Urinary Catheters - $2 billion problem waiting to be solved

Patients may be recommended to use Urinary Catheters if they are suffering from Urinary incontinence (leaking urine or being unable to control when they urinate) or Urinary retention (being unable to empty their bladder when they need to).

If we look at the big picture, and try to see this from a problem (urinary incontinence & retention) and solution (urinary catheters) perspective, we should strongly ask this question - Is this solution (Urinary Catheters in current form) a good solution? Are the patients completely satisfied? At the end of the day, a business is created and sustained as long as a better solution is provided to the customers.

There are mainly two types of urinary catheters – Indwelling and Intermittent. An indwelling catheter is the one that is left in the bladder and is for long term use (4-6 weeks). The catheter has a small balloon inflated on the end of it. This prevents the catheter from sliding out of the patient’s body. When the catheter needs to be removed, the balloon is deflated. First prototype of an Indwelling catheter was designed by a US based surgeon, Fredrick Foley, in 1930s and the catheter was named in his honour – Foley Catheter (see image of the basic design below). 

Foley catheters have been in use from last EIGHT decades now. According to a data, around 90 million Foley catheters are being used worldwide. It would have been fine if these catheters were a good solution and patients were happy and comfortable using it, which is not the case. Patients using these catheters report many problems the worst being urinary tract infections (UTI). Some of the additional ones are following –

•          Higher rate of stones
•          significantly increased risk of bladder cancer
•          odour, leakage
•          urethral damage

One could see a major attempt to solve this problem with a complete new solution in 1997, when a multidisciplinary partnership between academia and industry was set up to design and develop suprapubic catheters. The product however, is not prevalently used and it can be safely said that this solution failed to impress the patients/caregivers.

Intermittent catheters on the other hand are used when one needs to use a catheter sometimes. These catheters are removed after the flow of urine has stopped. Although, these catheters do offer a better solution compared to indwelling, it is still not a very comfortable solution as patients

•          have to monitor fluid intake
•          have to remember to catherize on time and adjust to fluid intake
•          may have to wake up at night to catherize
•          problems for those with limited hand function (elderly patients)

Despite of such problems, over 100 million intermittent catheters are used each year and they have been eating market share of indwelling catheters (which will still be used by the patients who cannot self catherize themselves).

If we look back in last eight decades, this space has seen very few innovations most of them are incremental (improvement in material, adding anti-infective agents, coating etc.). It seems that these are not enough. The patients have still lot of issues as they are still unhappy or uncomfortable with the current solutions (products). The big players should bring either breakthrough or disruptive innovations (What I mean by this) otherwise they are leaving a door open for small players & new entrants and the open door is unsolved problem and unsatisfied patients.

Urinary catheter market is around $2 billion. Small players/new entrants must have in their minds that it will be hard to capture a significant market share with “me too” products. If they can develop a good solution (probably a non-invasive one) then the opportunity is HUGE. 

Create your innovation ecosystem the iWay

Everybody in the technology and the business world has been astounded to see the growth Apple has seen in the last decade. Some say it is marketing, some say it the design brilliance, and a lot of people say it is the brilliance and vision of Steve Jobs. One of his brilliance was to create an innovation ecosystem around Apple’s products. He wasn’t content with only changing the music industry. He went on to change the mobile and computing industry as well. 

The graphic below will help us understand the innovation ecosystem better.

If we look closely, Apple did not start everything from scratch. They evolved iPod with flash memory and touch screen technology which were developed outside. Now, add a mobile phone and an internet communications device to iPod, you have an iPhone. Widen the screen of iPhone and increase computing capacity, you have an iPad. Usually, companies add features to their products, Apple added products (phone, tablets) to their existing features/technologies. Strange, isn’t it? Next in the ecosystem would be widely rumoured iTV? Very smartly, they created an innovation ecosystem and developed products that were disruptive for mobile and computing industry. Next in line is $100 billion TV industry.

May be some innovative organizations can take out some lessons from the Apple way (or iWay). First of all, the organizations need to have a vision, a vision that is not restricted by the existing limitations. The vision should be of an ideal product or solution in their domain. Once the vision is there, solutions should be looked both inside and outside the organization. One should be ready to go beyond their expertise and technology domain to bring the outside solutions and integrating them into their products. It might be a new product altogether.

Also, the organizations should think about creating an ecosystem around their existing products or solutions. If they modify their products a bit, can they solve some other customer need which is not their existing focus? For e.g. an insulin delivery device, if it is modified a bit, can it be used for diagnosis as well? Can it be used for delivering fluids during surgery? Can it be used for fluid extraction instead of delivery or both? Can it be used for delivering fluids in aerospace or auto industries where precision is the key? Possible I guess. If you could do that, you could create an altogether different market and create disruptive products.  

Start thinking about creating your own innovation ecosystem, the iWay.