Guy Lebeau is the chairman of the European medical technology industry association ( Eucomed ) and the chairman of the Johnson&Johnson group of companies.
What does eHealth represent to medical device industry?
Our industry needs to be proactive on what is going to happen in the health care system and what is going to happen in two to three years, and even 20 years' time. Eucomed believes eHealth is one of the ways to help medical devices to become known and technology to be understood.
Innovation in our industry is big and can be bigger. Everything we do needs to be done with a view to helping reduce hospitalisation, recovery time and other aspects that have economic influence. Reducing hospitalisation and patient recovery time by half, for example, has a huge economic impact and reducing surgery time diminishes the risks of surgery.
This is why the medical device industry needs to be more involved in the creation of health care systems that allow innovation by supporting the industry and that can bring solutions faster than the pharmaceutical industry. The medical device industry needs 18 months to bring a product onto the market, whereas the pharma industry cycle is totally different, some 10 years. Companies need to understand that we are a main partner of health care and we need to work with policymakers to create the products and devices that answer the needs of patients in the next 20 years. For example, a prothesis will allow people to do their favourite sport much longer throughout their lives and that will have a real impact on their lives.
For our industry, you have the actual use and the long-term use. Today, eHealth for our industry is communication and information about a product. It is about what a product can do to help patients and give them the information to decide and understand the different therapy alternatives. For example, either taking drugs for 20 years because you have hip pain or going to a surgery to have a hip prothesis. This is the situation today.
If we go further, you can imagine all the devices you can put inside or outside the body can be connected through the internet – such as checking via internet at home whether your pacemaker is working well. And at this point you start to save a lot of the infrastructure that we used to use. More and more macro-electronics is used in medicine and prothesis. For example, a device put in a patient can, in an integrated system, record the heart rhythm, detect if something is wrong and act accordingly.
The device will be used in eHealth, it is so obvious in terms of technology we use. eHealth for us is an issue of investment and innovation and one of the main goals of Eucomed is to convince our partners and health care stakeholders of how supporting innovation in medical device technology is going to help eHealth. This is because we need to invest a lot to connect our different devices through the Net.
Why do you need to convince the stakeholders? If they thought it was so useful, they wouldn't need to be convinced.
This is a historic issue linked to the reimbursement of products. When you have a product on the market, a government's decision to reimburse the product will be key to the development of that technology.
In the world of devices, we need to anticipate the way we are going to train people to use the product. For a drug, it is necessary to read the instructions, but for a medical device you need to be trained to use it. Training is a key activity of the medical device industry, because the use of the device will affect the outcomes of the therapy.
Compared to the pharmaceutical industry, the medical device industry is very heterogenic in its products and technologies which range from needles to very sophisticated products. We need to help people understand what medical devices can bring. A medical device solves a problem once you put it in, real-time. These real-time results help patients fast. We use eHealth today to make people aware of what medical devices can bring.
What are the main challenges facing the medical device industry today?
Because the industry is not yet well known, there is not enough data on financing of medical devices nor proof of how medical devices improve worker productivity and economic outcomes for Europe. Therefore we have created an independent research institute (see EurActiv 05/10/07) to study these two issues across Europe to come up with recommendations on financing and proof that our products are bringing wealth – the famous 'health equals wealth'.
Our industry represents €63 billion and nobody knows us or what we are doing. The economic impact of what we propose and the innovation of our products are something we need to make stakeholders aware of. And this is the main role of Eucomed, which exists to give access to devices to more people.
Currently Europe spends only 6% of its total health care expenditure on medical devices, whereas when you talk about any type of hospital activity, you have such devices.
But aren't you doing things the wrong way around – you first produce the technology and devices and then establish a research institute to find out the benefits?
This is because of the historic mosaic of companies. There are so many companies and nobody ever stood up saying "Hey guys, we need to give information,' because each company is like a drug – you need to explain technically what your product is going to bring in terms of both health and economic outcomes.
As an industry we need to anticipate and by doing that we realise that the economic benefit of medical devices is huge.
But what proof do you have so far, of clinical outcomes for example?
In surgery, for example, by decreasing recovery time, pain and putting people back in their jobs earlier has a direct economic impact and we have studies showing that. Eucomed is trying to help the industry to anticipate so that when we talk to a government body or regulator we have a solution and can ask for reimbursement. If we don't understand that we are part of the solution we are not going to do our job. Our wish, as Eucomed, is to be viewed as people who come with solutions and not just people who are going to try to support their industry. This is why we took the risk to create the independent research institute. We believe that the results will be obvious – that's why we took this risk.
You said your industry needs to work together with the governments to deliver better health care, but how about collaborating with doctors, who are not so sure about its benefits and feel that technology is imposed to them? How do you involve doctors in the development process of medical devices?
A study showed that 82-85% of the innovation in the medical device industry comes from partnership between engineers and doctors. We are so close to what doctors are doing that our innovation is with them. That is why the innovation cycle is so short.
When we work on the information on the devices, we work through doctor input, because they are the users, and we want them to answer the needs of their patients. Our industry has a sense of urgency, because once we have created a device, it will help the patient immediately. eHealth is for us the best way to make the people aware of the different solutions.
eHealth is sharing information real time with a doctor and I think that the doctors are motivated. They need to drive development.
What are the growth prospects of your industry?
The total industry is currently worth €64 billion and the yearly growth is around 5-6%. Yearly research investment is €4 billion, which represents 5-6%. In Europe, we have the critical mass of engineers in medical devices to help develop the products of tomorrow.