Rostislav Hartman, general manager of the Czech Republic for Zimmer Biomet and who also looks after numerous countries in a dynamic region in Eastern Europe, introduces Zimmer Biomet’s historical presence in the country and how the company continues to improve the quality of care for patients, in addition to improving efficiencies and clinical outcomes in the healthcare sector.
Comparing the Czech Republic with other markets in EE, I would say that the country provides a solid landscape for the introduction of new products and the latest developments
Rostislav, you have been a committed part of the Zimmer Biomet organization in the Czech Republic for over two decades. What keeps you so passionate about the Czech Republic’s medtech sphere and what would you highlight as a key milestone or achievement during this time?
The Czech medtech landscape is very interesting. I have been working for over 30 years in the healthcare sector, most of the time at Zimmer Biomet (ZB). At ZB, we have a mission to alleviate pain and improve the quality of life for people around the world. I feel strongly connected with that mission and I am happy to say I am passionate about this.
The Czech Republic is a part of Europe that underwent a lot of changes over the past 30 years. These countries were no longer under communist rule and started to build their democratic systems and environment. This change is also tightly connected with their healthcare sectors, as the economy plays a vital role in building up the system. Thanks to these developments and changes, ZB had a lot of projects in the region. We were establishing our presence in most of the markets and changing our business models to local scenarios to help serve patients better. I was responsible for a lot of these successful projects; I can declare them as my biggest achievement in the company.
How does the Czech Republic fit in the Eastern Europe region that ZB has established?
The Czech Republic is at ZB part of the Eastern European (EE) hub, which is a group of 18 markets spanning from the Baltics, through the Czech Republic, Slovakia, Hungary, Romania, and down to the Balkans and former Yugoslavia countries, including Malta, Cyprus and Gibraltar. This is quite a diverse region, with very small markets in terms of population size, but also some, like the Czech Republic, that have over ten million citizens. In these countries, there are varying levels of quality in the healthcare sector. They come together as there have similar levels of development and process. We can share experience and resources between them and can create synergies. The countries sizes allow for companies to achieve certain projects in the region. Out of these countries, the Czech Republic is one of the most mature, alongside Slovenia.
I will speak about our portfolio later, but we can say that our core business is knee and hip replacements. In this respect to differentiate the markets in the region, we use a coefficient to assess how many surgeries of both knee and hip replacements are done per 1000 population. This coefficient provides a benchmark to measure markets objectively. The number in the Czech Republic is three people per 1000. In countries like Romania, this stands at one, and in countries like Albania and Moldovia, it is even 0.3. This is a considerably lower penetration than the Czech Republic. However, the coefficient in Austria is 3.5. So, the Czech Republic is in the group of EE markets by far with the highest penetrations of such operations, however, there is still room to grow, looking Austria as an example.
Our products have a long history in the Czech market. We have been present in the country since the late nineties, so we are a well-known company alongside our products. In addition to this, we were the first company in the country to introduce innovative methods in orthopaedics, such as minimally invasive approaches or Patient Specific Instruments (PSI) for total knee replacement, allowing surgeons to make surgeries less invasive and helping hospitals to ensure more effective treatments.
Moreover, we are appreciated because of how we approach medical education for healthcare professionals (HCPs). As an example, in 2019 trained over 400 surgeons from the Czech Republic, approximately half of them were trained abroad. We invest a lot in this area, as we believe training is necessary and is part of the development of the orthopaedic area which we are committed to. When training is provided, surgeons can use our product the best way and can receive the best clinical outcomes and management of care. We have different kinds of training programs dedicated for junior as well as for senior surgeons We also supply training programs for nurses, as they are an important part of the overall management care process.
On top of our standard education courses, we also focus on modern digital educational technologies through interactive digital-learning platforms. Currently, we have over 300 Czech surgeons subscribed to our ZBI digital education portal. Surgeons can have access to online courses and surgeries, different kind of webinars, documents, and materials. Recently we expanded our portal by new modality so surgeons can also consult about their own difficult cases with respected Faculty members. We believe in these technologies, and the Czech Republic is at the forefront of them.
Can you introduce your product portfolio and how they compare in the Czech Republic?
ZB is no longer a company that sells implants. We also offer solutions for surgeons and hospitals performing surgeries. Our product portfolio can be broken down into three big categories. Firstly, RECON, which includes our knee and hip replacement products. Second, SET, which stands for Sports medicines, Extremities, and Trauma. Then, we have CMFT and spine products. These three groups are connected under the umbrella of ZB Connect, where we provide all kinds of solutions that connect these implants, including robotic platforms and another digital technologies, such as our “mymobility” application.
Speaking about robotic platforms we have ROSA brain, which is a robotic device for neurological operations that help surgeons to plan and perform surgeries in a minimally invasive way; and ROSA knee, which is used for total knee replacements Rosa Knee technology enables a personalized surgical plan based on each patient’s individual bone and soft tissue anatomy prior to the total knee arthroplasty. During surgery, it is also possible to adjust that plan based on the knee anatomy and soft tissues in real-time. These are our latest innovative solutions that complement ZB’s products, that we did not have before. We are very enthusiastic that we can offer these solutions to our customers locally.
Another program we offer under ZB Connect is so-called Rapid Recovery program, which is a comprehensive program helping hospitals to find the most effective way to run the overall patient procedure journey. Rapid Recovery optimizes the quality of care for the patient throughout the process including pre-operative and post-operative period to achieve the best clinical outcomes with higher efficiency.
Looking at our local footprint, ZB is the market leader in our areas. The range of our portfolio is wide, we are a respectable partner for the country’s key stakeholders. We are important for them and I believe we have a lot to offer the country’s healthcare sector. ZB is also a member of the CzechMed, the local medical devices association. This enables us to remain in close dialogue with the regulatory body the State Institute for Drug Control (SUKL), health insurers, and the hospital managers and surgeons. In the past, our customer was only the surgeon, which has now expanded. All of the stakeholders are our partners and we always aim to find solutions for all of them.
How would you asses the evolution of the market access landscape here for medical devices, especially in the last recent years?
Comparing the Czech Republic with other markets in EE, I would say that the country provides a solid landscape for the introduction of new products and the latest developments. At the same time, companies are forced to discuss a working price plan. I would caution that it is not always easy to argue the benefits of our innovations and we closely work with evidence-based medicine data
We are communicating with the hospitals, as they are making way for new technologies or innovations and saving space in their budgets for them. The majority of them realize the importance of innovation, so we have room to communicate the benefits of our products. We have data and information behind our product when we explain to management and surgeons. This is a discussion across healthcare professionals, administrators, and the owners of hospitals who are all making the final decisions.
We are showing this information as well to the regulatory authorities, including SUKL and the insurance companies. However, there is less transparency within the medical device segment for their decision-making process, so sometimes our communications get lost within their system, let’s say. We continue to lobby through CzechMed that there should be one system in place for pricing and reimbursement of medical devices, no matter what their categorization.
ZB recently introduced the unique digital platform mymobility™, to connect patients with their surgical teams throughout their entire episode of care. How would you assess the Czech Republic’s openness to these digital technologies?
The Czech Republic is pioneering in introducing digital technologies. When I speak about EE markets, the Czech Republic was always a pilot country where we introduced these technologies first and then shared our experiences with other countries before expanding.
mymobility™ is a mobile phone application for the patient that walks them through their journey of care, intending to have a better clinical result. It also connects patients more closely with their surgeon pre- and post-operation. We are enthusiastic about this platform and plan to introduce this application mid-2020.
Do you think the Czech Republic can “Close the Gap” on Europe?
I would say that looking at the developments of our neighbours is in our nature; we always want to be better. We are an ambitious country and have good local conditions to continue growing. I am optimistic that we will continue to develop, and ZB is committed to being a part of these changes.
The healthcare sector, in general, is undergoing big changes. Looking only at the Czech Republic, although we have a solid system now, it will be challenged, especially by an ageing population. Many question whether the system will remain sustainable in the long-term and if patients will continue to have access to innovation. If the system does not adapt, it will not be able to offer high-quality services to the Czechs.
This is the main issue for all key stakeholders, including the industry. ZB has always been a driver of change, specifically in the orthopaedic field. We take responsibility that we should help to change the system now, and we are committed to that. Also, we should consider that patients are different than 20 years ago. They are now a customer and more demanding. All health care stakeholders should realize this, to ensure patients get the best possible care and meet their expectations.
When your CEO Bryan Hansen joined the company at the start of 2018, he drafted a new “One Zimmer Biomet” corporate mission, as it was felt that this was a vital step toward rebuilding trust and a sense of shared purpose across the organization. How have you implemented this vision at a local level?
We have changed a lot since our new CEO was appointed, in addition to the arrival of our new EMEA president Didier Deltort. Since then, we started a lot of projects with many more to be kicked off. Our corporation shows a big dedication and focus on our region – confirmation that the strategy is the creation of a separate EMEA region called “Emerging Region” – where the Czech Republic plays an important role.
Geographically, we will look at every single country within the EE region to find the best market model. Internally, with our team members we are expanding our company mission, which is to alleviate pain and improve quality of life for patients all over the world. This is my commitment and commitment of all team members in the Czech Republic.