The Parkinson's Pen - US Bound

Another UK healthtech firm says the NHS won't pay for innovation

*See the bottom of this post for an update where Rutger Zietsma seeks to clarify a few things about his company.

This week I caught up with the maker of a Great British invention, the pen that can diagnose Parkinson’s. Okay, Rutger Zietsma is a Dutchman but he developed the Neuromotor Pen while working on his PhD in Edinburgh and his company which is trying to turn it into a commercial product is based there.

I first met Rutger in December 2023 when I was the guinea pig in a demo of the device he did for one of the Royal Institution Christmas Lectures on AI. A couple of months later he was a guest on the Movers and Shakers podcast where he demonstrated how the pen records a user’s handwriting on a tablet and is able to deliver a pretty fine grained analysis of their motor skills and from that deliver a diagnosis.

Rutger had been working on this idea for a decade and, in my ambition to work out just how health innovations come to be adopted, I was keen to stay in touch so when he told me that he and his wife would be in London for a couple of days this week I arranged a meeting.

First, he brought me up to date on some big advances in the neuromotor pen and the software that supports it. The pen itself has been remodelled by the German firm Stabilo to make it less clunky to hold but the big innovation was the introduction of several cognitive tests alongside the handwriting test. One example - the patient could be guided through a classic test where they are asked to draw a clock face and make the clock hands point to various times.

But surely, I pointed out, you could do that just as easily with pen and paper? Dr Zietsma explained that the software recorded far more detailed information such as how long it took the patient to complete the task and the way in which the pen hovers over the screen.

“From a clinician's point of view, when they see somebody with some movement problems, they don't always know - is this a movement problem? Could it be Parkinson's? Could it be a cognitive problem? And this tests both at the same time.”

He sees two main uses for the technology - GPs without specialist knowledge of Parkinson’s or Alzheimers could use it to decide which patients needed an urgent referral to a consultant while it would allow the specialist to monitor how a patient’s symptoms changed over time.

But I had an urgent question - I knew that the Neuropen was being trialled by the NHS in Northumbria but after all the years of work and millions of pounds in investment how soon would the pen become a commercial product earning revenue? And here Rutger Zietsma had a bombshell - the aim was for that to happen this year but in the United States, not the UK. Rutger has spent most of this year in California after his wife Sanja, who had worked with him on the pen for years, took up a post as an academic at Stanford University.

“We've decided to focus on the US because the US market is just a little bit easier. It's never going to be easy, but may be easier than the National Health Service.” And the main reason is one I have heard from many healthtech companies - the NHS just won’t pay for health innovation while US insurers will.

Rutger believes that his system, as well as improving care by making diagnosis more accurate, can save money in the long term by enabling neurologists to use their time more effectively. While in principle the NHS is all in favour of moves to boost productivity it is very rare, he says, for it to invest in the tools to achieve that.

There is no guarantee that the Neuromotor pen will become a profitable product. Rutger is embarking on a drive to raise the $10 milion he reckons will be needed to market the device and then support users. That won’t be easy in the current climate for tech investment and he admits that 2025 will be a make or break year for his company.

Manus Neurodynamica will still go on trying to work with the NHS and its headquarters remains in Edinburgh. But the fact that it is only the United States that offers a path to profit for it and many other healthtech firms should be of concern for a government convinced that the UK can be a leader in this field.

UPDATE

Rutger Zietsma has been in touch to say he feared he did not do enough to stress how far his company Manus Neurodynamica had advanced in the past year.

He explained that rapid progress had been made with getting the system approved by European and American regulators.

And while the big push to launch the product in the US is coming this year, the Neuromotor Pen has already been commercialised in that there have been sales to a number of clinics in Europe.

As for the NHS, the Northumbria trial had provided impressive evidence of the pen’s effectiveness as a tool for GPs trying to work out whether to send a patient on for an appointment with a specialist. And, he emphasises, this was a paid pilot.

I also heard from the CEO of another UK healthtech startup who said Rutger’s experience was typical:

“ I know a large number of UK HealthTech Founders and everyone has the same approach. UK for R&D + trials, USA for first sales, hopefully back to the UK one day...)”