Cincinnati’s biohealth industry is adapting, changing and overcoming new challenges

With hundreds of thousands of dead across the nation, there can be no silver lining to the cloud that has been COVID. Yet our Biohealth’s industry’s response to the deadly pandemic has been nothing short of a miracle.

Even now, vaccinations are being delivered to at-risk populations. Within a few short months, the deadly virus may be totally under control. It could soon be a nightmare that lives only in our collective memory, along with the grief of those with loved ones lost.

Working with the national government as a part of Operation Warp Speed, what used to take five or six years to develop, happened in just nine months. But it wasn’t just the application of Operation Warp Speed; encouraging public-private partnerships, eliminating barriers that allowed for faster clinical trials and coordinating efforts have helped to bring vaccines to the public faster than ever before. Overcoming this great national tragedy also took courage, innovation and modern wizardry within individual companies—many of them right here in the Greater Cincinnati area.

In addition to exposing great gaps in the health care and Biohealth industries, the Great Pandemic of 2020 pulled back the curtain on the city’s medical and technological wizards, changing the way we create pharmaceutical cures and medical devices all while impacting the ways we deliver health care.

Changing Traditional Health Care

It is certainly no secret that the Greater Cincinnati region has emerged as one of the fastest growing areas for Biohealth companies. The pandemic has only accelerated that growth.

The four major vaccines to combat the deadly virus have been on trials in the area. In November, Johnson & Johnson initiated the second global Phase 3 of its investigational vaccine candidate. AstraZeneca’s West Chester plant has been growing by leaps and bounds ramping up for the production of its vaccine. And both Moderna and Pfizer BioNTech have been on trials here as well.

“We in Greater Cincinnati should be proud of our region’s role in the fight against COVID-19,” says Tim Schroeder, CEO of Clinical Trial & Consulting (CTI), a full-service, global Contract Research Organization specializing in life-saving therapies for complex and critically ill patients. “From patient care to supply chain support, from testing kits to the development and manufacturing of treatments, we have played a major part in combatting the pandemic, not just here but around the world.

“In the heart of the Midwest, we have patient care and ground-breaking research that rivals hospitals around the world. Our health systems have provided unmatched care to patients who were critically ill with COVID-19. The workers at systems including The Christ Hospital, Cincinnati Children’s Hospital Medical Center, Mercy Health Cincinnati, St. Elizabeth Healthcare, TriHealth and University of Cincinnati, have displayed courage, empathy and dedication throughout the pandemic. We as a community have been beneficiaries of the remarkable efforts of these teams.”

CTI has certainly been one of the companies at the forefront.

“We are currently working on more than two dozen COVID-19 treatment and prevention programs around the world,” adds Thom O’Donnell, vice president of Laboratory Services at CTI. “Our team provides a wide range of services to help in the fight against COVID-19, including helping our sponsors work with the FDA, managing trials across the globe, making sure the data collected is clean and accurate and recruiting volunteers here in Cincinnati to take part in several different vaccine trials.” 

From a business perspective, Biohealth has been identified by REDI Cincinnati as one of southwest Ohio’s four key industry clusters, which it targets to attract new job creation and investment to the region.

“That’s because of the strong foundations of existing companies already doing business here, the strong pipeline of talent and the ecosystem that supports startups and Fortune 500 companies alike,” says Kimm Lauterbach, REDI Cincinnati’s president and CEO. “There are about 14,000 jobs in the Biohealth industry within the Cincinnati region, which doesn’t include hospitals or local health care providers. Those jobs are in industries like pharmaceuticals, medical devices and biotech. The industry makes up $3.5 billion of the region’s economy, and it has grown by 15.5% from 2014 to 2020.”

In addition to Johnson & Johnson, AstraZeneca and CTI, major Biohealth players in the region include Thermo Fisher Scientific, Teva and P&G, but there are really too many to fully count.

“Often times, people think of Biohealth as pharmaceuticals, medical devices and clinical testing, and we have all of those in the region, but Biohealth companies in the Cincinnati region cover a wide array of products and services,” says Lauterbach. “Companies like ThermoFisher, Teva and AstraZeneca make pills, capsules and injections. We also have companies like Meridian Bioscience, Q Laboratories, CTI and Medpace, which focus on clinical and diagnostic testing.”

Companies like Ethicon and Enable Injections are examples of companies that make medical devices.

“There are less obvious companies, which make everyday medical items either made, engineered, tested or headquartered here, like Hillrom or Casco Manufacturing Solutions making hospital beds, Standard Textile, which makes bedding and gowns, or even P&G, which makes countless over-the-counter health products,” she adds. “There are also companies like AssureCare with their health care management software or revenue cycle management company, Ensemble Health Partners.”

A Foundation for Success

Cincinnati’s Biohealth companies benefit from the same infrastructure and proximity to other markets as companies in other industry clusters, which includes access to the top cargo airport in the world the Cincinnati Northern Kentucky International Airport. But it’s also an enormous benefit to have institutions like Children’s Hospital and University of Cincinnati here to develop and attract top talent.

“UC, especially under David Adams leadership of the University of Cincinnati Research Institute, is really becoming an important source for future innovation here not just from the medical school, but also other parts of the university that deal with health care,” says Mike Venerable, CEO of CincyTech, a company that provides advice and capital to entrepreneurs in the Biohealth and high-tech industries. “We also have a very good relationship with Miami University, and we are also doing some work with the graduate program at Xavier.”

In addition to providing advice and capital, CincyTech has also been involved in the creation of a pipeline of talent for the Biohealth industry through a student engagement program that offers students a chance to grow professionally with startup companies through intern programs, special projects and actual job placement—the latter offering a key steppingstone to a career and valuable experience that makes the transition from student to employment that much easier. For its part, UC provides students with the ability to select a path toward medical device innovation or research innovation. It all adds up to building a Biohealth talent pool that is the envy of the nation.

“CTI began in Cincinnati because our founding talent came out of the University of Cincinnati,” says Schroeder. “We’ve stayed here because when companies hire a contract research organization, what they’re hiring is our people—and some of the best talent in the country comes out of the Cincinnati region.”

“With the universities and medical and hospital systems in Cincinnati, we have an exceptionally talented labor pool that is well educated and stable,” adds Allison Connaughton, director, Marketing and Corporate Communications for CTI. “In our industry, the turnover is about 25-30%. In contrast, CTI’s annual retention rate has consistently been 95%. There are many factors from an organizational standpoint that contribute to this, but the region and the attributes of our labor pool definitely play a role in that success.”

Other organizations developing talent and intellectual capital include Butler Tech with its dedicated Bioscience Center, which has seen such significant growth that it recently added a second floor to accommodate demand. Miami University offers a biomedical engineering program that produces talent that can analyze, design, synthesize and test products and processes in a variety of areas, such as medical equipment and instrumentation, pharmaceuticals, biotechnology, prosthetics and biomimetic materials. Bioscience and technology degrees and certificates are also offered at Cincinnati State, Sinclair and Great Oaks career campuses.

Northern Kentucky University, in partnership with St. Elizabeth Healthcare, is also contributing to the Biohealth ecosystem for the region. Through NKU’s Institute for Health Innovation and supporting grants and partnerships, the university is stimulating regional health care innovation and supporting health care workforce development.

NKU’s Health Innovation Center (HIC) and the College of Informatics support an integrated portfolio of programs to prepare a new generation of health leaders and to provide solutions to the population health and wellness challenges of the region.

Its programs include health informatics and health communication, as well a wide range of health care degrees. In addition, NKU supports the NKY-HII (Northern Kentucky Health Innovation Initiative), which over the past 18 months has assisted 58 regional health care startups in raising over $200,000,000 in investment capital.

NKU also recently launched the Collaborative for Economic Engagement, which brings together regional partners in a shared-services model to be a one-stop shop for entrepreneurs needing connection to resources, talent or data. One partner in the NKY Collaborative is NKU’s SoCap Accelerate, a pre-series A accelerator for health-related companies. SoCap Accelerate just graduated its first cohort and will be welcoming a second one this coming spring.

In addition to filling the Biohealth talent pipeline, the region has been very fortunate to have early-stage funding organizations including the aforementioned CincyTech, River Cities Capital and family investment funds that have made it possible for start-up biotechnology and biopharmaceutical companies like Aerpio Pharmaceuticals, Airway Therapeutics and Bexion Pharmaceuticals to flourish and push medicine forward, some of which may ultimately benefit COVID-19 patients.

“Regional groups have also made large strides to combat the financial impact of the crisis and support the efforts of the sectors previously described,” says Connaughton of CTI. “For example, in March, the Cincinnati USA Regional Chamber pivoted its operations to support businesses and the Cincinnati regional economy in the wake of the pandemic.”

The chamber, in partnership with the Cincinnati Business Committee/Cincinnati Regional Business Committee, launched RESTART, a group of business leaders working to guide the work of the business community in response to the COVID-19 outbreak.

“The group is acting as the business voice in the coordination of community efforts, playing a leadership role to keep our economy working during this uncharted time and into the future,” Connaughton adds. “RESTART has made health care a pillar of the future success of our community, prioritizing the health of local residents while working to overcome the economic challenges of the pandemic. The identification of health care as a pillar of success is well founded, as we have some of the most advanced, sought-after organizations in our backyard and they are making a difference in saving lives.”

A New Normal

While the value chain in our region makes it easy for Biohealth companies to make a home here, the pandemic may have actually made the industry stronger.

“I think we have some real pockets of strength when it comes to health care,” says Venerable. “There were some really positive trends that were going on before COVID that perhaps have been accelerated or enhanced by COVID that are going to drive a ton of changeover the next 10 years.”

One of the major advances in new drug development has been sometimes called chip science versus drip science, says Venerable. Computational discovery, which has been going on for the last 15 years, is one of the reasons so many companies were able to come up with so many different versions of a COVID vaccine.

Now we’re seeing that discovery happen across the board, not just for COVID vaccines, but for other new drug therapies, like gene therapy, cellular therapy and other small molecule drugs, says Venerable. Oncology is branching out to become a multi-therapeutic process where drugs and treatments are used in concert to better fight the adaptive aspects of cancer.

CincyTech funded a company with Cincinnati Children’s last year called Kurome Therapeutics, which has developed a drug to trick a tumor, says Venerable. It’s designed to deal with a tumor that has adapted to therapy. The drug basically “tricks” the tumor and subverts the cancer’s ability to evade the initial therapy.

“So chip science and silicone discovery are going to create all kinds of new options,” says Venerable. “And many of them are going to be very disruptive—the notion of curing a chronic rare disease is a pretty big thing.”

We’ll also likely see a lot of innovation and growth on the device side, Venerable notes, from large companies such as Johnson & Johnson and smaller companies like Standard Bariatrics and Enable Injections. You will have both new therapeutics and new devices that continue to grow the area’s Biohealth value chain.

Yet another interesting aspect of the Biohealth industry comes on the consumer side, as companies like Kroger and P&G grow into health care delivery.

“And part of that comes from the demand for more consumer choice, selfcare that has been highlighted by COVID,” says Venerable. “People are much more aware of their co-morbidities, their risk factors. They are very much aware of things they may not have been aware of before.”

People today are seeking health care information from primary care physicians and health care networks, but they also are starting to seek information and treatment through avenues such as telehealth.

“It’s very exciting to see how a consumer wants to navigate the system,” says Venerable. “What pieces of their health care will they be willing to get from Kroger or Walgreens versus traditional providers—many of whom are pairing up with these new sources.”

The last area of potential growth in Biohealth is also one of the weakest of the industry. While the industry has spent trillions of dollars on electronic health information exchange (HIE) there is still a lack of transparency in data, especially when it comes to tracking outcomes. While we are seeing a record pace in terms of vaccine development and therapeutics, we still don’t have data when it comes to outcomes or comorbidities, says Venerable.

“All of the things that we are doing are quite amazing, but do we have a rich data set when it comes to outcomes?” Venerable rhetorically asks. “Not really. We’re doing it with studies faster than ever before, but it should be a real-time thing.”

The pace of data collection has not caught up with the pace of explaining that data for the benefit of patients. Once we begin to better understand outcomes and how those outcomes are achieved through treatment processes, we can achieve better continuity of treatment.

“Then you can start going after equity issues, so the same processes and treatments can be followed at places like The Christ Hospital, near where I live, to other areas that are not so well off,” says Venerable. “We should be able to blind a patient and say this is their treatment path, and they should have the same outcomes regardless of income or race.”

It’s a coming revolution that will be driven by the exploitation of the data we collect and the sharing of data to achieve best practices. It will also allow us to make sure treatments are being deployed consistently across our entire health care system nationwide.