What nobody tells the inventor: Procurement is the Customer

I had a meeting recently with a company that advises medical device inventors on how to break into selling to NHS Trusts and wider healthcare markets. After discussing one of my new medical devices, explaining that feedback from clinicians had been extremely positive etc, she asked “Okay, but what does procurement think, as procurement is the customer?”

This was the first time I’d heard this straight up.  I suddenly realised I’d been thinking about my devices wrongly, I'd assumed the clinician was the customer.  If the clinician likes it, we’re onto something.  Obviously, it has to be priced somewhere appropriate, but clinical use for the patient is king?

But it seems in reality, especially with consumable single patient-use devices, that’s not quite how it works.  Clinicians might be the user, loving the idea, providing you with positive support even pushing for it when it’s available. However procurement is the gatekeeper for whether anything is actually purchased to benefit patients. 

Clinicians & procurement 

As an inventor from a clinical background developing medical devices, thoughts usually focus on the following:-

• Problem spotted is there a need, do I have a new solution to meet that need?

• Can staff use it, is it safe?

• Will clinicians want it?

  
  

You pick your councel wisely to seek advice about your new idea, but don’t blab about it to everyone who’ll listen, remember that’s rule number 1 in this game! If trusted, sensible fellow clinician’s say “yes, this works ”, that’s good feedback and just maybe you’re onto something, crack on, move forwards.

But here’s the kicker, it seems that nobody really tells the inventor that procurement (the customer) are thinking differently:

• What does it cost per unit?

• What does it replace?

• What’s the overall patient benefit & cost saving?

• Does it actually reduce overall spend anywhere?

• Can it be standardised across multiple sites?

• Does it create any extra handling, storage or training burden?

  
  

This is the uncomfortable truth for us inventors, a product can be clinically better than what’s out there or be brand new and filling that patient need gap. But the reality may be that sales just don’t happen. But why?

Designing without thinking about procurement is a huge mistake

This is the bit I think most inventors miss, I certainly did.

The genuine inventor designs inventions because they've spotted a problem.  It hits them and they feel it, it hit me feeling like a thunderbolt from the top of my head down through my body when I spotted the LEAFix problem. The problem affects the inventor, they can't let it go, it invades their mind, occupying their mind, pestering them. Anyone who's spotted a problem will know exactly what I describe here. The inventor may then do what most people never do, they think about solving the problem by inventing a solution.  However, what many of us don’t realise is that procurement is the customer. End customer product unit cost needs to be a major consideration in the design process:-

• Material choice

• Packaging

• Manufacturing process

• IP protection

• Regulation costs

• Margin expectations

  
  

All of the above, and more feed into what the final unit price will be.  But what will procurement pay, will they agree to buy at all??  This has to be the ultimate fundamental consideration.  Simple market research can help here, what are procurement willing to pay for such a device, will they buy?? 

Don’t make it an afterthought, I'm now baking these concepts into my new product design processes.

Looking back at LEAFix

When I reflect on my first device project LEAFix in tandem with a co-inventor, working with Innovation advisors & commercial partners I didn’t appreciate how dominant procurement decisions are in the real world, in terms of unit sales and adoption. It was never fully explained to me what this meant, how it could impact the product hitting the market and factors affecting potential sales. I was insistent on the selection of the particular LEAFix material & adhesive from a particular manufacturer used to create the product (incredible material btw, for patient care). However in hindsight I would have suggested analysing similar sister materials from the same manufacturer with the same adhesive, to possibly assure raw material supply and potentially sieve out costs to reduce end unit cost, without compromising function & device function.

It’s easy to blame “the NHS”: too simple?

When medical devices have been brought to market, meeting real clinical needs and benefiting both patients and healthcare workers, often procurement still don’t purchase them. This can lead to questions and frustrations being displayed by involved parties:-

• They don't see the value of improving patient care

• The NHS is slow to adopt innovation

• Current practice is harming patients

  
  

Sometimes that might feel true, but equally the products potentially have not been priced correctly for the market.

If a device is too expensive for what procurement expects in that category, cannot compete with the current practice pricing or if the cost structure has been driven up by material choices or margin expectations, then it’s not really fair to blame the system for not adopting it.

Maybe procurement aren’t ignoring innovation but making decisions within budgets that are already stretched?

My takeaway from that conversation

My thought’s on the design process of my medical device innovations have now altered, for example selection of materials must be meticulously scrutinised to squeeze out any end user costs possible in the manufacturing process, prior to MDR and production.

My advice to a budding inventor is to focus on end product cost figures, what will the price be? How does that compete with current practice, where can savings be made (including potential litigation from patient harm in current practice etc)? Push for these figures. Simple market research, a basic questionnaire can provide so much vital data.

A new product needs to tick procurements selection boxes to be adopted, and it seems end unit price in these times is a vital component. If a product is priced beyond what procurement sees as acceptable, adoption becomes difficult regardless of its clinical benefits.

With this newly gained knowledge I’ll adapt my designs accordingly and focus on materials and simplification going forward.  My niche is identifying and solving patient problems by designing single patient use, practical consumable medical devices. Clinicians might validate the idea but procurement decides (largely based on cost) whether it reaches a patient. Lesson learned.

I hope this information has helped somebody. Keep going!!