After eight weeks of national lockdown in an effort to defeat a deadly outbreak of COVID-19, Italy began to tentatively reopen certain businesses and put millions of citizens back to work on May 4. As part of that gradual reopening, Italian national and local authorities are undertaking extensive antibody testing campaigns to determine how many people may have developed immunity to the coronavirus. At the same time, the companies that make these tests — ranging from global players Abbott Laboratories and DiaSorin to local outfits such as Diesse Diagnostica and TechnoGenetics — are racing to win a share of an emerging market for tests that detect COVID-19 antibodies in the blood
One issue here, notes Dr. Antonio Giordano, the founder and director of the Sbarro Institute for Cancer Research and Molecular Medicine at Temple University in Philadelphia, is that it’s not clear whether current tests can tell the difference between antibodies for SARS-CoV-2, the coronavirus that causes COVID-19, and antibodies for the already circulating coronaviruses that cause the common cold.
Because of this variance between tests, Giordano suggests instead using only one, so at least any errors would be consistent, and therefore easier to account for. “It would be better to apply the same serological test in the whole country, to have a better picture of the diffusion of the virus throughout Italy,” he says.
“This is not a normal situation,” TechnoGenetics CEO Salvatore Cincotti told Forbes. “This is a time when competition should be accelerated, not reduced.”
DiaSorin, which is listed on the Milan stock exchange and recorded net profits of $190 million on revenues of $763 million in 2019, is a behemoth compared to TechnoGenetics, which ended 2019 with $29 million in sales. Founded in Lodi, south of Milan, in 1982, TechnoGenetics sold an 80% stake to a Chinese firm, publicly traded diagnostics maker Shanghai Kehua Bio-Engineering, for $20.3 million in 2015. Despite their difference in size, both firms are competing to provide antibody tests in Italy and beyond — DiaSorin is delivering tests to Belgium, Israel and Germany as well as the regions of Piedmont and Sicily, while TechnoGenetics validated its rapid testing kits with the canton of Ticino in Switzerland and has provided them to the southern Italian regions of Campania and Molise.
In a bid to keep up with larger competitors, some smaller firms are betting that offering more granular data will make their product stand out. Diesse Diagnostica Senese, a diagnostics firm based in Siena, Italy, is making tests that detect three kinds of antibodies the immune system develops to fight off a disease — IgG, IgA and IgM — unlike most of the other tests currently on the market, which only measure IgG and IgM
Diesse is providing the regional government in Tuscany with 500,000 antibody tests and is now producing 1.2 million tests a month. The firm, which has about 200 employees and was founded in 1980, pulls in 70% of its revenues from outside Italy and posted sales of $32 million in 2019. In May 2019, it was wholly acquired by French healthcare investment firm ArchiMed for about $32 million.
“We decided to launch a test which detects all three antibodies because the immune response to this virus is still poorly understood,” says Diesse CEO Massimiliano Boggetti. “We need important epidemiological studies to see if we can really say that those who have developed antibodies are immune.”
Since the COVID-19 pandemic began to wreak havoc in Italy in February, the country has been something of a harbinger for other affected nations in the West, offering a potential preview of the near future. Multinational firms are now making a push to enter the Italian market, seeking to use the country as a springboard to offer their antibody tests elsewhere as demand picks up. No company has been more prominent than U.S. giant Abbott Labs, which is providing antibody tests to the Italian government and is also sending kits to regional authorities in Sicily and Piedmont.
“The U.S. is a vast country, unlike Italy, with different climates and heterogeneous populations,” says Dr. Giordano of Temple University. “If everyone uses a different test, then at that point the states will have to take responsibility [for testing]. The U.S. needs to find a way to normalize the data across the country.”