GAT(T) in the market
An early Christmas thought in 2009 makes Johan Bender found the company GATT. In barely 12 years, the company develops an innovative blood-strengthening product, for which major pharmaceutical firms line up. In May 2022, GATT is acquired by Ethicon, which sets up shop on Nijmegen's Noviotech Campus. The success story illustrates why it is precisely in the Lifeport region that such companies are emerging.
Four days before Christmas, entrepreneur and pharmacist Johan Bender pays a quick visit to a congress. Outside on that Monday in 2009, it is heavily overcast and cold. In the heated conference room, Bender offers his thoughts on a failed project to use a spray to quickly close surgical wounds. And about another project to protect cannabis products from degradation with a special coating. Laboratory staff constantly complain about that coating because it really does stick everything together: the glassware at the table, even the lab technicians' hands. Terrible stuff...
At exactly half past two that afternoon, the sun breaks through in Bender's mind. Maybe one and one is three after all. Could he perhaps use that coating to stick human tissue together? That would be ideal for surgeons who want to close surgical wounds quickly after an operation, for example, without leaks. Just take a piece of tape with that sticky coating off the roll and stick it on. He can already see it: a roll of biodegradable duc tape as a standard tool in every operating theatre.
The Nijmegen company that emerged from this idea - GATT Technologies - will be acquired less than 15 years later in May 2022 by Ethicon, part of US pharmaceutical company Johnson & Johnson. It is a success story from Lifeport Arnhem Nijmegen Region, which illustrates how cooperation between entrepreneurs, knowledge institutions, government and investors leads to innovations and improvements in healthcare and additional employment.
Scientists increase opportunities
After Christmas, Bender calls on his network to check whether his idea makes sense. He first taps Prof. Jan van Hest, professor of Organic Chemistry at the Radboud University. Van Hest researches the sticky substance - the polymer based on polyethyl oxazoline, PEO for short. He pushes, turns and tinkers with it a bit, to conclude that it is quite promising. Compared to another substance already used in healthcare - PEG - it sticks more than twice as well.
"Then you want to know if the substance is pure and can be produced on a large scale," says Bender. "That is essential if you want to put a product on the market. Also essential: whether the substance is safe for humans." For an answer to both questions, he can turn to Radboud University and the Radboudumc. For research into patient safety and medical need - it is a product that the medical world is really waiting for - creates a valuable and lasting cooperation with Prof Harry van Goor, gastrointestinal surgeon at Radboudumc. Through Van Goor, access is created to the Department of Surgery, Medical Imaging, the Central Animal Laboratory and other departments that may be important for research and development of the product. At this early stage, the interlinking of entrepreneur and knowledge institutions is essential. Bender and Van Goor become a twofold unit through product development. "We have always had the ultimate clinical application in mind," says van Goor. "That requires mutual trust and an open, critical attitude towards each other in which it is sometimes allowed to crackle. This helped us a lot in the end, because it's better to kill off a hopeless project right away than to come to the conclusion after ten years that you are working on something nobody needs."
ERDF contribution
Another essential component: funding. Without funding, there is no research, let alone product development. The further development of the promising surgical tape requires a lot of money. Banks and traditional investment funds are not stepping in at this stage because they consider it too risky. The European Regional Development Fund (ERDF East) will come up with more than one and a half million euros grant does cross the bridge. "This is exactly what ERDF East is meant for," says programme manager Hans Ahoud. "ERDF East receives money from the European community to strengthen the regional economy in Gelderland and Overijssel. The idea is that promising innovations in the region can be brought to the market faster with our grants to create new jobs, especially in SMEs. It involves risky, early financing that does not always succeed, but if it does - as in the case of GATT - has positive effects for the region. In doing so, we explicitly assess whether the innovations fit within the spearheads we have formulated as provinces and regions. For Lifeport, as we call the innovation network around Arnhem-Nijmegen, is mainly about Health, Hightech and Energy. GATT fits perfectly into this picture. We helped the company get started at the time. Then they were able to take the next steps."
From plaster to patch
Besides investments from Bender and Oost NL, the ERDF grant proved to be of great value as some unexpected issues came to light. When scaling up, the substance could not be produced pure enough and the patch turned out not to work as well in practice as thought. Van Goor: "We saw that the plaster did not stick well but could stop bleeding. That's when we started to have robust discussions about the future in full transparency and confidence." "In which we actually quickly swapped the plaster for a patch, a bleeding sponge," says Bender. "The main consideration here was that you can demonstrate the effect of such a patch much better and faster, even during surgery, than the effect of a patch that, for example, prevents seam leaks from a stuck bowel after surgery. At that time around 2015, a bleeding agent, a haemostatic, came on the market that we felt was not nearly as good as ours. So in that respect, too, the switch from a plaster to a patch was obvious."
Responding to the new direction, Van Goor developed a bleeding model using surplus livers from the slaughterhouse, which greatly reduced the need for animal testing. This model enabled extensive trials and comparisons with existing haemostatics, so that by 2020 a solid dossier had been built up on the blood-clotting sponge. With excellent results!
East NL strengthens regional economy
At the time, GATT has already gone through several new rounds of funding, with particularly Eastern NL is a constant factor. Oost NL is the development company of the eastern Netherlands that, on behalf of the provinces of Gelderland and Overijssel, strengthens the regional economy with targeted investments. "Then we especially look at companies that bet on smart energy, accessible healthcare and sustainable food," says Viktor Mattousch, investment manager at Oost NL. "Preferably in cooperation with private investors, so that we can increase our financial clout and also immediately try to pave the way to follow-up financing already. We do not work with subsidies like ERDF, but with investments from which we prefer to get extra money and then invest it in new promising companies. For example, we have invested a total of more than two million euros in GATT until 2020."
The game is already on the wagon in 2020, as gradually the product's excellent results have also been noticed by major players in the haemostatics market, such as Baxter, CRBard and Ethicon, a subsidiary of Johnson & Johnson. Bender: "We had also been testing our own patch with existing products and that led to approaches and intensified contacts. Then a phase of strategic weighing up and negotiation begins, a 'tricky' period. If you sell too quickly, you get too little for your work. But if you go further with your product development, you also have to test it in humans. That requires high investments and money was not easy to come by at the time. In the end, we did opt for that further development route, for which we used, among other things, a bridging loan from Oost NL and a million-euro investment from the US investment company Northstar From my brother Andy Bender."
GATT acquired, product on the market
Then things move fast. In early 2021, it will be announced that the first patients at Radboudumc, UMC Groningen and Erasmus MC have been treated with GATT-Patch with good results. Van Goor: 'The patch can fill bleeding cavities when tissue has been cut away. The sponge can be cut to size, torn or rolled up, making it easy to handle in operating theatres. It also makes blood clot much faster than existing products and - big plus - it also does not contain human clotting products like many other haemostatics at the time."
After intensive negotiations with several parties, a deal will be concluded in May 2022. Ethicon, a subsidiary of Johnson & Johnson, will take over GATT. The acquisition price will not be disclosed, but for a premarket implantable medical device With the likelihood of an annual turnover of roughly $100-250 million, the amount must have been substantial. Johnson & Johnson will not disclose the deal until the end of 2023 when Ethicon acquires the CE hallmark for the patch received and can therefore enter the European market with it. Bender's modified Christmas idea could take operating theatres by storm. FDA approval is then just a matter of waiting, but with a green light, America can also get on the patch.
Well-being and prosperity
Importantly for Lifeport, ERDF and East NL, Ethicon is the Noviotech Campus in Nijmegen has chosen as production location for the patch. Bender, now associated with Ethicon as a consultant: "There we found sufficient space and cleanrooms needed to make our products. Meanwhile, we have already created just under 60 jobs there and we continue to grow. It is great that in this region we were able to seamlessly make the transition from small office to chemical research, clinical trials, the start-up of the company and the expansion to a large production site. Everything was always within a few square kilometres."
John van Sambeek, strategist Health at the Economic Board agrees: "The whole ecosystem around Lifeport Arnhem-Nijmegen is aimed at tackling social problems in Health, Hightech and Energy in particular. In a good innovation network, entrepreneurs can come up with solutions for this, are linked to scientists and knowledge institutes if necessary, get help with financing and investments and can test and validate their products and services in 'living labs' that we have designed. We facilitate and orchestrate where we can."
"Innovative ideas are essential for a healthy and sustainable future," says Jan van Dellen, director of The Economic Board. "Not everyone realises this, but making it happen also creates new jobs. Look at GATT, which went from idea to product and many jobs here in record time. Healthcare and the economy both benefit. That is what we stand for, linking welfare and prosperity. With almost 800,000 inhabitants in 18 municipalities in the Arnhem Nijmegen region, Lifeport is the fifth largest metropolitan region in the Netherlands. With a gross regional product of €27 billion, we are of national and international significance. We are not a copycat, but create our own identity in conjunction with our surrounding regions such as Brainport, Utrecht-Wageningen, Twente and the German Ruhr area. Our identity is green, healthy, sustainable and innovative. GATT's success story illustrates this excellently."
