Opinion article

How the medtech industry is meeting the COVID-19 challenge

Medtronic Senior Director: Market Access, Public Affairs & Policy, Andrew Wiltshire, provides an insight into the challenges facing medical technology companies during the COVID-19 crisis and the measures they have taken in response. He also reflects on the lessons for health policy that we can take from the crisis.

COVID-19 is an unprecedented challenge that requires an unprecedented response. We face this challenge together, and the medtech industry is doing all that it can to support the medical professionals we have worked with for decades to care for the COVID-19 patients who need our help.
The current crisis for a medtech company like Medtronic is driven by two opposing forces.
One is the need for a fast response. The co-ordination of therapy supply has moved to intense ‘war-like’ response activations, based on preparedness planning and a desire to minimise both harm and panic across our healthcare system. Like we have seen with community grocery buying, we have also seen examples of therapy stockpiling in the healthcare sector, which is placing strain on resources.
Fortunately, we were well-placed for our usual supply going into the pandemic. However, managing global supply chains and manufacturing in the face of country level lockdowns and movement restrictions, coupled with panic buying and preparedness planning, puts strain on even the most well-prepared supplier.
Within medtech, the highly technical and regulated nature of the industry means that supply shortages do not have an easy fix. The path to market for medical devices is specialised and can be long, involving significant investment in research and development to demonstrate the safety and effectiveness of any therapy going into market.
Funding of medical devices has its own challenges, involving negotiations with government and private health insurers for funding. If you consider the average time for a product to come to market in Australia from when an application to the Therapeutic Goods Administration (TGA) is first made, to when it is provided to a patient – and that this is only after significant time dedicated to development and clinical trials – a desire to fast-track the supply of new therapies is near unthinkable. It also raises the question of how this technology will be serviced and monitored in the long-term – medtech is a lifetime commitment.
The medtech industry has risen to these challenges. For Medtronic’s part, we identified a key concern for governments and healthcare workers around the world related to ventilator supply and publicly shared the design specifications for the Puritan BennettTM 560 (PB560) ventilator to enable rapid ventilator manufacturing. Medtronic are also partners of the Ventilator Training Alliance (VTA), a group of ventilator manufacturers that have joined forces to create an app-based ventilator-training solution for frontline medical professionals. Anyone can access the design specifications of our PB560 ventilator at our website and we have received 90,000 registrations for design specifications from across the world to date. The VTA App is free and aims to meet the emerging crisis related to training on ventilators due to new manufacturers and increases in new users due to shortages of respiratory therapists.  
Alongside these steps, we have increased production and distribution of our ventilators, pulse oximeters, and ECMO machines around the world, effectively doubling the number of shifts in the manufacturing of these products, including 24/7 operations.
On the other side of the crisis, traditional business operations for medtech may slow due to elective surgery bans and the reality of our changing community. 
A business slowdown in medtech brings with it the usual questions you would see in any business. How do you sustain a workforce dedicated to the delivery of healthcare, when the potential for that care is in limbo?
One bright spot for Medtronic is that much of our product portfolio can enable remote and connected care and follow up. The current situation has prompted us to rapidly accelerate our capability in this area, particularly for technologies such as our cardiac pacemakers and insulin pumps.
Remote care can in many ways be more effective and efficient for patients and healthcare providers. However, the widespread uptake of these options is hamstrung by reimbursement systems that do not adequately recognise the full potential of remote care. Addressing this issue would create significant benefits, not only during the COVID-19 crisis but in delivery of care after the pandemic.  
We have also faced many unforeseen challenges in the delivery of care. State border lockdowns to restrict community movement also impact the ability of our clinical and technical staff to attend life-saving procedures or to service technical equipment. Thankfully the Government moved swiftly to address this issue, but it also emphasises the importance of progressing telehealth initiatives and mobilising these areas to improve access in the delivery and funding of these modes of care.
Reassuringly, as is the case for many, as we seek connection at this time, we have not been alone. We have worked closely with our industry association, the MTAA through a working group to help government understand and coordinate the supply of COVID-19 critical products. This unprecedented collaboration in the industry and between industry and government has significantly contributed to national efforts to prepare our health system.
While there is more work to do, no one company can deliver all the products and supplies needed for this global pandemic. We will only defeat the virus by acting in unison, with smart and focused strategies for production, allocation and resourcing. We know this virus can and will be defeated, and we will do our utmost to make that a reality.
About the authors

Andrew Wiltshire

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Andrew Wiltshire is the Senior Director: Market Access, Public Affairs & Policy at Medtronic. He has more than 20 years of experience in all aspects of the medical technology and pharmaceutical industries. He is also a past member of the Medical Technology Association of Australia board of directors

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