How Alcon’s Jeannette Bankes Balances Her Passion for Science and Business

PODCAST EPISODE 289

Click here to watch the video version of this podcast.


Jeannette Bankes, president and general manager for the global surgical franchise at Alcon, learned early in her career that she had an interest not only in the complexity of vaccine and pharmaceutical development, but also in the business that drives it. Her combination of scientific passion and business expertise led her to become one of the first women with a science-technical background to hold a GM role at Boston Scientific, and to lead what is now a $5 billion-per-year surgical franchise within the world’s largest eye-care device company.

Take a listen as Bankes discusses with host Rob Rothman, MD, why she transitioned from the pharmaceutical industry to the medical device industry and how she developed the business acumen to succeed as a GM. She also shares what’s on the horizon for Alcon, and why the company values its strategic partners.

Press “play” and you will also learn:
• What a company like Alcon looks for in early- and late-stage innovation partners.
• How Alcon maintains its dominance despite fierce competition.
• How Alcon plans to utilize digital health and data science to improve phacoemulsification.
• The unsolved ophthalmic problems that Alcon plans to focus on over the next 10 years.

Transcript:

Rob Rothman: Good afternoon. OIS Podcast audience nice to be speaking with you again, let me now take the time to introduce somebody who I’m very excited to speak with Jeanette Bankes, who is the President and General Manager of the Global Surgical Franchise at Alcon. And Jeannette, you can correct me if I’m wrong, but I think that the global surgical franchise is the biggest part of Alcon somewhere around $5 billion or so of revenue per year. You can correct me if I’m wrong, thank you for taking the time to speak with us today.

Jeannette Bankes: Thank you. It’s a pleasure, Rob. Number one, you have a similar personality with me very driven, very passionate about the space you are correct. We’re close to 5 billion and growing both domestically and internationally. So very large business leader in a lot of the spaces that we compete in, and I’m a proud resident of Dallas, Texas about two years ago now, three years ago.

Rob Rothman: I think that a lot of people gonna want to hear how you got to where you are.

Jeannette Bankes: Born and raised in the Philadelphia area. It was always a math and science buff. I first thought I was going to declare pharmacy if he asked me why pharmacy that was the cool degree to have. I thought okay, I can do a lot with that. I got into undergraduate loved I know you guys are gonna shriek at this, but I loved organic chemistry, biochemistry, P-Chem. So for all the medical folks that might be listening to us. I tend to like the abstract things a complex things that you had to solve for it wasn’t memorization of biology well. I did a lot of biology It was a lot of memorization versus actual analytics. So my undergraduate degree I’m a scientist in the brain but a marketing and salesperson by heart you’ll get the feel that as you interview me my personality and, and my Spitfire ways about me. So undergraduate in STEM, I aspired to work for a large company coming out on my undergraduate degree, I had the pleasure of starting with Merck, fortune 500 for all those organic classes, were using the Merck manual for boiling points, etc. I knew Merck to be a household name of Fortune 500 company, I happened to be growing up in the Philadelphia areas to Lansdale, Pennsylvania, was home to me, or at least close to home. And so I started my career in vaccine production, bring it full circle COVID, you know, many family members and colleagues call me I did several years in vaccine development, production, etc. So you could always go there with me as well. It’ll be a personal view, and a scientific one as well. But spent several years at Merck, diverse career portfolio in both vaccines, and then ultimately realized the bigger part of Merck was in pharmaceutics. And so as I progressed, I was on a PhD track at first, I was doing clinical research for the company. And what I realized was I was that combination that love the business but love the science behind the business. And so I moved, and I literally said, Okay, I’m not going to finish my PhD, I’m going to join the business side of the house. And so I moved into a global role, creating what’s now over a billion-dollar enterprise for Merck, which is a private sector vaccine in Asia Pacific. That was one of my first business roles, and so jumped right into the fire with my scientific background, and went over during this will date US, China went to a one child role and, you know, antigens and safety of antigens for MMR, varicella, etc., were never more important to have a safe product. And so we stood up a private sector market in Asia Pacific. And that was my first foray into business. And I realized I could combine the passion of science with the passion of business that I was attracted to. And so I had a 12-to-13-year career with Merck, but I was missing something. And while I love the pharmaceutical industry, the piece of my job that I love most, is a collaborative partnership with physicians. And I realized that I loved creating science, developing science, and ultimately commercializing things that they needed. And so while I love molecules and understanding by availability, when you get into a medical device company, I call it an artistic science because while our engineers and our scientists can develop the best piece of equipment, what’s the one variable put on my analytical hat? It’s a surgical capabilities around the world. And so we have to navigate those that variability. And so in medical devices, what attracted me to Boston Scientific 2004 drug eluting stents, they were looking for pharma backgrounds. This was now a biological mechanical device, where you had to do for no pharma and devices at the same time, I was recruited to come into med devices and I never looked back and the reason that I was attracted to the market was that partnership and every part of the journey from ideation and we’ll talk about that for the folks that are financial, you know, private equity, what is it that a big company is looking for in that early stage innovation, even late stage we buy all across the board and M&A is a really could bring the artistic science the engineering company With the partnership, even in ophthalmology at every step of the journey, even post commercialization as we get larger number of patients, how do you actually think about the safety benefit risk of a product line? And are you really delivering on the promise of the technology? So that led me to Boston Scientific, I had very diverse roles. And I’ll describe why. So I started out in medical affairs build a medical affairs function with Boston. And that eventually led to head a clinical, head a regulatory, and ultimately a general manager role, one of the first technical females. So two first, a technical background running the full P&L and a female running the full P&L. And why did who I think is a phenomenal CEO is Mike Mahoney. Most people in the street know that name is he took a chance on me. And he took a chance on me because being at the right time, right spot, with my background, they had acquired a large company, American Medical Systems (AMS). And the leader needed to not only navigate the commercial globalization of the product line, but there was also product pipeline, things that we had to get accomplished. There were things we had to accomplish with the FDA from a regulatory perspective. So it was easier to take the chance on the scientists technical that was a commercial personality and had done things with the commercial teams. So that landed me in a general manager spot of their neurology division at Boston, and two and a half years ago, what led me to Alcon while I wasn’t looking to be recruited, it was very attractive and we’ll talk about the ophthalmic space, if you take a look at ophthalmology and where we’re headed with the even COVID think about I have my presbyopic so I my readers on with my contacts, is the amount of ophthalmic support that’s going to be needed, as we start to see you know, increased need retinal disease, increasing technology development, value proposition value creation in this space, my ability to take my science, my business and come to a different space. I’ve done cardiology, radiology, peripheral vascular, I’ve been in a lot of spaces, you know, it was attractive to me, it allowed me to step up to a president level, take on more complex roles at a company and go into a therapeutic area that was in need of innovation, we still haven’t fully developed drug solution in the eye, implantable, how do we get them, you know, better over time with innovation. So I joined Alcon, two and a half years ago, I run almost a $5 billion business. And what you’re gathering in my story is number one, diversity of my gender diversity, my background, diversity of my skill sets throughout my career. And I think it’s landed me in a great place to be able to drive through complex problems and solutions. With a large company, that’s going to be critically important. I always say that we have multiple senses, but the one that we don’t want to give up is our sight, you know, you don’t want to give up any sense, but sight is one of them. And the amount of eye care issues or issues we’re going to face with eye care in the next decade is going to be alarming, we don’t have enough physicians in the space to take care of it. So my ability to bring value proposition efficiency and technology and surgeries will serve the populations well that may help to partner with.

Rob Rothman: So you know, again, fascinate me that you’ve been involved in so many different sort of disease, state verticals across, you know, multiple different lines, multiple different companies. And just to be clear, and I think important for people to know you don’t have any formal business training.

Jeannette Bankes: Now, along your journey, I did go to Harvard’s courses running global businesses. So as you start out, I always tell I have two boys, look, your undergraduate degrees, introduce you to if it’s inside, you’re introduced to things and along your career journey. You’re gathering training and education. So it isn’t you start out you’re running a $5 billion business, it’s smaller steps towards P&L. So don’t be naive that in clinical trials, the amount of money being spent by these large companies having a VP role clinical, we’re spending millions to understand and file regulatory clinical. So it’s a crawl, walk, run. I’m now running a large company, large position, but P&L exposure, P&L experience doing some of the Harvard courses, gathering that financial acumen over time was either afforded through formal training in large institutions and or through your own company. So they do support your growth and learning. There’s no magic formula to any of us. If you would have asked me my crystal ball back at the age of 25. What do you want to be when you grow up? And if I would have looked in the crystal ball and they would have said you’re living in Dallas, Texas running a $5 billion business, I wouldn’t have guessed that and nor did I look that far ahead. My career advice to many that are young, whatever age, I consider myself candidate 50. It is just keep building skills in your, in your skill sets and your box, I call it your toolbox in your career. And look, you don’t know which one you’re going to pull out or what’s going to pay off. But fundamentally, as I’m hiring, I’m also looking for diversity. Because even if functionally and I tell this to the folks that are on Alcon, if you’re having regulatory, I still want you to be close to the procedure, understand what you’re talking to these regulatory agencies, so that you know whether or not you’re best serving the needs of the business as you’re helping navigate a regulatory filing. So regardless of what your career aspiration is, you need to sit back and realize the more you know about the business and the full enterprise, the better you are to navigate your own area of expertise, that’s always been a fundamental belief of mine. So I call it lifelong learner appetite for understanding the full business. So I can serve best in the role that I’m serving. And so that’s your best career advice, people, because everybody has a different passion on what they want to be.

Rob Rothman: It’s fascinating. It’s a great story. And it’s, you know, it’s certainly impressive, I’m sure you’ve heard that before, but I just think it’s a further validator of the mantra that a lot of people who are successful, sort of espouse when they talk to people, which is that, you know, you got to get out there and you got to learn, you know, it’s not just necessarily sitting in a classroom, and you don’t have to be an MBA to know how to run a business, you know, you don’t have to have that level of understanding, you know, to do certain things. So it’s just another validation that, you know, you can become the type of sort of successful business leader that you want to be by, you know, going through the process of educating yourself through experience. And I think that’s, what’s your label?

Jeannette Bankes: Absolutely all along the journey. You know, I was going I was signed up to go to the executive program working before I left my 18-month executive program. Well, that would have been very helpful, because it’s almost like I call it a crash along that journey. You are taken finance courses, you’re talking to Treasury, you’re understanding impairments, you’re so it’s funny, because it might have been an easier speed date to get all that right in one swoop. But you have to there’s a non-negotiable at the Harvard course that I went to there was a debate whether or not people were over their skis, are they faking it to make it was a good topic? And at first, my professor was Bill George, you know, Medtronic CEO, he’s great moderator said, Are you saying that women are doing that? And he’s like, no, Jeanette, debate me back? And I said, No, I think anybody in a large position, are they fully competent to be doing what they’re doing? And I would give it maybe the 80-20 rule where we probably all in any new role or learning 20-30% but are you a leader that knows that you have to learn it and you actually accomplishment versus you’re over your skis and you’re making business decisions, you may not have as much competency around. So you’re always learning. But I’m like, there are going to be people in every level medicine industry, that mean, maybe over their skis a little bit, but do they actually pull back and learn to actually ski flawlessly?

Rob Rothman: Crazy. Great. I mean, it’s fascinating. But yes, you’re right. There’s always opportunities to go back to school and or to incorporate education into the process, when you feel like you’re not understanding everything, or you feel like you need a greater degree of understanding of certain things you haven’t been taught before. But I’ve just always been I, you know, I tell this to my own kids as well, you know, getting out in the world and working and getting experience. And so you say to them, eventually becomes successful. So I’ll use you as an example when they push back. Usually push back on everything. So I’m sure that will happen again, there. So let’s move on for a little bit, I will start the next part of this part of the conversation with a thank you. And it’s a thank you because I am a practicing ophthalmologist. And as a practicing ophthalmologist, I can tell you that for nearly the entirety of my 24-23 years of practicing, I have relied upon Alcon products in the majority of situations in which I find myself either treating patients medically or surgically in the operating room, and that continues to be a trend going forward. And I think that one of the things that happens it’s not just an ophthalmology and it’s not just a society that people take for granted some of the work and technical skill that’s required in order to develop the products that we use today. So, you know, people have cataract surgery now and they come and ask them for a certain type of lens and, you know, they’re not 20 20 at the end of their surgery and are complaining and they have no idea how complex the optics of creating an intraocular lens or they don’t understand the fluidics of a phaco machine and what it takes to keep the eye pressurized and suck out interocular contents to put in, they just don’t get it and I think most ophthalmologists probably take it for granted as well. Right, we just use it, it’s just part of our routine. But Alcon has really, you know, pretty much been a leader, I think 90% of surgeons in the United States use Alcon surgical equipment. Is that correct? Yeah. So yes. So, it Yeah. So and again, you know, there are other surgical companies out there be, you know, has products and there are other surgical companies out there that do a good job, but it just, you know, people have migrated towards Alcon suite of products and lenses for a reason. And I think that it’s a testament to the quality of the company. And you get credit for that indirectly. So thank you. How did how did it get here? How is it? How did they get there? I mean, how do you manage to stay on top of this curve where the competition is fairly fierce? And what is it that you think differentiates Alcon from some other companies that has allowed you to maintain that dominant position for so long?

Jeannette Bankes: Well, first, thank you for acknowledgement of what Alcon’s accomplished. While I may be younger, younger and 10 year, I don’t lose sight, no pun intended, of how much Alcon contribute to the world, we’re global leader in ophthalmology. And there’s a humility to the company, they don’t take that for granted. We, it’s a we now with me being at the helm. We don’t take that for granted. Number one, it does take a lot of resources. I think the thing that its integrity, I’ll use the word integrity. And so people rely on Alcon to bring quality products around the world. And we pride ourselves and saying, Can we play in both premium markets, mid-tier different segments economically around the world? Are we really thinking about the value proposition? So you talk about phaco, you know, the evolution of phaco. And what we’ve done and the ability to remove a cataract in a seamlessly safe way, you know, takes a lot behind the scenes, both from a software, hardware, etc. So, look, we retain and attract talent that are best in class in a lot of spaces. So optics, yeah, you know, we just released two brand new interocular lenses that truly have delivered on a promise, we can give you four intermediate near sight in one lens, but don’t take for granted the fact that there’s a lot of physics, mathematics around landing that lens as a practitioner, and us even making sure we have all the diagnostics interoperability to allow you to do that. So we have a very solid optical team. We’re also known for capital equipment. So in the OR, it’s hard both from intellectual property, but also just the amount of subject matter experts sitting at Alcon that can actually deliver the devices that we’re delivering. But we never arrive, I’ll call it never arriving. We’re relentlessly dissatisfied in the fact that even though we’re the leader, there’s only number one spot and we are number one in surgical in almost all areas we plan, I think in all areas is what we said on capital markets day. And so in that space, we stay humble to realize that we still have evolution. So what surprised me the most about ophthalmology, when I came in, was the amount of manual inefficiency, I’ll call it. So if you take a look at robotics and other spaces, you take a look at electronical medical records, data capture and ability I think about radiology because I worked there, in my former job is we have so much value creation yet. I made the comment earlier that I’ll take a country like China, there’s not enough retinal surgeons, the amount of retinal disease in China with you know, high myopes, etc., is going to be further exceed the amount of practitioners we have over there. So we’ve got to think about how do we create value in efficiencies, retinal surgeries are long, you know that I know that? How do we actually optimize it let folks go faster in a safe manner? We’re going to do that in our next generation phaco system, both back and front of the eye? How do we actually bring a digital health suite that allows you to stop worrying about manual entry errors, and capture data from a biometer come across to the OR and actually do some of the algorithms that you know, there’s not a disparity between interoperative aberrometer versus biometry we’re doing all that at outcome we’re not resting on, “Hey, we’re number one.” We’re actually trying to figure out additional value proposition beyond technology but in data sciences as well, that’s our next journey at the company. Because we you do expect us number one, never let down quality, number two bring the best in class product and number three, figure out what I don’t know yet that I need to make my practice more efficient. They’re kind of the value props we watch.

Rob Rothman: Yeah, I mean, and you know, look again, I am one of the unique positions that I have in doing these interviews is that have a utilizer right. I’m not just the guy who’s you know, invest in companies actually use this stuff every Thursday. So you know, it’s been interesting to see the evolution of the technology over time, over the last 20 something years, and to sort of understand the complexities of how it got to where it is, and again, in the face of, you know, what is probably a fairly stiff level of competition, there has always been this ability for, for Alcon to have maintained that you know, dominance in the market, and I never really understood how you’ve managed to do that one of my favorite books actually isn’t in here yet. So one of my favorite books, yeah, it’s one of the favorite books, right? I don’t know if anybody can see, it’s probably backwards. But yeah, so. So yeah, so almost every CA I’ve ever spoken to has read it right is my best friend, one of my best friends, Jeff Smith gave me that book, when we launched the fund. And he’s like, this is how you’re gonna find out where you want to invest. And ultimately, you know, I think the point of that book, and what Alcon has managed to avoid is, you know, falling into a routine where you think that what you have is the only thing that will ever be needed. And it’s the best thing ever, and therefore you don’t need to innovate. And we would never case.

Jeannette Bankes: Yeah, it’s not look I and I give credit to Harvard again, and some of my business training is, look, you got companies, and there’s an S curve. And a lot of us industry gets stuck on the steepest part of that S curve. And you do in shops, because it’s more risky in a company, as a leader like myself and my team to take bets. There’s no magic formula to innovation. But you better have a well baked ideation team is thinking about what’s next. What’s next, I’m not planning for the short term, we’re now planning for the long term, because you should have been baking the short term already. And that’s a combination of internal organic investments, and external and watching the space. And but yet, you can’t put everything in the high risk your MP, everything’s high risk. In stage one, don’t know if it’s going to come out. It is the balancing act. There’s no magic formula. But I tend to say, Okay, I’m going to spend anywhere from 50 to 60% of the core business, make sure I’m not losing in that space. But I need the adjacencies at 20 or 30, in at least 10% of my bets are going to be that breakthrough technology that either reshapes a space and or bring something that’s so novel that either price increases reimbursement changes, value creation, either the payer or the provider, you have to run a business that way, the moment you get paralyzed, and I’ve seen leaders do it, and think it’s just an inch up, that’s too risky, you’ve lost the game, you’re going to lose one in three, you got to know that. But you’re going to bet on two of the three that are going to pan out so that and we do that both in, you know, organic and inorganic, we have to, you’re not going to stay number one by being paranoid or paralyzed.

Rob Rothman: Right. So let’s talk about that for a minute. Because I think for the entrepreneurs that on the audience, I think the inorganic growth is important to them. And I think they want to understand in some capacity, how they can sort of get into the mind of Alcon, you know, at least to try and understand whether or not they have a shot at, you know, creating some sort of partnership with you. And if it even if they’re not at that level, how they can interact with Alcon as a company in an early stage, if that’s possible to sort of gain some guidance as to whether or not they’re sort of barking up the right tree, is there a process or a pathway that you follow, or a way for you in our grant in organic growth pipeline, to sort of spread out to the world so that people can interact with you in some way?

Jeannette Bankes: Yeah, absolutely. The one thing I was pleasantly surprised with, I told you about the manual amount of manual data entry, and I’ll call it inefficiency. But we are where we are and will evolve it. The pleasant surprise to me was the amount of external partnerships we have a very active large BD&L business deals in licensing group at Alcon. And we do speeds every single week, people come into Alcon because they know number one our commercial footprint, it can be very positive for them, should their idea be liked by us whether it be royalties, patents developing to a point where we want to acquire, we’re very active in BD&L. And so and we’re efficient about it, if there’s an idea we’re looking for, everything’s gain for us, we’re humble enough to realize that there’s a lot of entrepreneurial craters that may be faster than us early stage. And so they’re doing some of the ideation work. The easiest way we are on our website, it’s there, Rob. So if a person wants to either get a hold of me, literally I keep a distance from the funding because I am the one that says the deed of the funding, but I send them right to my BD&L group. They have experts across clinical, regulatory, etc., that sits on that team financial, and they’ll engage with you and every week I’m looking at multiple number of ideas, we call them speeds. And we’re like is that in game? Is that not in game? And we’re humble enough to say well, we may not be interested but here’s some pearls of wisdom you might want to think about to get to the next stage and maybe we’re not ready to invest yet. But this is what it’s going to take for us to invest in that next, you know, series of funding round or whatever. But we placed bets early and late stage. So don’t be hesitant and shy about Alcon, you know, picking up and trying to call the biggie, because we were humble enough to realize that anybody can create an idea. We do watch the IP landscape, my biggest advice is, don’t recreate something, make sure you’re checking the IP, we have many people that come in, we’re like, do you realize there’s IP on that either we have it or somebody else does. So make sure you understand, you know, from an entrepreneurial level, you know, get your patents and make sure you’re not breaching somebody else’s. And if you’re really good at the space, and you know, the space well, there’s so much value yet to create. That’s why when I saw the pages of partnerships, and people were watching, it’s because we have a lot of things on sale for yet.

Rob Rothman: That’s the whole reason that we started, you know, what we started.

Jeannette Bankes: Nine companies, you said.

Rob Rothman: 13 – 13. And you know, we were ophthalmologists, and our advisory board are all ophthalmologists and, you know, ophthalmic executives from the past. And you know, we realized the practicing conditions and like, Where are these companies? Where is this technology? How are we going to get these things out into the world? And sort of that’s where we invest? So, you know, I think our responsibility as a venture capital fund with the level of expertise that we have internally, it’s sort of propagate some of these companies to a point where you’re ready for them, or where they have quality of data to be acquired by a strategic and I think that’s what we’ve given ourselves as an internal mandate. And because we realize this is just as you do that, there are so many unsolved issues in ophthalmology, it’s amazing with everything that we can do now, how many problems still exist, and they’re complex, the eye is a difficult place to play around. And you know, I think we’ll get there eventually, and hopefully, you know, all 13 of our companies will end up being successful because we think they solve problems that need to be solved, but ultimately, it’s challenged to it’s definitely a challenge. And you know, I think that we’re all hoping that we solve some of these sort of quickly, because you’re right, the amount of disease out there is going to increase rapidly over the next 20 years. And it’s going to become a public health crisis, you know, in a significant way, not only in the US, but everywhere. So.

Jeannette Bankes: Look at the big spaces and I don’t know your company’s you can expose it to me later, but is look myopia control. China, if you look at the ranking, cancers, number two myopia controls number three for the for the Chinese government. I don’t know if you knew that is, it’s huge. Second, I don’t think we’re arrived on AMD. It makes me sad. My mom’s an AMD patient that gets needles in the eyes every six weeks. And she’s looking to be like, okay, figure it out, right? We have so much space glaucoma, like hypertension, a lifelong disease, you’re not going to see them once you’re gonna see him multiple times. And do we have the right, you know, mild to moderate options all the way to severe refraction, refractive cases. So we haven’t solved there yet. That’s a lifelong journey with us, you’re gonna have it the rest of your life is just how do we mitigate it, control it and minimize, you know, damage to you or loss of sight? So I get giddy. That’s why I came to ophthalmology. And like, there’s so many spaces that we still have, at least in my age, I’m young, we have several decades of inventions, value creation, digital digitalization that we’re not even close to arriving. We’re not even attempted the journey yet, Rob.

Rob Rothman: So that’s a little glimpse into I think the next part of the conversation, which is so Alcon, you know, is, as you’ve already, you know, sort of explained, and as I think most of us have seen, throughout the years has always been progressive and how it approaches, you know, ophthalmic disease, what are the things that you think are going to be, you know, significant points of focus for you, aside from, let’s say, the management of ophthalmic’s disease? Is there any opportunity for other disease states, let’s say, or digital healthcare, diagnostics? How do you approach the outside of the United States landscape? How are those things sort of factored into the, you know, sort of, you know, let’s say, 30,000-foot level over the next 10 years for what Alcon wants to do?

Jeannette Bankes: I’ll start in reverse.

Rob Rothman: Without, without exposing anything that you’re not supposed to?

Jeannette Bankes: I won’t. I won’t I promise, Rob, is, from a global perspective, I’ll take it backwards. from a global perspective. Look, we’re increasing our footprint. We set a capital markets day, we had over 19 regulatory filings and approvals in China. So we didn’t have a big presence in Asia Pacific. And so we’re growing globally. There’s global growth opportunity for the company. But we also have to think about from a global footprint. You know, it’s not just premium people are going to be seeking, you know, what’s going to be interesting to watch in international as you think about med device regulations, MDR and MDD. And the changes there, how many companies are going to actually make it through there’s no longer substantial equivalence in products in Europe, and so did all these smaller companies do the clinical requirements to maintain in the market after 2024. So there may be this all of a sudden, oh my gosh, in the monofocal market, there’s not 12 competitors, there’s x now. So we’ve got to think about not just being a premium player let’s talk about what our role and responsibility is where we brought out a device called Legion, a portable phaco machine, look, we’ve got all of the traditional Lariat, Silver, we’ve got all the different generations of phaco, we had to think about both a portable in India, think about India and China, those remote parts of the country that have to still do phaco, we put out a what I’ll call a mid-tier phaco piece of equipment, and it’s doing phenomenally well, internationally. That’s our responsibility. We’re thinking about how do we still maintain a price acceptable monofocal along with premium lenses, everybody has a different economic value, a capability around the world. And so you’re seeing Alcon actually globalized in a more meaningful way, both with premium mid-tier offerings. So that’s number one. And you’ll see that as we talk to the street. Second is and we’re not shy, if there are international, and you talked about private equity investments, if there’s things that make sense, we also take to heart that it’s not just domestic American, that Europe and US, you know, have to drive what we do there large markets for us, there’s going to be unique things that are needed in countries like China and Australia, Asia Pacific, that may make us partner in a different way for technology just in that market. Okay, so we’re open to that as well, as a leader. I’ll say that, when we look at where we’re headed, you asked the question around different disease states, yes, if it makes sense to us. So think about as an investor in Alcon stop, we need to step back and make sure that there’s synergy there, we have a huge focus on ophthalmology, there are other spaces that I won’t mention, because we’re looking at that may make sense to us. There’s synergy, it’s in our area of expertise. And we’ll go there. But we have a lot to solve in ophthalmology, still and a lot of growth opportunity for us. And when you talk about diagnostics, that was your third part. Look, traditionally, you know, Alcon is in the OR, we are putting our foot in a meaningful way outside the OR. So we just launched a biometer called Argos. And so we’re getting competitive to the people that might be number one in that space, some of our competitors. And we have the ability with technical expertise internally to take it where you wouldn’t think you would be able to go. So can we scan the back of the eye for retinal disease in the optometrist’s office that by the way, they’re going to tag you next as an ophthalmologist, say, Hey, you know, Alcon’s new device can do everything from more accurate measurement easier to do, I’m getting good results. It’s going across the cloud; it’s coming into the OR. And by the way, did you realize that we scan the back of the eye, and we can see things in a more meaningful way. We’ve entered in a more meaningful way to the biometer market. And we’ve got technology coming out in the next several years that will literally create new for the whole world. So we’re excited about some of the technologies that may be able to do things beyond what you imagined now.

Rob Rothman: Yeah, it’s gonna be again, if you think about it, you say and, you know, it’s obvious right to the clinical world that said, of course, we need those things. And of course, we need that technology. I think the challenge is always finding, you know, high quality technology and making it affordable. Obviously, the biggest stumbling block that I think we all perceive that’s going to derail a lot of what we want to do is, you know, the need for increased amount of capital placed into the delivery of quality health care, right populations are aging. Physician reimbursements continue to drop. Alcon and other companies have managed to provide some revenue streams for physicians with premium services offerings, that, you know, sort of help mitigate some of that, but it’s a difficult cycle to navigate. And I, you know, it’s always the one checkbox in our diligence list that’s hard to, to navigate, which is what the reimbursement for this is going to be in three years, five years, seven years. How’s that, you know, impacting, as you’ve mentioned, you’ve already solved some of that outside of the US where obviously things can’t be as expensive as they are here. And that’s going to filter into I think, decision making amongst most either entrepreneurs in how they approach their technologies, and certainly from the strategic landscape and how they invest.

Jeannette Bankes: Rob, one comment is the health economics and reimbursement group reports into me I’ve a large organization, both for pricing, but also thinking about value creation in our technologies. It’s a core at what I’ve done in previous life as well, is, we’re thinking differently, though. So think about the reimbursement landscape and the pressure you’re facing. We’re making sure that as we think about value creation, can you imagine if we can create the center of the bar that allows a retinal surgeon to bring three more cases a day and because we’ve made it that much efficient, more efficient, or cataract surgeon and we’re running the data like we know what our next generation technology is going to do? You know, being able to have a cataract surgeon do one or two more a day, because we’ve been that efficient, or retinal surgeon three to four, that’s real. That’s what we’re gonna put on the board in the next couple of years. So, you know, with the, again, to make to the population increasing on eye disease, and I need us being able to bring more efficiency in a price pressure market, it’ll be value creation to you guys. And it’s not that we’re jacking up the price in a in a ludicrous way, we’re trying to maintain that partnership with you guys. But efficiency gains value creation, that’s how we think. And so we will win with you if we can do that for you.

Rob Rothman: Absolutely, I mean, it’s incredible how much I think sort of financial education physicians have had to go through over the last 10 years as they started to, you know, the perception of the past was the physicians make all this money, and we can just, you know, cut reimbursements, because there’ll be fine, but it’s really come to the point where the productivity curve and the expense curve have crisis crossed, and you start to see these, you know, significant downward pressure on physicians, large physician groups, health systems, and everybody to try and rein this stuff in. And people sometimes shake their heads, oh, my God, how do you do that many cataracts in a day, you know? And is that safe? and everything else? And I’m like, Yeah, actually, it is safe. And it’s actually required, because we’re running out of resources to take care of all of the people that actually need these procedures, like, you know, it’s always the answer, right? Well, yeah, I’ll just cancel 10 of those people, what are we gonna do with those so that I have a shorter day, like, these are people who need health care, not only in the US and across the world, but it’s interesting how the perspectives of the population and of the practicing physicians and of the you know, strategic entities like Alcon, perceive these things differently and educating the public, I think it’s going to be important to a greater degree as time goes on, healthcare is not going to get cheaper.

Jeannette Bankes: Yeah, and as diagnostics look, as we think that our next generation diagnostics, even some of the value creation, a scans, you have dense cataract artists can get through it. Now we’re not, we’re showing value creation on either cost avoidance somewhere else, time avoidance. So that’s, you know, there’s no longer a nice to have, it’s a need that we have to show you guys that we have to build technologies around that value creation and show you about your brand. But we can’t demand a price even at parity. So you’ll see us do that to make you more efficient, more effective, and never jeopardize safety, like you guys trust integrity, that word I use to begin with?

Rob Rothman: Well, listen, I cannot, you know, say enough how much I’ve enjoyed speaking to you know, today and in some of our preliminary discussions, and, you know, again, it’s a big thank you on behalf of me, and I think almost all the clinically practicing physicians that I know, who appreciate what you’ve provided for us and make us better at doing our jobs. And I think that we are all looking forward to what Alcon will bring us in the future to make us you know, better, more efficient and provide better outcomes. And, you know, you get the, you know, the majority of that credit. And I think that people who have listened to this podcast today will appreciate the drive, the commitment, the energy that you bring there. And we’ll sort of understand as time goes on that there’s a reason that this company is successful. And that’s why it continues to be successful. So for everybody who’s listening, I want to you know, again, special thank you to Jeannette Bankes for taking the time to talk to us today and I hope everybody enjoys listening to this and look forward to future conversations with you down the road. So Jeannette, thank you again and take care.

Jeannette Bankes: Thank you!

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