Building a better diagnostic test

DR. AHLFORS REMEMBERS A CUSTOMER COMING TO HIS COMPANY FOR DIAGNOSTIC TESTS and quizzing him on why his price was $200 for the list of tests on his requisition when one of his competitors quoted over $1,000 for the same services.

“Our price point is dramatically lower than the competition,” says Ahlfors, founder of Lilium founder of Lilium Diagnostics Inc. “We’re bringing the latest diagnostic technologies at wholesale prices direct to the consumer. I remember another customer asking us about a specific test and then asked multiple times if we were sure we understood what she was asking and not making a mistake. It was actually one of our most expensive tests at $80, but the big private labs were giving her quotes of

$500. Additionally, we provided results the same day while the other lab had informed her it would take 2 weeks to have the results.”

Lilium Diagnostics, based in Laval and Montreal, has developed and administers blood, antibody and RT-PCR tests, to name a few. The tests often include more test parameters than Lilium’s competitors, while charging less. For example, during COVID it built a reputation for fast RT-PCR tests that included detailed cycle threshold values.

Simply put, Lilium’s goal is to provide the best lab diagnostic tests at the best prices. In addition, 90 per cent of the company’s profits are invested back into research and development of new diagnostic tests and advances towards new ethical solutions to cure diseases. And, Lilium’s tests use up to 90 per cent less plastic waste than most other tests and use non-toxic materials in the diagnostics.

Being at the leading edge comes with its own set of challenges. There were long delays in receiving government approvals and permits, even though Lilium outperformed its peers in proficiency tests and received both national and international accreditation faster than its peers. “Unlike in Silicon Valley, the local government was not used to game-changing companies in the medical field” Ahlfors says.

Due to robotics and high-level automation, Lilium’s test results are often ready the same day, sometimes within hours. “People are kind of surprised by the price and speed at which they receive their test results,” Ahlfors says.

Lilium’s tests often include more parameters or tests compared to the competition. For example, it’s standard CBC (complete blood count) and urinalysis tests consist of 25 per cent more testing parameters than the competition, providing more detailed information of the results to doctors. This can help doctors make a more informed diagnosis and make better decisions. Some of these additional testing parameters are available from Lilium’s competitors, but they have to be requested separately and can add significantly to the bottom line the patient must pay.

For more expensive or rare tests, many labs accumulate samples over days or weeks and then run them all at the same time to lower their costs. Labs also often outsource at least some of their tests to other labs, such as those in the United States, to further save on costs. This means it can sometimes take many weeks to receive the results and the sample could undergo slight degradation during transport and storage. Until now, typically the race to lower costs results in the quality and speed of diagnostic tests to decrease.

Lilium has decided to take a different approach by making each standard test as comprehensive as possible, for example, by including everything in its standard tests rather than selling them as extras, and then lowering the price as much as possible by implementing the latest technologies. Lilium also runs all its tests in its own laboratory, allowing most results to be ready the same day.

“We use all the latest technology,” Ahlfors says. “Often labs don’t update their equipment because with every new platform you have to re-validate everything, re-certify everything, and re-evaluate the data. It takes months, it’s quite expensive and you need specialized talent to do that.”

Lilium’s roots are as a spinoff of a biotech company that used to develop such technologies and assays.

Whereas other diagnostic companies buy their equipment, tests and technology from the big diagnostic test providers, Lilium houses scientists who can develop these tests for the big providers that then sell them to the diagnostic companies. “We have that talent in house,” says Ahlfors.

Lilium also has robotics engineers on staff.

“Our robotics engineers have allowed us to automate the processes to a far greater extent than otherwise possible,” says Ahlfors. “That’s one reason we can do it faster and cheaper. We even have a robot for collecting samples that works with the nurses to automatically open and close tubes, scan, track, and pack them for transport to the lab.”

The Lilium system has automated patient identification scanning all the way from patient registration to final report generation. “We never have mix-ups of samples or any anything like that,” says Ahlfors. Being able to automate pretty well everything also saves a lot of time in terms of filling out paperwork, manually labelling the sample, manually registering and analyzing the sample in the lab, etc. Ahlfors says when it comes to pricing, Lilium’s model is to offer near-wholesale prices to all of its customers and he wonders if other companies do a bit of price-gouging with their captive audiences.

Lilium’s leadership is made up of scientists rather than business people, he says. And its philosophy, according to Ahlfors, is to help the community be healthy while also giving customers the best price it can. “We could, for example, just sell our tests 20 per cent cheaper than the competition and already get a lot of business, but instead we sell them up to 80 per cent cheaper because we can,” he says. “That’s our philosophy — if we can do it, we will.”

As he looks to the future, Ahlfors sees the company coming out with more tests, which, of course, takes time.

“The people who work at this company like to develop new things,” he says. “So with each new test that comes online, we’re proud of it. It’s just a different kind of drive. We are product development scientists driven more by coming up with new solutions than by money. And we want to do our part for the health-care industry, because it’s really not in very good shape right now in Canada.”

Lilium is also moving into personalized diagnostics, but is not giving any further details as it is still in the development phase. “We are looking into how to enhance precision medicine and offer better and cheaper diagnostic tests, resulting in more accurate diagnoses — and treatments — for patients. Our goal is to improve and speed up health care while lowering costs both in Canada and other countries.”