When Giffin Daughtridge was a 15-year-old in rural North Carolina, he was forced to grow up in a hurry. Specifically, Daughtridge was diagnosed with a potential testicular tumor. When the news came from the surgeon in Daughtridge’s living room, he watched his father cry for the first time. An aunt flew from Boston to North Carolina to be with the family. And all the while, his surgeon visited at home and was not only a medical support, but an emotional support. “That is when I knew I wanted to go into medicine,” recalls a now 27-year-old Daughtridge.
Fast-forward more than a decade and Daughtridge indeed is in medical school–finishing it up, actually. He’s also co-founded an HIV-fighting venture called UrSure, Inc., that’s the most recent startup to win Harvard Business School’s New Venture Competition in the Social Enterprise Track. This past Tuesday, in Burden Hall on the HBS campus, Daughtridge gave a 90-second pitch in front of hundreds of spectators that ended with, “So remember, preventing HIV–it’s as simple as one, two, pee.” The conclusion garnered laughs and the $50,000 grand prize for Daughtridge and co-founder, Helen Koenig.
“Today we’ve seen an explosion in entrepreneurship of all stripes,” Matt Segneri, director of the Social Enterprise Initiative at HBS said before Daughtridge and representatives from three other finalist teams took the stage for one last pitch to earn the cash. “Our students and alumni are creating bold ideas that are solving problems in private, public and nonprofit sectors. That’s because the MBA of the 21st Century is a tri-sector athlete—able to navigate deftly and well aware that one alone can’t settle all the problems the world is facing.”
DOUBLING THE NATIONAL ADHERENCE AVERAGE
Ironically, UrSure’s founding team doesn’t have an MBA. It doesn’t even have a business student. Yet, the upstart, which uses urine tests to drive adherence to HIV preventative pill, PrEP, beat out a record setting 62 teams (including UrSure). To be sure, the finalist teams were impressive. Runner up and crowd favorite, Confi, is a platform for “big sister” women’s health advice and serves as a sexual abuse prevention network. Similarly, Girls Health Champions is training and preparing girls to be peer mentors, educators and leaders in women’s health issues in their schools on a global level. The last finalist, Yellow Brick Road, is a connector for community college students to careers with ample economic opportunity.
Still, UrSure’s win totally makes sense. Traditionally, physicians have measured PrEP adherence via blood samples. The test involves needles, is invasive and takes days for blood results to return. Meanwhile, UrSure’s urine tests are non-invasive and have a faster return. They seem to be more popular, too. At a national level, the average adherence for PrEP usage hovers around 20% to 40%. For the 150 men using PrEP at UrSure’s Philadelphia’s clinic, the number is 80%.
The success, coupled with a medical trip to Bogotá, Colombia before medical school has led Daughtridge to pursue a graduate degree in pubic policy at Harvard’s Kennedy School and forego his medical residency to fully commit to UrSure.
GAPS IN PREVENTATIVE MEDECINES
After graduating from the University of North Carolina at Chapel Hill with a biology degree, Daughtridge was awarded a Fulbright Scholarship to work in Bogotá. He spent the year designing and directing a Hepatitis B vaccination program for transitioning sex workers alongside the Bogotá Secretary of Health. All told, Daughtridge’s program immunized nearly 200 women and transgender sex workers. He also learned some valuable lessons. First, preventative medicines don’t always make it to the vulnerable populations they are meant to serve.
“A lot of times the issue is the populations at the highest risk and the most in need of medications aren’t getting access to them,” Daughtridge tells We See Genius on a phone call. So at the end of the year, Daughtridge entered the University of Pennsylvania’s Perelman School of Medicine looking for a way to continue work with wide-scale preventative medicines.
When he arrived on campus, Daughtridge came armed with the idea to do something similar in Philadelphia. The problem after he met with medical professors? “They said, ‘well, we’ve actually been vaccinating people for Hepatitis B here in the U.S. for a while and that’s not really an issue here anymore,'” Daughtridge recalls. But a few told him about a similar growing movement for HIV. Enter Koenig. As a practicing physician and clinical assistant professor at Pennsylvania’s medical school, Koenig planned on starting a similar preventative program for HIV in Philadelphia, with one vulnerable population in mind.
“Young gay black men are the only group that has HIV increases,” says Daughtridge. And that was not OK for Daughtridge. “We have solutions to these problems,” Daughtridge continues. “For Hepatitis B, we have a way to prevent it. For HIV, we have a way to prevent it. It’s frustrating to see when the health care system is not operating at a level to protect these populations.”
A LESS INVASIVE VERSION OF THE TRADITIONAL BLOOD TEST
So in January of 2013–about six months after arriving on campus, Daughtridge and Koenig created their program to measure adherence to the PrEP pill. Men came to the clinic, would take seven pills for the week and come back every Monday night for the next batch. “We did that instead of every three months to increase adherence,” explains Daughtridge.
Still, it was unclear if the men were actually taking the medication. “The guys hated the needles,” Daughtridge says of the traditional blood tests. The problem with preventative medicine, Daughtridge explains, is people don’t take it because it doesn’t make them feel any different, which makes sense. “If you take a painkiller, that makes you feel better,” reasons Daughtridge. “If you could show someone the medicine is actually preventing and protecting them, they’re more likely to take it.”
So the team started looking at more “patient-friendly” ways to measure adherence and show the men the pills were in fact doing something. And they landed on urine tests. In partnership with the Children’s Hospital at the University of Pennsylvania, they developed a lab-based urine test.
“They loved it,” Daughtridge recalls. “For the first time, they could look and see it (PrEP) was actually protecting them. They could look and see their levels were in the protective range. And for the first time in their lives–after fearing HIV constantly–they could actually see they were protected from HIV and knew what to do to keep themselves protected.”
NEXT UP: ‘POINT-OF-CARE’ TEST
Daughtridge and Koenig began presenting the idea and results at conferences and were receiving positive feedback–and more. “We started realizing there are a lot of people who wanted to send us urine samples so let’s see how we can get this scaled up and provide this adherence boost,” says Daughtridge.
Up next were two partnerships with “large academic medical centers,” explains Daughtridge. The medical centers send urine tests to the UrSure lab in Philadelphia, they conduct the tests and send the results back. The work is monetized in a typical doctor buys product, insurance pays doctor-type of model, in which the medical centers pay for each lab result. “It’s classic health care fashion,” says Daughtridge. “The doctor buys our test for the patients and then gets paid by an insurer.”
Still, shipping urine tests can be a logistical headache. So UrSure is now developing a “point-of-care” test similar to an in-home pregnancy test, that could be used in a physician’s office. “You just dip it in the urine during a patient’s visit,” explains Daughtridge, noting they are using a Small Business Innovation Research grant from the National Institutes of Health to fund the development. The patient and physician can pretty much immediately see if the patient is taking the drug, which allows one-on-one counseling and conversation, leading to a more holistic approach. For the point-of-care tests, physicians would be charged for each individual testing stick, which would likely be covered by insurers, Daughtridge explains.
Daughtridge elected not to do his residency to see through wide-scale and far-reaching health care change. As a result, the team is currently in conversations for potential partnerships with health departments at state and local governments as well as some academic medical centers like the two they are already working with. “What we’re looking to do is continue to scale our program up, and get urine tests from as many groups as we can to prove out that this model works,” Daughtridge explains.
A MOOC-EDUCATED BUSINESSMAN
So how did a team with minimal business expertise beat out 61 teams comprised mainly of MBAs at one of the world’s best B-schools? Coursera, of course.
“One of the coolest parts about the entrepreneurship experience is you have to essentially be everything for your team at once,” believes Daughtridge. “So whether it’s marketing, sales, finance, management–the entire gamut–you have to learn those.”
And to learn some of those skills, Daughtridge has turned to massive open online courses (MOOCs). In particular, Daughtridge has found a MOOC taught by London Business School professor, entrepreneur and author, John Mullins particularly helpful. Mullins teaches a course based on his book, The Consumer-Funded Business. Daughtridge has also taken an entrepreneurial finance course at Harvard’s Kennedy School and has used MBAMath.com to develop his financial modeling and Excel prowess.
Moving forward, Daughtridge says one question in particular continues to weigh on his mind: “How can we design systems and build companies that deliver these medications or have policy structures that best serves the populations in need?”