The prosthetic market in India needs an organized ecosystem so that patients can easily access products: Yutaka Tokushima, CEO, Instalimb

Prostheses, an artificial device that replaces a missing body part, have the potential to give new life to anyone who has lost a limb in an accident or anamolia. According to a report by Grand View Research, 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% from 2021 to 2028.

Additionally, the drivers of growth are due to the increasing prevalence of sports injuries and road accidents, increasing number of diabetes-related amputations, and rising cases of osteosarcoma globally. According to reports, India has over half a million amputees, with tens of thousands being added to the amputee population every year. Due to economic disparities, generally affordable products have limited functionality or quality that does not live up to expectations. However, as market players in this segment increase, things might change.

In July this year, Instalimb, which claims to be the world’s leading Japanese supplier of 3D-designed leg prostheses, made a foray into the Indian market by launching its operations in Gurgaon with Rs. 26 crore (445 million) funding. yen). According to the company, the products are 3D printed and combined with artificial intelligence (AI). Financial reached out to Yutaka Tokushima, CEO, Instalimb and he talked about their expectations from the Indian markets, their key plans for Indian patients, prosthetics concerns, among others. Excerpts:

Instalimb recently launched its business in India and launched its prosthetic wearing solutions in Gurgaon. What is your project for the Indian market and what are your expectations?

We are very excited to foray into the Indian market and look forward to making a difference in the lives of patients here. The prosthetics market in India still needs an organized ecosystem that facilitates customer access to products. We are currently in the process of setting up joint projects with Jaipur Foot which are funded by the Japanese government and are also in talks with AIIMs.

Our aim is to reach the remote parts of India which is possible with the technologies we have. We no longer need large and heavy installations for casting plaster like the usual clinics do. In fact, we are setting up a “remote service” where our PO (prosthetist and orthotist) operates in remote areas with only 3D scanners. He sends the data to a central workshop, which then delivers the product, and then the local PO adapts the device. In the long term, we aim to maximize our impact by forming a coalition with other clinics that practice the same methodology as us. We will put our technology at their disposal to change the whole industry to provide better and more accessible prostheses.

What makes the Instalimb prosthetic leg unique and different from its contemporaries on the market? How can it benefit the Indians?

Our product is unique in every way, but most importantly because of the quality of its grip, its cost effectiveness and its customer experience. Our 3D techniques and AI allow us to manufacture very precise sockets while optimizing the cost of production. In addition, we offer innovative services such as the “free fit test”. In fact, we believe we are the only clinic that offers this service where patients can test our product before making a financial commitment. This is because we are very sure of our quality and we know that patients will love our plug once they try it. We also have our “online strain check” where patients can have their leg checked by a GP before their visit.

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What challenges do amputees face around the world? When it comes to cost and affordability, where does Instalimb stand? What is the price range for Indians?

Traditionally, the manufacturing process for prosthetic legs involves highly manual techniques that only trained prosthetists can perform. This was one of the main reasons for their high cost (5K$ in general) and sometimes their low quality if the prosthetists are not sufficiently trained and why 90% of amputees in the world still do not have access to prostheses . To solve this social problem, we reinvented and developed a whole process using 3D scanning, AI, CAD (computer-aided design) and 3D printers, and reduced the cost and price of the device by 1/10.

Our products are now known for their high quality and have enabled approximately 600 amputees in the Philippines and India to successfully walk. When it comes to quality, it’s a common myth that the quality of devices lies in the components (parts of the foot or knee joint for example), and that’s why people mistakenly perceive that international brands are good. We challenge this standard. While components are essential, we know that sockets matter most to a patient’s quality of life. And that’s the exact reason why we developed CAD software to design and create a socket tailored to each patient.

Do you plan 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 collaborate with leading organizations like Jaipur Foot and AIIMS. Additionally, we are looking for potential collaborators among individual practitioners who want to take advantage of 3D scanning and CAD design. As we plan to distribute this scan and design package early next year, you will definitely hear about other collaborations!

Currently, researchers around the world are working on the development of 3D body parts and organs. What are the main advantages? In your opinion, what will be the state of this market in the years to come?

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, which means the skills of the individual matter less. So even people in remote areas can perform 3D scanning with minimal training and measure the shape accurately. Also, this technique is enhanced with AI. Like Instalimb does, AI can optimize the design process based on scanned data and provide us with much more accurate CAD data. This means that we don’t need 70-year-old experienced professionals to create a large prosthetic leg, which makes us scalable.

There are many great innovations in 3D techniques and the orthopedic and prosthetic industry. Yet, we understand that most of them are project-based initiatives or grant-based projects that have no cost-effective mechanism to support without funds. As strong believers in the importance of sustainability as a business model, we believe that we are the only company that has successfully brought products to market and proven how this new business model works. We hope to highlight our nature as a social startup, which actually serves people AND brings profits.

In your opinion, what will be your main areas of intervention in India? Do you plan to develop other body parts besides the legs?

For now, our expertise is in above-knee and below-knee prostheses. We are also aiming to make our software available for other prostheses as mentioned earlier.

Developing or low-income countries do not have access to prostheses like other countries. What are the main reasons? What should be done to improve this?

An industrial structure that relies heavily on craftsmanship as well as manual labor unfortunately increases the cost of prostheses. We are trying to change this norm by digitizing processes and reducing costs, while improving quality.

In addition, some patients who received a poor quality leg prosthesis for free through donation sometimes give up using it because it causes them a lot of pain. We also want to reinvent this unfortunate perception that a prosthetic leg hurts.

In your opinion, what is the current and future status of prostheses? Where is India?

Unlike some other countries like the Philippines, India has many great practitioners and experts in the field of orthopedic devices. Yet, due to the high rate of traumatic accidents considering the size of the population, it is known that there are still many patients waiting for good prosthetic appliances. Together with other experts, we aim to provide the “ability to move” to everyone who needs it.

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