Aug. 31, 2022
Luís Meireles, CEO & Co-Owner at MDI
Luís Meireles is currently CEO and co-owner of MDI Industrial a Medical Device Industry in Brazil and a senior consultant for European companies. Luís is Portuguese, Ph.D. in Biotechnology but moved to Brazil, spending the last decade helping to introduce medical devices into Latin America he was responsible for the introduction of Mortara Instruments in Brazil with a successful plan growing from almost zero to one of the market leaders. He was a senior consultant for Hill-Rom visiting almost all countries in Latin America, being perfectly aware of the difficulties of implementing and growing the health market in LATAM, especially in Brazil.
WEBVTT
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Welcome to the Latin Metech Leaders podcast, a conversation with Metech leaders who have succeeded or plan to succeed in Latin America.
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Welcome to the Latin Method Leaders podcast, a conversation with leaders who have succeeded or plan to succeed in Latin America.
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Today our guest is Louis Mares, PhD and CEO at MDI Industrial, a medical device manufacturer in Brazil.
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Reese is also a senior consultant for European companies looking to do business in Brazil.
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So Louis, it's great to have you here in the show.
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Uh, welcome.
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Thank you for invitation to be a pleasure to share some experience and some thoughts if they are useful.
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Excellent.
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Uh, Louis, I'm, I'm so happy to have you here today.
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I'm, I'm sure many of our listeners are very curious about Brazil.
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Brazil, as you know, is a huge market.
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It's the largest market, uh, for medical devices in Latin America.
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So I always enjoy speaking with people like you.
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I've actually, I've only had about two guests like you, two or three, I don't remember.
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But, uh, it's such a huge country that we can have 200 guests.
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I still don't cover the whole market.
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Right.
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.
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It's a difficult market, but huge.
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Huge.
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Very large.
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All right.
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So Louis, let's get started talking about, um, your journey to Latin America.
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You are from Portugal and you moved to Brazil.
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How is it that you got involved with the medical device business in, in Brazil and Latin America?
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Well, this is a very long story that I will try to resume in a few minutes, otherwise, we can stay all day speaking about this.
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Okay.
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But I'll try to do it fast.
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Okay.
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So I, I'm by a technology.
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So my life started in the academy.
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I was a university teacher for a few, a few years during my PhD, and I started post-doc doctorate as well.
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But then I decided to raise my own company, and that was in Portugal.
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That was almost 20 years ago, kind.
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Uh, and then I started to work in the medical field.
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Uh, I always was very close to the medical field.
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I found out the cardiology market, and I started to work with several cardiologists.
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We raised a company in Portugal that was, uh, targeting that, that market.
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It was a startup, it was doing well.
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But, uh, with the crisis in Portugal, uh, I don't know if you remember, but Portugal, Spain, Greece.
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We had the fm fm i in, uh, there.
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So it was kind of tough at that moment for the startups.
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And we were growing in Brazil.
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Okay.
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We have had already a partnership in Brazil.
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We had our product certified here.
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So I moved here initially for, uh, one year or a couple of years just to launch the project here, try to make some, uh, some grow in Brazil, which was the same language, and, uh, and then go back.
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But during that, that course, I decided to stay here and, uh, started to understand this market.
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And I started to work with another companies here.
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Uh, and uh, and now I'm here for more than one day working in the medical device industry.
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Wow.
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Fascinating journey.
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I'm sure you have so much to tell about your, uh, stories and challenges in Brazil, because Brazil is famous for being kind of a difficult market to penetrate lots of laws and regulations, and it's protective, right?
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Uh, supposedly not, but its, its protective and it is difficult to, to penetrate.
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It's not very easy.
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You need to understand the culture first.
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Uh, and everything is different.
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Everything is different.
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So it's, it's really hard to just pick up products from America or Europe, which can be market leader there, and then implement it here and be, be successful because the challenges are, uh, are are very big.
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They are.
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And it's difficult to understand how to, how to do that.
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So you need first to understand the market, then to understand the people, the culture, and to set up a plan to, to do that.
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I did it with one American company at that time.
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Uh, we implemented instruments.
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Marta was a Milwaukee based company.
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They were leader in, uh, in cardiology at that, at that time in Europe.
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They were growing fast.
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And we started distribution here in, in Brazil, and we were running to be market leaders.
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So we, we, the grow was enormous, but then the mortal was acquired by hi and the Hi and then was acquired by Bax and uh, whatever.
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So things changed, but the project and the experience remain, and we are still known as the persons that that brought mortal and implemented mortal here.
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Excellent, excellent.
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So Louis, let's talk about trends.
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What trends do you see happening in Brazil or in Latin America that are, are worth mentioning today that are relevant to our discussion?
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Any political, economic, social trends that you see?
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First, you need to understand, or people need to understand that Latin America's continent with several countries, and it is totally different to enter in Brazil or Colombia or she is different.
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And the strategies are totally different.
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And the countries are in different, in different, uh, positions.
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Right now, of course, Brazil is the major country of Latin America.
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There are 220 million people in Brazil is a huge, huge market.
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Uh, so it's a very good playground to enter.
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And if you enter Brazil, which is difficult, then you have the doors open to the rest of the, the Latin America.
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Ok.
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Because you can have a very strong base.
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Brazil is, is not a, it should be one of the wealthy and rich, uh, countries in the world.
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There is everything here.
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You have oil, you have gold, you have diamonds, you have, uh, amazing agriculture.
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You have, uh, the rain forest, the Amazonian rain forest should be the most rich country
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In the world.
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Manufacturing.
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There's so much manufacturing happening there.
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Airplanes, cars, medical devices, everything.
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TVs, I mean,
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Everything.
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They do everything here.
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Uh, it's a huge, huge market and should be quite rich and wealthy.
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It's not because of political and historical reasons et set, but it should.
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But what I see, and I see a huge evolution in the last 10 years, It'll take 100 years, maybe it'll take a few generations, but it is getting stronger and the market is getting bigger, and things will, will, will, will evolve.
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So these emerging countries will be, will be to be focused in the next, in the next, in the next years.
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Okay.
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One trend that I see in the medical device in industries that I didn't see when I arrive is that, uh, is getting more and more protective.
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Ok.
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Uh, it's getting more difficult to register products here, for instance, uh, than it was 10 years ago.
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The regulation is getting tighten and, uh, is not that easy now to get a medical device.
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Certification, certification here, especially
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If it is of a higher class right, has
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Three, especially if it is a higher class.
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So I think that it was kind of easy, it was cumbersome and usually it took time because, uh, because the processes were bureaucratic.
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But it was easy.
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It was time consuming, but easy now it is the opposite.
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And Visa, which is the medical device regulator here, is working pretty much well.
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They answer fast, they answer professional, but they have tightened the rules and is not that easy to get to that get things done, which is good for good companies.
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Ok.
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So we are filtering the markets and the strongest and the organized and good products will stay.
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And the poor products and Chinese products and products with less, with less regulatory systems, we less, uh, difficult to, to to, to grow.
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The last legislation that arrived, uh, last, last, uh, couple of months is, I believe it was, it was May, uh, April of May is now, for instance, medical device software is subject to regulation, which was not, which was not.
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So for instance, if you, if you were to register a medical device, the test, uh, the equipment, the device and a software, the regulation was only on the device.
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The software was not subject to regulation.
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Now it is.
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So they will add it, the software engineers, how it was done, you has to give all the documentation of the software, how it is done, et cetera.
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Similar to Europe, for instance, which, which is new.
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And it'll change lots of things now because, because it, uh, it will make things, things, uh, harder.
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So that is a trend that we need to, to consider.
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It is getting difficult to get registration yet is, uh, is possible and uh, and professional.
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And that is, uh, a huge change because few years ago, people didn't want to come to Brazil because to register product in Visa was very difficult because they don't, it takes two years and it's nothing like this right now, it's professional.
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But if you have the right consultants and the right team and the correct quality management management system, you are able to do it in the, in the precise times.
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And also if you have a reference country approval, I guess that helps a lot.
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It helps, but it's not, uh, it is not, uh, mandatory.
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Okay.
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Okay.
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But, but it helps Now on Visa is part of international, uh, plan that has fda that test Japanese and Canadian.
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Oh, MD ist it.
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Yes.
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So you can, you can use my up with Misa or my, with Brazil and Visa as well.
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Europe is still out, but it is expected to come and that will, that will maybe do things.
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So for me, that is a major trend.
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Regulatory is now professional, but more difficult.
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That is one trend.
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The other as is that the market is getting more and more, uh, competitive.
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Okay.
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Uh, in Brazil, we now are facing, uh, I don't see a problem, but it is a trend.
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have two markets, the public sector and the private, and they are totally, totally different.
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And Thes must be different for both because it's, it's like two different markets, two different countries, two different approaches.
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But on the private sector, what we'll see and what we are seeing, there are major groups which are very few, three or four groups that are buying all the hospitals in, uh, in Brazil, for instance, I live in, uh, Salvador.
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And in the past four years, all the private hospitals were acquired.
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There are no more private hospitals.
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Individual, individual independence.
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They were acquired by major networks that are buying hospitals almost every month.
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Okay.
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Wow.
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So that is good and bad.
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That's what it's called systems in the United States, because the audience is familiar with that terminology.
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Why that is good, because if you get to enter that hospital network, you'll sell to all country.
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There are networks with, uh, that started with 10, 10 hospitals and now they have hundreds of hospitals.
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So if you get to your products inside, then you'll sell to all the network.
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So that is good.
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The part that is bad, it is more difficult because everybody's trying to do so, so you need to be good to be, so to do that.
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And then you have the pricing issues as they are big, what they're trying to do, they're trying to acquire in huge quantities, but lowering your, your margin.
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So you need to be very, very smart to be able to, to succeed, for instance, selling the products at lower margins so you can get in and then have a very good effective servicing that make you win during the, during the time with accessories, with servicing, with trainings, et cetera, for instance.
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So you need to have, to have strategies to go there.
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The good news is that you have to focus in a few, a few costs.
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It's easier, it's easier to do, uh, in terms of time or in terms of, uh, focus.
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But it's difficult.
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You need, you need to, you need to, to get in.
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So that is a trend.
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So you have now very, very big groups and there are a few others, but there are four that are just, just just exploding and buying hospitals and hospitals and hospitals.
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So it's consolidation of a fragmented industry.
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Yes.
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Used to be very fragmented.
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Now is more consolidated.
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So there is a trend of consolidation where the, the hospital systems are acquiring independent hospitals and creating large networks.
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Exactly.
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So one is the public sector for hospitals, the other is the private.
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And the private is, is being merged.
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So you need to know where you, where you, where you act.
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And anyways, the primary care, which for me is the most difficult one because Brazil's huge land, the infrastructure of transportations is poor.
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You was to travel by plane, you can't travel by car.
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There is no drains to travel between, between cities.
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So we always to to to be present.
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And if it, these hospitals, you can go to the major groups.
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If it's public, you have public standards, that's now everything online, etcetera.
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So you can, you can manage.
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So there's centralized, centralized, uh, purchasing in Brazil Yes.
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By the government, national government.
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But if your product, for instance, is for primary, primary care for physician offices, small, then you need to make, uh, sales representative network
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All over the country.
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All over the country because you can't be there easily.
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Ok.
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So you, you need to define different segments and then you, you have to attack each segment, uh, each segment, uh, differently.
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Ok.
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So that is, that is one, uh, one, uh, one issue that you need to understand.
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And as there were lots of companies coming to Brazil in the eighties and in the nineties that appear and disappear, they change distribution.
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Lots of times customers here, they don't trust, uh, outside brands in their offices unless they have somebody near that says, Look, doctor, I will support you.
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I have all information.
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I have a, if they don't have, uh, they don't pipe.
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Yeah.
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Interesting.
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It's, it's quite interesting.
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In cardiology, in cardiology, there are 17,000 cardiologists in, uh, in Brazil,
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17,000 cardiologists.
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1, 7, 17.
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Okay.
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Yeah.
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Thousand cardiologists.
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Uh, but the persons working, the cardiologists selling devices at the same, always the same.
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It's a, it's a very close, close group.
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And the brand is a commodity.
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Okay.
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The brand is a commodity.
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The cardiologist locally will buy what that person is selling him.
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Okay.
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Because he trusts him or her, because he's local, he speaks the same language.
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He's there forever.
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He knows where he lives.
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Yeah.
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And he's there for 20 years with a company there always support the customer.
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So to get his primary care, the, is to set up a sales representative network and get those small companies that are locally in supporting to work for you.
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So you need to be smart and to say that you have, uh, uh, a good portfolio with good prices, that you will support them, that you can, you can sustain.
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And then they will risk to change what they're doing and try to promote, to promote your brand.
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And they'll never, they will never do a swap like instant.
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They will test you.
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They will test in smoke once they will see how work.
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So there is a trust relation that you need to build until they really promote, promote your brand.
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So, and that's difficult to, that is difficult to acquire until you get, uh, a sales representative network.
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It takes a while.
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And you see, you have 27 states in Brazil, they are all separated and all with very individualities and different things.
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So it's, it's difficult.
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So you need to have at least 25, 20, 20 5 cents reps around, around, uh, around Brazil.
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And you have to be able to manage them and to teach and to coach and, uh, but it's, it's possible to, to do it.
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Hmm.
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Interesting.
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