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Lluis Chico

Director of Neos Surgery

The company led by Lluís Chico, Neos Surgery, has already established a first family of products for cranial surgery and is now taking an ambitious leap to focus on the spine. Chico measures each word, gives thanks for each step and is aware of the company’s positive growth, with turnover now at €1.7 millions. However this industrial engineer’s words are marked by prudence, putting his colleagues at the heart of the company that undoubtedly also benefits from the surgeons’ eyes to launch products to market. 

From the skull to the spine and from sophistication to ambition. This has been the natural evolution of Neos Surgery, a biotech company created from the work of two technology centers. It is now headed up by Lluís Chico, who has taken the company to more than 20 countries. With four FDA-approved products, the company is considering strategic alliances with other manufacturers as a way to grow: Neos contributes the development talent and is looking to gain a good global sales network.

Tell us about the jump from the skull to the spine.

We define ourselves as neurosurgery problem solvers, which includes the skull, brain and spine, so it’s part of our area of action. As a result of global contact with the market through our cranial fixation devices, we got feedback on unmet needs from our industrial and clinical contacts. And three or four years ago we decided to focus our strategic plan on elements more central to surgery. Since 2007 we’ve been researching topics related to the spine, which is an area with great potential.

How has your early experience with the skull helped you?

Having started with the skull is key. When we started, few of us had much experience in the medical device sector so we had to do something innovative to have a chance in the market, but were also aware of our limitations: we had a limited background and there was a limited ecosystem for medical devices. Regardless of how ambitious the projects we proposed were, it was highly likely that we would come up against many hurdles in our attempts to fund them. That’s why the first product we launched was sophisticated and innovative but isn't central to the surgery. This allowed us to go from idea to industrialization and manufacturing, including development, approval, marketing and sales. Thanks to this first project, we can now tackle more ambitious ones. We couldn’t have moved on to the spine without having first passed through the desert of the skull.

What sets your products apart?

Cranial loop has a clear unique selling point: it is highly intuitive without being instrumental, so you avoid sterilization and cleaning. Plus, the material is completely artifact-free in medical imaging, so it doesn’t hamper post-op diagnosis. The aneurysm clip has the same advantage of being artifact-free but also helps minimize risk to the patient and the surgery. For now, angiograms must be done by inserting contrast into the vessels with a catheter, as they have been compromised. Our material, however, is non-metallic and allows for patient follow-up with CTA, which is done through the arm without any risk of damage.

A sector like yours has a long time to market.

We knew that going in. With the first project, we rushed a lot, maybe too much, to survive. But now things are different. We’ve been able to do it with more time and without skimping on any phase: neither needs detection nor product creation through trial and error.

How do you detect the needs?

Engineers are the heart of Neos, with support from surgeons, radiologists and other physicians. We’ve always believed that the combination of these two worlds is key. This is also why I’m such a fan of the d·HEALTH Barcelona program, because it mixes settings and languages. It’s precisely this combination that led us to detect this need. We’re obsessed with observing surgeries, having contact with them, often without clear goals and just to observe. Interaction creates a funnel effect and you end up filtering until you come out with a few ideas that can become a business opportunity, not only because of the company’s capacities but also because of market opportunities.

A need isn't always an opportunity?

Whenever a surgeon comes to you with an idea, ask ten more to see if they need it too. Although these needs often start in a minority, we have to question them all. We can't risk solving a problem that isn't widespread enough to yield returns. It’s an ongoing dilemma. As a small organization, we aren’t able to look for solutions to minority issues, so we’ll leave that up to the big ones.

But innovation often comes from the smallest.

Lately we’ve seen that large companies don’t do research and development, but research and acquisition, because they don’t want to assume the risk or because small companies are more flexible and can afford to think outside the box. This is something difficult for large organizations because they have many layers and procedures, while in a small company ideas can flow… In Neos they flow between engineers, a physicist, a biologist, a chemist and, of course, financiers.

How do the company’s brains innovate?

The key lies in the fact that we are a creative team that doesn’t give up easily and will search for a solution until we come up with something. The sector is highly regulated in terms of materials and to contribute this innovation we have to push the materials to the limit in the process, like with the Cranial loop.

And you’ve gotten approval from international regulatory bodies…

Yes, and that’s something you can't control in terms of time. Four of our products have been approved by the FDA and we’ve been able to achieve this by going off book. You have to take risks. We said that the first family of products wouldn’t be enough for the FDA but we know that each case is unique, so we didn’t want to fall into clichés and we tried our luck.

Is the FDA the strictest body?

For me, the regulatory difficulties of the FDA aren’t number one. I would leave that to the Chinese or Japanese authorities because the process there is anything but systematic. With the FDA subjectivity doesn’t matter much, but in other places the roadmap isn't as clear and that makes the process much longer and more difficult.

Despite the difficulties, Neos Surgery is truly international.

95% of our sales are from abroad and we’re present in 20 countries, including China, the United States and the largest markets in Latin America. Our clients are international by vocation and need: neurosurgery is limited compared to other pathologies. We couldn’t survive if we were confined to our home market. We have to be prepared to go off script at any time.

Is that what has made you successful?

The potential turnover is great, although currently modest. We don’t consider the project successful yet. But it will be.

At least you’re a success story of companies spun off from two technology centers, Tecnalia and Ascamm.

I think they deserve great recognition, as the work they do isn't normally very glamorous because it takes time to see results. But they play a key role in supporting new spin-offs, given their initial structure. I would tell all centers that when they launch an initiative like this they have to believe that it will be great and to give them independence, as we were given. If not, they run the risk of just becoming an extension of the center.

What can we expect from Neos Surgery over the coming years?

We’ll be a combination of product manufacturers, which keeps us connected and gives us credibility in a market that is relentless, plus a product launcher. We have talent for creating, developing and certifying, and now slowly but surely marketing, but the infrastructure we need to market products globally is on another level. Partnerships with other manufacturers allow us to be complementary with people who may be less flexible creatively but have sales potential we don’t. In the United States we’ve set up a partnership with KLS Martin, who we will probably do some co-development or sales network with. However we also have our sights set on many other companies we could take the leap with. 

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