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MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 1CONFIDENTIAL
Emerging Industry Trends
and Implications for
MedTech R&D
MassMEDIC SEMINAR
10 October 2008
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 2CONFIDENTIAL
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MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 6CONFIDENTIAL
Introduction
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MedTech Industry Growth
MedTech industry has done extremely well in the past few years…
Double-digit revenue growth
High gross margins
EPS outperformed S&P 500
…and remains an attractive and growing industry
Demographic trends support continuing demand
Emerging markets provide further potential for growth
But there are signs of slower growth in the future
Lower revenue growth
Flat net incomes
Increasing competition
Growing pricing pressures
Increasing regulatory scrutiny
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 8CONFIDENTIAL
Four Industry Trends Present New Avenues for Growth
Technology Convergence
Demand for Efficient Health Care
Demand for Total Solutions
Globalization
1
2
3
4
Aligning R&D strategy with these industry trends will allow
MedTech companies to drive growth
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 9CONFIDENTIAL
Technology Convergence
Demand for Efficient
Health Care
Demand for Total Solutions
Globalization
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 10CONFIDENTIAL
Trend #1: Technology Convergence
Traditionally, medical
devices have employed
fewer, and core
technologies
Mechanical, electrical,
materials
Application and
combination of newer
technologies is enabling
improved product offerings
1
Medical Devices
Pharma-ceutical
and Biologics
Wireless Technology
Information Technology
Optics and Sensors
Robotics
Nano-technology
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$5,400$6,400
$11,500
$0
$2,000
$4,000
$6,000
$8,000
$10,000
$12,000
$14,000
2004 2005 2010$
in
mil
lio
ns
Demand for Combination Products
United States Europe Japan
Rest of World Worldwide
Growth in Convergent Technologies Is Driven by
Scientific and Economic Trends
Scientific research is generating new
technologies and cross-disciplinary
opportunities for medical devices
For example, tissue engineering,
microelectronics, biomaterials, drug-
delivery systems, drug-device
combinations
Demand from customers for more
effective treatments
Physicians, providers, payers, patients
Growing need to differentiate
products
To gain greater market share and better
reimbursement
Combination of technologies enables:
Improved functionality, efficacy, and
performance of products
Breakthrough innovation Source: BCC Research, Drug Device Combinations, June 2005
Drug-Device Combination Products
Market CAGR = 13.6%
1
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Biologics and Device Combination:
Improving Spinal Fusion Surgery
Medtronic—INFUSE® Bone Graft
A collagen sponge (device) combined with human
bone protein (biologic) to treat Degenerative Disc
Disease
Eliminates the need for bone graft harvesting and
one of the surgeries in traditional spinal fusion
procedures
Feature
Traditional
Spinal Fusion
Surgery
Surgery with
Biologic Bone
Protein
Number of Surgeries 2 1
Surgery Time 2.5–3.5 hours 2–3 hours
Patient TraumaMultiple incisions,
severe pain
Reduced blood
loss, less pain
Hospital Stay 3–7 days 2–5 days
Patient Satisfaction Rate 60–70% 90%
1
INFUSE® and LT-CAGE® are registered trademarks of Medtronic Sofamor Danek
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$0
$100
$200
$300
$400
$500
$600
20
02
20
03
20
04
20
05
20
06
20
07
Intuitive Surgical—Revenue ($ millions)
New Systems
Recurring Service
Convergence of Robotics and Surgical Devices:
Enhancing Surgeon Control and Precision
Intuitive Surgical—daVinci® Surgical
System
Allows surgeons to perform minimally invasive
surgery with robotic-assisted surgical
instruments and miniature cameras
Integrates 3-D HD endoscopy and state-of-
the-art robotic technology
Benefits to the surgeon
Improved dexterity and precision
Increased range of motion
Enhanced visualization
Improved access
Benefits to the patient
Reduced trauma and scarring
Reduced blood loss
Lower risk of infection
Faster recovery
850 installed sites, growing 25% annually
Source: 2007 Intuitive Surgical Annual Report
1
daVinci® Surgical System is a registered trademark of Intuitive Surgical, Inc.
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 14CONFIDENTIAL
Wireless Technology in Medical Devices:
Improving Patient Care
NeuroLogica Corp—CereTom™ Mobile CT
Scanner
Portable scanner that enables high-quality CT
images without the need to transport patients to an
Imaging Center
Incorporates a wireless image transfer system,
which allows instantaneous review of images
Feature CereTom™ Mobile CT Scanner Benefits
Mobility Can be used in the operating room
Allows physicians to access
critical imaging immediately
following surgery
Patient Safety
Critically ill patients, often with IVs
or ventilators, do not have to be
moved
Uninterrupted patient monitoring
and reduced patient trauma
Staff UtilizationFrees up nursing staff required for
moving patients
Overall improved patient care
in the hospital
1
CereTom™ is a trademark of NeuroLogica Corporation
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 15CONFIDENTIAL
Key Considerations in Employing Convergent
Technologies
Multiple regulatory pathways
Regulatory uncertainty
Regulatory
Complexity
Development
Complexity
Management
Complexity
Need for new skills, processes, cultures, and capabilities
Need for open innovation, collaborative development, and
partner management
Navigating the intellectual property landscape
Complex requirements: products, packaging, manufacturing
Longer development cycles and higher costs
Complexity in testing and validation
Uncertainty associated with new technologies
Integration of diverse technologies
Unforeseen technology interactionsTechnical Complexity
Commercial
Complexity Complex reimbursement and pricing issues
More complicated sales and service infrastructure
1
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Technology Convergence
Demand for Efficient
Health Care
Demand for Total Solutions
Globalization
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Trend #2: Demand for Efficient Health Care
Health care is a dynamic,
complex industry facing huge
cost pressures
Growing health care costs are
driving the need for health
care efficiency improvements
U.S. health care spending
estimated to grow from $2.3 trillion
(16% of GDP) in 2007 to $4.2
trillion (20% of GDP) in 2016
2
Higher Health Care
Costs
Inefficient Care
Protocols
Longer Hospital
Stays
Medical Errors
Hospital Acquired Infections
Expensive Care
Settings
Dis-connected Information
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Cost of Health Care Inefficiencies Is Astounding
Average cost of stay/day $4,800
Average length of stay x 5 days
Total hospitalizations/year x 40 million
Total hospitalization cost = $960 billion
Nationwide
hospitalization costs
approaching almost
a trillion dollars!
OR cost per minute $40
Average OR turnaround x 27 minutes
Total inpatient surgeries/year x 10 million
Total OR cost = $109 billion
Operating room
charges amount to
nearly $100 billion
Potential cost savings in reducing hospital stay by one day = $192 billion!
Potential cost savings in reducing surgery time by five minutes = $2 billion!
2
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Cost of Health Care Inefficiencies Is Astounding
Estimated infections per year 2 million
Avg. additional cost to treat infections x 15,275
Annual expenditure to treat HAIs = $30.5 billion
Cost of Hospital
Acquired Infections
(HAI) estimated to
be $30 billion
Medical intervention
is the leading cause
of death in the U.S.!
More and more payers, including Medicare, will be denying HAI claims,
beginning 2008
Researchers estimate economic cost of deaths due to medical interventions
to be $282 billion
Continued
559,312
652,091
783,936
Cancer
Heart disease
Medical Intervention
Leading Causes of Death in the U.S.
2
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 20CONFIDENTIAL
Improving Care Delivery Efficiency through an
Advanced Hospital Bed
Stryker Medical—InTouch Critical Care Bed
A multi-function integrated system that combines
advanced technology, connectivity, intuitive operation, and
ergonomics to the benefit of both patients and caregivers
FeatureInTouch Critical
Care Bed Benefit
Central
Interface
Multi-function touch
screen interface
Collects, processes,
and displays data
centrally
Protocol
Reminders
Alarms for tasks
such as feeding,
patient turns, and
medication
Organizes and
promotes compliance
with patient care
Low Bed Height 16 inches from floor
Improves ease of
patient transfer to
wheelchair
Maneuverability Motorized wheelsIncreases ease of
transport
2
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 21CONFIDENTIAL
Decreasing Hospital Stays and Recovery Periods
through Minimally Invasive Surgeries
Zimmer—MIS 2-Incision Hip Replacement
Adapted surgical tools and techniques for hip replacement
using minimally invasive surgical procedures
FeatureTraditional Hip
Replacement
Zimmer MIS 2-
Incision Hip
Procedure
Incision 10–12 inches 2–3 inches
Tissue Trauma
More muscles and
tendons cut or
separated
Muscles and
tendons avoided
Hospital Stay 3–5 days 1–2 days
RehabilitationLonger, more
painfulFaster, less painful
Scarring Large Small
2
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Enabling Efficient Home Health Care through
Remote Monitoring
Honeywell HomMed—Genesis DM
Web-enabled and customizable remote patient
monitoring device
FeatureHomMed—
Genesis DMBenefit
Vital Sign
Measurement
Measures heart rate,
blood pressure,
weight, pulse
oximetry, and blood
glucose
Enables daily, remote
detection of negative
outcomes
Connectivity Web-enabled
Downloads patient-
specific content,
updates, and prompts
User Interface Automated, simple Enhances usability
Display and
Buttons
Angled display and
large buttons
Aids in patient
compliance
DesignCompact and
lightweight (2 lbs)Increases portability
Angled display
with vivid
graphics to aid
patient
compliance
Compact
design,
portable,
lightweight
(2 lbs)
Partial
retest
button for
specific vital
sign
acquisition
Large tactile
buttons are
easy to feel,
easy to see
and easy to
use
2
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 23CONFIDENTIAL
Key R&D Considerations for Developing Products to
Improve Health Care Efficiency
Develop techniques for designing and manufacturing miniature
surgical tools and devices with tight tolerances
Develop minimally invasive and natural orifice surgical
procedures
Minimally Invasive
Surgery
Human-Centered
Design
Infection Prevention Design products that prevent or combat infections
Formulate devices with antimicrobials, disinfectants, and
anti-infectives like silver, copper, and steel
Focus on the user rather than the technology
Identify the context of use, workflows, and care settings
Design products that are user-friendly, error-proof, and efficient
Consider all the stakeholders—physicians, nurses, providers,
payers, pharmacists, patients
Recognize spoken and unspoken needs
Understand root causes of medical errors, HAIs
Understanding
Customer Needs
Telehealth and
Home Care
Design products that facilitate remote patient monitoring and
management and information portability
Incorporate features that accommodate end-users’ capabilities
and limitations
2
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 24CONFIDENTIAL
Technology Convergence
Demand for Efficient
Health Care
Demand for Total Solutions
Globalization
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 25CONFIDENTIAL
Trend #3: Demand for Total Solutions
Total Solution: System of health care interventions to provide integrative
patient care across all disease management stages
Multi-disciplinary combination of devices, systems, information technology, and health
care services
Demand for total solutions is a response to fragmented, duplicative and disconnected
health care
3
Prevention Screening Diagnostics Treatment Monitoring
Disease Management
Stretching
beyond Current
Focus
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 26CONFIDENTIAL
Total Solutions for Chronic Conditions
Conditions such as obesity, heart failure, asthma, and arthritis require early
intervention, multifaceted solutions, and continual monitoring to improve
patients’ lives and reduce overall health care spend
3
48% of the U.S. population has
one or more chronic
condition(s) … and this is
increasing!!!
83% of health care expenditure
is spent on treating people with
chronic conditions…
over $2 trillion
2/3 of our increase in health
care costs is due to increased
chronic diseaseSource: Partnerships for
Solutions (2004)
Nu
mb
er
of
Ch
ron
ic C
on
dit
ion
s
1
0
2
3
4
5+
% of health care spending
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 27CONFIDENTIAL
Integrated System for Proactive Diabetes Management
CGMS via
Glucose
Sensor
Insulin
PumpGlucose
Meter
Diabetes
Management
Software
Medtronic and LifeScan—Integrated
Diabetes Management System
Personalized reports help health care providers
discover trends and other lifestyle adjustments
to improve patients’ control over their diabetes
Product (Company) Function
CareLink Therapy Management Software (Medtronic)
Integrates information from all diabetes management tools
Displays integrated information as readable charts, graphs, and tables
OneTouch®
UltraLinkTM Meter (LifeScan)
Wirelessly transmits blood glucose data to Medtronic’s insulin pump
Eliminates data entry errors
MiniMed Paradigm Insulin Pump (Medtronic)
Precise, continuous, flexible insulin delivery
Guardian REAL-Time Continuous Glucose Monitoring System —CGMS (Medtronic)
Allows greater patient control Patient access to trend data Safety alarms
3
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 28CONFIDENTIAL
Integrated Solution for Acute Cardiac CarePhysio-Control—LIFENET STEMI Management
Solution
Combination of Web, broadband, and medical
technology to treat heart attack patients
Pre-hospital diagnosis of ST-Elevation Myocardial
Infarction (STEMI) is essential to reducing door-to-
balloon (D2B) time and saving patient lives
Hospital Based
Cardiac Care
Systems
In Motion on
Board Mobile
Gateway
LIFEPAK 12
Defibrillator/
Monitor
Product (Company) Benefits
Physio-Control’s LIFEPAK 12 Defibrillator (Physio-Control)
Leads wired to patient records patient data and transmits to On Mobile Gateway
In Motion On Board Mobile Gateway (Physio-Control)
Wirelessly transmits the diagnostic quality cardiac information to patient care team
Emergency Rooms, Cath Labs, Treatment Centers(Physio-Control)
Assess diagnostic data prior topatient arrival
Better organize resources Optimal triage and decisions
3
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 29CONFIDENTIAL
Key R&D Considerations for Providing Total Solutions
Health Care
Infrastructure
Marketing and
Licensing Strategy
Compliance Comply with HIPAA while sharing sensitive patient data
accurately, reliably, securely
Leverage and co-market products to develop total solutions
Increased business development emphasis
Focus on value creation by integrating products for disease
management, not just disease treatment
Often requires technologies and business models that are
beyond current core competencies
Multifaceted Product
Development
Global Markets
Provider IT systems and applications may require upgrading
Solutions that leverage and integrate with current infrastructure
Solutions need to take into account specific solution needs and
the surrounding health care environment for any given market
Key considerations include: reimbursement, clinician capability,
health care infrastructure, local practice
3
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 30CONFIDENTIAL
Technology Convergence
Demand for Efficient
Health Care
Demand for Total Solutions
Globalization
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Trend #4: R&D Globalization
As companies expand across the globe to access the potential of new
markets, the footprints of their R&D activities have also become more
international or dispersed
Establishing R&D sites closer to or in emerging markets allows these
companies to:
Design/adapt products and price to meet regional needs
Lower product development costs and reduce time-to-market
Utilize lower-cost, but qualified, research and engineering talent pool
4
―China ranked first as the most attractive location to establish R&D
activities in the coming years as part of the globalization of R&D with
61.8%, followed by the U.S. with 41.2% and India with 29.4%”
—World Investment Report 2005
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 32CONFIDENTIAL
Growing Globalization of Product and Technology
Development
29%
31%
25%
22%
23%
18%
17%
12%
15%
11%
12%
10%
9%
11%
9%
9%
11%
16%
Final Assembly & Configuration
Manufacturing
Warehousing & Transportation
Return & Customer Service
Procurement
Supply Chain Planning
IT/Shared Services
Product development
Innovation & Technology Development
Globalized Functions 2008 and Increase by 2010—MDD Companies(Percent Managed Outside of the Home Country)
% already globalized (2008) % increase by 2010
39%
37%
39%
50%
43%
50%
50%
104%
92%
Source: “Operational Strategy Globalization in Life Sciences Companies”, PRTM Global Supply Chain Trends Survey, 2008
4
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 33CONFIDENTIAL
MedTech R&D Globalization Examples
Siemens Medical Park, Shanghai, China
―Center of gravity‖ for Siemens’ activity in Asia
with a capital investment of $40 million
Stryker Corporation, Gurgaon, India
R&D center to design prototypes of implants for
―the tastes and preferences of the local market―
J&J’s Surgical Care Group, India
R&D facility to ―develop market-appropriate
products that address unmet medical needs‖
Terumo Global R&D strategy
Strategic M&A in the U.S. to acquire new
technologies; clinical trials in E.U. for faster
release of new products; technology integration
in Japan
GE Health Care, China
Established MR Academy in Shanghai to train
physicians
Global Research Center in Shanghai
Technology Center in Beijing
0%
20%
40%
60%
80%
100%
19
75
19
80
19
85
19
90
19
95
20
00
20
04
Home country Western Europe
USA China
India Other
Source: “Innovation: Is Global the Way Forward?”, A joint study by Booz &
Company and INSEAD, 2006
Distribution of Global R&D Sites
The relative share of industry-wide
R&D sites by location has been
shifting towards China and India
4
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 34CONFIDENTIAL
R&D Globalization Drivers
Market Drivers of Growth
Aging population and growing middle-class and
awareness of world-class treatments
Emerging medical tourism market
Fulfilling local demand through imports
Increasing growth in supporting industries:
Talent and infrastructure development in
Electronics and IT
Increasing emphasis on IP protection laws
R&D Operational Strategy
R&D in support of local manufacturing and local
supplier development
Lower R&D costs with rates 70% less than U.S.
R&D close to Asia market to better understand
needs and often enable market access
(government policy)
Growing low-cost, but qualified, physician base
and research talent pool
Medical Device Markets > $1B
Market US$
in BillionsImports
U.S. 82.6 32%
Deve
lop
ed m
ark
ets
(2–7%
gro
wth
)
Japan 19.1 34%
Germany 12.4 76%
U.K. 9.1 24%
France 7.5 36%
Italy 6.5 70%
Canada 4.7 75%
Spain 4.1 75%
China 3.7 43% Em
erg
ing
mark
ets
(8–12%
gro
wth
)
Brazil 2.6 30%
Poland 1.9 80%
Russia 1.8 80%
India 1.5 65%
Czech Republic 1.3 66%
Norway 1.2 73%
Source: Medical device market reports, Espicom business
intelligence reports, 2007
4
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 35CONFIDENTIAL
Using Global R&D to Reduce Development Costs and
Time-to-Market
GE—Portable ECG Machine MAC-400
Developed in India by GE Wipro Medical
Technologies
Lightweight and portable Electrocardiogram
(ECG) machine suitable for mobile cardiology
labs that can access rural areas
Key cost savings came from simple
modifications of ready-made parts
– Adapted printers from India’s bus
terminal kiosks for machine’s printer
– Utilized commercially available
processing chips
GE’s payback period = 18 months
Typical MAC-400
Development Cost $5.4M $500K
Time 3.5 years 22 months
Weight 15 lbs 3 lbs
ECG Cost to Patient $25–$100 $1
4
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 36CONFIDENTIAL
Using Global R&D to Develop Market Appropriate
Products
J&J DePuy—PFC Sigma RP-F Knee
Product development undertaken by DePuy
Orthopaedics, India
Knee implant developed specifically for the
Indian market
Allows patients to perform activities like kneeling
down to pray or bending to cook
Part of J&J’s strategy to grow presence in
Indian orthopaedic market
Number of knee replacement surgeries in India is
expected to rise to 39,000 by 2009 from 25,000
procedures performed in 2007
4
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 37CONFIDENTIAL
Transforming Global R&D Operating Model at a
Multi-Billion Dollar MedTech Company
Thirteen R&D sites mostly
located in U.S. and E.U.
countries with one low
cost country site
13% of R&D headcount in LCC
Minimal outsourcing of R&D <3%
Business units with significant differences in growth, market maturity, and
innovation needs making it difficult to balance and plan resourcing,
technology, and expertise
Company wants to reduce R&D budgets while introducing more new
products
Company wants to lower manufacturing costs by moving most
manufacturing to outsource partner with LCC assets
PRTM CASE STUDY
4
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A New R&D Operating ModelHCC BU 1–4 R&D
Product line management, innovation, and
complex design
Shared Asia Design Center
Support all BUs in product support and
design
Asia specific products and
commercialization
Functional resource pools that can ―flex‖ to
support variable demand across BUs—
increased utilization and productivity
NPD Outsource Partners
1–2 core partners
SW and HWR and test
China/India presence
MFG Outsource Partners
1–2 core partners
MFG and local supplier management
Product support R&D
Shared Asia
Design
Center
BU 1
R&DNPD
Outsource
Partner(s)
MFG
Outsource
Partner(s)
BU 2
R&D
BU 3
R&D
BU 4
R&D
Fixed R&D Capacity—HCC
Shared R&D Capacity —LCC
Outsource R&D Capacity—
LCC/HCC Variable Flexibility
Rebalancing Flexibility
Minimal Flexibility
4
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 39CONFIDENTIAL
Key ChallengesChoosing what should be in-house, outsourced, offshored Core competencies and competitive advantage
I.P. protection
Optimization of supply chain (materials, manufacturing, distribution)
Building capabilities and experience in a fast yet thoughtful manner
Changing structure and shifting work without delaying/changing product plans and
without affecting quality
Significant operational changes in managing R&D across company-owned sites and
across outsource partners
Product development process and regulatory compliance
Partner relationship management and partner management
Collaborative planning and priorities
Program team management and resourcing
Product Support Product Support
Product Design
Product Support
Product Design
Product Commercialization
Product Support
Product Design
Product Commercialization
Global Innovation
4
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Key R&D Considerations for Engaging in Global R&D
Take advantage of lower wage and benefits costs Tax incentives Increased travel
Compliance and I.P.
Protection
Alignment of R&D with manufacturing and distribution footprint Local supplier qualification and engagement in design
Significant differences in feature expectations Local R&D often not trained in voice of the customer, marketing,
or other business acumen Requires increased investment in local VOC and market research
Local Market
Offerings and Pricing
R&D Costs and
Incentives
Multi-Site
Development
Practices
Need to ensure local and global regulatory compliance Careful positioning and control of I.P., particularly in China Patient data privacy laws (i.e., China)
Supply-Chain
Network
Leadership and
Talent
Requires strong leadership, which can be hard to find Basic science and engineering can be plentiful Business and Innovation skills can be lacking
Enhanced collaborative development practices (portfolio management, stage-gate, and project management)
Culture and style awareness and management Communications and supporting technology
4
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 41CONFIDENTIAL
Conclusion
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Future of Medical Devices
Medical device companies can create value by increasing the paths to
existing and emerging markets by:
Enhancing operational effectiveness
Forge partnerships spanning resources and supply chain worldwide
Addressing changing disease portfolio
New technology designs that require knowledge of other engineering principles
Transforming the concept of administration of treatment
Patient centric strategies that will allow for effective treatment and quicker recovery
Providing low-cost solutions to treat chronic diseases
Customized and easy to use at-home and self-care products for the aging baby boomers
Revolutionizing medical monitoring
Networked technology to facilitate quicker data exchange and reduce medical errors
The future generation of effective medical device companies will bethose that leverage emerging trends to create a
portfolio of immediate and long-term opportunities
MassMEDIC Conference—10 October 2008 | © 2008 PRTM Proprietary | 43CONFIDENTIAL
Thank You
Tim J. DurstDirector
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9399 West Higgins Road
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Sharad RastogiDirector
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M+1 617.803.9373
1050 Winter Street
Waltham, MA 02451
U.S.A.
www.prtm.com