Appointed to lead Alcon in May 2014, George — who had been an executive at Alcon’s parent company, Novartis — revealed that as a youngster he had very high myopia. He told the crowd of nearly 800 packing the Grand Ballroom at the Palmer House in Chicago that at a young age he came to appreciate the stellar ophthalmic technologies that make a huge difference to the quality of life of patients.
George set an optimistic tone about the global eye care industry, stating, “Ophthalmology has tremendous unmet needs.” He noted that there are 20 million people globally who suffer from treatable cataracts, 25 million with age-related macular degeneration (AMD), 67 million with glaucoma and 1.7 billion with presbyopia.
Alcon annually spends approximately $1 billion in research and development and is “agnostic about whether it is for external or internal innovation,” according to George. This level of spending translates into roughly 9% of its estimated $11 billion of annual global sales, a percentage that is higher than most other medical device companies. Alcon focuses on specific therapeutic areas of interest, rather than on particular technologies, and has created a wide array of strategic partnerships in order to stay abreast or ahead of the innovation cycle.
Three key factors underpin the great growth potential of eye care, George said. These factors are the aging of the world’s population, a high unmet need in emerging markets, and exciting technological and scientific innovations. He stated that “innovation is not cheap,” citing that the clinical trial costs per patient in ophthalmic-related products is $22,000, higher than any other area of medicine.
George referenced a wide range of innovative ophthalmic products, categorized into cataract, surgical glaucoma, vitreoretinal, retina/pharma, and refractive areas. In the cataract arena, he expressed tremendous enthusiasm for Alcon’s very recently completed cash purchase of WaveTec Vision Systems Inc., which will bolster its already dominant cataract surgery franchise. Alcon has enjoyed very robust growth in the femtosecond laser assisted cataract removal market, as its July 2010 purchase of LenSx lasers has proven to be sagacious and well-timed.
In glaucoma surgery, George cited several technologies: MicroPulse laser therapy, sold by IRIDEX Corp. for laser trabeculoplasty; minimally invasive glaucoma stents, pioneered by Glaukos Corp., with many others in hot pursuit; filtration procedures with its own brand, the EX-PRESS shunt; and shunts and valves for later stage surgery.
George singled out several vitreoretinal technologies. These included the DigiSight mobile digital screening systems, Zeiss’ intraoperative diagnostics, Alcon’s own brands for high speed vitrectomy (Ultravit) and micro-vitrectomy systems, and the Grieshaber Finesse Flex Loop device.
In the retina/pharma area, he noted that there have been huge strides in the treatment of wet AMD, diabetic macular edema, and retinal vein occlusion, with attractive products emanating from several different companies.
The refractive area has also seen numerous exciting improvements, including the Innovega Inc. telescopic contact lens that can switch between normal and magnified vision by using slightly modified off-the-shelf 3D television glasses. The technology shows promise for severe vision problems like macular degeneration. Others George mentioned included a very low cost portable refractor from EyeNetra Inc., and an Ocular virtual reality headset to treat amblyopia.
George spent a few minutes discussing a relatively new initiative that he is personally very excited about — the strategic joint venture between Google and Alcon. He admitted that at first he was “very skeptical” about this venture but Google has “blown me away with their speed of innovation . . . and I am now very excited about this program.”
According to George, this JV involves non-invasive sensors, microchips, and other miniaturized electronics, and will strengthen Alcon’s leadership in contact lenses and intraocular lenses. The initial focus of this “smart lens” technology will be on diabetes and presbyopia.
The goal with diabetic patients is to better manage their disease by providing a continuous, minimally invasive measurement of the body’s glucose levels, measuring tear fluid in the eye and wirelessly connecting to a mobile device.
For people living with presbyopia, the lens has the potential to provide accommodative vision correction to help restore the eye’s natural autofocus on near objects in the form of an accommodative contact lens or intraocular lens as part of the refractive cataract treatment.
George said this project reflects one of his key management philosophies, which is, “We need to take big shots on goal.”