Thomas Prescott: Marketing Medical Technologies

I'm going to try very hard to play back the question and if I don't get it right, you're going to help me. I think there was a three part here. The first is interested in market penetration. How hard was it to get doctors to believe in and start to adopt? And then three, what kind of resources went into that? Was that pretty close? All right. It's hard. If the medical device industry, whether it's a dentist or a doctor in a specialty, they. They're looking for proof, clinical evidence, white papers, clinical studies in some cases, and in the early days, Align didn't have that. One of the reasons they went out quickly to consumers was to say, boy, who would really want braces? And they had a great value proposition. But the problem was, especially orthodontists, it was almost dogmatic. Everything they did was brackets and wires. So the job they had to do was explain them, give them the clinical reasons, the economic reasons and all the other reasons why they would say, you should trust us with part of your practice to at least start trying this. And the company wasn't really set up to do that. They didn't have a lot of people in the early days that understood clinical development and innovation inside medtech and why doctors make choices. So they went to the consumer. And it was exciting for a young private company to run a $30 million ad campaign. There was a lot of buzz, but very little of that translated into case starts for a line. It turned into a lot of case starts for the brackets. Manufacturers, they should have at least sent us Christmas cards. So the company, basically we had to retrench a bit, provide the reasons to believe clinical evidence and a lot of science, and we're still doing that. The consumer has far greater demand for this product than the channel. Our gp dentists and orthodontists who would still probably rather default with a little bit of. There's a group of committed champions here, maybe a third of the orthodontists out there, but many of them are more comfortable using traditional approaches. So you got to invest in clinical studies, trade shows, a lot of clinical education. We have an award winning website where we have a lot of CE content and bring them along, give them a reason to change. The other thing that happens in dentistry is how many of you are in biomedical or med tech or other areas in engineering. What's one thing, say cardiac surgery or interventional cardiology versus dentistry. What would be one big difference? Payer. The payer. The payer, yes. Private payer. That's a big difference. How about morbidity mortality? Anybody hear of somebody dying from a dental procedure? If it happens, you probably got very bad care. But the very low morbidity mortality in dentistry and orthodontic specialty and the very fragmented nature and private pay means they're slower to change. If a big change occurs in interventional cardiology, let's use stents changes within a quarter or two, you would see most people using what's now considered standard of care based on very clear clinical evidence. It would almost be irresponsible to stay with old technology if it was proven that there's greater morbidity and mortality. Now we'll test that when the government's the payer and say we don't care so much about that. But. And so back to your original reason. This is why it's taken a longer time. We're still working on it. The company spends a lot of money on clinical research, on sales and marketing and all those things. And I'd say we're still in the first or second inning of that adoption, and market share is still very small.