Restoring Our Vision
Over the last 20 years, one of the most promising, though one of the most challenging, applications of neurotechnology has been visual neuroprosthetics. The goal of restoring vision to blind people has attracted a wide array of researchers and entrepreneurs, and a relatively small though not insignificant amount of funding from investors, non-profit organizations, and government entities.
Sadly, the path to commercialization in this area has been littered with casualties. One of the first commercial efforts, a company called Optobionics, used a self-powered photodiode array to create an artificial silicon retina. The effort failed largely because the current generated by the photodiode was not powerful enough to activate retinal neurons. Since then, a number of other startups failed to survive, including the German firms IIP Technologies and Retina Implant, the Swiss firm Intelligent Medical Implants, and the Canadian firm iBionics. An Australian-government funded effort called Bionic Vision Australia failed a few years ago, although the commercial firm Bionic Vision Technologies picked up much of their IP and is moving forward toward commercialization.
The coronavirus pandemic of 2020 exerted tremendous financial pressure on the few remaining firms in this space, including BVT, Second Sight, and the French firm Pixium Vision. Last year, Second Sight announced its intention to wind down operations because of the pandemic’s impact on its fundraising activities. But as we report in our vendor profile in this issue, Second Sight emerged from the crisis by combining with Pixium Vision. While there is no guarantee that the combined firm will survive in the long term, the synergy between the two players offers hope for financial success. One factor that will help the combined firm in the U.S. is a somewhat more favorable reimbursement climate. Commonly accepted efficacy based pricing in the U.S. is about $150,000 per QALY compared to €50,000 per QALY in the EU. The emergence of the breakthrough device designation in the U.S. is another tool that could help speed the commercialization of visual neuroprosthetics.
Still, there is much more that the government could do to help make bionic vision a reality for blind people, given the carnage of startups in this space. To begin with, the federal government could make it a stated goal to achieve vision restoration for blind people, just as it made it a goal to develop vaccines for COVID-19. Rather than waiting for private investors to fund a commercially successful device, the government could issue contracts to purchase a quantity of devices and let vendors submit proposals, much like the Pentagon does with weapons systems or NASA did with space vehicles. Clearly, the goal of restoring vision is equally vital to our national interest, and would produce financial dividends to taxpayers in the long run.
Editor and Publisher