Testing, testing, testing. It has been a cornerstone of pandemic recovery strategies around the world, and the COVID-19 crisis has shone a bright light on the antiquated system we use to conduct diagnostic tests.
Diagnostics testing, of course, is much broader than the uncomfortable but vital nasal swabs many of us have received over the past year. In the U.S., over 7 billion annual out-of-hospital tests are run through an archaic, centralized lab system that is slow and expensive. As healthcare has evolved into more distributed sites of care (e.g. telehealth), new testing systems are needed to keep up.
After spending several months exploring the point-of-care diagnostic (“POCD”) testing space, today we are thrilled to announce that we are co-leading Truvian Sciences’ $105+ million Series C financing. We believe that Truvian is positioned to lead the transition to more convenient, proactive diagnostics in primary care through their unique, multiplex POC offering.
Let’s quickly address the elephant in the room. We’ve all either read Bad Blood or heard the punchline: be wary of blood diagnostics companies claiming they can run 800 tests off of a single finger prick. The hangover from Theranos is real, and as investors we approached diligence in this space with a high level of rigour. We’re incredibly excited about the science and engineering backbone of Truvian’s offering. We see this as the “Little Box that Could” in a sector that has so much potential to change how we receive diagnostic tests and the data-driven health decisions that can be unlocked as a result.
It’s High Time We Disrupted The Archaic Lab System …
The current process to get a panel of diagnostic tests is arduous and time-consuming. It typically takes a patient one week and multiple trips to complete a test and discuss results with their doctor. In the wake of wide-spread telehealth services and large retail health clinics (e.g. Walmart Health Centers) that all aim to provide timely, convenient healthcare, there is a growing disconnect between “instantaneous” patient-provider interaction and long testing timelines.
Aside from dismal turnaround times, the large, hidden drawback of the current lab system is the missed opportunity of enabling providers to have data-driven healthcare conversations with patients. You come in to a doctor, say how you’re feeling, a hypothesis is formed, and days later data arrives to help confirm or deny that hypothesis. Imagine a world where, instead, you were able to conveniently get key results before your scheduled conversation with a provider (perhaps in the doctor’s waiting room?). This would not only lead to better/faster treatment protocols (and thus healthcare outcomes), but it would also help decrease costs and congestion in the system.
… Enter Point-of-Care Diagnostics
In theory, it makes so much sense. Do a quick panel of tests before you visit a provider and get the results in time for the appointment. In practice, of course, it’s much more difficult to execute. Specimen-based diagnostics are complex: tests need to be done at precise temperatures, elements (such as plasma) need to be separated out from their neighboring components, reagents must be added, and different testing equipment will be needed for different analytes. Putting all of this into a small box that can rapidly yield accurate results in a POC setting is non-trivial, however advances in robotics and microfluidics have now made these devices a lot more feasible.
Truvian: A Well-Rounded System Poised to Disrupt
Truvian, a San Diego-based company, has developed a multiplex blood testing system that will allow for the rapid testing of dozens of different analytes through a single, benchtop device in a point-of-care setting.
From the outset, we were incredibly impressed with the deep diagnostics experience that the Truvian team has and the extensibility of the company’s platform. Through overcoming the engineering challenge of combining immunoassay, hematology and general chemistry functionalities, Truvian’s POC device is able to cover the most commonly prescribed tests that patients undergo during routine check ups.
On the commercial side, we believe Truvian’s small, portable form factor will allow it to seamlessly fit into existing workflows and thrive in a world where healthcare services are increasingly distributed across multiple mediums (e.g. in-person, telehealth, retail clinics). Over the past year, we’ve seen an incredible surge in investment from retailers and retail pharmacies in growing their clinic footprints and we believe Truvian is a strong ally to these businesses.
Truvian neatly hits on the two major pillars that WV believes are necessary for success in POC diagnostics: Science/Engineering Potential and Market Viability. We’ve outlined these in detail below.
Science & Engineering Potential: It Has to Work
Science and engineering potential is about traction and extensibility.
Traction: Does the company have a high probability of making something that does what it says it’s going to do?
Extensibility: Is the platform built in a way that’s easy to do more things in the future?
On traction, we believe that there is a spectrum of risk as systems proceed in their development lifecycle. On the earlier side, before efficacy data exists, you are essentially investing in the team. However, we see a “sweet spot” where some data exists and the company is gearing up for FDA approval, and this is exactly where Truvian finds themselves.
On extensibility, we are particularly excited about companies that are building multiple modalities in the same system. By building a multiplex system, the “menu” of tests that a company can build efficiently grows, which is important from a market perspective.
Market Potential: It Has to Sell
It goes without saying that commercialization is a critical part of POCD companies’ path to success. There are countless factors that buyers, whether they be physicians, retailers, or individuals, take into consideration. Some criteria we consider when we diligence companies in this space are listed below. This is by no means exhaustive and we look forward to refining this list as the next generation of instruments get into the hands of customers.
We appreciate that each POC setting (physicians’ offices, retail clinics, and in-home) has unique challenges and demands. We do not have a view that one setting is better than the other, but rather that assessing fit between a system and the POC setting it is targeting is critical. Return on investment is also imperative for all stakeholders involved. A system with strong market potential must have opportunities that clearly outweigh the challenges associated with implementation.
A Better Solution is Around the Corner…
Overall, we believe Truvian strongly incorporates both the technical capabilities and market potential to succeed. We are excited to partner with Jeff and the rest of the team at Truvian on their quest to upend the archaic lab testing industry and drive data-based healthcare decision-making. Stay tuned for more updates as they push ahead with their mission.