Doctors often prescribe a drug like clopidogrel (Plavix) or aspirin to help prevent their patients from suffering a heart attack, stroke, or even waxy plaque buildup along the inside of blood vessels. But how do they know if the dosage is correct, and that the drug prescribed is actually working as intended to prevent blood platelets from clumping together?
San Diego-based Accumetrics, a venture-backed medical diagnostics company, has a solution. “In a nutshell, we’re the leading company in the measurement of platelets,” says Accumetrics CEO Timothy Still.
Heart disease remains the leading killer of both men and women in the United States. And Still says Accumetrics sees a potential multi-billion-dollar market in helping doctors and patients calibrate the most widely used anti-clotting drugs. Still, who was named CEO last fall, joined Accumetrics with its fourth round of venture capital in 2007. After revamping the company over the past seven months, the CEO says he anticipates additional opportunities for Accumetrics if key regulatory developments unfold as he expects later this year.
Accumetrics says more than 80 million Americans have been diagnosed with one or more types of cardiovascular disease. The company says about 50 million Americans regularly take aspirin for its renowned anti-clotting benefits, and another 29 million take clopidogrel. But Accumetrics says the effect of such drugs can vary—some people show an inherent resistance—so that as many as one-third of the patients taking anti-clotting drugs are not getting the full intended effect.
So exactly how much of the intended effect is a patient actually getting?
Accumetrics makes an automated diagnostic instrument called VerifyNow, and replaceable test kits that are used to measure a patient’s individual response to anti-clotting drugs. The cost of the desktop unit is about $8,000, according to Still—a daunting price. Test cartridges are an additional cost, although Still says that is reimbursable and codes have been assigned by the American Medical Association to facilitate billing Medicare and health providers. (Still says the reimbursement rate for the clopidogrel test is $63 a cartridge). Accumetrics also offers other assays for measuring the effectiveness of other specific drugs on platelets, including aspirin, abciximab (ReoPro), and eptifibatide (Integrillin).
Still says Accumetrics’ diagnostic tests can help doctors adjust the dosage of the anti-platelet drugs they are prescribing to reach the proper balance in each patient. A dosage that is too low means the drug is not effective in preventing platelets from clumping together, and patients are at risk of a heart attack or stroke. On the other hand, too much of an anti-platelet drug can leave patients vulnerable to excessive bleeding.
Accumetrics’ aspirin test, introduced in 2003, can be done in medical offices under a CLIA waiver (Clinical Laboratory Improvement Amendment) that allows someone with minimal technical training to operate the VerifyNow system. Still told me the company expects to get a similar CLIA waiver by the end of this year for its clopidogrel assay. Still says that could substantially expand the company’s market because clopidogrel is among the 10 most-prescribed drugs in the U.S. (Clopidogrel is the nation’s No. 4 best-selling drug, with more than $3.9 billion in 2007 sales, according to IMS Health of Norwalk, CT.)
“I’m sure the founders would like to say this is just the way we planned it, but no one knew that Plavix would become such a blockbuster drug,” Still says.
The Accumetrics CEO says he’s also looking forward to Eli Lilly’s introduction of a new anti-platelet drug, prasugrel (Effient), that works very much like clopidogrel in blocking a key platelet receptor.
“What we really want to do is get our products designated as the standard of care when it comes to medical diagnostics for managing cardiovascular disease,” Still says.
Accumetrics was founded in 1997, after Robert Hillman, a San Diego biomedical engineer, heard a presentation about abciximab (ReoPro), the first intravenous anti-platelet drug. Hillman licensed the technology and founded Accumetrics with Dennis Durbin, who helped develop the diagnostic instrument. Silicon Valley’s Kleiner Perkins Caufield & Byers provided venture funding for the startup.
It turned out to be somewhat of a false start. Radiometer, a Danish maker of blood gas analyzers, acquired Accumetrics for $10 million in 2001. At the time, Radiometer said it did not expect Accumetrics to contribute positive profitability until fiscal 2004. Two years later, Radiometer was itself acquired by Danaher, the Washington D.C. manufacturing conglomerate. A short time later, Accumetrics was spun out to Hillman and others.
Since then, Still says the company has raised a total of almost $52 million in venture capital through four rounds. The list of investors includes Chicago-based Apothecary Capital, Oakland, CA-based Kaiser Permanente Ventures, St. Louis, MO-based RiverVest Venture Partners, Portland, OR-based Arnerich Massena & Associates, Austin, TX-based PTV Sciences, and Palo Alto, CA-based Essex Woodland Health Ventures.
Accumetrics now has about 80 employees, and Still says the company generated a little less than $9 million in revenue last year. In 2009, he expects that number will climb to between $12 million and $15 million—depending on how some things unfold. “We’re in a very good position,” Still says.
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