The Entrepreneur as Customer

“I’m going to live to be 1401,” I often say. 

People laugh, which is fine. I am serious.

“But I’m going to need replacement parts,” I usually add.

Thus begins my adventure as a customer in an emerging industry: regenerative medicine. Interesting to experience entrepreneurship from the buy-side. In IT entrepreneurial circles, this happens all the time. Early adopters of new technology come from within the industry, as they are in a position to understand the need and the benefits of innovations before a broader population.

I understand first-hand (pun intended) the basic human need for tissue regeneration – it literally relieves the pain caused by degeneration. After years of wear and tear, the cartilage my CMC joint2is almost gone and won’t heal. Delicate grasping is painful – I drop things. This inability to hold a piece of paper may impede my journey to the 22ndcentury3.

I’m faced with the intractable. Modern medicine has no restorative solutions. There are pain killers. Supportive braces. Electric can openers. It’s a problem that should be remedied, not compensated for.

There is an experimental approach: Stem cells. The scientist in me understands the theory, knows it could be the ultimate answer. Soft tissue replacement parts could be made – by installing a biological factory that regenerates the lost bits. But it’s new technology with limited testing, testing that might provide surprises not covered by the theory.

I leapt at the opportunity to undergo a cell transplant procedure with a full understanding of the risks, uncertainty and cost.

The trigger event for the this new technology were findings4that fat cells, from the abdomen, are a source of stem cells – cells that have the potential to multiply and form various types of tissue. This source is appealing (competitive advantage), compared to alternatives, that are uncomfortable for the patient (bone marrow harvest), or carry risks of rejection (if the stem cells are from a third party donor, rather than the recipient) or selection of unwanted features (culturing the cells in between harvest and injection may amplify unwanted traits). Hip and knee joint replacement is common with metal, plastic or ceramic parts. While generally successful, it is major surgery, costs $10,000’s, and requires months for the patient to fully recover. Replacement joints are less common in the hands.

I am an early adopter. Perhaps a consumer of an early stage prototype or minimum viable product, provider of input to get to product/market fit. Maybe even an investor, although I want to know if this is a scalable product. Currently, it needs a surgeon for administration, and a bunch of surgical equipment. However, this is indeed what puts the technology at the stage of product/market fit. It isn’t clear that the current approach can meet mass market demand, for technical reasons as much as anything else.

There is a great opportunity here. Clear unresolved pain, competitive advantage, timeliness, and a massive market for an effective treatment of osteoarthritis. The Arthritis Foundation states that 31 million Americans have osteoarthritis, and the expectation is that this will reach 78 million by 2040.5That’s a 5% year/year growth rate sustained for 20 years in a whomping big market. 

I’m excited to see the outcome of my treatment. Will there be regeneration and healing, so I can do mundane things like open a chip bag or put on socks without pain? There are no guarantees. As an emerging technology, there is knowledge to accumulate to optimize the product, possibly making it more effective and reliable. I’ll take the risk. I’m thrilled to be part of the development of this technology, the possibility to make a difference. That’s what entrepreneurship is all about.

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1I came up with this number after reading a theoretical paper many years ago about the limits of the human life span. Current estimates range from just over 100 to no limit. 

2Where the thumb bone connects to the wrist bone.

3This may seem melodramatic but there are studies that link an inability to do minor tasks with increases in depression, obesity and other chronic illness. 

4This paper summarizes the findings of a number of studies: Miana, V. V., & González, E. (2018). Adipose tissue stem cells in regenerative medicine. Ecancermedicalscience12, 822. doi:10.3332/ecancer.2018.822

5https://www.arthritis.org/about-arthritis/understanding-arthritis/arthritis-statistics-facts.php

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