Jan. 26, 2023
Antonio Trujillo, Ph.D, Health Economist & Professor
Dr. Antonio Trujillo is an Associate Professor in the Department of International Health with expertise in health economics, the economics of aging, and applied econometrics. Antonio is the co-director of the Master of Health Science (MHS) in Global Health Economics degree program. He teaches an advanced econometrics course on program impact evaluation using observational data and a course on behavioral economics and public health.
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Welcome to the Latin MedTech Leaders Podcast, a conversation with MedTech leaders who have succeeded or plan to succeed in Latin America.
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Please subscribe on your favorite podcasting platform.
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Apple Podcast, Spotify, Google Podcast.
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Amazon Music is teacher tuning iHeartRadio, Pandora, or these are Welcome to the Latin MedTech Leaders podcast, a conversation with leaders who have succeeded or plan to succeed in Latin America today.
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Our guest is Carlos Medina.
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He is the lead, uh, Mexican.
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He leads the Mexican team for a company whose core competency is to accelerate the entry of new products into emerging markets across the globe.
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The company is hosting LLC and, uh, Carlos Managers Mexico, central America, and the Caribbean.
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Right.
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Carlos.
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That's right on the Money.
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Julio, thank you for the invitation.
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Excellent, Carlos, it's great to have you here today.
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Welcome to the show.
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All right.
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So
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It's a pleasure having a, a chance to converse with your audience.
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Beautiful, beautiful.
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I'm, I'm, I'm very pleased to have you, you here, um, Hasting and, and, and, and me have known each other.
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Uh, your founder, Uzi and I have known each other for quite a while, so I'm, I'm very, um, pleased to, I'm privileged to having you today.
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Uh, ing is growing in Latin America, so I'm sure it's gonna be an exciting, uh, episode today,
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, and this, this is one more of those collaborations that we like so much.
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Excellent, excellent.
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Alright, Carlos, so let's get started with, um, your journey to Latin America.
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I understand that you're a medical doctor.
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You got involved in medical innovation with Haston, and tell us about your past and, and where you are today, how you got to where you are today.
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Well, it all started when I went into medical school because I went there looking to do some clinical research.
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I like to do complex puzzles and, uh, solve different, uh, difficult problems.
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And when I went into medical school, I was fortunate enough to be one of the first generations that had full access to the internet at the national University here in Mexico City.
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And that blew up a whole different world of technology that we could apply to medical science.
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So I ended up not going into, uh, clinical research, but rather, uh, going into medical informatics ever since I, uh, finished my clinical rotations.
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And I've been working on that, uh, for the past 20 plus years, going through editorial projects, uh, uh, continuing medical education, medical marketing, and now I'm working with trying to, uh, make business happen and to get, uh, the information flowing across the various health networks, uh, in Latin America.
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All right.
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Very good.
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And, uh, I just realized that I mispronounce the name of the company.
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I said Husting, it's Hasting.
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It, it really depends on which country you are at.
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Uh, the company, Brazilian and my Brazilian countryman, uh, com, my colleagues in Brazil, they usually call it Hasan has
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Okay.
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It may be just my, uh, us, uh, my us uh, biased creeping into the name, but, uh, I liked Haston because that brings the, the connotation of doing things faster.
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Very good.
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Yeah, I like that.
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I like that.
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All right, so the company is Brazilian, right?
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And we're gonna get to that in a moment, but, uh, uh, uh, we're gonna speak about, uh, the, the, the genesis of the company.
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Um, your founder and c e o has a very interesting, uh, story behind how he got started, uh, in this business in Brazil.
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Anyway, so let's talk about trench, uh, Carlos.
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Um, what trends do you see happening in Latin America that are relevant to our discussion today?
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Well, it's kind of hard to, uh, miss the elephant in the room.
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I mean, COVID has been throwing trends left and right, but I think it has brought, uh, into very sharp focus one of those trends, which is that most of the medical technologies take a little bit longer to get to, uh, the Latin American countries.
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And any efforts that we can expand to make that technology get to these countries faster is going to be beneficial for all, all the patients and the medical institutions as well.
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So that's the first one, trying to get, uh, medical technology to take root faster in this, uh, in these countries.
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But other than that, I do see a lot of efforts spent by the government and, uh, by, uh, even private companies like ours to collaborate and to build networks to accelerate the development of new technologies.
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I see a lot of startup clusters, uh, throughout Mexico.
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I've been fortunate enough to work in most of the countries in, in Latin America, and I, I see a lot of, uh, technologies being, being, being brought forth to solve the inequalities of access to the medical system, uh, which is sadly another one of those trends that, uh, that, that is, uh, deeply etched into the Latin American, uh, healthcare because, uh, you've got some very big, uh, differences between access to medical technology in the rural areas and in the cities, and even between countries.
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So being able to use technology, particularly information technology, to level the playing field and make sure that wherever you're at, you've got your cell phone in your hand, and you've got access to medical healthcare, that it has good quality and that can actually save you time, uh, and effort going to a hospital.
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I think that's another one of the big trends that we have seen right now.
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Excellent.
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Excellent.
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And, uh, I'm very pleased to, to to hear about these trends in Mexico.
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Uh, I imagine you're referring to Mexico a lot when you're talking about trends, since it's your natural market, and Mexico is one of the most, is is in the top three, uh, of the most attractive markets in Latin America is one of the biggest markets, right.
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With Brazil and then Columbia.
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So, and I love Mexico, by the way.
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It's a, it's a beautiful country.
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It's a country full of opportunities.
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Uh, and there's so much to do in Mexico, uh, still, I,
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Uh, I'll trade you.
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Uh, I will, we'll have to do a, an exchange program.
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You come to Mexico, I go to Columbia and leave Columbia dearly as well, so, yeah.
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Yeah.
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Excellent.
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Very good.
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I, I think that that's another thing.
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Every country has a different role to play in the big organization.
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You have even some much smaller, uh, countries like Costa Rica or even Republica Dominica, which have such a big place in medical device manufacturer and development that, uh, it, it really doesn't have to do with the market size.
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It, it needs to do, uh, it has a lot of, uh, a lot of, uh, investment into creating the right environment to make those make those prise fruitful.
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Yeah.
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Yeah.
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Yeah.
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It's, it's interesting that you mentioned Dominican Republic.
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Uh, there are a lot of early stage medical device clinical trials happening in the Dominican Republic.
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Not, not that much aspar, why, but, uh, I see a lot of, uh, companies going to, to the Dominican Republic, and especially because a lot of our physicians in the country, uh, get trained in the United States and go back to the Dominican Republic.
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So they're, they have access to their colleagues and, and all that.
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And
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So, correct.
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And, uh, when you couple that quality of clinicians willing to do the, the work with, uh, easy regulations that allow you to do the, do the clinical trials without sacrificing the security of the patients, that's another important part.
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I think that's a winning combination that a lot of other countries could, uh, could follow suit and, uh, start implementing.
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Yeah.
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Yeah.
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And Comfort Breeze is making some changes, right?
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To make it easier for clinical trials.
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Yes.
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Uh, step by step, they're going in that direction.
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So, uh, they're trying to fast track, uh, the clinical trials, uh, and they're also trying to, uh, uh, standardize the way that they evaluate things to be more in line with international regulations.
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I think that was, uh, uh, a little bit, uh, a long time, uh, incoming, but, uh, it's happening now with the new administration.
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Yeah.
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Yeah.
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All right.
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Yeah, we can talk about clinical trials in Latin America, uh, uh, for hours.
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Uh, that's probably a topic of another episode, but let's, let's get, um, uh, uh, in, in, let's speak in more detail about, uh, Hasting, right.
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Uh, and, and, uh, the origining of the company and, uh, what you guys are doing in Latin America.
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Yeah.
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Well, the company, as I said, was founded in Brazil, uh, founded by, uh, one of, of my former bosses, uh, Eduardo DeMelo, who has had a tremendous career.
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He's been in pharmaceutical companies.
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He's done research.
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He's been, uh, working in, uh, uh, clinical decision support system, which is actually where we met.
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We both worked that up to date, and then he left off to date and started working in other projects.
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And he started seeing and getting this idea of trying to do exactly what I described at the beginning, trying to get medical technology to take a route and to come to developing countries much faster than it currently was, because as I said, if, uh, if you got a great blockbuster drug or medical device, but if it won't be available in your country for two or three years after it starts being offered in the main market, that really limits the options of the patients and the doctors to provide the best care possible.
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And, uh, he started, he started building a network of, of collaboration throughout, uh, many countries, starting in Latin America.
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And then he started working with, uh, China.
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Now we've got affiliates in Europe, in South Africa.
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We're working on opening up, uh, operations in India, and we're building this collaboration network so that we can work with both medical, uh, device manufacturers and medical device distributors, as well as regulatory companies to make sure that we can actually speed things up and make those, uh, those technologies available as soon as possible, uh, in emerging countries where they're mostly needed.
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Sure, sure.
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As you correctly said, Carlos, our patients in the region have delayed access to medical innovation, and a lot of it has to do with, uh, lack of information, ignorance about Latin America and, and, and not seeing the region as a, as a, as a land of opportunity.
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I think there's so much to do in Latin America, and right now, uh, correct me if I'm wrong, but I think, uh, the countries like Mexico, Colombia, Chile, uh, are becoming leaders in the region, and, and they are O E C D aligned, even Costa Rica, they just became an O E C D country.
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So these countries are maturing.
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They are part of the global, um, economy, and they're important players.
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Uh, now they're part of the Pacific Alliance, which is a very, very, uh, strong block of, of, of forward-looking countries, uh, adopting international policies, best practices.
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And I think, uh, uh, that's part of the, uh, of what led to this situation of delayed medical innovation availability.
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But the other part is that, uh, when these companies start making it big, they are obviously and naturally, uh, attracted to the large markets in the US and Europe.
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So they're gonna be focused on achieving as much business as they can there.
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And, uh, a lot of the times they don't have the resources, whether they are material or, or human resources to, to be able to focus on expansion on countries that they see a secondary markets.
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So we can provide them an a, an opportunity to, uh, start working on those markets without having to distract themselves or their resources for that.
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So I think that's a big part of what's, uh, allowed us to be successful right now.
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That's your, your value proposition, right?
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So they don't, they don't have to invest much time and money and in, in, in these markets, you guys will take care of all the, the, the, the ugly work that needs to happen, and investment and all that.
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It's necessary work.
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And, uh, we'll do it.
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And, uh, we'll build, uh, what we hope to be a long-term partnership with both the originators, uh, the manufacturers and the distributors with us acting as catalysts in between to make thing, to make sure that things happen and they happen faster.
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That's a great word, catalyst.
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I like that.
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.
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Alright, Carlos, I'm very, very curious to hear what you think about Nancy.
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And, and you and I spoke about that in our initial conversation, uh, before the recording today.
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Uh, and what Namsa is doing in Latin America.
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I understand you guys are, um, are friends with Lansa, NAMSA have a collaboration with them.
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Can you elaborate on that, please?
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Sure, of course.
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Uh, NAMSA, uh, for those that don't, that are not familiar with, with that, they're probably not on the regulatory, uh, uh, arena, but NSE is a very big company in the US which now has, uh, uh, presence in at least, uh, three continents.
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Uh, right now with, uh, they provide both consulting and, um, testing services, laboratory services, as well as, uh, clinical, uh, they act as a C R O, uh, in many countries as well.
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So they, they actually call themselves, uh, medical research organization and, uh, we've been working with them for, uh, quite a few years right now to make sure that we can actually provide those quality services to our customers in Latin America.
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And I keep seeing them grow and grow because they've been offering, uh, exactly what, what they, what is needed in the region.
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So, uh, for companies that are looking to solve their regulatory, uh, issues for entry in the US and in Europe, those are the two markets where they, uh, where they are focused mostly.
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Uh, they've got consultants for every aspect of, uh, of the product development, specifically for medical devices.
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They don't do pharmaceuticals and, uh, they can provide end to end coverage.
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So, uh, it's a very good partnership, uh, for us.
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And that's been the backbone of, uh, a lot of our expansion to be truthful.
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Excellent, excellent.
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And also, they just acquired, uh, clean Logics, right?
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And Clean Logics had a strong presence in Colombia.
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Yes.
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So they just acquired Clean Logics, that's the latest, uh, the, the, the latest, uh, acquisition that they made, but they also acquired aps.
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And so they've acquired three major players in the regulatory, uh, and clinical research, uh, areas, uh, just in, this is Gerald alone.
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So they are, they are investing heavily in growth.
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And, uh, that's one of the other aspects that I really like, uh, about, uh, about the organization because they, they acquire technology to expand themselves.
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That's the nature of the business.
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That's one way to grow, but they don't lose the essence of those businesses.
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They keep what has made those businesses great companies, and they allow them to continue operating and to provide the services they have become, uh, known for.
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And they do that not only with the, uh, with the companies that they acquire, they also do that with partners like Haston because they, they know, we know the market.
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They know that we can provide the, the local know-how on how things should be done, and they really listen.
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So they're able to provide all of that information to their customers as well.
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Beautiful.
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Beautiful.
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Excellent.
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Yeah.
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I also understand they had another collaboration with somebody in Argentina, right?
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That was initial collaboration that they had in Latin America
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That's still going?
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Yes.
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Uh, uh, Haston, we work with them to take care of, uh, customers in, uh, most of Latin America except for the Southern Cone.
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So, Chile, Argentina?
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No.
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Why they handle with another company ly.
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I can't remember the name of them.
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If I remember, I'll let you know.
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Uh, but yeah, the, they, they have multiple partners and they're working, uh, with us here.
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And, uh, they're working with other local partners in other parts of the world as well, particularly in Asia.
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Excellent, excellent.
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All right.
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So Carlos, let's, um, talk about your practical experience in Mexico and elsewhere in Latin America.
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Um, uh, the uc relevant for the discussion today.
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Um, how are things going in Mexico in terms of regulatory approvals for, uh, innovative technologies?
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Uh, any challenges you can mention?
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Any, any tips, any best practices that you, you can share with us so that, uh, companies that are listening can, can learn from, from, from that?
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Sure.
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So I think that, uh, when you asked me what the situation is, uh, right now, of course, COVID has brought a lot of delays in the administrative side of the regulatory affairs.
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Uh, you mentioned Coffee Priest, for those that might not be, uh, as familiar with Mexico Coffee Priest is the, uh, decentralized organ from the Ministry of Health that handles all regulatory, uh, uh, issues for medical device and drug and food, uh, uh, kind of like the Mexican F D A, if you wanna look at it.
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I think that's the, the, the easiest way to understand it.
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And, uh, they started prioritizing, uh, the evaluation and approvals of technologies that were covid related, like many of, uh, of the regulatory agencies did.
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And right now they're working off cleaning up their backlog of, uh, submissions.
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And they're doing that with a very, with a, uh, well-structured program that they have.
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They're actually keeping us in the loop and, uh, giving us information on how that's proceeding, uh, week after week.
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Uh, so they're slowly but surely making, uh, making headwind there.
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Uh, it's still, uh, a long, uh, along, uh, response time on their part.
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So we're talking at a close to a year, uh, on response times.
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So, uh, we have a lot of medical technology that's just waiting for answers.
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Uh, but, uh, in the meantime, while they're doing that, uh, and dealing with the new leadership in place, they just had a change in their director, and that brought changes trickling down the line.
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Uh, but, uh, I think that has been a good change because, uh, they're starting to, uh, digitalize most of their processes.
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And with the current, we just tell, we also just had a, a digital agenda, uh, released for Mexico, which is going to bring a lot of digitalization of the processes so that, uh, things will happen faster and can be automated in many, in many of those arena.
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So things will get better.
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Uh, regarding the, the trends that you, uh, were mentioning, uh, we do, I, I have to, to bring to attention that we do have a lot of players in the medical devices and medical technology arena that have had to close because of, uh, the demands on their business.
00:20:24.740 --> 00:20:34.440
But I see another very big group of companies that have thrived, uh, as I mentioned, by using, uh, the technologies available.
00:20:34.441 --> 00:20:48.358
We've seen right now, uh, the, a lot of, uh, telemedicine companies providing, uh, video conferencing and providing secure communication with the patient so that they can be tended to, to, uh, from home.
00:20:48.618 --> 00:21:20.759
And I've seen in the past year, I think I've seen more new insurance and cooperative health plans, uh, so, uh, a lot of, uh, innovation as well in, in InsureTech, uh, to take up the demand that a lot of the major and, uh, classical health insurance companies maybe had to put a break on, on taking up, uh, health policies, because they expected a lot of expenses, uh, from Covid, which I think is natural for the, uh, for the dynamic of that business.
00:21:21.140 --> 00:21:26.358
But that meant there were a lot of people looking for, uh, other avenues to get healthcare coverage.
00:21:26.779 --> 00:21:31.240
And, uh, these other companies started to, uh, to invest and to develop them.
00:21:31.240 --> 00:21:32.920
And I think a couple of them are pretty good.
00:21:34.230 --> 00:21:34.230
Okay.
00:21:34.509 --> 00:21:34.509
Okay.
00:21:34.529 --> 00:21:39.269
And how do you see the current government and the outlook for the new government?
00:21:39.270 --> 00:21:46.349
Because Lopez obor right, is the new, is the current president, how many more years does he have?
00:21:47.079 --> 00:21:54.589
He just finished his third year, three years, uh, uh, and, uh, his, he has three more to go, so he sent
00:21:54.589 --> 00:21:55.230
Three more to go.
00:21:55.250 --> 00:21:55.670
Wow.
00:21:55.720 --> 00:21:56.910
So we're in the middle of
00:21:57.190 --> 00:21:57.190
.
00:21:57.191 --> 00:21:59.150
Yeah, he's right in the middle of his presidency.
00:21:59.630 --> 00:21:59.630
Mm-hmm.
00:22:00.390 --> 00:22:23.759
Uh, one thing I like about his, uh, his administration is that he has a lot of very good ideas on how to get, uh, how to enhance and, uh, uh, make all the processes that have been held up by bureaucracy and by, um, a corruption faster and cleaner.
00:22:25.130 --> 00:22:33.420
I think he needs, uh, a little bit of work and a little to listen a little bit more to his, uh, advices on how to get those done.
00:22:34.089 --> 00:22:36.368
Those have been hit or miss for me.
00:22:37.130 --> 00:22:57.809
Uh, but I, uh, I don't want to politicize this too much, uh, but, uh, the, the part that I, that I am most excited about is this, uh, digital, uh, digitalization act that just was proclaimed last month, because that's going to bring, uh, digitalization not just to healthcare, but to every aspect of the government.
00:22:58.339 --> 00:23:16.368
So, uh, a lot of the things that you formerly needed to go to an office and maybe, uh, uh, spend a lot of time, uh, cutting red tape, those should be enhanced, uh, in the next, uh, in the next few years.
00:23:16.750 --> 00:23:23.608
And particularly on the education and the access to the internet and to online services.
00:23:24.160 --> 00:23:26.049
I think they're going to be investing heavily.
00:23:27.089 --> 00:23:40.690
Uh, I'm not gonna go into detail on how those contracts will get, will get assigned, but, uh, at least we'll start to see a lot more people get access to the internet and be able to, to be more autonomous in that sense.
00:23:40.720 --> 00:23:41.210
Sure.
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