M2Test, the breakthrough osteoporosis prevention and monitoring system

M2Test has devised a new type of minimally invasive and painless examination to monitor osteoporosis, which has no contraindications. In Italy, a number of specialist and medical centres already have it, and the company is also collaborating with the insurance company BNP Paribas Cardif

Published on 20 Oct 2019

Concetta Desando


From mother and daughter to business associates and businesswomen. The story of M2Test is the story of an all-female startup born into a family, the one composed by mother Francesca Cosmi and daughter Alessandra Nicolosi. Together they founded a company with the aim of improving people’s lives through the prevention of osteoporosis. The founders, in fact, have developed Bes Test, a test for the evaluation of bone structure quality useful not only at the time of diagnosis but also in monitoring the disease. 

A startup with a clear social impact, then. It is no coincidence that M2Test is among the finalist startups of the 2018 edition of Open F@b Call4Ideas, the contest launched by BNP Paribas Cardif that last year was dedicated to positive impact innovation.  

What M2Test does 

Many people are exposed to an increased risk of spontaneous or trauma-induced fractures, with consequences in terms of quality of life and autonomy, due to osteoporosis. M2Test aims to improve the lives of these people, providing a unique, fast and non-invasive solution that allows you to monitor the real risk of bone fracture, following appropriate paths and remedies to keep the disease under control and meet the demand, growing throughout the industry, of greater efficiency, consistent quality and more and more safety. 

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The startup has devised Bes Test (Bone Elastic Structure Test) a new type of minimally invasive and painless examination for osteoporosis obtained by simulating the application of forces on a virtual biopsy of the patient’s bone architecture using radiographic images. M2Test is mainly aimed at doctors and multi-specialist centres. But its product, Bes Test, is aimed at everyone, men and women, and is also recommended to young people for screening activities. 

The history of M2Test 

The idea of founding a startup for the prevention of osteoporosis stems from the intuition (and passion) of Francesca Cosmi. Lecturer in mechanical engineering at the University of Trieste, thanks to his background in bioengineering, he taught at the school of orthopaedics. And that’s when he starts to get passionate about bone structure. “I’m fascinated by its modelling mechanism: even if it appears solid it’s actually a constantly changing fabric,” said Francesca. It was thanks to his experience at the school of orthopaedics that he became aware of the problem of osteoporosis: “Fifteen years ago, I was struck by the difficulty of diagnosing osteoporosis and the numerous fractures that occur because the damage is not recognized early on” continues the engineer. So she sets to work to find an engineering solution to the problem: “I built what we engineers call a numerical model capable of performing simulations. The system involves acquiring a virtual biopsy using three small ultra-low dose X-rays, and using these as a starting point to derive the mathematical models on which to make the simulations”. Mathematically, everything was perfect but bringing this model to market was not at all easy. “In the beginning, fifteen years ago, we used a mammogram to take X-rays: instead of the breast, we put our hand in order to have X-rays of sufficient quality. Changing the parameters resulted in high-quality digital radiography. I thought it was a viable project, but it wasn’t,” continues the engineer-entrepreneur. 

Only in 2015 was the mammograph replaced by an ultra-low radiation digital instrument. And at that point Francesca thinks about founding the startup involving her daughter Alessandra. “My daughter was getting her second degree in pharmacy after the one in herbal techniques. She was interested in the project and joined me”. M2Test was founded in Trieste on 6 October 2016. In the same year the startup wins the Innovation Factory Challenge, the call of the certified incubator of AREA Science Park which is now a member of the project. “The name of the startup is an acronym for micro-macro testing, i.e. tests that start from micro analysis to find macro properties. But it can also be understood as a ‘test of the mother and second daughter’, it is no coincidence that Alessandra is my second daughter,” Francesca points out. 

In nomen omen, then. The startup today operates in Friuli Venezia Giulia, Veneto, Lombardy, Tuscany, Emilia Romagna and Sardinia and has a team of 4 people: Francesca and Alessandra, in fact, have been joined by a person who is in charge of the secretariat and one who deals with research and development. 

The advantages of M2Test 

The main test for the diagnosis of osteoporosis is densitometry, an examination that measures the mineral density of bone. It is an analysis that can be repeated every two years due to the high radiation dose. M2Test does not replace densitometry but is a complementary examination that focuses on prevention and monitoring. “The examination can already be carried out at the age of 30 if there are cases of osteoporosis in the family, so as to have a picture of the situation. Then, during menopause, you can repeat the test and see if something has changed in the meantime” explains Alessandra Nicolosi, today CEO of the startup. “For those in therapy, then, the system designed by M2Test allows, thanks to the low radiation, to monitor the patient every three months: in this way the doctor can decide whether to change the current therapy or continue according to the changes reported by the X-rays” continues Alessandra. These are the great advantages of M2test: the prevention and monitoring of osteoporosis. The limit of densitometry, in fact, is the inability to consider the rapid change of bone: “There are many elements that influence the metabolism of bone, from lifestyle to stimuli. M2test allows to intervene in a short time, and this is the great advantage, also appreciated by doctors” specifies the entrepreneur. 

The business model 

M2test is aimed at doctors and specialist centres. The doctor, through the platform, uploads X-ray images and then these are analyzed by the software. After 5-10 minutes the doctor is notified that the report is ready. Referto reporting the degree of risk of fracture of the patient. “Through the platform the doctor can buy different solutions with three different quotes: package with a certain number of analyses; screening days where you pay per person; or there is a free loan solution for the use of the instrument” specifies Alessandra Nicolosi. The instrument costs 10 thousand euros. The test is now available in 10 centers but M2Test aims, by 2021, to expand its service throughout Italy, with at least one center per region, and to reach, in the future, Europe and the United States. “Every day I get about 30 questions from people from the South asking me where to take the test. That’s why our next step is diffusion on Italian territory,” continues the CEO. 

The reference market 

Osteoporosis is a huge market. In Italy, 900 thousand densitometries are carried out per year and the cost of post fracture expenses is around four million. In addition, it must be considered that a person who has suffered a fracture due to osteoporosis, once back home, is no longer autonomous and has difficulty in resuming normal daily life. All with repercussions both in the family and at work. Between 30 and 50% of people affected by a fracture caused by osteoporosis do not recover complete autonomy. That is why today there is an increasing demand (and awareness) for prevention. M2test fits right into this context. Bridging a market gap. 

A growing startup 

The startup is now growing strongly and has achieved, only in the last year, an increase in turnover of 50% compared to 2018. In addition, M2Test is constantly engaged in filing new patents and studying new projects to constantly improve its product. The company has won several awards, including the Start Cup FVG and the Rotary International Science and Technology Award in 2017, the Project HEaD Higher education and development and the POR FESR 2014-2020 – “Interventions to support the creation and consolidation of innovative start-ups through direct incentives” by the Autonomous Region of Friuli Venezia Giulia in 2018. Finally, in 2019, M2Test won the “MIA Miss In Action” award, the first Italian acceleration program for women entrepreneurs, strongly desired and coordinated by Isabella Fumagalli, CEO of BNP Paribas Cardif and Coordinator of BNP Paribas IFS for Italy, and Digital Magics, a certified incubator of innovative startups. Finally, also this year, the startup won the Lend lease selection for access to the GIP acceleration program of Skydeck, the accelerator of the University of Berkeley, which is already opening up new opportunities, particularly in the United States. 

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Concetta Desando

Due menzioni speciali al premio di giornalismo M.G. Cutuli, vincitrice del Premio Giuseppe Sciacca 2009, collabora con testate nazionali

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