Investing in Tomorrow, Today: What Are Europe's Emerging VC Leaders Betting On? | LSI Europe '23


Melissa Lezameta

Melissa Lezameta

Associate, Epidarex
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Maite Malet

Maite Malet

Investment & Corporate Development, Asabys Partners
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Estelle Botbol

Estelle Botbol

Associate, Speedinvest
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Austin Sawyer

Austin Sawyer

Associate, Nina Capital
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Beatriz Volckaert Almansa

Beatriz Volckaert Almansa

Senior Associate, Philips Ventures
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This discussion will review and assess the evolving trends within the healthtech, medtech, and biotech landscapes, exploring strategies to bolster these ecosystems amidst the prevailing investment climate.



Melissa Lezameta  0:05  
Thank you. Thank you everybody. Um, so maybe we could go just briefly over our funds. And you know, as for Henry said, what we're investing in these days. So just very, very brief summary of what all your funds are investing in.

Beatriz Volckaert Almansa  0:18  
So I'm Beatriz Volckaert of the Philips ventures team, the corporate venture arm at Philips, we are mainly investing in medtech and digital health companies in early stage across the globe, and Malian companies that are on strategy for our business units. We invest from consumer health oriented products to connected care, patient diagnosis, enterprise informatics, and image guided therapy. So a pleasure to be here. Thanks.

Austin Sawyer  0:48  
Hey, everyone, my name is Austin, part of Nina Capital. We're an early stage Health Tech fund focusing on pre seed and seed stage companies. We're based in Barcelona, but we invest all across the world. So Europe, UK, North America, and Israel, writing checks up to a million euros when we first come into companies and then following on to the next round for the most promising portfolio companies. And we invest in health tech in general. So in our portfolio, you'll see combinations of software and hardware and also more digital plays centered around data and computation.

Estelle Botbol  1:18  
Hi, everyone, so I missed out I work at at speed invest. And we're a venture capital fund that originated in Vienna, but now we're a Pan European. So we have offices in London, Paris, Berlin, Munich, and Vienna. And we're also a very early stage fund. So we invest that pre seed and seed stage. And we have six different teams that work across different verticals, including climate deep tech, and I'm part of the health and tech bio team, in which we invest in digital solutions, and also tech bio, which is like the new fancy name for Tools for Life Sciences. So yeah.

Maite Malet  1:52  
Hi, everyone, my turn from a service services venture capital firm, based in Barcelona, I'm actually based in New York, we invest both in biotech and also health tech, it's 50/50. And health tech includes both from traditional medical devices, so invasive medical devices, but also, anything with regards to digital medicine AI, we usually invest between seed to Series B, I'd say, it really depends. It goes case by case, we usually say we're agnostic, so we can look into anything really, super hands on investor, we like to help our companies as much as possible. Initial cheque size is usually around 4 million. And we can invest up to 50 million per company. And we have a geographic preference for European based companies, especially because team is here. I'd say probably like 40 50%, in Spain, and then the rest across Europe, and some in the US Israel, really case by case. Happy to be here. 

Melissa Lezameta  2:48  
Perfect. Thank you all. So maybe, because we're all associates here, we could take advantage of that a little bit and kind of introduce also the role of an associate and how these different roles within VC, and what we all do, and how associates were also a different avenue for founders to approach with their projects and their companies. So Maite I'll let you take it in. Find out a little bit.

Maite Malet  3:13  
Yeah, I mean, I guess it really the first fund by fund in general, depending on how big the fund is, but I'd say analysts in general they focus more on what has to do with different sourcing trends in the industry. Yeah, industry analysis, associate senior associate that says more hands on on speaking with founders understanding the deal, and also very much involved in everything that has to do with due diligence. Usually, Director/principal, I'd say more on executing actually the deal setting the term sheet. And partners, I'd say more than portfolio management. But like, for example, at Asabys, we always have usually like to be board, the board board director and then an observer. And it's always usually, the director is usually one of the partners of the firm, and then one of the associates take the observer role, so they can actually follow on that portfolio on a company and monitor it. I don't know if it's different than

Melissa Lezameta  4:10  
Yeah, where maybe from a corporate perspective, I know you have a lot of different roles too. And it's, it can be a little more complex and more diverse. So maybe you want to also explain that a bit. 

Beatriz Volckaert Almansa  4:19  
Yeah, sure. Well, yeah, I wanted to mention it because she had slightly different from our previous VC. So at the end, like the ventures team needs to team up with the business unit, their strategies, business development teams. And at the end, well, it's quite interesting dynamic. We need to kind of like be a bit into entrepreneurs inside the company and try to pitch also those companies, to multiple people. It's, yeah, it's an interesting process. And at the end, once you invest, it's kind of like, better of course for the company because you already open, open up these doors, and it's easier to scale it. But yeah, like just just wanted to mention it because for startups not, you don't need to just reach out to the ventures team but also to those a business unit or, or strategist person. 

Melissa Lezameta  5:18  
Perfect. Some of your question for both Austin and Estelle, one thing that we've seen along in this conference is how digital sales is just booming now. And that's obviously something that wasn't happening as much 10 years ago. And with it comes new challenges. So now moving forward, you know, it's been going on for a few years now. But moving forward, I think with with the boom, it's getting harder and harder to differentiate in this area. So when you're looking at new investments in digital, what are things that you're looking for? How do you see that?

Austin Sawyer  5:54  
Yeah, of course. So I think one of the things that's really difficult is, we've had to evolve in terms of our definition of what defensibility is, I think, when you invest in hardware, or deep tech type technologies, you can look at IP, or you can look at, you know, the technical barrier of the team, maybe they have, they've had some great research coming out of r&d labs and universities. And I think you know, what the boom of AI is, especially it's lowered that technical barrier. And now, you can't really assess companies in the same way. So I think that there's a couple of different things that we're using, first of all, is really recognizing unique workflows, I think that you know, when you see a variety of different companies trying to use AI tools for you know, X thing to improve efficiency, people think that they're the same, but in reality, they're really not like a good example of it is in hospital communication, very, you know, vague type vertical that everyone thinks is a very crowded market. But one of the things that we were looking at was how to approach urgent communication. So when you look at, for example, the pager systems and it not being reinvented for years, I think it has very different requirements. And we ended up you know, making a bet in that space, because we were just blown away by the founders knowledge of how that information had to be digested through the hospital system. And it was extremely complex to try and make the relationships and be integrated within the technologies in the same way. So you know, first look, the pitch deck, you say, Oh, this is just another communication play. But when you dive deeper, and really understand their knowledge of the space, and then being a student of the healthcare system, that was interesting. And I think, you know, on a broader sense, one of the areas that's exploding is revenue cycle management in general, you know, anything from prior authorizations to medical coding. And it's it's kind of a similar sense in terms of trying to assess what is novel about those technologies. And you can use workflows, like I just mentioned, or also you can have really unique datasets. So it's often it's very hard to capture clinical data and data from the insurance agencies together, and have those datasets at the early stages of companies. So we're seeing founders getting very creative in terms of early partnerships and creating models that do have somewhat of a technical defensibility based on those data sets. So I think, based on those two combinations, that's really how we're trying to evolve our definition of defensibility. And trying to assess founders across those areas.

Estelle Botbol  8:12  
Yeah, I definitely agree with with what you just said. And I think the way we look at it is that there's three different layers, there's the data access layer, the technology, and then customer and responding to their needs. And what we see is that value is getting increasingly put at these two edges. So at the data access, and making sure that you respond to, to client's needs. And by data access, I mean that a lot of companies will need to access complex datasets from hospitals, and often you will see that they will be running around to get access to this data. So it's actually more complex than than it should be. So having a company that really sits on on a goldmine of data that is partnering with a hospital from the start, is really something that we find exciting. On the technology side, AI is becoming more accessible. And and I think what we're starting to see is that in digital health, some companies are going as well as integrating more hardware or wetlab solutions on top of digital. And that can scare off a lot of like PureTech VCs, but we get quite excited by it. And a good example is a French company called Oracle Oncology. They're building 3d tumors. And they're sitting on data from the use of OC Institute where they get exclusive access. And with the combination of the digital data, AI and the data that they get from these 3d tumors, they can really capture the full cancer complexity. So I think it's quite interesting to see those hybrid models to have higher barriers to entry than like a pure software solution. And then obviously, having the right connections to corporates, the pharma, medtech companies, so assess their needs and really understanding who's the right person to talk to So can be quite complex as well. So making sure that the team knows how to navigate the different teams within pharma or corporates is also something that we look at.

Austin Sawyer  10:09  
The hybrid models, just one more point on that I think that's really interesting is what COVID kind of push telehealth companies and push kind of care away from the hospital. And I think, you know, we've seen people having a lot of trouble in terms of the hospitals now wanting ownership to shift back to the hospital of patients. So you have all these telehealth point solutions that now need to come back and really embrace hybrid care. And that is a whole new layer of problems in terms of interoperability. So we see a lot of digital companies actually trying to offer in some sort of service player actually deliver care to try and integrate that. And I think, as you said, it's it's a way that they can really differentiate, and that's coming back.

Melissa Lezameta  10:47  
Excellent, thanks. Um, so maybe, often cuz you guys do a lot of devices, too. When you see like new breakthroughs in an indication, let's say like we've had recently with Alzheimer's, does that influence at all how you look at new companies new opportunities in the device section, where they're also targeting the same indication? Does it affect your strategy at all? 

Austin Sawyer  11:11  
Yeah, I think, you know, the Alzheimer's boom has been exciting, but difficult at the same time. So for example, like, you know, there was, I think the FDA clearances were only in July. And I think there's something like 140 in the pipeline and clinical trials right now. So I think what we're trying to assess is really, when is the right time to get into that. And I think you can kind of look at the Alzheimer's space, and at least from our perspective, in two ways, so there's the clinical side of things that I think is still kind of up in the air with reimbursement, there's so new and the adoption hasn't really reached the scale yet, where people are in the clinical domain have business models that make a whole lot of sense. So I think we're following that area closely. But it's still challenging in our domain. And then the second area that's really interesting is looking at it from more of a pharma angle. So paying very close attention to at first kind of the troubles that they experienced in the clinical trials. So finding these patients detection, following through with these patients and having more companion diagnostics is interesting, and then following the patients over time. And we think that's an area that's really exciting right now, and it's probably reaching the time of inflection a little bit faster, is looking at the budgets from from a pharmaceutical perspective. So I'd say, Yeah, we're excited. But I think it's just the timing is something that's really tricky to figure out.

Melissa Lezameta  12:24  
Maybe from a corporate perspective, because we haven't touched much on it. What do you think are new areas up and coming? That are really exciting to you? 

Beatriz Volckaert Almansa  12:32  
Yeah, so um, maybe? Well, first of all, like the site from the perspective from Philips, and then what I've been seeing around. So while Philips, it's mainly focused on the three main therapeutic area, so cardiology, neurology oncology. At the end, like before, we're selling mostly like products. Now we're trying to sell more services across the healthcare continuum, to go through the customers at our hospitals. So from prevention, to diagnosis to treatment, monitoring, home, home monitoring. And while there's a lot of momentum on hybrid care solutions, automating primary care, accelerating the more out of hospital healthcare experiences. And for example, like one, one business that now it's quite clear for Philips is the enterprise informatics business, and at the end is trying to empower healthcare providers with data software's plus Harvard in order to in order to Yeah, like have better operational efficiency. And yeah, at the end, make better informed decisions. Another another trend that we've that we've been seeing is the use of generative AI on diagnostics and treatment. At the end, there are so many, so many applications. And again, more than the 80% of the AI solvers are mainly focused on on radiology too. And it's one of our core businesses, so and also like the users, clinicians, and patients are also our customers, so.

Melissa Lezameta  14:26  
you've already mentioned a bit you know, like the new things you're seeing in digital, one thing that's really seems like it's growing a lot is the area of management tools for physicians and hospitals. How difficult is it to differentiate here and I guess how much of a barrier that physicians know of all these tools and take them on? 

Estelle Botbol  14:49  
Yeah, no, I think it's definitely a really interesting space. So the first thing that we noticed is that there's this issue of caregiver burnout. So the The population is aging. But the number of clinicians and caregivers that are getting admitted doesn't change that much. So that means that they're getting more and more demand for health care services, but they don't necessarily have the capacity to do it. And as people leave, there aren't enough replacements. So there's really this issue where there's an increasing pressure on hospitals and healthcare systems. And I think that's probably the right time for AI solutions and, and to really enter the hospitals to alleviate the load of of caregivers. And I think that tools that we're quite excited about are some of the ones you mentioned, but really tools that can alleviate the administrative task burden. So AI for automation of these tasks of patient onboarding, or discharge, all these things that take a lot of the time of doctors and caregivers, I think are super interesting. But there's definitely a challenge. And in getting those solutions within hospitals, first of all, hospitals have very limited budgets for new technologies. So it's often very hard to sell very long cell cycles. And then there's also the issue of adoption from clinicians. And I have a friend who's a who's a surgeon in a French hospital, and she told me that there's often some conferences around new technologies that would come to the hospital. But no one actually has time to go to these conferences. So the rooms are often empty. And so doctors don't have the time to be aware of these solutions. And that creates quite an issue as well. So it probably would have to go towards like the education part, when they're still learning how to be doctors to know how to integrate these solutions. But it's a it's definitely a sector that's picking up. Yeah,

Melissa Lezameta  16:37  
I'm assuming as a follow up on that, like, yeah, because timing, is the time available to physicians, definitely, that's always been a limitation. So like, you know, can there be better ways, you know, to fully founders, to make all these technologies known to clinicians, I think we have to start thinking about more creative ways to get to get that out there to get information out there and to train them. And just so that they know the breadth and the scope of things that are available to them.

I think it's key to point on this, some of the struggles that we've seen, either with our portfolio companies, or new coverage that we're looking at, is usually the implementation within hospitals, and how really finding, let's say, those 510 KOLs, that are like the leaders within their hospitals, it's kind of key to dedicate like a lot of efforts and resources on trying to train them as much as possible, and for them to be the leaders within the organization. So a lot of times, they're like, No, we've been selling here, here, here, but it just taking like, let's say, 8 12 14 months to really get through the door, and suddenly you pick like the right person at that hospital that really falls in love with the technology, which is the one that pushes it forward. So

It's picking a leader.

Austin Sawyer  17:53  
What one additional challenge, too is, at least from what we've seen is there's almost more of a challenge convincing and educating the IT department physicians. So I think you know, that's still a huge blocker, in our opinion, and,

Melissa Lezameta  18:06  
"Oh, it's more work for us!" 

Austin Sawyer  18:08  
Yeah, and you know, they don't necessarily want point solutions, they already have maybe a player that as part of it, they expect them to go horizontally and expand. So I think that's one of the areas that still really hasn't been cracked, and often, at least from our perspective is almost more difficult than convincing the clinicians, especially in these type of more management, automation solutions.

Melissa Lezameta  18:26  
Interesting. So we've heard a lot and we all know what the market situation is right now and how it's been. My dad was wondering if you know, as VCs, as corporates, how can we help our companies? How can we help them come up with creative solutions? How can we help our portfolio companies, you know, with the network, who they connect with, or you know, to get a different exit to what we're used to? You have any examples?

Maite Malet  18:52  
Yeah, tricky question. Well, definitely the situation right now, of course, hasn't been the best. Hopefully, that changes with both public and almost private markets closed. But some of the things that we've done, we just recently announced the merger between Amelia Mutual Care, which was one of our portfolio companies here in Barcelona, leveraging VR to treat mental health disorders. And we merged that company with XR health, which was the leading VR company in the US focused on physical therapy and occupational therapy. And it was throughout the process of thinking, okay, how can we ensure that this company starts scaling faster or growing faster entering this new market sometimes, like being a Spanish company can be tough. I mean, we already know how fragmented the European market is. So sometimes to jump from country to country is kind of tough, and we'll kind of like Target the US as the next big thing. So that was like an exit for this company to actually be able to be part of a bigger or same size but like, more distributed Across payers and health systems in the US organization. And for both of them start targeting other type of clients therapeutic areas, which are completely synergistic. And opening bigger markets. So that was one kind of like an exit that we've announced recently with this. Now this company is part of xr health, and they're able to leverage the team that they have in Europe, with the teams that you have in the US, this company is also present in Israel. So that was one opportunity for this company to actually start, you know, reaching, I'd say, other markets, other targets and grow faster. So it doesn't necessarily need to be, you know, the traditional m&a process of just selling the company and IPO. Yeah, but we're definitely very hands on investors. In this regard. We're always looking for either corporate VCs to join with us, like we've co-invested with several of the corporates. DDC were friend recently, which they were here yesterday to. Because we think like always having a corporate in the room also helps with regards to try and to such as Philips, right, implementing that technology within their current network. We've gone visited with Medtronic, Baxter and several others. 

Melissa Lezameta  21:15  
So maybe we can throw this question at then from the corporate perspective, DC. Oh, so you know, can can you how can you support the companies and bring in some creative solutions?

Beatriz Volckaert Almansa  21:27  
Yeah, no, I can also echo what Maite said, we have been also seeing kind of like this merger. So companies are seeking for maybe some, like smaller players, more scale ups. So also the scale app can also access to the investor network that the previous company, the company has, and also in the US, yeah, like many companies are seeking to be sold to a large companies. Yeah. So these from the exits perspective, and how we, we bring value at the end? Well, I can't, in other panels, I've been hearing this also, that this year was the bridge, the bridge here, literally. So in order to, you know, to fund all these companies, supporting from a partnership perspective, it was key also from our side, and trying to strengthen and open kind of like the doors to our customers.

Melissa Lezameta  22:26  
So I also see a bit of an opportunity here to maybe discuss some regional differences, because every one of you here is based in a different place. So you know, we have New York, Paris, Barcelona, the Netherlands. So are we seeing any regional differences on both how the market is treating these different sectors and also hot technologies that are maybe popping up specifically in different regions? Or can you see any differences at all?

Maite Malet  22:50  
It's a US Europe, a lot of the deal flow that we're getting from the US lately, it's very much focused on efficiency tools. So let's say reducing admin burden, especially lowering costs, I mean, of course, the US have like one of the biggest problems healthcare wise. So I feel there, we've been seeing a lot more of this, take enablement tools for payers to actually do things better, more efficient, less costly. Whereas in Europe, we're have been seen more solutions within the diagnosis treatment space, trying to help diagnose faster, let's say, AI for pathology, to diagnose faster, or in the radiology space, same thing, being able to diagnose what type of cancer that patient has. I'd say we are getting more of this in Europe than pure efficiency tools in the US.

Estelle Botbol  23:46  
So I'm looking mostly at France, also the Netherlands and Spain. I would say that France has been innovating a lot in terms of hospitals solutions. So I've been seeing a lot of generative AI tools for diagnostics. So one company called Radium, for example, that just emerged in France. That's that's doing it for radiology. But there's also matrices AI for endometriosis. And I think that these reports are quite interesting as well, to discover new biomarkers for diseases like endometriosis, where the diagnostic is still quite unclear. So I see a lot of these new gen AI diagnostic tools coming up in France. In the Netherlands, life sciences tools are quite good. So the Netherlands is quite famous for its biotech ecosystem. There's a lot of really good biotech VCs there and a really good really good research institutes and laden ETFs. And so I see a lot of tools as well addressing challenges for for biotech and pharma companies and the drug development side emerging there. And that's also the same first vein I would say there's with the Barcelona Health Hub and a lot of different startups operating in the life sciences tool space that I find quite interesting.

Austin Sawyer  24:58  
Yeah, Netherlands has has been really interesting from like a computational biology perspective. Yeah, I think we've seen quite a lot in that space. In Spain, we've seen you know, the fertility research here is fantastic. I've seen, like, we made a bet in the pharmacy space helping Polly medicated patients kind of organize their medications and get that delivered. That was really interesting. In the States, besides efficiency, we've seen a fair amount around trying to gather like longitudinal patient records, for example, for some type of novel research with like pharmaceutical companies trying to develop some sort of solutions. So that's been interesting, a lot of strong like device plays Switzerland, so for example, like invasive cardiovascular devices and stuff like that. And then in the UK, a massive push into like care coordination. So trying to figure out like, who is the next doctor that I should see? How do we optimize this? How do we make it cost less and then hospital at home programs as well? 

Beatriz Volckaert Almansa  25:50  
Yeah, maybe, to provide another perspective from the funding side perspective. So for example, in the US, we are seeing a bit more like a down round. So a bit more aggressive on terms versus Europe that is more like flat rounds, or even just convertibles. And also, I wanted to mention that while like corporate VCs at the end, we've been not that impacted from from the public market as much in the VC space, as much as as maybe VC is. And at the end, it's all related to the to the market cap. And if there's money to invest on it's more like instead of near term through your money like that, from the from the market more like, Okay, makes sense from a strategic perspective. So we can invest.

Melissa Lezameta  26:40  
For more on this question. How about, like women's health? Have you all been seeing it? A big rise? And that? Is that also a bit regional? Or is that more of a general?

Maite Malet  26:54  
I'd say I've seen it across industry, like the pickup is crazy. I think what we're struggling to find there is more like, companies actually implementing that. Like we've seen a lot of very early stage women's health companies coming out, we usually in health tech, try to focus more on companies that at least have some early stage revenues, which has been tougher. But I think women's health, we've seen a lot of in the fertility, menstrual side of it, not that much. In other it's a more acute care condition, or diagnosis for specific things, which is something that we're missing there. I think like there's been a lot for patient monitoring on how to, you know, control, monitor your symptoms, I still there's, there's a huge need there. We at Asabys, like we're highly looking for companies in the femtech women sell space, like we think it's like a Tegrity that lacks a lot of funding. Definitely. I don't know what you've seen there. Yeah,

Austin Sawyer  27:50  
I think there's, at least from our perspective, like, historically, some of the bigger companies, they're very broad in terms of how they approach women's health, especially in the digital space. So for example, like, we see a lot of attractive solutions that are really diving into the core need in a better way. So for example, like menopause is an area that we've made a bet in, or like endometriosis, they're actually following the symptoms in a more dynamic way. And I think a lot of the problems with, you know, more generic telehealth companies is, by the time they actually get you care, your symptoms have shifted. And so I think they're, I think companies are being really creative in that in that realm, we've seen quite a bit in like maternal monitoring. So like, for example, you know, AI solutions for ultrasound during different times in pregnancy. And then we've seen quite a bit or at least had an interest in like, the children's health space. So kind of like right after birth, with the parents relationship with, like graduating from the NICU and kind of more holistic family care, in terms of from birth all the way up to like six months.

Melissa Lezameta  28:48  
Exciting. So you guys do very early stage to invest. Often, from basically what I'm looking at. So I was wondering, you know, like, for for digital health, when they're very early companies, you know, what are some of those roadblocks that these companies are facing in implementation? What are the first, you know, how can they put together right from the beginning a strategy? Or how can they improve the way they connect with the key state stakeholders, like we've been talking? It's really important, you know, what, what can they do in those early stages to improve on their strategy and implementation? 

Austin Sawyer  29:26  
Yeah, I think I'm gonna sound like a broken record with the IT situation. So I'll leave that behind. But I think, you know, in terms of capturing initial data to actually show a proof point, I think, you know, utilizing these consortiums that you see around the world, or biobanks can be interesting. So for example, like UK, Australia has an interesting one. There's even one in New York, that's a nonprofit that feeds in data from all the hospitals that you can approach. So there's a lot of creative ways that you can get access to those kinds of data without just approaching the hospital. So that's one area where we think really differentiates a lot of companies. and doing a little bit more research around like the competitive analysis and really understanding where they fit into the system, like your answers shouldn't shouldn't just be the markets big enough, we're gonna fit with these other competitors like really understanding and being thoughtful about your implementation. From a technology perspective, I mean, using true applications of AI and generative AI, instead of just slapping it on a pitch deck and saying, like, Woohoo, we fit your thesis, I think that's like a big one is actually making sure that your technology development isn't just to hype up a VC to fit their thesis that it actually is solving a critical need, and that you're utilizing that technology in a way that it you get the most out of it. That's most of the pieces of advice that we're trying to see. And I think a lot of companies in the early stages in digital health are almost over engineering their solution, where you could just mock it up on some sort of like even using G Suite, for example, and some of the more efficiency plays. So people are going and trying to spend a bunch of money in their pre seed rounds on trying to grade these fancy UIs and fancy technologies, where we're not really seeing it make the difference at the end of the day. So just being more thoughtful about how you're spending your money from a technology perspective, and figuring out like, is this outsourced? Is this insourced? What is actually going to make the difference for the next round? And what's going to convince the customer to make that push to adopt a pilot trial or actually buy the technology and just being a little bit more sensitive about how you're spending money, I think as well. 

Melissa Lezameta  31:26  
Yeah, definitely. So Beatriz, on the corporate side, and, you know, in this market, and what we've been seeing, like, how have you been seeing the exits? And how do you see that in the next few months? Do you think it's going to change?

Beatriz Volckaert Almansa  31:41  
Yeah, like, I think that, at the end, like the market will will be consolidated across across tech. So we're seeing it with with example that that Maite was was showing before, and some more examples in the US from Yeah, from my corporate site perspective, maybe companies that are a bit more, you know, like focus on the on the record business, you know, like if a company makes make sense, from a pure software plus hardware perspective, they might be way more open to to acquire them. The size of the deal might be a bit different versus versus past years. But yeah, I expect this this constellation, I'm just trying. 

Melissa Lezameta  32:29  
So I think like, for example, in the, you know, what are some of the challenges, Maite, as VCs that we can, you know, help fill just just from the VC perspective in until the market normalizes until it gets there? What, what can we as VCs do, specifically, what can we help with?

Maite Malet  32:48  
I mean, what we've been doing with our portfolio companies has been pushing them as much as possible, and helping them kind of like, rethink their actual business models and how to extend their cash as much as possible, make sure that those plans are visible in a way that, okay, let's focus on if we put some more internal rounds, because we've done it with some of our portfolio companies, the current shareholders, like, what's this money going to take you to? And how can you hit that inflection point that's actually be valuable for the rest of the industry. So a lot of, you know, sit down, brainstorm on really what the next step should be severed in turnarounds, but then the other thing that we're also doing is making sure that the network so VCs, we are really connected, and I feel more and more like, especially associates and senior associates, like we're all networking and sharing deals between each other. So that I think there's a lot of times that I would just with with one CEO or recently, and she was telling me about her, her company, and I was like, Okay, this is not a fit for us. But I know this five VCs that are looking into this, so I'm happy to make the intros. So I feel like we can be a lot more hands on and trying to support the industry as a whole to make sure that the money flows where it needs to be. And I would I would I really think there's a need is more on the growth stage. medtech Healthtech, like we feel like for like seed, pre-seed, series A has been covered lately, there's a lot more funds, usually supporting this. And some of the spaces that we're seeing, like lack of funding is around that gross state Series C, Series B, these companies that already have like nice revenues, but still need a bit more push to really scale. And still not in the pre IPO rounds, where you know, the Blackrocks of the world are gonna come. So I think there's an opportunity there.

Melissa Lezameta  34:44  
Yeah, I agree. And we've been doing kind of the same similar thing that you're describing now. I mean, I think this last year, we've definitely set in, you know, scheduled calls with different VCs to kind of share opportunities that maybe we wouldn't take on and sort of help the flow of money there.

Austin Sawyer  35:01  
So I think, one thing is like, especially at the pre seed and seed stage, making sure that we're keeping tabs on realistic sales cycles. So for example, like, if we have a precede company, they don't necessarily have time to go survey the market and talk to like pharma and hospitals and some of their potential customers on what's realistic. And so really trying to make sure that we're doing that work in terms of like, here's what's actually realistic, it's not six months, it's 15, or it's two years, or it's three years, or you shouldn't be trying to catch the big fish right off the bat, you should be going for the small customers. So I think if you do that correctly, and educate them in a way, then you can make their runways last longer, and actually make them get the revenues that will help them in the next round. Obviously, that's hard and challenging, where you have companies in the later stages have already hit that roadblock. But I think that's one of the most critical things that I see a lot of people running into lately, and they're not necessarily getting the advice that they need. Okay.

Melissa Lezameta  35:56  
And I guess maybe one last question. That's coming to an end, now. And this is a bit of a harder discussion about digital therapeutics, specifically, and maybe we can all have a little thought on this. And how are you seeing that? And I was seeing Finally, some bits and pieces coming together around the reimbursement. How is this gonna look in the next few months? Next couple years? And, again, is this an area where we might see new growth again? Or are we still in a sort of pause and wait kind of situation?

Estelle Botbol  36:29  
Yeah, I think digital Therapeutics is definitely a really exciting field for patients. Also, for pharma companies that are developing drugs and want to have a companion tool to it. There's been issues with with founders focusing a lot on reimbursement and sometimes not enough on on making the product sticky enough for patients or making sure that it's adopted by clinicians that they would prescribe it. I think that now, like different European countries are aware of it, they're trying to find synergies and ways to make it easier. But I think some interesting things that we've seen as well in our portfolio, because we have invested in four D tech companies, one of them is called Charles and they went for like a full like b2c approach to start with, which was quite interesting. They went for a market that has willingness to pay. That's an issue in Europe, as well as that people get healthcare reimbursed. So they're not always willing to pay for the tax tools. But they went for men's health disorders. So hair loss, sexual dysfunction, things that are quite immediate, and where people really need solutions. And they went for like full marketing consumer, and it worked quite well. So I think it's also interesting to combine a bit of these approaches not focusing too much on reimbursement, but also trying to find pockets where people are willing to pay

Melissa Lezameta  37:48  
And maybe going direct to customer for certain certain things. Whereas, the the payers may not be willing to pay the same prices for the digital solution versus the therapeutics, but that the patient will. Okay, excellent.

Maite Malet  38:02  
I mean, I think like, once you prove that there's a case, like we still believe in digital therapeutics, it's true that he has gone through a hype, but it's, I mean, it's still there, and the value is credible, there's large clinical trials that are proving that those solutions work. So it's all about making sure that the implementation is happening with a lot of times, it's like, we have CardiaCare in our portfolio, they are about to get well, they got diga temporary, and they're now trying to get the permanent one, which is looking good. And the main issue there is now even being reimbursed and paid by the German health insurance. The practitioners are still the big bottleneck there, which are not prescribing it enough. So like you don't need to focus on the reimbursement side of it. But then also in the implementation of these new technologies, which I think it all feeds back to the education component on saying why, while they're studying, why don't you know, start testing this type of new technologies coming up so that everyone feels comfortable with it? So we got to give him more time, I guess.

Melissa Lezameta  39:05  
Well, I mean, I think we're, we're mostly done. If there's any other questions, we'll be happy to take them and, yeah. Thank you all. 


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