[creativ_pullleft colour=”light-gray” colour_custom=”” text=”Episode 085″]
The fifth OIS@ASCRS delivered highlights on diagnostics, glaucoma devices, and What The Future of ophthalmology might bring. OIS Podcasts will provide a quick review of the day for those who couldn’t make it (or simply had overstuffed their meeting calendar in New Orleans).
Tom Salemi: Hi, Everyone, welcome back to the OIS Podcast. We are one week removed from OIS@ASCRS. It was last Thursday at the Intercontinental Hotel in New Orleans, and it was great. It was our biggest one yet. More than 500 people gathered to talk about the interior segment of the eye and to address a lot of the pressing issues in ophthalmology, including the premium channel, glaucoma. We covered the gamut. And you’ll be able to see it all and read it all on ois.net. We’re going to be updating that website with content as it comes in. So make sure you go to ois.net to check for content. Also, once there, sign up for our Eye on Innovation Newsletter, and that way we will send the content to you. So go to ois.net. Well, let’s get into the day. Bill Link led off OIS@ASCRS. He of course is one of our co-chairs along with Gil Kliman and Emmett Cunningham. And Bill, as he does when he leads off the OIS@ASCRS, sort of gave an overview of the sector. You can check it all out at ois.net. But one thing I’d like to really focus in on was toward the end of his presentation, Bill gave what I thought was a great list of principles for innovators or people looking to innovate. Let’s have a listen.
Bill Link: Principles of innovation. This is my view. Innovation is focused on important, big opportunities. We need to seek the truth along the way. We have to be candid and truth-seeking as we progress. We have to be disciplined. We have to try things. We never know enough to take risk out without trying it. We have to be willing to fail. It has to be in our culture. We hate it, but we may need to have a failure or a setback or two. We can’t be paralyzed by our mistakes. We can’t be paralyzed by our mistakes. Skilled, we have to be skilled. And a lot of times, as we’re building teams, we don’t have the range of skill. If we’re honestly innovating, and if it’s disruptive, we don’t know enough. And so we may need to bring talent in from other sectors that have skills and knowhow that we may not have on our team. And we have to be assertive and focused and tight, but not arrogant. OK, arrogance fails. Professionalism always pays off. Keep your head up. When it doesn’t work, admit it. Don’t explain it. Say Whoops, I tried it, didn’t quite work the way I wanted, I backed up and tried again. So those are the principles of innovation I like to remind myself of periodically, and each of us along the way.
TS: Well, Bill Link did his usual great job of leading off the conference. What followed next was several discussions on clinical areas within the interior segment. We looked at glaucoma. We looked at the premium channel, we talked about diagnostics. We had nearly three dozen companies presenting in the various sections, including the new What’s the Future section, which was playfully called WTF@OIS, a concept that Gil Kliman innovated, and we’ll discuss later on in this Podcast. We’re going to fast forward to the end of the day. Jim Mazzo finished up the conference with his Masters of the Universe conversation. We were very happy to have the leaders from ophthalmology’s strategic players on stage to discuss their view of innovation. And one new participant, or new to OIS at least for the last couple years, was Mike Ball, the new CEO of Alcon. And the conversation centered around the consolidation or the change that has gone on in ophthalmology. And Jim asked Mike whether that consolidation, whether those changes up top are impacting the specialty and slowing innovation. Let’s hear what Mike Ball had to say.
Mike Ball: I don’t think that consolidation is responsible for impacting the innovation either in the marketplace or with products. You know, what we talked about at AKOS was about all the opportunity I saw having been out of the market for maybe a decade, at least from a surgical standpoint, and come in and see all the opportunities in the market, much like Bill said. I mean I look out there; I see all those glasses out there and reading glasses. My God, there’s a couple million bucks right in this room here if you come over and see me after this talk. But the thing is if you look at things like refractive surgery, it was at one point 6 million procedures a year in the US, it’s down to 600,000. If you look at advanced technology IOLs, it’s only penetrated the market some 10, 12%. That should be up in the 20, 30% marker. Presbyopia, there’s really not a lot been happening in terms of actual, real, live outcomes. There’s stuff in the pipeline. So I think the market is huge. I think what you have to do if you’re in a big company, or even with investors, is come with a good game plan. You show them potential and growth, they’ll go for it.
TS: Tom Frinzi, the President of AMO, the newly appointed President of AMO, found himself on the Masters stage as well. And we also had a sit down with Tom Frinzi and the other representatives from the leaders in ophthalmology, and we’ll have those interviews on ois.net. But in this conversation, again, the question was what impact is consolidation having on innovation. And Tom brings a unique perspective, having been just recently the CEO of a startup, WaveTec, and having seen these ophthalmology world sort of from the startup view up. Now he’s at AMO, and he has a perspective looking down. So let’s hear what Tom has to say on consolidation and how it’s impacting innovation in ophthalmology.
Jim Mazzo: You have probably – I’m looking around. You’ve been in every stage of that, small, big, medium. So has consolidation hurt the industry?
Tom Frinzi: You know, first of all, I’d almost challenge: has it really consolidated? I think there’s been change of ownership, but you look across this dais, and it’s all the same companies that are still here. So I guess I challenge whether it’s really consolidated. But beyond that, no, I don’t think certainly for AMO, innovation hasn’t been stifled. Whether it was part of Allergan, whether it was stand alone or whether it was part of now Abbott, we’re proud of our pipeline. It’s probably the richest it’s been in its history, and we are looking forward to a steady cadence of innovation coming out. And I think over all three of our businesses, cataract, refractive and consumer eye health, because I think that’s a wonderful opportunity in terms of promoting ocular health. So I think innovation, this meeting proves it every 6 months when we gather. It’s alive and well, and it’s certainly alive and well in our organization. And I think from my own bias, I’m agnostic about where it comes from. Certainly, I’ve been part of the startup world, thanks to Bill, and we’ve had tremendous success. And I think big companies struggle sometimes with being able to be nimble enough to meet the needs of the marketplace. But I think there’s a healthy balance that you have to strike. And we do have a good internal program, but certainly we’re agnostic about if there’s good technology on the outside that can, as I said before, fit strategically and make a difference in terms of outcomes, we have to avail ourselves of that.
TS: OK, we’re going to take a quick break from this look back at OIS@ASCRS to just remind you to go to ois.net, not only to check out this great content, but also to sign up for the Eye On Innovation Newsletter and to check out information for OIS@ASRS. We’re putting together the agenda as we speak. It’s going to be August 8 in San Francisco. So go to ois.net. Now I had the pleasure of sitting down with the co-chairs of OIS, Gil Kliman, Bill Link and Emmett Cunningham to talk about the day: what were the high points, what they liked, and what their plans were for the future. So we’re going to just run the interview from start to finish. It’s also available on video form. We have that up on ois.net. But wanted to get it out to our Podcast listeners as well. It was a fun conversation, and something I hope we can repeat at future OIS’s. Let’s have a listen.
TS: This is Tom Salemi at OISTV for our debut sit down with the co-chairs. We’ll come up with a better name than that. But this is our opportunity to review our latest OIS@ASCRS and it’s the thirteenth OIS overall, and I think we’re debating as to which ASCRS –
Bill Link: Sixth.
TS: Sixth. So good job, gentlemen. It must be nice to – you’ve obviously worked on it through the months, and to see it sort of come to fruition and not have it set the hotel on fire must be pretty rewarding.
Gil Kliman: We just came up with all of it last night. So glad it worked out.
TS: Yeah. Who says cramming doesn’t work?
BL: Yeah, we got lucky again.
TS: But it started off great. I mean the breakfast breakout sessions; this is the second time we’ve done it. What do you think that adds to the agenda, Bill?
BL: You know, one of the things – first of all, we can have more topics and go a little deeper than we can if we go staccato through the presentation. And the other thing we’ve noticed is that we can get more of the leading docs to have their voice and their impact as well. So more key opinion leaders. So it’s a nice mix.
TS: And gentlemen, did you get to sit on yours and any feedback from the topics and from the attendees?
Emmett Cunningham: I think they were generally very well received. And we’ve always wrestled with whether to split the meeting into sessions or keep everyone together, and generally I think we’ve wanted to keep everyone together for the chemistry. And so this is a compromise that for now or we can let people go their own way and go into specific topics, deeper dives. But generally, we want everyone together as opposed to having tracks off in different parts of the hotel.
GK: It’s also nice to have the smaller format because we have such a large audience now of 500 plus. So to break it down a little bit, at least, in one segment.
BL: And it gives that chance for direct interaction and questions and interaction with the audience. So that one of the challenges we’ve faced is that we haven’t had a lot of – because of the size of the meeting, fortunately over 500 attendees this year –
TS: Good problem to have.
BL: A good problem to have. Is we’ve worked as planners and chairs for quite a number of times trying to think about how to interact more intimately with the audience. But it’s so big we can’t do it in the general session very well. And I think the breakfast sessions give a nice opportunity there.
TS: And Emmett, it sort of speaks to the strength of the OIS format that you were talking about earlier. It brings everyone together, kind of puts everyone on a level playing field. Do you see that being an extension –
Emmett Cunningham: I think, well, the question is why does everyone want to be together. I think it’s just a natural chemistry. It’s a natural union of the entrepreneur and the investor and the industrial or strategic partner. And it’s a place where everyone comes together, has this common goal of fostering innovation, and feels safe to do it. You know, it’s not the academic who walks into industry and feels like they’re out of place or vice versa, or the industry person who feels like they’re on the dark side or the venture capitalist is on the dark side in academics. Here, everyone is committed absolutely to that innovation. They come together and they feel great. And the other part of this, which also speaks to the breakfast, is just how much we have to cover and how active this space is. We’re now going to have a third meeting, and they’re all very, very popular because we have so much to cover. We could never even begin to touch most of what we’d like to touch if we just had the one day.
TS: And you’ve worked hard to keep it fresh. Gil, you brought a new element to the agenda, the WTF. And we can debate what it stands for. But overall we’re hearing –
BL: Luckily, we came up with something that was legitimate.
GK: That’s right. Well, it’s all –
BL: And we could say outside, What’s the future?
GK: What was fun for me being involved is when you came up with that idea, and I loved it. But I thought OK, what’s the signal that’s going to set? And then somebody came up with What’s the Future.
TS: That’s good.
GK: Sigh of relief. I thought OK, that works.
EC: Gil’s the only actually innovative venture capitalist up here.
BL: That’s true.
GK: That’s not true. Just an insomniac so I have more time to come up with these things. But no, it was really fun to be up there because I think one of the things we’ve been trying to do at OIS is to get more audience interaction. And so we played with different formats. And so it was really fun being on the podium and seeing the reaction of the audience initially to – just the expressions on their faces with some of these WTF companies. And then the actual polling. I was very surprised by many of the answers to the questions were not what I was expecting.
GK: So I was having a little WTF reaction up there myself that, wow, and we’ve got – it’s one thing I think we could cultivate more is we have incredibly rich audience of people with amazing experience. And to be able to get more input and interaction from them is something I think we’ll focus on in future meetings.
TS: And the glaucoma session that followed, I think this is a story you’ve been following at OIS for years, sort of the rise of the MIGS space. Emmett, you made a comment earlier, off camera, that this really speaks to the arrival of MIG.
EC: I had two senses when I was watching. So this is my tenth year in venture capital, and then my partners have been doing it much longer, and should add to this. But the first was that it was the first time that it crystalized for me just how impactful and important MIGS is going to be. It’s going to be totally disruptive because of that risk-benefit effort triangle that Ahmed talked about. There’s so little risk and so little effort, and you get the therapeutic benefit that it’s just going to – I think it will explode. And it sounds like it’s an overused term, but I think it will explode. And the other thing was, you know, when we live day to day in the trenches of this innovation, and we see how hard it is to raise money for these device companies in particular, you lose sight of the overarching arc of progress, right? And so you think Oh, devices are going away, or they’re not going to make it. And then you see this presentation and you understand that these device companies, which had such a hard time at points in their history, are poised to totally disrupt the space because of the perseverance. So if you persevere, it actually does come to an endgame which can be quite disruptive and different. That to me, that’s what I was thinking. I was like, Wow, I remember trying to get into Glaukos. I didn’t get into Glaukos. Thanks, Bill, very much.
BL: Sorry about that.
EC: That’s because we’re so close. And it had delays at the FDA and issues here and there.
BL: Yes, yeah.
EC: And now look at it. It’s really amazing.
TS: Well, you did get into Glaukos. I’m glad, Gil, you’re in between the two of them.
EC: Well, he’s in Glaukos but –
BL: And he’s between us.
TS: But you’ve seen MIGS rise as well. Do you hear –
GK: Yeah. Well, I think it’s part of a greater phenomenon that we’re trying to amplify here, which is market development and to accelerate in Asia. And in a lot of – I forget my physics, but I think the first law of motion is things are either at rest or moving in a straight line. And that’s not what innovation is about. Things have to be moving fast and doing left curves and so on. And so to the extent we can bring people together so they can see things that are coming over the horizon and then understand what they’re about, and then overcome some of their risk averseness, I think we can speed this up. It feels like this has happened a few different ways historically with OIS with MIGS, I think with femto cataract to some extent, and other areas that we focused on. And I think that’s pretty unique in ophthalmology is to bring people together in one space where the speed of innovation and adoption could actually be increased.
TS: Fantastic. And the day ended strongly with the Masters of the Universe panel. Jim Mazzo was having a good time up there, as he should. But there’s been a lot of shifts on the corporate level in ophthalmology, and the panel sort of reflected that. What was your takeaway from that?
BL: Well, a couple of things. What a privilege to have the leaders of the industry here, right? I mean carving time out of their immensely busy schedule, and join us at OIS. And to me that’s a signal of the impact and role that we play, and we have to take it seriously. We have to do it really well. And I think that commitment to doing things really well shows up in situations. So that’s kind of a general comment. And I think that what’s interesting to me about kind of the Masters panel, number one, Jim does a fabulous job. He has credibility and a sense of humor. And it becomes a conversation. It’s not all scripted, and so forth. And so we get, I think, more insight into each other and industry leaders than is typical overall. And I applaud the commitment that the leaders show in coming, and then being willing to interact in a somewhat spontaneous way. I think it just adds value. And sitting on that panel is like being a moderator and seeing the audience, right? It’s really informative to us. And it’s very gratifying to me when I can sit at the end of the day on a panel and see the room full, everybody quiet, nobody on the cell phone. They’re actually listening and engaged. To me, that’s the kind of engagement that we hope for and I think that format has worked.
EC: You’ve been a CEO a couple times, Bill. And so to me, again, as I sort of watch this, I was thinking if I were – what they may sort of find so attractive is that this is their one opportunity to directly connect with so many customers.
JM: And they actually see it and feel it. And that’s why I think they keep coming. Not because they have to or to appear. But I think they get that direct, immediate feedback.
BL: Yeah, good point. Yeah.
TS: Well, this was a successful and to a successful day. Anything we want to – closing comments on where OIS is headed? We’ve got a few exciting things happening this year. Obviously AAO is going to be big.
BL: Yeah. I want to say thank you to my colleagues and the team that helps put this together. And it’s amazing to play a role in facilitating innovation that helps people. And that’s what gets us here. And whether we’re an investor or an entrepreneur, an industry leader or a doc, that’s the common thread here. And again, Emmett’s idea, which was precious, and then I think with Gil and myself and Emmett and Craig and the team –
EC: Craig and the team, yeah.
BL: – we’ve gotten this to work pretty darn well. And shame on us if we don’t take advantage and take the responsibility of moving it forward. Emmett came up with yet another idea and more work, Ok, for us. What are you thinking, Emmett?
EC: Well, this is – I think you’re referring to the ASRS meeting which we’re now committed to do in August. It’ll be a half-day meeting to kick off. And again, it’s just that there’s so much activity an innovation in retina we can’t touch on it in just the one AAO meeting. And that’s not really addressed here. And so just at this meeting, I must have been, either directly or indirectly, five or six people who said I’m excited about that meeting.
BL: Right. Super.
EC: So I think people will go to – we hope people will go to it. And I know we’ll be there.
BL: Yeah. We’ll be there.
TS: Excellent. Well, thank you for your time today. Thank you for all the time you’ve put in on the conference. And thank you for giving me an opportunity to have this platform to really delve into the fascinating area of ophthalmology. It’s been a treat for me as well. So I look forward to OIS@ASRS. And I’ll learn to say that correctly. And thanks for joining us.
GK: Thank you.
BL: Very good.
TS: OK, that’s our quick wrap-up of OIS@ASCRS. Again, it was a wonderful day, jam-packed. Happy to have more than 500 folks there. Look forward to building on that if we can in the future. And of course, welcoming ASRS into the OIS family. Looking forward to that event coming up on August 8 in San Francisco. Thanks to everyone who attended and participated in last week’s OIS. Thank you, our listeners, for joining us on the OIS Podcast and don’t forget to go to ois.net for all the great content and more information about all of our upcoming OIS’s.