Based out of Atlanta, Georgia, ran by renowned Doctor Jay Yadav, MiRus is developing technology using a new superalloy – Molybdenum Rhenium (MoRe®). Not only is MoRe stronger than other alloys currently being used in the market, meaning smaller less invasive implants, whilst being more durable (their 4.5mm rods are significantly more durable than the standard 5.5mm Titanium or Cobalt Chrome rods), MiRus holds a family of patents to be the sole producer of devices from this material for the foreseeable future. Although starting in spine, MiRus is looking to raise the bar and challenge market dominance by looking at other orthopaedic and medical device markets in the near future.

I spoke with Mahesh Krishnan, Chief Commercial Officer at MiRus, to learn more about MoRe® and MiRus plans for market domination…

What does MiRus offer and what makes you different?

MiRus is a highly innovative Atlanta based company in this crowded space of vendors which has been highlighted in many forums, articles, clinical symposia, KOL meetings at NASS, SRS, CSRS, SMISS etc with our Molybdenum Rhenium (MoRe®) Superalloy that is 2-3 times stronger, more fatigue resistant and more hydrophilic than Ti or CoCr. These properties allow us to develop implants that are smaller, less invasive and yet more durable and bio-friendly. The last truly new alloy approved by the FDA was almost four decades ago. Patients and surgeons are increasing concerned about the biological behavior and metal ion deposition created by current implants. The European Union is considering labeling CoCr as a carcinogen and is desperately seeking alternatives. MiRus is strategically positioned to expand the use of MoRe to other orthopedic implants as well as cardiovascular implants which are almost completely based on CoCr.

Beyond the world’s best implants, MiRus is focused on end-to-end procedural solutions in the lifecycle of patient care from pre-operative surgical planning and risk stratification to better intra-operative tools including ultrasonic pedicle screw insertion systems to state-of-the-art post-operative monitoring apps and wearables. We plan to extend this strategy while developing foot/ankle, upper extremities, orthopedics and trauma, dental, CMF and cardiovascular applications. We have worldwide IP protection of our Superalloy and seek to bring meaningful innovations in medical devices to help improve efficiencies, reduce costs and expanded offering to a broader population.

In summary, MiRus is built upon a long foundation of basic research and large R&D investments leading to fundamentally better technology platform for the world’s best implants and surgical procedures.

How have you approached 2020 and the pandemic? What have you achieved?

As a company that has a thoughtful, battle-tested leader and Founder/CEO in Dr. Jay Yadav, we have closely followed all aspects of the pandemic from the beginning. Dr. Yadav and two of our senior managers who are nurses designed a comprehensive strategy which protected our employees but allowed us to keep our R&D and manufacturing facility open throughout the pandemic without closing for a single day. All employees took precautions for social distancing and came in to work to support our surgeons take care of their patients. We donated more than 4000 pieces of PPE to our local Cobb county first providers.

Strategically, we approached this as an opportunity to “pivot” and dial in to some key projects and opportunities and fast-tracked product rollout. We strategically reallocated resources to invest in key R&D projects that has demonstrated measurable positive results in Q3. We even had 14 high school, college and graduate school interns to support our software, hardware, manufacturing, operations, and sales/marketing teams. Our leadership team is quick to think and decisively act on challenges and move quickly to either address opportunities, business trends and grow our business prospects for long term success. We are very well positioned financially to capitalize on our investments including adding many key steps in building out the vertical integration of our 50,000 sqft manufacturing facility.

What would you have presented at NASS this year?

NASS 2020 would have been a banner year to showcase our continued innovations. A highlight would have been the world’s best expandable TLIF utilizing the MoRe superalloy to provide unmatched height expansion, lordosis, and graft window. In addition, we have tremendous interest in our unique family of 3D (3DR) printed interbodies which have the lowest stiffness of any interbodies and have a modulus almost identical to cancellous bone.

With just one year of commercialization of MoRe alloy in 2019, we have completed more than 2000 cases. With our 4.5mm MoRe rod super alloy (which is equivalent to a 5.5 rod) and the world’s smallest tulip, surgeons have done T2/T4/T10-Ilium long construct cases and many have declared that “they will never use a Ti or CoCr rod again for a long construct deformity”.

In addition, we would have shared the tremendous interest from surgeons on our Cygnus cervical plate which is the thinnest and narrowest plate in the world.

What are your thoughts on the industry and the NASS meeting becoming virtual?

The spine industry is going through several changes and impacts including:

a) pricing pressure from payers, hospitals, GPO/IDN,

b) reduced reimbursement for physicians for many procedures,

c) move from hospital-based procedures to ASC with approval of more than 60 CMS codes in surgery centers,

d) Covid related impact on company performance,

e) hospitals putting off purchase of capital equipment like Robots and Navigation forcing companies to alter plans,

f) lack of meaningful innovation and low barriers to entry allowing ~190 spine vendors that practically have no differentiation and finally,

g) distributors/sales reps looking for unique products to bring to their surgeons which offer clear differentiation. Companies are finding hard to sustain or grow business and even established publicly traded companies are throwing out silly and laughable commission % to attract new distributors. This is an unsustainable trend that is meant to drive short term profits without a cohesive strategy for growth.

The NASS meeting going virtual is a sign of the Covid times and is unavoidable given the circumstances of increased cases and reported deaths in the news. NASS is a very important meeting that relatively new vendors like MiRus who are seeking to challenge established players, seek to make an impact at with launch of new products, strategies and look forward to building new relationships with industry, KOL, surgeons and distributors/sales reps. We will miss the opportunity to continue to make an “impact” as we had done in prior years to showcase our innovations but certainly appreciate the great forum that NASS leadership has facilitated for vendors and community to meet and exchange ideas.

What are MiRus’ plans for 2021 and beyond?

MiRus has a strong year planned for 2021 with launches of our best-in-class interbodies, lateral system, standalone ALIF, posterior cervical system, mid-line screw system, next gen deformity system along with expanding our business line into foot and ankle platform. In addition, after an alpha rollout of our analytics platform in Q4 2020, we plan a broader launch of the platform along with the surgical planning software.

Our plans are to strengthen the complete offering with additional product developments including lateral expandable interbodies, expandable corpectomy interbody, variety of plating systems, and improvements to current offerings. We aim to offer a comprehensive solution to the spine market that includes not just hardware, but real time software planning and analytics in the continuum of patient care.

About Mahesh Krishnan, Chief Commercial Officer at MiRus

Mahesh Krishnan is the Chief Commercial Officer of MiRus and a 25 year veteran of the healthcare industry with experience in Orthopedics, Hospital solutions, Radiology, and Cardiology. Prior to joining MiRus, he launched the Orthopedic CT business in North America as the Vice President of Carestream Health. For many years Mahesh was the VP of Southeast area for Depuy Synthes spine business managing both direct and indirect channels, and leading the team to continuedgrowth in consecutive years. In addition, Mahesh has diverse experience in several global sales, marketing, operations and leadership roles including worldwide product branding and launch while he was global marketing director at Philips, manage entire P&L as VP of eastern division at Alliance Healthcare, Director of southeast sales and operations at Philips and Director of sales and marketing in Latin America for Marconi Medical systems.