The Designers

The Designers must satisfy the expectations of numerous stakeholders. The “value proposition” of the technology must include elements that increase its value for users and potential buyers (the market), while respecting medical technology regulatory requirements and, for investors to obtain returns on their investment, being as profitable as possible as quickly as possible.

“The idea was to create a system that was intelligent, which knew what the job of this person was, what he had to do, and which helped him do it.” (A designer-entrepreneur)

“the overriding principle is what’s best for the patient, because if it’s not best for the patient, we’re not interested in doing it.” (A designer-entrepreneur)

“we’ve made compromises… We knew that from a scientific standpoint we could obtain better results by doing things differently. But (the investors) told us to stay on the same track because they needed to see sales coming, so they could start to get money back.” (A designer-entrepreneur)

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The Investors

Investors pursue a specific goal: to obtain optimal return on investment. It is with this goal in mind that they choose the projects that will receive financing and influence the development of the technologies and companies.

The challenges faced by healthcare systems, such as population ageing, may represent “superb opportunities for investment”, as one investor puts it, provided that they translate into significant potential markets for the proposed technologies.

“I’m not paid to invest. I get paid to generate a return. So it’s not the $ 1 that I put, but the $ 10 I’ll be able to get in a few years from now.” (An investor)

“As an investor with deep pockets, I should be able to provide access to resources. I call this macro management; providing resources, providing help, opening doors.” (An investor)

“the best technology in the world, if it does not interest a potential client, is worthless. That’s why we will (…) spend more time on marketing aspects than on the technology.” (An investor)

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The Regulators

From the regulators’ perspective, the value of a technology is based on its conformity to quality, safety and efficacy standards.

Thus, regulators play a double role:

• a concrete role that affects the development of a new health technology as well as that of the firm bringing it to market;
• a symbolic role since regulatory approval increases the confidence of potential users and investors.

Approval by a regulatory agency automatically increases the value of a firm’s stock options.

“Manufacturers are in general addressing the new demands much more competently than they did before.” (A regulator)

“We sometimes see applications which we call ‘me too’ applications. It’s no different from twenty other ones out there (…). You know the world doesn’t need yet another of these things, but fine if you want to sell one, you get one. So we don’t judge whether this is really beneficial or new.” (A regulator)

“like the cost benefits, we don’t look at that and under our regulations, we just look at whether the device is safe and effective. (…) So we look at (the usability) but we don’t look at the cost or staff shortages or the needs.” (A regulator)

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The Policymakers – Innovation / R&D

For innovation policymakers, the value of a health technology depends on its ability to contribute to economic growth.

The role of policymakers is to level the playing field and to reduce risks for investors, thus facilitating their commitment to technology-based firms and, ultimately, fostering economic growth.

In the evaluation of emerging firms, policymakers call upon the expertise of entrepreneurs and investors. They do not make judgements on the value of the technology or on the business potential of the firm. They only evaluate conformity to the rules of the programs.

“Our take on this is that the goal of the exercise is to do economic development. So […] success, for our Ministry […], is number of firms, the number of jobs. ” (A policymaker)

“If the ministry is there … it helps entrepreneurs to seek and obtain funding. It secures investors.” (A policymaker)

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The Media

The media do more than simply “present” information: they offer a specific framing of the reality of the firms and their technologies. They treat on the same foot :

• the clinical value of a given technology and its commercial value,
• the clinical problem it seeks to address and the potential market it may conquer.

Obtaining regulatory approval is a major milestone for firms and their investors; it is regularly reported on in the business pages, almost always with a description of its effect on the value of the shares.

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