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Interview

CEO Emil Billbäck BONESUPPORT

Emil, you’ve had an exciting career leading up to your time at BONESUPPORT. What are the key lessons learned that you lean on now as the company continues to scale globally?

I’m driven by working on products and innovation that can provide a better quality of life for patients in need. I’ve lived and worked in many different parts of the world, so I have seen a range of health care systems, reimbursement models and therapy traditions. It has been a great learning experience. My main takeaway is that for a technology, innovation or a new science coming to the market to be successful, it has to add value to the stakeholders in the healthcare system. 

There is a lot of great science and innovation in the world, but for it to be a success, it must match an unmet need that is describable. In my world, that innovation only has a value if the customer assigns it a value. Our job as businesspeople is to look at that product or service and be able to position it, communicate it, package it, and deliver it so it fulfills the values associated with benefits of the product or service. 

I spent a fair bit of my professional career working in portfolio companies owned by private equity. And the model here is to jump on science, on technology or solutions that haven’t reached their full potential – to screen for diamonds in the rough, these breakthrough solutions that will make a difference. My experience until now helps me focus on ensuring BONESUPPORT’s technology and its benefits matches well with the clinical issues seen by treating physicians. 

You have been the CEO of BONESUPPORT since 2018. During this period the company and its portfolio have grown substantially and you are now moving towards your vision of becoming one of the global leaders in orthobiology. What would you say is the key to BONESUPPORT’s success?

Connecting an innovation with a clear patient need is a cornerstone to a successful business. This is what attracted me to BONESUPPORT and is also the beauty of our bone graft substitute CERAMENT. We have shown with solid evidence that not only does it bring a better patient outcome and give better tools to the operating surgeon, but it also reduces healthcare costs for society by around $28,000 per patient over two years, according to a recent study. So, you’re doing something good for the patient, helping the surgeon and lowering the cost for society. 

This is a trigger for us, knowing the organization is helping people get back to a better life. We are gaining the respect of the surgeons because they see that they can accomplish a better outcome. 

The standard of care has looked largely unchanged over the past 200 years, which was the first time a bone transplant was done. But this is associated with complications and issues that patients and doctors had to accept because there was no alternative. CERAMENT has shown with strong clinical data that it heals as well as a bone transplant and does it in a one-stage procedure. BONESUPPORT’s success comes from its technology and how now a synthetic alternative produces the same positive outcome as a bond transplant but is faster, has fewer complications, is easier for the patient and doesn’t require a risky second procedure. This is Swedish-spearheaded research and technology that is now starting to get access to the broader healthcare system. It’s an incredible moment for us and the market. 

BONESUPPORT recently entered the US market with CERAMENT G. Can you elaborate on the importance of this market for the company?

The US is the biggest market in the world for bone repair with about 360,000 operations each year to address skeletal injuries where the bone in the body can’t heal itself and surgical intervention is needed. The US is also a market that has a high bone infection rate and a high amputation rate. CERAMENT is the only product available and market approved by the US Food and Drug Administration for synthetic bone repair that includes antibiotics, which has been shown in studies to significantly reduce infections and amputation rates. I’m still amazed that BONESUPPORT, a small Swedish company, is the first in the world with this important product in an untapped market worth $780 million. Success in the US is also a bit of a litmus test for any device company since it is one of the toughest markets. Gaining approval from the FDA is a rigorous process and the competition is laser sharp. 

BONESUPPORT is targeting 40 percent sales growth per year in the next three years (2023-2025). What are the key drivers with this goal?

The key driver for our sales growth goal over the next three years will be CERAMENT G in the US, the only product in its category approved by the FDA in the largest graft market in the world, and the massive backlog of orthopedic surgery that built up during the pandemic. Many of these operations were simply put on hold making the backlog of needed operations huge, the biggest it has ever been. There are a lot of government activities to deplete this backlog though, so we believe there will be very favorable market dynamics going forward, especially for a product like ours where we help patients recover faster and reduce surgery times. BONESUPPORT is ready to scale. We have a strong US commercial sales force, the right product, and the market dynamics are clear for us to succeed in the US. The coming years will absolutely be exciting. 

BONESUPPORT has a strong investor base, including life science venture capital fund HealthCap, which has been a part of BONESUPPORT’s journey since 2006. How has HealthCap supported the company during this time and how important is it for a company to have access to such experience?

When I considered taking this job in 2018 one of the big positives for me was knowing the company had HealthCap as its main investor. Having a savvy and dedicated main owner was one of the lessons I learned from my own experience and from watching the market over the years. I knew HealthCap was a solid partner with an outstanding reputation. They know this sector in and out and have a clear strategy and position in the northern European VC market. HealthCap in our corner and supporting us over the past years has definitely been an important part of our journey. For me, their participation in strategic discussions and coaching is invaluable. Their team has a profound understanding of the different phases a company goes through – from development to eventually commercialization. They are more of a partner than owner.