, if Pillcam can come up with a micro-recorder (cheap to package it with the pill in a packet over the counter) then they win the game. The micro recorder could be flash memory based (cheaply available). The key element will be how images will be recorded by a small area of recorder location (if slapped on the skin like a Nicoderm patch).

This is a very interesting time as innovations are measured in terms of available infrastructure, market penetration, awareness, affordability and ease of use, and market barrier imposed by totally unique service offering over it’s competition.

Picture: Image taken by UW camera. Credit – University of Washington.

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Posted in biotech, diagnosis, drugs, medical device | 6 Comments »