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Interview: Walking the walk in health tech

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With a workforce that has tripled to 300 over the past three years, Corin is considered one of the great success stories to come out of the UK’s health tech sector.

Founded in the mid-1980s, Corin is an orthopaedics business headquartered in Cirencester, with international operations in countries including Germany, Australia, France, South Africa and the US. The company’s products combine the concept of traditional orthopaedic implants with technology and data, enabling the design and production of personalised implants for individual patients.

Health Tech World spoke with Paul Gibbons, who joined Corin three years ago as managing director.

He talked about the role of UK health tech start-ups in driving innovation, how Corin is competing with global blue-chip orthopaedic companies and the business’ rapid growth over several years.

HTW: What is one of the main challenges you face as UK-based SME?

PG: One of the key problems in our area is the fact that the top four orthopaedic companies dominate 90% of the business, so there’s a risk of them squashing out the smaller, more innovative UK start-ups.

The way that the buying systems are set up for the NHS means more and more contracts are going to these big blue-chip companies, which are mostly US-based.

They can offer primary hip, primary knee, revision hip, revision knee, trauma, spine etc. And for each one of those boxes an organisation ticks, they will offer a greater percentage discount.

If you’re a procurement person, you would probably be sitting there thinking, “I’m going go with these guys, because it’s simpler for me, I’ve only got one person to deal with, they supply all these different products and they offer a good discount”.

We have to battle against that, however it would us cost too much to have that same complexity of portfolio. So instead, we take the route of innovation.

Could you expand on this issue of innovation in the UK healthcare sector?

Before COVID-19, we went to see David Prior, Chair of NHS England to speak with him about our concerns.

Here is what we pitched to him: Blue-chip companies want to maintain market share; it wants to keep its existing customers and enlarge slowly, however that isn’t going to have an innovative drive, which is ultimately what will benefit the NHS.

The NHS will be getting more and more patients while receiving less and less money. So how do you balance that out?

If it gets to a point where there is not enough innovation, the NHS is going to grind along with technology from thirty years ago whilst new technology will go into the private health sector where there are people willing to pay for it.

This is what we have seen in the US and Australia. They are becoming increasingly technology-driven because the money is there to fund it. Worldwide success for the moment is being driven by these two countries’ private health-driven markers.

Corin was founded in the 1980s. Could you tell our readers about the early stages of the company?

Corin started out making metal-on-metal products for orthopaedics. It was about to be bought by Stryker and it was floating on the Stock Exchange in London; everything was looking good.

Then, the metal-on-metal disaster hit. Overnight, everything started to look really bad. There were a lot of things with metal-on-metal replacements that didn’t work. One of the primary issues was the release of cobalt-chromium ions, which reacted badly with patients’ bodies.

These products were being put into young patients, as young as 50 years old, but within 10 years, they were finding massive failures with soft tissue degeneration and bone degeneration.

We came off the stock exchange and very quickly put together a comprehensive portfolio covering a broad range of implants in order to survive.

Over the past few years, Corin has grown very quickly. What do you put this success down to?

Some of it is buying the correct companies abroad and targeting the right areas. For example, we bought our way into the French market. So, rather than setting up our own piece, we bought Tornier, which was a hip and knee company that had been around for over 20 years.

It had a good range of French-developed products used by French surgeons.

This gave us a footprint in Grenoble and allowed us to gain French business which is now one of our fastest-growing areas in Europe.

We also recently bought a micro-robotics company in the US which has developed a robotic tensioner device that can be put into the knee to gather soft tissue data. The programme then works out the best implant fit for the individual based on this data.

You also broke into the Australian market. How did this come about?

This was one of Stefano Alfonsi’s first wins after joining the company as CEO in 2012. We bought a start-up in Australia which had developed what we call an Optimised Positioning System (OPS) for hip replacements.

Although hip replacements are generally very successful, there are a small number of people that have problems with them.

The standard way of planning a hip replacement is a 2D X-Ray, however this doesn’t take into account how the patient moves.

For around 80% of the population, the 2D X-ray method is fine, but for 17% of people, their pelvis rotates a lot more forwards or backwards than normal. This can lead to dislocation.

What we do with the OPS is take three X-rays of the patient in different positions. We then merge this with a 3D CT scan to work out the optimal positioning of the hip replacement, and 3D print the jig which is unique to the specific patient.

You launched a new service called ‘Corin Connect’ in July this year. Could you explain what this is?

About a year and a half ago, we came up with the idea of an ecosystem of data to join together the different elements of the business.

We saw that we could join together patient data which we’re sampling through their smartphones, combine it together with the data that we’ve gathered from analysing patients pre-surgery, then combine this with post-operative data, physio data and interpretive data, like tissue samples from the knee.

We can then allow the surgeon to see all of this information on a dashboard so they can track patients and identify issues before they get worse.

In terms of the response, younger, open-minded surgeons think the idea is awesome. They can be sitting on the train and open up patient records, scans and data from previous cases.

What are Corin’s plans for the next 12 months?

A couple of months ago we started bringing the team back, keeping them safe and getting used to this new way of operating.

There’s a number of technology options that we had back in April that we’re now picking up and working with again.

We’d like to get around five UK digital specialist hospitals up and running with Corin Connect over the next 12 months. We’ll then start to look at how we can start adding AI into that to aid surgeons and orthopaedic directors in their decision making.

Ultimately, we want to use technology to provide clinical benefit. We want to give patients a better quality of life faster and give orthopaedic implants a longer lifespan.

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