Former Sales Account Manager at Masimo and Current Territory Manager at Stryker
Andrea is a trained biomedical physician and has over 15 years experience selling medical devices in Europe at both Masimo and Stryker. He is the Former Senior Sales Account Manager at Masimo, where he was responsible for managing all private and public healthcare facilities and hospitals in Italy. Andrea has experience in both capital and clinical sales selling both invasive and non-invasive medical devices. He is currently the Territory Manager for Italy for Surgical Orthopedic Instruments dealing with power tools for bone procedures for resurfacing and modelling bone in orthopedic and trauma procedures.Read moreView Profile Page
Andrea, can you just briefly share an introduction to your background, please?
I’m Andrea Martelli and I’m 49 years old. I have a degree in physics, with a PhD in biomedical physics and I have been involved in the medical device market for 15 years. The first 10 years were dealing with medical devices for anesthesiology and resuscitation both for non-invasive monitoring as well as invasive products, such as catheters, needles and products like that. For the last five years, from 2016, I have been working for Stryker Instruments, dealing with power tools for bone procedures, for drilling, resurfacing and modelling bone in orthopedic and trauma procedures.
I have always managed a direct and indirect salesforce, such as agents, distributors and sales reps. In my personal experience, over all these years, I have undertaken both marketing and pure sales activities.
Can you explain how the core Masimo SET technology works?
At the core of the Masimo technologies is the algorithm that they use and have implemented in their products, that is able to avoid noise in the analysis of the pulse oximetry. At the site of a measurement, usually the finger or the toe, we have an image of the central pulsation of the heart and this can be measured by using light. It is a specific bandwidth of the light in the infrared range, using the so-called lambda law. With this mathematical algorithm applied to a medical solution, we can recalculate and extract the oxygen concentration in blood as it is circulating in the veins, as well as the pulse rate.
The main problem with standard technology in pulse oximetry is the noise. Sometimes the patient moves; sometimes the patient may have a low temperature or lower overall total volume of fluids, so the signal is corrupted. At the very beginning, in the 1980s, thanks to the collaboration of the CEO at the time, Joe Kiani, and one of his colleagues from university, they developed an algorithm called SET, Signal Extraction Technology, that was able to avoid any noise.
Masimo SET is a unique solution and a very reliable way to determine the correct SpO2 concentration and pulse rate in a patient, even in challenging scenarios.
How could a bigger player, like Medtronic, potentially really compete with the SET technology that Masimo has?
Big players, like Medtronic or others, in my opinion, quite frankly, can’t compete with Masimo SET. It is a specific algorithm, so precise and well-developed, I honestly think that bigger players are not able to go as deep as Masimo has already been going for 40 years. This mathematical solution, applied to biological science was born 40 years ago. I saw different attempts from Medtronic and other players in the pulse oximetry and SpO2 markets to reach the Masimo solution and precision, consigning value to a monitoring parameter. In my opinion, they were not able to reach the same level. Masimo has absolutely not stopped R&D work so when the competitors try to get close, Masimo is always another step ahead.
What exactly is it about the technology that is so hard to compete with? I believe the sensors are now off-patent, so is it really just the algorithm that is the really important part?
The algorithm is the core and is unique. That kind of mathematical solution has four components. Each one of these parts are dedicated towards fixing one problem. The movement problem, the low volume problem, the temperature problem and the fourth one is a black box. They have never disclosed information about the fourth part, which is probably the real core. These four mathematical processes work together. Even if I have an emitting diode and a receiving diode, I can put them on my finger and I can have the raw signal, without any processing. The processing is the core.
Sensors are very advanced at Masimo, but other players, such as Medtronic, have their own their SpO2 line of products that are called Nellcor. With the Nellcor pulse oximeter, for example, it is a standalone and single-use sensor with a sticking sensor that you can only use once. You can use it for eight hours, over one day, but the day after or at the end of the period, you have to change it. It is not only Masimo has that; all the other competitors and other players in this market have it, because it is not a patent. The patent is the algorithm. The patent is the processing of the raw signal that they do.
What do you think is the biggest risk to Masimo losing market share?
The risk is mainly in countries that are not so well-driven, from an economic and financial point of view and the first problem that I faced, in my experience, is the price. There is well-known market law that the better the product, generally, the higher the price. For example, in our case, in Italy, from 2012 to 2016, we faced a double price problem. We were offering single use sensors for 10 EURO and the Nellcor one was five. This is the main problem. In different countries – if we look at the European frame – there are many problems, from an economic point of view, that I can see.
I can see problems from a user point of view. Masimo products need to be used in a very specific manner. For example, they give a specific indication as to how to put the sensor on. You have to follow an exact procedure. The deeper you go in a specific field, you have to be very strict at following how the product is used. Sometimes this is not possible because there are issues with the patients; for example, moving, even if they are adults and they are able to understand that they shouldn’t. Sometimes they face complaints from professionals in the healthcare market, such as doctors or nurses, that our technology is not so different from others that they use. But this depends on the understanding they have in the way that it is used. If you speak with a customer that follows the indications from Masimo exactly, they are happy and they are confident in the product and they think that the product is better than the others in the market.
In Europe, putting aside the price issue, you’re saying it’s also a training issue where the hospitals don’t necessarily train the nurses or doctors correctly, so they don’t understand the quality of the product?
That is absolutely correct. In fact, at one time, we had a marketing campaign concerning the correct usage, with two people who were in specialist roles and their only function was to go to a different hospital each day, reinforcing the usage indication, usage protocol and providing training.
Before we discuss the sales process of SET, can we just look at how, potentially, hospitals are structured differently in Europe versus the US? Are there any clear differences in the setup of the hospital, in terms of the different wards or anything that we should be aware of?
There are differences. Firstly, US hospitals are all private. In Europe, we have a consistent quota of public hospitals. The public nature of the accounts changes the mindset of stakeholders inside the hospitals completely. Managing money and financial viability in a private versus a public framework is completely different. Moreover, in the US, there is a very powerful element that is represented by insurance companies. They push hospitals to have the best technology in the market, in all medical fields, because the insurance companies sell their products by telling customers that their accounts have the top products, the top doctors, the top processes in the world.
In Europe, this is not the case. Nowadays, we are seeing a process like this, but for example, in Italy, it is at the very early stage and we don’t know what is going on, currently, in the UK or Germany but Spain and France are at the same level as Italy.