Development story of
Moldcare
Moldcare RI II is one of the products marketed worldwide by ALCARE Co., Ltd. (hereinafter referred to as
"ALCARE"). Since its introduction, Moldcare RI II has long been favored by partners all over the world, and
has thus continually changed in response to market opinions.
In this presentation, we at ALCARE introduce the motivation behind the creation of this unique product of a
cushion intended for radiography, its development background, and future prospects.
01 Background of the development of Moldcare RI II
ALCARE, the company that developed Japan’s first plaster cast products in 1953, was about to launch the development of an easily, flexibly moldable splint made of hydraulic setting urethane resin in the 1990s, ahead of our competitors, using hydraulic setting urethane resin roll casts at the time. The ALCARE laboratory at the time considered horizontal application of hydraulic setting urethane resin to other product families in addition to the roll casts, and in fact, a variety of ideas were born based on technological considerations. At that time, we at ALCARE were handling thermoplastic masks (shells) for immobilization of the patient’s face during radiography. These were intended for gamma knife therapy, but a problem with unstable immobilization remained. We were then asked about the possibility to develop a pillow that could be shaped freely to adapt to secure immobilization around the patient’s neck. This motivated us to propose a convincing solution in the field of radiography using the core technology obtained through external fixation in orthopedics, which had been our business domain since the establishment of the company. In this way, the technological development of Moldcare RI II was launched.
02 Our commitment to the development of Moldcare RI II
The core technology for the development of Moldcare RI II originated from AWAOKOSHI（※1）,featuring the best-proportioned formulation of polystyrene beads and hydraulic setting urethane resin materials. How could we find the best formulation of beads and urethane resin materials? The greater the resin content, the stiffer the product would become, making it more difficult to shape it freely, and increasingly the cost simultaneously. To find the optimal proportion, we conducted various tests and repeated hypothesis verification. There was also another problem, namely, the manufacturing method. To build a facility for mixing beads and urethane resin materials, we worked with a raw material supplier to design and realize a prototype from scratch. We also applied for and obtained patents in many countries around the world to proceed with the development.
※1
AWAOKOSHI is generally the one of Japan’s oldest known sweets which is cereal puffs,
candied and compressed into bars
03 Marketing as a global product
We visited some national universities and the National Cancer Center many times for evaluation of our product samples for the head and neck. At the time we were told that the product would not be used widely in Japan if it is marketed and that the field of radiotherapy would not be the main offset in Japan because radiotherapy is an adjunct approach and resection by surgeons is a more popular treatment option. In fact, we presented the product at various academic exhibitions at meetings of the Japanese Society for Radiation Oncology (JASTRO) and others, but we felt that it would be a small market if limited only to domestic sales in Japan. On the other hand, we were advised about the selling approach of firstly marketing the product overseas, including the US, where there is a greater need for radiotherapy, and then to reverse-import into Japan because initial release in Japan would not assure successful sales. We thus considered to work with a partner and decided to tie up with a trading company with a strong overseas presence to initially sell the product on overseas markets and to then reimport it back into Japan.
04 Pursuit of quality and ease of use
The most notable features of Moldcare RI II are its highly accurate immobilization and ease of preparation. The development staff, however, encountered two problems. One was the leaking of resin from the knit material wrapped around the cushion, and was resolved after much trial and error by the development of the optimum proportion of content materials to eliminate possible leaking of resin. The other problem concerned fluid infiltration into Moldcare RI II. The hydraulic setting plaster cast is typically immersed directly in the water in a bucket and then squeezed for clinical use. Moldcare RI II, however, is too large in size to be immersed in a bucket of water adequately. Therefore, the instructions for use provided with Moldcare RI II at the time of its initial release stated to cut the top of the aluminum package containing the Moldcare RI II and then to spray water from a faucet on the Moldcare RI II in the aluminum package.
This method, however, was not easy due to some disadvantages, i.e., towels had to be available in advance and the floor could become wet with water from the aluminum package. One of the development staff members then discovered a method of infiltrating the Moldcare RI II with water by spraying. To find the best suitable spray, several garden sprays were bought at a home improvement center and through trial and error the current method of pressurized infiltration of water with a water spray was finally born.
05 Future development
In these days with the growing number of cancer patients worldwide, the demand for radiotherapy is expected to increase in view of its contribution to preserve the cancer site without resection. There is also a current trend of medical technology to provide fractionated higher dose irradiation therapy based on the enhanced accuracy of radiotherapy equipment and also with the initiation of including the Radiation Oncology Alternative Payment Model (ROAPM) in the healthcare and medical policies in the US, which is intended to place greater importance on the efficiency of treatment. Moldcare RI II is thus expected to serve as a powerful tool for its ability to achieve a high degree of immobilization. While responding to the market needs, we at ALCARE wish to continue contributing to ensure safer and more secure radiation therapy by spreading the easy-to-use hydraulic setting cushions featuring advanced immobilization all over the world.