Authors: Professor James Moore Jr, Yunus Kutlu
We have no shortage of innovative ideas or talented people in MedTech in this country. But in my eleven years as a professor of medical device design at Imperial, I’ve seen countless good ideas go to waste. At the Centre for Sectoral Economic Performance, we are investigating why this is and what industry, government and academia can do to change it.
MedTech’s outsize contribution to the UK economy
MedTech is any technology that a clinician might use to improve or to save a patient’s life – from pacemakers to prosthetic limbs, MRI scans to plasters. The UK sector, which is mostly SMEs, employs 163,00 people and has an annual turnover of £36 billion.[1]
Despite being half the size of Biopharmaceuticals in terms of jobs, MedTech contributes £13.5 billion to the UK economy annually, about the same as Biopharma’s £15 billion. Its annual growth rate between 2016 and 2020 was 19% – far higher than Biopharma’s 3%.[2]
But the MedTech sector’s remarkable vitality is in spite – not because – of government policy. Regulatory uncertainty, scarce funding, and ineffective NHS procurement processes make it extremely difficult for MedTech inventions to develop into viable businesses.
The Peezy: a breakthrough device now withdrawn from the UK
Forte Medical’s Peezy device, invented in the UK but now only available in the US, is a dispiritingly typical example.[3]
NHS GP Dr Vincent Forte invented the Peezy and founded Forte Medical with his sister Giovanna in 2002. The Peezy is a cheap-to-produce device which makes midstream urine samples easier to collect. Forte Medical made a prototype, secured a patent, then ran real-world trials which showed that the Peezy radically reduces the risk of contamination, and therefore the unnecessary prescription of antibiotics. The potential benefits to the NHS were enormous.
Yet twenty-two years since the invention of the Peezy, NHS doctors are still sending female patients – sometimes heavily pregnant, sometimes elderly and frail – to surgery toilets with tiny sample vials and near impossible-to-follow instructions. Due to siloed budgets, resistance to change and lack of incentives for adoption, Forte Medical has withdrawn completely from the UK NHS market.
I see similar stories time and again. In just over a decade at Imperial, I have helped ten spinout companies form out of my department. One has been highly successful at securing investment. Two or three are just about managing. The rest have foundered. This doesn’t inspire our students to pursue biomedical engineering and develop MedTech devices.
The policy solution: certainty, funding, and procurement
But it’s a story we can change. With focused industry/government interventions, the UK can unleash the full potential of UK MedTech.
First and most pressingly, MedTech companies need regulatory certainty.
Because the UK represents only 3% of the global market, UK MedTech companies prioritise exports. Post-Brexit, the UK adopted its own regulatory framework, based on the EU’s Medical Device Directive (MDD) and overseen by the MHRA. But the EU’s ongoing transition to the Medical Device Regulation (MDR) means that 70% of UK-made devices will soon be noncompliant. It may also lead to some life-saving technologies being unavailable to NHS patients.
The MHRA should align regulations with those of the MDR and the American Food and Drug Administration (FDA). Outside those frameworks, there are opportunities to make the UK a more desirable destination for clinical trials of cutting-edge technologies. The Treasury should increase MHRA’s budget to that end.
Second, MedTech companies need better access to funding.
While the MedTech sector produces more university spinouts than Biopharma, the underlying research funding base for MedTech is only one fifteenth the size of the funding available to Biopharma. Sources of grant funding for MedTech SMEs are limited to Innovate UK and the National Institute for Health and Care Research (NIHR), where only about half of the applications determined to be viable actually get funded. Private investment is scarce and concentrated towards established companies.
So the Department for Health and Social Care (DHSC) and UK Research and Innovation (UKRI) should increase funding for NIHR and Innovate UK to a sufficient level that all viable projects can receive funding.
Finally, MedTech companies need the NHS to overhaul its innovation and procurement culture. The NHS’s ineffective procurement processes make it difficult for MedTech firms to access the UK market. It also prevents UK patients from reaping the benefits of the NHS’s position as an ideal testing ground for new technologies.
Universities must push for tailored support for MedTech spinouts
The government must do more to support the UK’s special position as a market primed for MedTech innovation. There are more MedTech spinouts than any other type of university spinout.
University innovation and entrepreneurship programmes should also provide tailored support for MedTech spinouts. Imperial’s new venture fund, Science Capital, will provide Imperial’s entrepreneurs access to capital and proof-of-concept funding to realise the full potential of their businesses.
MedTech is a key research area for both the White City Deep Tech Campus and the Centre for Sectoral Economic Performance, who sponsored our analysis of the UK MedTech sector.
The detailed policy recommendations in the resulting report should form a central input to a government wishing to develop a growth strategy for the country – they show how these industries could increase the UK’s global competitiveness and value added per capita. If the recommendations are implemented, there’s almost no limit to the good that MedTech can do – not only for the UK economy but for patients all around the world.[4]
Professor James Moore is the Bagrit Chair in Medical Device Design at the Department of Bioengineering, and co-author of ‘Sectoral Systems of Innovation and the UK’s Competitiveness: The UK MedTech Sector’ published by the Centre for Sectoral Economic Performance. He does research on the lymphatic system, initiated two degree programmes in MedTech entrepreneurship and has co-founded five MedTech startup companies.
The Centre for Sectoral Economic Performance at Imperial College London investigates how to improve the competitiveness of the UK economy and drive economic growth. It is a joint initiative between Imperial’s Faculty of Engineering and the Imperial College Business School –bringing together the UK’s top engineers, scientists and economists with the UK’s science and technology industries to co-design globally competitive strategies for major global challenges: like net zero, economic competition and technological disruptions.
[1] 348-IMP-Public-Affairs-3-reports_Medtech_AW_DIGITAL_SINGLES_Sept23.pdf (imperial.ac.uk), p. 17.
[2] 348-IMP-Public-Affairs-3-reports_Medtech_AW_DIGITAL_SINGLES_Sept23.pdf (imperial.ac.uk), p. 9.
[3] Peezy Midstream UK – Forte Medical (forte-medical.co.uk)
[4] 348-IMP-Public-Affairs-3-reports_Medtech_AW_DIGITAL_SINGLES_Sept23.pdf (imperial.ac.uk)