CHAIN INTEGRATION: ‘Some suppliers have become true strategic partners in medical technology’

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The Southern Netherlands excels in medical technology. Companies continuously put innovative, useful, smart machines and applications on the market. How do they collaborate with their suppliers and research institutes? What do they do, what do they want, what do they need? A small tour of four completely different companies, with each and every one having a worldwide market and a solid production base in the region.

Judith Heikoop (IME): ‘We also have suppliers who work for ASML. They know what it’s like to work with very exact specifications.’ Photo: Erik van der Burgt

MEDICAL-TECHNOLOGICAL MANUFACTURING COMPANIES IN THE NETHERLANDS (1)

‘Our extended team is in the Eindhoven region. Here we find the manufacturing companies who help develop our machines, the designers who work on the appearance and user-friendliness of our products, and the suppliers of the necessary raw materials’, says Judith Heikoop, managing director of IME Medical Electrospinning in Waalre, a spin-off from Eindhoven University of Technology (TU/e) and manufacturer of electrospinning machines. The electrospinning technology is used to produce scaffolds for regenerative medicine. Liquid polymer is ingeniously ‘woven’ into, for example, a stent to strengthen a vein. The body grows its own tissue between those synthetic fibres. The scaffold can be biodegradable and over time make room for that natural material.

World leader
Research institutes and companies in the medical-technological and pharmaceutical sectors buy the electrospinning machines for their own research. IME supports its clients in scaling up and improving medical applications for the machines. In addition, the company produces scaffolds on its own machines on contract. The majority of clients are based in Europe, the United States and China. ‘We want to become the ASML in our market’, said Heikoop in a previous interview with Link Magazine. ‘IME is the world technology leader in electrospinning. Mind you: That’s what clients have said about us. They are our true ambassadors’, says Judith Heikoop. IME has undertaken various co-development projects with clients. One of them was supposed to share the results one of these days at a major conference in Silicon Valley, Napa, but that conference has been postponed due to the corona crisis.
IME works with clients worldwide on specific applications. The innovation of the machines themselves is done with suppliers in the Brainport region. Heikoop is enthusiastic about the (South) Dutch ecosystem. ‘We’re in a unique knowledge region. We incorporate our own medical knowledge and electrospinning know-how into our machines, as well the expertise of the local industry. How do we make sure together that the machine does exactly what it’s supposed to do? How can we optimise its production? In a number of cases, our suppliers have become true strategic partners.’
Worldwide IME actually only finds these kinds of partners in the Brainport region, the managing director of IME adds for good measure. ‘We also have suppliers who work for ASML. They know what it’s like to work with very exact specifications. We are dealing with nanofibres, which requires utmost precision. There are only few companies that can deliver the quality we need.’

Cleanroom-plus
One of the strategic partners is Eindhoven-based BKB Precision, a high-grade plastics machining company. In early March IME and BKB received a €50,000 grant from the Stimuleringsfonds (Incentives Fund) of the Eindhoven Metropolitan Region for their project ‘Next-Level Inert Production Environment’. The production of scaffolds requires a very clean, stable environment. IME and BKB are building a cleanroom-plus, based on inert plastics. Heikoop says, ‘We are constantly talking to our partners about our needs, how things can be done differently and better.’
Suppliers find IME interesting because of the leading role it plays, because it innovates on the edge of what is possible. Moreover, a global market for electrospinning machines is on the horizon, according to Heikoop: ‘We often use the competitive argument that our machines are so good because we can do things with our partners that can’t be done in other countries. Americans like to proclaim that everything is better and more innovative in the USA. But the fact that they are working with a Dutch party like us means that they can’t find that knowledge there. We may end up producing scaffolds for clients at various locations around the world, but the engineering and development activities will remain here.’

Passion-proof
Industrial designer and managing director Peter van de Graaf has rented business space at Strijp-S in Eindhoven for his company Choice for Women. That is a former Philips site: the former Philips buildings are home to a range of young, knowledge-intensive, hip companies. ‘Such a complex has it all. You feel that everyone here is working on new things, thinking and working in an unconventional way.’
Van de Graaf has for a long time been mulling over an idea for the ideal contraception for women: A high-tech method without hormones, which requires no discipline and is passion-proof , i.e. available 24/7 without having to think about it. Choice for Women is what the product-in-development is now called: in the future, a woman will receive a minuscule implant in both fallopian tubes and be able to open and close two valves with wireless energy from the outside at will in the course of her life.

Growing network

Peter van de Graaf (Choice for Women): ‘We started from scratch. We rely heavily on the network we’re building around us.’ Photo: Choice for Women

Peter van de Graaf has already discovered through many reactions that women cannot wait to start using Choice for Women. But it will be many more years before a complex medical-technological product such as this can be marketed. With a growing network of researchers and companies in medical technology, especially in the south of the Netherlands, he is working intensively to make Choice for Women a reality. Large-scale clinical trials are expected in about four years’ time.
‘It is crucial to be based in Eindhoven, because there is a lot of technological and medical knowledge available here.’ Van de Graaf’s first job at Eindhoven University of Technology was at the Centre for Wireless Technology. A number of professors from the faculties of Electrical Engineering, Biomedical Technology and Industrial Design now sit on the advisory board of Choice for Women, as well as a gynaecologist from the Máxima Medical Center. Van de Graaf also labels the University’s Equipment & Prototype Center as indispensable. ‘They build the most complicated research set-ups and equipment there and have numerous contacts with interesting companies.’ There he finds the microtechnological expertise he needs. ‘It’s a huge development process. Without a nearby network of knowledge partners and companies, this would remain a fantasy.’

Living tissue
LifeTec from Eindhoven has conducted experiments on living tissue for Choice for Women. LifeTec carries out pre-clinical contract research to accelerate biomedical innovations. Various animal experiments can now gradually begin. The day before the interview, a veterinarian and Peter van de Graaf introduced the first prototypes in rabbits in an animal testing centre. ‘We’re still not sure if it’s going work. Technically we will no doubt get the valves working one way or another, but we’re talking about a tube with a diameter of 1.6 mm and a length of 5 mm.’ Can the body hold such a device in the fallopian tube for a prolonged period of time? It must be safe. ‘We rely heavily on the network. An important part of my role is always to choose intelligently which expertise we need and where to get it. One advantage: our story appeals immediately.’ Van de Graaf wants to sense personal enthusiasm in the parties he teams up with. ‘If people are as passionate as we are, this will boost our cooperation enormously.’
Choice for Women develops everything in-house. The tiny motor works on the basis of memory metal. ‘We transmit wireless power to it to set the motor in motion. We made indirect contact with Thales in Paris, which is working on graphene energy carriers. Based here in the south of the Netherlands, we acquire knowledge from Europe.’

Cycling with FES
Every year BerkelBike from Sint-Michielsgestel in Brabant supplies about a hundred special bikes to people with paraplegia or with, for example, Parkinson’s disease or multiple sclerosis. The BerkelBike is a combination of a handcycle and a recumbent bicycle and is controlled with both arms and legs. Cyclists with paraplegia activate their leg muscles via the Functional Electrical Stimulation System (FES). Chemist and exercise physiologist Rik Berkelmans saw universities in various countries trying to build a bicycle for paraplegic patients. They all made more or less the same mistakes, he discovered, for example by not finishing a design from scratch. And it is very important that both legs and arms move, as this generates more power and trains the body much better.

Suppliers close to home
Berkelmans worked at a physics lab at the time. In his spare time he developed a plan for his own bicycle, which won him the prestigious Millennium Prize. Suddenly he had 100,000 guilders of start-up capital and an idea with a ‘good plan’ label on it. ‘When I had to start building, I wasn’t able to weld or to design electronics, so I first went to talk to recumbent bicycle manufacturer Flevobike from Dronten. That’s how one contact led to another.’
Suppliers close to home are important to him. It makes collaboration easier and more pleasant. Matas Electronics in Best mounts the components on the printed circuit boards. The plastic housings of the stimulators come from Formit in Valkenswaard. The front foil for the control panel is produced by Metafas in Asten. Battery Fact in Nijmegen supplies the batteries. The motors come from V-bike in Amsterdam. He also wanted the aluminium frames to be produced in the Netherlands, but that proved to be difficult, so these come from Taiwan.
Berkelmans says, ‘In the selection of suppliers, knowledge and reliability are key criteria. Our products are complex and have to be reliable. We have clients in Australia, South Africa, the United States and Brazil, so you don’t want any complaints. And we need a short supply chain. For example, if we order the motors from Taiwan or China, you get unwanted hick-ups. Clients often have special requests, for chin control for example. This requires short lines of communication with the suppliers: if we know exactly how the control of the motor works, we can make the proper connections. If the price allows it, I prefer parties close to home, with which we can continue to innovate.’

‘À la man on the moon’
A problem in the Southern Netherlands region is that there is cut-throat competition for good, technical people. At BerkelBike (now a staff of seven), someone with a technical-business background and someone for testing and co-development can start straight away.
BerkelBike is ideally based in the Netherlands. Rik Berkelmans would, however, like to see the government initiate more projects with entrepreneurs, ‘à la first man on the moon’: set an ambitious goal and along the way the partners will undoubtedly come up with all kinds of other innovations together. ‘We wanted a bicycle for people with paraplegia. Now, completely contrary to expectation, other target groups use the bicycle as well. Some sleep with FES trousers to stimulate their muscles. That’s how you make progress together.’

Workflow

Hans van Wijngaarden (Xyall): ‘I see an excellent supply base for high-tech mechatronic-optical systems in Eindhoven.’ Photo: Sam Rentmeester

Xyall from Eindhoven is set to launch its first high-tech tissue dissection system by the end of the year. This allows the workflow of pathologists and histologists to be digitised and automated: it is an extremely fast and accurate way of working that produces a very reliable diagnostic test result, for example in cancer patients, says Hans van Wijngaarden, one of the founders of Xyall. Tumour dissection has so far been labour-intensive and error-prone. The first Automated Tissue Dissection solution is intended for large laboratories where up to thousands of samples are tested daily. Next March, at an international pathologists’ conference in the United States, a smaller version of Xyall will be introduced, especially for hospitals with a molecular diagnostics laboratory.

Ingredients
Van Wijngaarden was involved in setting up Philips Digital Pathology. A similar product was already under development, but Philips did not want to take it any further. At that time he worked together with CCM in Nuenen (supplier of high-quality mechatronics) and Sioux Technologies in Eindhoven (with state-of-the-art knowledge in the field of optics, image analysis algorithms, medical robotics and data processing), as well as with Motic, a leader in optical components. Sioux (now the owner of CCM) wanted to invest. All the ingredients and all the parties necessary to have Xyall get off to a good start were close at hand. A large American molecular-diagnostics company, which advises specialists on whether or not to use chemo treatments for cancer, has turned up as the first client.

THEME: ‘WORKING TOGETHER’ AND ‘SYSTEMS THINKING’ SKILLS MAKE THE SOUTHERN NETHERLANDS RESILIENT. Read the South Netherlands Special digitally

Agility
Van Wijngaarden says, ‘Eindhoven has an excellent supply base for high-tech mechatronic-optical systems. Together with partners, we can develop quickly and change with great agility. When selecting suppliers, mutual trust is paramount for me. I want to be able to look people in the eye on a regular basis. Of course there are issues, for example about price or delivery time. But in a good mutual relationship, you always manage to settle them.’ Sioux is an informal investor. Motic also proved willing to take a risk and take on part of the financing. ‘We bear the responsibility together.’

Tour of the Dutch medtech
‘In the four interviews with the companies you sense that people speak the same language and know each other’s expectations. They have the same blood type. That makes for excellent cooperation and innovation’, says business developer Steven van Roon of maxon benelux (50 employees) in Enschede. Headquartered in Switzerland, maxon (3,000 employees) is the ‘global market leader’ in the field of high-precision drive systems. Maxon’s system solutions can be found in surgical hand-held devices, humanoid robots and high-precision industrial installations. Approximately 40-45 percent of the worldwide turnover comes from the medical technology sector.
Together with Link Magazine, maxon has devised a plan to take a Dutch medtech tour. For this first ‘stage’, companies in the south of the Netherlands were interviewed, remotely because of the corona crisis. Round-table discussions will follow in other parts of the Netherlands. ‘Proximity and meeting each other in person are important’, Van Roon concludes from the interviews.

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