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Evolving Global Digital & Marketplace Models | LSI Europe '22


Scott Carson

Scott Carson

Founder, MRP
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Paul Tomasic

Paul Tomasic

Managing Director - Head of European Healthcare, Houlihan Lokey
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Peter Stebbins

Peter Stebbins

Executive Chair of the Board, Nurami Medical
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Dale Koop

Dale Koop

Chief Science Officer, MRP
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Tom Parsley

Tom Parsley

Managing Consultant, Credera
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Tech stacks, as we all experience in every aspect of our consumer lives, allow us to review data to make purchase decisions. These are now coming to Medtech and will transform traditional sales processes while dramatically cutting costs for customers and manufacturers.


Scott Carson  0:04  

I'm going to start out by asking Dr. Koop a question. We were speaking the other day. And you mentioned the death of the salesman, referencing the great great playwright, Arthur Miller. What did you mean by that?


Dale Koop  0:18  

Well, I wasn't actually referring to murdering sales guys, but more of the occupation of the sales Field Sales Rep, which is a legacy occupation that was absolutely necessary. 20 years ago, when that was the source of information for clinicians, I mean, otherwise, they'd have to go to the encyclopedia, university libraries to get information which wasn't always up to date, journal articles are usually published a year too late. So the the source of information has always been the field sales rep who would come in the new generation of clinicians grew up in the Wikipedia YouTube era. And they're used to getting their information from other sources, peers, the internet, and they don't necessarily trust field sales reps, and they don't even need field sales reps for information. And they, everybody realizes that the information you get from a field sales rep is not only limited to a subset of the total information, but also it's very conflicted, because they, they're paid for by the manufacturer they represent. So there's a big need to our drive for these new clinicians that are coming or they're a doctor, they're just starting to come out of their fellowship. It's changed in the way purchasing and information gathering is done and sales reps, Field Sales reps who can't evolve to a new role of information aggregators, almost purchasing agents are gonna go away that occupation.


Scott Carson  1:51  

One of the things that I was thinking about as I was preparing for the panel is, I was reminded of a quote from over 20 years ago from a friend of mine, Mark Lorimer, who was, he was an attorney and became the CEO of Autobytel. So it's over 20 years ago, and at the beginning of auto buy, tell there was eBay and Craigslist, and that was kind of the first digitization of automobile sales. And he made a statement, the Wall Street Journal, he said, committed to the future will be the survivors. And what that was saying was, is if you weren't moving to online sales, and online education of automobiles, you weren't going to not survive. And I think med tech finds itself in pharma and med surg in the exact same place. And there's some interesting data that's coming online right now. That's available to everybody. But we now know that millennials make 44% of the decisions on b2b transactions. We also know that those same Millennials 70% of them prefer digital interaction versus in person interaction in their decision process. In some cases, it can be as high as 80%, depending on the sector. So Tom, we were talking earlier about how reps and the industry may need to pivot. So what's next,


Tom Parsley  3:03  

There's a series of things that you either need to transform into if you are a legacy player in the space. Or if you are a new startup bringing something to market, you've got the opportunity to start on next best practice. So everything from the way that you put together your data around the customers that you go after, the way that you pull together, your market sizing and your market options that you go after, and making sure you set up the correct tech to be in place for you to be able to position your content to those users in the best possible way. So you know, as you touched on, we're no longer in a situation where we are marketing to and trying to sell to people who are going to be happy with a one size fits all, one person one rep relationship, instead, we need to be having a single source of content where they can go to wherever they want to, we need to be able to offer different marketing and sales materials at the point of them wanting to dip in and out of it. And something I think we're going to go on to also is there is a wider group of customers that we need to speak to rather than just that one single customer space that previously you had that relationship one to one, and that's no longer there. So setting ourselves up from a technology point of view, to be able to have that marketing presence across multiple platforms to dip in and out of as and when your various different customer personas want to access it.


Scott Carson  4:28  

We saw this and it was referenced in a panel holder earlier this year, where Ashwin Kerwin from Airbnb had shared with us that the hotel industry was really a one to one relationship. And what Airbnb did is made a one to many. And I think that's what you're referencing. And earlier Peter, you and I were talking about was at the VAC the value added committee or the analysis and value analysis committee and how what Tom was saying is going to create a great change. So what are we going to see there? 


Peter Stebbins  4:57  

Yeah so, again, as people may know, in the us really to get into a hospital and even increasingly into inferior surgery centers and errors, you need to go through a value analysis committee. So in some ways, it's the same, you need to have that surgeon champion, you did need to start there. But you also need to bring in the purchasing the corporate procurement, which means they're gonna check what the prices might be for some other sister company or sister unit or hospital from that same economic entity, but then also biomedical, and infection control and and all the rest. So, you know, we're talking a little bit about the notion of going to a totally online marketplace, but I think there's going to be this situation where you're going to have to still have something in the hospital and I mean, at the in the hospital, very cross stakeholder driven within within the hospital make these decisions. And in the in the short term, it's it's a kind of hand hand combat, but I think the companies that will succeed, they will figure out the best way to make sure that those companies can the stakeholders can take off yeah, this is covered, I don't need to come in in person to go through this with that particular function. But eventually get through that that VAC council because again, that can take let's committees can take six to nine months pretty easily three months is pretty short.


Scott Carson  6:18  

What we're what we're talking about is that over the next few years, you're gonna see a radical change in the way products and services are marketed within med tech and pharma and med surg. And what I mean by that is, currently if you go on pretty much any manufacturers website, it's a marketing website, it doesn't provide any significant data or analytics or good, better best, any of that information doesn't exist. So the first thing you're going to see is what I call intelligent data, you're going to start to see intelligent data be or intelligent digital begin to get out there could be training, education, could be additional information, then you're gonna see a digital capacity enablers. This is what we've seen in other industries, followed by marketplaces, and then fully ecosystems. And, Paul, you've you've had actually seen some ecosystems start to get evolved. So why now in med tech and pharma, why is it now versus five years ago, 10 years ago? And what are you seeing from the altitude that you're in? And investment banking?


Paul Tomasic  7:18  

Yeah, I think we're starting to see an empowerment from clinicians and patients of how they're approaching the industry. To take a page out of pharma, I think the concept of personalized medicine is starting to take hold in the area of med tech, you know, pharma, they always talk about not only the death of the salesman, but the death of the blockbuster drug, where medicines will no longer be producing the next Lipitor, which is a $20 billion drug, but having much more personalized treatment where the clinician and the patient will have the type of access to data in order to make treatment paradigms that are very specific to patients. And that enables them to then want and desire actually, the clinical data. The second is there's a convergence going on in the industry. I think that med tech companies no longer need or can see themselves as product companies alone. They need to think about, for example, the success of the entire procedure, alongside the success of their own products. So this goes very much to what we've seen in the US and movement toward outcomes based care, reimbursement, driven by the need to actually show results. And it's not just about the product, but it's about the service and how that product is delivered into the patient. So widening effect. And the third really comes down to technology. I think for the first time, we are really seeing technology interplay with med tech in a way that we probably haven't seen for many years in the past. Clearly COVID was a was a big impetus for the med tech industry. And indeed, it's starting to produce some very innovative businesses out of it.


Scott Carson  9:00  

No question. I touched on it earlier that automotives took roughly 20 years from that kind of initial inception of concept to where now, Ford announced this week that 50% of its orders in our cars are coming online. And they also did something else that was really unique is they're now going to test the light pricing. So flat rate pricing, and dealers will not be able to sell the EV line, if they don't agree to non variable pricing, fixed pricing. So we're starting to see that happen and consumerism and I think COVID You touched on


Peter Stebbins  9:30  

That almost like Saturn back in 1991. 


Scott Carson  9:34  

Saturn 1991, that didn't end so well.


Peter Stebbins  9:36  

I know. I guess you just, I mean, I think we got to look at this, all this stuff that's going to happen. We got to figure out within med tech, how is your particular customer your company's going to play out on this on this continuum of a shift going on one direction and some are going to work and some aren't


Scott Carson  9:51  

Some won't. So after good, maybe, Paul, tell us in the EU and some of the things what have you made some tangible examples of what you're speaking because I think Peter brings up a good point. This is a very grey process over the next few years, maybe it could have been five or 10 years. I think it's going to be a few years. But what are tangible examples right now?


Paul Tomasic  10:11  

Yeah, I think it starts with building trust between the clinician and the manufacturer or clinician, ultimately the patient community. And we've seen those models really emerge in Europe. Good example on that, as a company, that's been a tremendous success, starting in France, but now pan Europe called Dr. Lib, which now has about 300,000 doctors on his platform connecting 70 million patients around it. And this is a service that was originally set up really as a as a 24/7 connection between patients, in order for bookings with doctors, but you can start to see as as consumers get comfortable, clinicians get comfortable with the use of this platform to compare the service offering that that clinicians can deliver, they could start to drive products through that platform. And we've started to see that extension. There's a great example in the atomic sector of a company called brillon DE, which is a German company that's now gone panEuropean that originally was set up to link consumers with opticians and ophthalmologists for eye exams, and has now been able to move and evolve that model to a point where you can also start delivering some of that acuity testing in that case, remotely to two patients. Now, if you think about that concept from service to a device, if you now have the trust in patients along a platform like that, and start having the products that could do eye exams and retinal scans, remotely, you've now managed to bridge the service with the product and in a very powerful way that will really change the dynamic of how Thalmic care is delivered.


Scott Carson  12:02  

So what you just described as a pre mark, remarkable compression, you are taking out the providers that guys like us that wear glasses have to go get that eye exam to get the glasses, you're eliminating that you're also bringing the manufacturer directly to the provider or to the retailer, lowering cost by potentially 30 40%. So you're gonna see great compression there. The other thing that you just touched on is this convergence now of clinicians and patients collaborating in a rather remarkable way that we've never seen before, that are really driving the decisions upstream on what's purchased. Do you were touching on where you think this is going to move in the form of data on sites such like a consumer reports or report like websites? What did you mean by that?


Dale Koop  12:48  

Well, I mean, there's going to be easier access to information for the clinicians and the patients. Basically, what I touched on earlier is we're not dependent on the manufacturers to provide that information. Because with the advent of things like Tiktok and Instagram and influencers and these, this new generation of purchasers who grew up their native digitally, that's how they like to get information. There's a vacuum there to provide that information, because there's a need. And people see that and sites that can do comparison, and Amazon's a good example, you can go on there you can see reviews of actual buyers ratings, of all the different products that you're looking for. And whether it's Amazon or Consumer Reports, this information is now just readily available to everybody. And I think if Saturn would have waited till YouTube would've been successfull.


Scott Carson  13:49  

One of the things you touched on we were talking about this earlier is that 510 K CEs don't provide a lot of data. And so there just isn't much data out there to


Dale Koop  13:58  

look at. Well, the data is also even though it's the FDA has cleared it, it's also conflicted data because it's manufacturer provided data. It's not third party objective data that's provided there. And if you go on to the 510 case, you can't even get in well in our industry in the aesthetic industry on those products. You can't even get the relevant specifications, you get some filtered specifications or synthesized specifications that make the product look good. Or, more specifically, they're trying to make it look like a predicate device, even though it's not and so they they changed the way the specifications are actually shown in the FDA 510 K. So it looks like a predicate device, but then they go marketed in something new and unique.


Scott Carson  14:45  

So, Tom, we were talking earlier about and now that all this data is going to just naturally evolve because you have this convergence of clinicians and patients coming together. This data is going to start populating there's already a massive void One of the things you noticed working with a healthcare client is the lack of mastery and sales process and sales, education and salespeople. You came from the tech world, you're now part of a very large, global, digitally enabled firm. What are you seeing in healthcare that I think, you know, the healthcare leadership and investors here need to hear about about the sales, competency and mastery?


Tom Parsley  15:22  

Yeah, just just to put some context around that. I, my career has been working cross sector in digital transformation and working with sales and marketing teams and bringing them together. And I've done some work with a couple of couple of different health care, one prosthetic limb manufacturer, another case they, again struggling with their lack of access to HCPs, because of the VC process that you talked about Peter, what I was staggered by was was just how positively medieval some of the approach to B2B sales is and how siloed sales and marketing is at what is a B2B effectively industry. Now B2B tends to be a lot better having sales and marketing aligned in the area of tech, particularly in kind of tech startups and, and a lot of tech startups, I've got a similar profile to what you know, a lot of the brands that are attending this conference, and that are getting a lot of private equity investment. But yet, they don't seem to be learning from the big tech unicorns that are going down the kind of Rev ops model and measuring everything with revenue. So if you really simple things like sales qualification methods, like medic and bans and things that have been around in 1015 20 years in, in classic tech b2b sales, in healthcare, they just don't seem to have been able to move on from from that kind of relationship that they used to have. What I'm helping the clients to Credera working with at the moment is, and in this particular space, is to try and think more like a tech company in terms of how they understand the total buying persona at the app per client, or at the hospital or wherever the clinician, that the consultants, because no longer is this one person. So you've got to identify your champion, you got to identify your economic blight, you've got to identify your blockers, and then you've got to effectively liaise with your marketing to create material that's going to be available to them at the point where on their affinity loop of where they go from no brand awareness through to buying their 15th 16th thing from you, you are always available to tell them this is why we are the right step for you. And likewise, that data has to flow back into the decision making process as you guys touched on, you have to be able to understand this is what's working well and playing well in marketing. This is what from a sales point of view, whether that be interactivity, online, interactivity on social, that needs to play back into the decisions we make in product development going forward, and try and be more agile, which I know is tricky in this world. But try and find your agile, find your way of iterating find your way of trying to strip out process wherever you can to try and get what you're picking up from sales interactions and what your customers are telling you into how you move your product and how you move your business forward next.


Scott Carson  18:11  

If I'm sitting in the audience, and I'm listening to that, I'm like, You know what, there's massive regulatory barriers that will keep any of this from happening. And that's always been something I could count on to maintain a slow, as you said, medieval sales process. We've got two great minds here. One from the EU, one from the US. And in Paul and Peter. And, Paul, I'd like you to start and can can you as it relates to regulatory? Can you give us some examples maybe of how this is playing out in the US and potentially how this is playing out? Peter and in Europe and then Peter, how it's playing out in the US from a regulatory standpoint. 


Paul Tomasic  18:54  

Yeah maybe I'll start with with the European side, I think perhaps a still a step behind as to where it's gone in the US. But there's certainly increasing amount of momentum around getting, I would say Pan European systems in place in order to do it. There's a European directive that just is going through European Parliament now and March of this year, around creating a European data marketplace system for the first time ever one of the main thematics running through that is this system of interoperability. The ability for people not only to own and possess their own medical records, but then to have the systems the national systems that are in place in each individual country be able to talk to each other right so you'd have your system in France or Germany or it's gonna say the UK but no longer the UK in order to have these systems being able to to communicate with each other and really allow patients, but then also the delivery of care to transcend borders, I go back to the doctor lib example for a minute started off in France is now rapidly expanded into Italy, in Germany and other countries. So the other, I think thing that we're seeing is the company's prompting the regulatory system. Sometimes we think about regulation coming in place, corporates responding to regulation, I think in this area of the digital movement, we could be seeing it the other way around, where the technology that drive the demand from the consumers, and the technology is forcing the hand of the regulatory systems to in fact, change their policy. I sometimes refer to it as the anti Brexit dynamic where we are seeing this slow coming together of systems across Europe. In a way that's actually quite interesting.


Scott Carson  20:56  

Yeah, you just it typically we find regulatory behind kind of technology, but nearly in this case, what you just said is, is the manufacturers the service providers in health care will pull that with them exactly along with Peter, your thoughts? And


Peter Stebbins  21:11  

yes, so I guess one that just pulling up on both the points was, I think it's important for the audience who are largely in med tech, either med device companies, or digitally enabled to not just go oh my god, I'm not snowflake, I'm not gonna do this whole, you know, straight up b2b, you know, SaaS model. In fact, I one of the company advises a SaaS company for prior authorization. And I do, there are things that can be very easily pulled out, and probably already are somewhat being built. And again, my hands are saying, here's, here's that model of a classic b2b SaaS model. And over here is an old school, you know, rep focused. And that's the only point of this fear. But I think companies need to look at who are they in the world? Do they have any influence directly on patients or not? And to what extent can they have direct influence how much of a debt secondary through orthopedic surgeon, or how much of it's gonna be non existent because it's a, it's a heartfelt company or a neurosurgery company, and you're not really going to make a lot of benefit there. But the notion is, hey, we need to figure out how to get closer to over here. Yep, and understand what that means in terms of how that sales organization needs to shift a little bit in terms of our mentality, certainly the be more digital natives as a sales rep is good. But also, recognizing that people coming out of fellowship now are going to be you know, they've been playing Halo forever. So they're used to just kind of talking to people under headset and do lots of stuff at once. And that's, that's a mindset that they may be wanting to look on. LinkedIn is the right thing, but they may even want to learning information on LinkedIn or, or Twitter or whatever, kind of get that, that that marketing message. So therefore, you were that marketing team, you did not just have good brochures to be at meetings with that rep to handle or even to be honest, most device company didn't focus on, you know, surgeon education kind of either face to face or not virtually, kind of replicate that face to face, but more, you know, having it be off cycle and somehow learn on that. So I think from a regulatory perspective, you know, part it comes down to who can actually make the decision, I think the bigger issue to us is going to be to some extent the the payment system, right, in terms of you talked about having a service line, and it's not just a procedure as all the service around it. But the real challenge for for med device companies, Okay, where am I making money on that, right. So there are a lot of things that have been done, which have just become table stakes, that you're not getting credit for anyway. But now you have a whole complicated process in place to offer this, when in fact, that doesn't matter, they're still going to apply and the reimbursements be based on that, on that little piece there. And at the end of day, depending on the back end may or may not be able to steer your decision on, do you get to launch a new product? And importantly, do you get to defend against somebody else trying to take your share, because at the end of day, let's talk about orthopedics. Like you have a couple players in there, you want to bring somebody else in, they may not be a new company, but it's you know, an old product or established established product that you use down the street, you bring it in? How do you make sure your back is strong enough to keep that one out. And I do think that the notion of having some of the that data for some of the other elements that Dale was talking about, be available for biomedical engineering and for and for infection control and organize in such a way that people don't need to feel they need to scratch and claw to get the information to feel good about it. That is just it's just available in a very vac friendly format. And it's in it's trusted, and they can just pull that piece out, rather than having that rep who has other better if she has better things to do than try to pull that back.


Tom Parsley  24:47  

That's the thing though, about the vac friendly format, is that that isn't just one thing that isn't just two things that isn't just three things and that's I think a huge mind shift change from from what I've seen since spending a lot of this year as I say advising clients in this space is realizing that one method or one format, or one medium is not going to cut it any more. And you need to be able to have the key messages that you want to get across around the product where you're at who you help and why. And the pain points that you resolve for the lunch, we were talking about, you know, infection control, all these different things that go into a VAC. Why do you make? Why does your drug Why does your tech Why does your device make life easier? And what what pain points does it address for all of those various different members of the VAC, and bear in mind, each of those different personas might want to go after and get that information on different platforms simultaneously. And so you have to when you're planning how you're how you're go to market strategy for this new product, or tech or, or SAS, whatever is you're developing, you need to make sure you've accounted for how you're going to make sure your message is in place across that. And tech is the only way to scale that. So having something like a CDP in place customer data, something where you're able to plan your go to market through this message across these platforms in this sequential way, with some kind of digital asset management system. We're not talking huge investments in tech, it's just a fundamental getting your tech stack right at the point of going to market or at the point of rejuvenating and transforming your go to market. And that's where I think it's obvious disease


Peter Stebbins  26:24  

points, the fact that kind of come up, this is a biomed. And the IT rights, so we need to come up with firewalls or buy those are, again, big pain, sometimes for VAC, and if you can have a really good system that that's an opportunity. Well, you


Scott Carson  26:35  

guys said two things, I'm gonna try to tie them together. So Peter made this comment about you just can't give that surgeon a brochure. And you made a comment of a persona. It might be helpful, Tom, if you explain to everybody what a persona is, because this is a very important thing on the Infinity curve or infinity cycle that you were talking about earlier, that we believe in and is a kind of a point of reference. We've recently partnered with a dermatologist. He's not he hasn't even opened a practice yet. He's young, he's significantly involved in the space. He's actually just took his board. He's opened his practice. But he's got 18 million Tiktok followers. Yeah, 18 million. He is influencing patients decisions. He's influencing clinicians decisions, manufacturing decisions. So why does somebody what? Does he have a persona? And why does individual personas matter in the millennials that are now making decisions? And why doesn't this brochure help anymore?


Tom Parsley  27:28  

When it comes to the fact that there may well be a persona within your target market, to whom a brochure brochure is fine. And brilliant, doesn't mean you're not, you're never allowed to print anything. Again, that's not what we're talking about, that the whole idea of a persona is, you have your ideal customer persona, or your ideal customer profile. And that might be a particular consultant, there might be a particular clinician, it might be a dermatologist, but then within that, you need to break that down into okay, we've got our digitally native millennial. And in five to 10 years time, you're going to have even more digitally native people who have curated their own online presence since they left college since they finished their degree or started their degree, like, for example, a dermatologist friend with 18 million followers, I think you said, Yeah. So you're going to have a particularly savvy persona, who you might an influence a persona, if you like, who if you you know that if you can crack getting in front of those and get them to extol the virtues of your pain points, the things that are your USP is the reason why they would use you over a competitor, then you might put more of your effort into your marketing and sales resource to get more of those types of personas. So by persona, we simply mean, this is their job title, this is their age, this is the place they tend to like to get their information from this is the media that they are most comfortable, or rather than the different mediums they're most comfortable interacting with us in and then you start to build marketing campaigns around that and sales campaigns around that. But But yeah, the important thing is you can't just say I will we sell to dermatologists, right, that's the customer persona done. There is just too many different ways in which that a dermatologist and the people around that dermatologist or their could their clinic are going to make decisions. And crucially, if you're new to the market, find out about new products, because they're not all going to be coming to conferences. They're not all going to be watching live streams of, of med tech conferences. They are going to be getting things via Tik Tok via YouTube via pre roll ads on YouTube, et cetera.


Paul Tomasic  29:30  

I think if I could have said that, I think there's also a data generation point that is very, very important. You know, for years, the production of clinical data in the mindset of the healthcare industry has been to get approval for products. The reason you go out primarily to do clinical studies evaluations is to get your FDA approval to get your CE mark. I think what we're also talking about is a world where the data that you'll generate back to the Consumer Reports concept for medtech is needs needs to be an ongoing process in order to continue the communication loop with clinicians, but also with patients, you've seen that very much in the pharmaceutical industry where you've seen a surge in really two things, you've seen the concept of phase four clinical studies, where more and more money is going into not only getting through phase three clinical trials, but the after market analysis, which is partly a regulatory concept, but also partly a marketing concept. You've seen the emergence of outsourcing as another example, again, in pharma. And also in med tech, where I think there's an acknowledgment that in order to do more, you may need to go out of the bounds of your organization in order to get third party providers to add to that. So I think there's an element absolutely of delivering the message and how it's delivered to the clinicians and the patients. But I think what that's going to feed into is also a need to generate more data.


Peter Stebbins  31:03  

One thing I want to jump out from him before I had been director marketing for free Europe for a coffee for a while, and I was very struck by that we've been talking a lot about the US. But I think for this audience, we start tomorrow, in in Europe, but there were there was very struck by how important the chief was the professor with a capital P, right, they have a lot of control. And to this day, they still seem to have a lot of control. Again, all of this decision making may kind of like the dam may break overnight, and it goes quickly. And if it does, I think it could be because the other element that it was always more in, in Europe and Latin America and Asia pack is the the RFP process. So there's really a much more formal bidding process. And again, to Dale's point, I really think the opportunity for that sweet spot of like having the best data and winning business might be in the ability to have the most elegant, user friendly, when someone's doing a, you know, a bid for the NHS or for, you know, the city of Mumbai or whatever, to have some really good information there in such a way that everybody has a checklist to fill out. But if you can actually win that bid through just being better organized than the others, I think there could be an opportunity to accelerate that shift.


Scott Carson  32:16  

You guys are touching on a few things that I wanted to bring up is, in a few discussions we've had over the last two days, we've heard from some leadership CEOs, they said, Well, Scott, we have a marketing department, we have a sales department, we're just going to kind of pivot these guys a little bit and it all be good. And I am sitting there kind of struck that, that that isn't going to work. They can't pivot quick enough, you're going to have to be thinking CRO CSO, you're going to have to be thinking data analytics. And so I guess I want to go back to you, Tom for just a second or talk about that, then I'm gonna go over to Paul and something. But can you explain why just trying to make adjustments to sales and marketing is going to work and maybe even Dale, you talk about over the years over the last few decades, pretty much everybody has learned to distrust salespeople because they all have the single best product to sell. So kind of throw it out there about sales and marketing, maybe not being able to pivot and kind of sales perception. And then I want to circle back to Paul.


Tom Parsley  33:17  

Yes, I think the is less of a case of pivoting and more of a case of aligning, the salespeople need to behave much more like marketers. And there's a term Account Based Marketing, or account based sales, when that's applied to marketing, whereby effectively what you're doing is you're picking one particular brand, one particular target. And that might be one specific consultant, one specific professor, or it might be a university if you sell into that place, or it might be a an a hospital. And then what you do is you build a campaign over 12 months or 18 months where you effectively make sure you map out I'm going to make sure I see them at these three conference conferences. I'm going to make sure that I go to three of their events, I'm going to make sure that I provide these key milestones through our development, r&d year, whatever we have is whichever brand we are. And I'm going to give them these updates that are personalized to because they're in the south of England because they are in the Midwest, because they are dermatology, because whatever, this is the specific spin to them. And salespeople will say Well, that's what I do. And I have conversations Yeah, brilliant. But you need to think about that in material and in content. And there needs to be video and it needs to be available online. It needs to be available, not when you're there shaking hands. And from a marketing point of view, they the way they need to align is they need to make that easier for the salespeople. So it might be that you need fewer reps. And what you need is reps to work better with sales reps to work better with marketing to say hey, this is what has always worked face to face for me. I need you to basically move that online give me that personalization. So that I am able to spread that throughout my kind of account based on plan that I've put together to target these core people that I have to make sure I get in by the end of the year.


Scott Carson  35:07  

You know, as we wrap up here, I want to just kind of maybe bring this together a little bit is all the things that we're discussing are regarding the democratization of trust, is, what I mean by that is that we're not necessarily creating a new industry. But really what we're doing is providing information out there, that allows clinicians and patients to make better decisions based on trust, based on information. And I'm going to circle back on a couple of things. But there was one point I wanted to bring up, Paul Paul, that you had talked about, that you're seeing within within equity is buying traditional distribution that have that last mile relationship, and digital firms are coming over the top of it, and white labeling private labeling into that distribution channels. So they're getting, they're buying it a one or two times multiple, they're coming in laying in tech and getting a massive multiple.


Paul Tomasic  35:57  

Yeah, I'll use an old adage to bring all this together. But as you know, follow the money as to where investment dollars are going. You know, we've had a trend in the last five to 10 years where if you look at any sub sector within healthcare, this is a cross services farm, a specialty farm, etc. The greatest increase in valuation multiples is, has been in medical devices, we've seen medical product multiples go from for more established companies and in the low double digits, high single digits up to the high teens, and certainly north of 20 times profits. Conversely, I think what we're now seeing in the last two years is people trying to think about other ways they could capitalize on that trend, perhaps by going into distribution models, disrupting those distribution models, or put a different way, using those distribution models in a way that they could leverage those platforms for own product sales. So at a high level, what does that mean? It means being able to instead of spending 20 times EBIT da to buy an established products company, you know, maybe the route is to buy a distribution company with that kind of power at a at a less expensive multiple. And being able to put own products in a more intelligent way through that platform, that distribution platform, use some of the digital means to optimize the way of selling that product, and finding better ways to maximize the end result of those product sales, but actually doing it via a distribution platform to start with. And I think that's been one of the big investment themes, certainly that we've observed in Europe over the last couple of years. And it's really a different way to play the products market, which is getting arguably too expensive, via the distribution route to do that.


Scott Carson  37:55  

And I think that's as we look to wrap up in the in the minute that we have. I'm somewhat known for saying things that are a bit of a stretch, but I'm gonna throw some things out there. We were talking a little bit about Saturn. You know, Saturn didn't make it but you know what, nobody 20 years ago and automotives was talking about Tesla. But now everybody's talking about Tesla and trying to become Tesla. And I would believe that what this med tech doesn't realize is brands don't matter right now. And in 20 years in this space, they're going to matter less, because we're seeing brands now be created in a moment. And that's because of the digitization that's taking place so quickly. So granted, there's going to be some gray out there, but I also think there's going to be some radical change. Gentlemen, thank you. That's good. Learned a lot. And super pleasure. It's great. Thanks.


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