The Irish Advantage: A Hub for International Growth | LSI Europe '25

Joey Mason  0:05  
So welcome everybody. I'm Joey Mason, moderating the panel today. Wear a couple of hats at the conference. Say half of it is with clar capital, which is a venture debt provider. We do life science investing early stage growth companies when they're revenue generating. I also am a venture advisor with sophomore partners in Ireland, which is really related to today's topic, and sophanova as a range of I'm sure everybody knows who sophomore is. I probably doesn't need too much introduction. So on that note, speaking of introductions, introduce the panel. Maybe Eamon. Give us a quick overview.

Eamon Brady  0:43  
Hi everybody. Eamon Brady, CEO of a cute heart failure company called White swell. I've been in med tech for 30 odd years, and this is my third start up. So looking forward to the discussion today.

Caroline Gaynor  0:58  
Caroline Gaynor, so partner with light stone ventures. It's a US venture fund that we invest globally. I sit in the Dublin office and charge source European deal flow. Also have a role in the ivca, which obviously is trying to promote venture investing within Ireland and the startup ecosystem.

Wayne Allen  1:16  
Hi everyone. Wayne Allen, I am the CEO of company called perfuse, clinical stage, heading to commercial stage, interventional device company, 20 years in med tech. This my second start up looking forward to a conversation

Joey Mason  1:32  
super well. The topic is the Irish advantage, that we're a hub for international growth. And I guess when people ask us, you know, when's a good time to start a hope, it's like plant in a tree. You know, 20 years ago was the answer and, but if you're looking at it now, well, what do you do? And before we go into we had a bit of prep before this. We had a list of questions, and just gonna throw a quick curve ball over explain to people what enterprise Ireland is, because they're a thread that goes through absolutely everything that's involved in the Irish med tech sector and has for the last 30 years. And for those of you who don't know it, it's essentially, it's a semi state government body that is made up of a bunch of smashed in, you know, research foundations, financing, and it is done. It has been a thread that's gone through everything that has pulled or supports a lot of the sector. So quick thoughts on to explain to you what is AI, how and how. Like, sorry, I'm starting it from the premise that you just couldn't make it up. You could not start with a white page and say our blank sheet. Say we're going to design AI you wouldn't like it just doesn't make any sense. So how did they get here, and why is it such a big part?

Eamon Brady  2:55  
Eamon, I think, to push enterprise Ireland in context, it's important to think about kind of overall Irish industrial policy over the last 30 years. And the there are two organizations, the Ida and enterprise Ireland. And the IDA look after kind of foreign direct investment into Ireland. So they've been very successful at pulling in large corporates and bringing them into the country. And then enterprise Ireland has a different mandate, and they're more focused on serving the needs of the indigenous sector within within Ireland. And they do everything, as Joey says, from you know, supporting the colleges, supporting kind of research centers, grants all the way through to equity funding and even investing in some of the venture funds as well. So everything to do with supporting the Irish indigenous sector falls within Enterprise Ireland's domain and and they're very focused on kind of thinking about, you know, the hub, and the development of the hub, and what are the gaps, and how can they be innovative as the company, as business moves forward in the country.

Caroline Gaynor  4:01  
And I'd agree with all that, obviously. But you know, when you think of AI and seed invention scheme, that I think, if we were to go way back, that was kind of the genesis of really putting a focus on Ireland, on startups, on entrepreneurs, and creating that ecosystem. And, you know, there were various other factors. It wasn't just that alone, but no AI, I think to date, are one of the biggest seed investors in Europe. They still maintain that and you know, in my own role, when I left pharma and started trying to navigate the startup space, it was AI that you meet every step along the way, be it spinning out of the university, be it as a female founder, even and equity to help you get on the ladder from that perspective, or just cash and help and support and introductions. They really feed into every single part of the startup journey, and especially for try to support people who maybe don't necessarily know what they're doing, right so and guiding you towards different pots of money. So they are really integral. I think they're the first person you meet in your journey, and they stay with you then the whole way through. Obviously. Different factors take over as you move along. But, you know, without them, it would, I don't think we'd see half as many starting frankly, I think they do provide that starting point.

Wayne Allen  5:12  
Well, not much to add to that, really, but I give you my own personal experience. I've raised six or seven rounds now, over two companies and EIA have been in every single round, you know. So that's kind of what they are there. It really matters early days, I guess you know, they're writing six figure checks when no one else will write them. I don't know if you want to introduce bio innovate now, but sorry,

Joey Mason  5:33  
perfect time. That's actually all part of it. That's right. It's really hard organization and historically, to explain how it got to where it is, but it's, it's core to how Ireland, the the system in Ireland, has worked, and how it's developed over the last year. There's loads of other things as well, but AI is, is core. So, yeah, go through, yeah.

Wayne Allen  5:54  
And I think it's worth giving a bit of context as well. Like I work in the US a lot. We're engaged in big studies in the US. When you talk to Americans about Ireland, and you get into describing the country like they're quite surprised. 5 million people, you can drive from like, west to east in two and a half hours. It's, it's kind of, I guess we definitely punch above our weight in med tech based on the size of the country and its capability. But without the likes of enterprise Ireland, you couldn't have, you know, I guess the likes myself and Caroline came from the bio innovate program. So just quickly give you the Genesis there. So it's based upon Biodesign Stanford. However, it's very much like an Irish model, right? You cannot compare Galway to Stanford. It's incomparable in lots of reasons, for lots of reasons. So but enterprise Ireland, you know, we're the key founder of that. That was 2011 was the first year of bio innovate. And I guess if anyone's not familiar with that model, basically, you get a small team who live in a hospital for 10 months, you try and find an unmet clinical need, and you try and form a company. That's basically it in a couple of sentences. So like I said, Caroline and I came from that, and Edwards iron got that off the ground and and when you finish bio innovate, that's a 10 month program. Guess what? They're waiting for you there for a commercialization fund. When we started in 2011 2012 we got 350k I believe now it's eight or 900k so now you've got and when we used to engage with the Biodesign folks in Stanford, and they couldn't believe this, you got basically three years worth of runway. It's not a huge amount of cash, but you're buying time, right? You can pay yourself 50 grand, keep the lights on at home and spend three years and go and do an animal study and get a couple

Joey Mason  7:37  
of hands and I think that's part of how I was thinking about what. It basically underwrote bio innovate. It continues to underwrite. It is invented, the commercialization fund, to essentially fund bio innovate, which causes consternation around the country, but that's what it was for. And the reason you know these are all non companies. The commercialization fund is for university based projects because of state age rules in Europe, so you can't give a million to an early start up without ownership and all the rubbish that goes with that. And so, yeah, I found this very creative solution, and I've reviewed a bunch of the commercialization fund applications, as I'm sure you guys do too, they're really complex. I met some guy in reimbursement today, an expert, and say, Actually the comm fund applications talk about reimbursement like these are essentially commercial ready projects. And that's the whole point of getting, getting the 900 900 to a million. And AI basically made the policy. And I don't think many countries can do that if, partly because we are so small, there's 5 million people so but it's, oh, by the way, another bit, which no one mentioned, is it's a competitor conference. But without them, there wouldn't be that conference. It was dead, and it was dead, actually, after disaster here 15, none of 15, sorry, just 11 years ago, and they brought it to Dublin, and now it's in the calendar. In April, end of April, early May, every year, half the world and the Medtech world comes to Dublin, and they do other things. Medtech Innovator does their only non US program out there. So, like again, they underwrote it, they wrote the first check. They brought in 40 pounds. Like they without that, it wouldn't have happened. Yeah, so there's the team. That's it. If I'm thinking of, how do you do it again? You kind of need to find something like that, because none of us can do this all by ourselves. We have our different roles. So speaker, where's things? Where do things stand at the moment in Irish med tech, if you took a snapshot today, Wayne, do you want to have have a go? I mean, you're bio innovate alum. You've raised lots of money, you've got lots of background in the on the industry side. But. Where do you see it now, from your

Wayne Allen  10:01  
perspective, I guess, like, I think it's constantly evolving. If you look at the genesis of it, you know, go from you could nearly take it by the decades. I think the we're moving now, I think, into the next kind of phase. I think the Pro V, there was a proverb around announced a couple of weeks ago. It was $80 million I think that represents it. That's a huge round. It's a commercial round, and they're going to the US. They're trying to get market leadership. You got some serious investors in there. So that's the direction it's going in. 10 years ago, that wouldn't have happened. I was looking at Aiman, we're in the stroke space. Eamonns, previous company was in the stroke space. We were like, Okay, if you raise 25 million, you try and take a shot at exit. But now these companies are raising 8090, 100 million, and they're they're trying to go all the way. So I think that's the direction it's heading in. It used to be all very Galway centric, West centric. It's kind of spread around the country now. So moving into connected health, AI other spaces before it was all cardiovascular catheters. That was kind of the origin of the space. And now you can see it spreading out into other towns and other areas. So that's kind of the next five is it's hard to see these when you're in the middle of it, but that's where I would, I would guess

Joey Mason  11:16  
right Eamon from the kind of call it repeat offender.

Eamon Brady  11:19  
And I think one thing that I'd layer into the evolution of the hub in Ireland is the manufacturing capability and the large corporate sector is of fundamental importance. I think in any hub you have to have large corporates that anchor talent and the anchor all of the supporting companies around about those and, you know, in Galway that started off with Sierra barred, no Medtronic and Boston Scientific, but, you know, you take the top 15 medical device companies in the world, they all have manufacturing operations in Ireland, and that means that you have a very large pool of talent that is anchored in the country. And I think that's a huge strength of the hub over the years. It's also a potential weakness as we move forward and then to kind of follow on from Wayne's thinking. I think if you were looking at output today, I would say probably 85 or 90% of product sales from Ireland are coming from the large corporate sector, and not the startups. But that's because, you know, the startups up to now have been kind of getting to a point and exiting, and now we're moving into a phase where startups are raising larger rounds of funds. They're going into commercial phase. And I think the next phase of evolution is where you start to see companies become I call them Irish multinational, kind of indigenous Irish multinational companies. And I think there'll be a lot more of those as we move as we move forward. And I also think the more the heart the difficulty getting companies off at earlier stages is a factor in driving the industry in that direction. You've got to go farther, you've got to go deeper into commercialization, you've got to deal with reimbursement, you've got to deal with commercial challenges in order to exit companies. I think that's also a factor in just driving us in that direction.

Wayne Allen  13:01  
Yeah, we're forced in that direction before, in order of choice. But a good example there of a company becoming a multinational is air Gen rice. So they're doing 100 and 50 million, probably an Irish med tech unicorn in the mail. Absolutely. Yeah. So perfect example, market leader for long time. Yeah? You know,

Joey Mason  13:20  
yeah, Caroline, you've obviously a different perspective from actually, broadly. I mean, you've got the bio innovate background. You have the you've been working with the US Vc as the Irish sort of person on the ground and so, and now you've got the overall view of what's going on in venture with the as chair of the ivca. Where do you see it today? And kind of your thoughts of where it's come from? Yeah.

Caroline Gaynor  13:48  
So look, I think from a med tech hub perspective, in Ireland, we're doing really well. I mean, I also work in the biotech side, and we kill to have any of this infrastructure. There's numerous reasons why it hasn't worked as well on the biotech side. But I think you're right, having the big, large corporates here, if you can get them doing the R and D, and get them involved in that ecosystem. And, you know, being able to pull talent out there, it's huge. You know, there's a lot of talk, and in the obviously, in particular, we think, you know, we need more scaling capital. We need bigger local funds that can write some of these big checks, be less reliant on the international VCs, and that's part of the problem, for sure. The other sort of issue that I'm not sure we got around is the number one launch market still, for them, for most of us here, will be the US, you know, and until Europe, and whether Europe can, or ever, Will, become a valuable competing option for that, and it used to be. I mean, it used to be, so it's not to say we can't go back to that, but I think scaling capital is part of it. But at the end of the day, you got to be where you're going to launch, or whether the HQ needs to be there, we can debate. It probably does not. And that probably is a feature of having international VCs who are US based, wanting the HQ to be in the US. But. And, you know, that's what we have to figure out. It's how to get more money into local VCs, and what strategies we employ to do that. I feel the last 10 years, because of various coalition governments, there's been no big policy moves. I mean, I felt the Irish rules, very brave. If you look back in history at trying new things, trying to be at the forefront of enter your seed, you know, creating that infrastructure, and it feels like it's maybe stagnated a little bit. Other countries have in some way copied. They're competing, you know. And now we have the high tech which we haven't necessarily jumped on board with, and then you have the low cost economies which are coming on stream, and we're sort of in the middle. So we need to find new ways to make sure, make sure we continue to have this hope of excellence that we don't see it tickle away over time. But you know, we speak English, we're very close, the same reasons that, you know, people like to be here. It's an easy option, if you're looking at Europe, as you know, a landing pod where you're going to put your operations iron instead, as attractive, I think you mentioned

Joey Mason  16:01  
international funds being in there. And I kind of, I guess, early experience when I was in Delta, like 20 years ago, I used to go do a lot of scour it around Scotland as part of my, you know, patch. And it was a thriving venture investment environment in Scotland in the early 90s. And I think the government kind of feared it was done, and just switched off, and within three or four years, it was dead. It literally and it hasn't recovered. Sep, for example, came down south, and it was so fragile back in Ireland, I think the role of the likes of ISAF, who've been an absolute catalyst in bringing the international funds. That creates problems. I think it certainly creates jealousy and animosity among the local funds. And having been in one, it was like, why can't we get that money? But that's serving a different purpose. I mean, you

Caroline Gaynor  16:59  
Oh, it's, I think it's fantastic. I mean, we're now seeing interest in Ireland from funds that, typically, you'd really have had to drag them over here, and now they're actively on the ground. They're looking, they're intrigued, they're open to doing deals in Ireland. So look, it's all net positive. That says who you know that money may go elsewhere. I think having local, bigger funds also makes a lot of sense. And I know, you know, if you say are obviously trying to unlock Ben money insurance money, there's just phenomenal amount of money on deposit in Ireland, and you know, we should be putting that to use for our own economy. But, um, yeah, that's, that's a bigger policy change,

Joey Mason  17:34  
bigger policy Yeah, and we've got high networks in syndicates who are doing it at the earlier stage as well. I mean crowd funding, which is small. I mean, I gotta get it like, there's, there's, this is very, the picture is very, is, you know, rapidly changes and it's, there's never anything. It's perfect. That's just not how these things go. Aim, and you actually mentioned these, some of the international companies, multinationals, the parts who essentially started, they were the foundation for the the sector which had a rotate, rotated out of it, metal bashing for some of the big computer companies that then went new, Like deck, which suddenly stopped manufacturing. What do? What else do those multinational, I think, of the overseas network that they bring expertise, you know, the Irish overseas who want to come in, like, how does that play out in the in the sector?

Eamon Brady  18:35  
You know, if you, if you look at an awful lot of the early startups in Ireland. And even still today, like the people that are manning those are coming from, from large corporates, I bet you, if you went through the bio innovate companies, I mean, the bio innovate model is fantastic because you pay the mortgage while you're getting your start up, up and off. And most of the time it's people in their in their authorities. But like I would say, a high percentage of those are coming from, from large corporate multinationals. And so there are huge repositories for talent that eventually come into the start of the startup sector. And they've you know as as those companies developed in Ireland. I mean, it started off in the very early days in purely manufacturing. We were low cost labor, labor market with English speaking, well educated people that allowed us multinationals to sell their devices in Europe. But then, you know, those bases started to compete for R and D and, you know, regulatory jobs, and they started to kind of add the full functional expertise. If you want to hire a regulatory leader now, you know, you're going to look to someone like Medtronic or Boston Scientific to go and hire them out of so that talent pool across all of the functions is really important. Kind of startups depending on trying to poach them, and they're hard got because the corporates pay well, and they'll have, they have, they have good packages.

Joey Mason  19:54  
And when you sold your RV, I mean, they basically J and J established a. A center, and what, how has that given people access, then into the larger beast that is J and J at senior level. I mean, I can only imagine that's advantageous.

Eamon Brady  20:14  
Well, interestingly, you know, almost all of the senior management team from uravi stayed with J and J and know that organization is doing J and J, S, R and D worldwide for the neurovascular business. So they've really kind of pulled pull that in. I was very careful the first couple of years. I behave myself, but we've pulled one or two kind of key hires out of it, so we still look at it as a repository for talent.

Joey Mason  20:44  
That's great. That's great. And I presume mean way, you know, as you're looking into the states, is there that network that you're able to feed into in terms of finding talent and finding people who can, you know, help guide the way, either through direct hires, through consultants working at, got the Irish diaspora in hospitals, you know, champions. I mean, is that a bit oversold, or is that actually, is there something there?

Wayne Allen  21:08  
There's something there, you know, like we it's such a small community. We all know each other. I would easily reach out to any kind of Irish expat who's embedded in us, med tech, and ask their advice and on something. But I think generally, go back to Amos point, it is the kind of the deep cluster and the good training level that the multinationals developing arena. You've got a really solid base there. They're paid well. They're trained well. So really, if you're going to take someone from a multinational to start up like they really want to do it, you know? So it's, I think it's a small percentage, probably five or 10% of that base that actually want to join a startup. You're getting the best of the best. So you're getting people who are really well trained, really well educated, and then they have the desire to join a startup. So I think we're very fortunate, really, to have that in our doorstep. We don't have to lean on, you know, reaching out to, you know, I guess, bringing people from other countries in, and dealing with visas and stuff like, it's just all it's just all there in the doorstep. That's the isn't that the definition of a cluster or a hub? You know?

Joey Mason  22:06  
Yeah, no, absolutely. Speaking of hub, what is your How do you think of out of the hub? What is it manufacturing hub? Is it a cardiovascular Where do you see it? Or is it a rain the range of services? Or, I think when we were chatting, Amy said, The only constant is change. Yeah, just have to adapt. So we've gone from a very narrow base to where we are. How do you see it today? And where can it adapt? And then we maybe reach out later about what are the challenges?

Eamon Brady  22:39  
You know, I think a hub really is about a depth of expertise that runs, you know, across different groups. So you've got companies that have specialism, you have universities that line up behind that. You have, you know, sub suppliers and services that sit into it, you know, and like, there are lots of hubbells around around the world. I was reading a thing recently that said 50% of payroll in Europe comes from hubs of one make shape or forum. So the really important component of wealth, wealth creation and unemployment, you know, when you look at kind of that, that specialism. So I think about it as deep specialism, like 90% of cardiovascular current stents are made, are made. Of the world's current stents were made in Ireland. 50% of ventilators are made in Ireland. And that's a kind of a depth in very specific med tech sectors, not in every sector, in very specific med tech sectors. And I think the same is happening in other hubs around the world, where those hubs specialize very deeply in one in one sector. I think that's a challenge for the evolution of the homegrown industries. You know, you don't have, you know, 10 Euro vascular companies in Ireland. You know, you've got Williams company at the moment, you haven't got 10 heart failure companies. You have maybe two or three. So So that's that depth of synergy in some of those individual here, but you have a lot of vascular companies, and so that is there in depth. So creating depth in a Hubbell, think is really important.

Caroline Gaynor  24:16  
How do you see Caroline? I agree with that, just having everything around it. But then what I think Ireland brings is just everybody knows everybody, and you're only ever two phone calls away from getting an answer. If I can think of what makes a hub work, truly, it's that, because you'll have all your various cohorts of players, takes a village, as you say. But being able to pick up the phone and know you can talk to somebody without it being something that seems a monstrous task is huge. And I've seen that in everywhere I've worked to be a pharma there's nothing you can't solve, really, if you know within the ecosystem, there's going to be somebody that can help you. And I feel in this country or in Ireland, we have access to that more so than others. There seems there's more layers to get to the right people in other places you mentioned.

Joey Mason  25:00  
That biotech hasn't worked. Do any thoughts on why? I mean, I've always opinions. So when I let you go,

Caroline Gaynor  25:09  
so I think, you know, AI is phenomenal, and it's done a great job. If you think the check size, I think it just simply doesn't work for biotech. Whereas two to 5 million can get you a long distance of the way in med tech, and it can get you to the point that you've got something for real, and in biotech, that's not going to get you really anywhere, for the most part. And so there's a gap still, right? So it just needs to be a bigger quantum, and we haven't quite figured that out. Plus, we don't have the skill set the FDI, and it's very heavy manufacturing, it's regulatory, but, you know, there's, there's plenty of talent. It's just not in the translation, not in the chemistry, not in the early stage, and it just takes a lot of money, I

Joey Mason  25:47  
think, almost going back to Evans, point to there's a there's that, essentially, you don't need manufacturing. You can have a buy you can have a virtual biotech company anywhere in the world. Those need new all you need is internet connection, yeah. And so the execs can be one place. The manufacturing can be off somewhere else. Your clinical trials is run somewhere else. Your regulatory and compliance, you don't need presence. Whereas, if you're manufacturing, you need presence. It's simple. And if you have all the contract suppliers into there, they have to be somewhere. And that's the whole. Biotech model has essentially become, become virtual. I think Wayne for you, thoughts on what, what is your thought of a better hub from a

Wayne Allen  26:27  
couple of things there. Aim talked about manufacturing like, I do think we're that we have a level of excellence in advanced manufacturing. And, like, I have recent experience of this, you know, one of our contract manufacturers, like, you know, they're always, this is, I think, probably one of the differences, always trying to evolve, always pushing themselves, always trying to keep ahead. What can we do different? So they have developed a team that will basically build equipment so, you know, reduce your cogs, speed up manufacturing. They used to outsource that. It used to take six months, big, long process. Get CE mark. They do that now in a couple of months, and they see Mark the machine on site. You know, it's that sort of stuff that you don't get anywhere else. Like we did a kind of a back it up envelope analysis, looking at tariffs. If we move to the US and manufacture our devices there, you know, the trade off. Like it was no advantage to do that, you know, because I guess the cost of of goods and services and they were, is higher in the US. So, so realistically, you've got, at the moment, anime, you've got really advanced, high end manufacturing. For us anyway, that's a key part of the hub. I think another important piece as well is, you know, the folks who get exits reinvesting. There's a reinvesting culture. When I started out with Embo the first day, the first company, you know, there was a Medtech angels group. Now they tap out very easily because it's such a small community, but still, they're still there, right? And they want to give back and are interested. Aim is done the same. Sonya Ravi found in whiteswell. So there is that that's part, a big part, of our hope. I mean,

Joey Mason  27:53  
certainly, when I started in the sector, when Frank, when I came back to Ireland, a long time ago, there was no sector. So if I was looking for a job, I ended up doing biotech, because there was simply another there. And you do have repeat entrepreneurs, kind of a general thought, Is it unlikely success? What could have derailed it as time passed? I mean, is it, you know, we had a global financial crisis? Could have, I mean, made Ireland bankrupt, everybody who had money, private investors, they all went bust because they were overloaded with that. What? What have we avoided and managed to just keep going that could have knocked

Eamon Brady  28:33  
us out? I think the hub in Ireland is still relatively young. I know 30 years is a long time, and I've aged those 30 years. But, you know, when you compare it to, you know, some of the US hubs, you know, it's still relatively young, like, I tend to think that there was even very little US corporate manufacturing going on before the 1980s it was the 1980s and 90s that you really saw the expansion of that, you know, if you look at, I think, very interesting to track as a patent landscape, from from, from Ireland. And so there were very few patents filed from Irish med tech industry up until the naughties. It started to tape off in the 90s. Hit a whole, hit a whole new level in 2010 and so 2010 is not that long ago. It's 15 years ago. So we're not that long as an, as a, you know, a very innovative sector. And so I kind of feel like we're still at the early stages of innovation. And so I think we have, there are plenty of risks ahead. I do kind of feel that the, you know, the large multinationals and the risks on that front are fundamentally important, and losing a lot of that, I think would would weaken the hub significantly. So I'd be watching that. I would hope to see a much greater presence of Irish indigenous manufacturing in the next two two decades. I think that's the next phase of evolution, and I think that would help to kind of consolidate the sector. And I think there's a maturity in financing also that's. That way, I'd agree.

Wayne Allen  30:03  
Yeah, I think, like, the whole thing is rooted in the multinationals. You said, What could have derailed it? If the multinationals left, that would have derailed it, without a doubt. But like, they've stayed, and they've been there now for, you know, some of them, 4050, years, to eamonns point, just making sure that advanced manufacturing, sustainable, it says at that level of excellence, but you're not turning it into something that is not going to work financially. So it's, these are all fine lines. They're all kind of, they feed each other, you know. So it's again, it's hard to stand back sometimes and see what what should be next. But I do think if we could bring more, more VCs in more later stage money, keep the manufacturing solid, keep the US multinationals there. And I think basically, you know, keep feeding the startups. I think enterprise Ireland, they probably never say it, you know, but you know, it used to be all about jobs and return of tax. But I think realistically, now they know it's almost like a VC mindset, even though they're not a VC. But we'll invest in 10, and two or three will work out, and we'll still be good. I think they take that mindset and keep, keep promoting that. That's, that's probably the lifeblood of at least, yeah, anything in

Joey Mason  31:12  
beginning policy is not, they're not trying to pick winners. They're saying the sector will support a sector. Yeah, Karen, you've mentioned before. The Well, you mentioned here, but the lack of support from a sales perspective, you just simply can't sell product and but if you even go back a bit further, I mean, we don't have a very good hospital system that supports clinical research. Nobody gets sharing a research time, and we don't have electronic medical records. It's not like we're starting, you know, we we have lots of imperfections. How would you see that broader, you know, gaps that will, I think, you know, an increase. They are a risk.

Caroline Gaynor  31:50  
Yeah, absolutely. I mean, fundamental issues. You can't do much in the Irish market, whether it's trialing or product or anything. And if I go, you know, I like to go back to my pharma days sometimes, but I used to bang the drum a lot to get trials to Ireland and sell them on the concept of Ireland. And there's so many positives. I mean, so many of our clinicians are trained in the US. They bring that US mindset. They are literally like America and Europe. And you know, my German colleagues used to be completely perplexed when we were following us guidelines, not European guidelines. And so the trial for Europe was totally different. And then they started seeing, as someone hate say it, but as the 51st state, and we were the place they could run studies in Europe. Get used to that, but with their trial, and so that changed the metric for them. But, you know, with that, you have to show you had capabilities. And it took a lot of promises. Some were an epic failure. I mean, some sites, you'd have to ring every day to get them just to do their job. It was, was not plain sailing. But I think what pharma came to see was Ireland can be really good at certain things. We're really good at h TAs. We're very good at having pricing negotiations. And I feel for the med tech sector, if we can take some of that learning, maybe, like regulatory in the MD, or can we not, if we can be true experts, even on that piece, and make it as seamless as possible in what probably will be complexity, you know, really staff up at a government level on regulatory expertise and just become the center. We have to think outside of just FDI. There has to be other reasons for people to be here, because we're dependable. There's less risk, and it'll be smooth and simpler process. So it's looking at the whole I guess picture, rather than just what's worked in the past, because you have to keep moving, complacency will be over this. Yeah, yeah.

Joey Mason  33:30  
Enemy, take a break for a minute. Ask. Were there any questions from the audience if you missed out? O Lynn, David, Azure.

Audience Question  33:46  
So first of all, thanks very much for a good panel, a couple of comments and then a couple of questions, if you don't mind. So I mean, I think aim hit the nail on head at the beginning. Look, it's, it's 30 or 40 years of deliverment, a deliberate government policy, with all of the wrap around, with the multinationals, with all of the supports around the supply chain and all of that kind of stuff, one of the other things that's really very important is the educational infrastructure in the country. So there was a report recently in The Economist saying that 90% of 18 to 21 year olds are in third level education in Ireland, and that's because we have a free university system, right? But even underneath that, the same report said that at high school level, our school kids are ranking third in the world, behind Japan and Korea in mathematical literacy. So I think that's that's a really, really important part, you know? So you have to take all of that as part of the piece. So now the questions, I mean, you know, leaving aside for a moment, you know the current administration in the US, like, where do you see the dark clouds gathering for the Irish med tech sector as we look forward,

Joey Mason  34:52  
Who wants to start? 

Eamon Brady  34:55  
I would worry about you. The developments in China and India, and the growing med tech sector there, and then becoming a really powerful competing force internationally. And I would also worry about pull back to the to the US. I think the combination those two kind of concern me.

Caroline Gaynor  35:17  
Yeah, spot on. I mean, again in biotech, we're seeing China are winning increasingly and ever so. And I squeeze MEDEX and ax in a place they'll come so. So for me, that is the biggest threat on a number of fronts. And then I guess if relations, for whatever reason, between Europe and US deteriorate, that's that's a problem, and it's more a problem because maybe it will be a taser to Europe, and we'll actually all start trying to act as one union, finally. But I, you know, fundamentally, can't really see that. So Europe will always be held back by the nature of how it's put together. It's why it works in some areas and why it's hard and others. And it's just it's a complex market, so to the extent we can work together to have more unified approach, to reimburse from pricing and just make things more certain and less time consuming. You know, we need to, I think, focus on that, just to protect ourselves a little bit for what is emerging new world dynamics,

Wayne Allen  36:15  
way, yeah, nothing really to add to that, like it's the, you know, you know that phrase, I don't know which politician said is closer to Boston than Berlin. So that door, that door could be closing. And I think that was kind of eamonns point where the US becomes more insular. It's harder to crack in there.

Joey Mason  36:33  
Is there an advantage to be taken with MDR actually becoming resolved in some way, because, like, Europe shot itself in the foot thick, so incredibly, stupidly, is that going to swing? I mean, all I see is more us. Will you be a more us? E or, as my whole career has gone, I that everything is more us. So that's where the risk

Wayne Allen  36:53  
you don't think it's resolved, you know, that, like, it's still there. And if it changes, it's going to take years as well. So, you know, if you just look, just take my own example. You know, if you looked at even the sales, the opportunity in the US versus Europe, they're not comparable. You know, probably get a third of the price in Europe for the same device.

Joey Mason  37:13  
Thanks, Eamon. 

Eamon Brady  37:14  
And yeah, I probably hit you in the comment on something, something else. And, you know, I think one of the biggest structural problems for Europe is this patent system. You know, I kind of, I love the US patent system. I think inventors get rewarded for their inventions in the US in Europe. I think most patents are loss making. Most patents are loss making. In general, almost all patents in Europe are loss making like in reality, when you file patents in Europe, you're filing it so that you can tick a box for an acquiring company when they ask you, have you got equivalent patents in Europe? Mostly they're worthless because the claims are too narrow and they're enforceable and in kind of individual jurisdictions, if Europe got its act together and had a single patent that was inventor friendly and allowed you to have broad claim coverage for your invention, you would have a lot more European multinational medical device companies. It's a fundamental limitation.

Joey Mason  38:13  
Absolutely. Any other questions, please. Yeah.

Audience Question 2  38:25  
It. I was originally going to talk about, you talked about clinical trials, and one of my things is to control that with data. And have you considered things like digital clinical trials as a kind of like conjurer? And to answer this question, it's control of the data within Ireland. I mean, I work with the agricultural section of Ireland and on, on sort flanks, things like that, which I won't go down that rabbit hole, quite literally, haha. But, but, yeah, I think, I think control of data, control of what's happening with with within Ireland, is key to this. I think,

Caroline Gaynor  38:59  
sure, yeah. So we don't even have regulatory.

Audience Question 2  39:01  
Yeah, Europe and the US, the Boston comic, that was hilarious. But yeah, I think control of that's really important, I think, for Ireland, for and for the United Kingdom as well. This, there's a lot to be that we can both learn from each other.

Joey Mason  39:14  
Actually agree. I mean, well, I mean, there's a very basic question, we don't have electronic medical records. Pretty hard to do electronic trials. Now, it's apparently coming through, and I'd love, by the way, we have massive, I know that's it. We've total schizophrenia about GDPR. And we have, yeah, we have a regulator that has historically been considered in the whipping child of, you know, meta and Google and everybody. So any any thoughts on

Eamon Brady  39:46  
it just might go a single, single, single comment, like I was talking to this gentleman earlier on today, and I was making the point that I don't know how many doctors I have spoken to over the year, and they say, you know, we've got this large repository of data. Whether it's in stroke or in heart failure in our institution, that we can mine, but actually they never share it. These are all kind of silos of data that exist in all sorts of places all over the world and that are not been been leveraged. And there is an enormous gap there for somebody to go and find a way to anonymize that data use. You know, modern computer, modern computing, artificial intelligence, to actually do better diagnosis of patients and understand kind of patient outcomes on an individual patient basis. But, you know, I think that's, that's, that's a huge opportunity,

Audience Question 2  40:38  
is in terms of the hub so, and then that's all goes to migrate, or suddenly in Ireland, the UK and Europe, some extent, the USA, Canada, that they're sick. You speak about a lot of stakes benefit before I think, cool.

Joey Mason  40:53  
Yeah, we're out of time. One last question, if I may, which is, okay, we're talking about the Irish hub. Is there any way you see that Ireland as a hub would work with the other European hubs? We think of Scandinavia, Switzerland, Dutch the Israelis. I mean, anything formal, are we all competing in our own little worlds?

Caroline Gaynor  41:19  
I feel very they are working together already. I mean, that's a top level, right? And certainly I see this. Obviously we're trying to get this biotech hub up and running now, huge input from, you know, functional, successful hubs across Europe. They're all willing to help, give their advice. I think we're probably a bit further ahead on the med tech one, and maybe we can be the ones providing advice. You're certainly competing, but you're not really at the same time. I think most of these hubs are funded by state money, who are very inward looking and trying to support their own economy. So I think you can learn from each other. Possible.

Eamon Brady  41:52  
I would agree with that too. You have vertical silos, but each of those hubs have their own vertical silo, their own areas of special specialism, and so you can, you can cross pollinate those and super and create value.

Wayne Allen  42:04  
I'd agree, like Scandinavia, dialysis imaging, you know, Ireland's cardiovascular

Joey Mason  42:10  
that's it we ever thanks very much, guys. Thank you.