Monthly Archives: October 2011

I attended a small SVB-sponsored seminar today with the chair of the Medical Technologies Advisory Committee (“MTAC”) of NICE. I think I was the only VC invited (or that bothered to show up) and there was a captive audience of small device companies. The slides are available here and below.

Any device with a new procedure MUST go through the Interventional Procedures committee before a NICE technology appraisal can occur. An IP review can take 6 months. Devices should be CE marked at time of review. New procedures can be submitted by hospitals, clinicians, or manufacturers. Seldom are procedures denied (only about 2 in 350 cases), but often times procedures without strong evidence will be given special arrangements. Such arrangements take the form of governance (telling the hospital), consent (telling the patient), or research (reviewing the outcomes). Evidence considered by the Interventional Procedures committee includes published studies, questionnaires completed by medical advisors, questionnaires completed by patient commentators, committee members’ knowledge, and public consultation.

Technology appraisals by MTAC occur after the procedure has cleared the Interventional Procedures committee. These are confidential reviews of the evidence and economic models presented by the manufacturer. MTAC carefully studies patient outcomes or experience, use of resources (facilities, staff, tests), cost, and sustainability. Manufacturers can continue to market product during this period. If a resolution is put in place, the device is not “mandatory” in the UK, but it is economically advantaged. If a technology is not accepted, then the manufacturer will receive a letter with reasons why and advice. The goal of MTAC is to boost adoption of novel and useful technologies.

I was most surprised to learn that the UK Trade and Investment office is available to offer FREE assistance with navigating all of these processes. While these processes seem complicated, difficult to manage, and highly ambiguous, there is actually outstanding support available, even for US-based medtech companies.


September’s Health 2.0 Conference brought together 1500 attendees for two days of hour-long panels punctuated with a flurry of 3½ minute demos by young, ambitious technologists hoping to “save the world” with the latest and greatest iPhone app.  In general, I found the event to be disappointing, or at least lacking in investable ideas.  There were dozens of companies creating “social” and “mobile” communities with “game mechanics” to fight obesity or encourage “wellness.”

In a session called “Employers, Payers, and the Great Health 2.0 Awakening,” Aetna’s CEO remarked that the company is becoming a healthcare IT company that “dabbles in insurance.”  Kaiser’s CEO talked about having 190 accounting systems… and the need for unifying solutions.  Yet there was quite a noticeable disconnect between these bigger picture themes and all of the noise around iPad apps and telemedicine.  It’s clear that the big guys are beginning to experiment with some of these new technologies, but as we all know, it’s hard to make things happen quickly inside of these huge machines.

I sat through a lunch with Rick Gilfillan from the CMS Innovation Center, though again, didn’t come away with many specifics except that there is $10B being directed into new models of payment and care delivery.  During the Q&A, many entrepreneurs expressed frustration with the lack of transparency about how to tap into this funding.  Rick repeatedly referred them to the website for online submissions and said that there were “a few people” evaluating the proposals, but couldn’t provide much detail on what was being rolled out.

During a Tuesday afternoon session called “Launch,” 10 companies did demos:
•     Basis – A pulse & health monitor on your wrist
•     Clarimed – Ratings and info on devices, diets, and much more
•     CareCoach – Recording, sharing & improving what happens in the doctor’s exam room
•     GLU – Revolutionary new social network and research tissue bank for people with type I Diabetes
•     GoodRx – Shows you the best price on drugs by retail location
•     HealthPer – Improving employees’ health engagement and productivity using incentives and techniques from gaming
•     Medify – New style of health search and information sorting engine for consumers
•     Numera|Social – Completely Facebook-based social health management platform
•     1 + 1 Labs – Lab results explained visually according to Thomas Goetz’s feedback loop
•     WellnessFX – Complete health management system based on mass customization of personalized testing and treatment

Canaan has seen Basis, Medify and WellnessFX, which were all in the top 5, by audience voting.  I think this demonstrates that Canaan IS in the deal flow of the higher quality Health 2.0 companies.

I’m not sure there would be much benefit from attending the conference in future years as it is a costly event and the actionable items were few.  However, it does bring several people to town, and Canaan used the opportunity to host a small group dinner with several of our portfolio company CEO’s, friends of the firm, and guests from the Dept. of Health and Human Services.