On this episode of Spotlight on Women in Health Ventures, we spoke with Daria Lemann-Blumenthal, CEO of BELKIN Laser. Daria is a mother of five, and BELKIN is an Israeli company addressing unmet needs in the glaucoma space. Read on to learn about addressing the glaucoma space, being CEO of a global series B company, and being a mother all the while.
BELKIN Laser’s technology aims to change the glaucoma treatment space with a fast, accessible technology. It all began when, after completing her executive MBA, Daria Lemann-Blumenthal, a lawyer by profession from a line of ophthalmologists, approached the RAD BioMed Accelerator in Israel, looking for a company to work with. Dr. Michael Belkin had approached the same accelerator with the BELKIN Laser technology, looking for a CEO. When the accelerator named Daria as the one who would lead BELKIN, Dr. Belkin laughed: Daria’s father, an ophthalmologist, was one of Dr. Belkin’s mentors. From there, Daria has led the company through clinical trials in Europe, Israel, and next year, China as well.
Theia has a special connection to BELKIN and Daria, as Irene Park and Sumun Khetpal, two of our co-founders, worked with Daria and the founding scientist Dr. Michael Belkin through Penn’s Roy and Diana Vagelos Program in Life Sciences and Management’s capstone course.
Glaucoma & BELKIN Laser
Worldwide, 80 million people have glaucoma — the leading cause of irreversible blindness. There are two types of glaucoma: open-angle and closed-angle. In open-angle glaucoma, the most common form of glaucoma, the eye cannot drain fluid in the eye well, leading to fluid buildup over time. In closed-angle glaucoma, the drainage angle in the eye gets blocked so that fluid cannot leave the eye. In both of these types of glaucoma, the fluid buildup exerts pressure on the optic nerve, leading to damage and, with time, loss of peripheral vision (tunnel vision). This can lead to irreversible blindness.
Treatment for glaucoma currently is focused on slowing or stopping further damage caused by high eye pressure. The most common treatment is eye drop medication, which needs to be applied every day. Eye drops are thought to be convenient, as they can be administered by the patient at home and are non-invasive; but in reality, compliance is a huge issue. Daily drops are hard to remember, especially in a lifelong treatment. People over 70 years old are at much higher risk for glaucoma, and patients at that age have an even more difficult time remembering to administer their own eye drops.
Daria states that by a year after prescription, only about 50% of patients still use their eye drops consistently in the US.
Laser treatment is another potential first-line treatment for glaucoma, but it has not taken hold as such. There are currently two types of surgery for glaucoma: selective laser trabeculoplasty (SLT) for open-angle glaucoma, and laser iridotomy for closed-angle glaucoma. The primary weakness of laser treatment is that it involves prolonged contact with the eye (usually around ten minutes), with manual application of laser beams, which causes corneal abrasions and discomfort to the patient. Additionally, laser treatment necessitates a glaucoma specialist, so that only a small subsection of ophthalmologists can actually perform these procedures. In 2019, however, the Lancet published the Laser in Glaucoma and ocular HyperTension (LiGHT) study, which found that SLT as a first line treatment is more cost effective than eye drops. Even with this recognition, though, the weaknesses of SLT remain.
This is where BELKIN Laser comes in. BELKIN Laser’s direct selective laser trabeculoplasty (DSLT) tackles the compliance issue by requiring annual instead of daily interventions. The technology does not require contact with the eye, is painless, and can be used by any ophthalmologist easily.
The goal is for any patient to have access to glaucoma care while preserving high quality of life, and Daria compares this innovation to washing laundry by hand versus using a washing machine — “the machine does the work for you.”
BELKIN’s DSLT is especially exciting because it could potentially address closed-angle glaucoma, which is more prominent in East Asian populations, and is the subject of next year’s clinical trials in China and Singapore.
The crucial relationship between a scientist and an entrepreneur
“A killer technology has to be paired with a killer strategy.”
In taking over the commercialization of the BELKIN technology from the scientist Dr. Belkin himself, Daria had to recognize that Dr. Belkin was entrusting his idea, “his baby”, as she put it, to someone else and that he was trusting others to raise this child to be an adult. She understands that this is an immeasurable amount of trust, and it comes with the acceptance that a “greater good will come out of the letting go.” And so, growing a company from inception can almost be like a parent raising a child.
Eyes on the world: running a global company
With an eye on expanding into global markets, Daria and the BELKIN team have had to make decisions on where to take their technology next. So far, they have worked with investors and patients around the world, including in Israel, the United States, Europe, China, Japan, and Singapore.
Daria has learned that each country has its strengths and challenges. The United States has the biggest market with regard to revenue, not number of patients. China has the largest potential market, but it is harder to penetrate, more conservative, and does not have considerably large revenue. The team has had to look at the state of the country now, the way the country is headed, and also what the company’s value proposition is and how that fits with the different markets. For example, right now BELKIN is trying to enter the closed-angle glaucoma market, and this condition is much more prevalent in China, so China is a good market for them to target. Choosing a global market involves considering the current market, market potential, competition, cultural barriers, investment patterns, and more factors that may be different or difficult to navigate.
Once a market has been chosen, the company needs to ensure they are ready to take on a whole new market. They work closely with advisors, and often have “in-house country managers to help bridge language and cultural gaps”. These cultural gaps are vital to understand for clinical trial recruiting and patient interactions, as well as pitching and marketing strategy. She works with her medical advisory board, a group of key decision makers, to ensure that they are choosing the right hospitals and PIs for their studies.
In addition, every country and region has different regulatory expectations, so the company always has to be ready to adjust processes and comply with relevant regulatory requirements,
which Daria names as something the team did early in the process. One such example is that Israeli companies often expand into the European market, so that they often have to get the CE marking required for products in the European Economic Area, as opposed to the FDA approval that US-based companies are familiar with.
Israeli innovation culture
Daria explains that Israel is a “startup nation” of sorts: there are 21 startups for every 1431 people. The Israel Innovation Authority, a government ministry in Israel, is responsible for fostering the technological innovation ecosystem.
There is a general mindset of chutzpah, which Daria translates as “the ability to dare without being paralyzed by the fear of failure.”
The culture around innovation there has led to very productive collaborations: Daria sees mutual cooperation, generosity, a high level of openness and advice between people in the same field, and an “all for one and one for all” mentality.
With regard to women, she says, there is a very large group that communicates through Telegram and Whatsapp, through which women are able to learn from each other. Daria emphasizes that you never choose a contract research organization (CRO) without first asking in the group, because there you will get “the real and true and most candid answers”.
Being a woman, a mother, and a CEO
Building a family while building a company
“Surround yourself with people who believe in you, persist, and don’t give up on having a family, even a big one!”
When Daria was completing her EMBA, she was a mother of three. The highlight of her program was traveling to China for ten days to present a company to her fellow students. She had a four month-old daughter at home, so she thought she could not go. But Daria’s mother made her go, and Daria was distraught. She left the house crying, pumping milk as often as she could to ensure that her child would be fed. The trip, at the end of the day, was rewarding, and in retrospect she would not have changed her decision. But this is just one example of the difficult choices Daria has had to make in what to give up and what to pursue.
While being CEO of BELKIN Laser, Daria is a mother of five.
“Yes, you can manage it all, but there is a big ‘but’. You need to decide that this is what you want.”
Daria recognizes that support — emotional and financial — from home was a big factor in her being able to pursue the goals that she has. “My parents always believed in me.” Like Daria explained about young women being encouraged to innovate, it was this faith and support from her parents that helped her establish a mindset that she was absolutely capable of what she wanted to do.
Daria had her first child at 30, and has had four more since. Her kids respect her career, and she knows that this is the best education they could possibly get, as she is leading by example. Her children will have grown up knowing that their mother is a prime example of innovation in the healthcare space. Indeed, Daria is proud to see women bringing their children to work, as mothers should not be ashamed of the balance they have to find between family and career. Daria’s husband has been a supporter throughout her journey, but she recognizes that it can be challenging to have healthy relationships. She advises that “You need to be clear about expectations, and decisions should be mutual.”
Daria hopes that mothers present their children with the full possibilities, and that they emphasize that “girls can do everything they want, and give them the tools to reach their dreams.”
Culture around women in the workplace
“From a policy standpoint, women have to be supported in a venture.” Daria has found that Israel is doing a lot for working mothers, but can always do more to support, naming Scandinavian countries as one good example. Daria highlights that the “support has to be there from the day the woman is born,” so that when a woman entrepreneur gets to the point where she wants to start a company, she is already in a great position and has had the encouragement she needs. This sort of support and encouragement looks like ensuring that women are exposed to innovative culture early, and are given options to innovate and lead.
In terms of culture, women also contribute to a team differently than men do, Daria has found.
“Women are usually more collaborative, care more about the well-being of the team, can better sense what others feel, and have a different way of being a leader.”
In this way, women are vital to the success of a company, and having more women in healthcare leadership will help lead to more collaborative and innovative work environments. Collaboration also expands outside the workplace, in that being a good listener and understanding others is important in establishing relationships and working with investors, physicians, and patients. The BELKIN Laser Board of Directors reflects Daria’s vision for more women in healthcare leadership, with three female members and four male members.
Yes, you CAN have it all
Daria makes it clear that it is in fact possible to have it all, but you have to be “aware of the price; purposefully planning your life and making conscious decisions are critical to success.” If you are making a difficult decision, try out Daria’s mental exercise. “When I make decisions in life I try to imagine myself at the age of 80 looking back [on the decision and ask] ‘will I be happy with this decision?’ If I know I will be fulfilled, I know this is a good decision.”
Want to learn more about tackling a global market? Listen to and read about Theia’s interview with Nimmi Ramanujam, founder of Calla Health!
And keep an eye out for our upcoming interview with Rui Jing Jiang, co-founder and CEO of Avisi Technologies, who started tackling glaucoma with another unique solution while she was an undergraduate student!
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Story written by Luiza Perez and Priya Kumar.
