How to Expand a Market Using a Direct to Consumer Strategy

Written By Patrick Kothe
 
 
 
 

Kevin Hardage is President and General Manager at Teleflex Interventional Urology. They’re treating a common problem males face as we age - Benign Prostatic Hyperplasia, or BPH. Their minimally invasive treatment provides relief for patients, and an effective way for physicians to better treat the disease.  In this Episode Kevin shares the issues with BPH, educating physicians who use the product, direct to consumer marketing, metrics and objectives within DTC, how to involve referring physicians, and team development.

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Episode Transcript

This transcript was generated using an automated transcription service and is minimally edited. Please forgive the mistakes contained within it.

Patrick Kothe 00:31

Welcome! Most of us know how to enter a known market and take market share. But creating a new category is a completely different animal and medical device, we usually have relatively small sales forces. And we're focused on the clinicians that use our products and also supply chain GPO and IDN folks that facilitate the purchasing process. What do we do when we have to educate the patients and also a huge referral base? Well, that's one of the topics we're going to tackle today. Also, if you're a man, or have a man in your life, you need to listen to this one because the problem we're going to discuss is most likely going to impact you. And you should educate yourself on the available options. Our guest today is Kevin Hardage, President and General Manager at Teleflex Interventional Urology. They're treating a common problem males face as we age, benign prostatic hyperplasia, or BPH. Their minimally invasive treatment provides relief for patients. But getting the word out to the public is a challenge. But it's key to expanding the market size. In our conversation, we discussed the problem that is BPH, educating the physicians the use of product, direct to consumer marketing, metrics and objectives within DTC how to involve referring physicians and team development. Here's our conversation. Kevin, you spent the first three years of your career at Hyatt Hotels and ADP before a very successful 23 year stint in sales and marketing at Covidien, which was eventually acquired by Medtronic. What made you choose medical device?

Kevin Hardage 02:38

Yeah, thanks, Pat. I got to say medical device for me, it might have been part in the family and in the blood and part just the calling there with regards to just having a more meaningful career when it comes to helping helping community and I my dad was a head of sales for many years growing up. And actually in the med device sector, he led a number of different businesses within the Cordis family of products way back when and it grew on me. And it was something that I eventually steered my career towards. But yeah, it's been a fun, very wild and successful ride so far.

Patrick Kothe 03:17

Well, it's interesting, some of us in our careers, we, we follow our parents, and some of us we run away from our parents, and it sounds like you followed your your dad, and specifically into into sales and marketing. So what is it about sales and marketing that, that excites you,

Kevin Hardage 03:34

I've always loved the cause and effect of things and the ability to see things through. And I always felt like just being in sales, I was I was leaving off a piece of the overall commercial process and following, you know, following, you know, from concept all the way to sell whatever technology and business you're building and, and vice versa. On the marketing side, you always felt a little bit removed from that day to day connection with the customer, at least as compared to what the sales reps go through. So it was that kind of healthy, elastic, you know, elasticity between the two that that really, you know, brought those two areas together for me. And I think that's why ultimately, the managed kind of the general management and President roles. Were always the the ultimate kind of connection point getting to see the entire process through and having having a voice in the process and always leaning on the importance of what a customer's voice can do for your business, whether it's good or whether it's a challenging comment that you've got to react to.

Patrick Kothe 04:40

So like you I've got a background I've got roughly a third of my career is in sales, a third in marketing, and our third is as CEO. I've got preference between sales and marketing. Do you have a preference if you're going to only get to choose one, sales or marketing? What would it be?

Kevin Hardage 04:58

Well, I'm not I'm not playing too. To the to least, the audience that's largest in my organization. But I do have to say, carrying the bag, and probably being a region sales manager was always built in that job for me. Again, having the ability to run your business the way you saw fit, tap into the matrix, you know, starting my early days with Covidien and the ability to lean on different cross functional resources to help you deliver what your customer is asking for. And, and again, getting back to being on the front end of the spear as far as the day to day engagement with our customers, whether it's orthopedic surgery, or now in the urology space. That's, that's the most fun for me. And that's probably why I enjoy getting in the field as much as I can.

Patrick Kothe 05:46

So after 23, very successful years with Medtronic, you decided to leave one of the most successful companies in our space, a largest largest company owner in our space for a new challenge. What was it about the new challenge that made you move into a into a new company?

Kevin Hardage 06:09

Yeah, that's, that's the ultimate question, Pat, I appreciate you asking it. Because, to be honest, I was extremely happy at Medtronic, my Covidien days and then eventually my Medtronic days, the opportunity to grow my career. Medtronic gave me so many opportunities to expand roles and responsibilities and experience skill sets that I wouldn't have gotten anywhere else to my at least from my opinion, and the ability to kind of grow up in that organization and take on new challenges, and ultimately, help build other careers to be a part of that was always a draw for me. So I never saw myself leaving Medtronic. It was a little bit of timing, and also, the opportunity that presented itself. I you know, the great thing about Medtronic is many people come and go. And we had a number of colleagues over the years that left for different organizations. And one in particular was Teleflex, where I had a number of colleagues head there many years ago. And we kept in touch and they shared their experiences. And they always refer to it as is kind of a small version of what Covidien was like, growth through acquisition and building enterprises. And having the ability to really be on the on the the front end of things and make decisions and be accountable to those decisions as you were building those enterprises. And it always was interesting to me, because I missed some of those experiences as we got bigger within Medtronic, but it wasn't until Teleflex acquired a company referred to as Neo Trac, that acquisition took place in, you know, roughly 2018, I believe, and I heard about Nia Trek and heard about the Euro lift technology and their unique business proposition and what they were solving from a patient condition perspective, but didn't think a lot of it until, you know, the two areas came together. Back to that timing perspective. You know, we had just gotten through COVID. And we had just started to I started to transition into a different business within surgical or within Medtronic referred to as the surgical innovations business. And during that transition, a former Teleflex, or former Medtronic colleague at Teleflex, reached out and just mentioned that we've got an opening at the leadership position within this new business, we acquired Nia track, and it's, it's got all the aspects of what we've talked about Kevin, you know, looking to market development, you know, build a new enterprise solving a condition that has been a challenge for probably 40 plus years with no real innovation to it in the form of BPH benign prostatic hyperplasia. And we feel like you would be kind of a perfect fit with your experiences and what kind of excites you and, and gets you up in the morning. So researched a ton talked to a number of people within the urology space, which is an area I didn't have experience in and ultimately made the decision to take that plunge. I think the timing was great. Medtronic was looking through a lot of change within their surgical enterprise. And I felt like it was a good time to hand that over to the next in line there and instead out and take on a new challenge.

Patrick Kothe 09:29

So Kevin, when you moved over, where were were they with the product, was it in development? Was it approved at that point, where was it? From development standpoint,

Kevin Hardage 09:41

if you take a step back and maybe just a little color on it, a couple of founders by the name of Ted Lampson and Joe Cantonese, back in really 2004 forms knee attrack when they created a technology called Euro lift that is also referred to an industry is a prostate or urethra. A lift or pull technology in it, it was the first of its kind, but it took a long time to eventually get to market. And they started from the beginning with significant investment in research, making sure there was a wealth of clinical data behind it. And ultimately, really, slowly ramped the technology up starting in Australia, and then eventually making its way to the US. And this technology. If you if you look at the whole BPH market landscape today, which, which is a condition where you know, men roughly 45 years or older start to, you know, their prostate starts to grow and obstruction forms with regards to your urethra, which ultimately creates a problem where patients are getting up through the night, or men are getting up through the night, having to go to the bathroom multiple times. And it's a very inconvenient condition. And a lot of times can lead to chronic conditions, whether it's bladder health challenges, and ultimately leading to maybe permanent catheter isation. Over time, once you get a lot older, so early intervention is the key here. And this technology was the first of its kind in that it could basically displace what was common in industry today to treat that, whether it's drug therapy, which is problematic for all the symptoms associated with drug therapy, or there was another procedure that had been around for 40 years, which was referred to as turret. And this is basically a technology that I often call the roto Rooter, that people would get. And that's a very, not only a lot of complications associated with it can be painful, can cause hospital length of stay, leading complications. But ultimately, it's not something men are looking to proactively go in and have done. So as a result. The the your, your lift technology allows for a very easy minimally invasive procedure that you can either do in the office under local or within the hospital in general, but you have a lot of flexibility there. And it also appeals to I think, a broader audience, because patients are looking to maintain their sexual function, you know, whether you're 4555, or even 75. And this is a technology that allows for that. So there's a lot of different aspects that made this unique. And something that was disruptive to this space, it was just a matter of how do we create the awareness. So really, you know, 2015, to now is when it's really started to ramp up and hit the market. And that's where I come in, you know, in 2020 21, had the opportunity to take the lead here and, and really pick up where Ted and Joe left off with regards to developing this. And we could speak to that. But it's been a it's been interesting coming out of COVID at a time such as this, but it's also been the most rewarding from overcoming adversity, when you look at the many different challenges in the urology space, but also in healthcare as a whole.

Patrick Kothe 13:09

So if I have it correctly, then the product was was approved sales had begun before you got there. And you were you joined the team to help expand, expand those sales.

Kevin Hardage 13:23

Yeah, that's right. That's right. Just to give you a perspective on that today, the market is made up of about 14 million men that are suffering from BPH, but only 2% actually get a procedure done, whether it's your left, or whether it's the term that I referred to earlier. So it's very untapped. And it's been 2% penetrated from a procedure standpoint for the last few years. So that's, I think, you know, transitioning to your question of where I come in the opportunity to really look at how do you expand the pie? How do you expand the procedure side, knowing that more than half of those 14 million patients, their solution is simply either watchful waiting or drug therapy, and not doing anything and just sitting idle and dealing with the complications of what comes with that. So how do you expand the pie, both through our commercial organization, but also through a pretty targeted clinical research investment? To ensure that we're tapping into things like how do how does your lift compared to drug therapy in the ongoing research there? Or how does it compare to watchful waiting? By doing nothing over time? Do you see complications as a result of that? So that's one aspect of it. And then also, you know, we know that you know, a little little more than a third of the 10,000 urologist in the US today are currently trained to do the airlift procedure. There's still a large untapped market there with regards to surgeons that haven't taken this this this skill On yet, so the ability to partner with the surgeons and how they develop their practice, both from, you know, setting up the airlift procedure, partnering with them on how they might market their the procedure in their local markets. And then, you know, the other piece to this is making sure that we're providing air cover from a direct to consumer perspective and an offering up indirectly, through just market awareness campaigns both digitally, as well as from an advertisement perspective on TV, educational campaigns, which I'm sure you or others have seen seen out there, we refer to it as a pitstop campaign.

Patrick Kothe 15:39

So let's go back for a second, the prostate, when many people think of prostate, prostate cancer is prominent in those thoughts. What does a patient journey look like? They've got some symptoms that are going on, and from what I understand the symptoms of prostate cancer and BPH are similar. Is that correct?

Kevin Hardage 16:01

Well, it maybe even, maybe even make it simpler. A lot of times patients, yes, they'll measure PSA levels. But a lot of times, when they go into the office, the first thing a urologist will do, or his office staff will do is have have the patient fill out a survey. And it's a simple survey referred to as IPSs, or international prostate symptom score survey. And it's it's a, it's a series of questions that basically ask them how they're feeling, what's their quality of life like, and ultimately, what it spits out is a symptom score that tells the patient and the physician to work together on either you've got an obstruction or a potential obstruction. And ultimately, you need to take action. And it's a way to get the patient's attention and ask, you know, certain questions to lead them down whatever their care pathway journey is. So there could be a decision point to ultimately have a procedure, or it, it'll for sure lead them to the next step, potentially, which is either that physician is going to say, there's a certain drug therapy regimen we're going to put you on, or it's time to do what they refer to as a Cystoscopy. It's a little more invasive, it's a scope that goes in your urethra, and they ultimately evaluate both the bladder and the urethra to determine if if you've got BPH and that, you know, then you you're kind of working down the care pathway from there.

Patrick Kothe 17:30

So you mentioned several challenges, the challenge of educating, urologists, the challenge of educating patients, the challenge of expanding the market, in general, let's take those kind of one at a time. And let's start off talking about educating the physicians. What are the challenges there? What Why have only a certain number of urologists adopted the technique?

Kevin Hardage 18:02

Yeah, it's a great question. So when we wrangle with quite a bit, and to get to the answer, you kind of have to look at kind of pre COVID, post COVID. Post COVID. As we all know, there were the you know, many challenges that came with that. Ultimately, eventually, staffing challenges, there was a effect on patients prioritizing their life. So quality of lives, something that they're willing to take action on are not elective procedures or not. So the ability for a patient to take the time, especially when you're talking about men, look, we're being men, we know the last thing we want to do is go make a call and schedule an appointment with a doc, especially for something that either may be not as common to them, or maybe they don't understand as well. And a lot of times those patients when they finally do make the call, they go in and see their primary care as opposed to I'm going to pick up the phone and call a urologist specifically. So a big challenge, whether it's COVID or not COVID Is the patient finding their way to the urologist? That's one part of it. The other part of it is when you look at the urologist today in the US, there's roughly 10,000 urologist out there in the US and out of those 10,000. A third of them are 65 years or older. So for the last few years, we've seen an influx of urologist retiring at a pretty fast rate to the point where a lot of the patient throughput has been compromised. You have a number of priorities that these urology practices are dealing with BPH is just one of them. Maybe we're talking about prostate cancer, maybe we're talking about kidney stones, it depends on the condition and where the surgeon focuses their procedure time. And ultimately, now you've reduced the amount of surgeons out there. So we've seen over the last three three to four years, a real challenge with patients finding their way to the right urologists, but also actually getting to procedure just because of the increased length of time it takes to get diagnostics and eventually get a procedure. So part of its the delay process in the health care model today based on what I just described. And then the other part of it is patients taking action and knowing where to take that action to. And that's where we come in with some of the different initiatives, we have to really connect those dots for that patient.

Patrick Kothe 20:36

So let's let's start with the patient because you just kind of describe the journey, and it ends up at the neurologist, but it doesn't start at the neurologists. So a patient hit is is experiencing symptoms, what symptoms would be primary symptoms for BPH?

Kevin Hardage 20:54

Yeah, the primary symptoms would be, this is the most common, they get up maybe three to six times in the middle of the night, to go to the bathroom. The inability to empty their bladder is the big challenge that comes with BPH. And they refer to the symptom being lower urinary tract symptoms. So lots is the common term used within Urology. And it's, it's a big challenge, whether it's a dad taking his kid to a baseball game, and having to get up multiple times to hit the restroom, whether it's someone commuting to work, and having to stop multiple times along the way, in traffic to find a restroom. There's a number of men that that really suffer with this, but those are the more common examples of what symptoms look like. And, and a lot of times for men, it takes until it becomes unbearable, that they take action. And a lot of times that can be at a point where it's getting to a point of being too late. So bringing more of the younger patient, the patient that maybe has seen early onset BPH at age 50, or 60, for that matter, because if you look at people getting treated today, just take your lift as an example, the average age of a your lift procedure or patient is seven years of age. But we know data tells us that they're experiencing those symptoms way earlier than that.

Patrick Kothe 22:23

I saw statistics, that 51 to 60 year olds, the percentage of men with BPH is 50%. From 60 to 69, it's 70% and 70. Plus, it's 80%. Those are huge numbers. So when we talk about expanding that pie, it's these people that have have the symptoms. So so they they are getting up three, four or five times a night, there's an issue, they typically will not go to the urologist, they'll typically typically go to their primary care physician at that point, how educated are the primary care physicians and is that one of your one of your potential education opportunities.

Kevin Hardage 23:12

That's probably the biggest opportunity when we think about patients being kind of locked up to a primary care and maybe not finding their way they continue to maybe spin, they're on the spin cycle of drug therapy, a lot of times with primary care knows that they can maybe they prescribe tamsulosin. It's an alpha blocker as a starting point. And, and they just kind of get on this drug therapy train. And a lot of times, that's fine or 30 to 40% of the time, that patient, after just a few short months, drops their drug therapy regime. And then they just have a patient fall out. They don't they don't get back on the care path journey. So we know that the primary care definitely can do more. And that's a big opportunity for us when we think about how we direct our marketing efforts, whether it's direct to consumer through advertisement, as well as the digital efforts. But also how do we create that bridge, that partnership between the urologist and the primary care that's in their network so that they can stay in that kind of closed loop approach. We utilize our clinical team in those areas to try to bridge the gap through different health network talks. But also, our sales teams are helping to facilitate and bridging those conversations. But we know it can all happen through one kind of lever. It's a it's definitely a multifaceted approach that we have to come at it with a pretty significant investment to help make that work.

Patrick Kothe 24:46

So how did you develop the strategy for doing this? What were what were the key learnings that you had to say, you know, we need to attack this and we're going to put the resources as you said it's a signal Forget the amount of resources but also multi resources that you need to need to put together. How did you understand the process, and then put the put the strategies in place to be able to affect change?

Kevin Hardage 25:17

Well, it's first I will say we haven't solved for a yet because back to what I said earlier, we're 2% penetrated, we've got a long way to go. We have made incremental steps for sure. And like any good business, you inspect what you expect, I will say, out of all my years of Medtronic, I've never seen better management of data analytics than in the interventional urology business I'm in today, we have a wealth of expertise when it comes to pulling the data together and mining it, and ultimately drawing conclusions from it on how we direct our resource investments. But ultimately, we've got a long way to go. And whether it's using claims data, or third party data, we're constantly on a monthly basis revisiting how are we influencing and steering, the consumer sentiment, and ultimately taking that action. We also have set up a website, or website today, your lift.com enables us to really track our progress made, for example, when a when advertisements go out on TV, you're watching the Yellowstone TV series on Pyrmont. We advertise there, and you can see a direct correlation to website visits, the minute those ad campaigns err, we follow the patients through that that internet, or website care pathway. Last year, I think we did about two and a half million patient visits through our website 350,000 of those 2.5 million visits, those patients took action and actually filled out an IPSs survey. And then that triggered ultimately them taking action to find a physician. And we have the ability to help physician or help patients find the best physicians within their territory so that they can obviously get the procedure done but but also get it done by the best of the best based on what we refer to as Center of Excellence sites. These are surgeons that have done the most your lifts out of others. And obviously, you're demonstrating great results. So there's a lot of different ways we get at that to your question. But measuring that and constantly refining our strategy around that is is something we spend a lot of time on.

Patrick Kothe 27:39

The pharmaceutical industry has great history with direct to consumer advertising, not so much with medical device. It's been kind of spotty with with effectiveness within medical device. How did you guys approach that knowing that you didn't have a whole lot of experience? Is it something that you did inside? Did you bring in consultants to do it? How did you approach that?

Kevin Hardage 28:07

Yeah, I'll give a lot of credit. To a few folks on our marketing team. Tom pan shack who leads our DTC efforts within our marketing department brought those expertise over from his time at j&j, actually, from the pharmaceutical realm. And they started the audit, we started our first campaign right before I walked in the door in 2020. It was a test it was we knew it, it worked in the pharmaceutical industry. Obviously, we're all inundated with pharmaceutical advertising. And we knew that this type of condition, required a response and it was going to require men to take action. And we knew men don't like to visit doctor. So we had to give some extra, some extra firepower behind creating that, that that change in their day to day. So it was a test and we slowly ramped it up over time from 2020 all the way to this year. We've revamped our campaign based on some of the market testing. So this year we launched our new pitstop campaign that's trying to go a little bit to that earlier intervention audience when we think about bringing in someone younger than 70 years of age, and like I said earlier, we continually measure it. We do use an outside service to tell us how is the urolift brand awareness increasing? Is it increasing? To that point in 2022, we saw a 20% increase in the male audience brand awareness. We also constantly survey our physicians nearly 60% of have the audience that that viewed a TV ad took action and and made a visit to the neurologist based on urology, serve A work that tells us 60% of the time, you know, they're referencing your lift by name. So there's a lot of ways to triangulate that. But those are a few examples. And we're never going to be at the scale of pharmaceuticals. That's not our goal. It's it's definitely a multi pronged approach. And this is just one piece of that. But we do know that we have increased the throughput. And we've definitely increased the overall number of those 14 million men that are taking action. And that's most important, and if it if it goes to from 2% penetration of getting the procedure to three or 4%. That's significant. And candidly, I think in today's environment, where you have less urologist, having the ability to take on more procedures, we feel like that would be a massive increase. And both from a business perspective, but also our effect on improving outcomes side of it, and we'd be really happy with that.

Patrick Kothe 31:00

Well, targeting is is really important in this space, because by definition your product is is is only dealing with half the population. It's just males, not females, and then it's plus 50. That really, you're targeting. So you can't really do broad advertising and you would spend a tremendous amount of money. If you weren't if you weren't really microtargeting, some of these things. The other thing that you mentioned was the difference between an awareness campaign and an action campaign. And awareness is is one thing, it's kind of a broad thing. And that's one thing to measure. But are they taking action? That's probably I don't want to put words in your mouth. But of those two, when you're doing the DTC advertising. Are you more focusing on the awareness side? Are you more focusing on the action side?

Kevin Hardage 31:57

Well, in a perfect world, we would do both, I would say we have better, we have better visibility, to measure awareness than we do taking action. There's different ways that we've been able to draw an indirect conclusion on the awareness turning to action. But that's an area that's a blind spot for us in large part and where we have to take, you know, some assumptions. It talked about the the many resources we're investing here. This is not just a unique us problem, as you can imagine 14 million patients in the US but there's close to 100 million men suffering from BPH worldwide, we've had to be really smart about how we allocate our resources and approach and target in your words, those right markets, where we have the ability to build market access and partner with societies, in government. In specific countries where we know, there's an opportunity such as Japan, where we recently launched last year after getting reimbursement established, and that market is taking off from a growth perspective. And we've definitely tapped into a market where there was a big need. And those those type of kind of playbook approaches taking what worked in the US customizing it to the unique market needs. And applying it in each of these countries where we see our biggest opportunity to drive awareness and impact is something that our team is spending a lot of time on. And, and again, it goes back to how do we budget imbalance priorities and investments to ensure we're making a difference.

Patrick Kothe 33:37

So kind of going back to a funnel, so to speak, you've got 10,000, and us 10,000 People that are potential customers for using your device, but they're not going to get there. Unless the top of the funnel knows you've got the patient, then the primary care physician then going into the specialist, primary care physician is an extremely important group. But there's I don't know how many 100,000 I don't know how many primary care physicians there are out there. But there's a lot, a lot more than than the 10,000, which feed into the into those 10,000. So you need to make changes in their practice and educate in their practice. And you can do that a couple of ways. You can go directly at them or you can enable your 10,000 to educate them. And it becomes kind of starkly that's that's worked in other industries, where the specialist is educating their refers into this. How do you get at those primary care physicians and are you using the urologist to help to educate that market?

Kevin Hardage 34:53

Yeah, I mean, well, first of all, we have to solicit the neurologist to help them help them so ofs This is not something we can do alone. There's a number of ways we can get out for one, the importance of partnering with industry and society. So we're very much partnering with the AQa American urology association to ensure as they are the leaders in creating that awareness, not just within urology, but they have the same problem statement of how do we how do we unlock the the opportunity for those patients, you know, with with their primary care? So there's many initiatives through research through educational programs that we partner with a QA and then at the field level, your question is a good one, like how many, how many primary cares are there in the in the US, I would say, total full time, primary cares is on the magnitude of over 250,000 In the US, next to 10,000. Neurologists. So I'm not driving my sellers to the primary care, that would be a significant waste of time. That's like trying to compete with pharmaceuticals on DTC and try to scale our button, it's just not an option. So we have to be smarter, we have to look at it from the earlier comments around how do we ensure our urologists and also a more commonly used resource in the urology practices, the Advanced Practice provider, the a PPS, these are Physician Assistant nurse assistants that that are that are geared towards specialization within the urology practices to help both the care pathway and also a lot of times can be advocates and voices in and helping the educational process. So whether it's the patients, or doing health talks in in joint efforts within communities with both the neurologist and members of their practice, like the HPPs, in partnership with local primary cares to talk through the care pathway and to educate these primary care. So they understand the challenges with prescribing drugs on a continual basis. But also the challenges of letting BPH continue to, you know, escalate over time, as a patient goes from 50 to 70. Their bladder doesn't operate the same way it did before, when they were 50. A lot of times, just like a heart is a muscle, the bladder is a muscle and you can have chronic challenges. And ultimately, that patient could potentially have incontinence challenges and have a permanent catheter the rest of their life. So making sure primary care is is on the front end of that educated and making sure they know where to send their patients. And that's where many of those health talks partnership with industry like a UA, and also, our direct consumer work is really geared towards that that drug therapy patient.

Patrick Kothe 37:59

Kevin, is this the first time that you've really had to go after this DTC component. And this, this funnel component to primary care is this the first time you've really had to go to it at this level?

Kevin Hardage 38:11

Well, I will say, if I'm being truthful, this organization, there was so much opportunity right out of the gates with the existing patients that were with what they were at their limits. That's why our average age is 70, that market is still still a large market. And while yes, there's more competitors entering the BPH space, your lift is still set aside as a unique offering that that allows for a patient to take action easier, have less challenges and complications post procedure and and ultimately access the procedure and any site of service, whether it be hospital ASC or office. So still in a really strong space there. And that's why our sweet spot is still that older patient. So the business hasn't taken hasn't really swung for the fences with regards to the drug therapy patient. And I feel like that is where our biggest and next frontier is. So I would say we're early stages there. This is something in the last few years we've really gotten serious about and our actions as it relates to results will start to show up over the next say three to five years.

Patrick Kothe 39:28

That's a really interesting way to put it because you're focusing on immediate wins. And then focus you need to you need to have some focus on the immediate wins. But you also need to focus on the big picture and the big picture is is you know what your predecessor or what your successor is going to be interested in five 810 years down the road. You know what, what seeds Did you plant to be able to make the market explode?

Kevin Hardage 39:57

Yeah, absolutely. And if I leave this If I were to win the lottery and retire in the next year or two, don't expect it, but if it happened, yeah, my my legacy and our team's legacy, hopefully is around the ability to tap into those patients that are stuck in the drug therapy world and not not getting the education they deserve. And obviously, the solution that they need. That's a big piece of it. And I think also, it's absolutely fundamental to the growth of our businesses, the globalization of your lift in our ability to transform many markets outside of the US, because like I said, it's 100 million patients that are suffering across many different developed markets with good health care, foundation, and market access opportunities, we just have to bring those two together. And I think our success is really dependent on the ability to partner with, with our teams across these different countries, and also to scale up investments around resources to support those those teams and driving that really important education that's needed.

Patrick Kothe 41:12

Kevin, you mentioned teams several times there and called out a couple of people specifically, none of our strategies work without without teams, you grew up in a Medtronic culture for a long period of time. And then you moved into into another culture, and Teleflex as a company has its own culture, but a division within a company is got its own culture, too. So let's talk a little bit about team building and culture. And what your transition was, when you moved from something that you know, that was you for 23 years, and then moving into something else. What was that, like?

Kevin Hardage 41:52

Look, when I walked in the door a couple of years ago, in fact, two years ago, this month, there was the business was at an inflection point, there were definitely a number of team members, especially when you look at our commercial organization and sales, where we had a specific hiring profile. To start this business, which evolved a bit when this business started, we needed we needed a startup minded seller, someone who typically from a profile perspective, spends three to five years in a business and then moves to the next and their job was really to, to come in and help develop this market help create the educational tools help, you know, develop the care pathway and profile for your lift to take off. At the same time. As I walked in, we were going through that place where these some of these reps, some of these sellers had had already kind of hit those milestones, and we're looking for the next big challenge. So I was coming in looking to build a business to look at this, this urology space is an opportunity to expand our position in the market when we look at your lift, and more importantly, when we look at broadening our position within urology, and especially BPH. So looking at the whole care pathway, how do we influence and an innovate on the diagnostic side all the way through the process to the endpoint of the procedure side, and everything in there between. So our goal is to make sure we've got the right people on the bus, but people that are looking to, to really build a career and a sustainable career, not just within interventional urology, but potentially across Teleflex. So within that timeframe of coming in, it was really important we transitioned our profile to to take both the benefits of people that that still carry the fire for your left that wanted to finish what they started, and then compliment them on hiring new reps into the organization and across really our entire commercial organization, that we're looking to build careers. They have that hunger, they have that desire, but they also have that itch to really ensure they keep evolving their careers and have opportunities to build those careers, which a lot of times in small startup companies you don't have. But the unique value proposition we have here at Teleflex is you do have that we do build careers and give you different opportunities to take on new challenges. So that was that was the dynamic. And I think we did a pretty good job. And I'll give a lot of credit to our commercial leadership team for really helping to build that framework and ultimately put us in the position we're in today.

Patrick Kothe 44:44

Kevin, I got two more questions for you. The first is you're coming in as an outsider to an existing team. And you've got you know, ideas on how things should look in that team as an outsider or who's coming into into a team? How do you best integrate, knowing that there's probably going to be some change coming?

Kevin Hardage 45:09

Great question and a question that I've been working on the answer for the last couple of years, I think the starting point for me was one, when you walk into a business where you're the unknown, you don't have a urology background, but you've got those commercial experiences to bring with you. And you come from an organization that has brand identity, the first, the first step in the process for me was getting in the field, working alongside each of my key leaders to really learn what they do, but also, as we're learning along the way, offer up those examples and those experiences that I that I bring over, whether it be the commercialization of your lift, and ways to do that, maybe faster, smarter, and, and maybe considerations for different type of resource support. And as you start to build that credibility and your earn that through, you know, walking alongside some of our key leaders in the organization, the other piece of it in parallel and equally as important as this business was built at the very beginning, with the key urologists, those key opinion leaders in this space, that helped helped evolve your lift that had voices into development and or procedure techniques. So I hit the road, I was on the road, really, I haven't stopped for the last two years. And really, you know, getting into these practices and, and hearing from our best and brightest neurologists in the US as well as abroad. And those two things combined put me in a position along the way, to be able to offer up changes to, to throw out new ideas. And ultimately, we've leveraged a lot of our leadership within the organization versus that new leader that brings outside people, we took a different tact, we we identified those talents across the business and and repurposed, you know, those individuals into new roles, expanded roles, and that's helped foster and create an environment where people can see it, as it relates to building your career here, and maybe a different way that they hadn't considered before.

Patrick Kothe 47:24

So all of us have been members of a team, we're all members that have teams, sometimes we're leader to teams, sometimes we're not the leader of the team. So when you came in, and you had a vision for what's going on some some of the members I'm sure made the transition, and some of them didn't make the transition, because they weren't, weren't optimal for the team that that you wanted. But I want to kind of finish off by asking about being a good team member. So you're not the leader of the team. But you're a team member? What kind of advice would you give to our listeners? Even you know, especially in times of change, what makes a good team member to help to do to make this team more effective?

Kevin Hardage 48:15

Yeah, that's, that's, that's a good question. And something that I spend as a leader in our leadership team spends thinking about, we have, we have a vision statement here we refer to it's called Transforming neurology around the world, by uniting uncommon people passion and innovation to make lives better. And I say that because we recently added uncommon in that vision statement, because we've developed a team that we believe is really uncommon. And those individuals across different functions, whether it be the unique business model we have that not only is that a sales structure, but equally a clinical structure. That's that's partnering with both faculty, urologist in the field that, that want to help develop this market, through education, whether it's our Clinical Affairs team, or our Scientific Affairs team. It requires that we all have this uncommon approach, and that we have this alignment with each other to get the job done. And it's it's something I've seen and felt and it's hard to describe. But working in this organization, it's something we that's, that's the unique ingredient to the recipe for what we do. And it requires that we have each other's back it requires that there's, you know, we're creating those those career opportunities. It requires that we also challenge each other and create that competitive work environment that's healthy and helps us grow. Knowing the work we have to do here is immense. So for me, it's it's probably leaning on that word uncommon, and then it showing up through some of those examples I just shared.

Patrick Kothe 50:08

We all need to thank Kevin for leading us on a really interesting topic in conversation. We often hear jokes about people getting up in in the middle of the night, multiple times to urinate. But it really isn't a joke for the people who have to live this life. I learned several things in my pre show research. But I learned a lot more in conversation with Kevin. And I hope you did, too. A few of my takeaways. First, concentrate on the immediate opportunity, Kevin discussed the 70 year old patient, and that's where they initially have focused, because it's something that's, that's right there in front of them. And it's for people that have problems. So really, you know, taking advantage of that opportunity. And solving the problem for the clinicians and the patients is really the first place to start. And the other thing is you can't get to the broad market without you being successful in one of your sub markets, make sure that you take advantage of that, but also putting a little bit of the focus on the long term to the second thing was bring in experts in areas where you're not strong. It's so easy to add responsibility to somebody who's already on your team, hey, we've got this issue, can you pick it up? It's an area that we need to really take advantage of. But what are you really doing when you're doing that? There's a learning curve associated with that. And they're gonna have to learn all kinds of new things. And, you know, how effective are there going to be an awful lot? How long is it going to take for them to come up to speed. So what what Kevin team did was bring in an expert from the outside that had pharma expertise in this DD DTC space, and really accelerated their learning and had somebody who is highly skilled in that area. So make sure that when you have these areas that you evaluate internal resources, but don't be afraid to go outside and bring in the resource from the outside. The last thing is measuring and adapting. And he mentioned that on several occasions, they put something out into the marketplace measured, it found out that it wasn't quite right, they adapted it and went back out. And that's something that that we should all do. But in order to do that, what you have to do is you have to be precise in your objective. We talked about awareness versus action campaigns, and what exactly are you trying to try to accomplish? So be precise in your objective? Realize that you're not going to get it right the first time. But what you really have to have is the metrics, what are the metrics that you're going to use to measure that? Because if without that, you don't know if you're going to be successful, and you won't know what to change. So measure adapt. It's a long term game, you're not going to get it right the first time. But if you use a system, you will get it right eventually. Thank you for listening. Make sure you get episodes downloaded to your device automatically by liking or subscribing to the mastering medical device podcast wherever you get your podcast. Also, please spread the word and tell a friend or two to listen to the mastering medical device podcast as interviews like today's can help you become a more effective medical device leader. Work hard. Be kind

 
Patrick Kothe
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