I frequently see conclusions about the the future of medtech derived by analysts who are walking backward looking at their feet — living by the tenet of “past is prologue”. This type of “foresight” presumes an unchanging set of forces, leading (at best) to a conclusion that the future will hold more of the same.
Yet, the future of medtech is dictated far more significantly not by what has already happened, or as a result of past trends continuing as future trends, but by what has not happened yet. The major thrust of any significant growth (and isn’t growth what interests us?) comes primarily from events that do not as clearly follow from past events:
- Surgical device sales forecasts are uprooted by introduction of laparoscopy
- Tissue engineering preempts conventional treatments in wound, orthopedics, cardiology…
- Success in type 1 diabetes treatment will be determined by device advances as well as cell therapy advances
- Systems biology reveals risks and opportunities previously unseen
If you view your markets myopically, then you consider your competitors to be limited to those whose products most resemble your own. If you have a long view, you consider what might be possible based on available/emerging technology to tap into untapped demand or simply create latent demand that no company has yet been sufficiently visionary or innovative to seize. What patient populations, clinical practice patterns and their trends are the pulse that you monitor (or are you even monitoring these)? There is a gap between what is available and a whole set of patients virtually untreated, physicians unsatisfied, and third party payers struggling. Are you an angioplasty catheter manufacturer — or a coronary artery disease solution? Do you make devices — or outcomes?
Look at staid “device” companies like Baxter International and see that they have “biosurgery” divisions. Look at Medtronic and appreciate that they are as sensitive to developments in glucose monitoring and insulin pump technologies as they are to the litany of cell therapy approaches under pursuit. (These companies are fundamentally aware of technology “S-curves” — see graphic at right.)
Virtually every area of current clinical practice is subject to change when considering drug/device hybrids, biomaterials, nanotechnology/MEMs devices and coatings, biotechnology, pharmaceutical (and its growing sophistication in drug development), western medicine and eastern medicine, healthcare reform, cost containment, RFIDs, 3D printing, information technology — it is imperative to see the upside and downside of these.
These are some of the forces that less characteristic of the past that are leading to startling new success in medtech developments:
- Materials technologies are redefining the nature and functional limits of medical devices
- Technologies more closely aligned with cure than symptomatic treatment gain rapid acceptance
- The practice of considering outcomes measures of highly diverse technology solutions to disease has ascended to prominence in the mindsets of healthcare systems and payers
- The use of information technologies and cross-medical discipline initiatives enables rapid determination of likely success and failures in whole new ways
Aside from the demands for operational efficiency and managing cash flows, the success or failure of medical technology companies has become a reflection of how well these companies position themselves now and in the future with an imaginative long view. Companies must consider the revenue streams in Year 1, Year 5 and Year 10.