July 26, 2019

Guillaume Corpart, Founder & CEO, Global Health Intelligence (GHI)

Guillaume Corpart, Founder & CEO, Global Health Intelligence (GHI)

Guillaume Corpart is the Founder and CEO of Global Health Intelligence. With over 20 years’ business consulting experience, Mr. Corpart supports life-science companies in their growth plans throughout emerging markets.

Global Health Intelligence developed HospiScope – the world’s largest hospital database focused on Latin America, with profiles on over 18,000 hospitals in the region. Through HospiScope medical equipment manufacturers can increase visibility into market opportunities and key accounts.

Through ShareScope clients can determine market size & share of both medical equipment and medical devices with over 90% accuracy. In 2018, Global Health Intelligence launched SurgiScope – detailing procedure volumes by hospital and thus enabling device manufacturers to identify targeted opportunities by account.

In 2011, Mr. Corpart was awarded the Prix Releve Excellence from l’Ecole des Hautes Etudes Commerciales and in 2014 Mr. Corpart received the Outstanding Business Award from the Canadian Chamber of Commerce in Mexico. Mr. Corpart has a B.A. in Marketing and Entrepreneurship from l’Ecole des Hautes Etudes Commerciales (Montreal, Canada) and in 2017 pursued a degree in Scaling Businesses at the Stanford School of Business (California, USA). Mr. Corpart is fluent in English, French and Spanish.

WEBVTT

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Welcome to the Latin Med tech leaders podcast.

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This is a weekly conversation with med tech leaders who have succeeded in Latin America

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today.

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Our guest is John core part.

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Hey, good job.

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It's great to have you here on the show today.

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Welcome.

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Thanks Julio.

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Always a pleasure.

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Awesome.

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Well, listeners, John B is a special guest today.

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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.

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Very, very excited to have him on the show today.

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And, uh, he is the founder and CEO of global health intelligence.

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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.

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In 2011,[inaudible] was awarded the, how do you pronounce it?

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Oh,[inaudible] that one?

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Yes.

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Now one from, what's the name of this school?

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Yeah, it's the business school of University of Montreal.

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Excellent.

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There was in 2014 and he also received the outstanding business award from the Canadian Chamber of Commerce in Mexico.

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And he has a very intriguing story about his life in Mexico.

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He's going to share with us soon.

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And John also has a BA in marketing and intrepreneurship from, how do you pronounce it?

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Liquid[inaudible] against the business school for University of Montreal.

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Excellent.

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And in 2017 he pursued a degree in his scaling businesses at the Stanford School of business in California.

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So he jumped again, welcome to the show.

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I'm very, very excited and looking forward to our conversation today.

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Great.

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Thanks for coming.

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And thank you for the invitation.

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It's always a pleasure to talk with you and to collaborate with you.

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And even more so in the context of this wonderful podcast,

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Greg.

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Yup.

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So let's get started.

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So please tell listeners about your journey to Latin America.

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I mean, you were born in Canada and the French, uh, region.

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So how do you get involved with Latin America?

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Correct.

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Thank you.

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Well, actually I was born in France, but I lived in Canada for well over 20 years.

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And um, you know, finishing my degree as a good be a student.

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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.

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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.

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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.

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And that turned into an 11 year love affair with Mexico.

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Fascinating.

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That's the story of young graduates, right?

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To follow their passion, follow their heart.

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Yeah.

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Excellent.

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Well, so let's get a little deeper into the conversation today about life sciences and opportunities in Latin America.

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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?

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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.

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We are talking about 600 million people region wide.

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But the complexities of the market is really what makes it stand out.

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Certainly Brazil is the largest opportunity, but it's also the market where we have Brazilian speakers, right?

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And so, and everything's kind of unique in Brazil.

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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.

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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.

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Okay.

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So let's get us a little more familiar with your work.

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How is it that you get started in the market research sector?

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I understand was in Mexico, right?

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And how you expand it to the u s et Cetera.

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Sure, absolutely.

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So I started back in a market research and we called it market intelligence.

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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.

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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.

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So integrating a market intelligence suite of services really made sense in order to understand and do all the pre deal type work.

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And it's at that point that I started focusing on the health care space because I was just naturally drawn to it.

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I found that fascinating and I was very passionate about it.

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And this is during my time in Mexico.

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A few years later, you know, I left croll wanting to go back on my own and I found a global health intelligence.

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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.

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And there is no such directory in Latin America.

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And maybe we'd like to develop on like that starting with Brazil.

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And so we began on that mission with that one client to a database of hospitals in Brazil and it soon expanded to Mexico.

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And then Columbia was quite successful and we now cover 17 markets.

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So we have the world's largest hospital demographics database focused on Latin America.

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So we've got started and now we're also doing procedure volumes and Mito market size and market share and trends and stuff.

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So it's pretty cool.

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We're very excited about what we do.

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Sure.

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So could you please describe a typical engagement kind engagement of viewers?

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I mean, that's usually the problem that a client has and you can solve with your market intelligence services.

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Sure, absolutely.

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Thank you.

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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.

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And this is true for both very large multinational companies as well as for startups.

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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?

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So for them understanding the demographics and the characteristics of the hospitals is really interesting.

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And so we can run propensity analysis on our hospital database to say which hospitals are the most prone to acquiring certain equipment.

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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.

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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?

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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.

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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.

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We're talking about over 22,000 hospitals.

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How can I get it?

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Where do I need to start?

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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.

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So those are just a few examples of the clients that we work.

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Fascinating.

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And what about obtaining the data for the services that you offer?

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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.

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So how do you do about obtaining these data?

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Absolutely.

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That's a terrific question.

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So it depends on the data.

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So that we're looking at, and I'd say Julio, that there's an additional factor here that most companies look at.

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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.

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So you have not only discrepancies in the type of information.

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So for instance, Brazil and Chile and even Mexico have a fairly good information.

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And I'd say even to some degree Columbia as well in terms of the, the, the government information that's processed.

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But other countries like Argentina, Peru, and Ecuador are very information poor.

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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.

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So you know, the information that the Brazilian statistics institute has is not necessarily the same as that of Mexico.

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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.

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So that's really one of the value propositions that we have is the ability to compare markets.

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Not just in fact that we're able to cover 17 markets, but we covered them with the same parameters.

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Hmm.

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That's fascinating.

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That's really good.

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Yeah.

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So to answer your question, how do we go about it?

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Well, we have a call center in Mexico where we actually call it a hospital's.

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We call up about 10,000 hospitals every year to gather information on data and on infrastructure.

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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.

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Interesting.

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Hoping our hospitals to provide this information.

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Do you have to pay for these or how does it work?

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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.

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We also are often in publications.

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And so in order for hospitals to benefit from the visibility that we create, they need to participate in our data gathering.

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Right.

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So it's kind of an exchange.

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They participate with us.

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We get that information is part of our database, but we also give them exposure and visibility through our different outlets.

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Oh, says two way.

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Um, bio preposition here.

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Yeah, absolutely.

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Yeah.

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We do have to keep their interests in line because at the end of the day, they're the ones also

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providing the data to us.

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Absolutely.

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Yeah.

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Makes Sense.

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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?

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Sure, absolutely.

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So the very first one is called a hospi scope.

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And hospi scope is the database of hospitals.

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And database is a very simplistic term for what we offer because we cover 17 markets.

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We have over 150 data points per hospital, including number of beds, number of equipment, number of operating rooms, et cetera.

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So that's Hospi scope.

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Um, we then have surgery scope, which is a very similar data set, but the focus there is on the procedure volumes per hospital.

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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.

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And then the third data set that we manage is called share scope.

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And He, what we look at is market size and market share for different medical devices, medical equipment and consumables.

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So it could be anything from CT scanners to MRIs down to pacemakers or neurostimulators or infusion pumps.

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So yeah, it's pretty broad array.

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Very, very good.

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I'm very shocked that nobody has done anything like this before in Latin America.

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I mean American companies or European companies that wanted to add to the vision were hungry for this type of information.

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And to see that you guys are solving these problems, the industry,

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it is fascinating and it is a gap in the market.

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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.

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And that's what it comes down to.

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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.

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More and more we're talking about team collaborations and people making fact based decisions in collaboration with one another.

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Whether that'd be, you know, on a local level, on a local country level, on a regional level or on a global level.

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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.

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And that's really what this is all about.

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And the reality of this is that the companies that have the information are better off.

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There's a gap in what's accessible in terms of data and it creates data assymetry.

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And that's the reason for our business to give.

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The companies that are more diligent in their processes that incorporate fact-based decisions will come out ahead in the long run.

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That's just the rules of, of the market dynamics.

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Yeah.

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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.

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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.

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They know how to generate demand for their drugs, medical device, equipment companies.

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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.

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And one of the problems in the medical device world or medical technology industry is the fact that you rely on it.

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The shooter that has database on assumptions, anecdotes, the distributor gathers data out by having dinner conversations with friends or colleagues.

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And that's the data that gets fed to the manufacturer in the U S or Europe.

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And not only that is also the fact that the interest of the shooter is not always aligned with the interest of the manufacturer.

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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.

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So what do you think about this?

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You touched upon a few really good points here, who you are.

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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.

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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.

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And so getting it right is critical for them.

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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.

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Medical device companies and manufacturers are much closer in terms of business operation to technology companies than the art to Pharma.

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Although they both operate under, you know, the healthcare life sciences umbrella and they can come out with adjustments to their medical devices.

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Literally every year when you stand with a new type of coding, et Cetera, it can take maybe one to three years to develop.

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Unlike Pharma, which can take 10 years to develop.

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And so the cycles around medical technology and Micheal devices is actually much shorter and much quicker.

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So what I've seen is that it's therefore also much harder.

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They haven't invested the time on the culture to develop the market intelligence and market information that pharmaceutical companies have now.

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I think that's also beginning to change.

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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.

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So that's very favorable for our business.

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But regardless, I think you're entirely right that the way that the products are commercialized in Latin America.

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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.

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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.

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Again, it's not going to be holistic.

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It's not going to be representative of the entire market.

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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.

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Contradicted said also the right goals for their distributors.

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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.

00:21:08.950 --> 00:21:14.440
And the reason for that is one is because of what's happening in Europe as we just described.

00:21:14.440 --> 00:21:31.349
And second is the FDA is becoming a lot friendlier to medical device companies looking to commercialize the technology because patients in Europe were getting breakthrough innovations before first.

00:21:31.559 --> 00:21:47.549
So American patients were left behind and the FDA is changing its stance on how to deal with businesses and now is a more pro business mentality and that is helping us companies stay in America.

00:21:47.640 --> 00:21:59.339
So now we have an America first mentality for my article, I interview over 30 CEOs of medical device companies and a lot of these CEOs have forgotten about Europe.

00:22:00.089 --> 00:22:00.450
Totally.

00:22:00.690 --> 00:22:05.640
I mean they don't want to deal with the EOM MDR at least for now or for the coming years.

00:22:06.059 --> 00:22:08.849
So they are looking for new markets.

00:22:09.420 --> 00:22:21.509
And my argument is that what's happening with the Pacific alliance in Latin America, these companies have a very interesting opportunity in their backyard.

00:22:21.779 --> 00:22:27.660
They don't have to go forward to China or to the middle is, I know, I know Japan is a very attractive market.

00:22:27.779 --> 00:22:29.099
It's one of the top markets in the world.

00:22:29.339 --> 00:22:31.680
China is a very, very attractive market.

00:22:31.920 --> 00:22:33.539
Of course it has many challenges.

00:22:33.869 --> 00:22:38.190
The regulatory approval process may take years, I mean at least a year or something like that.

00:22:38.329 --> 00:22:43.289
And so it's very prolonged and expensive and dealing with the shooters in China, et Cetera.

00:22:43.470 --> 00:22:45.450
Intellectual property is an issue.

00:22:45.809 --> 00:22:51.210
So Latin America is becoming a market that is worth looking into.

00:22:51.809 --> 00:23:02.819
And I don't know how much you've heard about the Pacific alliance, but, uh, one of the goals of the lions is to have Chile, Colombia, Peru and Mexico as a single regulatory market.

00:23:03.329 --> 00:23:20.640
What if you obtain, first you can have the same set of requirements for medical technologies and it started with pharmaceuticals and it will eventually, um, move on into low risk devices and eventually higher risk devices.

00:23:21.029 --> 00:23:32.039
But the idea is to make it easier for medical device companies to enter these four countries as a to block so that patients have access to these breakthrough innovative technologies.

00:23:32.220 --> 00:23:33.390
So once you've taken all of this,

00:23:34.460 --> 00:23:36.299
great, you touched with some really good points here.

00:23:36.329 --> 00:23:47.029
Maybe starting with the regulatory aspect of the FDA, but also the regulators region wide or even globally, these regulatory bodies are experts on creating regulations.

00:23:47.150 --> 00:24:00.799
They're not necessarily experts on understanding products and devices and typically, you know pharmaceutical and medical devices since they're both healthcare related, both life science driven are kind of clumped together by regulatory bodies.

00:24:00.859 --> 00:24:10.849
And I think that now we're starting to see much more consolidation of associations around medical devices that are lobbying and making their point heard.

00:24:10.851 --> 00:24:23.119
Then you cannot treat a medical device or medical technology the same way that you can treat a pharmaceutical because the market drivers are completely different because the way that products are consumed are completely different.

00:24:23.509 --> 00:24:26.150
You can't treat a pacemaker like you can treat a pill.

00:24:26.210 --> 00:24:26.480
Right.

00:24:26.480 --> 00:24:32.539
In terms of a regulatory step one and I think the points being heard across region, I'm starting to see that distinction.

00:24:32.759 --> 00:24:41.059
Maybe starting about five years ago till today, I'm starting to see a shift there, which is a good thing because medical devices and equipment, it is something completely different than pharmaceuticals.

00:24:41.690 --> 00:24:48.049
And to your point where, uh, your first mentality and now an America first mentality, I couldn't agree more.

00:24:48.109 --> 00:25:03.829
I remember just a few years ago touring companies in the U S and saying, they're telling me, you're giving me to, we're a very international company, 30% of our revenue comes from, or 40% of our revenue comes from outside of the U S so we consider ourselves international.

00:25:04.220 --> 00:25:05.029
I'm like, okay, cool.

00:25:05.030 --> 00:25:06.470
So how much is us?

00:25:06.471 --> 00:25:08.390
How much is the different blocks?

00:25:08.391 --> 00:25:11.089
And they said, well, you know, 60% us, 40% Europe.

00:25:11.569 --> 00:25:12.799
That's hardly international.

00:25:12.800 --> 00:25:12.950
Right?

00:25:13.490 --> 00:25:18.079
It's a funny comment, but it's not reflective of the opportunity that stands on a global level.

00:25:18.080 --> 00:25:19.819
And I'll get into that in just a second.

00:25:20.000 --> 00:25:40.460
But the point here is that we have a lot of American companies that see the first point of internationalism as Europe and, or at least we had until very recently, and then the rest of the world, it was kind of like, you know, two step process, first the u s and then Europe and an afterthought the rest of the world, including Latin America or Asia.

00:25:40.759 --> 00:25:52.640
And I do see that starting to change because of things like you mentioned, you know, the Pacific alliance and in that it's really important to know the development and the importance of Chili in Latin America, especially on the hospital sector.

00:25:53.359 --> 00:25:54.740
Chili's a very advanced market.

00:25:54.799 --> 00:25:59.539
It's probably the market that's most similar to what we're used to seeing in the u s or Europe.

00:25:59.930 --> 00:26:10.579
The average bed size of hospitals is like a hundred beds per hospital versus about 160 in us and Europe and about 45 in the rest of Latin America.

00:26:10.759 --> 00:26:11.000
Right?

00:26:11.000 --> 00:26:26.839
So hospitals are much bigger, which means that they have ability to leverage investments, ability to to scale growth, ability to invest in technologies and equipment, much more similar to what we're used to seeing us in Europe.

00:26:27.140 --> 00:26:33.170
And that's very different than the rest of the region where the average hospital has about 45 beds, right?

00:26:33.170 --> 00:26:38.470
So much fewer capabilities of investment and leverage ability, right?

00:26:38.740 --> 00:26:45.059
So on that same note of investing and an ability to invest, there's two things that we have to keep in mind.

00:26:45.089 --> 00:26:52.200
The very first thing is the opportunity on a global level of the different regions or blocks or groups of companies.

00:26:52.349 --> 00:26:57.059
And we're talking about approximately a hundred thousand hospitals worldwide.

00:26:57.390 --> 00:27:06.450
There's only about 28% that are in developed economies that being, you know, United States, Canada, Europe, Japan, Australia.

00:27:06.839 --> 00:27:08.940
So that's 28,000 hospitals.

00:27:09.269 --> 00:27:12.390
We have another 23,000 hospitals in China by itself.

00:27:12.839 --> 00:27:27.089
And then the Latin America by itself again, is another 23% so 23% of the world's hospitals are in Latin America and 75% of the world's hospitals are in emerging markets, are developing economies.

00:27:27.090 --> 00:27:34.680
You know, so when you're standing in Europe or in the United States and you're coming out with these new technologies and stuff, you're thinking, Geez, you know, who am I selling it to?

00:27:34.680 --> 00:27:35.849
How am I commercializing it?

00:27:36.240 --> 00:27:51.390
We have to keep in mind that most of the time those products and technologies will be consumed only about a quarter of the world's hospitals and then 75% of the world's hospitals, 75% of the opportunity will only see it much further down the line.

00:27:51.630 --> 00:27:56.970
And they might not be able to invest in them right away because of their leveraging abilities.

00:27:57.029 --> 00:27:57.329
Right.

00:27:57.330 --> 00:28:08.220
So the fact that a hospital has 45 beds on average in Latin America or in Asia, really impedes the ability to invest in highly advanced or very capital intensive equipment.

00:28:08.460 --> 00:28:25.980
So, I mean, maybe from your perspective, you're seeing something similar, but I'm, you know, ever more talking to startup firms in the u s or in Europe or even in Latin America that are developing products and devices specific for emerging markets, in which understanding that the market dynamics are completely different.

00:28:26.279 --> 00:28:40.529
These markets are underserved and they're not underserved from a technology standpoint, they're underserved from a market access to that point in the sense that we cannot sell a$2 million CT scanner or we can, but it's only going to be to very few hospitals.

00:28:40.740 --> 00:28:46.740
So what can we do in terms of the technology that can be commercialized in smaller settings?

00:28:47.099 --> 00:28:50.490
You know, uh, do we have to change the technology to have to change the equipment?

00:28:50.670 --> 00:28:52.589
Do we have to adapt the devices?

00:28:52.859 --> 00:28:55.230
Do we have to change the way we're commercializing them?

00:28:55.460 --> 00:28:59.220
Maybe it's more of a consignment issue rather than a direct sale.

00:28:59.400 --> 00:29:00.690
We have to provide financing.

00:29:00.930 --> 00:29:09.359
And those are really some of the important questions that are being asked in order to drive access because access is not just getting more patients.

00:29:09.361 --> 00:29:14.970
Access to care is getting patients care, but getting first of all quality care.

00:29:15.509 --> 00:29:17.490
And secondly, getting it in a timely manner.

00:29:17.730 --> 00:29:20.819
How do we drive access to quality care in a timely manner?

00:29:21.079 --> 00:29:24.750
And I think that's the big question that a lot of companies are asking themselves.

00:29:25.670 --> 00:29:28.700
And you loved that insight that you gave about Chile.

00:29:28.940 --> 00:29:35.240
So if it is okay with you, could you take us through a journey through our Latin America?

00:29:35.779 --> 00:29:40.250
Can you tell us some insights about the different markets?

00:29:40.250 --> 00:29:42.230
I mean, things that hip hop

00:29:42.519 --> 00:29:46.609
things that like, wow, I mean what, he knows this about Chile or Columbia or approved.

00:29:46.670 --> 00:29:55.250
So could you please tell us the insight or take us through a journey in the region, give us some highlights of the countries, things that pop up in each major market.

00:29:55.970 --> 00:29:56.720
Yeah, absolutely.

00:29:56.930 --> 00:30:06.500
So I think the very first thing that always catches people off guard is to think that 75% of the world's hospitals are in emerging and developing economies, right?

00:30:06.799 --> 00:30:15.559
And so that's kind of an immediate eye opener because it helps rethink the international a commercialization sales strategies.

00:30:15.980 --> 00:30:20.779
And within that 25% of the world's hospitals about are in Latin America, right?

00:30:21.109 --> 00:30:27.680
So Latin America is important in a global standpoint in terms of the number of opportunities and the commercialization aspect.

00:30:27.910 --> 00:30:37.910
I mean if we draw a list of the top 10 countries by number of hospitals in emerging markets, clearly you know China and India are at the top of the list.

00:30:38.269 --> 00:30:50.029
But within that top 10 list, four countries, or in Latin America we're talking about Brazil, Mexico, Colombia and Argentina, each of which have over 2000 hospitals, Brazil, even over 6,000 hospitals.

00:30:50.329 --> 00:30:57.200
So we're talking about large countries with a lot of hospitals and therefore big opportunities.

00:30:57.349 --> 00:31:01.069
So region wide, we're talking about nearly 22,000 hospitals.

00:31:01.070 --> 00:31:08.690
In Latin America, we're talking about almost 1 million hospital beds and about 50,000 to operating rooms.

00:31:08.960 --> 00:31:26.059
It's a big opportunity, but getting access and being able to really target and focus on one specific medical device for medical equipment is really where the challenge and comes into play because within all of these countries, there's many intricacies of how the systems operate.

00:31:26.359 --> 00:31:27.829
And I'll give you a quick example.

00:31:27.990 --> 00:31:38.480
In Mexico for instance, the average hospital has around 49 beds, but the public sector hospitals have over a hundred beds on average and the private sector have around 15 beds.

00:31:38.930 --> 00:31:53.359
And that's because of the rapid expansion of private health care system in Mexico that's now being commercialized even through pharmacy chains and the need to have quicker ambulatory short-stay facilities.

00:31:53.690 --> 00:32:00.769
And so those that help promote, you know, pop up hospitals with 10 1520 beds across Mexico.

00:32:01.009 --> 00:32:03.920
So that's a bit of an extreme case, but it's a reality.

00:32:03.950 --> 00:32:05.359
It's a reality that we're seeing.

00:32:05.630 --> 00:32:06.319
Fascinating.

00:32:06.589 --> 00:32:10.789
Could you tell us a little bit about Columbia, for example, what practice people's heads up at Columbia

00:32:10.809 --> 00:32:12.579
for example, Columbia is a fascinating market.

00:32:12.789 --> 00:32:16.450
It's one that I've always loved because it's a very noble market.

00:32:16.451 --> 00:32:24.039
I find that the processes in place, while very bureaucratic, they're very formal and they're followed to the t.

00:32:24.160 --> 00:32:27.789
So I'm always pleased to work in the Colombian market for that reason.

00:32:28.240 --> 00:32:33.640
Now you know, mind you, Columbus also extremely bureaucratic market and who you are, I think you can test to that.

00:32:35.059 --> 00:32:48.470
And it isn't working with over 2000 hospitals in a market in which in the couple of years what we're seeing is because of the price regulation, the price caps that have been put on to certain equipment, certain devices and certain pharmaceuticals.

00:32:48.710 --> 00:33:04.250
We're thinking it's a market that's been, in terms of healthcare space that's been slowing down a little, but nonetheless, it's a great market to conduct in human trials for clinical trials amongst others and the professionalism of the Colombian market is quite commendable on a regional standpoint.

00:33:04.920 --> 00:33:05.940
Maybe get it all right.

00:33:06.200 --> 00:33:07.460
Well continuing the journey.

00:33:07.490 --> 00:33:08.599
What about Peru?

00:33:08.900 --> 00:33:09.859
What can you tell us about it?

00:33:10.589 --> 00:33:21.279
Peru's an interesting market because we have some hospitals like the[inaudible] which I visited just last year, has world class installations for procedure.

00:33:21.309 --> 00:33:27.009
We visited some of their operating rooms and they are a really spectacular and that's within the public sector.

00:33:27.369 --> 00:33:29.950
Unfortunately it's not widespread, right?

00:33:29.951 --> 00:33:39.549
So much like the rest of Latin America, you have certain hospitals which are absolutely fascinating, which are world-class, which stand out even within the public sector.

00:33:39.819 --> 00:33:45.880
But the fact that they're not widespread means that access for patients within the public sector is really sporadic.

00:33:46.240 --> 00:33:55.750
And so oftentimes there's long wait times to get operated on or to get the proper care, and those wait times can increase the deterioration of health during that time.

00:33:56.650 --> 00:33:59.920
In the case of Chile, we talked about Chili, just a moment to go in.

00:33:59.921 --> 00:34:04.450
It's a fascinating country because it only has approximately 400 hospitals.

00:34:04.690 --> 00:34:13.510
So it's a relatively small market, but the level of sophistication of the Chilean a healthcare market is really unique across Latin America.

00:34:14.130 --> 00:34:23.739
There's some of the most advanced hospitals, they're larger in general, so they have much more scalability, much more investment capabilities, and they're very proficient in Well-run.

00:34:24.039 --> 00:34:34.269
So oftentimes, you know, we see companies looking at the Chilean market, not because of the size, but more because it's a great foothold and great starting point for Latin America.

00:34:34.570 --> 00:34:40.090
And a great way to test products in a market that's not so different from a size perspective.

00:34:40.210 --> 00:34:43.750
The average hospital size, I mean, than other countries in the U S or Europe.

00:34:44.139 --> 00:34:44.949
Very good point.

00:34:45.219 --> 00:34:47.320
Okay, so what about Argentina?

00:34:47.980 --> 00:34:50.739
Argentina is some big market over 2000 hospitals.

00:34:50.740 --> 00:34:53.860
Again, we're talking about nearly a hundred thousand beds.

00:34:54.099 --> 00:34:55.360
It's a big market.

00:34:55.690 --> 00:35:13.300
The challenge we face in Argentina on a regular basis, aside from the political woes, which are kind of unique even by Latin American standards, is the fact that the Ministry of Health doesn't have a proper accounting of hospital infrastructure like equipment, beds, procedures, et cetera.

00:35:13.659 --> 00:35:19.420
And it makes it very challenging for companies operating in the urgent time market to make consistent decisions.

00:35:19.420 --> 00:35:19.750
Right.

00:35:20.019 --> 00:35:23.469
So it's a double challenge there for companies looking to enter the Argentine market.

00:35:24.489 --> 00:35:24.489
Hmm.

00:35:24.820 --> 00:35:25.269
Okay.

00:35:25.510 --> 00:35:26.170
Fascinating.

00:35:26.860 --> 00:35:30.449
Well before we close the yum, I like to

00:35:30.610 --> 00:35:35.860
talk about the trends in that thing America that you see happening as we speak.

00:35:36.309 --> 00:35:44.550
And what do you common goals for the future from the APD mythology standpoint and from the business standpoint, what do you see coming to Latin America?

00:35:44.550 --> 00:35:51.179
What do you see happening right now that represents an opportunity for boring medical technology companies to sell their products?

00:35:51.329 --> 00:35:52.440
There's three things.

00:35:52.440 --> 00:35:57.960
Three factors that from our perspective are critical that we've been talking about for a few years now.

00:35:57.989 --> 00:36:00.090
The very first of which is the aging population.

00:36:00.090 --> 00:36:05.159
And that's something that everybody or surrounding healthcare globally often talks about.

00:36:05.369 --> 00:36:07.590
But what's unique about Latin America is Atlanta.

00:36:07.590 --> 00:36:11.010
America is the fastest aging population in the world.

00:36:11.400 --> 00:36:12.929
And you know, what does that mean?

00:36:13.050 --> 00:36:22.530
Well, it means that if we look at the population curve today, we have a large number of the population being within the 30 to 45 age range.

00:36:22.590 --> 00:36:30.900
In fact, I would go as young as 15 to about 45 and so within 40 years, that bulk of population will be considerably older.

00:36:31.019 --> 00:36:42.380
But what's unique about Latin America is that the rate of the marital rate and the rate of childbirth is much lower in this generation here, the millennials than it was in their previous generations.

00:36:42.380 --> 00:36:45.300
So folks who are getting married later, they're having babies later.

00:36:45.599 --> 00:36:50.219
And so there's a huge dropoff young folks in this coming generations.

00:36:50.550 --> 00:36:55.380
And so we're having an elderly population without necessarily having the replacement of the young folks.

00:36:55.710 --> 00:37:05.010
We're expecting to see a growth of over 145 million people aged over 60 within the next three years.

00:37:05.460 --> 00:37:09.269
And that's triple what that age category is today.

00:37:09.630 --> 00:37:18.539
We're expecting a growth of over 50% of age group, 45 to 60 so that's a growth of over 50 million people in that age group.

00:37:19.110 --> 00:37:23.699
So Latin America is aging a lot faster than most other regions around the world.

00:37:23.969 --> 00:37:31.500
That clearly has a huge impact when it comes to chronic diseases, the cost of care, the maintenance of care, etc.

00:37:31.650 --> 00:37:32.460
Across the region.

00:37:32.630 --> 00:37:34.889
I'd say that's the very first big, big driver.

00:37:35.659 --> 00:37:35.659
Totally.

00:37:36.360 --> 00:37:36.360
Hmm.

00:37:36.929 --> 00:37:37.320
Well good.

00:37:37.320 --> 00:37:39.750
John, anything else to add before we close?

00:37:40.210 --> 00:37:40.420
Yeah.

00:37:40.579 --> 00:37:45.190
When a across another two drivers that we're seeing a region wide is the obesity epidemic.

00:37:45.250 --> 00:37:49.539
Countries in Latin America are generally much heavier than others around the world.

00:37:49.719 --> 00:37:52.900
So again, the issue around obesity's that it has nurture.

00:37:53.170 --> 00:37:57.130
So it's not a problem that we can solve overnight, but rather it's going to take a long time.

00:37:57.130 --> 00:38:00.039
So again, driving healthcare needs across the region.

00:38:00.610 --> 00:38:07.809
And I'd say an overarching theme that touches multiple sectors of which health care is the a productivity issue.

00:38:07.969 --> 00:38:10.030
And Latin America needs to be more productive.

00:38:10.150 --> 00:38:18.969
It needs to have more productive healthcare systems in order to face these challenges, whether it's aging, population, obesity, whatever it might be.

00:38:19.269 --> 00:38:23.349
There's an intrinsic element to being able to have a more productive health care system.

00:38:23.889 --> 00:38:26.110
And I think there's companies that are very innovative in that sense.

00:38:26.199 --> 00:38:37.929
Like we will, Dr is a Colombian company broadening access to care through mobile phones, pharmacies across the region that are also, you know, taking role of primary care facilities amongst others.

00:38:38.050 --> 00:38:43.300
Telemedicine is growing higher growth if EMR systems and packs and race amongst others.

00:38:43.539 --> 00:38:50.710
So I think that there are initiatives in that sense, but they need to be more consolidated and a little bit more strategic and driven really to have a huge impact.

00:38:51.070 --> 00:38:52.630
But definitely that's some thoughts for the future.

00:38:52.630 --> 00:38:54.519
And I'd love to hear what you have to say about that.

00:38:55.300 --> 00:38:57.130
I'm very intrigued with that last point.

00:38:57.130 --> 00:39:12.219
I mean the first two, yes, I end up new, but about the productivity, I've read the reports where for example, in the case of Colombia, a worker, the typical worker in Columbia is four times less productive than a typical worker in the United States.

00:39:12.579 --> 00:39:19.630
So it's interesting how you shop, what a that to health care and I've never seen that angle and makes perfect sense.

00:39:19.730 --> 00:39:29.440
So there's an opportunity for companies to implement anticipates in hospitals to increase productivity software and then Terri management trying to great gourds and things of that nature, I guess.

00:39:29.590 --> 00:39:35.409
Yeah, and remote patient monitoring as this charge patients faster, but monitor them from my phone to that point.

00:39:35.411 --> 00:39:35.809
Who you're in.

00:39:35.820 --> 00:39:36.420
It's a great one.

00:39:36.440 --> 00:39:40.630
We often look at healthcare systems as a cost to the society, right?

00:39:40.630 --> 00:39:53.659
So we invest so much in healthcare, but the reality is we should look at it not from a cost perspective, but really from an investment standpoint, how much does it cost to have a labor force that's not fully productive, right?

00:39:53.710 --> 00:40:09.610
Because of health and if we look at that from a GDP standpoint and say, well, if we had a very efficient healthcare system that really enabled our company, our folks to be more productive, more often at work, miss fewer days of work, et Cetera, how much does that have an impact on our GDP?

00:40:09.989 --> 00:40:11.159
Very good point.

00:40:11.161 --> 00:40:23.639
I mean sometimes, at least in Columbia, that is the country that is closest to me to make an appointment, to see a primary care physician, you have to stay in line from seven in the morning until noon.

00:40:23.940 --> 00:40:24.329
No magic.

00:40:24.420 --> 00:40:27.420
You have to get out of work to stay 90 just to make an appointment.

00:40:27.449 --> 00:40:32.760
Then you have to go back the day of your appointment and also staying in line for four or five hours.

00:40:32.789 --> 00:40:33.809
It doesn't make any sense.

00:40:34.019 --> 00:40:40.230
And then another line to make an appointment for the specialists and then another nine to see the specialist.

00:40:41.309 --> 00:40:41.909
Wow.

00:40:42.000 --> 00:40:43.349
Yeah, that's a very good point.

00:40:43.351 --> 00:40:46.380
The productivity issue and never really thought about it, but very clever.

00:40:46.889 --> 00:40:47.489
Thanks for that.

00:40:47.699 --> 00:40:49.409
Any final thoughts before we close?

00:40:49.411 --> 00:40:58.320
I mean, in other words, what would you say to the CEO of a medical technology company in the u s Europe just to evaluate in markets to penetrate?

00:40:58.320 --> 00:41:00.030
I mean, what will be your words to him?

00:41:00.280 --> 00:41:07.510
I'd say the very first thing is that Latin America is a very large opportunity, but it's an opportunity that has to be approached carefully.

00:41:07.659 --> 00:41:14.590
It has to be studied and it has to be approached very strategically in order to really get the benefits out of the market.

00:41:14.860 --> 00:41:23.739
It's also a region that has natural ups and downs that's cyclical and it's a longterm investment in bet, so be ready for that.

00:41:23.980 --> 00:41:35.389
Those companies aren't doing well, whether they're Johnson and Johnson's of the world, the ges, the Phillips, the Siemens, et Cetera, were well established with been growing for many years and gained a good foothold in the market.

00:41:35.690 --> 00:41:36.980
They're there for the long run.

00:41:37.159 --> 00:41:39.710
It's a longterm vision and investment.

00:41:40.510 --> 00:41:41.280
Greg, the yum.

00:41:41.349 --> 00:41:43.360
Thank you so much for being on the show today.

00:41:43.360 --> 00:41:52.750
I really appreciate your insight, your comments about the opportunities in the market, and I'm sure listeners got a lot out of these episodes, so thank you again.

00:41:52.751 --> 00:41:55.539
I look forward to having you here again in the near future,

00:41:55.659 --> 00:41:55.989
who you are.

00:41:55.990 --> 00:41:56.650
Thank you so much.

00:41:56.650 --> 00:42:00.369
This is a really terrific opportunity and thank you listeners for tuning in.

00:42:00.489 --> 00:42:00.880
Excellent.

00:42:00.909 --> 00:42:01.030
Bye.

00:42:01.030 --> 00:42:01.269
Bye.