Movers & Shakers Interview with Vivek Trikha, Head- Diagnostics, OncQuest Laboratories Limited
OncQuest Laboratories Limited (formerly Dabur OncQuest) formally announced its existence as an independent entity, moving away from being a part of Dabur Pharma Limited, on December 31, 2007. OncQuest Laboratories Limited was incorporated in January 2008.
Frost & Sullivan brings to you Healthcare Practice Analyst, Jayant Singh (JS), in conversation with Vivek Trikha (VT), Head - Diagnostics, OncQuest Laboratories Limited.
JS: Please give a brief overview of the company and yourself.
VT: OncQuest was conceptualized in Dabur Pharmaceuticals. Dabur Research Foundation had plans of launching diagnostic testing facilities for cancer testing. The choice was between selling diagnostic kits and going into the lab services market of cancer testing. Lack of organized and credible testing facilities for cancer and general dissatisfaction amongst KOLs regarding quantity and quality of communications, tilted the decision in favor of the lab services market and this led to the birth of OncQuest. The company started with Flowcytometry & Polymerase Chain Reaction (PCR) based technology and gradually added layers to it, like Fluorescence in Situ Hybridization (FISH) and Cytogenetics. The pilot phase started in Jaipur, Lucknow, and Ludhiana, followed by phase-wise expansions in the Southern, Western, and Eastern parts of India. The facilities are now available at 45 locations with the hub in Delhi.
In addition to Providing Diagnostic solutions, OncQuest also has a well defined goal to:
Effective assessment of diagnosis & prognosis
Appropriate management of therapy & drug resistance
Assessment of risk & predisposition
I have been associated with Dabur OncQuest, Molecular Diagnostics Reference Laboratory Delhi, the leader in Indian oncology market, since last six years as the Head – Diagnostics. Having joined the company after a highly successful tenure with Specialty Ranbaxy Ltd. - Specialized Clinical Reference Laboratories, Mumbai, for seven years with the last responsibility of the Marketing Manager. The educational qualifications comprise of Post Graduate Diploma in Medical Laboratory Technology from S.I.E.S College and Post Graduate Diploma in Industrial Analytical Chemistry from Ruia College Mumbai, after graduating with Microbiology as principle subject from Mumbai University.
JS: What are the key factors, which differentiate you from competitors?
VT: We are the only players in the lab services market with a dedicated focus on cancer testing. Cancer testing is very different from other lab tests as it calls for a lot of interaction between the clinicians and the lab. Since, we offer only cancer testing, the quality of interaction increases drastically. This adds to the comfort level of the clinicians. We also position ourselves as a one-stop solution for cancer testing, from diagnosis to monitoring. We have achieved this by bringing technologies like PCR, FISH, and Cytometry under one roof and backing up the technologies with efficient people. In addition another Critical Success Factor (CSF) at OncQuest has been offering the highest technology at the most cost-effective prices due to higher volumes than most labs with the best turn around times (TATs) the strategies followed at OncQuest include:
Drug response/ resistance
JS: Does an exclusive cancer testing model offer any other benefit, which differentiates it from competitors?
VT: Focus on cancer testing helps us in having a large volume test batch, thus resulting in economies of scale. Due to this, we are able to offer a 15-20 percent price benefit to patients.
Secondly, this model has helped us in strengthening our internal R&D practice and we are able to offer new and better tests. For example, we have been able to offer mutation analysis for Gleevec, a drug used to treat Chronic Myelogenous Leukemia (CML). This was possible only due to our strong R&D practice.
JS: What is the acceptance of molecular testing facilities amongst the medical community?
VT: Doctors have clearly acknowledged the role of molecular testing and its utility in monitoring patient therapy. With the launch of new and better therapies for cancer, this phenomenon will gain further ground. Additionally, an average growth of 150-200 percent of OncQuest for the past few years last 3 years to be precise is an added proof of the credibility and robustness of this technology. This approach has had few key achievements for OncQuest:
RQ-PCR assays for monitoring of CML patients
RQ-PCR based gene amplification assays for profiling of Ca. breast
RT-PCR based diagnostic assays for-
FLT3- AML prognostication
FIP1L1- PDGFRa- Chronic eosinophilic leukemia
Flow cytometry based diagnosis of PNH
CD20 study- patient stratification for Rituximab therapy
CD52 study- patient stratification for Campath1 therapy
IRMA- comprehensive mutation analysis of CML patients resistant to Imatinib
Patient stratification for alternate therapy
JS: What were the challenges in establishing molecular testing as a benchmark for cancer monitoring and diagnosis?
VT: The biggest problem roadblock in the way of establishing molecular testing as a benchmark for cancer monitoring and diagnosis was the lack of awareness amongst clinicians other than the KOLs about this technology. Creating this awareness was the biggest challenge. A wider test menu along with strong R&D helped us in overcoming this challenge smoothly.
JS: Can you share some thoughts about the expansion plans of OncQuest? Will the expansion be geographic or through expansion of service offerings?
VT: We will be following a two-pronged approach for expansion: expansion of service offerings and expansion in new geographies. We plan to offer testing for infectious diseases, which lead to cancer; for example, Human Papilloma Virus (HPV), which leads to cervical cancer. There are no plans to enter any other testing segment beyond cancer. We would also look at expanding our footprint beyond SAARC countries. We expect CAP accreditation to help us in expanding our footprint geographically.
JS: What is the revenue growth you are looking for OncQuest?
VT: We aim to grow at 150-200 percent for the next few years and touch a revenue figure of INR 500 Million by 2012-13.
JS: What is the size of the cancer testing market and how effectively is it catered to?
VT: The size of the market is around INR 2.5-3.5 billion currently. A significant amount of this business (around 45 percent) is captive and rarely comes out of hospitals. Around 55 percent of this business is in open space, which is being catered to by players like us. There is a significant part of the population for which cancer goes undetected. Our aim is to ensure that this population also gets the best testing facilities. We undertake a lot of awareness-building campaigns to achieve this.
JS: What are the various technology platforms, which are used to test cancer? What are their respective shares?
VT: Histopathology, Immunoassays, and molecular testing are a few major platforms for cancer testing. Histopathology has the highest share followed by Immunoassays and molecular testing.
JS: Which of these segments is expected to witness the highest growth? Why?
VT: All the segments are expected to witness good growth. However, molecular testing is foreseen to show the highest increase. This will be primarily on account of the increase in number of hospitals offering treatment facilities, which is likely to ultimately increase the size of the market
JS: What role will Theranostics play in driving this growth?
VT: In the times to come, Theranostics is likely to act as a strong growth driver for molecular testing. The launch of new therapy regimen like Gleevec is a strong example for it.
Genetic heterogeneity exists even with defined subgroups. Ignoring this variability is a major cause of limitations of present cancer therapeutics ie Cost/ Efficacy/ QOL
Provide earlier detection of genetic predisposition
novel drug design and development
JS: How well equipped is OncQuest to tap this growth opportunity?
VT: We are well ahead of the times in terms of customizing our facilities to offer unique services to pharmaceutical companies launching these therapies. For example, broadly; develop a clinically relevant molecular taxonomy for select diseases
Molecular phenotype for staging, prognosis and disease progression
Identify and validate Macroarray patterns which can serve as a unique fingerprint of specific disease subtypes
JS: What are your thoughts on the consolidation in lab services?
VT: Consolidation is the road ahead?); labs are likely to tend to follow either of the business models as mentioned below
Captive model - for example, Fortis, Large Hospital group from North India
Lab management model - for example, Metropolis Laboratory chain from Mumbai
Franchisee model - for example, Thyrocare, specialised Chain of Endocrine Testing lab from Mumbai
Hub and Spoke model - OncQuest and Wellspring-(wellspring is also captive model.)
A lot of realignment and churning out is expected in this segment. Smaller players are likely to have to associate themselves with the bigger ones for better resource utilization.
JS: Please share your thoughts on the tax regulatory norms for this industry and how it is affecting the same? What is the solution for it?
VT: It is quite a sorry state of affairs in our country. We don't even have the minimal norms & standards for setting up a lab and offer diagnostic testing services. It's a vicious cycle; labs, which tend to follow good practices, are forced to offer services at a high cost. This makes them non-competitive when compared to their peers who compromise on quality A serious effort should be undertaken by neutral bodies like the National Accreditation Board (NABL) and Quality Council of India (QCI) to set certain standards for this industry. It should be done in a phased manner and the last stage should be a mandatory accreditation for all labs operating in India.
Thank you, Vivek, for your time.
