With global ambitions, Atrys Health, a publicly traded Spanish health-tech company, is betting on telediagnosis and last-generation radiotherapy to lead the precision medicine race, not missing the Big Data opportunities along the way. Its executive president, Dr. Santiago de Torres, explains why nothing is “too fast” when aiming for a seat at the big table.

 

“They have told us that we might be going too fast, but you need to be a giant to do business with giants.

Dr. Santiago de Torres

With dashing headlines across Spain’s news media, from “ready to play with the big ones” to “revenue up 5x in the first half of 2021,” Atrys Health is trying to position itself as an upcoming health-tech conglomerate, a multi-dimensional player in telemedicine, tele diagnostics, big data and next-generation radiotherapy.

Atrys Health’s roots can be traced back to 2007, but it was not until 2016 that it adopted its current name, coinciding with the entrance to the Spanish equity market for small growth companies (MAB). The Madrid-based company has been growing non-stop ever since – Atrys’ valuation has gone from €16 million to nearly €600 million in 2022 – thanks to a bold acquisition and partnership strategy. This year, the company has made another leap forward on its way to playing with the big ones, taking its stock to Spain’s main market.

“They have told us that we might be going too fast, but you need to be a giant to do business with giants,” the company’s executive president, Dr. Santiago de Torres, told PharmaBoardroom in a recent interview. The business they want to do with giants, however, is not crystal clear at first glance.

 

A work-in-progress business model

The company’s most noticeable business unit – accounting for 40 percent of total revenue – is precision medicine. The unit focuses on three activities that, while different in nature, complement each other in a way that covers two big elements: diagnosis and treatment.

First, Atrys Health offers remote diagnostic services to health providers that wish to outsource them, meaning that an image taken at a partner hospital is uploaded to the cloud, analyzed by one of 600 licensed doctors placed in seven countries, and returned in no more than 48 hours – 60 minutes in emergency situations. In other words, telediagnosis.

“We are in seven countries and have 2,300 employees. We have created a huge virtual hospital,” De Torres explained, “[24/7 online diagnostics] makes it possible to overcome the scarcity of specialists in certain areas, as well as the optimization of resources by avoiding unnecessary travel and traffic within hospitals.”

De Torres, a medical doctor with a specialty in clinical pharmacology, has been with the company from the beginning and previously worked in Spain’s Ministry of Health and Ministry of Culture.

Asked about concerns that the outsourcing of medical decisions to doctors from non-EU countries could create friction between patients and health providers, the executive explained that all of the healthcare practitioners involved in online diagnosis of third country patient images must be recognized by the country’s health authority. A Colombian doctor analyzing an image from Portugal, for instance, must have a valid medical license in the eyes of Portuguese authorities.

Second, the company has ventured into healthcare provision, conducting high-precision radiotherapy in oncology patients from one of nine single-dose image-guided radiotherapy (SD-IGRT) machines – 7 Varian True Beam and 2 Elekta – that the company has in Spain, Portugal and Switzerland. Their recent partnership with leading Spanish insurer Sanitas to build a €10 million oncology center in Madrid serves as a good example. In addition to the radiotherapy centers, Atrys operates five laboratories in Spain that complement its diagnosis offering.

“[High-precision radiotherapy] allows the number of radiotherapy sessions to be reduced from 30-35 sessions to 1-7 sessions by applying higher radiation doses… It is revolutionary technology,” says De Torres, arguing that digital health companies are stronger by providing in-person services.

And third, leveraging all the data accumulated from those operations, Atrys has created a medical records database called BIG-PAC with anonymized data from over 2 million patients, offering insights to all kinds of companies, from pharmaceutical companies to consultancy groups. “It is the largest of its kind in Spain,” De Torres has said. In other words, the company is betting on the power of big data.

The remaining two business units, occupational risk prevention (40 percent of revenue) and regulatory compliance (15 percent), were not extensively discussed by De Torres during our interview, but, according to an Atrys-commissioned external review, they include B2B occupational safety and health advisory services, preventive medical examinations, training and regulatory compliance for 84,000 SMEs.

 

Acquisitions: all or nothing in the road to $1 billion

The stable rise of the company’s market value is not necessarily due to superb financial results – Atrys posted a net loss of €2 million in 2020 and of €23 million in 2021 – but rather a series of acquisitions aimed at strengthening its commercial partnerships, infrastructure, IP and workforce.

“We are a growth company. What’s important is to grow as fast as possible doing what we know how to do best. Atrys does not acquire companies if it is not 100 percent,” De Torres explained.

The largest such acquisition to date occurred in 2021 when the company succeeded in a €223-million takeover bid for Aspy, one of the leading occupational risk prevention companies in Spain; the move, according to media reports, provides Atrys with critical mass, liquidity and more cyclical business activities by gaining access to 234 centers and 130,000 customers.

Other notable acquisitions to date include Radio-Onkologie Amsler (Swiss radiotherapy provider), Lentitutdes for €16.6 million (Portuguese oncology services provider), and Genetyca (Portuguese genetic diagnostics player).

The moves have not gone unnoticed by national and international media. This year, the Financial Times included Atrys on its ranking of 1,000 fastest growing companies in Europe, which took into account the period between 2017 and 2020.

De Torres, a self-described adventuresome doctor, is in on a quest to use his medical background and acquired financial know how to capitalize on the digitalization boom and the rising costs of healthcare systems: “The objective for 2022 is to reach a valuation of $1 billion dollars.”

Aiming to expand on his ambitions for the company, De Torres lamented missed opportunities by established Spanish health companies in the past, vowing to not miss his chance. “Had prominent Spanish pharma companies (Esteve, Ferrer, Grifols, Almirall, Reig Jofre) joined forces early on, they would have created a global leader… Atrys Health has a global mindset,” he contends.