Is the Swedish Biotech Start-up Cellink Revolutionizing the Health Care Industry by Playing God?
There is a large shortage of organs available for lifesaving transplants. As a result medical researchers are turning to 3D bioprinting to address the growing shortage. Swedish start-up Cellink is revolutionizing the bioprinting industry with its innovative bioink, making bioprinting more widely accessible.
A major problem in health care is the global shortage of organs available for lifesaving transplants. In the UK patients on average have to wait 944 days to get a kidney transplant, and similar can be seen for other organs[1]. In the US only one third of the more than 114,000 patients on the national transplant waiting list received a transplant last year[2]. As a result 20 people die every day in the US alone waiting for an organ transplant[3].
However, the imbalance between supply and demand for organ transplants continues to widen[4]. The demand for transplants has increased as a result of an aging population, and lifestyle factors adding to the burden of illness[5]. The organ donor is usually a victim of a sudden fatal event, e.g. a car accident or a stroke, but as cars become safer and first-aid becomes increasingly effective there are less suitable donors[6].
Medical researchers are turning to regenerative medicine, particularly 3D bioprinting, to address the growing shortage. 3D printing technology was invented in the 1980s, and is today used to manufacture everything from trainers to vehicle parts[7]. Bioprinting offers the potential to manufacture human tissues and ultimately organs on demand for the many patients globally in desperate need of transplants[8]. However, this requires printing with living cells, which is significantly more difficult than printing of plastic or metal-based components[9][10].
Swedish Biotech start-up, Cellink, was founded in 2016 to focus on the development of bioprinting technologies[11]. The company introduced the first standardized bioink, a biomaterial, consisting primarily of nanocellulose alginate, enabling human cells to grow and thrive as they would in the human body[12]. The launch was a success and the company won several awards for innovation, in addition to financial backing from prominent investors[13].
Cellink’s unique bioink and pricing strategy has reinvented the bioprinting business model and widened accessibility of the bioprinting technology worldwide. Given the critical role of the bioink component in the business model, it is crucial to invest in further development of the bioink, coupled with commercialization of the offering, to sustain Cellink’s competitive advantage.
Although bioprinting is used to print select human tissues, the technology remains largely experimental[19][20]. Thus, uncertainties remain regarding market uptake and adoption across applications. Remembering that Cellink is a relatively small start-up with limited resources, the lack of focus across geographies, customers and applications is concerning. Rather the company should focus on a select number of promising and disruptive use cases to ensure faster and more sustainable impact. Pharmaceutical and cosmetic applications show most promise as the use cases are more feasible, and face less ethical controversy compared to clinical applications. Cellink should target efforts on US and Scandinavia given their existing bandwidth and general organ demand in these regions.
Given the increased competitiveness in the market and the inherent technology uncertainties, Cellink should consider partnering with large pharmaceutical companies to secure financial stability long-term and the ability to whether out a potentially slow market adoption.
However, bioprinting raises a number of ethical issues. One emerging concern is that the cost of bioprinting treatments may increase disparity in health care. Another is ensuring that clinical applications are safe and effective. Lastly, and most controversially, bioprinting could potentially be used to create lungs that oxygenate blood more efficiently or skin tissue that doesn’t age, allowing some humans the benefits of artificially enhanced organs.[21][22] It is thus instrumental that Cellink collaborate with regulators and market participants to create awareness of the intrinsic risks and opportunities, and ultimately develop industry standards for the bioprinting industry.
One question remains though, how do we, not God, balance the opportunity of saving thousands of lives with the risk of potential misuse of the bioprinting technology?
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Sources:
[1] “Waiting time to kidney transplant down 18% but shortage of donors still costing lives”, press release, March 9 2017, on NHS website, https://www.organdonation.nhs.uk/news-and-campaigns/news/waiting-time-to-kidney-transplant-down-18-but-shortage-of-donors-still-costing-lives/, accessed November 2018.
[2] U.S. Government Information on Organ Donation and Transplantation, “Organ Donation Statistics”, https://www.organdonor.gov/statistics-stories/statistics.html, accessed November 2018.
[3] U.S. Government Information on Organ Donation and Transplantation, “Organ Donation Statistics”, https://www.organdonor.gov/statistics-stories/statistics.html, accessed November 2018.
[4] Organ Procurement and Transplantation Network, “Need continues to grow”, https://optn.transplant.hrsa.gov/need-continues-to-grow/, accessed November 2018.
[5] Sarah White et al., “The global diffusion of organ transplantation: trends, drivers and policy implications”, Bulletin of the World Health Organization, August 22, 2014, http://www.who.int/bulletin/online_first/blt.14.137653.pdf, accessed November 2018.
[6] “A tissue of truth: Printed human body parts could soon be available for transplant”, January 28, 2017, The Economist, https://www.economist.com/science-and-technology/2017/01/28/printed-human-body-parts-could-soon-be-available-for-transplant, accessed November 2018.
[7] Hendricks Drew, ” 3D Printing Is Already Changing Health Care”, Harvard Business Review, March 4, 2016, https://hbr.org/2016/03/3d-printing-is-already-changing-health-care, accessed November 2018.
[8] “A tissue of truth: Printed human body parts could soon be available for transplant”, January 28, 2017, The Economist, https://www.economist.com/science-and-technology/2017/01/28/printed-human-body-parts-could-soon-be-available-for-transplant, accessed November 2018.
[9] “Printing a bit of me”, March 8, 2014, The Economist, https://www.economist.com/technology-quarterly/2014/03/08/printing-a-bit-of-me, accessed November 2018.
[10] S. Murphy, and A. Atala, 3D bioprinting of tissues and organs, Nature Biotechnology 32, no. 8 (2014): 773, 778.
[11] Cellink, “About Us”, https://cellink.com/about-us/, accessed November 2018.
[12] “3D printers start to build factories of the future”, June 29, 2018, The Economist, https://www.economist.com/briefing/2017/06/29/3d-printers-start-to-build-factories-of-the-future, accessed November 2018.
[13] Lewis Tim, “Could 3D printing solve the organ transplant shortage?”, The Guardian, July 30, 2017, https://www.theguardian.com/technology/2017/jul/30/will-3d-printing-solve-the-organ-transplant-shortage, accessed November 2018.
[14] Cellink, “Bioink”, https://cellink.com/bioink/, accessed November 2018.
[15] “3D printers start to build factories of the future”, June 29, 2018, The Economist, https://www.economist.com/briefing/2017/06/29/3d-printers-start-to-build-factories-of-the-future, accessed November 2018.
[16] Lewis Tim, “Could 3D printing solve the organ transplant shortage?”, The Guardian, July 30, 2017, https://www.theguardian.com/technology/2017/jul/30/will-3d-printing-solve-the-organ-transplant-shortage, accessed November 2018.
[17] Cellink, “Bioprinter”, https://cellink.com/bioprinter/, accessed November 2018
[18] Cellink, “About Us”, https://cellink.com/about-us/, accessed November 2018.
[19] “A tissue of truth: Printed human body parts could soon be available for transplant”, January 28, 2017, The Economist, https://www.economist.com/science-and-technology/2017/01/28/printed-human-body-parts-could-soon-be-available-for-transplant, accessed November 2018.
[20] S. Murphy, and A. Atala, 3D bioprinting of tissues and organs, Nature Biotechnology 32, no. 8 (2014): 773.
[21] Williams Rhiannon, “3D printing human tissue and organs sparks ethics debate”, The Telegraph, Jan 29, 2014, https://www.telegraph.co.uk/technology/news/10604035/3D-printing-human-tissue-and-organs-to-spark-ethics-debate.html, accessed November 2018.
[22] Sanjairaj Vijayavenkataraman et al., “3D bioprinting – An Ethical, Legal and Social Aspects (ELSA) framework”, Department of Mechanical Engineering, National University of Singapore, Working paper, August 9, 2016, https://www.sciencedirect.com/science/article/pii/S2405886616300021, accessed November 2018.
[Featured image] Dormehl Luke, “Inside Cellink, the Swedish company building 3D printers for living tissue”, Digital Trends, April 20, 2018, https://www.digitaltrends.com/cool-tech/inside-cellink-hq/, accessed November 2018.
Really good write-up! I like their pricing model and think it makes a lot of sense. On the point of focus, if the bioink Cellink has developed is truly standardized, then I can see how they might be able to get away with not picking a specific application to go after. However, I agree that they should probably narrow their focus in terms of geography and customer a bit more, especially since I imagine they use a sales force to reach their customers.
I agree with your assessment of the ethical issues. While it might be hard for them as a startup to prioritize working with regulators and their customers, I can see this as a competitive advantage for them if they are proactive in educating all parties about the issues associated with the use of the technology as it could establish them as a trustworthy player and thought leader in the space.
Very thoughtful! My father had a kidney transplant last year so this definitely resonates with me. His kidney transplant was from someone who was in a fatal car crash which backs up your point that suitable donors may decline as cars become safer. This innovation would solve the demand/supply issue as well as help schedule kidney transplants (right now if you are on the list waiting for a donor, you have to be on call and come in at a moment’s notice).
It sounds like Cellink will be able to make viable organs 10+ years out. With so much uncertainty around it, I wonder whether this company will be able to effectively compete with large pharmaceutical companies, especially if they decide to participate in this space. I like your idea around having Cellink partner with companies already in this space.
Great article! Very interesting. I think your concern around the new technology increasing the cost of healthcare is valid, particularly in the social and political environment of the western world today that is so focused on reducing healthcare expenditures. A natural follow-up question to that concern is, what costs does this technology save patients and payors? E.g., does a biotreatment for a particular organ save money on unneeded future hospital visits and/or surgeries? If so, even if a bioprinting treatment is quite expensive, it could save the healthcare system money in the long run and could get payors and regulators excited about adopting the technology.