An Interview with Karen Drexler

Proof That The Experiences Which Inform and Mold Our Personal History Can have a Lasting Impact On The Greater Good of the World

Today for our interview in Bone Health Technologies’ new blog series I’m here with Karen Drexler, who is one of our board members.  I’d love to start with some background. How did you get into the med tech field? Tell me a little bit about the early stages of your career. 

In college, I studied chemical engineering. I was inspired to do that because my father worked for Exxon, which was actually Esso at that point, and was building chemical plants and working with chemical engineers. I thought it was really interesting. I didn’t really understand that there were basically no women who worked in that field. I studied chemical engineering and wanted to work in energy, and got particularly interested in solar energy. While I was in college, we had the two oil crises going on with significant oil shortages and high prices. There was a flood of money into alternate energy, solar in particular. I ended up doing a junior project and a senior thesis on solar energy, and expected to go into the energy field. I had gotten accepted to a two-year program with the Solar Energy Research Institute in Albuquerque and Stanford, one year in each place. 

In my senior year of college, two things happened. One is that the second oil crisis ended, and all the alternate energy funding went away. So, this program that I was supposed to go to had its funding cut.  The second is that my father was diagnosed with diabetes. He was almost certainly, misdiagnosed as a Type II, when he was a late-onset Type I based on the way he responded to insulin. He was put on insulin, using urine dipsticks, which was state-of-the-art at that time, and we now know is totally inadequate. He was frequently at risk of going into a coma because he was being given way too much insulin.  The amount of insulin a Type II patient uses is typically way higher than that of a Type I patient. He ended up having a massive heart attack and died right after I graduated from college. 

I didn’t know what to do. I applied for entry-level chemical engineering jobs, and they just sounded boring. On a whim, I interviewed with the Boston Consulting Group. I went to BCG in Boston for two years while trying to figure out what to do with my life. 

However, I was completely changed by the experience with my dad. I decided I had to work in healthcare. I didn’t know he was misdiagnosed, but I knew he was not optimally treated. Fortunately, I got to work on a couple of healthcare cases at BCG. I decided that I would go to business school, use that opportunity to really learn about the healthcare field as opposed to the energy field, and make my way in healthcare. I ended up choosing Stanford (I had to get in first of course) mainly because of its location in Silicon Valley. Being in the heart of so much innovation in the healthcare space, it just seemed like the right thing to do. I thought I’d go back to Boston, which I loved, but fell in love with Silicon Valley and have been here ever since.

After business school, how did you get into Medtech, specifically? 

My first year in business school, one of the speakers was Len Baker, a founder of Sutter Hill Ventures, one of the storied venture funds around. After the lecture, he was bombarded with people who wanted to go and work in venture. Almost everybody in my class either went into venture capital or investment banking. I was looking for a healthcare company to join. I approached Len and asked if I could meet with him to talk about start-ups in healthcare.  It turned out that he had just funded a startup called LifeScan, which was the first company that was focused on building home blood glucose monitoring for people with diabetes. It was also a perfect fit with my personal interests.

There was very little home blood testing going on at that time – it was almost all urine testing. Two large companies had taken chemistry sets that were available in doctors’ offices that involved washing and timing and made them available for home use. Very few Physicians were willing to let patients do that at home because they thought patients would make mistakes that could be dangerous. LifeScan was founded to make home blood glucose testing easy so that patients would have the information they needed to control their diet and their lifestyle. Very fortunately, through this connection with Len, I was introduced to LifeScan. I met with the CEO, Jim Wilson, who has become a lifelong friend. This was in the old days of answering machines and not cell phones. Literally, by the time I got home from my interview with him, I had a message on my answering machine offering me a summer job.

LifeScan was a tiny venture-backed company of about 30 people. I worked there during the summer between years of business school. Before the end of the summer, they posted a product manager position in which I was really interested, but I had another year of school. I convinced them to hire me, and that I could do the job while I was completing business school. I started at LifeScan full-time at the beginning of my second year of full-time business school and ended up staying 11 years, helping grow the company from zero to over a billion in revenue, gaining the opportunity to work in basically every functional area of the company because of the support of the CEO.

My longest tenure was in operations, using my engineering background. I ran instrument manufacturing, including purchasing and training, for about seven years. I also held finance, quality and commercial roles. I started the first business unit at LifeScan, a whole company that was set up internally with senior R&D, operations, quality, and marketing people reporting to me. It was an amazing experience.

What was the next step for you after LifeScan? 

While I was at LifeScan, I came up with some ideas for products that involved dramatically reducing the amount of blood to be used in testing with the goal of reducing/minimizing the pain of fingerstick testing. At that point, we were doing fingersticks with big, I mean, really big needles. We needed at least 10 microliters of blood to do a test. I had some ideas for obtaining smaller amounts of blood, which also required that we reinvent the way we did the measurement. I brought it to LifeScan, and they said, “Interesting, but no, thank you. We have so much infrastructure built around manufacturing our current products; we’re not interested in a platform change of that sort at this point.”

I left, with their blessing, and went on to start a company, Amira Medical, where we developed exactly that technology. We invented a whole new optical system that could work with a small amount of blood, about 1 microliter, and a new way of sampling blood to make testing virtually painless.  I invited Jim Wilson to join as board chairman to help guide me in my first CEO role. Jim has been a mentor and a friend throughout my career. Jim had left LifeScan years before when we sold that business to Johnson & Johnson. I ran Amira for about six years before selling that business to Roche Diabetes Care. 

I decided that having been through this rodeo twice, from ground zero up through exiting a company, I wanted to be able to help other entrepreneurs, in particular women, with some of the lessons learned. After the Amira exit, I got very involved in an organization called Astia – a non-profit that was founded to support high-potential female founders. I’ve spent considerable energy on work with Astia ever since.

In addition to BHT, what other companies or organizations are you involved with? 

It’s a long list. I’m actually on seven boards at the moment, which is a big number. Four of the companies are public, and three are private. Of the public companies, the largest one is ResMed, which is in out-of-hospital care, particularly in the respiratory space, things like CPAP devices and ventilators. Outset Medical makes a portable dialysis system that is cleared for home use all the way through ICU. It’s really interesting technology in a pretty stodgy market so that’s fun. Tivic Health, which is an Astia company, makes therapeutic devices, the first one of which is a topical bioelectronic medicine device for relief of sinus pain, pressure, and congestion. The fourth public company is called EBR Systems, a clinical-stage company in the cardiac rhythm management space. 

In addition to Bone Health Technologies, I’m on the board of two private AI companies. VIDA Diagnostics has proprietary, FDA cleared lung biomarkers based on AI and imaging that help with disease diagnosis and tracking. Huma is an AI company that uses machine learning to make interrogating complex data sets in healthcare very simple. 

What got you involved in Bone Health Technologies? What attracted you to working with and supporting the company? 

I was interested in the opportunity of working with you [Laura Yecies]. In addition, I’ve had a strong interest in the women’s health area and have started and advised companies in that space. Maybe, seven years ago now, maybe longer, I tried to start a fund with two female physicians that was focused on the area of women’s health. We were probably two or three years too early. In addition, I’m exactly in your target demographic for the Osteoboost Belt and I’m frustrated by the lack of solutions for me and others. 

The opportunity to address osteopenia a white space where the available therapies are geared at people who have already progressed all the way to osteoporosis. In general, the side effect profiles for approved drugs are too harsh for them to be recommended for people who are earlier in that process. Doctors say, “Yeah. Take your calcium, and go out and run, or whatever.” There’s not a lot of information. There really are no therapies. The opportunity to get into a white space with a therapeutic device, where there’s really nothing else, is really exciting. That’s also what makes it a great investment opportunity. One of the reasons I was interested in the company is I thought it would be a good fit for Astia, for some of our funding mechanisms. In fact, that worked. Astia became an investor in Bone Health, and so there were a lot of reasons to get involved.

What do you see as the biggest opportunities and challenges for the company? 

Well, initially, we’re looking at an RX clearance. As an RX device, we need to be able to get to physicians, or set up a network of physicians, to be able to prescribe. We expect that the prescription will be motivated by scores from a Dexascan. I’ve been surprised, through this project, to learn that so many women who would qualify for Dexascans, which should be covered by their insurance, aren’t getting them. One challenge is just to help with the awareness that people can get a Dexascan. Again, for our initial clearance with an RX product, in order to qualify for getting a prescription for this device. We’re going to need to be marketing to patients and to doctors. One of the benefits of a white space is you don’t have competition. One of the downsides is you have to be out there making noise. You have to create the market. You have to let people know that there is a solution that they should be thinking about. I think the biggest challenges are actually in that area, not on delivering a device, not on providing a great app with great functionality, but on building the market in a white space where solutions don’t exist.

Where do you focus your efforts in your work with BHT?

As a board member, I am involved in reviewing management’s plans for the company, challenging assumptions and setting/approving goals to make sure the company is focused on what we believe are the most important tasks.  Personally, I have vocally urged and supported the work to build Osteoboost as a connected device, building the app to provide education and community in addition to collecting data from the device. I have brought many medical devices to market, both as rx and direct to consumer, so I particularly enjoy contributing to our early thinking around go to market.

Is there anything else on the opportunities side that you would like to comment on? 

Our initial trials are focused mainly on older women with Dexa scores that show that they’re heading toward osteoporosis, but there are many other populations for which this therapy is appropriate. We know there are younger people who are dealing with the side effects of cancer drugs, for example, that end up harming their bone health. Although it’s much more prevalent in women, osteopenia still impacts a significant percentage of men. There is a real opportunity to do studies with additional populations and to demonstrate impact on a larger total market which is really exciting. We have largely focused on the US market, but there are some great international partners out there for us.   We’re currently focused on the low back and hips, but there may be other embodiments of the technology that could address other parts of the body that are vulnerable. There are opportunities in many directions.

What do you see as the key changes in the Medtech world right now? 

Well, these trends have been going on for some time, although COVID accelerated some of them. One is the move to out-of-hospital care. There are experts in our space who believe that in the future, hospitals will become basically intensive care, and everything else will happen in other lower-cost environments. That’s definitely a mega trend in our space and something that we can take advantage of because doing things at home can be both convenient and inexpensive – but requires interventions that are easy to use and compelling to maintain user interest and commitment. The other trend I’d put under a broad umbrella of patient empowerment. The rise of high-deductible health plans have made people much more aware of what healthcare costs and where their dollars are going. The value of preventative care, I think, has risen in many people’s opinions. We also have seen wearables mostly in the consumer space, making people aware that they can measure and monitor a whole bunch of things about their bodies. We’ve seen these driving outcomes in sports, sleep, and in other areas that are considered more wellness as opposed to strictly health. We’re developing a wearable, and people will have information that they can use as prevention for worsening disease. We will be hitting the market at just the right time. There’s so much attention now on women’s health, including menopause, areas that have been underserved in the past.  Women of our mother’s generation, or their mothers, were willing to suffer in silence. If they had issues with incontinence or other taboo topics, they would just stay home, stop being active and often not even talk to a doctor about things because it was too embarrassing. What we’re seeing in our generation is that women are just not prepared to give up on their active lives because their bones might be weakening or something else might be happening. We want solutions. Women control a lot of the money in this country and in particular, control the family finances in terms of healthcare – as much as 90% of healthcare spending. Women now are willing to spend money on themselves so they can have better lives and be more productive and more active. That trend is completely in our favor.

We’re starting to see some nice exits in women’s health. One of the companies I was involved in, almost right from the beginning, was nVision, an Astia-funded company that was deploying technology into the fallopian tubes for early identification of ovarian cancer, as well as blockages that could relate to infertility. They had a terrific exit to Boston Scientific. Recently, Alydia, which is another Astia company, had a great exit to Organon. We’re starting to see some of these bigger companies beefing up their women’s health groups. In the past, there had been a trend toward companies divesting of women’s health assets.  We’re early enough in this field that every exit makes an impact. It helps people realize that this is a huge field and that people are willing to pay money for solutions. It’s an exciting time for our BHT.

LINKS & INFORMATION: 

Connect with Karen on LinkedIn 

This interview was conducted by Bone Health Technologies CEO and Board Member Laura Yecies. She regularly writes and speaks on topics of female entrepreneurship, women working in technology and med tech, industry news, and Bone Health Technologies. Connect with Laura on LinkedIn.