Diagnostic firm takes on big guns

Anand and Serita Kumble.
Anand and Serita Kumble.

It took a few years, but Anand and Serita Kumble finally found the problem they were looking for.

The couple, originally from India, left Stanford University with a lot of knowledge about miniaturising and multiplexing technologies that were connected to the university’s participation in the Human Genome Project.

“The focus for VCs in the US, as you’d imagine, was how do you make a billion dollars out of the Human Genome project, and how do you use the technology to cure cancer, to get better drugs,” says Anand Kumble. “Maybe we’re not smart enough to cure cancer. But we thought we could use the technologies we’ve learned and our skills to tackle other immediate problems the planet has.”

The problem the couple was looking for turned out to be more about economics than medical science. 

Traditionally, medical diagnostics — enzyme-linked immunosorbent assay (ELISA) and the pre-natal TORCH (toxoplasmosis, other infections, rubella, cytomegalovirus, herpes simplex virus) pre-natal blood test — were too expensive for many patients in poorer countries, forcing doctors to treat conditions based purely on symptoms and experience.

The Kumbles settled in New Zealand in 2005 and a year later founded Pictor.

It was based on the idea that diagnostic testing for infectious diseases could be made affordable to those in disease and poverty-prone markets. 

After years developing a proof of concept, early investment rounds and passing regulatory muster overseas, Pictor has entered its commercialisation phase, with its first sale to a hospital near Bangkok that piloted the system.

Pictor, in a way, is the diagnostic David taking on Goliaths set in their ways.

“Globally, there are no more than six to eight companies that make these products, most of them from Europe, and they are quite expensive,” says Anand Kumble. “Typically it will cost the patient US$15 to US$25 for the profile, and to a lot of people that is not insignificant.”

The result, he says, is doctors will treat based on symptoms and epidemiological knowledge, sometimes leading to ineffectual treatment because the diagnosis is inadequate. 

“It’s not based on best medical practice but cost,” he says.

Pictor claims to bring the cost of testing to $1 per profile, depending on the kind of diagnostic. 

In auto-immune diagnostics, blood is drawn and mixed with a catalyst in a well on a slide, reacting only if a particular antibody is present in the drawn sample. 

The dominance of traditional manufacturers such as Roche and Siemens, with their proprietary hardware and slide systems, locks medical providers into relatively expensive maintenance contracts.

The price is driven up further because the slides are designed to only test a set number of samples at a time.

Pictor’s answer is to house an off-the-shelf camera together with some circuitry printed by a Wellington lithographer in a small casing that plugs into a PC or laptop, where Pictor’s analysis software runs. 

Starter kits from Pictor begin at NZ$1000, compared with large manufacturers who sell machines for between $4000 and $8000.

The Kumbles’ experience in miniaturisation and high-throughput technology helped in the design of their modular panel. Each panel contains 16 wells, with 25 ‘dots’ — small points where the reaction occurs — in each to accommodate eight tests at a time per well. 

The 16 wells can be broken down and used two wells at a time, the rest stored for later tests. (Each panel is manufactured to be used for one particular test).

“What we were mindful of was that this sort of technical hassle you have to overcome, so we put a lot of controls into our panel,” says Kumble. “We put on the panel eight tests in duplicate, and still had nine more dots for test control. If they mess up the test, the software can pick up the error and won’t allow them to see the results.”

Other companies also sell the multiplexing technology but tend to continue on this idea that Kumble describes as the “old model”.

“It’s them saying, ‘let’s have a closed system, let’s sell you an instrument, tie you up in a contract and sell you our reagents’,” he says. “That hasn’t quite gone away.”

Pictor is now commercialising for other markets, working out commercial arrangements to sell the system through two laboratories in Malaysia. 

And in India, it is working with a diagnostics distributor on a TORCH assay, which diagnoses pathogens that Pictor says if not found early enough in a mother during pregnancy, “can have devastating consequences”.

The company expects to complete commercialisation by the end of 2013.

It now employs six engineers at its Parnell, Auckland, office for technology development and quality assurance.

The company has received funding from several investors, including Stephen Tindall’s K1W1. But more expansion may require this David to make friends with one of the world’s Goliaths.

“Our objective this year is to demonstrate that this technology is useful and can make a difference to how diagnostics are being done globally and to prove that it can work in a number of disease areas,” Kumble says. “We will have to have a strategic relationship with someone with a global network to really deploy this on a global scale. It can’t be Pictor. That’s just not us, sitting here and unpacking boxes of webcams.”