A South African medtech startup with a reloadable epinephrine auto-injector is betting Maryland’s manufacturing infrastructure — and a network of operators who actually pick up the phone — can carry it into the world’s largest allergy market.
Giancarlo Beukes nearly died from an anaphylactic reaction. He didn’t have an auto-injector. He survived, finished his master’s in biomedical engineering at the University of Cape Town, and wants to ensure that the device that wasn’t there when he needed it shouldn’t be out of reach for anyone else.
Eight years later, Impulse Biomed, the company he co-founded with friend and fellow UCT engineer Gokul Nair, is opening its U.S. headquarters. Not in Boston or the Bay Area, but in Baltimore; at The LaunchPort, an ISO-13485 medical device manufacturing accelerator inside the City Garage on Baltimore Peninsula.
“If you’re not making someone else’s life better, then you’re wasting your time,” Beukes likes to say — a personal motto that has become Impulse Biomedical’s operating principle. It’s also a useful lens for understanding why a Cape Town company chose Baltimore over the coastal hubs that typically claim international medtech entrants.
A smarter auto-injector for the people who need one
Impulse Biomedical’s flagship device, the ZiBiPen, is a reloadable epinephrine auto-injector — the first of its kind, globally patented, and built around a premise that sounds obvious once you hear it: the medicine inside an EpiPen costs almost nothing. The device costs the rest.
The company intends to come to market with a focus on epinephrine, for which they have already completed successful clinical trials, but the auto-injector can be used for other medicines as well and so they have a keen eye on the field of additional product applications.
In the United States, a brand-name EpiPen twin-pack runs $300 to $700 without insurance, with authorized generics landing between $150 and $400. Prices climbed roughly 600% between 2007 and 2016 — from about $100 to more than $600 — even as the underlying epinephrine remained a cheap, century-old drug. Periodic shortages since 2018 have forced the FDA to extend shelf-life dating just to keep devices on pharmacy shelves. A 2018 cost-effectiveness analysis in JAMA Network Open pegged the value-based ceiling price for an auto-injector at roughly $24.
The ZiBiPen attacks the math directly. Patients use a small tool to swap out an expired cartridge every 12 months, keeping the injector itself in service for years. Less plastic in landfills, less money out of pocket, and — critically — a device users learn once rather than re-learning each prescription cycle. Beukes and Nair are also targeting the second-order problem the existing market has long ignored: in an emergency with a 15-minute window, even adults misfire conventional auto-injectors. Simpler mechanics save lives.
Impulse already holds utility patents granted in multiple countries around the world including the US, Canada, and RSA, as well as design patents granted in the US, and RSA. It’s also not a one-product company. Its first commercial device, the Easy Squeezy — an ergonomic sleeve that snaps onto a standard asthma inhaler and reduces the activation force by roughly 4x — is in nearly 800 stores across South Africa, has crossed 22,000 units sold, and recently launched in the United Kingdom. The Easy Squeezy gave the founders the muscle memory of running a regulated device company. The ZiBiPen is what they want to be known for.
Along with the new U.S. operation, the company is actively looking for what Nair calls “sector specific” investors. That includes those that understand the medical device, allergy and immunology space who can join with Impulse as they scale through clinicals to enter the market.
Why City Garage made the call easy
The path to Maryland ran through Impulse’s investor, ANZA Capital, and board member Robert Williams, who pointed Beukes and Nair towards the Maryland Global Gateway Soft Landing Program — the Maryland Department of Commerce’s structured on-ramp for international companies establishing U.S. operations. Conversations with the program’s team led directly to The LaunchPort, where Managing Director Bob Storey and Executive Director Edmund Pendleton sat down with the Impulse team to map out what a U.S. operation would actually look like.
“We are thrilled to be working closely with Maryland Department of Commerce to bring promising international medtech companies to Baltimore,” Storey said when the partnership was announced. “LaunchPort brings a rare combination of deep medtech accelerator expertise and FDA-registered manufacturing infrastructure, built specifically for the regulatory and commercial complexity international companies face when entering the U.S. market.”
That kind of warm-handoff connectivity is the thesis of the BioHealth Capital Region. LaunchPort isn’t a co-working space with a coffee bar — it’s a working contract manufacturer with clean rooms, sterilization capacity, regulatory support, and a roster of medtech residents spanning cardiology, neurosurgery, IVD, and ophthalmology. For a company that needs to assemble, sterilize, and ship a Class 2 combination product into the U.S. market, the alternative isn’t another incubator. It’s building infrastructure from scratch.
There is also a sharper, more tactical reason: tariffs. With trade policy on imported medical devices and components in flux, manufacturing the ZiBiPen on U.S. soil isn’t a branding exercise — it’s an operating-cost decision that determines whether the device hits the price point the market needs.
“Establishing our U.S. presence through the Maryland Global Gateway program is a pivotal milestone for Impulse Biomedical,” Beukes said when the company’s acceptance was announced earlier this month. “The strategic support from the Maryland Department of Commerce and the specialised expertise at The LaunchPort will be key in smoothing our transition into the U.S. market, ensuring we are well positioned for long-term success and impact.”
Behind the press-release language, the choice reflects a colder calculus: the BioHealth Capital Region is one of the few places in the United States where a medtech startup can co-locate engineering, regulated manufacturing, FDA proximity, and an academic talent pipeline within the same zip code.
Hiring Maryland-first
Impulse plans to bring on a U.S.-based team of five to ten people over the next several years, starting with commercial and regulatory functions. The FDA pathway and reimbursement strategy for a reloadable auto-injector is novel territory so retaining that expertise is important to the company.
Fundraising and Commercial strategy is supported by Rachel Offenburg, who manages market access and investor relations across the company’s U.S. and European corridors. The structure is small, distributed, and unmistakably operator-led — a profile the BioHealth Capital Region has quietly become very good at supporting.
The patient is always in the room
What separates Beukes and Nair from the typical founder archetype that has become wearyingly familiar in medtech is how rarely the conversation drifts from the patient. They still tells the story of an early hospital interview with a young asthmatic struggling to compress an inhaler — a moment that he and Nair point to as the reason the Easy Squeezy exists at all. Beukes still talks about his own anaphylactic episode in the first person, not as origin-story branding but as the reason any of this matters.
“Those in need of healthcare technologies should be able to access them,” Nair has said. “It’s a simple concept, and yet it’s not a reality. Why?”
That question — and the clarity of conviction behind it, combined with regulated manufacturing on Baltimore Peninsula, a globally-patented platform, and a credible thesis on cost — is what an exporter of medical-device innovation actually looks like in 2026. Baltimore just happened to be ready when they arrived.
