Intervju z Nano Bit-Avragim

“Kakšna je evolucija sprememb možnih financiranj startupov v zdravstvu? “

Biotehnologije in rešitve digitalnega zdravja se razlikujejo pri načinu zbiranja sredstev za razvoj. A številni trendi na področju investicij so skupni, opazuje Nana Bit-Avragim, arhitektka poslovnega razvoja rešitev na področju digitalnega zdravja. Leti 2018 in 2019 sta na področje digitalnega zdravja prinesli rekordno količino kapitala.

Podjetja, ki razvijajo rešitve za zdravstvo, so že od nekdaj veljala za tvegane naložbe, saj med drugim traja dolgo, preden rešitve pridejo na trg. Posledično je iskanje investicij za startupe težje, sploh v prvih fazah podjetij.“Investitorji v ZDA in korporacije, evropska, specifično nemška, podjetja hitreje financirajo v seriji C ali kasneje,” pravi Nana Bit-Avragim.

Digitalno zdravje in biotehnologija

V primerjavi z rešitvami za digitalno zdravje, kamor spadajo različne aplikacije in programi večinoma za posvete na spletu in telemedicino, je biotehnološki razvoj veliko dražji, več denarja je namenjenega in potrebnega za raziskave in razvoj. Zaradi tega so biotehnološka podjetja večinoma izpeljanke raziskovalnih univerzitetnih projektov ali patentirane rešitve s potencialom za komercializacijo.

V javnosti odmevnejši izumi na področju biotehnologije v zadnjem času so 3D tiskane rešitve in diagnostika na podlagi metode CRISPR. “Ameriško podjetje Mamooth Biosciences, ki se ukvarja s CRISPR tehnologijo, trenutno prehaja na področje gensko zasnovane diagnostike, kar bi zahvaljujoč natančni diagnostični metodi, ki ne zahteva široke infrastrukture in visoko kvalificiranega kadra, znižalo stroške testiranja za infekcijske bolezni. Na področju 3D tiska vodilno podjetje Cellink, deluje v smeri tiska celotnega srca. Če bi lahko začeli tiskati organe, bi to radikalno spremenilo področje transplantacijske medicine. Ocenjeno je, da bi 3D biotiskanje letno rešilo 100.000 življenja zaradi krajšega čakanja na primerni organ,” dva primera navaja Nana Bit-Avragim.

Priložnosti med javnimi viri financiranja

V Evropi veliko držav kot so Nemčija, Avstrija in Francija, ponujajo različna javna sredstva za mlada podjetja. Francoska vlada je leta 2018 začela izvajati celovit program za uvajanje telemedicine in z umetno inteligenco podprte platforme, kar predstavlja priložnost za gradnjo telemedicinske infrastrukture v države. “V Nemčiji sta glavni mesti z javnim financiranjem Berlin in Munchen, ki podjetjem ponujata 100.000 evrov zagonskega kapitala,” navaja Nana Bit-Avragim.

Če je bila Nemčija še nedavno videna kot država, ki zaradi strogih zahtev po varovanju podatkov spada med počasnejše države pri digitalizaciji na nacionalni ravni, se od leta 2019 obetajo spremembe. Nov zakon o eZdravju uvaja zahtevo za vključevanje validiranih digitalnih zdravstvenih rešitev v sheme javnega zdravstvenega zavarovanja. V ZDA na drugi strani, Silicijevo dolino z gradnjo lastnih ekosistemov začenjajo dohitevati Texas, New Jersey, Severna Karolina in Boston.

“Ena posebnosti ameriškega trga, manj pogosta v Evropi, so operativni vlagatelji, ki poleg finančne podpore v startupe posegajo pri kadrovanju. Njihov namen je najti najboljše manjkajoče kadre za uspeh podjetja, kar odpira nove možnosti za hitrejši razvoj. Evropski primer takšnega investitorja ja Project A in Berlin,” še omenja Nana Bit-Avragim.

Kaj je narobe z lokalnimi podjetji?

Bit-Avragimova opaža tudi, da v več primerih po svetu investitorje bolj privlačijo podjetja izven lastnega okolja. Nemški podjetji Ada Health in Kaia Health sta le dva primera zelo uspešnih nemških podjetij, ki so ju podprli tuji investitorji. “To ovira razvoj lokalnega ekosistema, kar je škoda,” meni Nana.

Še en viden preskok v miselnosti investitorjev je odmik od poudarka po hitri rasti podjetij in njihovih ocenah vrednosti. Poudarek se seli k širitvi prisotnosti produktov ali storitev podjetij na trgu in ustvarjanju denarnih tokov že v zgodnjih fazah. “Dober investitor bo podjetju predlagal počasnejšo rast, ki pa omogoča boljšo definicijo ključnih kupcev in pozicioniranje na trgu.”

Ustanovitelji podjetij postajajo zadržani do deljenje deležev podjetja

Eden izmed trendov med podjetniki, piše New York Times, je želja ustanoviteljev po neodvisnosti od institucionalnih investitorjev. Nov koncept, ki ga omenja Nana Bit-Avragim, so investicije merjene po učinku. Gre za koncept z visokim tveganjem, pri katerem je ekipa glavni dejavnik odločanja za investitorje. Model odpira nove možnosti predvsem za ženske podjetnice. “Trenutno dva odstotka ženskih ustanoviteljic dobi investicije, čeprav so ženske boljše pri zbiranju investicij. Raje sredstva nabirajo počasi in se na investitorje obrnejo v seriji A zbiranja denarja, zgodnejše faze pa poskušajo izvesti z drugimi finančnimi viri,” komentira Bit-Avragimova.

Še en nov koncept, ki prihaja iz Kanade, je koncept radikalne radodarnosti SheEO. V sklopu koncepta je 500 žensk iz Kanade doniralo 1000 dolarjev za sklad za ženske ustanoviteljice na šestih področjih, med katerimi je tudi zdravstvo. V sklopu koncepta izbrana podjetja prejmejo 100.000 dolarjev visoko posojilo brez obresti. Podjetja dobijo tudi dostop do povezav, ki jih imajo investitorke.

“Rethinking the funding landscape in digital health “

2018 and 2019 were record years in terms of funding digital health solutions so far. While biotech and digital health are specific when it comes to fundraising and returns on investments, several trends in startup funding are happening in general, observes Nana Bit—Avragim, digital health business architect.

Healthtech companies are risky investments due to the long road for products to reach the market. This, in turn, toughens raising larger amounts of money in the early stages of companies. “Investors in the US and corporations are more open to funding European - specifically German - companies starting from Series C and later-stage funding rounds,” says Nana Bit-Avragim.

Digital health and biotech

Compared to digital health solutions - from software solutions for telemedicine and online consultation - biotech development is much more expensive, with more money spent on research and development. Consequently, many biotech companies are spin-offs from university research projects or are patented findings that hold commercialisation promise.

More visible examples of the latest biotech inventions are 3D printing solutions or CRISPR diagnostics solutions. “The US-based company Mamooth Biosciences, developing CRISPR products, is currently shifting in the area of gene engineering diagnostics, which could radically decrease prices of testing for infectious diseases and enable precise solutions for rapid diagnostics to eliminate the need for expansive laboratories. In the 3D printing space, Cellink, the US and Swedish leading bioprinter and bioink company, aims at 3D printing the whole heart. The area of organ transplantation could be radically improved if these solutions turn out to be safe and effective. For people living with terminal kidney insufficiency, 3D bioprinting could save about 100.000 lives yearly due to shorter waiting times for organ transplantation,” explains Nana Bit-Avragim.

Public funding opportunities

In Europe, many countries such as Germany, Austria and France offer various public funding options. The French government started a comprehensive program for AI-based platforms and telemedicine in 2018, which offers a great opportunity to build a telemedicine infrastructure in the country. There’s plenty of funding coming into Germany with Munich and Berlin as two cities with several public funding opportunities of around 100.000 euros for seed funding, says Nana Bit-Avragim.

If Germany was seen as a slow-moving country when it comes to digitization, an important change happen last year. The new eHealth law opened the doors for startups with validated solutions to be included in public insurance schemes for reimbursements.

In the USA, Texas, Seattle, New Jersey, North Carolina are among the cities highly competing with Silicon Valley and Boston with their development of specialized ecosystems.

One of the specifics of the US market are also operational VCs, which are less known in Europe. Operational VCs don’t only fund companies but their team structure - they try to find good missing team members that have the potential to accelerate the development of a specific company. A European example of such an investment firm would be Project A in Berlin.

Low interest of investors for local companies?

A surprising Nana’s observation based on discussions with various global players is that investors often seem to be more interested in companies outside of their own country. Ada Health and Kaia Health are just two examples of today successful startups that received VC money mostly from abroad. “This hinders the development of local ecosystems, which is a shame,” says Nana.

Moving aside the appeal to invest into foreign companies, another notable shift in the mindset of investors is happening - they are moving away from strong pressure to get fast high returns caused by the rapid growth of companies and their valuations. The emphasis is moving towards companies scaling their products and creating revenue streams first, as early as possible. “Many investors are hoping to get the product to market, but the good investors will recommend startups to grow slowly, take time to define good customers and find their place on the market.”

Funding in general: founders don’t want to give up equity

As mentioned in the New York Times, a new trend is also developing where startups don’t want to be dependant on institutional investors. New funding models are following this trend. A new concept mentioned by Nana Bit-Avragim is impact investments, which is a high-risk concept with the team being the main metric for investment. This opens up new opportunities, especially for women entrepreneurs. “At the moment, only two per cent of female founders get funded. However, female founders are better fundraisers - they fundraise slower but going straight to A round, with trying to get through earlier stages with different funding,” comments Nana. Another new concept coming from Canada is the radical generosity concept - SheEO,  where 500 women in the country donated 1000 dollars for a fund for female lead companies in six different areas. The interesting thing about the concept is that companies get a 100.000 dollars loan without interest rates. Companies also get access to the networks of included investors.