Sontra Medical Corporation (SONT)
Interview with:
Thomas W. Davison, Ph.D., President, Chief Executive Officer and Director
Business News, Financial News, Stocks, Money & Investment Ideas, CEO Interview
and Information on their
SonoPrep® technology, a novel, non-invasive and painless skin permeation technique

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Sontra Medical Corporation is now in the final product development Phase with their SonoPrep® device for a non-invasive approach to making the skin permeable

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Healthcare
Biotechnology & Drugs
(NASD: SONT)


Sontra Medical Corporation

58 Charles Street
Cambridge, MA 02141
Phone: 617-494-5337


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Thomas W. Davison, Ph.D.
President, Chief Executive Officer
and Director

Interview conducted by:
Lynn Fosse
Editor

CEOCFOinterviews.com
December 2002

Bio of CEO,
Thomas W. Davison Ph.D.
President, CEO and Director

Dr. Davison joined Sontra in May 2002. Dr. Davison, previously was founder and Chief Executive Officer of Endius Inc. (1996-2002), a company focused on minimally invasive spine surgery. Prior to his employment at Endius, Dr. Davison was founder and President of UltraCision Inc. (1988-1995), a recognized technology leader in laparoscopic surgical instruments. UltraCision was acquired by Ethicon Endosurgery, a Johnson & Johnson Company, in November 1995, at which time Dr. Davison became Vice President of Strategic Applications of UltraCision for Ethicon Endosurgery. Dr. Davison has also held during his thirty-year career various marketing and technical positions within the pharmaceutical and healthcare industry. Dr. Davison holds a B.A. in Biology/Chemistry and a Ph.D. in Mammalian Physiology from Kent State University.


Company Profile:
Sontra Medical Corporation (NASDAQ Small Cap: SONT), founded in 1996, is the pioneer of SonoPrep® technology, a novel, non-invasive and painless skin permeation technique that uses ultrasound to permeate the skin. Their skin permeation device provides a convenient way to enhance permeability through a short (15 seconds), well-controlled burst of low-frequency (compared to diagnostic imaging) ultrasonic energy to the skin that allows sustained permeability for up to 24 hours. The transport properties of the outermost layer of the skin (the stratum corneum) are greatly improved after skin permeation and the technique opens up the potential for non-invasive transdermal diagnostics and the enhanced delivery of drugs through the skin. The SonoPrep device is a portable, hand-held ultrasound device that consists of a power and control unit, an applicator hand piece and a single-use disposable coupling medium cartridge. It employs a proprietary feedback system that automates the skin permeation process by monitoring skin permeability based on the change in electrical impedance.

The Company's vision is for painless and continuous transdermal diagnosis and drug delivery that will improve patient outcome and reduce health care costs. These benefits will be realized with improved patient compliance to treatment, continuous diagnosis and data collection and new routes for continuous drug delivery.

SonoPrep skin permeation technology addresses major unmet market needs in to the following market segments: diabetes management-glucose monitoring, drug delivery-transdermal delivery and electrophysiology-skin preparation.


Sontra's lead product in development:
Symphony™ Diabetes Management System for the continuous non-invasive monitoring of glucose levels in diabetic patients. It consists of the hand-held SonoPrep device, used to permeate the skin, and a sensor/patch that can be worn anywhere on the body by the patient to detect glucose levels and other analytes contained in interstitial fluid. It will transmit continuous data wirelessly to a glucose meter.

SonoPrep IDXT Skin Preparation System - The SonoPrep application permeates the skin to improve the electrical signals obtained from electrophysiology test such as electro-cardiograms (EKG). The first commercial applications for the SonoPrep IDX system will be for skin preparation prior to electrode placement during EKG testing. It consists of a SonoPrep ultrasound skin permeation device (a control unit, applicator hand piece, single use disposable coupling medium cartridge) and electrodes.

Other product development programs include:
Enhanced Delivery and decrease the onset time of topical drugs and cosmetics.
Sontra conducted a 40-patient human clinical study in which the skin was pre-treated with SonoPrep prior to application of a topical anesthetic. Skin permeation enabled the anesthetic to be delivered significantly faster and the onset of anesthesia was reduced from one hour (controls) to about five minutes. Use of SonoPrep to accelerate skin anesthesia will enable pediatricians to reduce the anxiety of children who do not tolerate needle sticks well.


Drug Delivery-Large Molecule Drugs  (injectable biopharmaceuticals) - Sontra’s revolutionary ultrasonic skin permeation technology platform can expand the therapeutic value of many existing drugs through transdermal delivery and make possible the delivery of large molecule biopharmaceuticals that otherwise cannot be delivered transdermally. Sontra's initial studies in the area of transdermal drug delivery, suggest that ultrasound-mediated skin permeation can enhance transport rates across the skin up to 100-fold for both small and large compounds. Sontra is investigating the delivery of several large proteins and peptides by incorporating the use of the SonoPrep device in combination with transdermal patches to deliver the drug transdermally. 

CEOCFOinterviews: Dr. Davison, where was Sontra Medical Corporation when you became its CEO and what changes did you orchestrate?

Dr. Davison: “When I came here in May, Sontra Medical, had developed a very effective device for making the skin permeable. However, the company was still predominantly research oriented. Today, we are predominantly a product development company and we are investigating various applications for our skin permeation technology. Our current efforts also include development of a sensor for blood glucose detection that will provide for a continuous glucose monitor for managing diabetics. We have a very clear-cut time-line towards the development of the SonoPrep® device for the blood glucose monitor and a Skin Prep application for delivering a topical anesthetic drug that will make the skin numb immediately. We believe the Skin Prep application will significantly improve EKG readings and other electrophysiological measurements.”

CEOCFOinterviews: Where exactly are you in the development of these products?

Dr. Davison: “Our SonoPrep® device for the drug delivery of the topical anesthetic and for the Skin Prep application for electrophysiology, is just entering into the final product development Phase. Our aim is for the product to be released by the end of next year (2003).”

CEOCFOinterviews: What markets do your products address besides glucose monitoring?

Dr. Davison: “One of our applications addresses the topical anesthetic market. It is primarily for pediatrics and very sick children who are anxious about the prospect of having to have repeated needle punctures. This device will make their skin numb immediately, as it will be used to accelerate the delivery and the onset of anesthesia of topical anesthetics. A second application with the same basic product is to treat the skin prior to applying electrodes, to measure electrophysiologic events. One possible example would be to do a completely needle-free Electromyogram (EMG). An Electromyogram is used in evaluating a nerve injury or lower back pain problems and to help spine surgeons identify the nerves that are involved. Today, EMG is conducted by placing needles into the muscle; we believe we can do this transdermally with skin electrodes. When a patient moves around, there is a lot of jitter in the reading, and by having a significantly reduced skin resistance to the signal, we get a much better reading, leading to improved accuracy.”

CEOCFOinterviews: Can you explain how the SonoPrep® device is used in glucose monitoring?


Dr. Davison: “Blood glucose monitoring is a significantly larger market, for our SonoPrep® device. We are developing a glucose biosensor, which will be applied directly over the permeable skin site.  The sensor will provide continuous blood glucose readings so that the patient will be able to predict when they are going into a hyperglycemic or hypoglycemic event, prior to it happening. In contrast, today, patients have to stick their fingers typically three to five times a day to obtain a single reading and then inject insulin or eat to stabilize the glucose level. By having continuous readings, the patients will know exactly where they are at all times.”

CEOCFOinterviews: How does the SonoPrep® technology work?

Dr. Davison: “The SonoPrep® device, is an ultrasound mediated, skin permeation device; it provides a low-frequency ultrasonic energy through a liquid coupling medium.  Cavitation and relatively high sheer forces within the coupling medium disorganizes the lipids that are in the outer layer of the skin. The stratum corneum (outermost layer of the skin) is the protective coating of the body, and by disorganizing the lipids, it makes the skin permeable to water. Drugs that are water based can very easily go through the skin and into the capillary bed and analytes such as glucose can diffuse through the skin to the surface for analysis by sensors.

For the patient, the SonoPrep skin permeation device is so simple that it can be and will be applied directly by the patient. It is a relatively small hand-piece that contains the coupling medium in a capsule. The patient pushes a button on the control device to make it ready, and then they press the SonoPrep hand-piece down on the skin. The device is activated for about 15 seconds and it automatically turns off when the appropriate amount of ultrasound energy has been delivered to make the skin permeable. It works every time and consistently from patient-to-patient, because it has a control feedback mechanism that senses by measuring electrical conductivity which, increases dramatically when the skin is permeable. It is very safe and very easy to do. The same method is used to achieve skin permeation for every application.”

CEOCFOinterviews: Can your device have an affect on the cost of healthcare?

Dr. Davison: “In the electrophysiology area, we are gong to be doing clinical studies in a number of areas, and we believe that by making the skin resistance almost negligible, the physicians will be able to see signals that they otherwise cannot see. We have been looking at evaluating nerve conductivity; and in this application, reduced impendance can significantly reduce the amount of error. In stress test EKG, the technology can significantly improve the sensitivity and specificity of those tests, so that there are fewer erroneous results that lead to additional costly procedures that would be done or repeating procedures. The bottom line is, we expect to significantly reduce the overall cost of disease management, by making the tests more accurate, or enabling the physicians to see signals that they couldn’t otherwise have seen.”

CEOCFOinterviews: How much will it cost the healthcare facility, patient and pharmaceutical company to purchase and operate your device?


Dr. Davison: “With respect to the cost, we expect the cost of the hardware, our SonoPrep® device, to be less than a thousand dollars for the clinical applications, probably closer to five thousand dollars for the clinical research applications., where we would be developing new enabling procedures. For the blood glucose device, we expect all of the hardware to be less than five hundred dollars because we feel that is what the price point has to be for the home blood glucose market. The disposables for the blood glucose would be in line to what patients pay currently for test strips; that would be four to five dollars a day. We expect that all of the applications will have cost benefit considerations that will persuade the end users to want to adopt.”

CEOCFOinterviews: That doesn’t sound very expensive for what it can do!

Dr. Davison: “We don’t think it is either. Our goal is to expand the applications of the SonoPrep® device, and to develop the product so it is affordable, and we expect that will make the purchase decision very easy for the end user. In most cases, the application of the device will be enabling, so that drugs that normally cannot be delivered transdermally, will be delivered transdermally. We have seen plenty of applications in the diagnostic end, beginning with blood glucose and going to a complete blood analysis performed without needles through a transdermally patch that would pick up and collect all of the analytes that need to be evaluated.”

CEOCFOinterviews: Is this patented technology, and do you own it?

Dr. Davison: “Yes, the technology is patented. It technology was developed originally at MIT, in Dr. Robert Langer’s laboratory. Dr. Langer is a preeminent scientist in drug delivery. His associate, Dr. Joseph Kost, who, today, the Chief Scientific Officer of Sontra, Together they developed a patent portfolio that was licensed by Sontra when it was incorporated. Since then, we have expanded the patent portfolio and intellectual property significantly. We currently have eleven patents that have been issued and several others that have been allowed; we will be announcing various new issuances as they occur in the near future. These patents create a very solid ‘picket fence’ around the intellectual property for our SonoPrep® device and for the methods that we use to combine this technology with others for glucose detection and drug delivery.”

CEOCFOinterviews: What sets Sontra Medical apart from other companies in your industry?

Dr. Davison: “There are several initiatives on the blood glucose monitoring side of our business, because the major companies and all the physicians in the world see that a non-invasive continuous glucose monitor would be a ‘Holy Grail’ and change the way physicians are able to manage diabetes. There is a lot of interest in this area and there are several companies that are at Sontra’s stage, which have relatively non-invasive methods for doing a continuous glucose monitor. There are several companies whose products are electrodes that are implanted under the skin that provide continuous glucose readings.

We believe that we have a very sound approach. By being able to make the skin permeable we can develop a truly non-invasive method and can collect samples continuously as opposed to intermittently. The more data that is collected the more accurate the device can be made. The ability to make the skin permeable and the ability to collect data continuously is where we stand out. The other attempts do not facilitate the fully non-invasive approach and the ability to take continuous readings. All the readings have to be intermittent because it is very difficult to get a glucose sample through the skin without first making it permeable. We have the most effective method of making the skin permeable in a non-invasive approach.”

CEOCFOinterviews: What is the plan for getting the products out into the market?

Dr. Davison: “Our strategy is very clear for the diabetes management product; we are looking for a strategic partner. We are in conversations with and have had evaluations with several prospective partners and we expect to consummate a strategic relationship before the end of the first half of next year. The relationship would give our partner  exclusive rights to our technology for continuous glucose monitoring; we would receive funds to complete the development of the sensor and  would receive a license fee and eventually a royalty stream. Probably more importantly, we would receive a supply contract for SonoPrep® because we will be the manufacturers of SonoPrep®. We, most likely, also will manufacture the coupling agent. The ultrasonic coupling fluid that is delivered between the ultrasonic device and the skin is proprietary technology.”

CEOCFOinterviews: What is your current cash and credit position?

Dr. Davison: “We currently have 2.8 million dollars; our cash burn is 300 thousand a month and we expect to consummate a strategic partnership probably before the money runs out. We are also looking at some alternative means of financing.”

CEOCFOinterviews: Will you tell us a little about the size of the market you are addressing for the various products?

Dr. Davison: “Home glucose monitoring  is a 4 billion dollar market that is growing rapidly. It is expected to reach 8 billion in the year “2007.” Growth in that market segment, is the result of the Diabetes Control Study that was publised in 1992-1993.  The study proved that more frequent glucose monitoring and adjustment of the insulin level, significantly reduced complications do to diabetes. The topical anesthetic is our first drug delivery application; there are many more opportunities in drug delivery and the market for transdermal drug delivery is about 4 billion.  That market is expected to grow to about 15 billion in 3-5 years as transdermal technologies such as SonoPrep®, are introduced into the market.”

CEOCFOinterviews: Can you explain your application for SonoPrep® in the cosmetic area?

Dr. Davison: “The cosmetic applications are a sub-segment of the drug delivery field, although I would prefer to refer to it as the dermatology field. There are a lot of dermatologic conditions that are cosmetic in nature that require more effective delivery of various agents into the skin to mitigate skin conditions. These first applications of SonoPrep® in drug delivery will be to deliver drugs directly into the skin. The topical anesthetic is such an application; another application that we are looking into would be the delivery of a ‘photo dynamic’ therapy agent for treatment of pre-cancerous lesions in dermatology. Eventually we believe we will be able to deliver chemotherapeutic agents directly into the skin to treat malignancies without having to do excisions or be able to minimize the excisions that would have to be done. I agree with the term cosmetic because most of these dermatologic procedures are cosmetic. Of course, the cancer applications go far beyond that.”

CEOCFOinterviews: How do you decide what particular areas you would like to target with an application for product development?

Dr. Davison: “That is a challenge! When I joined the company, there was no clearly defined path that was being taken; we were looking at everything. We are now focusing based on the size of the market opportunities and the creation of a long and short -term product pipeline. There are some applications, which have significantly reduced regulatory barriers, and a lot less technical risk; we see those as short- term applications.  We put the EKG, the electrophysiology prep, and the topical anesthesia application in that category. We plan to follow these topical drug applications with the other topically applied drugs that can be improved with skin permeation.

The diabetic system is a longer-term product because it we require a lengthy regulatory approval process. The longest-term applications will be to deliver drugs that today cannot be delivered transdermally because of their larger molecular weights. Every time a new opportunity presents itself, we do a market analysis or an application analysis. We evaluate the market size, time to market, technical risk.  We essentially apply these variables and create an equation if you will, which will help us prioritize the project as a short-term or long-term, high probability of success or low probability of success. Based on that analysis, we determine where we are going to go next and where we are going to focus our resources today.”

CEOCFOinterviews: What is the most important thing for a company such as Sontra Medical to accomplish before trying to bring your products to the marketplace?

Dr. Davison: “I think the most important thing that we have to do is establish clinical credibility by doing clinical research and showing the medical community the data that proves the safety and the efficacy of the applications we are developing. That is part-and-parcel of marketing any medical product; you have to have clinical data and you have to have good research performed by highly credible opinion-leading physicians and surgeons at highly recognized institutions and we are doing that.”

CEOCFOinterviews: In closing, what would you like to say to shareholders and potential investors, and why should they be looking at you now?

Dr. Davison: “I feel that we offer an opportunity for significant increase in value in the short-term. We expect to achieve several important milestones in the near-term, which would make an investment in the company very high. In the near term we expect to complete a diabetes strategic partnership, and expect to receive a 510 k approval for clearance to market for the SonoPrep® electrophysiology applications and shortly after that, the anesthetic applications. We will be introducing products before the end of next year. We have a very clear pipeline of milestones that we will achieve and those accomplishments will increase our value.”

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