As 6ft 7ins tall Rory Cameron is hard to miss.聽聽He isn鈥檛 an outwardly emotional man and when he talks about the moment his MedTech business Gendius went into administration, he isn鈥檛 looking for sympathy or scapegoats, instead preferring to see it as a learning.
The 51-year-old hasn鈥檛 spoken publicly before about the collapse of his Alderley Park-based startup but it鈥檚 clear he has learnt a huge amount from the experience.
鈥淭he worst thing is family members,鈥� he recalls. 鈥淚 had cousins and my brother had invested money because they believed in what I was doing.
鈥淚t was that letting go but still feeling hugely responsible. I had this sick feeling that I鈥檇 let people down. The amazing team that had been with me on the journey and our investors.
鈥淲e were caught in the startup trap of having all our eggs in one basket. When AstraZeneca decided not to press ahead with the commercial licensing deal the game was up.鈥�
Last week聽Manchester-based hiring platform Orka Technology Group joined the growing ranks of companies going into administration. It came just three years after they announced a 拢29m investment round.
Cameron went through the same process in December 2023 and wants to share the experience to help others.
Founded in 2015, the startup created a ground-breaking聽algorithm that could better identify which patients with type 2 diabetics were most likely to develop chronic kidney disease (CKD).
Gendius piloted the algorithm in over 19 countries, screened 500,000 type 2 diabetes patients in less than six months and raised 拢4m.
Cameron compared the fateful final meeting with AstraZeneca to a game a poker.
Game of poker
鈥淚 had four aces in my hand but didn鈥檛 have the money to call my fellow players,鈥� he recalled. 鈥淲e had the validation and regulatory approval for our chronic kidney disease calculator but didn鈥檛 have the financial runway to go any further.
Gendius鈥� pre-screening CKD tech granted UK regulatory approval
鈥淚 have lots of learnings and now is the right time to talk about it to help other entrepreneurs on their journey.鈥�
Cameron鈥檚 own journey with Gendius started in 2015, following an impressive 20-year career in pharma, including a decade at AstraZeneca.
鈥淭he idea for Gendius came from my co-founder聽Chris Genders after he developed Type 2 diabetes at age of 50,鈥� he explained. 聽鈥淗e would tell you himself, he was not the best at managing his diabetes.
鈥淗e played rugby years ago at Sales Sharks so he鈥檚 always been a fit guy. At the age of 50 he wasn鈥檛 feeling right so went to the doctors and found out he had diabetes.
鈥淪oon after his diagnosis he had a foot ulcer followed by a small heart attack.
鈥淎lthough he knew about diabetes what he didn鈥檛 know about was the side-effects and what would happen next and how quickly these things can happen.
鈥淭hat鈥檚 where the idea for Gendius came from. We wanted to make sure that anybody else diagnosed with type 2 diabetes would not just wander into getting kidney failure, foot ulcers, heart attacks etc. We wanted to educate them in understanding their risk and help them do聽something about聽it.
Rory Cameron, co-founder, Gendius
鈥淚t鈥檚 really quite a horrible disease. It鈥檚 the number one cause of kidney failure, blindness and lower limb amputation. You鈥檝e also got about a 2.5x increased risk of dying from a heart attack or stroke.
鈥淵ou get the shock of the diagnosis but then you get the worry about all these things that might be around the corner.
鈥淐hris and I met at a service station on the M6 to discuss it and it went from there.鈥�
For the first two years Cameron didn鈥檛 take a salary from the business.
鈥淥riginally we were looking at an app-based platform to help patients manage their disease better and then we were getting pharma clients to purchase licences for that product,鈥� he said. 鈥淒octors could then manage patients via the app remotely.
鈥淭he challenge with that is patients wouldn鈥檛 pay. It鈥檚 the usual story. As we went further into it, we realised if we could find out the true risk of these individual diseases we could then get pharma clients to pay for it because they had the drugs as a solution.
鈥淗ealthcare providers were also interested聽as people were being聽diagnosed and treated earlier聽before they developed costly complications. It was a win-win-win.鈥�
The game-breaker for Gendius was the creation of an algorithm that would better predict which patients with type 2 diabetes would go on to develop chronic kidney disease.
Cameron said: 鈥淥ne of the things about chronic kidney disease is you don鈥檛 feel your kidneys getting worse. It鈥檚 like blood pressure.聽聽You can lose up to 50 per cent of your kidney capacity 鈥� in effect one of your kidneys.
鈥淚t鈥檚 only at that point that you feel any different so you present too late to do anything about it other than going onto dialysis and wait for a kidney transplant.
鈥淭he figures in the US show that nine out of 10 patients with kidney disease are unaware that they have it. Globally in 2023 approximately 850 million people had CKD.鈥�
Gendius鈥櫬燼lgorithm聽was based on five key data points 鈥撀燼ge, blood pressure; gender; body mass index; and how long a patient has had diabetes for.
Trials showed the algorithm聽had an 80 per cent success rate of predicting which patients would have a positive test for chronic kidney disease. It also reduced the number of patients you needed to send for laboratory diagnostic聽testing by over 50 per cent.
Raised 拢4m
It was a compelling case and Gendius raised 拢4m in investment from a mixture of VC; crowdfunding; grant funding; and high net worth individuals.
Cameron said: 鈥淪omeone once said to me that as a CEO his job was 11 months of fundraising, one month to have a holiday and recharge his batteries and then he was straight聽back in it. That鈥檚 exactly what it is.
鈥淚f you wait to raise your funds until you need them it鈥檚 the worst time to raise your money because then you鈥檙e desperate for it and often your cash runway is too short.鈥�
Gendius鈥� next big break came when they took part in聽Pitch@Palace, a programme set up by Prince Andrew, and met representatives of聽AstraZeneca.
鈥淭hey had their own clinical data sets and they paid for our clinical team to access their data,鈥� he said.
鈥淲e ended up looking at the records of these patients to see who was most at risk of kidney disease. We tracked them over five years but we went back rather than having to do it again. We identified the clinical risk factors that could be used to predict聽who went on to get CKD.鈥�
The largest single test was in Taiwan with more than 150,000 patients.
鈥淚t was a complete game-changer,鈥� said Cameron. 鈥淭here鈥檚 a group called the International Diabetes Federation (IDF) and we ended up on their website, the first pre-screening algorithm for chronic kidney disease (CKD) to do so. This was聽being shared with all their members.
鈥淭he next thing we were working on, and we鈥檇 had discussion with AstraZeneca on, was identifying people at risk of heart failure, further down the line looking at fatty liver disease.鈥�
In 2023 Cameron stepped up his efforts to secure new funding when the bombshell dropped in May that his wife Anna had been diagnosed with cancer.
鈥淚鈥檇 been at a family wedding in Mexico when she called me with the news that a biopsy had confirmed cancer,鈥� he said.
While that was going on in the background, Cameron was locked in make-or-break talks with AstraZeneca that he hoped would secure the future of Gendius.
鈥淚n April 2023 we launched the algorithm across 19 different countries,鈥� he said.
鈥淒uring this journey we鈥檇 also got data sharing agreements with over 100 GP practices in the UK.
鈥淔rom these practices we could extract聽anonymised data, millions of data points around聽metabolic diseases. We could use these for new algorithms in heart failure, fatty liver disease and other聽metabolic聽diseases.
鈥淎t the end of doing this trial with AstraZeneca, when we screened 500,000 patients in six months, the plan was they would then agree to a licensing fee.鈥�
The trials found that 300,000 of the screened 500,000 patients with type 2 diabetes were at high risk of developing chronic kidney disease.
鈥淭hose were brand new cases and AstraZeneca had one of a new class of drugs that have been shown to聽stabalises the kidney, basically a wonder drug,鈥� he said.
鈥淲e had 300,000 patients there who could be diagnosed earlier and given this drug that may result in them never聽having kidney failure.鈥�
Put simply Cameron hoped AstraZeneca would buy a licence from Gendius to turn the business into a SaaS-based business with 拢1m ARR.
The two sides met in September when AstraZeneca indicated they wanted to screen 7.2 million people in 2024.
However, by October, the pharmaceutical giant had slashed this number down to 1.2 million patients.
鈥淚鈥檓 thinking 鈥榟ow do I hit 拢1m ARR with 1.2m patients? That鈥檚 what I need. How do we even breakeven on that?鈥�,鈥� recalled Cameron.
End of the road
However, four weeks later, it got even worse when AstraZeneca told Cameron at a meeting in Cambridge that they didn鈥檛 want to go ahead all.
鈥淚 felt physically sick,鈥� admitted Cameron. 鈥淎t that point I didn鈥檛 know how we would be able to move forward. We鈥檇 told the investors that we were looking at doing 7.2m screenings. They thought that was positive. Then we went back to our investors to say it wasn鈥檛 7.2m screenings but 1.2m.
鈥淭hen a few weeks later you鈥檙e going back to them again to say it was nothing so the investors are saying 鈥榳e don鈥檛 believe you any more鈥�.鈥�
Cameron also recalls how he felt a huge responsibility聽for team of regulatory specialists, data scientists, IT developers and others that he鈥檇 brought together.
He said their last 鈥榬oll of the dice鈥� was to try and secure an聽Innovate UK investor partnership grant with the support of Praetura but when that failed the call to the administrators followed.
鈥淚 had to phone investors to say they鈥檇 lost their money,鈥� he said. 鈥淲e had two big investors in the US who鈥檇 invested 拢1m each in the company and I was humbled by their responses 鈥楻ory, you gave it a massive go. You and the team should be proud of what you did. These investors understood the risk and didn鈥檛聽see what we had achieved as a failure, even though they had lost their聽investment.
鈥淭here was a genuine understanding over the last couple of years that raising money has been really hard. The markets have been in a difficult place. But it is interesting as not many share these experiences.”
Today Cameron is no longer involved in the company and his wife鈥檚 treatment for cancer has gone well.
He bears no ill will toward AstraZeneca, understanding that the focus can change and so聽can budgets and personnel, but the consequences for startups can be dire.
However it hasn’t聽put him off and he鈥檚 looking for his next role supporting other CEOs or coming back as a CEO of a later stage business.
- On April 18th, Rory Cameron will be taking place in a business breakfast entitled 鈥楬ow to spot a perfect investor from a poisonous one鈥�. It鈥檚 been organised by Sanderson Recruitment in association with TechBlast. Register