WEBVTT
00:00:05.200 --> 00:00:07.870
Welcome to the Latin Med tech leaders podcast.
00:00:08.169 --> 00:00:13.240
This is a weekly conversation with med tech leaders who have succeeded in Latin America
00:00:15.109 --> 00:00:15.500
today.
00:00:15.500 --> 00:00:18.109
Our guest is John core part.
00:00:18.170 --> 00:00:18.890
Hey, good job.
00:00:18.890 --> 00:00:20.510
It's great to have you here on the show today.
00:00:20.570 --> 00:00:20.989
Welcome.
00:00:21.460 --> 00:00:22.120
Thanks Julio.
00:00:22.120 --> 00:00:22.989
Always a pleasure.
00:00:23.800 --> 00:00:24.239
Awesome.
00:00:25.250 --> 00:00:28.339
Well, listeners, John B is a special guest today.
00:00:28.341 --> 00:00:41.420
He is neither a med device either who has experience commercializing technologies or conducting first in human trials in Latin America, but he's a market research consultant.
00:00:41.630 --> 00:00:44.719
Very, very excited to have him on the show today.
00:00:45.289 --> 00:00:50.570
And, uh, he is the founder and CEO of global health intelligence.
00:00:50.939 --> 00:01:05.000
Uh, G H I, Eh, he has over 20 years of consulting experience and he supports life science companies in their growth plans throughout emerging markets with a special emphasis in Latin America.
00:01:05.599 --> 00:01:09.890
In 2011,[inaudible] was awarded the, how do you pronounce it?
00:01:10.739 --> 00:01:14.170
Oh,[inaudible] that one?
00:01:15.569 --> 00:01:15.900
Yes.
00:01:16.129 --> 00:01:18.870
Now one from, what's the name of this school?
00:01:20.040 --> 00:01:24.780
Yeah, it's the business school of University of Montreal.
00:01:24.930 --> 00:01:25.439
Excellent.
00:01:25.469 --> 00:01:34.290
There was in 2014 and he also received the outstanding business award from the Canadian Chamber of Commerce in Mexico.
00:01:34.920 --> 00:01:39.099
And he has a very intriguing story about his life in Mexico.
00:01:39.170 --> 00:01:40.620
He's going to share with us soon.
00:01:41.129 --> 00:01:46.980
And John also has a BA in marketing and intrepreneurship from, how do you pronounce it?
00:01:47.409 --> 00:01:51.060
Liquid[inaudible] against the business school for University of Montreal.
00:01:51.750 --> 00:01:52.290
Excellent.
00:01:52.680 --> 00:02:00.299
And in 2017 he pursued a degree in his scaling businesses at the Stanford School of business in California.
00:02:00.659 --> 00:02:03.299
So he jumped again, welcome to the show.
00:02:03.301 --> 00:02:07.439
I'm very, very excited and looking forward to our conversation today.
00:02:07.730 --> 00:02:08.030
Great.
00:02:08.031 --> 00:02:08.500
Thanks for coming.
00:02:08.650 --> 00:02:09.620
And thank you for the invitation.
00:02:09.621 --> 00:02:11.810
It's always a pleasure to talk with you and to collaborate with you.
00:02:11.811 --> 00:02:14.569
And even more so in the context of this wonderful podcast,
00:02:15.060 --> 00:02:15.509
Greg.
00:02:15.780 --> 00:02:15.780
Yup.
00:02:15.810 --> 00:02:16.740
So let's get started.
00:02:17.250 --> 00:02:20.969
So please tell listeners about your journey to Latin America.
00:02:20.971 --> 00:02:24.270
I mean, you were born in Canada and the French, uh, region.
00:02:24.270 --> 00:02:26.280
So how do you get involved with Latin America?
00:02:26.629 --> 00:02:26.960
Correct.
00:02:26.961 --> 00:02:27.229
Thank you.
00:02:27.230 --> 00:02:31.400
Well, actually I was born in France, but I lived in Canada for well over 20 years.
00:02:31.430 --> 00:02:35.569
And um, you know, finishing my degree as a good be a student.
00:02:35.960 --> 00:02:45.740
No one doesn't really know what they want to do, but I knew from the get go that I wanted to travel internationally and Hispanic, Latin America was always an attraction of mine.
00:02:46.099 --> 00:02:55.849
So I backpacked around Argentina for a few months and when my visa ran out, I went back to Montreal and I said, I got to find a job in Latin America.
00:02:55.909 --> 00:03:04.060
And that point I knew very little Spanish, but I was able to convince a company in Mexico to hire me as an intern for six months.
00:03:04.330 --> 00:03:07.389
And that turned into an 11 year love affair with Mexico.
00:03:10.319 --> 00:03:10.319
Fascinating.
00:03:12.069 --> 00:03:14.259
That's the story of young graduates, right?
00:03:14.379 --> 00:03:16.000
To follow their passion, follow their heart.
00:03:16.210 --> 00:03:16.569
Yeah.
00:03:16.599 --> 00:03:17.080
Excellent.
00:03:17.409 --> 00:03:24.849
Well, so let's get a little deeper into the conversation today about life sciences and opportunities in Latin America.
00:03:25.240 --> 00:03:35.169
So what's your overall perception of Latin America as a market for life science and medical device or drug companies to commercialize your products?
00:03:35.400 --> 00:03:46.259
Life Sciences in general, you know, whether we're talking about pharmaceuticals or medical devices or equipment or you can, consumables is a huge market, a huge opportunity for any global manufacturer.
00:03:46.319 --> 00:03:49.319
We are talking about 600 million people region wide.
00:03:49.710 --> 00:03:52.979
But the complexities of the market is really what makes it stand out.
00:03:53.370 --> 00:04:00.900
Certainly Brazil is the largest opportunity, but it's also the market where we have Brazilian speakers, right?
00:04:00.901 --> 00:04:03.449
And so, and everything's kind of unique in Brazil.
00:04:03.900 --> 00:04:17.519
So we're talking about 600 million folks that spread out over 22 countries with each of them having their own regulatory infrastructure, their own market access issues, their own customs and borders and distribution networks.
00:04:17.850 --> 00:04:24.839
So in reaching the market in the efficient and effective manner is what I see as one of the challenges for life sciences companies today.
00:04:25.019 --> 00:04:25.350
Okay.
00:04:25.350 --> 00:04:28.889
So let's get us a little more familiar with your work.
00:04:29.189 --> 00:04:32.850
How is it that you get started in the market research sector?
00:04:33.000 --> 00:04:34.500
I understand was in Mexico, right?
00:04:34.769 --> 00:04:37.290
And how you expand it to the u s et Cetera.
00:04:37.550 --> 00:04:38.240
Sure, absolutely.
00:04:38.240 --> 00:04:42.620
So I started back in a market research and we called it market intelligence.
00:04:42.620 --> 00:04:51.500
We were one of the first companies as Info Americas to brand market intelligence in Latin America back in the early two thousands when I first drive to Mexico.
00:04:51.500 --> 00:05:01.519
And we grew our little business to a couple million dollars and sold it to a multinational called cruel that focused in background checks, due diligence and mergers and acquisitions.
00:05:01.819 --> 00:05:09.680
So integrating a market intelligence suite of services really made sense in order to understand and do all the pre deal type work.
00:05:09.800 --> 00:05:14.990
And it's at that point that I started focusing on the health care space because I was just naturally drawn to it.
00:05:14.990 --> 00:05:17.209
I found that fascinating and I was very passionate about it.
00:05:17.540 --> 00:05:19.220
And this is during my time in Mexico.
00:05:19.430 --> 00:05:24.529
A few years later, you know, I left croll wanting to go back on my own and I found a global health intelligence.
00:05:24.980 --> 00:05:46.939
And really the interesting story here is that it began with a client, a client that I'd been working with for years who said, hey, owe, you know, in the United States and in Europe there's directories of hospitals, um, directors, but not just a listing, but directories that have texture in terms of information around beds, around infrastructure, around equipment.
00:05:47.269 --> 00:05:49.370
And there is no such directory in Latin America.
00:05:49.370 --> 00:05:52.970
And maybe we'd like to develop on like that starting with Brazil.
00:05:53.120 --> 00:06:00.889
And so we began on that mission with that one client to a database of hospitals in Brazil and it soon expanded to Mexico.
00:06:00.891 --> 00:06:05.689
And then Columbia was quite successful and we now cover 17 markets.
00:06:05.690 --> 00:06:10.519
So we have the world's largest hospital demographics database focused on Latin America.
00:06:10.819 --> 00:06:16.459
So we've got started and now we're also doing procedure volumes and Mito market size and market share and trends and stuff.
00:06:16.461 --> 00:06:17.120
So it's pretty cool.
00:06:17.120 --> 00:06:18.410
We're very excited about what we do.
00:06:18.600 --> 00:06:19.199
Sure.
00:06:19.319 --> 00:06:23.459
So could you please describe a typical engagement kind engagement of viewers?
00:06:23.461 --> 00:06:30.180
I mean, that's usually the problem that a client has and you can solve with your market intelligence services.
00:06:30.490 --> 00:06:31.060
Sure, absolutely.
00:06:31.060 --> 00:06:31.329
Thank you.
00:06:31.331 --> 00:06:45.370
So clients come to us with an array of issues surrounding Latin America, but it all focuses around being able to understand to size and to take advantage of the opportunity that Latin America represents.
00:06:45.759 --> 00:06:50.829
And this is true for both very large multinational companies as well as for startups.
00:06:51.100 --> 00:07:04.269
To give you an example, we work with very large equipment manufacturers in the X-ray, MRI, CT scanner space, and they want to understand what hospitals are prone to acquiring their equipment in the future, right?
00:07:04.540 --> 00:07:10.060
So for them understanding the demographics and the characteristics of the hospitals is really interesting.
00:07:10.060 --> 00:07:17.529
And so we can run propensity analysis on our hospital database to say which hospitals are the most prone to acquiring certain equipment.
00:07:17.920 --> 00:07:30.639
So that's the one client type on the other end of the scale, like the complete other extreme, we have companies that are looking to introduce new ways of commercialization for equipment, for parts and for devices.
00:07:30.910 --> 00:07:43.629
So thinking ahead and thinking, Geez, you know, would hospitals be willing to change the way they purchase, you know, spare parts or consumables, would they be able to go online and do e-commerce for that?
00:07:44.170 --> 00:07:51.670
And then finally, smaller companies that are, and they're not always smaller, but let's call them newer companies to the Latin American field.
00:07:52.089 --> 00:08:00.250
And now they could be multinationals from Europe or from Asia or even from the United States and looking at Latin America for the first time and saying, wow, this is a big market.
00:08:00.759 --> 00:08:03.310
We're talking about over 22,000 hospitals.
00:08:03.579 --> 00:08:04.449
How can I get it?
00:08:04.810 --> 00:08:06.009
Where do I need to start?
00:08:06.339 --> 00:08:14.019
And so we help them understand the opportunity there, where they can start, what's ideal for their company and their products and their services.
00:08:14.410 --> 00:08:16.629
So those are just a few examples of the clients that we work.
00:08:16.730 --> 00:08:17.449
Fascinating.
00:08:17.810 --> 00:08:21.829
And what about obtaining the data for the services that you offer?
00:08:21.831 --> 00:08:41.879
I mean, of course without revealing confidential information, but that's, you have any idea of the work involving in gathering this data because it's my understanding that this data in Latin America is really difficult to obtain because government agencies do not really have, except couple of cases in Latin America, they don't really have a data sets, official data.
00:08:42.000 --> 00:08:44.210
So how do you do about obtaining these data?
00:08:45.690 --> 00:08:46.139
Absolutely.
00:08:46.179 --> 00:08:47.279
That's a terrific question.
00:08:47.730 --> 00:08:48.990
So it depends on the data.
00:08:48.990 --> 00:08:55.590
So that we're looking at, and I'd say Julio, that there's an additional factor here that most companies look at.
00:08:55.591 --> 00:09:04.740
Latin America as a whole, certainly they have offices in multiple countries, but when they're reporting Latin America, they report Latin America as one block.
00:09:05.159 --> 00:09:09.419
So you have not only discrepancies in the type of information.
00:09:09.421 --> 00:09:15.000
So for instance, Brazil and Chile and even Mexico have a fairly good information.
00:09:15.210 --> 00:09:20.610
And I'd say even to some degree Columbia as well in terms of the, the, the government information that's processed.
00:09:21.059 --> 00:09:25.649
But other countries like Argentina, Peru, and Ecuador are very information poor.
00:09:25.950 --> 00:09:34.679
So not only is there an issue in terms of what countries have information that's available, but there's also then a question of compare ability of information across markets.
00:09:34.950 --> 00:09:41.549
So you know, the information that the Brazilian statistics institute has is not necessarily the same as that of Mexico.
00:09:41.850 --> 00:09:51.120
And for a company that's looking region wide, they need to compare apples to apples is very difficult to make decisions when you're not comparing the same basis throughout.
00:09:51.570 --> 00:09:56.250
So that's really one of the value propositions that we have is the ability to compare markets.
00:09:56.490 --> 00:10:00.929
Not just in fact that we're able to cover 17 markets, but we covered them with the same parameters.
00:10:01.639 --> 00:10:01.639
Hmm.
00:10:02.059 --> 00:10:02.990
That's fascinating.
00:10:03.080 --> 00:10:03.980
That's really good.
00:10:04.159 --> 00:10:04.549
Yeah.
00:10:04.669 --> 00:10:06.649
So to answer your question, how do we go about it?
00:10:06.860 --> 00:10:10.789
Well, we have a call center in Mexico where we actually call it a hospital's.
00:10:10.791 --> 00:10:17.120
We call up about 10,000 hospitals every year to gather information on data and on infrastructure.
00:10:17.480 --> 00:10:27.169
So through this podcast, unfortunately you can see, but I've got a ton of gray hair and a lot of it comes from the complexities of managing that type of volume of data.
00:10:27.309 --> 00:10:27.970
Interesting.
00:10:28.629 --> 00:10:31.450
Hoping our hospitals to provide this information.
00:10:31.451 --> 00:10:33.549
Do you have to pay for these or how does it work?
00:10:34.139 --> 00:10:41.970
Yeah, and we don't pay hospitals to participate, but what we do offer is we have rankings of, you know, the most equipped hospitals in the region.
00:10:42.210 --> 00:10:44.519
We also are often in publications.
00:10:44.820 --> 00:10:52.740
And so in order for hospitals to benefit from the visibility that we create, they need to participate in our data gathering.
00:10:53.039 --> 00:10:53.309
Right.
00:10:53.340 --> 00:10:54.299
So it's kind of an exchange.
00:10:54.301 --> 00:10:55.559
They participate with us.
00:10:55.561 --> 00:11:01.139
We get that information is part of our database, but we also give them exposure and visibility through our different outlets.
00:11:01.279 --> 00:11:04.279
Oh, says two way.
00:11:04.759 --> 00:11:06.590
Um, bio preposition here.
00:11:07.210 --> 00:11:08.080
Yeah, absolutely.
00:11:08.110 --> 00:11:08.230
Yeah.
00:11:08.230 --> 00:11:11.200
We do have to keep their interests in line because at the end of the day, they're the ones also
00:11:11.289 --> 00:11:12.429
providing the data to us.
00:11:12.490 --> 00:11:13.090
Absolutely.
00:11:13.149 --> 00:11:13.379
Yeah.
00:11:13.399 --> 00:11:13.899
Makes Sense.
00:11:14.230 --> 00:11:22.179
So when are the, you said three or four services that you guys have, could you please describe the four data sets that you guys offer to the market?
00:11:23.070 --> 00:11:23.580
Sure, absolutely.
00:11:23.581 --> 00:11:26.070
So the very first one is called a hospi scope.
00:11:26.460 --> 00:11:29.129
And hospi scope is the database of hospitals.
00:11:29.159 --> 00:11:34.019
And database is a very simplistic term for what we offer because we cover 17 markets.
00:11:34.289 --> 00:11:41.970
We have over 150 data points per hospital, including number of beds, number of equipment, number of operating rooms, et cetera.
00:11:42.210 --> 00:11:43.500
So that's Hospi scope.
00:11:44.309 --> 00:11:53.070
Um, we then have surgery scope, which is a very similar data set, but the focus there is on the procedure volumes per hospital.
00:11:53.320 --> 00:12:06.549
So whether it's by ICD nine code or by four NASA or ts or twos in the case of Brazil, you know, by code of procedure we can identify how many procedures are being conducted in hospitals within multiple markets.
00:12:07.450 --> 00:12:10.929
And then the third data set that we manage is called share scope.
00:12:11.259 --> 00:12:18.700
And He, what we look at is market size and market share for different medical devices, medical equipment and consumables.
00:12:18.820 --> 00:12:26.200
So it could be anything from CT scanners to MRIs down to pacemakers or neurostimulators or infusion pumps.
00:12:26.529 --> 00:12:28.090
So yeah, it's pretty broad array.
00:12:28.200 --> 00:12:29.279
Very, very good.
00:12:29.639 --> 00:12:35.159
I'm very shocked that nobody has done anything like this before in Latin America.
00:12:35.160 --> 00:12:41.850
I mean American companies or European companies that wanted to add to the vision were hungry for this type of information.
00:12:41.850 --> 00:12:46.200
And to see that you guys are solving these problems, the industry,
00:12:46.429 --> 00:12:48.590
it is fascinating and it is a gap in the market.
00:12:48.970 --> 00:12:58.639
Um, companies are hungry for information because at the end of the day, what we're seeing is companies are ever more interested in making fact based decisions.
00:12:58.850 --> 00:13:00.019
And that's what it comes down to.
00:13:00.230 --> 00:13:11.120
The time of, you know, making guesstimates and relying on one expert in Argentina to reveal the market strategy for the next five years is a thing of the past.
00:13:11.179 --> 00:13:18.230
More and more we're talking about team collaborations and people making fact based decisions in collaboration with one another.
00:13:18.440 --> 00:13:23.929
Whether that'd be, you know, on a local level, on a local country level, on a regional level or on a global level.
00:13:24.289 --> 00:13:33.919
And so having that information and being able to share it really gives companies a lot of empowerment in terms of developing better plans for the future, better growth plans.
00:13:34.250 --> 00:13:35.779
And that's really what this is all about.
00:13:36.379 --> 00:13:41.120
And the reality of this is that the companies that have the information are better off.
00:13:41.659 --> 00:13:46.580
There's a gap in what's accessible in terms of data and it creates data assymetry.
00:13:46.789 --> 00:13:49.789
And that's the reason for our business to give.
00:13:49.791 --> 00:13:57.019
The companies that are more diligent in their processes that incorporate fact-based decisions will come out ahead in the long run.
00:13:57.259 --> 00:13:59.330
That's just the rules of, of the market dynamics.
00:13:59.559 --> 00:14:00.129
Yeah.
00:14:00.220 --> 00:14:18.500
One thing I've noticed, John, is that pharmaceutical companies are way ahead of medical device for medical equipment companies in the way they penetrate a new market from a surgical companies are, I dunno if the right word is by nature very aggressive and they do their due diligence.
00:14:18.500 --> 00:14:31.970
They do the research, they know all the data points that they need to succeed in a market and they have market access experts working for them to make sure they know how to generate demand with the right information.
00:14:32.120 --> 00:14:36.710
They know how to generate demand for their drugs, medical device, equipment companies.
00:14:36.799 --> 00:15:02.899
In my opinion, based on what I've read and the conversation I had with leaders of the miniTek industry is probably five to 10 years behind my opinion and I think now you're seeing medical technology companies looking at market access strategies to penetrate these markets because becoming a lot more competitive and they need data to make decisions.
00:15:03.169 --> 00:15:10.490
And one of the problems in the medical device world or medical technology industry is the fact that you rely on it.
00:15:10.490 --> 00:15:23.600
The shooter that has database on assumptions, anecdotes, the distributor gathers data out by having dinner conversations with friends or colleagues.
00:15:23.929 --> 00:15:28.460
And that's the data that gets fed to the manufacturer in the U S or Europe.
00:15:28.700 --> 00:15:36.980
And not only that is also the fact that the interest of the shooter is not always aligned with the interest of the manufacturer.
00:15:37.309 --> 00:15:47.269
The shooter will only tell you a side of the story that helps advance his agenda, which may be different from the actual or the real story.
00:15:47.480 --> 00:15:48.500
So what do you think about this?
00:15:49.669 --> 00:15:52.340
You touched upon a few really good points here, who you are.
00:15:52.429 --> 00:16:00.500
So just to begin with, the relationship between Pharma and medical devices is one that's fascinating because they're both in the life sciences field.
00:16:00.830 --> 00:16:10.610
However, the stakes for Pharma companies to develop a product can be, you know, the investment required is in the tens in the hundreds of millions of dollars.
00:16:10.879 --> 00:16:14.120
And so getting it right is critical for them.
00:16:14.389 --> 00:16:25.309
Historically a companies like IQ via or like no block or closeup amongst others have developed tools to help pharmaceutical companies, you know, measure the market, understand it, et cetera.
00:16:26.070 --> 00:16:34.850
Medical device companies and manufacturers are much closer in terms of business operation to technology companies than the art to Pharma.
00:16:34.909 --> 00:16:42.649
Although they both operate under, you know, the healthcare life sciences umbrella and they can come out with adjustments to their medical devices.
00:16:42.799 --> 00:16:48.769
Literally every year when you stand with a new type of coding, et Cetera, it can take maybe one to three years to develop.
00:16:48.980 --> 00:16:51.710
Unlike Pharma, which can take 10 years to develop.
00:16:52.009 --> 00:16:58.159
And so the cycles around medical technology and Micheal devices is actually much shorter and much quicker.
00:16:58.669 --> 00:17:02.090
So what I've seen is that it's therefore also much harder.
00:17:02.091 --> 00:17:10.670
They haven't invested the time on the culture to develop the market intelligence and market information that pharmaceutical companies have now.
00:17:10.671 --> 00:17:12.200
I think that's also beginning to change.
00:17:12.799 --> 00:17:20.750
I'm seeing more and more medical device companies understanding the needs to get it right in terms of their developments, in terms of their access to the market, et cetera.
00:17:20.839 --> 00:17:23.029
So that's very favorable for our business.
00:17:23.750 --> 00:17:28.789
But regardless, I think you're entirely right that the way that the products are commercialized in Latin America.
00:17:28.790 --> 00:17:38.089
So a heavy use of distributors is also a challenge that's somewhat unique to the medical device field because the interests are not necessarily aligned between the distributor and the manufacturer.
00:17:38.599 --> 00:17:52.900
And oftentimes the distributors, like you said, you know, they'll know that their market information from speaking to buddies or contacts within the hospital networks or within the purchasing organisms, but it'll often be, um, you know, just a singular point of view.
00:17:53.140 --> 00:17:54.579
Again, it's not going to be holistic.
00:17:54.580 --> 00:17:56.710
It's not going to be representative of the entire market.
00:17:56.859 --> 00:18:07.329
So it's very important for manufacturers to be able to, to understand the entire vision of the market and get unbiased third party opinions in order to validate.
00:18:08.079 --> 00:18:10.390
Contradicted said also the right goals for their distributors.
00:18:11.019 --> 00:18:13.069
Well, I'll say, yeah, absolutely right.
00:18:14.250 --> 00:18:42.150
The topic that comes to mind is the EU MDR UBM from France who probably are very familiar with the European regulations for medical devices and probably heard about the transition that is going on as we speak between the medical device directive and d to The new MDR actually started in France because of the pip scandal.
00:18:42.589 --> 00:18:43.299
Do you remember that?
00:18:43.690 --> 00:18:44.250
Yes, absolutely.
00:18:44.359 --> 00:18:44.579
Yeah.
00:18:44.829 --> 00:18:57.569
Okay, so now we have these new regulation that will come into effect in May, 2020 and he looks like it's going to change the dynamics of the medical device industry or whatever it is.
00:18:57.940 --> 00:19:04.450
Yeah, I'm not sure if the impact in Latin America to be quite frankly or how that will impact regulatory bodies across the region.
00:19:04.690 --> 00:19:07.089
Well, I'm speaking about commercialization.
00:19:07.240 --> 00:19:11.619
In other words, this is my angle with this comment and I'm actually writing an article.
00:19:11.710 --> 00:19:12.640
Actually I just did.
00:19:12.730 --> 00:19:18.250
I just sent an article to the editor of a maybe device online about this specific topic.
00:19:18.849 --> 00:19:28.509
What's happening is that the requirements to have an medical device in the market in Europe, IVD product as well.
00:19:28.900 --> 00:19:33.130
A medical technology in general are a lot higher now, more stringent.
00:19:33.519 --> 00:19:38.079
So first you're going to have clinical research requirements.
00:19:38.080 --> 00:19:46.329
I mean, I loved, it's an impressive amount of clinical data that you have to show to prove efficacy of your technology.
00:19:46.750 --> 00:19:57.460
So these companies, US companies had the Europe first mentality where they always thought about Europe as the first market to entered.
00:19:58.000 --> 00:20:01.539
In other words in the industry, what's called the a purse mentality.
00:20:01.720 --> 00:20:07.150
And these, your purse mentality was based on the premise that the European regulations were very relaxed.
00:20:07.509 --> 00:20:12.579
You only had to show safety of your medical technology, not necessarily efficacy.
00:20:13.150 --> 00:20:20.930
So these set us companies had a way to wipe it where they first Seeked CE mark approval.
00:20:21.440 --> 00:20:23.420
They started selling their devices in Europe.
00:20:23.630 --> 00:20:29.210
They became more attractive to a larger company like Medtronic posters and typic to acquire them.
00:20:29.720 --> 00:20:38.509
And it would lead these new company, these larger company handle the FDA and make the investments necessary to get FDA approval.
00:20:38.869 --> 00:20:44.690
And then after FDA approval, they were probably think of a lot of the Americas as a market.
00:20:45.470 --> 00:21:03.130
But now we have a different, with the EMDR coming into place in about a year, we have a situation where the Europe first mentality is no longer the predominant way to market now is America first mentality.
00:21:03.549 --> 00:21:08.589
And I don't want to sound like a Trump supporter, but it truly is an American first mentality.