Signature Series: What's Holding Asia Back in Medtech | LSI Asia '25

John Eng  0:04  
Dan, thanks to LSI for your inaugural event here. I personally am very excited. I had the chance to be at Dana Point early on this year, and it's so great to see many familiar faces here in Singapore as well. So thanks to LSI and nice to see you again. Dan,

Dan Lippis  0:20  
thanks, John, good to be here. Yeah. And also extend my appreciation. And it's an honor to be here with LSI, you know, at this conference. So looking forward to this

John Eng  0:31  
session Absolutely. Yeah, it's a actually. Shall we start by taking a quick round of introductions? Yeah, maybe I'll turn the mic over to you first, maybe a quick introduction of yourself. Actually, how long have you been in Singapore? Yeah. And since we're in Singapore, do you have any favorite local cuisine? Yeah,

Dan Lippis  0:52  
that's a good question. So just a little bit about so I'm based here in Singapore, not for that long. Actually, I sort of grew up in this region, and, you know, the accent is Australian. So I was part of the Asia PAC region from the early stage of my career. Lived and worked a long time in the US and Europe. Now making my way back and have the privilege of being based in Singapore with Edwards Life Sciences leading their Japan, Greater China and Asia Pacific commercial businesses across Edwards life sciences. So I've been at Edwards for a decent amount of time. It's my 15th anniversary just passed, and so I've been with Edwards for quite a long time, and most of that experience has been living the transcatheter aortic valve replacement journey with Edwards life sciences. So my perspective that I'm bringing here is is quite maybe narrow and and selective, but it's a, it's a, it's an interesting perspective, nonetheless, given Edwards innovation model and commitment to a narrow innovation model. So that's the bit of background now favorite. I've been here 18 months, right? And living not far from Newton mot, so it's a nice, convenient spot, and favorite foods I have a lot. I mean, there's one sort of thing that is, is struggle for me is, is, you know, how much of the local food that I consume? So I have to be very active while I'm here, because I love it all. But probably, you know, you know, apart from all the favorites of satays and luxes and Nazi the mark and all that good stuff, but I am a fan of of spicy food, and so I actually really like the the proximity that we have here to Southeast Asia for, you know, for Thai and for Indian and for even, you know, Chinese food. And so might surprise people how much heat I can handle in my, in my in my local foods, but it's been fun so far.

John Eng  2:55  
Well, I know where to ask you for for lunch or dinner next time,

Dan Lippis  2:58  
yeah, I'm keeping a list of

John Eng  3:02  
Yeah, thanks. Thanks, Dan, maybe just a quick one of introduction of myself as well. So myself. I'm Jon. I represent Singapore EDB. Singapore. EDB is a government agency traditionally been working with global enterprises, really all over the world, many of them at the conference today as well, to explore Singapore, explore Asia for growth opportunities. I'm based in Singapore. Now, I used to live in Chicago as well for three years, but currently I'm based in Singapore. I lead the med tech practice for us. And med tech is a big sector for Singapore as well. Being in a Ritz you can't imagine it, but as a small island country, we produce about $19 billion of medical devices every year. 16,000 of us in the sector producing life science tools, implantables, as well as other kinds of devices in this very exciting space. So nice to be here. And thanks again, LSI

Dan Lippis  3:56  
and a decent amount of heart valves as well, for sure.

John Eng  4:02  
Yeah, so maybe we can get things started. So the title is, what's holding Asia back and med tech? Actually, when it comes to med tech, I think what comes to my mind first is US and Europe right as a launch market, and definitely where innovations originate from, actually, from your standpoint and your experiences so far, you do, you agree with that, and has it always been the case US and Europe?

Dan Lippis  4:32  
First of all, the the title is provocative for a reason, right? There's a lot to be excited about, but we're going to focus on, perhaps the, you know, the perspective of, like, you know, perhaps imaging a future. But to answer the question, yeah, I think it's fair. It's fair to say, especially when you look at it from an MNC perspective, is that the focus has historically been US and Europe. It hasn't always. Is been consistent, and we can get into that, especially over the last 15 years, there's been some major shifts that have kind of changed the game when it comes to how you apply an innovation model, or parts of the journey of the innovation model in those different regions. But I think that that's fair, and I think with everything else that's going on in the world right now, which is kind of dynamic, right, is it's starting to sharpen the focus again, right? And I think that that's something that we all need to be aware of. So to, you know, broadly speaking, I would say, yeah, that's fair, but not necessarily, not necessarily always the same way, right?

John Eng  5:41  
Got it actually, the taver story is an interesting one, one that my team and I look through every now and then, yeah, how it originated, and how the technology involved based on the environment. Yeah, do you want to share a bit of insight?

Dan Lippis  5:55  
Well, maybe I can. I mentioned that like the US Europe, so looking at through the lens of of Tavi, if you like, you know, one of the things that has been a game changer with through the lens of this type of technology and the relative value that each region brings to the innovation process, right? I would say that where there has been a big shift is even at the beginning of like going back 15 years, maybe 20 years, Europe was the obvious place to do early clinical work or early studies for A new technology. And the reason for that is you had a very predictable regulatory pathway that could give you access to a lot of countries and markets, but it was fast. You didn't have to go through all the heavy the rigorous, heavy steps of a of an FDA approval, or a or a PMDA approval in Japan. So it naturally attracted the entire industry towards Europe. So this is, you know, a competitive advantage for a region to attract investment. And us, was a huge market, and still is, and provided a lot of value and patient act and a consistent patient access perspective. And so the end game might have been to go to, you know, to get an FDA approval, but your early work, or, you know, it's typically happened in in Europe, what's shifted in the last five years, which has been quite interesting to to watch, is how the FDA has an in combination, you know, with with CMS, you know, who pays for a lot of this sort of stuff, have been a lot more competitive and made active decisions to try and track early clinical work to the US at the same time, exactly the same time that the there's medical device regulation reform going on in Europe right so now you take an incentive and a motivated government or region to try and attract investment, and you've got the incumbent who is going through change and going through a, I guess, a a reform that makes it less reliable and less clear. And then this completely changes from an MNC, where you invest and why you invest, and where you decide to do your your clinical work. And from my viewpoint, it was a very sharp shift, right, at least, from, from what I could observe of investments moving out of Europe into the US, right? And that has an impact on the whole ecosystem, right? Yeah, there are, there are physicians, there are, there are universities, there are hospitals that have built an infrastructure based on this. And there is an investment stream that kind of changes overnight, and it kind of disrupts the whole ecosystem, you know, over the over that time period, my responsibilities were based in Europe, and I, you know, come from a position of trying to fight for Europe, trying to, you know, try to bring these investments and these things. You can even imagine, the conversations inside of Edwards Life Sciences about, hey, let's not be so rash about making the decision, about doing this or doing that, but it's a real decision and real discussion. And the point that I'm trying to make is, is that the regions where investment goes for innovation, it has to be logical, it has to be competitive, right? And it has to be sustainable. And you have to have a pathway. If you have a long term view, you have to have a pathway whereby the risk that you're willing to take, there has to be a known ecosystem of points of failure and reward. And I think that that is. Thing that you know, as we go through this conversation, as we go through where what's holding Asia back is, where in that ecosystem, can we be strong, and can we provide that value, and where is it maybe more transactional, and we have work to do if we want to compete against US Europe from an innovation perspective. But hopefully that's some background. Now, as far as the Tavi story, there's so many different rabbit holes we could go down, but I'm happy to share some perspective if it's interesting to either to the audience or or to you. John,

John Eng  10:35  
sure, yeah, maybe I can call on that as we go through I think our conversation today, yeah, there's a lot of learnings from the Terri example, for sure, yeah, but I thought the points that you shared earlier on are really salient and also a very good reminder. I think we all know it's never just only about the product. I think it's about getting a product to market in order to get that impact. And the second point is getting it into market again is also not about the product. It's really about the larger environment, whether it's regulations, government support, or even, I think, for med tech, the availability of the best clinicians to help you get to market. Yeah. Well, yeah. And the third thing that I perhaps take away is also then the importance of the continued importance of that ecosystem approach. Because, like you said, you don't want this to be just a transactional, short term kind of view. You want long term. You want predictability. And I think for us, we are, we also want to generate a flywheel of an ecosystem in Asia as well to do med tech.

Dan Lippis  11:47  
So a lot of a lot of people, and especially our customers, like you know, if we, when you when you working with the physicians who ultimately apply the technologies to treat their patients, a lot of we end up in conversation thinking that innovation is a choice that, like, you know, Edwards life sciences, chooses an innovation strategy, right? I think that the nature of our narrow focus demands that you have to have an innovation strategy, otherwise you become irrelevant pretty quickly, right? I think that's but the choice is actually the physicians. If there's no value in innovation, no company is going to invest, no venture capitalist is going to invest. If there's no even if there's a clinical unmet need, even if there's a, you know, a need for innovation, if there's no value in it, then it's a difficult strategy. So if you think about a company like Edwards, who has a narrow focus in an area that there's huge clinical unmet need, the sustainability and the ecosystem has to be able to there has to be a pathway for reward, because the innovation process is a super commitment, right? It's, you know, we, we, as a company, we spend, and it's very public, we spend close to 20% of our revenue back into R and D. Very little of that is actually idea generation, right, the innovation that is required to transform a therapy or to change the practice of medicine in a particular therapeutic area, the lift is massive across the ecosystem. So you know this, this concept of like not having a sustainable recognition of value as you go through that journey is a scary one, particularly if you're in it for the long term. That's right, there's plenty of opportunity in the short term for everybody, but, like, not necessarily, if you have a very long term view,

John Eng  13:46  
yeah, really tests the result. And have a lot of respect for innovators.

Dan Lippis  13:51  
Yeah, it's, I guess, I guess you may kiss more frogs than you wish to to get to any kind of Princess or Prince. It's, it's not for the faint hearted, I guess.

John Eng  14:03  
Yeah. But actually, then if I double click Asia and just draw on your wealth experiences in this part of the world as well. Do you think there's an area that Asia can be competitive in when it comes to med tech innovation, and where have you seen some of those actually?

Dan Lippis  14:22  
I mean, I don't think I would be here if I wasn't as intoxicated by the opportunity as I think everybody is. You know, there's a big difference. You know, probably spent 20 years away from Asia, if you like, and it's interesting for me to come back and see the observation and the change, right? And I think, you know, 20 years ago, I think you know, the value that was being created here in Asia was based on cost of labor, right, and manufacturing. And I think that that was just. An obvious, it was a competitive, I guess, point of differentiation that provided access to, you know, to the conversation, or to you know, into the industry. Now you see a lot more capability being built and available everywhere. It's not necessarily coordinated. It's not necessarily accessible all the way through. It's not necessarily visible. But when you live it, you see, you see the how digital the population here is, how tech forward the population is, and that creates opportunity, right? I think, like, you know, you just have to go through an airport in the US and then come back home and go, Wow. You know, we really do things quite forward, in a forward way of thinking here. And so this is, this is opportunity. This, from a med tech perspective, not easy to harness, but creates opportunity. The second thing that I would say that's always the superpower of this region is the population, and that population, by the way, is massive. So from an unmet need, from a clinical unmet need perspective, is always been there. By the way, it was there 20 years ago, but it it's always there. The challenge is accessing it in a reliable, predictable way, but that population is also becoming more educated with every generation, and more wealthy with every generation, and that in itself, drives change right and demands different solutions. And so there's opportunity in that everything that I've spoken about so far would be largely transactional opportunity from a from a supplier perspective. Or, you know that you look at that and go, Wow, that might be an interesting market, if you like, because of that that happening. The question then becomes is, how do you operationalize that, for it to be competitive or an interesting way to invest in because it might bring value outside of Asia, right? I still think that there is more value in Asia for Asia than there is in Asia or outside of Asia. And I think that's the transformation that would be interesting if it could happen that would change the value proposition of this region from a med tech, innovation leadership perspective,

John Eng  17:29  
I like what you just said. I think tech is fighting for us, and why I think very excited to have LSI here is being able to firstly, understand the tremendous need in Asia. But secondly, are there solutions that Asia can generate to solve Asia's needs while also thinking about bringing it to rest of the world?

Dan Lippis  17:50  
So, but I'm sure the audience would agree, it's a lot easier to say than to do.

John Eng  17:53  
Right? Exactly. Yeah, yeah. And I think what you also mentioned, you know, as companies think about Asia. The first thought is cost of labor arbitrage, and it's manufacturing. And then they think about market, right? And then we think about what's next for Asia, given the evolution to some sense, as you're sharing that, I'm also thinking about our journey as a tiny island in Singapore,

Dan Lippis  18:20  
you know, it's fascinating. Jon, like, I'm, you know, as I'm sitting here, I'm like, Hey, this is how Edwards thinks about the innovation process from a company perspective, from a long term strategy perspective. And then I realized, wow. I mean, Singapore has a reputation for being very strategic in the way that the government thinks long term and thinks about its planning and all those sorts of things. And I'm sure the EDB does the same thing. So I'm curious to hear from you about how you and your position at the EDB looks at the same opportunity and challenges. Is there something that either resonates or is different from the EDB perspective as we're having this conversation?

John Eng  18:59  
Well, I definitely, I think broadly, I think there are similarities. I think for us as a country, we constantly have to stay on our toes, on figuring out, you know, where is the innovation happening, and how do we think a few steps ahead, alongside the industry? Yeah. So I think for us, Singapore is not a large country. I said a few times, actually, we are about 5 million people, five to 6 million people. And naturally, when they think of Singapore, it's not for the market in terms of its size, but traditionally, they think of Singapore as a location whereby, you know, we've got good physicians, we've got a relatively good health system, we've got processes. And to your point about predictability, I think we are relatively predictable. We like to think so vis a vis many other parts. In the world today. So traditionally, in spite of science, I think where Singapore, where Singapore features in companies, Asia strategy is a location for for launch, right? We talked about tevr. I think surgical robotics is another exciting area. I think the first robotic assisted surgery was done in Singapore in the 1919 99 for tevre as well. I was looking the day, I think the first procedure for tevra was done in Singapore as well for Asia in, I think the early 2010s Yeah. So I think in general, that has been how companies think of Singapore. We have a bit of a manufacturing base as well, and it all starts with the precision manufacturing sector here, by legacy, Singapore was low cost, but, you know, we built from there. And I think today, beyond just being a location for launch and training of physicians, Singapore continues to do a bit of manufacturing using technology, as I mentioned, about 19 billion of that. But I think how we are evolving as well, just like I think the trajectory you've outlined is, I think we've got decent technical talent here, with environment that is close to Asia, relatively representative of that diversity that's in Asia, right? Because you talk about Asia is not a homogeneous, 3 billion market. It's really, really fragmented, but a lot of that diversity is represented in the microcosm that's in Singapore. So I think we are starting to see companies actually do a lot more in innovation here as a trusted location for companies right to who are interested to innovate in this part of the world, very often for Asia, as you were, you were saying,

Dan Lippis  21:57  
So, gone through the same, yeah, gone through the same evolution that I was talking about from from my own personal observations, which is fascinating.

John Eng  22:05  
Yeah, I was taking down notes about what you were saying couple of you know, hashtag, predictability market in Asia, for Asia. These were things that, somehow or another, in reflection, are things that we've kind of gone through the journey as well.

Dan Lippis  22:19  
Yeah, you mentioned predictability. I think what people under appreciate in the innovation cycle, or the journey that you go on from taking an idea to you know a reality or transformation in medicine is how important trust is, right? You You cannot work with people that you don't trust, because you're going to fail more often than you're going to succeed. The rapid learning that is required, and the comfort in the learning, or the application of the learning, is so fundamental that if you're doing it with unknown entities, with unknown countries, with unknown physicians, or an unpredictable in an unpredictable environment, it's just hard to, you know, to go on that journey, right? And so I think this is an area where, if Asia wants and can I truly believe they can be more prominent in how they're part of the innovation story outside of Asia. For MNCs that are based outside of Asia, then there has to be, there has to be a predictability or a way to generate and create and and cultivate trust. And I think that's something that you probably, and with the Singapore government and EDB have probably realized, as well as is that, you know, you can have a great idea, you can have an interesting pitch, but at the end of the day, it's still people and, you know, and entities working together on a common goal that makes it, you know, viable. So it's, it's something that I think about a lot, because these are the conversations that I have with my partners and colleagues based in the United States all the time about, why would we do it here versus there, or why wouldn't we do it like this or with that person, or whatever? And it's always ends up coming down to a relationship, you know, trust based decision making. So it's fascinating. Yeah,

John Eng  24:23  
trust is built on communication. I think a very common challenge or opportunity, actually, some people really love it, is the diversity of the different cultures as well. So in Asia, you are not dealing with just one market. It's so many different markets. So really, kudos to all the people working in the Asia Pacific commercial region. It's not easy navigating across the different markets. Yeah, yeah. And cultural context and all a

Dan Lippis  24:51  
lot of cultural challenges. We have a lot of diversity, yep, not necessarily always, a lot of tolerance. And I think that's that. Yeah, you know, it's very real. You have a lot of languages, you know, and that's what makes it beautiful, and and there is so much opportunity, but at the same time, it's hard to harness as a region, right? Because a lot of that gets then trapped within the invisible walls of a country, border, limits, and so, you know, again, you know, Europe takes advantage of having a European Commission and centralized policy, and that works to their advantage when it comes to attracting certain investments, you know, in in med tech and Biopharma and all those sorts of things. You know, we don't get to benefit from those same types of, I guess, governance, but we have other opportunities. You know, one of the challenges that we face, and we will continue to face, with an aging population and a population problem, is the rising cost of health care, yes, right, and the fact that there's always been, for as long as that, I have been involved in the med tech space, there has always been unlimited demand for health care and limited budgets. That's always been the case. This is nothing new. This is not a 2025 problem or a 2030 problem. So access to care has been and always will be a challenge. The concept of cutting your way to the solution, yeah, is going to lead to probably quite disappointing results, right? So, you know, I have a personal saying that you can't cut your way to the top. You can't cut your way to growth, right? So how you make investments, and how you have strategies to deal with these problems and invest in the right innovations that are either capacity building or value creating or problem solving in the right way, require strategy and leadership.

John Eng  27:03  
Yeah, yeah, yeah. I think these challenges that we have to kind of navigate as we think about, I guess better quality care, that to your point, earlier on as well as the education becomes more sophisticated, they're going to want better care as well. Yeah, you mentioned trust. You mentioned, I think dealing with healthcare costs. Are there one or two other key challenges you think Asia will face in terms of being a med tech giant?

Dan Lippis  27:37  
Well, I think it's related, and it's in and it's in access to innovation. So innovation, by nature, is supposed to bring value to the system. Innovation is expensive in terms of, it's an expensive journey to go on, not saying that innovation has to be expensive to acquire. But the process of innovation and the ecosystem of innovation is is, if it was easy, then everyone would be doing it, and we wouldn't be having these meetings, and we wouldn't have the people that are in this room and at this conference. And so it does require a level of commitment, courage, and you know, and budget to a sustainable budget to try and execute. People go on that journey because you believe, at the end of the day that if you crack the code on something, or if you deliver, you're able to deliver on the promise of whatever the idea might be. You can change the way that we do things for the better. And in this instance, it's in how medicine might be applied for a particular medical condition or disease state patient, and that has to bring value to the system, value in that is worth paying for, yeah, and then it is worth going again, and it is worth sort of feeding itself to bring better solutions over time, to care. And I think we've got an enormous amount of his history of that in all types of medicine over the last 100 years. It's amazing how far we've progressed, but you're only going to invest in things that bring value, and that value gets rewarded. So the idea of not having, not getting reward for that value is challenging, right? And I think that that's, you know, when we apply, when we look at this of this region, we look at the markets within this region, and you and you look at the predictability, or be the nature of how innovation is being either regulated or valued, then it becomes a big deal in terms of how patients get access to it right. And every. One of these decisions, and every one of these markets is going to be looked at differently, even if there isn't a huge unmet need because of that very equation, right? And I think that's just the harsh reality. So the big challenge for the region is being is having a predictable access, patient access, strategies for meaningful innovation. And I think that you know that is, that is a life's work.

John Eng  30:25  
Yeah, yeah. I think for us as well. I think for Singapore, we are watching healthcare costs very closely. And your point is not just about putting in subtractions. I think it's also generating taking a more taking a more data back, evidence based approach. And to your point, I think technologies in precision medicine actually allow us to better quantify some of these outcomes, as we then put that into the equation, which may or may not need to be updated to your point, so that the best technologies can get to consumers, I mean, patients, at the right time. Yeah,

Dan Lippis  31:13  
and not and again, maybe it's, it's less interesting in this part. But the reality is, too is, is that you can, you can bring an enormous amount of value to a society, right? You can bring an enormous amount of difference with an innovation in Medtech that changes the quality adjusted life here, or changes the quality of life in general of a patient and from a society perspective, that's valuable, but maybe at a hospital economic level, like you know, for an annual budget, it's unhelpful. Yeah. And so there's sometimes these things, two different types of economics and two different types of decision making. In fact, every day it's different. They're at odds with each other. That's right, that also makes it difficult for innovation to live, right? But these are the sorts of things that you know that's part of the challenge, that's part of the whole process. When it is one system like the United States, it's a clear you got a clear goal to go focus, right? That's right. When it's one policy that you need to change in Europe, it's clearer. When it's 45 different countries with all with their own thing, and by province, it's different, and all that sort of stuff. It makes it harder to harness the opportunity and create solutions for patient access. And I think that's the big challenge that we have in Asia. But it doesn't change the fact that the opportunity isn't there. It just means that the opportunity requires a lot more work,

John Eng  32:38  
yeah, capacity, hopefully more predictability in the future. Yeah. But actually, then, to that point, I think, you know, where do you see bright spots for for Asia when it comes to in terms of technologies? Since you're out here LSI, are there certain technologies you feel Asia can take the lead? You mentioned digital? Well,

Dan Lippis  32:57  
you know, that's the obvious one, and it's not so relevant in my world, but there's massive opportunity there, right? And there's actually a, you know, was just having dinner last night with colleagues who are here from from Israel, who are working in our plant in in Singapore, testing different theories and ideas around different applications of of AI based things, and it's like, Oh, wow. I didn't even know that, you know, this was happening in my backyard, but it's, it's fantastic. There is a real, there's a real opportunity for for that in this region, and the application in healthcare. And I think, you know, you know, I think that this is an area where Asia could disrupt, right? And but like you said in with the EDB and with Singapore, it's a competitive world out there. It's one thing to sort of disrupt one time, and it's another thing to do it sustainably over and over again and lead, you know, the process of disruption from a long term perspective. And so I think from that perspective, for sure, digital application, it's a, it's a, it's a region that is very data forward, right? Healthcare is often not everywhere, but in major markets, is, is is data forward and and smart in its application, right? And so there's opportunity there, you know, I think that, like you mentioned, from a skills perspective, yeah, I think that we have a lot of skills, you know, technical skills in the region that creates opportunity, you know, to from, from the innovation there may not be the end to end attractiveness to take advantage of those skills, but they're there and so and then, like I said before, the population and the access to talent and the mindset that people have here. The it's amazing how passionate people are in this region. You forget sometimes. And so there is a willingness here that doesn't exist anywhere else, an ambition that exists here that is quite different. And I think that that can be harnessed in a very positive way as well.

John Eng  35:19  
Yeah, that's very good to hear. Technology wise, are there things besides digital you're looking for? You think, I think that's the big

Dan Lippis  35:27  
core of it. I think that there are a lot of actually, there's a lot of interesting technologies that are coming out of this region, but they're going to struggle to live outside the region. And I think that that's kind of like, you know, I think that right now, when I, when I look at a lot of the technologies and ideas, first of all, that wouldn't have happened 20 years ago or 25 years ago, so the fact that it's happening is an is a shift, right? And that's amazing. That's creating a lot of opportunity for and I would imagine why there's a lot of people at this conference is there's a lot of really interesting things that are happening. The quality of those new innovations coming out of the region are also, I wouldn't say, consistent, that you can get really high quality as well, but it is difficult. I think that at the moment, it's still transactional, right? It's still going to be early stage without like, you know, it's going to be idea creation, idea exit type thing. It's hard to imagine something that is going to be generated here, or anything that I'm seeing as generated that's actually going to be developed here and then changed even within the life cycle. So, but robotics is an area that I think in this region, particularly surgical robotics, cardiovascular robotics, is an area that I think will will explode here before it does in the West. And that is just the because it's the because the patients demand it, and I think that is going to create opportunities in that space that is probably led through demand here, which I think is super exciting.

John Eng  37:08  
Yeah, well, it addresses one of the key gaps in this part of the world, which is there's not enough clinicians to deliver the increasing level of care that all of us require. Yeah, well, thank you so much, Dan for sharing with us your insights. I really loved the stories that you shared from your experiences living in this part of the world and actually in the US as well. Thanks for sharing. I think you raised a couple of points for Asia that I think we in this part of the world can can think about. I think certainly dealing with that cost dynamic. How do you think about value based care, option versus just a focus and cost? I think that's food for thought. For Singapore. We think about it in terms of having more data to back up some of these interventions, but that's something for us to think about. The second is a wish list that I think I've been working with EDB for about 15 years now. The second that I took away is actually around the convergence of the markets in Asia. Instead of tackling Asia, instead of tackling Asia as a giant, we have to deal with many, many different markets. Yeah, and the extent to which we can forge more convergence, whether in terms of clinical practice or regulations, I think that's something that we aspire towards. What I came across the other day was between Singapore and Thailand. At least there's a level of mutual recognition, even for med tech. But certainly we hope that that's more of this, or more patients can benefit from the technology

Dan Lippis  38:43  
that, and that ultimately would be my dream, like you know, is that, from a med tech perspective, Asia is not a sum of markets that is actually a region that that can lead That's right, Right, and that in in a reliable, predictable way. And I think, I think it's, it's 100% possible, but it's not going to be so easy. So, you know, like everything i is, you know, one of my favorite quotes is opportunity is missed by most people because it's pressed in overalls and it looks like hard work, and that's the Thomas Edison quote. But I think it's going to be the same as far as how we push forward here with innovation. But clearly, we've come a long way over the last, you know, 2530 years, and at that pace, there's no reason to think that we can, you know, go even further and even faster over the next 2025 I hope to have a front row seat.

John Eng  39:39  
Yes, you're in you're in Asia, yeah, hard work, but the price is there well. And on that note, let me, let us join. Join me in giving Dan a big round of applause for his generous sharing.

Dan Lippis  39:51  
Thanks, John,

John Eng  39:53  
thank you, Dan. Appreciate it.