Signature Series: Can Asia Produce a Medtech Unicorn? | LSI Asia '25

Greg Garfield  0:00  
Well, welcome everybody. Thanks for bearing with the photo session there. Really pleased to be here today to talk about whether Southeast Asia can prevent unicorn. Really great news I got on the way in first before I share that, Lemme introduce myself. I'll give Abel a chance to introduce himself. I'll share with you what that great news was, and then we'll really dive into the subject. So as we go along, feel free to ask questions, interrupt, share thoughts that you might have. We're happy to make this as interactive as we can. So by way, background, my name is Greg Garfield. I'm the senior managing director of a fund called KCK Medtech. KCK is an evergreen fund. We focus exclusively on medical devices, typically commercial stage medical devices. We do sometimes invest a little bit earlier than that, but primarily, the bulk of our investments have been in what people would call growth equity or growth capital. We're a very long oriented fund as an evergreen fund. So we really think a lot about today's topic, how do you build a company that can become extremely valuable over time, and let us compound our capital in those in those companies over a long period of time. So maybe I'll pause there, let you give your introduction, and then I'll share the great news.

Abel Ang  1:24  
So first of all, I wanted to thank the LSI folks for the invitation, and thank Greg for, you know, agreeing to sit down and have this chat with me. I certainly feel much less alone in this large room with Greg on the on the stage. A little bit about myself. I've been in healthcare for 30 years. Spent the last 20 years in medical devices. And actually, the thing that kind of has, I've been focused on, and I'll speak about the fun shortly, is really about bringing disruptive devices to the marketplace, right? I brought 100 medical devices to the marketplace. Advanced med tech is also an evergreen type of structure. We are a investment holding company as a part of advanced med tech holdings, which is a global urology company. We are the medical device platform of local sovereign wealth fund called Temasek Holdings. And you know what we primarily do is looking for disruptive innovations in three areas in kidney care, second area in Respiratory Care, and then the third area actually is in urology, which is the domain that Evans Medtech has an operating business in. So okay, so I am dropping in and out. Thank you. Okay, so great. Go ahead. Great. Well, the

Greg Garfield  2:45  
great news is, Can Asia produce a med tech unicorn? The answer is yes. So we can. We could be done with the session today. I think probably people have come to learn more about that. But as many of you are aware, there's been a relatively recent listing of a Singapore based company on the Hong Kong exchange that's valued now over a billion dollars, and so unequivocally, we can answer that question, yes. What we hope to do today is give more perspective on that, both from an investor's perspective as well as a company's perspective. So I think it's a an incredible accomplishment by them. It's a great sign for the for the sector. It's a great sign for the geography. But really, as we hope to do today, is peel the onion back more and kind of understand what does it take to become a Medtech unicorn? What of the attributes of the company are need to be met to be able to satisfy that? Are there either unique challenges or opportunities about this geography and a number of other topics? So kind of with that, maybe I'll turn it over to you to get your initial thoughts and reaction to that news and see where we go from here.

Abel Ang  3:55  
Sounds good. So actually, I thought it was interesting time to actually have this discussion, because I think that one of the things that perhaps the community here in Asia, specifically Singapore, could probably be thinking about is this concept of building for valuation, or building for value, right? And especially because we've got a couple of startups founders here in the room, I thought might be useful, and I'll share a story. And actually, I realized that Greg actually also has a apocryphal story, which is kind of tells you about what sometimes happens. So we have a company we've had multiple exits in our portfolio. One of our exits actually was a company that went listing, and it got to a half a billion dollar valuation, so not a unicorn. But what happened is that they actually ran into some trouble, and eventually they ran out of funding, and they de listed. This was after the investors had all taken their money out. So. So the sad part of the story is actually the founders that had spent 1015, 20 years of your lives in the company actually did not get a lot of value out of the company. So it had a good valuation, but not much value for the founders, right? So that's one story. Another story I would share is another company that I've gotten to know through the My teaching at Stanford, Biodesign, which is a company called Neo tract, and it's a company that, for the longest time, was the tiniest company. You wouldn't even realize how big this company, and I think Greg knows them. Well, sure, there you go. So you Why don't you tell the story? I mean, when they exited, they were still less than 50 people on staff, so I'm told, yeah, right, please and

Greg Garfield  5:47  
well, where do you want me to it's a long story. So Neo track had a technology for treating BPH, benign prostate hyperplasia. They spent at least 10 years working the process through the FDA, and there were a variety of fits and starts associated with that. Ultimately, they did get the technology approved and saw very rapid market adoption, and came up on a point where they were considering going public, but instead took a exit through an acquisition by company called Teleflex, back at the time, a very good exit for a company their stage, 50 employees, probably a little more than 50 employees in because they had started to build out the commercial organization at the time. But as I recall, it was around an $800 million exit with the potential for milestones. Now, there was a lot of debate and consternation on that board about whether they should have taken the company public, because they were going quite rapidly at the time, and there's a chance they could have gotten the unicorn valuation or more, although shortly after the acquisition, covid hit and shut down a lot of the operations. And as many of you are familiar, many medical device companies, especially some of the smaller ones, really struggled during covid, including struggling with valuation. So it's a it's one of those where I think probably at the end of the day, the board made the right decision. But always tough to know what that counterfactual is, what they might have left on the table well,

Abel Ang  7:20  
but the Epilog of that story is, you know, so I was, I knew of them at the start. I also was very familiar of them, with them after they exited. So Liam Kelley is the CEO of Teleflex. He's a longtime friend of mine, and actually at one point, Teleflex had a third of their $40 billion valuation attributed to new track, which is this one device called Euro lift, right? And if you go and google how much the exit was, the investors did not get a billion, but the exit that was publicized was 1.1 billion, of which about 300 was milestones, and 800 million was cash, right? And I think that, you know, I think it's worth sharing these two stories, because you have one where the founders did very, very well, right? I mean, now the founders are all over the business, right? That go back to neurotrack, and then do you have the portfolio company that I shared about where the founders have, they still have to work because, you know, they the exit did not facilitate a life of financial independence. And I think that you know, in this, in this discussion that we are having, you know, can Asia build a Medtech unicorn? I think especially for the founders or even some of the operators in the room, the question is, what are you building for? Are you building for valuation? Right? Because what's the stock market price is not what's in your bank account. Unfortunately, people confuse the two, right? And ultimately what value is is what's in your bank account when the company is no longer around or the company has been sold, right? So I think that that's maybe something worth thinking

Greg Garfield  8:52  
about, yeah. And I would add, we, particularly my Fund, which is an evergreen fund, think a little differently generally about IPOs. They're they're obviously incredibly well publicized. They, they, for a lot of people, sort of represent the pinnacle of your efforts is we get to go we get to go public. We're represented and recognized on an exchange. We hopefully get to a billion dollars or some other significant valuation at the end of the day, they really still are fundraising events. You're raising more capital for the company to grow the company. And if you've built a great company, and the company is delivering value to, first and foremost, to patients, to healthcare workers, to systems, to payers, then at the end of the day, the market's going to recognize that value for you. And I think too often companies go public, they get a little too focused on what the stock price is. They spend a lot of time thinking about how they're going to make their next quarters revenue or earnings, and they begin to ignore some of the fundamentals that have to. Do with building, you know, really great businesses. And so for for many of our companies, we have in our portfolio, we've had two companies go public, one of which ended up with almost a $2 billion market cap before they've settled back down to about 400 million now. So there's a relatively wide range. And I'm sad to report, we didn't get out at 2 billion. We're still holding holding firm at at 400 million. And the other one went up to 800 million and and kind of back down to 500 million. It's an interesting story. The name of the company was neuro pace, 20 years from the date the company formed until they went public, so think of how much capital came in over that time. They're an implantable technology for treating epilepsy, so an implantable pulse generator that sits inside the cranium senses epileptic seizures and then delivers electric therapy to interrupt a seizure, but it took them 20 years to get to market and build enough commercial momentum to to go public. In the course of that 20 years, many of the investors were wiped out as subsequent rounds of financing came in. Many people went to the company and left over that period of time, and ultimately, kind of, those who who stuck with it, have enjoyed what has turned into a nice IPO, although even their journey since being a public company has been rocky. They they went out at $16 a share, which was three or 400 million. They rose, I think, as high as 27 or 28 as far down as under $1 and they've, they've kind of climbed back to 12 now. And so I guess the point, at least in part, is really here to explore more. What are the fundamentals of building a company and the value in the company, so that it can be recognized, whether that's by strategics, whether that's by a public market, and certainly so that the employees and founders who sweat equity goes into it ultimately gets rewarded. And I do think there's there's danger in chasing valuations. There are ways to drive after valuations, and I'm always concerned when companies start to talk in that way, because it worries me that we've taken off our eye off the ball of just making the best therapies that make the most difference in the outcome for patients

Abel Ang  12:30  
well, and I think that on that point maybe Greg, lemme pose this question to You, right. Moderator, but what do you see maybe three, three. And obviously, I'll share my thoughts as well. What are the three things that you see in companies that build for value, right? I think we can generally agree with the group that we have in the room that we want to build for value as opposed to building for valuation. What are three attributes that you see in companies that build for value.

Greg Garfield  13:01  
Yeah, you know, Team, Team, Team, if I was going to answer, answer in one way, but I do think that's where it all starts, is a leadership team that is that has the sort of the same genetic makeup and orientation we really are thinking about how we're going to build a company for value. We understand that in medical technologies in particular, there aren't a lot of shortcuts. Right at the end of the day, there's a patient who's going to benefit from our our therapies help be helped along by diagnoses, clinicians who've taken an oath to serve these patients rely on our technologies. And so there really aren't, you know, easy, fast paths forward. And so it starts with a great team. We've done a great deal of work looking at this from the public market lens. So what is it that public markets, and particularly because we are US based, we've got more, a little more of a us focus on this. But what do public markets recognize and for the early stage high growth Medtech companies, it's the rate at which your revenue is growing. Is the highest correlation to your value. It's your gross margin. So what is that percentage? The higher that is, the higher your valuation is likely to be. And then, typically it's the size of the addressable markets, or are you going after something that that really matters to patients and the health care system. So we certainly use those as as filters as we think about investment opportunities. But frequently it comes back to team and and the confidence you have in the decisions the team makes because you're trying to diligence the opportunity, and at least in no small part, they've been diligencing it as they work hard at it for for years and years. And so if you gain confidence in them, you gain more and more confidence that when those really challenging issues come up, which they always do, at least in. Yeah, at least in our portfolio, we don't have any, any that have been smooth, uninterrupted sailings up to up to unicorn status, yet that the team will be there to address those and handle those issues, and they'll stay with it as they work through the valuation challenges and the and the value creation challenges. What are your three?

Abel Ang  15:19  
So actually, I like what you said about total addressable market, right? Tam, so our, our tree actually follows the acronym. Tam, so the first one is talent, similar to yours. And I think that on the talent front, what we see, especially here in Asia, is that a lot of the talent is not fit for purpose, in the sense that they are attempting to do things that they have never done before, right? So I'll give you an example, attempting to take a medical device through a PMA approval route, and nobody on the team has ever done it, right? And I think that for me, getting a talent or a talented team that's fit for purpose is important. I think that the A is really ambition, very similar to what you just talked about. But I think that ambition in the sense that it needs to be an ambition that is grounded in reality. And sometimes, I often hear this, and I see this, the ambition is always we are going to get an FDA approval. And unfortunately, in this part of the world, because we don't have the talent, the ambition of getting an FDA approval, the approval does not mean that the sales is going to come. I think during the course of the next few days, you will meet people at this event that actually have FDA approvals, but they're not selling a lot of it, which then does not create a lot of value. And then the final thought I would have is, actually, we need markets, right? We need good, strong markets for the devices to reach the valuations that we talked about. And funny story, and I don't know if Greg remembers this, actually, Greg and I met because of Matt O'Brien from Piper Jeffries, or well Piper Sandler, they call themselves today, right? And you know Matt was like, I know Greg. I know you. You guys need to know each other, and that's how we connected. And that's what a well functioning market looks like, right? People who are strong in equity capital markets, people who are strong in the private markets, there is a capital market to support the medical devices going out. Because if you only have private markets without capital markets, actually that's like clapping with one hand, right? So I think that we need the three right talent, we need ambition, and we need markets. So as you can imagine, for many of the companies in our portfolio, we are now taking them to the US. We are literally redomic selling our companies out of Singapore into the US because of point number three. So that's a little bit of what we are thinking.

Greg Garfield  17:52  
Yeah, no, I like I like that. I think the some of the challenges here you're much more familiar with, which is, you know, why this, this panel's obviously so relevant. I'd love to hear a little bit more about your thoughts on the market here, and why is there only one hand clapping, and what can we collectively do, if anything, to other than just shift everything over to the US to help the other hand clap?

Abel Ang  18:16  
No, I think that we are trying, you know, and a couple of things. And we've got some colleagues from the government sector. They are here. Certainly, there's an effort to try and what I call bring our capital markets to what I would expect would be a, you know, global standing. So I give you an example, and for some of the overseas guests in the audience, we actually maintain in the Singapore exchange a list called the watch list, right? So imagine public listed companies, where the exchange puts a bunch of companies in the naughty corner. Literally, I mean no other exchange in the world. Do you have something called a watch list, right? Fortunately, we are actually in the process of disbanding the watch list, which I think is something, which I think we should do right, but it kind of gives you a bit of a sensing of what the local market looks like, that we actually do maintain a naughty corner that fully all the disclosures that you have and all the things that you have, they are actually publicly released. Are not enough information for people to form an opinion that actually the regulator has to say we actually have a watch list. So, you know, caveat, mTOR plus plus plus, right? So I think it gives you a bit of a sensing that is a regulatory guide that watch list is going to be disbanded in, hopefully in next couple of months. But I think it gives you a bit of the sentiment that is happening here. One of the other things that we don't really need to take a look at is, you know, people like Matt O'Brien, right? You know, I am told I don't know this for a fact, but I'm told by ECM teams in the Goldman Sachs and Morgan Stanley software Asia that we actually have one healthcare dedicated specialist in Singapore. Singapore, in any of the banks, one person, so only one man, O'Brien in the whole of Singapore, right? And I think that that is something that we can definitely do something about if we really want to have a well functioning market. Because if you don't have healthcare specialist coverage, you know, what kind of ambition Can you have to actually really develop a marketplace. So I think that those are things that are coming down the pipe, right, and then you have other things like liquidity and so on, so forth, but I think that you need to put the basic pieces into place in order to have a well functioning market. And I think we're in the process of working through some of this. And I, while I'm optimistic, I think that if you have companies that need cash right now, right? And they have an ambition to be global, right? We can't wait for some of these things to get done. We have to go out and get it done. So that's why we're doing

Greg Garfield  20:49  
it. Yeah, and there's a really, really tough balance there. And I probably many of you appreciate this, but it's, it's remarkable the the way capital flows down from successful public markets. And so, as I said earlier, we as a fund, don't overemphasize going public. We see this as another milestone in a journey. But there is a great deal of capital that comes into the public markets. When you have successful companies having successful outcomes, it forces other capital to start to go earlier in the in the ecosystem, and invest earlier and earlier in companies at earlier stages. And so it has a nice, sort of fortuitous cycle. The biggest capital at the top pushes the next biggest capital down, pushes the next biggest capital down, and so on. It's really challenging when you've got an ecosystem where there are a lot of companies that are at the kind of a B, maybe early C stage, but there isn't capital that comes sort of top down, in a manner of speaking, to support them, because at least in some part, they look and they say, Okay, where am I going with this? When am I going to see my exit? When am I going to see my liquidity, you know, paint that picture for me. And I like your analogy. To the extent there's only one hand clapping, it's a, it's kind of a hard picture for people to wrap their head around, which, which creates a, you know, more of an over emphasis on some of those more established markets, including in the US. And I think you're, you know, you're smart to bring companies there. I mean, the nice thing is, there's a great capital market system there. The challenge, of course, is, you know, indoctrinating into a culture and into a set of challenges that are less familiar for people who you know are from this geography so

Abel Ang  22:36  
well. And I think that that's why the LSI, you know, this is the first LSI conference here in Asia. And it's useful because, you know, for companies, they are having aspiration, aspiration to go to the US again, back to My Tam, you know, meeting people who actually have done it yet, right? Meeting folks like Greg, bringing other people who have done it into the ecosystem. I think that's a fairly helpful dynamic, because I don't think it makes sense just to focus your capital raising or your talent seeking in Asia, because you're located in Asia, right? I think that ultimately, if you look further afield, I do think that we have global beating technologies here. I just don't think that we have the, enough of the talent pool, maybe enough of the smart money ambition, and then, you know, the markets not quite there yet, so we have a ways to

Greg Garfield  23:29  
go. Yeah, yeah. And I would, for those of you who are with startup companies and raising capital, I know it's always very difficult, and there's a temptation when you can get a get a check, to take the check, I challenge you to think very carefully about your capital partners. So you really are looking for those who have experience, who will lean in and help you, who themselves, maybe have done PMA, some, many of the, many of the firms like mine, are composed largely of X operators. So we've run companies, both fortune 500 and startup companies. We know how painful PMS can be. I'm waiting on an approval right now. That is 18 months. So the study was three years to enroll, two years follow up. We submitted at the end of the follow up. It's been 18 months, and we don't yet have the approval. And so if you think about six and a half years of kind of capital and work, it's not, not for the faint of heart. We're excited about the company and the technology, and so we're we're sort of happy to be there, but it's important to have capital partners who know what they're signing up for and who can help you, especially if you choose to move your some or all of your enterprise to the US or another geography. Any questions, as we've kind of gone along here. It's been a little bit of a monolog or by log here, but happy to happy to answer questions, your thoughts from it.

Abel Ang  25:00  
Henry has a question.

Greg Garfield  25:03  
Fire away. 

Henry Peck  25:03  
He used the mic at the center of yours. First of all, thank you both for doing this. Thinking about what you said about capital markets. Kind of look outside of Medtech, what's happening maybe in us, venture and private markets, companies staying private later and later and later, seems to be just an abundance of money interested in private capital. I don't know when stripe or SpaceX are ever going to IPO, because why do they need to? And if the investors can take secondaries along the way, then everyone's happy for you know, for that. Juxtapose that with Australia, where you've got these micro cap IPOs, right companies hitting the public markets. It's like the two ends of this spectrum when you think about Asia producing a med tech unicorn. Where do you see that, you know, both unicorn status and liquidity for the investors, the entrepreneurial team coming from. Do you see them kind of building in Asia and then maybe pursuing another market? Like you see a lot with London based companies. They don't want to go out in the London, you know, LSC, they want to go out in the US. Do you see it being early public markets, and they grow in the public market. Do you see it more as strategic M and A like, where's that billion dollar status and liquidity going to come from? 

Greg Garfield  26:12  
Yeah, you want me to take virtual so a lot of, lot of great thoughts baked into that, baked into that question, I would say what you're seeing on what, what I think of as sort of the more the traditional tech side, in my mind, is a preview of what we're going to see across all investing, including med tech and healthcare, which is very large amounts of private equity that have less interest in the liquidity that comes from a public market, and more interest in Just finding ways to make capital compound over time. The the benefit of being private, when you do that, if you're Space X, you can blow up a rocket and your your stock doesn't go to $2 right? I mean, you can think long term thoughts. You can invest in the business with a long term value creation orientation and not have to worry about what the public markets say. I I'm firmly convinced that that same capital exists out there, and that we'll see it come towards medical technologies, and in fact, to some degree, we already have. And for those of you who aren't as familiar with it, secondary markets are just markets where people who own shares in a private company can turn around and sell them to other private investors. And there are you can do that by approaching an individual. I can come to able and say, I'd love to buy shares in one of your companies today, and he can sell them to me. But increasingly, there are a number of brokers and and other exchanges that are set up to facilitate these and to me, they're a great, great new growth in the capital ecosystem, because I think it allows management team to really stay focused on growing it and and of the secondary markets. In my mind, by far the most important thing is, is it gives employees and founders a chance to sell some of their shares in secondary markets with respect to your your kind of your question. I mean, I think at the end of the day, and my prognostications are almost always wrong, so I'll throw that out. At the end of the day, the most probable, you know, likely next unicorns out of Southeast Asia probably are listed on the US exchange. It's just, you know, as able observe, there's mostly two hands clapping there. And I think it's it's going to be easiest for companies to go there create value. Because I agree, the technologies I've seen, the seen the identification of the need for the healthcare system or the patient. It's spot on for many of the companies I've met here. And so I think the the ecosystem is thriving, but you've got a capital problem and and the US, I don't want to oversell the US, it's got its we've got our own capital problems and and the markets kind of open and close in the US as well, and capital flows towards AI instead of towards med tech. But on balance, I feel like those markets are are healthier. And of course, if we look at the last, you know, really kind of 30 years, the vast majority of unicorns have been created on on those markets. And so I don't, I don't see that changing in the near term it. I do think we need to do all the right things and and kind of build the healthy capital ecosystem worldwide. But, you know, certainly in the near term, I suspect that's probably, probably where you're going to see more of those different thoughts or opinions or

Abel Ang  29:40  
so. I think that my, my, my, my view is especially to Henry's question about companies staying private for longer and getting to the right sweet spot. I think that one thing for if I could make a recommendation to the operators that are in the room, right? Uh. If, because you are in Asia, and you're raising in Asia, you have to accept that your Asian norm is you have to run for profitability. I don't think that you will have the luxury of raising hundreds and hundreds of millions of dollars, and people are going to keep funding, loss, loss, loss, right? And actually, if you are in that unique and we do have companies that are in this space that have run for profitability and have grown to very sizable companies. I give you two transactions that have happened in the last 24 months. One of them is fongs engineering, not a very big company. They only got to about $30 million of sales, but they were transacted for $100 million so 3x and they were transacted about 12x EBITDA. 3x was revenue 12x EBITDA. This is in the cdmo space, right? You have another company in Hong Kong called quasar, right? It's a company that was transacted to boy, which is another private equity for six, $50 million right? They were transacted at 16 and a half EBITDA, right? And about five to 6x of revenue, right? And why I raised those two benchmarks to your attention is very simple, right? These are people who have grown up here in this part of the world. They have chased markets that have allowed them to become grow revenue, grow profitability, and have created incredible amount of value for the founders, right? As opposed to basically betting on the technology and chucking and both of these companies, to be absolutely candid, could have gone the route of spend more and more on R and D, right, and never have profitability, and the founders would actually be not anywhere wealthier today. They would not have created any value for the investment of time and effort and the risk that they have taken. So I think that that's one thing, which is, if you are in this part of the world, play to the norms of this part of the world, or the other path you could potentially take is, as what Greg said, is, you know, get to a certain point, pivot into a new market and start there and network and build that kind of company that you want to, but to sit in Asia and say, I'm going to make a, you know, loss after loss after loss, right? You know, I think it's going to be very, very difficult. That's point number one. I think Point number two is this. I think even the companies that we do have, they are already listed, right? Most recent one is more access. I would be very surprised if they don't do a list somewhere, because currently, the trading volume is 1/3 of 1% 1/3 of 1% every day, right? Albeit not much trading history. But whatever value that you see based on 1/3 of 1% trading volume, I can tell you it's the wrong number, right, you know, which means nobody gets to exit, not strategics, not investors, not founders, nobody. And I mean, we all love Lee Han. He's a, you know, Outstanding Teacher of the community in Singapore, but I think we all want him to have some liquidity, right, you know. So I think that gives you a bit of a sensing to Henry's question, sometimes, going public is the right thing to do to raise money, but is it the right thing to do for the founders and the families and all their associated the company? That's a larger deliberation, just just for food for thought,

Greg Garfield  33:14  
and it's a Just quickly, thank you. Just quickly coming back to the to the first point. You know, even in the US, sort of four or five years ago, the scorecard was all revenue growth, and especially when it came to commercialization. And so we saw company after company come through, raise capital on the public markets and spend it to expand their commercial footprint. And they they did grow. Many of them grew revenue very fast and never became profitable. And sort of among those, one of the poster childs was never, which peaked, I think it at at four or 5 billion in market cap, and ultimately transacted just earlier this year, earlier this year, late last year, for 400 million. They they were at three or 400 million in revenue and still unprofitable, and that's just not that's not tenable anymore in any market. And so if you can get to profitability, you can control your own destiny. You can continue to create value. You can work to invest more in your pipeline once you're profitable. So they're the world, in a manner of speaking, kind of becomes your oyster. So big, big fans of companies both growing and getting to profitability, it's always a tough there's always a tough tension there, right? Which is a good, healthy tension for management teams to struggle with. Yeah, please, can I ask? Go ahead, Eric, sure. That's the inverse of what you described. 

Audience Question 2  34:41  
Yeah, you have opportunity to work with US companies that are thinking about expansion to Asia. Yes, I'm curious for your take on the Asian market, when you're working with these companies and they're growing commercially, because you describe the exact trade off, get the revenue and get the regulatory milestones, get some revenue in places like China, Japan or you. Singapore, New Zealand, which can be quicker. Or, you know, how do you think about that in terms of just the context of getting these valuation milestones for the US companies, thinking of Asia? 

Greg Garfield  35:08  
Yeah, you know, for our portfolio, what do we have? We have 16 companies, 10 are commercial, and four are international, and I kind of wish I push the other six there, frankly. I mean, we we get, we don't always get so the challenge usually is that we've built commercial infrastructure in the US and we're able to leverage it, and so many of our companies are between kind of 10 and 150 million in sales, and in in that spot, most of them still have a lot of penetration to do in the US market. And so it's the easy analysis is always well, if we're going to spend one more dollar on commercialization, we should spend it in the US because we get more leverage out of that sale. Invariably, we, when we do commercial, commercialize internationally, we do get incremental revenue which matters to the revenue growth that first and foremost across the top line, we build capabilities in other markets. We learn a lot from physicians and and and and our employees in international markets, and generally, I think, create the value of the continue to grow and create the value of the firm internationally. And so in from, from a US centric perspective Europe, Europe in particular, used to be a market we would often go to even ahead of the US, because the regulatory barriers were, were lower, and in general, the markets, you know, sort of paid up for technologies. Increasingly, we look worldwide for for those next market opportunities. But it's, it is still tough. It's it's us is just by far the biggest market, you know, in the world still for consuming medical technologies. And so there's a, there's a sense of gravity associated with that that kind of causes you to start there. It's good question, yeah, if you

Abel Ang  37:12  
couldn't do better than that, yeah, any last thoughts? Great. You want 

Greg Garfield  37:16  
a couple minutes left? I was just gonna see if there's any final questions or, yeah, no, let's see.

Audience Question 3  37:26  
Thank you. Hi. My name is Srini. I'm a startup founder in the structural heart space. My question relates to early stage startups here, domiciled in Singapore, raising money and in the context of US investors, what we have seen in the biotech space is, in the past couple of years, an interest from strategics, perhaps investors also to look at assets in Asia and doing licensing and such type of deals. Do you see a similar type of trend and interest for Asia built assets or med tech companies and technologies from us strategics and also US investors, especially if it's early stage, what's Do you see any trends? What are your thoughts on that? Yeah, thank you. 

Greg Garfield  38:17  
So I'm probably less it's been a while since I worked for a strategic so I was, I was with Johnson and Johnson, you know, kind of 15 years ago. They've obviously been very active worldwide, including specifically here in Singapore and and in Asia. PAC, so I'm probably less capable of that on the on the investment side, absolutely. And, you know, there's not a lot I have to thank the pandemic for, but I would say zoom and the ability to sort of speak to people face to face worldwide, hear their stories, understand the opportunities they've identified and the technologies they've developed have certainly given our firm increasing confidence and interest to make investments both in Asia as well as other parts of the world. And I think that's generally the sentiment. And you'll find that capital on balance is in many ways, relatively agnostic. If it's a great idea and a great team, then it just doesn't matter where it sits on planet Earth.

Abel Ang  39:23  
Okay? I see a bunch of people waving behind Yeah. So I wanted to thank everybody for taking the time to be in this talk. We hope that you got something out of it. And I wanted to thank Greg for being willing to be on stage. 

Greg Garfield  39:44  
Oh, thank you. I'm the moderator. Thanks everyone.