Prosthetics, an artificial device that replaces a missing body part, has the potential of giving a new leash of life to anyone who has lost a limb in an accident or any anamoly. According to a report by Grand View Reasearch, the global prosthetics and orthotics market size was valued at USD 6.11 billion in 2020 and is expected to grow at a compound annual growth rate (CAGR) of 4.2 percent from 2021 to 2028.
Moreover, drivers of growth is because of the growing prevalence of sports injuries and road accidents, the rising number of diabetes-related amputations, and the growing instances of osteosarcoma around the world. According to reports, India has more than half a million amputees, with tens of thousands added to the amputee population every year. Due to economical disparties, the products that are usually affordable have limited functionality or quality not upto the expectations. However, as the market players in this segment are rising, things might turn around.
In July this year, Instalimb which claims to be world’s first 3-D designed prosthetic leg provider from Japan forayed into the Indian market by launching its operations in Gurgaon with Rs. 26 Crore funding (445mn Yen). According to the company, the products are 3-D printed and laced with Artificial Intelligence (AI). Financial Express.com reached out to Yutaka Tokushima, CEO, Instalimb and he talked about their expectations from the Indian markets, their key plans for the Indian patients, concerns related to prosthetics among others. Exerpts:
Instalimb recently initiated its India business and launched its prosthetic wear solutions in Gurgaon. What is your plan for the India market and what are your expectations?
We are very excited to foray into the Indian market and are looking forward to making a difference in the lives of patients here. The prosthetic market in India still needs an organized ecosystem that makes it easier for customers to access the products. We are currently in the process of implementing joint projects with Jaipur Foot that are funded by the Japanese government and are also in talks with AIIMs.
We aim to reach out to remote areas in India, which is possible because of the technologies we have. We no more need large and heavy setups for plaster casting that usual clinics do. In fact, we are implementing a ‘remote service’ where our PO (Prosthetist & Orthotist) operates in remote areas with just 3D scanners. He sends data to a central workshop, which then delivers the product and then the local PO fits the device. In the long term, we aim to maximize our impact by making a coalition with other clinics that practice the same methodology as us. We will make our technology available to them so that we change the whole industry to provide better and more accessible prosthetics.
What makes Instalimb’s prosthetic leg unique and different from its contemporaries in the market? How can it benefit Indians?
Our product is unique in every aspect, but especially because of its socket quality, cost effectiveness and customer experience. Our 3D techniques and AI enable us to fabricate very accurately-fit sockets while ensuring the cost of production is optimized. Also, we provide innovative services like ‘Free Test Fitting’. In fact, we believe we are the only clinic that provides this service where patients can test our product before making any financial commitment. This is because we are very sure of our quality and we know that patients will love our socket once they test it out. We also have our ‘online stump-check’ where patients can get their leg checked by a PO prior to their visit.
What are the challenges that amputees face across the world? With respect to cost and affordability, where does Instalimb stand? What is the price range for Indians?
Traditionally, the fabrication process of prosthetic legs involves highly manual techniques that only trained prosthetists can do. This was one of the primary reasons for their high cost ($5K in general) and sometimes low quality if prosthetists are not trained enough and why 90% of amputees in the world still do not have access to prosthetics. To tackle this social issue, we reinvented and developed a whole process by utilizing 3D scanning, AI, CAD (Computer Aided Design) and 3D printers, and minimized the cost and price of the device by 1/10.
Our products are now known for great quality and have successfully provided the ability to walk to around 600 amputees in the Philippines and India. When it comes to quality, it is a common myth that the quality of the devices lies in components (foot parts or knee joint for example), and that is why people mistakenly perceive that international brands are good. We question this norm. Although components are essential, we know that sockets matter the most for the quality of life of patients. And this is the exact reason that we have developed CAD software to design and create a fit socket for each patient.
Are you planning to collaborate with Indian stakeholders to become accessible to patients in India? How and what are your key strategies in this segment?
Yes. As mentioned above, we are collaborating with prominent organizations like Jaipur Foot and AIIMS. In addition, we are seeking potential collaborators among single practitioners who want to take advantage of 3D scanning and CAD design. As we plan to distribute this scanning and designing package early next year, you will hear of more collaborations for sure!
At present, researchers across the world are working towards developing 3-D body parts and organs. What are the key benefits of this? According to you, what will be the status of this market in the coming years?
There are so many benefits, the list is endless. With 3D techniques, we can capture and create nuanced shapes and figures of body parts in a standardized way, meaning the skillset of the individual matters less. So even persons in remote areas can do the 3D scanning with minimal training and measure the shape accurately. In addition, this technique is enhanced along with AI. As Instalimb does, AI can optimize the designing process based on the scanned data, and provide us far more accurate CAD data. This means that we don’t need 70-year old-experienced professionals to create a great prosthetic leg, making us scalable.
There are many great innovations in 3D techniques and the Orthopedic & Prosthetics industry. Yet, we understand most of them are project-based initiatives or grant-based projects that do not have a profitable mechanism to sustain without funds. As a strong believer in the importance of sustainability as a business model, we are sure that we are the only company that has actually succeeded in commercializing products and proving how this new business model works. We hope to highlight our social startup nature, which actually serves people AND brings profit.
According to you, what will be your key focus areas in India? Are you planning to develop other body parts along with the legs?
For now our expertise lies in the above-knee and below-knee prosthetics. We also aim to make our software available for other prosthetics as mentioned earlier.
Developing or low-income countries do not have access to prosthetics as other nations do. What are the key reasons? What needs to be done to improve this?
An industry structure that highly depends on craftsmanship as well as manual work increases the cost of prosthetics, unfortunately. We are trying to change this norm by digitizing processes and cutting cost, while enhancing quality.
In addition, some patients who have received a low-quality prosthetic leg for free through donation, sometimes give up using it because it causes them so much pain. We also want to reinvent this unfortunate perception that a prosthetic leg hurts.
According to you, what are the present and future status of prosthetics? Where does India stand in this?
Unlike some other countries like the Philippines, India has many great practitioners and experts in the P&O field. Yet, due to the high rate of traumatic accidents given the population size, we know that there are still numerous patients who are waiting for good prosthetic devices. Along with other experts, we aim to provide the ‘ability to move’ to everyone in need.