Movers & Shakers Interview with Vivek Trikha, Head- Diagnostics, OncQuest

Laboratories Limited
OncQuest Laboratories Limited (formerly Dabur OncQuest) formally announced its existence as
an independent entity, moving away from being a part of Dabur Pharma Limited, on December
31, 2007. OncQuest Laboratories Limited was incorporated in January 2008.

Frost & Sullivan brings to you Healthcare Practice Analyst, Jayant Singh (JS), in conversation
with Vivek Trikha (VT), Head - Diagnostics, OncQuest Laboratories Limited.
JS: Please give a brief overview of the company and yourself.
VT: OncQuest was conceptualized in Dabur Pharmaceuticals. Dabur Research Foundation had
plans of launching diagnostic testing facilities for cancer testing. The choice was between selling
diagnostic kits and going into the lab services market of cancer testing. Lack of organized and
credible testing facilities for cancer and general dissatisfaction amongst KOLs regarding quantity
and quality of communications, tilted the decision in favor of the lab services market and this led
to the birth of OncQuest. The company started with Flowcytometry & Polymerase Chain
Reaction (PCR) based technology and gradually added layers to it, like Fluorescence in Situ
Hybridization (FISH) and Cytogenetics. The pilot phase started in Jaipur, Lucknow, and
Ludhiana, followed by phase-wise expansions in the Southern, Western, and Eastern parts of
India. The facilities are now available at 45 locations with the hub in Delhi.
In addition to Providing Diagnostic solutions, OncQuest also has a well defined goal to:

Develop novel molecular assays to provideo Effective assessment of diagnosis & prognosis
o

Appropriate management of therapy & drug resistance

Assessment of risk & predisposition

Evolve molecular taxonomy of select diseases

Identify biomarkers

Therapeutic targets

Clinical targets

I have been associated with Dabur OncQuest, Molecular Diagnostics Reference Laboratory
Delhi, the leader in Indian oncology market, since last six years as the Head Diagnostics.
Having joined the company after a highly successful tenure with Specialty Ranbaxy Ltd. Specialized Clinical Reference Laboratories, Mumbai, for seven years with the last responsibility

of the Marketing Manager. The educational qualifications comprise of Post Graduate Diploma in
Medical Laboratory Technology from S.I.E.S College and Post Graduate Diploma in Industrial
Analytical Chemistry from Ruia College Mumbai, after graduating with Microbiology as
principle subject from Mumbai University.
JS: What are the key factors, which differentiate you from competitors?
VT: We are the only players in the lab services market with a dedicated focus on cancer testing.
Cancer testing is very different from other lab tests as it calls for a lot of interaction between the
clinicians and the lab. Since, we offer only cancer testing, the quality of interaction increases
drastically. This adds to the comfort level of the clinicians. We also position ourselves as a onestop solution for cancer testing, from diagnosis to monitoring. We have achieved this by bringing
technologies like PCR, FISH, and Cytometry under one roof and backing up the technologies
with efficient people. In addition another Critical Success Factor (CSF) at OncQuest has been
offering the highest technology at the most cost-effective prices due to higher volumes than most
labs with the best turn around times (TATs) the strategies followed at OncQuest include:

Development of assays for targeted drugs for

o Diagnostic
o

Monitoring

Drug response/ resistance

Development of assays of Pharmacogenetic relevance

Development of assays for drugs in phase II & III trials

Development of assays for predicting risk of Adverse Events

Predisposition & Risk Analysis assays

JS: Does an exclusive cancer testing model offer any other benefit, which differentiates it
from competitors?
VT: Focus on cancer testing helps us in having a large volume test batch, thus resulting in
economies of scale. Due to this, we are able to offer a 15-20 percent price benefit to patients.
Secondly, this model has helped us in strengthening our internal R&D practice and we are able to
offer new and better tests. For example, we have been able to offer mutation analysis for
Gleevec, a drug used to treat Chronic Myelogenous Leukemia (CML). This was possible only
due to our strong R&D practice.
JS: What is the acceptance of molecular testing facilities amongst the medical community?
VT: Doctors have clearly acknowledged the role of molecular testing and its utility in monitoring
patient therapy. With the launch of new and better therapies for cancer, this phenomenon will
gain further ground. Additionally, an average growth of 150-200 percent of OncQuest for the

past few years last 3 years to be precise is an added proof of the credibility and robustness of this
technology. This approach has had few key achievements for OncQuest:

First commercial laboratory in India to offer o RQ-PCR assays for monitoring of CML patients
o

RQ-PCR based gene amplification assays for profiling of Ca. breast

RT-PCR based diagnostic assays for-

FLT3- AML prognostication

JAK2- Polycythemia vera

FIP1L1- PDGFRa- Chronic eosinophilic leukemia

Flow cytometry based diagnosis of PNH

CD20 study- patient stratification for Rituximab therapy

CD52 study- patient stratification for Campath1 therapy

First commercial laboratory internationally to offer o

IRMA- comprehensive mutation analysis of CML patients resistant to Imatinib

Patient stratification for alternate therapy

JS: What were the challenges in establishing molecular testing as a benchmark for cancer
monitoring and diagnosis?
VT: The biggest problem roadblock in the way of establishing molecular testing as a benchmark
for cancer monitoring and diagnosis was the lack of awareness amongst clinicians other than the
KOLs about this technology. Creating this awareness was the biggest challenge. A wider test
menu along with strong R&D helped us in overcoming this challenge smoothly.
JS: Can you share some thoughts about the expansion plans of OncQuest? Will the
expansion be geographic or through expansion of service offerings?
VT: We will be following a two-pronged approach for expansion: expansion of service offerings
and expansion in new geographies. We plan to offer testing for infectious diseases, which lead to
cancer; for example, Human Papilloma Virus (HPV), which leads to cervical cancer. There are
no plans to enter any other testing segment beyond cancer. We would also look at expanding our
footprint beyond SAARC countries. We expect CAP accreditation to help us in expanding our
footprint geographically.
JS: What is the revenue growth you are looking for OncQuest?

VT: We aim to grow at 150-200 percent for the next few years and touch a revenue figure of INR
500 Million by 2012-13.
JS: What is the size of the cancer testing market and how effectively is it catered to?
VT: The size of the market is around INR 2.5-3.5 billion currently. A significant amount of this
business (around 45 percent) is captive and rarely comes out of hospitals. Around 55 percent of
this business is in open space, which is being catered to by players like us. There is a significant
part of the population for which cancer goes undetected. Our aim is to ensure that this population
also gets the best testing facilities. We undertake a lot of awareness-building campaigns to
achieve this.
JS: What are the various technology platforms, which are used to test cancer? What are
their respective shares?
VT: Histopathology, Immunoassays, and molecular testing are a few major platforms for cancer
testing. Histopathology has the highest share followed by Immunoassays and molecular testing.
JS: Which of these segments is expected to witness the highest growth? Why?
VT: All the segments are expected to witness good growth. However, molecular testing is
foreseen to show the highest increase. This will be primarily on account of the increase in
number of hospitals offering treatment facilities, which is likely to ultimately increase the size of
the market
JS: What role will Theranostics play in driving this growth?
VT: In the times to come, Theranostics is likely to act as a strong growth driver for molecular
testing. The launch of new therapy regimen like Gleevec is a strong example for it.
Genetic heterogeneity exists even with defined subgroups. Ignoring this variability is a major
cause of limitations of present cancer therapeutics ie Cost/ Efficacy/ QOL
Our Goal is to:

Integrate information from patient's genomic profile with clinical data to afford o Improved diagnosis
o

Personalized Medication

Provide earlier detection of genetic predisposition

To reintegrate data from clinic to drive

o

novel drug design and development

Gene therapy

JS: How well equipped is OncQuest to tap this growth opportunity?

VT: We are well ahead of the times in terms of customizing our facilities to offer unique services
to pharmaceutical companies launching these therapies. For example, broadly; develop a
clinically relevant molecular taxonomy for select diseases

Oncology
Cardiology

Type 2 Diabetes

Molecular phenotype for staging, prognosis and disease progression

Identify and validate Macroarray patterns which can serve as a unique fingerprint of specific
disease subtypes

Gene expression profile

CGH profile

Methylation profile

JS: What are your thoughts on the consolidation in lab services?

VT: Consolidation is the road ahead?); labs are likely to tend to follow either of the business
models as mentioned below
1. Captive model - for example, Fortis, Large Hospital group from North India
2. Lab management model - for example, Metropolis Laboratory chain from Mumbai
3. Franchisee model - for example, Thyrocare, specialised Chain of Endocrine Testing lab
from Mumbai
4. Hub and Spoke model - OncQuest and Wellspring-(wellspring is also captive model.)
A lot of realignment and churning out is expected in this segment. Smaller players are likely to
have to associate themselves with the bigger ones for better resource utilization.
JS: Please share your thoughts on the tax regulatory norms for this industry and how it is
affecting the same? What is the solution for it?
VT: It is quite a sorry state of affairs in our country. We don't even have the minimal norms &
standards for setting up a lab and offer diagnostic testing services. It's a vicious cycle; labs,
which tend to follow good practices, are forced to offer services at a high cost. This makes them
non-competitive when compared to their peers who compromise on quality A serious effort
should be undertaken by neutral bodies like the National Accreditation Board (NABL) and
Quality Council of India (QCI) to set certain standards for this industry. It should be done in a

phased manner and the last stage should be a mandatory accreditation for all labs operating in
India.