Providing medical interventions to slow myopia progression

With Japan’s aging population there is increased social security expenses and more pressure on private finances. To reduce medical expenses efforts are being made, but to compound the issue the domestic market is slowly but surely shrinking. Japan isn’t the only country with these problems, we’ve seen the same situation in countries such as Korea, the US, and China. What are the main challenges and opportunities this situation is presenting to firms such as yours that exist in the medical sector?

Let me start by describing Menicon’s attempts to tackle this issue. Recent research has revealed that myopia itself is not a disease but instead is now considered a mother of sorts to other diseases. We categorize myopia under three levels of severity; low myopia, mid myopia, and high myopia. Take cataracts for example, when you compare low myopia people with non-myopia people, the risk is double, and with high myopia, the risk is 5.5 times more. ⁽¹⁾  As myopia sets in, the risk of serious eye disease will also increase, along with the patient's age. Retinal detachment is 21 times more likely to occur with myopic people than it is with people who have no signs of myopia. ⁽¹⁾

With corrective glasses or contact lenses, myopic people can see, but as they get older they are exposed to much more risk of visual impairment. I would go as far as to say that realistically this is more of a social problem than a disease itself. The cost to take care of these people will be significant.

The other trend that we are concerned about is the fact that the prevalence of myopia is increasing globally. Currently, about 30% of the global population is myopic, with 5% falling under the high myopia category. ⁽²⁾ Of course, this is of concern since it leads to more serious problems in the future. By 2050 experts are predicting that this myopic figure will jump to 50% of the world’s population, with 10% being under the high myopic category. ⁽²⁾ Social costs are going to rise considerably considering how many more people are going to be myopic.

As a company that contributes to society by providing superior vision, we have been having many discussions on how to tackle this issue. This is our responsibility. Take our Menicon Bloom product for example, it has regulatory indications of myopia control for CE and it can be of some help to society because we are providing medical intervention and we can slow down the progress of myopia. Unfortunately, it is an irrevocable disease once you become myopic, but with current technology, the progress of myopia can be slowed down. If you don’t have any medical intervention your myopia will continue to progress year-by-year and will inevitably reach certain severe levels after some time. If you start myopic treatment through medical intervention, you can slow down the progress. This means that if we can lower the level of myopia and slow down the progress the risk of more serious eye disease also decreases  This is something we can provide and contribute to society. Although it is not cheap treatment, it is economically effective since the numbers of serious myopic will not reach those expected levels, and honestly, I feel this is the responsibility of companies that have technologies in this area.

One of the big challenges when trying to tackle this myopia epidemic is also finding not only a solution once you have myopia but also prevention to avoid the onset of myopia altogether. Myopia can start due to a series of factors such as genetics, visual stress, and the prevalence of screens. How does your Bloom program and your company as a whole help prevent the onset of myopia?

Researchers are still researching how we can reduce the rate of myopia onset. So far the main focus has been to slow down myopia once it has started. Some optometrists are trying to find ways to prevent the onset of myopia, but once it starts, there is no going back to normal. Normally when people start going to see an eye doctor it is because they already have onset myopia. The current approach is capturing these groups of people and introducing them to treatment options, and then after that the doctors and patients make the decisions. We hope that as many people as possible take the treatment.

The global contact lens market size was valued at about USD 10 billion in 2023 and is expected to reach more than USD 15 billion by 2030, with an annual growth rate of 5%. How do you envision yourself adapting to these growing needs and taking advantage of contact lens growth both domestically and overseas?

There has been market growth at a faster speed than what we had anticipated after the Corona convergence. There is a situation where production capacity is not keeping up with demand, and we believe it is necessary to build up production capacity as soon as possible.

It is said that the inventory level of daily contact lens products decreased substantially after COVID-19, and most manufacturers announced backorders for certain product SKUs.

One big activity we are doing is adjusting our production capacity to the level that meets the growing needs we’ve spoken about already.

It is known that the contact lens market is very competitive with many key players. These key players are known to provide total solutions from the prevention and detection of eyesight issues to offering some optical solutions, and even refractive surgeries if needed. What would you say are the main competitive advantages of your company that appeal to both domestic and international markets?

I would say that the overall tendency of the market right now is described as a product deficit. Again, this comes back to production capacity, and right now there is not enough to comply with the growing demands globally. Whoever can take advantage of this and produce enough lenses for the global demand will take the leading position in the market. When that happens, we can think about strategies to differentiate ourselves from others, but currently, we cannot.

Retail prices are increasing over the past two years and we expect this trend may continue until the global capacity catches up with global growth.

Spherical lenses are used around the world and can cover the main needs of customers, however, there are some limits. For example, aberrations can occur and the light can fail to converge at the same point, making the edge of the field of vision (FOV) kind of blurry. One solution is to produce aspherical lenses that provide perfect light convergence, however, these can be more costly to manufacture. How is Menicon alleviating these kinds of issues with spherical contact lenses and providing customers with a clearer FOV?

One solution is to diversify our lineup of products, which is designed to meet the specific needs of the market. This is a key part of the solution, and as a company, we strive to meet the needs of individual eyes. To do so we stock both spherical and aspherical types of lenses for our customers.

Spherical contact lenses: Miru 1day UpSide

Mojo Vision

Aspherical contact lenses: Four Seasons (A three-month replacement daily wear RGP contact lens)

Mojo Vision

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Menicon has sales operations not only in Japan but in more than 80 countries around the world, and as such you must face consumers that have different physical features, especially when we talk about eyes. There are big physical differences between Asian individuals and Western individuals. How do you ensure that you can tailor your products to meet the demands of each specific market?

As far as soft contact lens material is concerned, the difference in eye shape among different ethnic groups doesn’t matter so much because the material itself is soft. The slight difference can be covered with the flexibility of the material.

Since attempts to accommodate interracial physical characteristics in hard contact lenses require individualized lens manufacturing, some hard lenses are produced to order.

Cosmetic lenses are also another area where we need to strategize and soft lenses in this area don’t have many design variations available. Cosmetics lenses come in many different designs and are particularly popular among Asian women.

One of the unique features of Menicon is the integration that your company has approved. Of course, you are famous for designing and manufacturing lenses, but your firm also takes care of its care solutions and your material development which is unique. What advantages does combining all of this into one offer to your company? Do you have any examples of products or solutions that you’ve developed by combining all of these key elements?

This can be a double-edged sword because we need more staff to take care of all the functions required for product development. I need to have a material scientist, an optical designer, a process engineer, a retail department, and so on. This may not be considered a good way to manage the business, however, as you alluded to, there can be advantages. If you want to customize your products to be very segmented or targeted to a patient this is the approach. You can tailor a material or a feature to meet a specific need because we have so many skilled staff with specific skill sets. They consider this their craftwork and are always striving to make made-to-order products. Having this function all under one roof is an advantage at times in a competitive market.

From our understanding, you have jointly developed with an American startup called Mojo Vision, and that has resulted in a very innovative technology called Smart Contact Lenses, which allows users to visualize data such as maps or other information in real-time using 5G technology. How long will it take to implement and commercialize such technology? How do you foresee this market in 10 years?

We are not setting a particular target to commercialize this product. As soon as possible is the hope. In this contact lens industry, delivering innovation is getting more difficult. Major innovations include the introduction of silicon hydrogel, but this all happened 20 years ago. After this, we have been repeating small improvements but there haven’t been any breakthroughs. We believe that the substantial breakthrough everyone is looking for could be delivered by non-contact lens-based technology. Contact lenses themselves including the shape, material, and design have all become quite mature and saturated, therefore if any big steps are to be taken they need to come from outside of the box.

Spherical contact lenses: Miru 1day UpSide

Mojo Vision

Aspherical contact lenses: Four Seasons (A three-month replacement daily wear RGP contact lens)

Mojo Vision

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Mojo Vision’s staff mostly come from other industries such as tech or electrical appliances. They are all very experienced professionals, but completely outside of the contact lens traditions. Once you start thinking outside of the box, interesting and new ideas can form, so Smart Contact Lenses are one of those ideas. We see it as tech people and medical people joining together to produce one idea.

Besides Mojo Vision, some other smart contact lenses are being developed in this industry. The technology is coming, so we believe that this sort of device combined with a contact lens could become a trend. We have a good platform partner that can accommodate different types of technology inside the contact lens, but if another partner besides Mojo Visions wants to do something with contact lenses I believe we can be an excellent partner. We can load other products and technologies into the contact lens as long as it's small.

You’ve mentioned diversification in the contact lens field, but in recent years we’ve also seen diversification within the medical technology and life sciences fields. Recently we saw that you’ve made forays into the agriculture sector where you created a decomposition accelerator for rice. Can you explain your diversification strategy and why you chose this sector along with some others? What are the advantages a contact lens manufacturer has when you enter new industries or fields that are unrelated to ophthalmology?

The reason why we’ve decided to do business unrelated to contact lenses is that we are looking at further business development. We want to have a second business since the contact lens business represents about 90% of our consolidated revenue. We want to continue to grow, but it is never a bad idea to have more baskets to put eggs into.

In terms of our strengths in entering new markets or fields, I think that although sometimes a product might not seem related to contact lenses, there might be an element that is derived from the technology we currently possess or are actively developing. It is all based on our original business.

One of the strengths of Japan in general is its ability to develop very innovative solutions to the growing needs of society. We know that Menicon developed a leading-edge technology with the concept of smart touch design which makes it possible to apply contact lenses without touching the inner face of the lens. How are your products incorporating this smart touch technology, and how has the technology itself been received so far by customers?

We first launched the smart touch products under the brand name Magic in 2011 in Japan as a national brand.

After that, we launched our Miru 1day UpSide series, which is on the market as a 1DAY Menicon PremiO line in Japan, under a different type of packaging but with the same smart touch technology. So far, this has become the signature product from Menicon, especially in the daily disposable lenses area. We’ve received very positive feedback from both eye care practitioners and patients since it enables new users of contact lenses to avoid contaminating their eyes.

This technology requires quite a complicated manufacturing process and it might be why other contact lens manufacturers are not adopting this sort of packaging configuration.

Moving forward, what is the main focus of your R&D strategy? Are there any new products or developments that you would like to share with us today?

There is a limit to what I can share today since I don’t want to disclose trade secrets, so unfortunately I can only give you the general strategic direction we are going. Menicon is committed to innovation, so we are continuously strengthening our R&D capabilities. Recently some Asian SMEs have come into this industry, so right now their focus is on cost competitiveness but they will inevitably grow in the coming years. I think their issues are going to come in terms of replicating some of the technological innovations firms like ours have developed since they can easily produce conventional materials but what we do is on a completely different level. At the same time, Menicon is in a position to challenge some of the bigger manufacturers. To that end, our unique innovations are what enable us not only to differentiate ourselves from these new firms but also to challenge the larger, more established firms. We aren’t looking to tackle cost competitiveness, since our strength is more in innovation and products that truly push the boundaries of what is possible with contact lenses. This accumulation of science and technology will give us an advantage in the market at both the lower and upper levels. We believe that by focusing on this strength we can continue to grow the company.

Menicon has a presence in over 80 countries worldwide, so where is next? Where would you like to continue your international expansion and what strategy will you employ to do so?

Our basic strategy outside of Japan is to tackle markets through our subsidiaries which we have in major countries. Those major countries are areas that have a certain sized contact lens market, so we are talking about the US, China, Europe, and Southeast Pacific. We are deploying our direct sales forces in over 15 countries worldwide but the rest we rely on distributors since our resources outside Japan are limited. This is why we value business partnerships in smaller markets.

Contact lenses are unique in the fact that while they do have consumers and end users, they have to go through a medical practitioner, so getting the support of these medical individuals is vital, especially in penetrating advanced markets. If you look at Europe or the US, those medical practitioners are generally known to be quite conservative it’s sometimes quite hard to make them change their minds, especially when competing with legacy brands such as Johnson & Johnson. Often it isn’t even a matter of technology, rather it comes down to reputation and therefore it can be challenging for newcomers to compete. How do you overcome this challenge?

Although our business size has not been that big historically outside of Japan, Menicon’s name is still reasonably well-known among eyecare practitioners. The RGP lens was a niche field outside of Japan, so because of that strengthening in this niche area allowed our name to be known by many medical professionals.

Since Menicon's SCL is still not well-known among eyecare practitioners, we will promote the superiority of Menicon's scientific technology, hygiene aspects such as Smart Touch, and of course, the price, to gain acceptance among practitioners overseas.  By pushing our technology and our hygienic strengths we are building a compelling case for our products to be recommended by medical practitioners.

During our research we saw that Menicon recently adopted a dual-management structure, making room for a CEO and a COO. With this new structure of the group, is there a goal or ambition that you would like to personally achieve?

There are two objectives:

One is to increase the presence of Menicon as a mainstay contact lens manufacturer overseas, just as Menicon is known in Japan. Becoming a major player in contact lenses in the global market is a big goal for me.

Our founder first invented the corneal contact lens in Japan. This business started from what is considered quite an unusual idea, especially at the time our founder first introduced corneal contact lenses. In fact, in those days contact lenses were Scleral contact lenses, which was the standard, but our founder had never seen real contact lenses. He thought that contact lenses were just size to cover the cornea itself, which led to the introduction of corneal contact lenses. Although his ideas were considered extraordinary in those days, now they have resulted in the company you see today.

Hidenari Tanaka CEO, who succeeded the business from the founder 23 years ago, has introduced Japan's first contact lenses flat-rate subscription plan which is called the Mels plan. The corneal contact lens and the Mels plan have been the backbone of Menicon. These ideas were born from out-of-the-box thinking and their originality. However, it is difficult to continue to offer unconventional ideas and for employees to realize them. Therefore, I aspire to encourage the organization and employees to think of ideas and develop them as strategies for Menicon. An organization that changes in many ways, especially in the field of R&D, is more resilient than one that simply follows the CEO's word.

My second goal is to develop an organization that can generate ideas.