21 Jan 2019
Shaping innovation in MedTech in The Netherlands
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With technology at the heart of so many medical breakthroughs, Jochem Overbosch met three leaders driving change to discuss how the pace of innovation might be accelerated.
The Netherlands’ Medical Technology industry is one of the most vibrant and innovative in the global market. The heart of that innovation is less about technology and more about meeting patients’ need, collaborating across the sector and finding creative ways to shift technology interventions from treatment to prevention and diagnosis.
Odgers Berndtson’s Global Healthcare Practice Co-Chair, Jochem Overbosch recently met with three leaders driving innovation in the Netherlands’ MedTech field.
Dirk-Jan Masman is Head of Valorisation at the Radboud UMC. Marijn Meuwese is Head Of Consulting for Integrated Health Solutions at Medtronic for the regions Alpine, Benelux, Greece and Israel (ABGI). And the final scientist is someone once aptly named ‘the most entrepreneurial Professor in The Netherlands, Clemens van Blitterswijk.
The shape of innovation
For a long time, innovation in the field of human or life sciences has been a short-hand for technological innovation, with devices being what springs to most people’s minds.
Traditional hardware and devices have until recently been the traditional domain for MedTech, says Marijn Meuwese - Medtronic’s Head Of Consulting , Integrated Health Solutions, ABGI. Now more often than not, hardware, software and associated services to support patients are converging into a single product.
“A good example is pacemakers,” says Meuwese. “Medtronic is very involved in developing remote monitoring capabilities. Remote monitoring provides the healthcare professional with ways to track the patient’s condition as well as the technical integrity of the implant, such as battery status, from a distance or by the patients themselves. This requires hardware, data analysis and change in the way care is delivered in hospitals.”
"Traditionally MedTech was about devices, now increasingly in combination with software and services around that.”While sector innovation is nearly always technologically driven, UMC Radboud’s Head of Valorisation Dirk-Jan Masman points out that the “presence of technology within the medical domain is so enormous, the current definition of MedTech is kind of an old concept.
It should be broadened to encompass the potential value from the technological developments over the next decade, including innovative developments which we can’t even identify now. Innovations will span everything from diagnostics, treatment, monitoring and medication, and will be much more individualized than we can foresee now.”
Like many similar terms such as HealthTech, EdTech and MarTech, the ubiquity of technology in human medical science means that the term is losing its meaning. While devices and supporting software and services described by Meuwese remain an important segment where innovation can arise, it is the way technology is employed across the whole sector which is resulting in innovation. So that makes it interesting to find out what the sources of- and barriers to sector innovation are.
Where do medical technology innovations come from?
“It is very broad,” says scientist Clemens van Blitterswijk,“The bulk of the Medtech/Life Sciences research takes place in academic hospitals. But also via medical faculties, technical universities and start-ups, often off-shoot enterprises from universities.”
“What we have in The Netherlands is highly regarded science. What we did not have until about ten years ago was entrepreneurship in science. This has become much better. Professors at universities now really enjoy applying their expertise in an entrepreneurial setting. The government has stimulated this development through various public-private partnerships, which means that the commercial application of MedTech is now better than it ever was.”
In a market where academic institutions are ever more part of the commercial landscape, others operating in the market have the “challenge to weigh their own innovations against options that come up elsewhere,” says Masman. “It is important to objectively balance these two sources of value with a global application of impact in mind.”
"This process of value creation from knowledge – once called ‘Technology Transfer’ and more recently ‘Valorisation’ – is where a lot of the innovative thinking comes from."
“At Radboud UMC we first look internally at what our patients need is and what our research ambitions are, and subsequently focus on supporting innovations within these domains. And secondly, we scan externally how global technological developments in these same domains are progressing, evaluate them, and test them on a number of criteria to look if they are fit to focus on further.”
“We try to determine the impact these technologies may have on improving healthcare, both with regards to our patients needs and to our research. Then, and only then, we assess the impact on cost structures.”
What defines success for medical technology innovators and patients alike?
Masman: “We look at what the innovation will mean for a patient, for the improvement of healthcare as a whole and then we look at the associated cost. With our team we try to look ahead and consider if something is financially healthy over a longer time horizon, even if in the short term costs seem to outrun benefits. It helps that we are a not-for-profit organization and still have the opportunity to do so.”
For Meuwese, innovation can come in different forms. “When a new product is introduced, such as the implantable pacemaker in the fifties, that is a breakthrough innovation, changing patients’ lives. Other innovations build on these breakthroughs and are aimed at further improving the performance and value for patients, such as tiny batteries that can last longer. Other forms of innovation beyond the product are service and business model innovations, for example different payment models based on outcome for the patient and effectiveness of the treatment.”
“One of our goals is to allow procedures for patients to be as minimally invasive as possible.”
Masman: “The ability to measure through your mobile phone is very valuable. Through a drop of blood, software can interpret so many different aspects of a patient’s condition. A system can interpret real-time data and say ‘take half a pill’, which improves the quality of life of these patients significantly.”
“Patients with haemophilia can now track their clotting factors through their phone, track their condition and report progress to their doctor. This improves the lives of patients dramatically and we can further improve treatment and research from the patterns of the data we can collect from these patients. I find these innovations beautiful.”
What are the challenges in making preventive medicine/technology a success?
Van Blitterswijk: “The shift from curative to preventive healthcare means that in the long term you need to carry out fewer interventions. Which means diagnostics becomes much more important. But we are still far from that, because we know so little yet.”
“When a disease is caused by one thing, for example one gene, it is fairly easy. But mostly that’s not the case. When more genetic, hormonal and habitual factors are involved, it is much harder to prevent a disease from happening. Everyone knows that it is not good to be overweight and not exercise, but nevertheless there is a great number of people who are overweight and do not exercise.”
Masman: “Food is more and more identified as one of the most important determinants of our health. It is very difficult to translate this insight into policy, or some way of ‘treatment’ for which costs can be funded similar to curative treatments.”
“We have to still explore what our society wants to do, what our politicians want to represent and how research can accelerate the innovation curve in this domain.”
For Masman, the challenges for successful preventative medicine comes down to who takes responsibility and what system there is put in place to cover costs. “If a patient is ill, then there is a system of healthcare insurance to cover the costs of the patient’s treatment. With prevention it is different, because there is no defined treatment. It is very unclear who’s going to pay for what.”
With the challenge of not having a holistic system to tackle primary prevention, secondary prevention/early detection is where MedTech plays the largest part, says Meuwese. “The technology that focuses on lifestyle and primary prevention is more in apps and coaching, and there are a great number of companies active in that field.”
“A more general challenge is that healthcare benefits fall somewhere else than where costs are carried” says van Blitterswijk. “A new method can be at the expense of one group of medical professionals, and favour another. Embracing new technology by the medical community is often very hard.”
How can the public and private sectors drive innovations in medical technology?
Masman: “The government could advise us if an innovation could be part of the publicly-funded healthcare insurance package or not. If an innovation is on the horizon, it would be very helpful to have a process in place where government and insurers would be able to tell us whether the innovation will be funded, dependent on whether the innovation lives up to the its claims.
Zorginstituut in The Netherlands for example could organise this. This process would allow us to invest in even better targeted investments, which would result in a higher innovation yield on our portfolio.”
“Moreover, I would love it if we could combine public investment funds with private funds, for example by involving private equity.”“We would ask a private fund for its risk appetite, and then bundle projects with a particular risk profile for a particular investor. If we could put an additional €100.000,- into a project from a private fund, we could substantially lower the risk profile of the project, which in itself could draw additional investments.”
Blitterswijk: “The government can steer innovations in MedTech through subsidies or bringing together the right parties. In The Netherlands, we have some of the largest European venture capital providers in the field of Life Sciences.
But moving public innovation knowledge to MedTech or to privately funded companies is not yet where it should be. That’s not only because of financial considerations, but mostly because of people. In Boston or Silicon Valley, we see good public/private cooperation much more often.”
Meuwese: “I think the government should create a supportive environment for innovation, but not drive innovation. Innovation is fundamentally driven by patient needs and market demand around the world. A good example is the left-ventricular assist device or support heart. Scientists and MedTech companies developed that, due to the shortage of donors. It’s not that the government asks MedTech to develop that. The government can help fund research, but should ensure a good process for admission and reimbursement.”
“I think scientists and doctors from both sides can play a much larger role and create much more impact if they would work together.”
“For example, if the government says e-health is the future, we would ask them to create a context in which e-health can foster. The government could make sure the right infrastructure and regulations are in place. It could ensure a good market environment, clear standards for companies, and encourage public/private partnerships. It’s more about facilitating, creating the right conditions. MedTech needs a business climate to harness those innovations that have real impact.”
Driving change and ultimately having a significant impact on patients’ lives is the driving force behind many of Odgers Berndtson’s placements. As Jochem puts it: “Innovation is at the heart of our clients’ change agenda. All we do is make this change agenda very explicit, and then translate the agenda to personalities who can make this change happen.” Since Odgers Berndtson is by far the premier headhunter in the global healthcare sector, we can help our clients by showing them how other healthcare providers or payors create value. This is where innovation and global scale very nicely double up for our clients’ benefit.
Odgers Berndtson’s Global Healthcare Practice works with a wide range of service providers, payors, and governing bodies to secure innovative and highly-motivated leaders. To find out more, please get in touch below.