A view from the top

      We often hear from experts in the field of ophthalmology about how technological advances are helping their practice. We rarely hear from the people pushing these innovations, however. The Ophthalmology Futures European Forum 2017 in Lisbon brought together some of the leaders in ophthalmology for a talk entitled “A view from the top: Corporate CEOs interviewed”. Chairing this discussion was James Mazzo, Global President for Carl Zeiss Meditec’s Strategic Business Unit Ophthalmic Devices. On the panel were Alcon CEO Michael Ball, Tom Frinzi, Worldwide President of Surgical at Johnson & Johnson Vision and Dr Ludwin Monz, President and CEO of Carl Zeiss Meditec. To start with, Mazzo pressed Frinzi on Johnson & Johnson Vision’s acquisition of TearScience, a US-based company that specialises in the treatment of dry eye disease. The move made perfect sense, said Frinzi. “A healthy ocular surface is critical not only to prolonged contact lens use, which also plays to our portfolio, as well as to surgery, be it corneal-based or lens-based surgery.” While Johnson & Johnson Vision moved into dry eye, Alcon took a step into the area of Minimally-Invasive Glaucoma Surgery (MIGS) with the development of the CyPass Micro-Stent, which is implanted in the eye to reduce intraocular pressure. “When you look at glaucoma drops, and even seeing my parents fight with each other about putting drops in each other’s eyes – not a pretty sight whatsoever – to get a surgical technique, a surgical product that can relieve them of that burden, I think is tremendous,” said Ball. “Given compliance is the biggest enemy of drops and given its importance in this setting, I think getting MIGS out there is fantastic.” While there is an additional cost for the procedure, he believes it pays for itself when offset against the price of living with glaucoma. “I think it’s incumbent on us to look at the economics associated with that and make sure that the payers across healthcare understand what a great plus this could be.” While ZEISS had not made any surgical acquisitions, Monz spoke about Veracity, a cloud-based platform for planning and administration in cataract surgery ZEISS had recently acquired. He believed this represented a step forwards in how digital systems are changing the face of surgery and ophthalmology. From using electronic records to increase efficiency and improve processes, he feels the next step is learning from the clinical data itself. Frinzi spoke about his own company’s progress in the digital arena. “Obviously, we’re doing the near-term things, making sure our equipment technologies talk to one another, and communicate with one another wirelessly, but it’s an opportunity for growth for us, to get smarter and learn how to apply it across our portfolio.” Ball agreed that digital was key, while acknowledging the difficulty for “dinosaurs” like himself: “It’s not natural to go after the digital era if you will, we have to force ourselves and get the people in the door who are way, way, way, way younger than us to get this thing moving along.” Monz did express concern however. As European authorities introduce stricter regulations, he sees a knock-on effect not just in ophthalmology but across medical industries. “I’ve heard that medtech companies – not just ophthalmology but neighbouring industries – were basically saying ‘we will not maintain our full portfolio, because it’s just too expensive to get the reapprovals’.” Approvals are key for Alcon: “I think we will go where the approvals are and where the opportunities are. I see Asia developing as everybody does, as a very good market in terms of getting more coverage. But I still see great opportunities in Europe and in North America,” stressed Ball. “I point to AT-IOLs as something I think that baby-boomers want. They don’t want what their parents had, they want the newest technology, and they want to live a 
full active life until they’re 85, 95, 
100 years old.” For Frinzi and Johnson & Johnson Vision, changing regulations may or may not change their approach. “Historically we’ve brought a lot of things OUS (outside the United States) because it was a clearer path to the market. The fact that Europe is moving a little closer to what the US has in terms of regulatory pathways may level the playing field.” The chair also pressed Ball on some of the mistakes he’d made in business, and what he might change throughout his career at companies like Allergan and Hospira. “As I look at it, if you don’t make mistakes, you aren’t taking enough risks. You have to make mistakes, especially if you’re betting on innovation. It’s always great to have the sure thing, but you can’t move the science forward then. If you’re not getting smoked on a couple of deals, then you’re not doing a good job.” Words to remember for aspiring CEOs.