by Brian Chapman, Principal, ZS
I’ve lately been thinking a lot about innovation. As someone whose livelihood depends on a healthy and robust medical technology sector, I spend a lot of time scanning the horizon for the opportunities that will drive our success and the extinction-event asteroids that will threaten it. I’ve found one topic that is occupying my time—transformative innovation.
The sector is far from moribund. Yes, we are struggling with some organizational discomfort in dealing with rising costs by raising price without having the next incremental innovation to tie for lifecycle management. Yes, procedure volumes are taking time to return to pre-pandemic levels with staffing issues still a central issue for our customers. Yes, we are struggling to re-establish functioning supply chains in light of all this turbulence. But when you look at actual growth, the picture is mixed.
Therapy penetration is something we do well—continuous glucose monitoring, structural heart, point- of-care testing, neuro modulation and electrophysiology are great examples of driving growth with market penetration based on sustaining innovation. We have a strong playbook for taking a great idea and scaling it. Much of the growth we enjoy now comes from these past innovations, but one could argue this is all fairly predictable and low risk.
Truly new therapies and categories are a little harder to find. Perhaps this shouldn’t be surprising because the dominant strategy for growth in the industry has been the tuck in of small, mostly single-product companies to build a business with category leadership in the adjacencies. This worries me because it isn’t clear where the next step change innovation will originate.
Robotics also have gotten tremendous attention and investment. Again here is a potential new category of growth focused not on the device but on the procedure. There is great promise to improve surgeon performance, longevity and efficiency, not to mention outcomes. I think this is playing out in orthopedics, but honestly, has all this investment expanded the market or simply become an additional way in which the players compete for fundamentally the same pool of value? With soft tissue robots, we have an even longer road to prove value. A colleague asked me, “Which codes can I find that indicate robotic surgery with special reimbursement?” and I could only think of one to which to point her. I want to believe we are headed into a world of new possibilities and upside, but so far I see innovation focused on supplying a new capability instead of solving problems that create new value. Turning new procedural hardware into unique value will take time. I don’t mean to question the long-term value potential, but I’m not yet sure this is a panacea to address the lack of transformative growth. At least not soon.
Unfortunately the macroeconomic environment is further forcing our hand. Start-ups are having to contend with an unfriendly funding environment that might handicap valuations and make unhealthy burn rates existential. But the big medtech companies are now forced to focus on short-term earnings per share, and that singular focus means acquisitions that are dilutive in the short term are hard to swallow. So even the traditional mergers and acquisitions route for inorganic growth is less friendly.
The title of this column is “Can Big Medtech Still Take Big Swings,” and I’ve been arguing that there are forces conspiring to make this difficult. However, I don’t think it’s all gloom and doom. The promise of connected health looms large for our industry, and innovative funding strategies and courageous leaders still helm our companies. Please join me for my session at AdvaMed’s 2022 medtech conference in Boston, where I will discuss with industry leaders the state of innovation in our industry and how we can push ourselves to expect more.