which validates that Pluss’ methods for
making and testing the MiraCradle meet
accepted international requirements. Pluss
is working to obtain CE Mark certification in
Europe for the device as well.
Pluss is also making progress with the
product’s distribution. The company continues to be focused on India as its primary
market, but also has plans underway to
distribute the device to hospitals in Kenya
and South Africa; it also sees a market for
smaller hospitals and clinics in the U.S. and
Europe that are looking for low-cost alternatives to the pricey hypothermia treatment systems that are currently available.
But if the MiraCradle is gaining traction,
Pluss does not anticipate making a significant profit from the device, and expects no
profit at all anytime soon. Going back to the
original purpose of Dr. Thomas’ design, the
MiraCradle is meant for low-resource medical
facilities that cannot pay exorbitant prices
for new technologies. While its target users
are not 10-bed rural clinics that often lack
even basic medical machinery—the device
is still too complex to function effectively
without appropriate monitoring equipment
and trained staff—nor are they top tier
private hospitals. Jhanwar says that ideal
candidates for the MiraCradle are small hospitals with a neonatal intensive care unit.
To reach them, Pluss priced the neonatal cooling bed at 240,000 Indian rupees,
or about $4,000. The team understands,
however, that although the price is roughly
a tenth of alternative technologies, there
will be challenges and pushback. Some
doctors, including Dr. Thomas initially, have
said that the cost is too high given the
low-cost of the materials used to make it.
Jhanwar counters that the materials are only
one factor in the price.
“There are several major factors that
account for the cost other than manufacturing. One is development. We spent three
years making the product,” Jhanwar explains.
“Then there is the the process of obtaining
certification in different countries, secur-
ing patents and trademarks for intellectual
property protection, and marketing—and
those costs are really high.”
Pluss learned the hard way how difficult
it is to market the product themselves
within the medical community, where they
do not have long-standing relationships.
Instead, they have now turned to working
with distributors, who take a commission of
30 percent or more of the sales price. These
margins may seem high, but Jhanwar con-
cedes it is standard practice in the industry.
Furthermore, because hypothermic treatment is not a widely recognized intervention
for birth asphyxia in places like India and
Kenya, these distributors play a critical role
in educating medical communities on the
usefulness of Pluss’ product. Jhanwar says
this is a major reason that sales volumes
have been slow to gain momentum.
“The time and effort it takes to educate
people about the treatment and market the
product is really significant. The conversion
cycle for one sale is about three months,”
Pluss has hosted eight treatment education workshops with doctors around India
like the first one it held with Thomas in
Vellore. Once informed about the treatment
and product, some doctors acknowledged
that such a device cannot be sold at a very
low price. For one, in order for advances
in medical technology to become more
widely available, they have to be financially
sustainable. Also, they should not be priced
so low that they are purchased by facilities
that are not equipped to use them.
“If it becomes too cheap, everybody will
buy it,” Thomas explains. “These babies are
sick. If you drop the price too much, people
who [cannot provide] the appropriate level
of care will be tempted to advertise it and
Dr. Suman Rao, a neonatologist from St.
John’s Medical College in Bangalore agrees.
“[The MiraCradle] shouldn’t be marketed
as so easy that anyone can use it. You can’t
use it everywhere that there is asphyxia—it
should only be used in hospitals that are
able to deal with the complications of
asphyxia as well as the complications of
cooling,” she says.
Jhanwar says that as the MiraCradle
becomes more widely known, the costs will
even out. This means that in places like
Kenya, where cooling as a treatment for
birth asphyxia is still not widely used, it will
take time to develop the market. Even then,
hospitals will probably require financial
support from funding organizations like the
World Health Organization or the Bill and
Melinda Gates Foundation to purchase the
cradles. But in other places like the U.S., the
MiraCradle has the potential to establish
itself as a cost-effective alternative to
more expensive, active-controlled models.
Indeed, the team says it is starting to catch
the attention of potential distributors in
some parts of the U.S.
Pluss hopes that the MiraCradle will one
day help sick babies all over the world. In
spite of the team’s steep learning curve
upon entering the world of medical devices,
support networks for this kind of social
a market for the product, and it will take time.
impact work are beginning to take notice.
The company was a recent winner of the
India Innovation Growth Program (IIGP),
an international technology development
program that helps recipients commercialize
their products for the international market.
“They came in with a highly technical, but
also simplistic solution that met the practi-
cal needs of developing countries, and yet
maintained the very high tolerances that are
required for treating babies with asphyxia,”
states Mike Fields, a business development
manager for IIGP.
If anything, that will be the message that
takes their innovation forward. •
Education about the treatment will be key to developing