The NGAL Test Addresses a significant global market opportunity
In the US, BioPorto’s initial focus with The NGAL Test is in the pediatric intensive care setting, followed by future expansion into new indications such as
nephrotoxicity monitoring, testing in the emergency department, and the adult population. BioPorto estimates that the total addressable opportunity in
the US is approximately $1.2 billion annually for all potential applications including outpatient monitoring. BioPorto believes that the global addressable
market for The NGAL Test is approximately $3 billion.
Focus on $1B European and Other Markets that accept CE Mark while FDA approval is Pending
The NGAL Test is currently available for IVD use in Europe and other geographies under its CE Mark for measurement of NGAL for all patient populations,
disease states, and instruments. While awaiting the FDA’s decision on the NGAL test submission for pediatric use in the ICU in the US, BioPorto is expanding
its presence to drive adoption in Europe. The Company recently announced the additions of Mr. Nis Kruse as EVP of Strategic Partnerships and GM of
EMEA/APAC and Dr. Tabari Baker as VP of Global Medical Affairs. Combined with the Company’s global marketing organization, BioPorto’s executive team
will focus on activities to drive market adoption in targeted European markets, including extensive market education on AKI and the value of testing for
NGAL, while also strengthening our distribution sales channels.
Steady Focus on US Regulatory Pathway for The NGAL Test
In 2022, the Company achieved a major milestone. After three years of dedicated effort during the COVID-19 pandemic, BioPorto completed a three-phase
clinical study that included 16 hospital sites in the US. Extensive data analysis was completed to determine if the Company’s targeted endpoints were met.
The De Novo application for the NGAL test for risk assessment of pediatric patients admitted to the ICU, ages 3 months to 21 years old, on the Roche Cobas
c501 clinical chemistry analyzer was submitted to the FDA on November 10, 2022. BioPorto previously obtained a Breakthrough Device Designation from
the FDA for the NGAL test, and therefore engagement with the FDA began immediately following submission. The review is ongoing, with formal FDA
requests for Additional Information (AI) issued as required. Although a single instrument represents a limited market opportunity, it does follow the
guidelines dictated by the FDA’s Replacement Reagent and Instrument Family Policy for In Vitro Diagnostic Devices. Following FDA approval, the Company
can conduct brief validation work and file to expand the marketing authorization to include additional, common Roche instruments. Roche is generally
recognized to have the largest share of the clinical chemistry market.
These subsequent submissions will be filed as 510(k) applications and can use existing pediatric samples for instrument expansions and adult clinical trials
for specified adult populations. With the first prospective approval of the NGAL test serving as a predicate device referable for future submissions, it is
anticipated that the regulatory review cycle will be brief and less complex.
Approach to Expand the US Total Addressable Market
Pediatric Market Expansion
BioPorto’s US commercial strategy for NGAL tests is designed to build a market for urinary biomarkers in AKI. Starting in the smaller, focused pediatric
market will help to build awareness and momentum ahead of launch in the larger adult market. The pediatric market includes a well-established network
of nephrologists and critical care physicians that present as Key Opinion Leaders (KOLs) in AKI, and that have objective, independent experience with, and
favorable opinions of, NGAL as a biomarker for risk assessment of AKI and, in turn, the market potential for NGAL tests.
Upon prospective FDA approval, the Company will invest in a commercial strategy for the pediatric launch of the NGAL test with three focus areas:
• Peer-to-peer education: Leveraging KOLs and other experts to describe the value of using NGAL in daily practice to other doctors through grand
round presentations, events, webinars, testimonials, and presentations at scientific meetings.
• Clinical sales representatives: A dedicated sales team with clinical experience allowing BioPorto to engage with doctors at prospective accounts
and have detailed clinical discussions about the product and its use and connect prospective customers with reference customers who are
champions of The NGAL Test. This sales team will also ensure there is alignment and buy-in among all decision makers in the hospital system.
• Medical Science Liaisons (MSLs): Building a dedicated MSL team is critical to furthering deep clinical discussions with doctors. This team will
consist of professionals with pediatric and adult ICU experience, for example former critical care nurses, who can engage in scientific discourse
on the use of NGAL in the medical management of AKI. This team will provide step-by-step tools to guide hospitals’ implementation of new
NGAL test-based kidney biomarker programs.
Adult Market Entry and Expansion
The pediatric indication includes patients up to the age of 22. Therefore, adult hospitals that also care for patients aged 18 to 21 are expected to provide
a bridge to the adult ICU market, as the laboratories in these hospitals will already be able to run NGAL tests, and adult-focused physicians will be able to
refer to their pediatric colleagues as to their experience with the NGAL tests clinically. BioPorto anticipates this will accelerate NGAL test adoption in the
adult market with prospective FDA approval of NGAL following the design and completion of one or more corresponding, necessary clinical trials.
To expand access to the adult market, the Company will select and perform appropriate clinical trials to support older adults and other clinical indications.
BioPorto’s strategy includes initiatives that will follow the initial adult FDA approval and any associated clinical trials:
• Distribution partnerships with additional instrument manufacturers, e.g., Roche, Siemens, and Abbott, to enable laboratories with any
instrument platform to order and run NGAL tests.
• Collaboration with advocacy groups, such as the National Kidney Foundation, KDIGO—Kidney Disease Improving Global Outcomes (a global
organization that develops and implements evidence-based clinical practice guidelines in kidney disease), and ADQI—Adult Disease Quality