When I moved into cardiovascular recruitment, one area that was causing disruption was the Cardiac Transcatheter Valve business, particularly TAVI, which seemed to slowly be eating away at the Surgical Valve space. Like any ambitious Surgical Valve or Stent Sales Rep, I wanted in! I was attracted to the space due to the innovation, the excitement of working in and being associated with such a niche product segment and the financial rewards that came with it.
I have watched this market boom over the years and I appreciate the segment continues to grow, in part, due to the increase in number of patients with severe aortic stenosis. Take North America as an example:
The backlash to this growth is that small/ medium sized manufacturers are being snapped up by the bigger players; so, a “boom” may not necessarily translate to more jobs. Everyone familiar with the market is aware of the recent acquisition of Symetis by Boston Scientific and this is only one of a handful of acquisitions that have taken place over the last 5 years. Granted, this is probably due to the competitive nature of the market and M&As are a major component in successful business but we’ve even seen companies go bankrupt due to the ferocious competition within the space and the struggle to compete with the significantly high quality devices already currently flying off the shelves, devices such as Edwards Lifesciences’ Sapien line.
Common valves for Trancatheter Aortic Valve Implantation
So, a booming product segment doesn’t necessarily mean successful companies and it can mean that small, pioneering businesses in the sector are ripe for acquisition.
However, as TAVI continues its growth over the next 10 years as expected, what impact will this have on the number of available opportunities, and the wider job market, in the Transcatheter Valve space?
The acquisition of Symetis by Boston Scientific will no doubt have a very positive impact on the clinical community and, I presume, will allow hospitals to buy more of these products at a lower price but all companies, particularly bigger, corporate players will always look at streamlining operations in order to implement a more profitable business model. Usually, after an acquisition like this takes place the integrated employees are asked to leave, so bigger companies don't necessarily mean more jobs!
Earlier this year, Abbott Vascular finalised the buyout of St Jude Medical; this acquisition meant the coming together of two complimentary product portfolios, which in theory suggests that the acquired company’s staff should not need to worry about job losses. Unfortunately though, this hasn’t been the case; over the years, I’ve been in touch with hundreds of candidates post-merger who are all unsure about what the future holds for them within their new organisations and, as a result, ask me to confidentially assist them in looking for a new opportunity.
It’s not all bad though! From a recruitment perspective, there are definitely two sides to the coin. These acquisitions mean I have the opportunity to work with some of the top-class candidates that are looking for new work as a result of redundancies. The drawback however, is that there are less and less companies to network with in order to find these individuals a new position; it seems as the segment grows (due to patient/ clinical demand) the number of companies supplying to the space decreases, meaning less available positions.
Consequently, this limits the work I do in the space, which, like many of my candidates, has led me to exploring other innovative areas within the field. More recently, the TMVR segment has started to gain traction with companies such as Abbott (MitraClip), Cardiac Dimensions (Carillon) and NeoChord (DS1000) making names for themselves due to them being some of the first companies with CE mark.
The Innovative Carillon Device, Manufactured by Cardiac Dimensions
Similarly to TAVI, the TMVR market is set to grow dramatically over the next 5 years, reaching a value of ~$3Bn USD by 2022. I’d like to think that over the next few years, this has a direct correlation with the amount of companies receiving CE mark/ FDA approval and therefore looking to hire commercial teams as a consequence but, who knows. Maybe it’ll do what Renal Denervation did and flop, maybe it’ll be the next TAVI and mature after a few years.
The constant changing demands of the market makes it difficult to come to a conclusion however, from my time spent working in this field, it seems that “expansion” will often lead to commoditisation and large companies monopolising markets, as we’ve started to see with TAVI. This then could mean less jobs, but what is driving job creation and growth is innovation. The aforementioned TMVR, as well as even more advance technologies such as Transcatheter Tricuspid Valves & Structural Heart related Embolic Cerebral Protection will surely come tearing into the market in the not too distant future, bringing with them a whole variety of new positions!
I’d love to know what my network thinks on this topic. How have you seen the variety of opportunities change? What do you think will be the next big breakthrough in Structural Heart? Please leave your thoughts in the comments section below.