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2 days ago

HealthPadTalks: Pilot-Grade Leadership

HealthPad
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Medical Technology
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AI
British Airways
commentary
digital health
HealthPadTalks
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MedTech
podcast

Should MedTech leaders be evaluated with the same rigour as airline pilots? Pilots undergo intensive, twice-yearly assessments because lives are at stake. Yet executives making life-impacting decisions are judged largely on short-term financial metrics. This episode of HealthPadTalks argues for a pilot-inspired, holistic appraisal model - spanning ethics, crisis readiness, communication, compliance, and teamwork - for the MedTech C-suite. LISTEN NOW!

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1 week, 1 day ago

MedTech’s Comfort Crisis

HealthPad
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Medical Technology
Tags:
AI
analogue mindset
commentary
digital health
Medical Technology
stagnation

  • MedTech’s hidden stagnation: Behind steady revenues and strong compliance lies a crisis - growth has decoupled from innovation
  • The governance paradox: Boards designed for stability and safety now inadvertently suppress strategic renewal and digital transformation
  • The analogue mindset problem: Legacy leadership habits and risk-averse cultures keep MedTech anchored in a manufacturing past
  • Governance without growth: Today’s governance model protects the status quo but fails to build adaptive, data-driven capability for the future
  • From compliance to curiosity: MedTech must evolve its boardrooms and executive teams - redefining fiduciary duty, incentives, and composition - to turn governance into a catalyst for digital-age growth.

MedTech’s Comfort Crisis

On the surface, MedTech has rarely appeared stronger. Revenues are steady, margins solid, compliance rigorous. Boards meet their obligations, regulators are reassured, and investors continue to value the sector’s predictable performance. It is a portrait of success - the kind that populates annual reports with confident language about resilience and long-term value creation.

Yet beneath this stability sits a more uncomfortable truth. As the wider healthcare ecosystem accelerates into the data-driven age, many established, legacy MedTech organisations are losing momentum. Growth is increasingly disconnected from innovation. Digital transformation is referenced as an aspiration rather than an operational reality. Industry acclaim gravitates toward incremental product improvements instead of meaningful, outcomes-driven advances. The result is a subtle but persistent erosion of strategic relevance.

This is MedTech’s silent crisis - not a crisis of failure, but of comfort. Governance remains prudent, compliant, and disciplined, yet it has become designed for continuity rather than renewal, for risk minimisation rather than value creation. In a healthcare landscape rapidly reshaped by data, algorithms, and platform economics, stability is no longer synonymous with strength. Increasingly, it risks becoming a form of strategic stagnation.
 
In This Commentary

This Commentary calls on MedTech boards, CEOs, and investors to rethink how they lead. Its central, if uncomfortable, thesis is that the analogue mindset that built MedTech’s global champions now threatens to constrain their future. To thrive, the sector’s leaders must abandon legacy assumptions and embrace a new, data-driven, platform-based model of value creation.
 
The Value Plateau

For nearly two decades, MedTech was defined by sustained expansion - innovation cycles driven by engineering excellence, reinforced by regulatory moats, and amplified by an era of near-zero interest rates that enabled finance-led M&A. Scale became the dominant strategy, capital was abundant, and valuations rose with reassuring consistency. Growth felt structural, almost inevitable.

That cycle has ended. Despite sound fundamentals, total shareholder returns for many legacy MedTech companies now lag the broader healthcare market - a trend mirrored in McKinsey’s finding that the S&P 500 has outperformed large-cap MedTech every year since 2019. The sector has reached a value plateau: profitable, resilient, but strategically underpowered.

The causes are structural. Product pipelines are increasingly characterised by incrementalism - devices that are smaller, lighter, marginally smarter. Digital, data, or service-led innovation remains the exception rather than the norm. Meanwhile, new entrants - from digital health insurgents to consumer-technology platforms - are redefining how value is created and experienced across the patient and clinician journey. They move faster, iterate continuously, and monetise through models that transcend traditional device economics.

Legacy players, by contrast, continue to measure success through familiar industrial metrics: units shipped, approvals secured, margins defended. Digital initiatives are appended to the core business rather than embedded within it. AI pilots proliferate, but few transition to enterprise-scale transformation.

Markets have adjusted accordingly. Investors now reward predictability not because it inspires confidence in future growth, but because they have stopped expecting innovation-led upside from mature MedTech. Capital that once backed the sector’s R&D engine has shifted toward more dynamic health-tech, data-driven, and platform-based models. What remains is a shareholder base that prizes discipline, efficiency, and cash stability. Boards are applauded for prudence rather than ambition.

The result is a sector configured to preserve value more effectively than it creates it - not a sign of financial fragility, but of strategic stagnation. It reflects an implicit acceptance that many legacy MedTech firms have become custodians of past innovation rather than creators of future advantage.
Quantum computing is moving from lab curiosity to healthcare catalyst, driven by breakthroughs like Google’s Willow chip. LISTEN NOW to the latest episode of HealthPadTalks and discover how quantum computing could accelerate drug discovery, refine diagnostics, advance precision medicine, and transform clinical operations. 
 
The Analogue Mindset

At the heart of today’s stagnation is not a lack of ambition, but a mindset - an operating system shaped by decades of analogue-era success. For more than fifty years, MedTech leaders thrived in a world where companies were fundamentally manufacturers: regulated producers of precision-engineered devices. Winning meant operational excellence, clinical trustworthiness, and global scale.

That legacy built extraordinary organisations. It also forged a leadership identity. The archetypal MedTech executive is an engineer, operator, regulator - or increasingly, a financially trained leader shaped by decades of cost discipline and margin protection. Across the industry, boards remain anchored by auditors, compliance experts, CFOs, and manufacturing veterans. The result is a governance centre of gravity oriented toward control, predictability, and capital efficiency.

In this environment, strategic discussions naturally gravitate toward the familiar terrain of supply chains, inspections, unit economics, and risk mitigation. These capabilities have been essential to MedTech’s rise - but they also reinforce an instinct to optimise the current model rather than reimagine the next one.

This analogue worldview delivered significant achievements: safer devices, unmatched reliability, and global reach. But it also entrenched a narrow conception of innovation - the idea that progress is principally about technical refinement. In a digital economy where value is created through data, connectivity, and user experience, that definition no longer scales. Yet many MedTech companies still frame “digital” as a programme to be managed rather than a core business architecture to be built.

The analogue mindset reveals itself in subtle but telling ways: data teams buried in IT rather than embedded in strategy; digital health units ring-fenced from mainstream product lines; leadership meetings where risk is defined almost exclusively as regulatory exposure rather than competitive opportunity. This is not a failure of capability. It is the natural inertia of a generation that mastered a model the industry long rewarded.

The strategic imperative now is not to defend that mindset, but to recognise it - and consciously reset it. As one industry veteran put it, “We’re still perfecting titanium while the rest of healthcare is wiring the patient.” The organisations that thrive next will be those whose leaders honour the strengths of their analogue heritage while decisively adopting a digital posture for the decade ahead.
 
Governance Without Growth

Governance is designed to safeguard value creation. In MedTech, however, it increasingly constrains it.

Most governance frameworks were built for an era when the primary threat was regulatory, not competitive. Boards were structured to ensure compliance and operational continuity, not to catalyse strategic reinvention. Their composition still reflects that origin: deep expertise in finance, audit, regulatory affairs, and quality systems - but limited fluency in data-driven business models, platform economics, or software-enabled value creation. Risk committees are world-class at interrogating safety, quality, and supply chains, yet less equipped to assess the strategic risk of standing still.
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Incentives reinforce this protective posture. Executive compensation remains weighted toward near-term operational metrics - revenue reliability, margin stability, cost discipline. Fewer mechanisms reward capability building, digital integration, or ecosystem positioning. The implicit message is consistent: optimise the model you have, and avoid unnecessary disruption, even as that model loses relevance.

Investors amplify the dynamic. For years, they rewarded MedTech for consistency, resilience, and predictable cash flows. But while many still prioritise stability, they are increasingly signalling discomfort with innovation timelines that lag adjacent sectors. The result is a contradictory pressure: deliver dependable performance today yet somehow transform tomorrow - without visible volatility.
The irony is stark. MedTech boards are among the most disciplined in global industry - processes impeccable, oversight rigorous, risk controls exemplary. Yet this strength has become a strategic constraint. Governance has become so effective at protecting the legacy business that it leaves little bandwidth or imagination to build the future.
 
The Cost of the Analogue Playbook

The consequence of maintaining an analogue playbook is not dramatic collapse but slow strategic drift. MedTech remains essential - but it is gradually moving to the periphery of healthcare’s future unless it adapts with intent.

Innovation leakage. The most valuable data streams now come from wearables, remote monitoring, and digital therapeutics - categories shaped by firms that were born digital and instinctively understand software, behavioural design, and monetisation. Traditional MedTech, built on device excellence, often still views hardware as an endpoint rather than a gateway to continuous, data-enabled care.

Margin pressure. As procurement becomes more price-driven and device differentiation narrows, value is migrating to software, analytics, and integrated services. Digital platform players are capturing recurring revenue streams, while many MedTechs still treat the digital layer as an add-on rather than a core value driver.

Talent imbalance. The most ambitious AI and data talent gravitates toward environments that offer speed, autonomy, and the chance to shape new models. Legacy MedTech organisations - optimised for reliability and risk control - can unintentionally signal rigidity to the innovators they need. The issue is not culture failure but cultural mismatch.

Investor restlessness. Capital markets are recalibrating. While long-term investors have historically prized MedTech’s resilience, they are now looking for credible pathways to digital-led growth. In their place, more reactive capital introduces volatility not seen since the last consolidation wave. The message is measured but unmistakable: operational excellence remains necessary, but it is no longer sufficient.
Strategic marginalisation. If MedTech does not own the patient interface, it risks becoming healthcare’s hardware backbone - still vital, but increasingly interchangeable - while others control the data, relationships, and economics of care.

We have seen this pattern in other industries. Automakers once believed their competitive edge lay in engines, manufacturing scale, and incremental refinement. Then software reframed mobility. Tesla did not replace the car; it redefined what a car is.
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MedTech now faces a similar inflection point. The winners will not abandon their analogue heritage - they will build on it, evolving from precision manufacturers into orchestrators of outcomes across connected, intelligent health systems. The shift is not a repudiation of the past, but a deliberate extension of it.
 
From Governance to Growth: The Adaptive Board

The question is not how governance becomes less rigorous, but how it becomes more strategically relevant. The MedTech boards that lead the next decade will be those that extend their traditional strengths - discipline, accountability, and stewardship - into a posture that actively enables growth.

Reframe fiduciary duty. In a rapidly shifting healthcare landscape, long-term risk management now includes safeguarding the organisation’s capacity to adapt. Strategic inertia is itself a form of value erosion. Modern fiduciary duty means ensuring the enterprise can learn, pivot, and scale new models at market speed - not just protect what already works.

Rewire board composition. Diversity of thought and experience is becoming as important as demographic diversity. Boards benefit when seasoned operators, clinicians, and financial stewards are complemented by directors with deep understanding of data ecosystems, payer economics, and platform business models. This is not about adding a token “digital person,” but enriching the board with peers who can challenge assumptions with equal credibility.

Make governance dynamic. Many MedTech boards excel at internal oversight but have limited exposure to the frontier of innovation. Forward-looking organisations are addressing this by creating Innovation or Technology Committees alongside Audit, Quality, and Risk. Their mandate: steward capability building, evaluate technology bets, and cultivate ecosystem partnerships. This outward orientation - engaging start-ups, academic labs, and tech leaders - signals to emerging talent that the company is serious about shaping the future.

Evolve incentives. Executive rewards need to reflect indicators of transformation - digital revenue mix, speed of capability adoption, partnership depth, and platform maturity. These metrics are not “soft” but correlate with resilience and long-term enterprise value.

Rebalance risk. Traditional governance emphasised variance as danger. Adaptive governance recognises that, in fast-changing markets, stasis can be the greater risk. The goal is not volatility for its own sake, but a calibrated willingness to embrace thoughtful experimentation.

Educate investors. Boards play a critical role in helping capital markets understand the optionality created by transformation. Clear, metric-anchored narratives about capability building, technology integration, and ecosystem expansion can shift investor perception from cost to value creation.

The goal is not reckless governance, but ambidextrous governance - protecting the core while cultivating what comes next. The defining question for the next era is no longer only “Are we compliant?” but also “Are we evolving fast enough?” Traditional strengths remain essential; the opportunity is to redeploy them toward shaping the future rather than merely defending the past.
 
The New Playbook

What does a post-analogue MedTech playbook look like? Above all, it starts with a mindset shift - not from discipline to disruption, but from control alone to controlled curiosity. The organisations that thrive will be those that preserve their operational strengths while opening more space for exploration, learning, and strategic experimentation.

Short term (12 months). Begin by understanding the organisation’s and the board’s digital readiness. How confidently can directors interrogate a data strategy or challenge assumptions about platform economics, patient engagement, or AI-enabled workflows? Many boards are already adding this literacy through briefings, deep dives, and targeted education. Some leading companies complement this with a “digital advisory circle” - a group of next-generation leaders and external experts who bring fresh questions and broaden perspective. At the same time, recalibrate incentives so that transformation outcomes - capability adoption, digital traction, partnership development - sit alongside traditional operational metrics.

Medium term (2–3 years). Shift capital allocation to include structured “learning investments”: small, well-governed experiments in data-driven services, subscription models, AI-enabled care pathways, and cross-sector partnerships. These are not moonshots; they are disciplined probes into the future. Forge alliances with AI start-ups, applied research labs, and digital health accelerators to expand the organisation’s innovation surface area. Redefine innovation KPIs around learning velocity - how quickly teams can test, refine, and scale what works. The emphasis moves from output to throughput: a steady flow of insights, pilots, and proofs of value.

Long term (3–5 years). Evolve the organisational identity. The MedTech leader of the next decade is not just a manufacturer of devices but an orchestrator of outcomes, integrating data, devices, and decision support into connected care experiences. Institutionalise renewal at the board level: ongoing engagement with digital ecosystems, structured immersion in emerging technologies, rotations with start-up observers, and a standing agenda item on organisational learning. This ensures that transformation is not episodic but systemic.

The new playbook is not about abandoning what made MedTech successful. It is about modernising the mental models that sit atop those strengths. The analogue mindset equated control with excellence; the digital era equates learning with longevity. Boards and executives who embrace adaptation as part of their fiduciary role - protecting today while preparing for tomorrow - will define the next chapter of MedTech leadership.
 
Takeaways

MedTech’s challenge is not a failure of intelligence or intent - it is a crisis of imagination. Leaders understand where healthcare is heading, yet legacy systems, incentives, and success patterns can make it difficult to shift at the speed the future now demands. The encouraging truth is that a crisis shaped by governance can be solved through governance. The discipline that delivered MedTech’s reputation for safety, reliability, and trust can now be redeployed to unlock agility, innovation, and growth.

The pivot requires a particular kind of courage: the willingness to recognise that a model designed to protect value may now need to evolve to create it. This is not an indictment of the past, but an invitation to extend its strengths. The future of healthcare will be shaped by leaders who can blend the industry’s traditional assets - clinical credibility, regulatory mastery, operational excellence - with digital fluency, ecosystem thinking, and creative ambition.

Transformation is not disorder; it is competence expressed at a higher tempo. If governance evolves from a posture of compliance to one of informed curiosity, and if investors increasingly reward adaptability alongside predictability, MedTech can once again become a primary engine of healthcare progress.

The end of the analogue mindset is not the end of MedTech - it is the opening of its next chapter. A chapter to be written by leaders confident enough in their expertise to stretch beyond it, and bold enough to evolve before the market forces them to. The future will not belong to those who wait for perfect clarity, but to those who govern with purpose, imagination, and a commitment to continual discovery.
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aidan williams

Skill Up
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Skill Up is a leading online education provider offering CPD (Continuing Professional Development) accredited certificates. Committed to delivering a rigorous online education experience, Skill Up empowers learners to acquire industry-relevant skills that are recognised and valued worldwide.


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5 months, 2 weeks ago

Think Bold Act Smart

HealthPad
Directory:
Medical Technology
Tags:
AI
commentary
corporate culture
data analysis
digital health
leadership
MedTech
platform
talent retention
  • Legacy MedTech's decline is chronic and systemic, not a cyclical setback 
  • Leadership’s focus on short-term gains hinders long-term renewal
  • A five-pillar blueprint outlines how to rebuild relevance through digital, platform, and patient-first strategies
  • Mindset transformation is essential: from quarterly reflexes to future-focused leadership
  • Inaction is costly; only bold, strategic moves can counter rising structural and competitive threats

Think Bold Act Smart

On May 7, 2025, HealthPad published a provocative Commentary, MedTech’s Blueprint for Failure, arguing that the industry's crisis is not cyclical - but structural. A handful of elite firms continue to outperform, yet a long tail of underachievers grows more exposed and fragmented. Capital and confidence flow to the few; the rest are left treading water.

This is not a failure of operational know-how. It is a failure of mindset. MedTech leaders - particularly in struggling firms - are trapped in the tyranny of short-term performance. Quarterly earnings dominate attention, leaving little bandwidth for strategic pivots. As a result, imperatives like AI, digital therapeutics, patient empowerment, ESG, and value-based care are sidelined - not for lack of vision, but because they seem like luxuries amid firefighting.

The analogy is clinical: like patients who dismiss early signs of chronic illness, many MedTech firms misread weak signals - innovation fatigue, vanishing product differentiation, talent attrition - as non-urgent. Comforted by legacy KPIs and familiar processes, they miss the onset of decline. By the time symptoms worsen, remedies are limited.

This is not dramatic collapse - it is slow erosion. And it is becoming endemic. Former high-flyers now face falling valuations, stagnation, outdated leadership, and mounting regulatory pressures. Yet even as they spiral into defensive postures, they cling to the false prudence of operational modifications over strategic reinvention.

Investors are not looking for recovery - they are looking for renewal. Leaders must act now, not just to repair, but to reimagine. Because those who just fix the past will be eclipsed by those building what is next.
 
In this Commentary

This Commentary offers a counterpoint to the earlier “MedTech’s Blueprint for Failure”, which highlighted the significance of shifting the focus from short-term symptom management to long-term systemic renewal. If MedTech’s ailments are chronic, the remedy must go beyond operational repairs to address the cultural rift between legacy leadership and the demands of a digital, patient-centric era. This is not about weathering another earnings cycle - it is about acting decisively before the market forces change upon you. Even under pressure, MedTech leaders must pursue a holistic, adaptable transformation strategy - one that reclaims relevance in a sector being reshaped by innovation and evolving expectations.
 
Diagnosis Confirmed
 
Chronic Decline, not a Temporary Setback
 
What once drove MedTech’s success is now its liability. Like a patient in the early stages of chronic illness, the industry is not unaware - it is falsely reassured. The symptoms are there: stalled innovation, thinning differentiation, quiet attrition. But the absence of acute crisis masks the reality of structural decline.

This is not about incompetence - it is complacency. MedTech firms that once dominated by optimising for scale and efficiency are now applying outdated logic to a changed landscape. The metrics still look familiar, the routines still run - but the market has moved on.

Healthcare is not undergoing a sudden disruption; it is experiencing a slow, systemic shift. And like the onset of chronic disease, that change is easy to ignore - until it is too late. MedTech’s failure to confront early signals has dulled its instincts, hardened risk aversion, and widened its blind spots. The slow pace of decline makes it easy to rationalise. That is what makes it so dangerous.

This is not a slump. It is a slow bleed. Over the past decade, many MedTechs have starved their future relevance by clinging to legacy businesses. By the time the damage becomes undeniable, talent has left, capital has fled, and competitors have reinvented the rules.

This is not random deterioration - it is strategic atrophy. And like any degenerative condition, it will not respond to cosmetic adjustments. Optimising legacy systems without redefining purpose is like treating organ failure with aspirin. It may dull the pain - but the collapse will continue. Without reinvention, decline is not just possible. It is inevitable.
 
The Danger of Treating Symptoms Instead of the Disease

Legacy MedTech is stuck in a cycle of symptom management - treating surface-level issues while the underlying condition festers. Tactics like spending freezes, SKU cuts, and compliance overhauls create the illusion of control, but they rarely lead to transformation. These are not strategic shifts; they are coping mechanisms.

Yes, addressing debt, regulation, and margin pressure is necessary - but it is triage, not treatment. These moves may stabilise the patient, but they do not restore health. Worse, they offer false reassurance, allowing leadership to sidestep important questions: What is the business of our business? How do we stay relevant in a system now shaped by platforms, data, and patient autonomy?

The danger lies in defaulting to familiar playbooks. What once felt safe - efficiency, standardisation, scale - is now a liability in a world pivoting to digital, decentralised, and outcomes-driven care. Recycling old strategies for new realities deepens the strategic inertia that is eroding long-term viability.

This is not about tightening bolts on a ship already adrift. It is about redesigning the vessel - its structure, purpose, and direction - before the rising tide of healthcare transformation makes any course correction irrelevant.

End of the Pitch


The new episode of HealthPadTalks is available. Listen now!
A New Strategic Immune System
 
Five Pillars of MedTech Renewal

This is the inflection point - and for many underperforming MedTechs, it arrives amid a perfect storm: mounting debt ceilings, aging leadership teams, regulatory remediation, declining valuations, flatlining growth, and portfolios anchored in slow-growth markets. These compounding pressures make strategic pivoting feel not only daunting but, at times, impossible. And yet, standing still is not an option. Recovery from chronic decline will not come through marginal reform or operational fixes; it demands a systemic overhaul - a new strategic immune system. One not built to defend legacy structures, but to cultivate relevance, reinvention, and resilience in a healthcare ecosystem evolving faster than most executives have prepared for. Navigating this transition requires pragmatism, but also urgency - a readiness to tackle immediate constraints while laying the groundwork for long-term renewal.

What follows is a blueprint for regeneration. A transformation rooted in five shifts, each essential for restoring adaptive strength and ensuring long-term viability.

1. Relevance-First Leadership
The future will not be shaped by leaders who cling to control, but by those who embrace curiosity, adaptability, and - crucially - humility. In a rapidly evolving healthcare landscape, humility is not weakness; it is a strategic strength. It allows leaders to acknowledge what they do not know, create space for new voices, and adapt in the face of complexity. Legacy experience must converge with emerging insight. This requires building leadership teams that integrate institutional knowledge with the perspectives of digital natives, global innovators, patient advocates, and platform strategists. Boards and C-suites can no longer mirror only the industry’s past - they must be designed to anticipate and shape its future.

2. A Digital and Data-Driven Core
While physical devices remain foundational, the value in MedTech will increasingly come from data - how it is captured, connected, and converted into insight. Building a digital and data-driven core means embedding AI, machine learning, and predictive analytics into every layer of the business - from R&D and clinical development to commercial strategy and post-market engagement. The shift is from managing products to unlocking intelligence. MedTech leaders must evolve their operating models to reflect this new reality: treating software not as an add-on, but as a central engine of growth. This requires three moves: (i) constructing a modern tech stack (across engagement, intelligence, and infrastructure), (ii) adopting agile development practices within a regulated environment, and (iii) securing the right mix of digital talent and IP.

3. Platform and Ecosystem Thinking
The traditional MedTech sales model - built on hardware-first, product-centric strategies and long, transactional sales cycles - is no longer fit for purpose. It is dying. As the healthcare landscape evolves, monolithic business models are giving way to modular, connected ecosystems that prioritise flexibility, speed, and outcomes over proprietary control.

Yet, many MedTech organisations remain slow to adapt, weighed down not only by traditional systems but by legacy mindsets. A large share of industry leadership consists of digital immigrants - executives whose formative years predate the platform economy. As a result, strategic transformation is often constrained by outdated assumptions and a reluctance to embrace the principles of interoperability, data liquidity, and open collaboration.

The future will belong to leaders who do not try to own the stack but rather enable it. This means designing for interoperability from the ground up, treating open APIs as foundational infrastructure, and cultivating partnerships across software, services, and adjacent sectors. Siloed value chains must be dismantled in favour of dynamic, cross-functional networks that accelerate innovation and scale seamlessly across care pathways. The winners will think in platforms, build for ecosystems, and act with the urgency that today’s healthcare demands.

4. Rethinking Global Growth
The 85% of the world’s population living outside North America and Europe - contributing ~40% of global GDP - can no longer be treated as a strategic afterthought. Africa, India, the Middle East, and Latin America are not “too complex” to engage; they are too consequential to overlook.

Future growth in MedTech will not be driven by retrofitting Western models for emerging markets. It will come from reimagining value creation through digital-first delivery, radical affordability, and contextual innovation. These regions demand solutions designed for their realities - not watered-down versions of legacy products, but purpose-built offerings that address structural gaps with creativity and scalability.

Success will hinge on shifting decision-making closer to the ground. Empowered, locally rooted teams - not distant headquarters - must lead the charge, combining cultural fluency with entrepreneurial agility. What was once seen as peripheral or optional must now be reframed as central to any strategy.

In a world where innovation is increasingly decentralised and demand is global, ignoring emerging markets is no longer just shortsighted - it is strategically negligent.

5. Patient Agency and Health Equity by Design
The era of the passive patient is over. Today’s healthcare consumer is a data steward, informed decision-maker, and empowered participant in a dynamic marketplace. Transparency, interoperability, and collaborative innovation are no longer aspirational ideals - they are essential pillars of modern healthcare. Health equity is not a charitable endeavour; it is a strategic imperative. Meaningful inclusion must be embedded into the fabric of clinical trials, go-to-market strategies, and product development from the outset - not as an afterthought, but as a competitive advantage.

This is not a matter of modernising the margins - it is about reprogramming the organisational DNA. These five pillars lay the foundation for a strategic reset that positions MedTech companies not only to weather the next wave of disruption, but to actively shape it. In this context, boards - especially of underperforming firms - must recognise that strategy is their remit. The responsibility to provide clear, forward-looking leadership is not optional; it is imperative. Now more than ever, they are expected to not only answer critical questions, but to define the path ahead.
HealthPadTalks is a podcast exploring the trends redefining healthcare’s future. Building on HealthPad’s Commentaries, we don’t just deliver answers — we question them. Through bold ideas, diverse voices, and meaningful debate, we aim to improve outcomes, cut costs, and expand access for all. Make sure to follow us! 
Culture Reset
 
From Quarterly Thinking to Decade-Building
 
If legacy MedTech is serious about renewal, the transformation must begin not with tech or devices - but with mindset. The core barrier is not capital, capability, or intent. It is cultural inertia. Years of debt-fuelled M&A have hardwired a belief that scale equals strength. But in chasing size, agility has been sacrificed.

This is an industry built for quarterly wins, not long-term breakthroughs. It struggles to balance innovation with operational demands, future-building with present pressures. As long as that remains true, transformation will stay stuck in PowerPoint.

Under stress, leaders tend to default to familiar moves: cut costs, chase efficiency, avoid risk. Rational, maybe - but it is a slow bleed. The fixation on short-term certainty starves long-term relevance. Breaking the cycle requires a cultural reset. Governance, incentives, and investor narratives must shift to reward boldness, not just margin defence. Cost control is discipline - not direction.

Enduring relevance demands experimentation, resilience, and the courage to embrace uncertainty. The future of healthcare will not unfold predictably - and strategy must be just as nonlinear. Scenario thinking and foresight must move from the occasional offsite to everyday practice. Cultures built for control will not survive a system defined by speed and flux. The winners will not be the biggest. They will be the most adaptive. The era of maintenance is over. This is the era of builders.
 
Navigating the Transformation
 
 From Theory to Execution in a Constrained Reality
 
Transformation, when spoken of in White Papers and keynote speeches, can feel abstract - aspirational but detached. For many legacy MedTech executives, the reality is less forgiving. High debt loads, remediation demands from FDA warning letters, tariff volatility, and investor scrutiny do not create fertile ground for reinvention. But this is why transformation must be pragmatic, not theoretical. It must be built into the constraints - not postponed because of them.

Legacy MedTech needs a roadmap - focused, executable, and achievable within 12–36-months. This horizon will not solve everything, but it can move a company from reactive to revitalised.

Phase 1   Audit the Blind Spots
Begin with transparency - transformation is impossible without a clear view of reality. This is more than performance dashboards and metrics reviews; it means surfacing the inconvenient truths the organisation would rather ignore. Strategic blind spots - whether digital inertia, talent erosion, or cultural rigidity - must be connected to operational symptoms: compliance exposure, stagnant innovation, declining revenues, and loss of market relevance.

The critical questions are simple but uncomfortable: where are we falling behind? And more provocatively, who on the leadership team is equipped to close those gaps?

Too often, leadership structures are relics of past successes or the byproduct of internal politics, not instruments of forward strategy. Updating the playbook is hard enough, replacing the players can feel institutionally threatening. In a resource-constrained environment, such recalibration is not just difficult; it can seem impossible. But avoiding it guarantees strategic drift.

Consider Philips in the early 2010s - a company that confronted similar institutional inertia. By recalibrating its leadership and shedding legacy assets, it made space for renewal. The lesson: pruning is not failure. It is a precondition for reinvention. Clinging to outdated leadership logic may feel safe, but it is often the most expensive risk of all.

Phase 2   Build the Digital Spine - Without Breaking the Bank
Relevance in today’s healthcare landscape does not demand overnight reinvention - but it does necessitate a shift. The move from product-centric models to data-driven infrastructure is not a cosmetic change; it is a structural one. And it will not come easily. Many company executives, and board directors, shaped by the conventions of a prior industry era, are unprepared to navigate this transformation. Their frameworks for success were forged in a context that is rapidly dissolving under the weight of digital acceleration and new market expectations.

Still, even amid fiscal constraints, organisations can make meaningful progress. Targeted investments in interoperable systems, AI-readiness, and API-friendly platforms can unlock new revenue streams, enhance responsiveness to regulatory demands, and enable smarter scaling. Consider GE Healthcare’s collaboration with Lunit, a South Korean medical AI start-up. This was not an expensive moonshot - it was a deliberate, strategic bolt-on. And yet, it yielded an outsized impact: democratising access to AI-driven diagnostics, easing clinician burden, and transforming data from a passive byproduct into an active engine of value creation and improved patient outcomes.

Phase 3  Pilot the Future Under Pressure
Transformation does not need to start at scale - it needs to start with evidence. While impact is often equated with size, the catalyst for meaningful change is proof, not breadth. Decades of debt-fuelled expansion have conditioned many executive mindsets to pursue scale as a default strategy. But in today’s MedTech landscape, progress requires a shift: rather than relying on traditional commercial playbooks, leaders must learn to spot edge opportunities - underpenetrated specialties, digitally neglected workflows, or adjacent markets - where focused, agile pilots can generate rapid, high-signal validation. Scale should follow insight, not precede it.

A case in point: Medtronic’s GI Genius. Rather than pursuing a traditional go-to-market strategy, the company partnered leanly with Cosmo Pharmaceuticals to launch internationally. The result? A low-risk initiative that offered high learning value and future-facing positioning. Especially in capital-constrained environments, such pilots play a dual role: they reduce exposure while broadcasting a message of strategic direction.

For those unfamiliar with this playbook, the goal is not to "prove" transformation in theory, but to earn credibility through compact, collaborative experimentation.
Lead the Shift or Be Left Behind

Transformation under constraint is not a contradiction - it is how reinvention starts. But for many MedTech leaders, shaped by years of easy capital and unchecked growth, this moment demands a mindset shift. The old playbook - incrementalism, deferring tough calls, avoiding trade-offs - is no longer viable.

Sustainable growth now depends on confronting inefficiencies, making hard decisions, and reallocating resources with intent. What once looked like manageable underperformance is now a strategic liability.

Those who shift from reactive management to deliberate reinvention - who sunset legacy assets, make bold hires, and place focused, future-facing bets - will not just survive, but will lead. In this new era, capital discipline, digital fluency, and courage are the currencies of leadership.
 
The Cost of Strategic Inaction
 
Acquisition, Obsolescence - or Worse
 
In today’s MedTech landscape, inaction is not neutral - it compounds decline. What may seem like prudent caution often conceals a more insidious risk: mistaking activity for strategy. This is especially true when organisations become fixated on remediation efforts - resolving FDA warning letters, mending broken processes, or addressing legacy compliance gaps. While these actions are essential, treating them as the sole focus can be fatal. Remediation alone is not a growth strategy; it is a baseline obligation. In a sector shaped by regulatory scrutiny, pricing pressures, and tighter capital, standing still may feel responsible - but the market does not reward stability without progress. It penalises hesitation with eroding relevance, diminished market share, and vulnerability to more adaptive, forward-leaning competitors.

Look no further than recent cautionary tales. Zimmer Biomet’s divestiture of its spine and dental units was framed as strategic - but it was a move to stem margin erosion and recalibrate under pressure. Olympus’ spin-off of its imaging division was not innovation - it was a retreat from a legacy asset that had lost its edge. These were not proactive plays - they were forced responses to long-ignored relevance gaps. These outcomes are not isolated missteps. They are predictable endpoints of sustained strategic inertia.

Meanwhile, capital is flowing toward businesses designed for speed, intelligence, and adaptability. Investors - whether private equity or strategic - are backing AI-native platforms, remote diagnostics, and software-centric care models. Not because of hype, but because such companies are built for scale, flexibility, and user-centric value. Consider Butterfly Network: a company that did not just reimagine ultrasound hardware - it redefined its pricing, access, and clinical utility. In doing so, it captured investor interest that legacy players could not.

In this environment, relevance is not a nice-to-have - it is a prerequisite for survival. MedTech incumbents with shrinking multiples and swelling debt burdens may be tempted to preserve what is left. But without a clear path to future fit, preservation turns into liquidation. If you do not disrupt your own model, the market will - then acquire what remains at a discount, restructure it, and extract the value you failed to unlock.

The window for incrementalism has closed. The market is not waiting for laggards to catch up. It is rewarding the bold, bypassing the static, and writing off those who stay silent too long. The only risk now is pretending there is still time.
 
Takeaways

The era of comforting narratives is over. Legacy is not a shield - it is a mirror, reflecting both past success and deferred decisions. MedTech is not on the brink of reinvention; it is at risk of fading relevance, mistaking historical resilience for future readiness.

Cost-cutting is not a growth strategy. Reorgs will not rebuild capability. And digital fluency cannot be postponed. Declining margins, stagnant pipelines, talent attrition, and waning physician mindshare are not anomalies - they are symptoms of strategic drift. This is not a call for disruption for disruption’s sake. It is a call for disciplined boldness: to rethink sacred assumptions, redefine organisational identity, and lead with clarity, not caution. The path forward is not abstract: (i) Rewire leadership incentives for long-term value, (ii) Build a digital core - not digital cosmetics, (iii) Shift from closed systems to open platforms, (iv) Treat equity and patient agency as strategy, not compliance, and (v) Invest where others overlook.

Yes, headwinds are real. But they are not reasons to stall - they are reasons to act. The future is not inevitable. But it is still available - to those who move first, think deeper, and lead with intent. MedTech must choose and shape what is next or become a footnote in someone else’s strategy.
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11 months, 3 weeks ago

MedTech Market Access for a Digital Era

HealthPad
Directory:
Medical Technology
Tags:
commentary
digital health
MedTech
predictive analytics
value-based healthcare
  • Traditional, high-touch sales approaches fail to meet the demands of today’s healthcare systems
  • Value-based care, digital health, AI and increased patient voices are reshaping purchasing priorities and market dynamics
  • Marketing success lies in outcome-based partnerships, AI-driven insights, and integrated digital solutions
  • MedTech leaders must become digitally fluent, foster innovation, and prioritise long-term value

MedTech Market Access for a Digital Era

In the late 20th century, the MedTech industry thrived, powered by a sales-driven approach that prioritised the relationship between sales representatives and healthcare providers. These strategies, built on personal trust and labour-intensive engagement, played a pivotal role in bringing transformative technologies to patients. However, the healthcare landscape of the 21st century is evolving rapidly. The traditional relationship-centric sales model, once a cornerstone of success, is now at odds with the demands of modern healthcare ecosystems.

The rise of value-based healthcare, digital health platforms, and AI-driven personalised therapies has redefined how healthcare is delivered and measured. Providers and healthcare systems are seeking solutions and services that demonstrate tangible clinical and economic value, integrate into digital workflows, and support data-driven decision-making. This shift requires MedTech companies to transcend traditional sales policies and embrace innovative, technology-enabled approaches to market access. Success in this rapidly changing era demands not just products but also partnerships, where digital tools, real-world evidence, and collaborative strategies drive sustainable outcomes. It is time to rethink how MedTech engages with the healthcare sector in a world shaped by data, efficiency, and value.
 
In this Commentary

This Commentary explores the decline of the traditional MedTech sales model, once built on personal relationships and high-touch engagement, in an era dominated by value-based care, digital health, and AI-driven healthcare solutions and services. It highlights the misalignment of traditional strategies with modern healthcare needs and suggests ideas for reimagining market access. By embracing outcome-based partnerships, leveraging AI, and embedding digital services, MedTech companies can position themselves as leaders in the evolving healthcare landscape.
 
The Rise and Resilience of the Traditional MedTech Sales Model

The traditional sales-driven model in MedTech emerged as a natural response to the needs of both the industry and the healthcare ecosystem. Sales representatives were more than transactional intermediaries; they played multifaceted roles as educators, advocates, and trusted advisors. Their expertise bridged the gap between cutting-edge medical technologies and the overburdened physicians tasked with delivering care. Often, these representatives worked directly alongside clinicians, providing support in operating rooms during surgeries, or guiding optimal device use, ensuring that complex products achieved their intended outcomes.

This model thrived during a time when clinicians held significant autonomy in selecting tools and technologies. Purchasing decisions were often personal, based on trust and familiarity, which made relationship-building important. MedTech companies responded by assembling well-trained, specialised salesforces adept at navigating these nuanced dynamics. Firms like Johnson & Johnson, Abbott, and Medtronic solidified their market dominance - the combined 3 companies account for ~16% of the global MedTech market - by cultivating deep customer loyalty through this hands-on approach, reinforcing their reputations as partners in care rather than just vendors.

Even as healthcare evolves, the resilience of this model is evident. Its foundational emphasis on trust, expertise, and collaboration remains a cornerstone, albeit one facing new challenges in an era of value-based care and centralised purchasing decisions.
 
Why Traditional MedTechs Cling to Old Ways

Despite significant changes in healthcare delivery, many MedTech companies remain tethered to this traditional sales model. There are several reasons for this inertia.

1. Cultural Legacy of Sales Dominance
Senior leadership teams in many traditional MedTech firms are frequently comprised of executives who built their careers in sales, fostering a deep-rooted belief that success is driven by high-touch, relationship-oriented selling. This perspective often aligns with the sector’s historical reliance on personal connections to drive growth. Shifting such entrenched mindsets can be a challenge, particularly in organisations with a legacy of success using these approaches. It requires not only cultural transformation but also demonstrating the value of alternative strategies.

2. Misaligned Incentives
Many MedTechs continue to incentivise their commercial teams using metrics focused on short-term sales performance, such as quarterly revenue targets or the volume of devices sold. While effective for driving immediate results, these incentives create a strong disincentive to explore alternative strategies that may better serve long-term objectives. By prioritising near-term gains, companies risk stifling innovation and missing opportunities to align more closely with evolving customer needs, ultimately limiting their potential for sustainable growth.

3. Lack of Digital Fluency at the Top
Traditional MedTech leaders frequently lack the digital fluency needed to fully understand and embrace the transformative potential of tools such as AI, predictive analytics, and digital service layers. This gap in knowhow and experience can encourage scepticism about the value and efficacy of digital-first strategies, often leading to hesitation or underinvestment in these innovations. Without a clear appreciation of how such technologies can drive competitive advantage, organisations risk falling behind in an increasingly tech-driven healthcare landscape.

4. Complexity of Healthcare Systems
Selling to healthcare providers, payers, and integrated delivery systems is more complex than engaging with individual clinicians. These broader stakeholders demand value propositions that go beyond individual product benefits, requiring an understanding of system-wide outcomes, cost-effectiveness, and interoperability. Despite this shift in the healthcare environment, many MedTech companies remain hesitant to move beyond their traditional clinician-focused sales strategies. Such reluctance stems from a preference for familiar approaches and a lack of confidence in navigating system-based selling challenges.

5. Resistance to Risk
The MedTech industry operates within a highly regulated ecosystem, where strict compliance standards and patient safety are paramount. As a result, companies tend to be inherently risk-averse, with leadership often cautious about pursuing change. This hesitation is driven by concerns that innovation or new strategies could inadvertently compromise regulatory compliance, disrupt established customer relationships, or threaten existing revenue streams. While this caution is understandable, it can sometimes hinder the agility needed to adapt to evolving market demands.
 
Why the Traditional Sales Model No Longer Works

The healthcare industry’s transition to value-based healthcare, alongside the rapid rise of digital health solutions, has rendered the traditional sales model increasingly obsolete. Here’s why:
 
1. Shift to Value-Based Care

Under value-based care, healthcare providers are incentivised to deliver superior patient outcomes while controlling costs. This shift moves away from traditional fee-for-service models, where clinicians had discretion to select high-cost devices, toward systems emphasising cost-effectiveness and real world evidence-based results. MedTech companies must adapt by demonstrating their devices provide measurable, impactful value through robust data and clinical evidence, rather than relying on persuasive sales tactics or legacy relationships to drive adoption.
 
2. Consolidation of Decision-Making
 
Purchasing decisions in healthcare have shifted from individual clinicians to procurement committees, group purchasing organisations (GPOs), and hospital executives, who now drive the process. These stakeholders prioritise data-driven evidence that demonstrates both clinical efficacy and economic value, leaving little room for decisions influenced by personal relationships. This transition emphasises the growing significance of robust metrics and compelling outcomes in shaping purchasing strategies and aligning with institutional priorities.
 
3. Digital Health and AI Disruption
 
The rapid proliferation of digital health solutions and services has heightened expectations for seamless integration, real-time data sharing, and personalised user experiences. As a result, legacy MedTech devices that lack advanced digital capabilities are increasingly perceived as outdated and less competitive. This shift is obliging companies to rethink their product strategies and marketing approaches, emphasising innovation, connectivity, and alignment with evolving healthcare ecosystems to remain relevant and meet the demands of modern stakeholders.
 
4. Rising Patient Empowerment

The healthcare landscape is undergoing a transformative shift as patients take an active, informed role in their care decisions, driven by digital tools and unprecedented access to information. As highlighted in Choice Matters by Gordon Moore et al, empowered patients influence health outcomes and reshape healthcare expectations, demanding transparency, personalisation, and value. For MedTech companies, adapting to this paradigm requires prioritising patient-centric strategies, fostering collaboration, and delivering tailored solutions to remain relevant and trusted in an era of heightened patient agency.
 
Reimagining Market Access: Ideas for the Digital-First Era

To thrive in this digital era, MedTech companies must embrace changes to how they market and distribute their products. Here are three strategies for rethinking market access:

Outcome-Based Partnerships
The traditional fee-for-product sales model in MedTech needs to evolve into outcome-based partnerships that align the incentives of MedTech companies with those of healthcare providers. Such partnerships can include innovative risk-sharing agreements where payment is directly linked to the device's performance in delivering measurable clinical outcomes.

For instance, rather than selling a surgical robot outright, a MedTech company might partner with a hospital to deploy the technology while sharing in the cost savings generated by fewer surgical complications and improved patient recovery rates. Similarly, companies specialising in wearable health devices could base their pricing on tangible metrics, such as increased patient adherence to prescribed treatment plans or significant reductions in hospital readmissions, ensuring mutual value creation.

Challenges and Solution
Challenge Establishing robust data and metrics to measure outcomes.
Solution Adapt existing products to generate data and work collaboratively with healthcare providers to define clear, evidence-based performance indicators. Leverage real-world evidence to validate outcomes over time.

Leveraging AI and Predictive Analytics
AI and predictive analytics are poised to transform how MedTech companies demonstrate value to payers and healthcare systems. By leveraging data from clinical trials, real-world usage, and digital health platforms, companies can build predictive models that quantify the long-term clinical and economic benefits of their devices.

For example, a MedTech company specialising in cardiac implants could use predictive analytics to highlight how its products reduce lifetime healthcare costs by reducing hospitalisations and improving patient outcomes. Additionally, AI-driven insights can help tailor value propositions to address the unique priorities of each healthcare provider, such as reducing readmission rates or improving operational efficiency, ultimately strengthening sales strategies, and fostering more meaningful partnerships.

Challenges and Solutions
Challenge Accessing high-quality, longitudinal data.
Solution Partner with healthcare providers, payers, and academic institutions to co-develop data-sharing agreements that ensure mutual benefit.
 
Embedding Digital Service Layers
MedTech companies must shift from a hardware-focused sales approach to delivering integrated solutions that combine devices with advanced digital service layers. These layers might include features like: (i) remote monitoring for continuous patient care, (ii) predictive maintenance alerts to optimise the uptime of surgical equipment, and (iii) AI-powered decision support tools that assist clinicians in making more accurate and timely interventions.

For instance, a company selling glucose monitors could enhance its offering by integrating them with a digital health platform that provides patients with personalised insights and actionable recommendations for managing their diabetes. These digital services not only foster long-term engagement with patients and healthcare providers but also create recurring revenue streams, reinforce brand loyalty, and position MedTech companies as indispensable partners in the care continuum.

Challenges and Solutions
Challenge Developing and maintaining high-quality software capabilities.
Solution Invest in in-house digital talent or pursue strategic acquisitions of digital health start-ups.
 
Case Study

DePuy Synthes, a Johnson & Johnson company and a global leader in orthopaedics, exemplifies how traditional corporations can transform sales strategies to thrive in the 21st century. By leveraging digital tools, data-driven insights, and personalised customer engagement, DePuy Synthes has set a new industry benchmark.

Central to this transformation is the adoption of Salesforce, a powerful customer relationship management platform. By centralising customer data and enabling real-time sales tracking, Salesforce empowers DePuy Synthes to make data-driven decisions and respond swiftly to customer needs. Complementing this, the company has incorporated Virtual Reality and Augmented Reality into its sales processes. These immersive technologies facilitate product demonstrations and surgical simulations, providing healthcare professionals with risk-free, hands-on experiences that build trust and confidence in complex orthopaedic solutions.

DePuy Synthes also employs targeted digital marketing strategies, including content marketing, social media engagement, and personalised email campaigns, to expand its reach and foster brand awareness. Through these channels, the company communicates with both healthcare professionals and patients, driving lead generation in a competitive market.

Data and predictive analytics, plays a role in refining sales strategies. DePuy Synthes leverages analytics to identify market trends, predict customer needs, and tailor offerings to specific segments. Predictive analytics further enhances inventory management and positions the company to seize emerging opportunities.

Remote collaboration tools, such as virtual meetings and webinars, enable DePuy Synthes to engage healthcare professionals globally, sharing product knowledge and maintaining client relationships without geographical constraints. This commitment to accessibility and innovation is emphasised by personalised customer experiences, where tailored recommendations and dedicated support teams foster loyalty and trust.

DePuy Synthes’ transformation underscores the need for MedTech companies to modernise their sales strategies. By embracing digital innovation, data-driven insights, and customer-centric approaches, DePuy Synthes has enhanced efficiency and secured its competitive edge, serving as a model for industry evolution.
 
Call to Action: A New Vision for MedTech Leadership

The transition to a digital-first era demands not only new strategies but also a shift in leadership mindset. MedTech executives must champion digital fluency and cultivate a culture of innovation and experimentation across their organisations. Key steps could include: (i) establishing dedicated innovation teams to pilot transformative market access and value-based care models, (ii) integrating chief digital officers into the executive leadership teams to drive digital transformation, and (iii) aligning incentive structures to prioritise long-term value creation over short-term revenue goals. By embracing these changes, MedTech companies can break free from legacy limitations.
 
Takeaways

The traditional MedTech sales model, while effective in its time, has reached its limits in today’s rapidly evolving healthcare landscape. In an era shaped by value-based care, digital health integration, and AI-driven personalisation, adhering to outdated approaches risks diminishing relevance. The future belongs to companies bold enough to reimagine how their solutions are marketed, adopted, and integrated into the broader healthcare ecosystem.

By shifting to outcome-based partnerships, MedTech firms can align their success with measurable clinical improvements and cost savings for providers. Leveraging AI and predictive analytics empowers companies to demonstrate the long-term value of their products while tailoring offerings to the specific needs of healthcare systems. Embedding digital service layers not only enhances product functionality but also fosters long-term relationships and recurring revenue streams.

This is not the end of MedTech’s growth potential but a pivotal moment to transform. By embracing these changes, companies can redefine their role as essential partners in delivering smarter, more sustainable healthcare.
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1 year ago

Ending MedTech's Debt Era: A Call for Strategic Renewal

HealthPad
Directory:
Medical Technology
Tags:
commentary
digital health
M&A
MedTech
personalised medicine
value creation
  • The MedTech industry’s debt-driven growth has succeeded but it now faces challenges like stifled innovation and inefficiency
  • Leaders must rethink M&A, prioritise deleveraging, embrace digital transformation, and foster R&D partnerships to navigate a changing landscape
  • Adapting to personalised home-based care and tailoring strategies for emerging markets are needed for future success
  • Achievement hinges on mastering digital health, sustainability, agile leadership, and global market adaptation

Ending MedTech's Debt Era: A Call for Strategic Renewal

Over the past four decades, the MedTech industry has transformed healthcare, improving, and saving billions of lives while reshaping society. Pioneering innovations have expanded access to care, empowered healthcare providers and patients, and redefined the management of diseases. During this period of change, debt financing emerged as a cornerstone of growth, enabling MedTech leaders to push boundaries and redefine markets through ambitious mergers and acquisitions (M&A). Landmark deals, such as Medtronic’s $50bn acquisition of Covidien in 2015 and Johnson & Johnson’s $16.6bn purchase of Abiomed in 2022, illustrate how access to capital has driven strategic expansion and reshaped the global MedTech landscape.

Even in times of economic upheaval, such as the 2008 financial crisis, the perceived stability of healthcare allowed MedTech companies to access debt markets with relative ease. Firms like Stryker and Zimmer Biomet leveraged this financial resilience to fuel acquisitions, enter new markets, and invest in emerging technologies. Historically low interest rates during the 2000s and 2010s further reinforced the sector’s preference for debt over equity, leading to a persistent reliance on leverage as a growth mechanism. This approach not only enabled companies to scale rapidly but also delivered consistent returns to investors while addressing critical healthcare needs.

However, the reliance on debt financing has subtly but significantly influenced the strategic orientation of MedTech companies. Decades of alignment with banks and financial institutions have tended to elevate the significance of finance within corporate decision-making. Yet, while partnerships with the financial sector have flourished, collaboration with other equally critical stakeholders - such as research institutions, tech giants, start-ups, and centres of excellence in areas like AI, machine learning, genomics, blockchain, and IoT - has often been neglected. This gap has constrained many companies’ ability to harness the full potential of rapidly evolving technologies and their promise to disrupt and redefine healthcare.

Today, the MedTech industry stands at a crossroads. For many traditional firms, stagnant valuations, slowing growth trajectories, and shifting healthcare priorities signal that the debt-driven strategies of the past may no longer suffice. Market consolidation, while enabling economies of scale, has had unintentional consequences that have stifled competition, diverted resources from transformative R&D, and entrenched an incremental approach to innovation. As healthcare systems worldwide confront aging populations, increasing demands for equitable access, and the integration of advanced technologies, the urgency for change has never been greater.

The path forward requires rethinking MedTech’s growth model - one that moves beyond the short-term gains of financial engineering toward long-term value creation. This entails renewed investments in transformative innovation, sustainability, and equitable healthcare delivery. It also calls for cultivating broader and more impactful collaborations with the world’s most dynamic ecosystems of innovation, from academic research hubs to disruptive start-ups and technology leaders. Only by embracing this shift can MedTech companies remain relevant, resilient, and capable of addressing the complex healthcare challenges of the 21st century.

Reducing the dominance of MedTech’s debt era is not merely an economic transition; it is an opportunity to reimagine the industry’s role in shaping the future of health.
 
In this Commentary

This Commentary explores the transformative journey of the MedTech industry as it transitions from a debt-driven growth model to a future focused on strategic evolution. It examines the consequences of debt dependency, such as stifled innovation and operational inefficiencies, and outlines a roadmap for success in an era shaped by digital transformation, patient-centric care, and global market adaptation. With insights on M&A strategies, deleveraging, R&D, and leadership, it offers a vision for the industry’s next chapter.
 
A Perfect Storm of Industry Transformation

Healthcare delivery is on the brink of change, driven by converging forces reshaping the industry. In developed markets, aging populations are driving demand for more efficient, accessible care models. Meanwhile, middle- and lower-income nations, including economic powerhouses like China, India, and Brazil, are rapidly expanding their healthcare R&D capabilities, challenging the traditional dominance of Western MedTech firms. To stay competitive, industry giants like Johnson & Johnson (J&J), Abbott, and Medtronic have strategically established manufacturing and R&D hubs in these emerging markets, where growth rates outpace developed countries.

Simultaneously, care delivery is shifting from hospitals to homes and community settings, enabled by digital health innovations and patient-centric models. Since 1980, advancements in medical technologies have driven a 38% reduction in the number of patient-days spent in hospitals, reflecting a broader trend toward decentralised care.

At the same time, advances in biomedical science and technology - ranging from personalised medicine to artificial intelligence (AI) - are transforming how diseases are diagnosed, treated, and managed. Such breakthroughs coincide with an era of geopolitical volatility, characterised by increased regulatory scrutiny, evolving trade dynamics, and intensifying competitive pressures.
In this rapidly evolving environment, the traditional playbook of leveraging debt to achieve scale is no longer sufficient. Instead, MedTech companies must navigate these complexities with agility, investing in innovation, operational efficiency, and strategic partnerships to stay ahead in a redefined global healthcare landscape.
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Revitalising MedTech Innovation: Strategies for Growth
The Consequences of Debt Dependency: Adapting to a Multipolar World

Historically, debt-financed growth has been a cornerstone of success for many MedTech companies, enabling rapid expansion and strategic acquisitions. This approach has allowed firms to scale quickly, consolidate market share, and deliver stable returns to investors. However, reliance on debt-driven strategies has also created challenges, particularly in today’s rapidly evolving landscape.

High leverage often constrains MedTech companies’ ability to allocate resources toward transformative R&D or respond nimbly to market disruptions. Overemphasis on M&A activity has frequently resulted in poorly integrated businesses, operational inefficiencies, and, in some cases, regulatory scrutiny - including FDA warnings and product recalls. This focus on financial engineering has, at times, come at the expense of building critical capabilities in digital transformation, innovation, and adapting to increasingly globalised and diverse markets.

Debt-fuelled consolidation has shaped an industry structure dominated by a handful of key players such as Medtronic, Johnson & Johnson, Abbott, and GE Healthcare, which consistently secure dominant positions in core segments like cardiovascular devices, imaging, and diagnostics. For instance, Medtronic alone holds >30% of the global pacemaker market, and the top 10 MedTech firms collectively account for ~50% of global market revenue. These industry giants leverage extensive distribution networks and economies of scale, creating substantial barriers to entry for smaller competitors and enabling tight control over pricing and market access.

While this concentration has historically provided stability and predictability, it has also stifled competitive pressures. Incrementalism in innovation - where advancements are evolutionary rather than disruptive - has become a hallmark of the sector. Additionally, pricing strategies driven by dominant players often place financial strain on global healthcare systems, compounding affordability challenges.

The industry’s legacy focus on US-centric markets and financial paradigms has delivered substantial success. However, this approach risks becoming a liability in a multipolar world where healthcare delivery is being reshaped by rapidly evolving technologies, diverse patient voices, and regionally distinct regulatory environments. To remain competitive, MedTech companies must adapt to these shifts by embracing long-term investments in innovation, fostering regional responsiveness, and adopting sustainable growth practices that align with the needs of a dynamic and interconnected global market.

Strategically, the path forward requires a recalibration from short-term financial gains to a forward-looking approach - one that not only anticipates technological disruptions but also integrates the evolving expectations of patients and healthcare providers. In this era of transformation, agility, inclusivity, and sustained innovation will define success.
 
Preparing for the Future: A Strategic Reorientation
 
The MedTech industry is pivoting toward a technology-driven, patient-centric, value-based, care model, fuelled by AI, cloud computing, extended reality, and 5G connectivity. Achieving success in this evolving landscape will require seamless data sharing, integration of virtual care, and robust cross-sector collaboration. As debt-fuelled growth gives way to a focus on resilience and adaptability, MedTech firms must align with emerging healthcare paradigms to stay competitive and ensure long-term success. This means embracing innovation, operational excellence, and digital transformation while rethinking traditional growth models to meet the dynamic needs of patients, providers, and regulators. The six strategies outlined below provide a roadmap to navigate this transformation effectively.

1. Rethinking M&A with a Strategic Lens
MedTech companies must transition from broad, growth-focused acquisitions to a more deliberate and strategic approach to M&A aimed at fostering sustainable, long-term value. This means focusing on deals that enhance core capabilities, such as digital health, advanced data analytics, robotics, or access to high-growth emerging markets. Acquisitions should align with the company’s vision for future healthcare trends, including precision medicine, minimally invasive procedures, and patient-centric, value-based care. Medtronic’s acquisition of Mazor Robotics illustrates this approach, enabling integration of robotics and AI into surgical platforms. Such targeted investments, which will be the subject of a future Commentary, ensure companies are positioned to lead in innovation and address evolving needs, rather than expanding scale.

2. Deleveraging to Unlock Flexibility
Reducing debt levels is an important step in freeing up capital for innovation and enhancing operational resilience. Companies such as Boston Scientific have exemplified this approach by strategically lowering their leverage in recent years. This financial discipline has enabled them to invest in high-growth areas like electrophysiology and structural heart therapies. Moreover, deleveraging fortifies businesses against economic and geopolitical shocks, laying a foundation for growth and long-term strategic flexibility.

3. Investing in Novel R&D and Partnerships
The future calls for a heightened commitment to transformative R&D, prioritising collaboration, and adaptability. Embracing open innovation models - through partnerships with start-ups, academic institutions, and technology leaders - has become essential. Johnson & Johnson’s JLABS initiative exemplifies this approach by offering critical resources and mentorship to early-stage innovators. These partnerships not only accelerate the development of ground-breaking solutions and services but also cultivate a dynamic ecosystem where ideas flourish, reinforcing a culture of innovation that drives sustainable progress.

4. Digitisation and Operational Excellence
Digital transformation has become an imperative rather than an option in today’s competitive landscape. Organisations must digitise their operations, products, and services to drive efficiency, improve patient outcomes, and maintain market relevance. Siemens Healthineers’ syngo Virtual Cockpit exemplifies the power of digital innovation, enabling remote operation of imaging systems to tackle real-world healthcare delivery challenges. By integrating advanced technologies, companies can address critical needs and unlock new avenues for value creation and growth.

5. Expanding into New Markets
Emerging markets offer growth potential, but capturing this opportunity requires more than exporting existing products. Success hinges on tailoring solutions to meet local needs, fostering partnerships, and understanding the challenges of these regions. Abbott’s strategy exemplifies this approach through its development of affordable diagnostic tools designed for low-resource settings. This focus has bolstered its presence in rapidly expanding markets like India and Africa, where rising healthcare demand aligns with innovative, cost-effective solutions.

6. Enhancing Patient-Centric Solutions
As healthcare increasingly shifts to homes and communities, companies must innovate solutions and services that empower both patients and caregivers. Wearable devices, telehealth platforms, and remote monitoring tools are no longer optional but essential for modern care delivery. Philip’s strategic transformation into a health technology leader emphasises this trend, with a focus on connected care and informatics. By aligning with patient-centric models, such innovations improve access, enhance patient outcomes, and address the growing demand for personalised, decentralised care solutions.
 
Beyond Financial Acumen: The Capabilities of the Future

The capabilities essential for future success in the MedTech industry extend beyond traditional financial engineering and banking relationships. To remain competitive and drive innovation, companies must develop and prioritise expertise in critical areas such as:
  • Digital Health and Data Science Harnessing the power of AI, machine learning, and data to drive innovation and improve decision-making.
  • Global Market Adaptation Navigating diverse regulatory environments, cultural contexts, and economic conditions to expand access and market share.
  • Collaborative Innovation Building ecosystems of partners, from start-ups to tech giants, to accelerate the development and deployment of new solutions and services.
  • Agile Leadership Embracing adaptive, forward-thinking leadership that prioritises resilience, ethical decision-making, and a long-term vision.
  • Sustainability and Equity Addressing the growing demand for sustainable practices and equitable access to healthcare, particularly in underserved markets.
Takeaways

The MedTech industry has achieved significant milestones over the past 40 years, largely driven by an American worldview and a debt-fuelled growth model. This era has brought life-saving technologies to billions, established globally recognised brands, and delivered substantial returns to stakeholders. These accomplishments deserve recognition. However, the landscape is changing, and the industry now faces a pivotal moment. The future promises to be different, shaped by transformative technologies, shifting care paradigms, and an increasingly multipolar world.

Forward-thinking leaders understand that the strategies of the past are no longer sufficient. They are embracing change by reducing reliance on debt, adopting disciplined and strategic M&A approaches, accelerating digitisation, investing in transformative R&D, and fostering collaboration across ecosystems. These actions not only prepare companies to navigate an evolving market but also position them to lead an era of innovation.

The next chapter for MedTech will be defined by those willing to adapt and anticipate the needs of a rapidly changing world. By building capabilities that align with the evolving expectations of patients, providers, and societies, these leaders will chart a path toward sustainable growth, technological advancement, and a more equitable and patient-focused global healthcare system.
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10 years, 5 months ago

Online video education can reduce the burden of diabetes

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Diabetes
Tags:
commentary
Diabetes
diabetes care
diabetes education
diabetes prevention
digital health
healthcare costs
 
 

Online video education can reduce the burden of diabetes

  • UK treatment costs for diabetes are £10bn per year and rising fast
  • London CCG adopts video education to reduce the burden of diabetes
  • Diabetes educational videos delivered directly to patients’ mobiles
  • Enhances patient satisfaction yet reduces face-time with doctors
  • Videos are peoples’ preferred way to receive healthcare information
  • Videos increase knowledge and self-management, and slows complications
  • Videos deliver 10 times the response rate of text and graphics

      


Managing My Diabetes is a new, evidence-based service, which offers a smarter and better way to engage and educate people with type-2 diabetes. It’s delivered by video directly to patients’ mobiles, and aims to significantly dent the eye watering, and rapidly escalating personal, financial and societal costs of this preventable condition. A London CCG is an early adopter. 

Dr Seth Rankin, co-chair of Wandsworth CCG’s Diabetes Group, Managing Partner of Wandsworth Medical Centre, and a long time advocate of the use of video in diabetes education, says, “In traditional doctor-patient consultations, patients often don’t absorb important information, and videos help to redress this. Managing My Diabetes engages patients, and provides them with trusted and convenient video information about their condition, which is a necessary prerequisite for any behavioural change”.

In addition to being the preferred format for patients to receive healthcare information, videos generate responses that are 10-times greater than that generated by text and graphics. Further, unlike health professionals, videos never wear out, they can be dubbed in any language, they’re easily and cheaply updated.
 

Importance of a patient user-base

Once people with diabetes are familiar with the initial Managing My Diabetes service, health providers can easily bolt on additional services to help people further manage their diabetes. This follows the model of digital champions such as Google and Facebook, which succeeded by using a simple core service, which successfully built a user base, and then, and only then, offered more services, thus continuously increasing the familiarity of their users with their services; and in turn the intensity with which they use them. Recently, the Department of Health failed to establish an online doctor-patient user-base for a £31m telehealth project, and it failed, see, Lessons from an axed telehealth project. 

Rankin describes the genesis and benefits of Managing My Diabetes:

      

        (click on the image to play the video) 


Video content library

Currently, there is no easy way for people with diabetes to quickly and easily obtain reliable online answers to their FAQs in video formats that they prefer, and there is no easy method for health professionals to post answers to patients’ questions about diabetes in a convenient online video format. 

At the heart of Managing My Diabetes is a content library of some 250 videos contributed by local health professionals, which address patients’ FAQs about managing their diabetes. Each video is between 60 and 80 seconds in duration, which is the average attention span of people seeking online video healthcare information. All videos are linked to bios of the contributors, which help patients judge the validity of the videos. 

Health professionals can cluster and send videos directly to patients’ mobiles to quickly and efficiently address their questions. Also, patients can rapidly access the entire diabetes video content library at any time, from anywhere on any devise. 

Managing My Diabetes is designed to: (i) enhance the connectivity between local health professionals and patients, (ii) increase the knowledge of diabetes among people with the condition, (iii) encourage self-management, (iv) slow the onset of complications, and (v) reduce face-time with doctors. 

Roni Saha, a consultant in acute medicine, diabetes and endocrinology at St George’s University Hospital, London, who contributed a portfolio of educational videos to Managing My Diabetes, describes risks for pregnant women with diabetes: 

       

     (click on the image to play the video) 
 

Traditional diabetes education has failed 

No one knows the true costs of type-2 diabetes, but its treatment costs alone are estimated to be some £10bn per year, and, in 20 years, expected to increase to £17bn; with diabetes complications costing a further £12bn per year. This highlights the pressing need to reduce the burden of the condition, which can be achieved by effective education. 

Traditional diabetes education that cost millions has failed to reduce the burden of diabetes. According to the National Diabetes Audit, less that 2% of people with diabetes attend any form of structured education. Instead, they regularly search the Internet for healthcare information, and use social media to share information they find. This is carried out at lightning speed, 24-7, 365 days a year. 

Health providers must come to terms with the fact that the balance of power has shifted from traditional providers of diabetes education to people living with the condition who are primarily interested in how education affects their outcomes. Failure to provide this link, leads to people disengaging and losing interest. 
 

What do people with diabetes want? 

Understanding the myths and realities about what patients really want from diabetes education is vital to capturing its value. A 2014 study by HealthPad into the efficacy of using videos in diabetes education concluded that there is a significant unmet need for trusted and convenient video educational material to help people manage their diabetes remotely: see: How GPs can improve diabetes outcomes and reduce costs. 
 

Age factor 

Because 63% of people with type-2 diabetes in England are over 60, a question that must be asked is whether delivering educational videos directly to their mobiles is really appropriate. The HealthPad study suggests that it is, and a 2014 McKinsey & Co survey on patients’ opinions of digital healthcare services agrees. Patients over 50 want digital healthcare services as much as younger counterparts. By 2018 smartphone penetration in the UK is expected to be almost 100%. The over 55s are experiencing the fastest year-on-year smartphone penetration, and the difference in smartphone penetration by age is expected to disappear by 2020, and Internet use has shifted from being exceptional to being commonplace.

Mobile devices are ubiquitous and personal, and competition will continue to drive lower pricing and increase functionality. Managing My Diabetes ensures that people living with diabetes will always be part of the doctor-patient network, which increases the variety; velocity, volume and value of educational information patients can receive.
 

Takeaways

Managing My Diabetes has been developed, tested and adopted by a London CCG. It has also a number of clinical champions. The service is designed to be easily and cost effectively embedded in primary care practices, and can be delivered in any language. 

If Managing My Diabetes is to dent the devastating burden of type-2 diabetes it will require national leadership to encourage CCG’s to adopt it, and health professionals to embrace it. Will NHS England and Diabetes UK play this much needed leadership role? If, in five years time, the burden of type-2 diabetes in England has not been significantly reduced, who will be accountable?
 
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