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Why Israeli Technology Is About To Make Injections Obsolete

For many sufferers of age onset diabetes, one of the hardest aspects of treating this condition is having to get used to injecting insulin daily. However, an Israeli company, Oramed Pharmaceuticals, has just developed an oral form of insulin that may make these daily shots a thing of the past.

I recently interviewed Nadav Kidron, CEO of Oramed, on my radio show Goldstein On Gelt about this revolutionary new product. Here's a transcript of the interview.

Douglas Goldstein: Can you tell us a little bit about your company?

Nadav Kidron: What Oramed has is the technology that was developed at Hadassah Medical Center right here in Jerusalem, and the technology allows us to take injectables and deliver them orally. The latest product that Oramed has is oral insulin. So diabetics can take insulin as an earlier treatment and by doing so, they can treat much better the diabetes because of the earlier oral administration.

Douglas Goldstein: When you say "oral administration," you mean when a diabetic isn't feeling well he can just pop a pill?

Nadav Kidron: The truth is that when they don't feel well they should do it because it's a long journey for diabetics, and the sooner they start with insulin the better it is. Many diabetics don't want to take the injection. If we can offer them an oral insulin to be taken earlier on, and it's something they have to take on a regular basis everyday regardless of how they feel, it will help them overall to be in better control of their diabetes.

Douglas Goldstein: From what I understand, this is actually quite revolutionary because insulin has long been considered something that couldn't be taken orally. Is that correct?

Nadav Kidron: It's absolutely correct, and in Israel we love to do things which are considered to be impossible to do, so we just wanted to join the trend.

Douglas Goldstein: Is it a science that our listeners could understand? Can you give us a summary of how it is that you broke through that barrier?

Nadav Kidron: Just to give a general overview, the reason that small proteins, which are called peptides, cannot be delivered orally is because we have two obstacles. There's a problem of degradation and there's a problem of the size. The technology that Oramed has basically helps to take it and protect the peptide, in this case the insulin, from degradation. Using an absorption enhancer, we can deliver it given the size limitation into the portal vein and then basically the peptide, in this case as I said the insulin, goes into the liver and then the liver. That's the organ that has control over the regulation of the insulin into the secretion of the insulin into the bloodstream, and that's exactly what's happening with oral insulin.

Douglas Goldstein: How has it been actually working on the practical level?

Nadav Kidron: The practical level is very simple. You get a pill the same way you buy Advil or whatever it is that you buy out there. When you look around at people over the age of 30-40, 10% of then have diabetes. When someone goes to their annual check at the doctor and suddenly they are told, "Sorry to tell you, but your blood sugar level are too high and we have to do something about it," one of the first remedies, one of the first medications they're going to have is actually oral insulin.

Douglas Goldstein: Let's talk about the business side of it, including current marketing efforts. Are you still in development or are you actually selling this?

Nadav Kidron: We are actually in between, meaning the product is ready, and I wish we could sell it but in order for us to sell it there's a whole Via Dolorosa that we have to go through. We have to go through the FDA in order to get the FDA's permission to sell it. Many of you know that in order to develop a drug there's phase 1, there's phase 2, and there's phase 3. So we are now starting the phase 2B with the FDA, which is quite an advanced stage to be at. It's very unfortunate because the number of diabetics is becoming so big. The market of diabetes in the world is around half a trillion dollars, 500 billion dollars a year, and the idea is to tap into this market and actually maybe reduce a little bit the cost of this market by giving the oral medication earlier on and preventing some of the complications that come later on.

Douglas Goldstein: Can you tell us from an investment standpoint: If someone is going to come and take your ideas, are they yours to keep?

Nadav Kidron: This is where patents come into play. Let's say that a company like Oramed makes a deal with a big pharmacy so that they can take care of the distribution, the essence of what we actually give them is the IP and in most of the world today, including some of the developing countries, the IP has tremendous value for it and the reason companies are willing to invest hundreds of millions of dollars in developing drugs is of course you get that IP protection that allows for those companies down the line to make a nice profit on these products that they sell to the end user.

Douglas Goldstein: So you've pretty much wrapped up what you have ready to sell it overseas.

Nadav Kidron: Yes.

Douglas Goldstein: A lot of the issues that come up when people talk about Israel high tech is that Israel is very ingenuious in coming up with the new ideas but then unfortunately they're not able to actually get it out to market and they have to sell it out. People refer to this as a brain drain. Are you on that path or is there some way that this technology is going to continue to benefit Israel for years to come?

Nadav Kidron: I'm a real Zionist and when I go around the world and I tell people what we do, I think it means a lot of respect in different ways for people who live in Israel especially when there's all the BDS and everything else going on out there. So we can tell people, "You want to boycott Israel? No problem, but it's oral insulin and your father needs it. You should consider boycotting that as well." So I think there's tremendous value in making sure that with these innovations that were thought of in Israel, at the end of the day people can make the connection and understand, "Hey, this thing was actually thought of, developed, and invented in Israel." It's the reason that if you want to sell a drug to several million diabetics out there, you need to have a sales force. Rather than one company to put up the sales force, in order for them to reach all the doctors, all the hospitals, and all of that, it makes much more sense to collaborate with a big pharma that already has the sales force on the ground and utilize the sales force. That will be the most efficient way to move forward, and that's why unfortunately in many cases there's absolutely no other way than having this partnership in order to maximize the effects and the profit of this specific product.

Douglas Goldstein: Have you set up any such partnerships yet or that's still on the way?

Nadav Kidron: I have to be very careful. We are a public company so I'm always thinking of what I'm saying, but I can tell you that we have disclosed that we are having discussions with a potential big pharma. We haven't disclosed anything beyond that, so as far as that I'm happy to share.

Douglas Goldstein: In other countries outside the United States, in some other countries FDAs are a little bit less stringent and are happy to get new ideas to the market sooner. Have you found that as well?

Nadav Kidron: What is interesting is that we published a few months ago that we got an investment from a Chinese pharma, and we said that we see them as a gateway into potentially the Chinese market. Last week, I was in China and you look at the CFDA, which is the Chinese FDA, and they live in their own world. They say, "You know what, either way, I don't care where you're standing with the FDA. You come into China and you have to start from scratch." We have quite a big market out there. So there are definitely other places different than the United States that someone may consider moving forward in order to get the regulatory approval. I don't want to send away any American listeners, and specifically the ones in New York, but I'm going to share a big secret with people from New York. Let's keep it confidential - but there's a real world out there beyond New York.

Douglas Goldstein: How about the technology being used for other types of medication? Is your technology broader than just for insulin?

Nadav Kidron: Yeah, so we have actually a platform technology that allows Oramed to take injectables and deliver them orally. We have limitations, but just to give an example think about flu vaccine. Someone can take flu vaccine and instead of taking it as an injection they can take it orally. So that can be a game changing thing because many people who wouldn't necessary take the flu vaccine, they don't want to get the shot, may take it because they can take it orally. Someone who's older and cannot make it to the pharmacy, or someone who's younger or whatever, can just take it with a glass of water. There's definitely yet a lot of things that we're looking to explore down the line but we decided to start with insulin because we have years of experience specifically with insulin. Because it's such a big market and because there's such a big need for it, that's why our flagship product at this point is oral insulin.

Douglas Goldstein: How can people follow you and follow the company?

Nadav Kidron: It's very simple. Everybody is welcome to log on to our website and you can actually put your own email there so you can get the updates from us as we move forward. We also have a Facebook page, Oramed Pharmaceutical. It's very easy, and if anybody comes to Jerusalem you could just stop by. We're at the High Tech Park and I'm always happy to see people who come to visit us.