Kotak’s investment strategy in life sciences evolving

In light of some outstanding innovation happening through the BIRAC startup incubation and funding ecosystem, the team at Kotak having led over 40 plus investments in very successful pharma, biopharma, biologics and enzyme companies over the past 3.5 decades has launched an early stage investment programme in 2019 to support new age businesses and differentiated innovations in the biotech / medtech/ healthtech sector in the country. The strategy is to invest in transformational healthcare companies developing and commercialising novel therapeutics, medical devices and services that address unmet medical needs through innovation. We are pursuing investment opportunities in companies that are attempting to solve some of the most important unmet medical needs in the areas of oncology, immunology, ophthalmology, infectious diseases, metabolic diseases, neuroscience and dermatology space leveraging on extensive relationships with pharmaceutical companies and medical institutions to advance delivery of affordable patient care with determination to positively impact society.

Over the past 2.5 years the team has already built an early stage biotech/medtech /healthtech portfolio of 15 companies so far. Some of the companies where Kotak has commitments to date include Myvax (Influenza and Covid Vaccines), Pandorum (bioengineered corneal tissue), Eyestem (cell therapy for age related macular degeneration), Ahammune (drug candidate for Vitiligo), Bugworks (drug candidates for AMR and Immunotherapy), Immuneal (CAR-T Cell cancer immunotherapy ), Niramai (breast cancer screening device), Epigeneres (early stage cancer detection), Healthians (Healthcare Diagnostics), Fullife (consumer wellness products), Meddo (chain of OPD clinics), NeuroEquilibrium (chain of vertigo clinics), Medfin (virtual hospital model for day care surgeries) among others.

This is in addition to our growth/ structured /pre-IPO investment strategy in this space which we will continue to scale up further (recent past investments include Omniactive and PharmEasy).

Drugs & Pharmaceuticals, Shasun Pharmaceuticals, Encube Ethicals, raised large sums from PE players to accomplish scale. The enormous funding support from PE players and capital markets enabled the sector to emerge as amongst the key drivers in achieving better health outcomes, domestically and globally. During this decade, India gained strength in generic drugs, vaccine production and biopharmaceuticals and got recognised as ‘the pharmacy of the world’ , the world’s largest provider of generic drugs. This decade also witnessed a number of buyout transactions led by PE funds for the first time in the country of companies such as Gland Pharma, Bharat Serums & Vaccines, Rubicon Research, Sutures India, Anjan Drugs, Veeda Clinical Research and most recently J B Chemicals & Pharmaceuticals Limited and Avra Labs.

The last decade also saw the birth of Biotechnology Industry Research Assistance Council (BIRAC) as an institution, which has brought about a transformational change in the innovation and entrepreneurship ecosystem in the Life Sciences sector in the country. Since it’s incorporation in 2012, BIRAC has initiated several funding programmes that has helped bridge the gap in the industry-academia innovation research and facilitate novel drug discovery, vaccine development, medical device and agri -component companies. BIRAC has funded over 1000 startups, 60 Bio Incubators across the country at an enormous velocity. Several of these startups have graduated to attracting third party investments from angel investors, early stage VC‘s in the country and introduced innovative products and services in the markets. We will see many of these attracting several rounds of funding from VC/PE players over the next few years and gaining prominence in domestic and global markets. A lot has improved on the Indian regulatory front too on the processes for approvals of clinical trials and grant of manufacturing licences over the past 6-7 years, which has helped the innovation ecosystem reinforcing confidence amongst Indian VC/PE Funds.

Life Sciences startup landscape in the coming years

COVID-19 has spared none. Its scale and spread were underestimated and were beyond projections by scientific models. Amidst the turmoil, Healthcare-Pharma-Biotech industry rose to the occasion to undertake an unprecedented initiative to fight the pandemic. As we look back at the year gone by, the pandemic has offered many learnings to the Healthcare-Pharma-Biotech industry that potentially unlocks several opportunities in the coming year and decade. Clearly, this pandemic has been a period of hostile adversity that spurred innovation and behavioural changes and helped address some of the biggest problems.

Longstanding practices in the healthcare sector have been transformed, perhaps forever. Vaccine development usually took years or even decades. In just one year since the Covid pandemic started, the world had several safe and effective vaccines including a few by Indian vaccine manufacturers. The regulators too demonstrated unprecedented flexibility in fast tracking clinical trials, reviews and conditional approvals. Healthcare professionals who have otherwise taken decades to adopt digital technologies, shifted to providing tele- consultations across the globe as in-person consultations dropped. The telemedicine guidelines launched by Indian regulators in the midst of the early 2020 lockdown boosted telehealth adoption among patients and healthcare providers. Pharma companies too adopted digital modes for interacting with medical professionals. Be it medical providers, insurance providers or manufacturers, all rapidly transformed their ways of working. E-commerce became the way of life for delivering healthcare diagnostics, pharmaceuticals, devices and oxygenators. New consumer behaviours will compel the continued transformation of healthcare delivery models.

In the midst of these challenges, astute startups in the healthtech /medtech space grabbed opportunities as they aimed to fill the gap in this sector bringing in tech-enabled innovations. Online consultations / telemedicine, Online pharmacies, Diagnostic testing labs, Home testing and Home Healthcare for instance, caught the attention of consumers as well as investors in 2020 -21. With focus shifting to health consciousness in the aftermath of COVID-19, wellness and fitness startups too gained prominence last year. Healthcare analytics and artificial intelligence opened up an entirely new spectrum of opportunities with applications in drug discovery, clinical trials, diagnosis, imaging diagnostics, treatment, health records etc. The healthtech /medtech sector received $2.2 billion funding across 131 deals in 2021. For the first time in India, four health tech startups – Pharmeasy, Curefit, Pristyn Care and Innovaccer became Unicorns during the year. The development of COVID-19 vaccines is just the most compelling example of the potential of life sciences. We could see global disease burden being addressed with capabilities such as gene-editing technologies to curb malaria, cellular therapies to repair or even replace damaged cells and tissues and new kinds of vaccines for non-communicable diseases, including cancer and heart disease.

Biomarker research is crucial for understanding disease pathogenesis, identifying various stages of the disease, monitoring disease severity and therapeutic response, and predicting patient prognosis. Monitoring biomarkers in clinical trial endpoints is critical for predicting the efficacy of novel medications throughout the drug discovery and development process. Merck has constantly been advancing the technologies for biomarker research and validation. In a conversation with Biospectrum, Dr. Pragya D Yadav (Scientist ‘E’ and Group Leader, ICMR-National Institute of

Virology) discussed the integration of multiplexing immunoassay technology in drug/vaccine development. Dr. Pankaj Kumar Joshi (Head of Commercial Marketing at Merck) also highlighted the recent advancements by Merck.

How will the Indian biopharma market evolve along with the surge of cutting-edge technologies in terms of precision medicine?

Dr. Yadav: In the future, a key initiative should be to develop a world-class pharmaceutical plant with cutting-edge machines that manufacture products at high speed with precision and reliability that is consummate with quality and compliance standards. This will help accelerate indigenous vaccine research in India. The newer technologies to be developed include multiplex immunoassay which enables the detection of as many analytes as possible in a single assay all in all to reduce the overall number of assays, as a way forward towards this step.

How can multiplex immunoassays support the development and clinical trials for vaccine and drug development efforts?

Dr. Yadav: Finding novel ways to use technologies that have been previously proven to work in vaccine development is one way to further speed up. In vaccine development, safety and efficacy are critical. Recent studies have shown that multiplex immunoassays offer a flexible way to monitor immune responses. The process of screening is necessary to ensure that only the best candidates are selected for further testing, but can be time-consuming and resource-intensive. Multiplex immunoassays have been used throughout the vaccine research process to expedite screening. Requiring only small amounts of a clinical sample, multiplex immunoassays can be applied at all stages of vaccine/drug development, including at the preclinical stage, and is a proven tool to monitor critical safety and efficacy of the process. Specifically, it helps in the precise understanding of the immune status in terms of pathogen-specific cytokine and antibody profile of the study participants.

With the increasing need for multiplexing biomarker analysis, how does Merck enable access to these new technologies for the scientific community?

Dr. Joshi: “Prevention is better than cure” is an excellent metaphor for biomarker research. Multiplex immunoassays help speed up disease research and biomarker discovery. We can help the scientific community to acquire data that they can trust out of each sample, with little repetition to make the best next-step decisions. Whether one needs an ultrasensitive detection from an SMC™ assay, robust ELISAs, or rich multiplex profiling data using MILLIPLEX® and Luminex® xMAP® technologies,

we pioneer in bringing the best solutions to enable scientific research in the life science space. Merck has created two labs to enable easier access to these state-of-the-art technologies: the Merck Innovation Lab and the High-End Skill Development Lab. Both our labs are equipped with cutting-edge technologies like the Luminex® systems, SMCxPRO™ for ultra-high immunoassays, SNAP i.d® 2.0 Protein Detection System, and the Auto2D® Automated 2-D Gel Electrophoresis Device. From antibodies to enzymes to small bioactive molecules and custom services, we have the solutions you need for any biomarker analysis.

How multiplex immunoassay contributes to serotyping and sero-surveillance studies?

Dr. Yadav: Serological data indicating the presence and level of antibodies against infectious disease antigens provide indicators of exposure and transmission patterns in a population. Laboratory testing for large-scale serosurveys is often hindered by time-consuming immunoassays that employ multiple tandem steps. Serosurveillance is increasingly becoming an attractive and economical strategy for multiple disease-specific public health programs in hope to gather information within a population regarding pathogen exposure or vaccination coverage. The use of bead-based multiplex immunoassay technology has been gaining recognition as a nextgeneration screening tool in seroprevalence studies with high-throughput and timely collection of antibody data. Bead-based multiplex immunoassays contribute to serotyping and sero-surveillance studies through simultaneous detection of multiple pathogen-specific antibody responses in a small volume (25ul or 50 ul) of serum/plasma or other clinical samples. It also has the advantage of investigating a large number of clinical samples in a high-thorughout manner in short period of time.

How does Merck support the vaccine development process, specifically in bringing the candidates to market?

Dr. Joshi: During the development of vaccine candidates, biomarkers can help anticipate adverse events. Understanding vaccination effectiveness and safety are critical during clinical trials. To find clinically useful biomarkers, patients must be stratified to find the best prospects. Merck’s MILLIPLEX® biomarker screening assays detect over 1,300 soluble analytes across 11 species, making it the most comprehensive in the industry, including the NHP (non-human primate) panels to aid the COVID-19 vaccine developments.

A diverse portfolio facilitates the transition from animal models to clinical research. Along with multiplex immunoassay solutions, our Single Molecule Counting™-based SMCxPRO™ can aid in the stratification of clinical trial participants and gain of insights into vaccine candidate efficacy. Our MILLIPLEX® assays aid the detection and exploration of biomarkers, whilst SMCxPRO™ enables the detection of minute yet critical changes of the biomarkers level.

How will the newly introduced xMAP® INTELLIFLEX system support the acceleration of research?

Dr. Joshi: The Luminex xMAP® INTELLIFLEX system, was introduced with our goal of providing the finest solutions for novel biomarker research. The system includes an integrated touch screen with updated software and comes in two configurations. A high-throughput RUO version with all the advantages of bead-based multiplexing, as well as a second variant (DRSE) with a dual reporter and side eject variation that is more suited for automation. The dual reporter channel increases the number of data points acquired from a single sample, which improves efficiency. With access to progressive tools, services and expertise, we are proud to be partners of researchers in their scientific breakthroughs, solving the toughest problems in life science.