Axtion Independence Mobility Inc.: Challenges from Prototype to Market Launch

All figures in Canadian dollars unless otherwise noted.

As Tracey McGillivray looked over the newest technical specs for her company’s prototype, the Ibex Lift, early one chilly morning in January, 2020, she couldn’t help but smile. The development of the Ibex Lift had been a labour of love and the start of a “second act” for her after she retired from a successful career as an executive in the technology industry. After several years of hard work, the prototype designed to assist individuals experiencing mobility challenges was almost ready. It was a significant milestone, years in the making, and McGillivray was hopeful that it would be the foundation of a company that could both earn profits and address a serious issue.

While the end of the prototype phase was exciting, it also presented new challenges. As Chief Executive Officer (CEO) of Axtion Independence Mobility Inc. (Axtion), McGillivray knew that a lot of work lay ahead for herself and the company’s other co-founder and current Chief Product Officer (CPO), Liam Maaskant. The Ibex Lift had the potential to positively impact many people’s lives as a revolutionary mobility aid, helping to support independence and hopefully prevent serious injuries. However, McGillivray knew that many high-potential products didn’t succeed; for the Ibex Lift to have the most significant impact and reach the most people, they needed significant resources and a well-formulated plan. McGillivray, Maaskant, and the team had already raised over $355,000 in non-dilutive, non-repayable grants and over $170,000 in founder funding. This funding would cover the costs to complete product development and prepare a product for market. But what market? The team needed to quickly make some critical decisions to get the product into the market and become commercially sustainable; it was time to identify the quantitative and qualitative benefits for stakeholders and potential market segments and determine an appropriate price point to analyze the product’s financial viability.

Company Background

Axtion was co-founded in January 2020 by McGillivray and Maaskant. McGillivray decided to create the company when her father, then in his 80s, developed mobility issues; he was falling down more frequently and could not get up on his own. McGillivray’s mother, also in her 80s, could not help her husband rise after these falls. Although never causing physical harm, her father’s falls resulted in multiple calls to 911 for assistance getting to his feet again, using valuable medical resources and causing embarrassment. McGillivray searched for a mobility aid product that could help older adults like her father upright themselves after a minor fall but found nothing available that suited her needs. The only lift devices were large, heavy, stationary units designed to move a person in and out of bed.

Through her research, McGillivray came to recognize fall prevention and recovery as a major issue not only for her own family but for Canada’s aging population and that of the entire developed world. The over 50 age cohort was the fastest-growing age group, with the over 80 cohort growing most rapidly. The Public Health Agency of Canada reported in 2014 that 20% to 30% of Canadians over 65 were likely to fall each year, and 85% of hospitalizations from injuries were due to falls.^[1] This escalating health issue incurred substantial costs for the federal government in 2023, amounting to approximately $5.6 billion, marking a significant rise from $2 billion annually in 2014, primarily attributed to extended hospital stays resulting from falls.^[2][3] While McGillivray found significant literature on fall prevention, there was little focus on fall recovery.

Searching for help to devise a solution, McGillivray (Class of 1987) reached out to fellow Acadia University alum Maaskant (Class of 2019) in November 2019. Maaskant’s background and education were in mechanical engineering, and he possessed the design skills that McGillivray knew would be essential to find a fall recovery solution for older adults.

Meet the Ibex Lift

McGillivray and Maaskant named their product the “Ibex Lift” after the sure-footed wild mountain goats known for their ability to climb sheer mountainsides. The Ibex Lift was essentially a rollator walker, one of the most commonly used mobility aid devices in the world, but with a critical difference. Maaskant had developed the concept of adding an elevating seat, which could adjust anywhere between floor level and 24 inches (61cm), allowing users to reach lower heights without risky movements, reduce balance requirements, and conserve energy. Because of its design, the Ibex Lift offered features that distinguished it from standard rollator walkers and traditional lift systems. With this elevating ability, the Ibex Lift had the potential to help with fall recovery. In addition to fall recovery, the Ibex could also help people who had difficulty standing after doing activities that required them to stoop down, like gardening or cooking. It could therefore support users’ daily activities and promote independence by preventing falls, assisting in fall recovery without the medical aid, and allowing users to stand after ground-based activities.

Maaskant’s first mock-ups of the Ibex were designed as a proof of concept rather than for aesthetics. These models were made of things like heavy aluminum and pieces of two-by-four; Maakant also used scavenged parts like the screws from car jacks to provide elevation. Another prototype that included features like swivel wheels and collapsibility was soon developed, but this proved too complex to develop fully. Finally, with help from government funding and university programs, Axtion produced the prototype Ibex that McGillivray and Maaskant believed would be the basis for a viable product to produce in large numbers and take to market.

The Ibex Lift supported users’ daily activities by assisting with safe mobility, helping to prevent falls, and offering independent recovery from falls. See Exhibit 1 – Ibex Lift Prototype and Exhibit 2 – The Ibex Lift.

In December 2020, Axtion submitted a patent application for a walker apparatus with a lifting platform. The prototype was shown in various forums and received significant positive feedback. The company won the 2022 Longevity Economy Showcase pitch competition in Atlantic Canada, sponsored by Aging2.0.^[4] Axtion was subsequently invited to show the Ibex Lift at Revolutionize 2022 in Boston, Massachusetts, where it placed second. In addition, the product was shown to clinicians, including physiotherapists, occupational therapists, and physicians from Canada and the UK, and was positively received. Axtion was also selected to participate in the Developers Showcase at RESNA 2022, the conference of the Rehabilitation Engineering and Assistive Technology Society of North America, where the company won the Impact Award.^[5]

Now, in January 2023, McGillivray and the team at Axtion had developed a plan to send the current version of the Ibex Lift to market in the first quarter (Q1) of 2024 and rollout subsequent enhanced versions in 2025 (with an emergency help button) and in 2026 (a summonable, autonomous, intelligent device).

The Competition

Axtion management had identified no direct competitors, as there were lift/rollator combination products on the market. Four main products comprised the patient lift sector.

Raizer II

Liftup Inc.’s Raizer II was a “battery-operated mobile lifting chair” that required only a single operator to lift a fallen individual to a near-standing position.^[6] The Raizer II was assembled around the fallen individual, being stored in two bags or on an optional trolley. The product was available in Canada, the United States, and Puerto Rico. The product was sold in Canada through two distributors: 101 Mobility, with locations in Ontario, British Columbia, and Alberta; and the Jackson Park Health Centre in Windsor, Ontario. The product retailed for $4,995 (US).^[7]

Mangar

Mangar Health USA was a division of Mangar Health, which in turn was a subsidiary of Mangar International Ltd.^[8] Mangar was ultimately a member of the Winncare Group, a France-based multinational firm specializing in designing, manufacturing, and selling medical devices.^[9]

Established in 1981, Mangar was the vision of David Garman, who set out to solve the problem of an older relative’s inability to get in and out of the bath. From there, Mangar’s product line expanded to include a variety of mobility solutions.

Mangar described itself as a “world leader in the design, manufacture, and supply of inflatable moving & handling and bathing equipment.”^[10] Mangar’s patient lifting line of products consisted of three lifting cushions designed to lift patients from a fall,^[11] ranging in price from $1,750 to $5,595.^[12]

Hoyer Lifts

The Hoyer Lift was the vision of Ted Hoyer, who had quadriplegia, and his cousin Victor Hildemann. They created their first patient lift in Hoyer’s garage in 1949.^[13] Ted Hoyer passed away in 1954, shortly after the company’s first manufacturing facility was completed. Hoyer Lifts continued to be manufactured in Wisconsin, U.S., and the company was run by Ted Hoyer’s wife and Victor Hildeman.

Arguably the patient lift industry leader, Hoyer offers many patient lifts, from manual and electric lifts to those specifically designed for bathtubs and pools.^[14] Standard manual Hoyer patient lifts ranged in price from $1,495 (US) to $3,450 (US), while electric lifts could retail for up to $9,425. Hoyer lifts were distributed worldwide in nearly 2,000 retail outlets.^[15]

IndeeLift

With the slogan “The People Picker Upper!,” IndeeLift’s line of products was specifically designed to “pick people up safely from the floor”^[16][17]. Founded by Steve Powell, IndeeLift was started to help Powell’s aging father, who suffered from frequent falls. Powell determined that the Hoyer options, which were recommended to assist his father, were not optimal for his father’s situation so Powell set out to design his lift.^[18]

IndeeLift currently offered four lifts, with two of these specifically targeted toward healthcare and emergency services providers. The remaining two lifts, the FTS-400 and the HFL-300/400 were designed for home and residential use. These models retailed for $3,495 (US) and $2,645 (US), respectively. IndeeLift had an extensive dealer network, including ten authorized dealers in the United States and international dealers in Canada, Australia, the United Kingdom, and more.^[19]

Initial Year of Business

Development Costs and Funding

During its first year in operation, Axtion’s focus was primarily on product design in development. The company had been successful in securing mulitple grants for this work. The grants were “non-dilutive and non-repayable,” which meant that the funding was given to the company without surrendering any stake in the company or requiring repayment. See Table 1 – Axtion’s Costs and Uses of Funding for an outline of funding sources and uses. Any costs not funded by grants were covered through founder funding.

Table 1 – Axtion’s Costs and Uses of Funding (in Canadian Dollars)

Source: Based on data supplied by Axtion Independence Mobility Inc.

Costs

The Ibex Lift estimated cost breakdown once it was put into production was as follows:

• Manufacturing (per unit): $800 to $1,000
• Distribution & Retail Costs: 50% of sales revenue
• Product Liability Insurance: $0.35 per every $100 in revenue
• Selling, General & Admin: $500k in year 1, $1 million in year 2, $1.25 million in year 3

For more details on the cost breakdown, see Exhibit 3 – 2022 Costs.

Sales

While Ibex Lift was awaiting a final patent approval, it could be sold as “patent pending” because the organization had “freedom to operate” status. This status was granted because Axtion had received regulatory approvals from Health Canada and the U.S. Food and Drug Administration (FDA).

McGillivray and her team hoped that the product would be ready to launch in Q1 of 2024. The team still needed to determine the appropriate price point for the Ibex Lift. They were considering using a value-based pricing approach, which would require a marketing strategy focusing on stakeholders’ perceived value of the Ibex Lift. They also planned to develop a value proposition to communicate to targeted stakeholders that summarized the unique benefits of the Ibex Lift.

The Ibex Lift would not be covered under the medical device reimbursement programs available in 2024, because there was no medical devise reimbursement code for a hybrid rollator/lift. Axtion considered applying for a new medical device reimbursement code to cover their device, but realized the process would require resources to complete and could take two to three years to be processed, with no guarantee of approval. For the product to be viable, accurate pricing would need to be determined with consideration toward the target market. See Exhibit 4 – Population Summary for more information on the size and scope of the target market.

Stakeholders

McGillivray and her team believed that the Ibex Lift could significantly benefit the lives of its users, as well as their caregivers and family members, and by improving the lives of those with mobility needs, the lift would also benefit other stakeholders, including clinicians, distributors, durable medical equipment (DME) retailers, and the broader healthcare system.

Conclusion

McGillivray and Maaskant had some decisions to make regarding the future of the Ibex Lift. In addition to defining the quantitative and qualitative value and benefits for stakeholders, pricing the Ibex Lift product, identifying the market segment, and working to understand potential market receptivity, they needed to evaluate the product’s financial viability. McGillivray wondered if they had considered all key aspects to evaluate the best options for the Ibex Lift going forward. Were they missing any critical information? Ibex Lift was almost ready to launch, but the next steps were critical to its success.

Exhibits

Exhibit 1 – Ibex Lift Prototype

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Exhibit 2 – The Ibex Lift

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Exhibit 3 – 2022 Costs – No Sales, in Canadian Dollars

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Exhibit 4 – Population Summary

Population Summary: Canada

Source: Based on data from Statistics Canada. (2023, November 15). Census Profile, 2021 Census of Population. https://www12.statcan.gc.ca/census-recensement/2021/dp-pd/prof/index.cfm?Lang=E

Population Summary: U.S.

Source: Based on data from Rubin, E. (2023, January 19). Elderly population in U.S. by state [Table]. Consumer Affairs. https://www.consumeraffairs.com/homeowners/elderly-population-by-state.html

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