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2022年8月31-9月2日 | 上海世博展览馆1&2号馆

Medtech's Biggest Problem Right Now: Hospital Labor Shortages

2021-11-04

By this point in the pandemic, hospitals have gotten pretty good at managing surges in COVID-19 cases, and medical device companies have gotten better at predicting how those surges will impact procedure volumes. Now the industry has to learn how to deal with other macroeconomic challenges that could be considered offshoots of the pandemic, such as supply chain problems, and hospital labor shortages.

According to a recent letter the American Nurses Association (ANA) sent to the Department of Health and Human Services, nursing shortages are being reported all over the country. The letter points to some depressing stats: Mississippi has seen a decrease of 2,000 nurses since the beginning of 2021; hospitals in Tennessee are operating with 1,000 fewer staff than at the beginning of the pandemic, prompting the state to call on its National Guard for reinforcements; Texas is recruiting 2,500 nurses from outside the state, a number that is expected to fall short of demand; Louisiana had more than 6,000 unfilled nursing positions open across the state even before the Delta variant created a surge in COVID-19 cases (the ANA also noted that Louisiana’s hospital labor shortage may be even more severe in the aftermath of Hurricane Ida); and Nebraska has gone so far as to recruit unvaccinated nurses to address hospital labor shortages in the state.

"These current circumstances have only exacerbated underlying, chronic nursing workforce challenges that have persisted for years," wrote Ernest Grant, president of the ANA, in the letter. "Since the nation began COVID-19 mitigation and response efforts, much focus has been placed on nurses facing shortages of equipment to appropriately care for patients. Now, it is imperative that the administration acknowledge and take concrete steps to address a more dire shortage: a crisis-level human resource shortage of nurses that puts our ability to care for patients in jeopardy."

For the medical device industry, hospital labor shortages in the United States could soften procedure volumes just as the healthcare industry is finally learning how to manage surges in COVID-19 cases. The topic has also come up during every earnings call that MD+DI has covered so far during the current earning season.

During Boston Scientific's third-quarter earnings call Wednesday, Danielle Antalffy, a senior research analyst covering medtech at SVB Leerink, asked CEO Mike Mahoney about the hospital labor shortages. Antalffy said the labor shortages seem like "a tougher nut to crack, as far as when that will resolve," and suggested that it's not something that can fix itself overnight.

"I've been in the field a lot recently, and it is an issue for hospital CEOs, no doubt about it," Mahoney said. "They've had to increase their wages and labor force expenses to accommodate increasing wages for nurses and staff, and so forth."

The Boston Scientific CEO did sound optimistic about this challenge, however, as he touted the resiliency of hospitals.

"Hospitals, just like anybody else, they innovate, and they find a way," Mahoney said. "... I think the (COVID-19) surges will calm, and the staffing shortages will likely linger a bit. But hospitals are pretty resilient in figuring out ways to drive volume."

Some things that Boston Scientific and other medical device companies are doing to help with the hospital labor shortages issue is by pushing the use of telemedicine and pre-screening for patients, along with introducing technologies that drive efficiency and staff productivity.

Boston Scientific also doesn't consider itself a surgery company, Mahoney said, because the company is not driving procedures that require multi-day hospital stays.

"The portfolio shift, the shift to interventional medicine, is helpful for hospitals, and it gets patients in and out of the clinic or outpatient setting typically in the same day. And you see more of our complex procedures because of the capabilities and the technology we have augmented by imaging moved to more outpatient settings," he said. "... So I think a combination of telehealth, combination of outpatient orientation, and same-day procedures is very helpful for our product mix."

Despite the surge in COVID-19 cases, hospital labor shortages, and other macroeconomic headwinds the medical device industry is dealing with, Boston Scientific still managed to see 4% organic growth during the third quarter compared to the third quarter of 2019.

"Four percent is not a great number, but it's not a bad number ... given the Delta surge," Mahoney said during the call.

Ashley McEvoy, executive vice president and worldwide chairman of medical devices at Johnson & Johnson, said J&J expects hospitals to continue to face labor shortages.

"I don't expect that to get better in quarter four, nor in 2022, but they've been quite masterful on how to manage patient flows," McEvoy said. "When I talk to hospital systems over the past three weeks, in particular in the United States, they are ramping up again and resuming elective procedures."

She added that J&J's medical device business is also keeping an eye on vaccination rates, patient sentiment, and other dynamics that could impact procedure volumes going forward.

Intuitive Surgical is also tracking the hospital labor shortages. Marshall Mohr, Intuitive's chief financial officer, said that these shortages, along with supply chain issues, are challenging some hospital capacities and could impact deferrable procedures, including da Vinci robotic procedures, going forward. These challenges come at a time when the robotic surgery pioneer is also learning to navigate a changing competitive landscape with newcomers to the market like Medtronic's Hugo system.

Jamie Samath, Intuitive's senior vice president of finance emphasized during his comments on the company's recent earnings call the company's current forecast for 2021 procedure growth does not reflect hospital labor shortages, or a resurgence of COVID-19.

"We've had anecdotal inputs from some customers that they're facing staffing shortages, Other customers have said to us that they're able to overcome those risks," Samath said, adding that there's no clear evidence yet in terms of the staffing shortages impacting procedures.

What are medtech executives saying about the supply chain problems?

In addition to hospital labor shortages, the supply chain has been another hot topic during recent medical device earnings calls.

"The global supply chains have not been able to keep up with the strong demand out there," Robert Funck, chief financial officer at Abbott, said during the company's recent earnings call. "And so, like others, we're seeing some increased input cost across areas of our business. We're experiencing some higher shipping costs and, in some cases, higher commodity costs.... In some areas, we have flexibility to adjust pricing a bit and we plan to do that. In other areas, that flexibility doesn't exist. And so, we're working to mitigate the impacts we're seeing, such as looking at other manufacturing costs."

Funck added, however, that Abbott has a strong procurement organization, and that Abbott's suppliers understand the critical nature of its products.

"And so, we've been successful in terms of ensuring that we're able to get what we need to support the business," he said.

Intuitive's Mohr didn't hold back on how tough the supply chain issue has become.

"The environment as it relates to supply chain has deteriorated, gotten more difficult over time," Mohr said. "And as we said, we've dedicated substantial resources to dealing with those shortages and has not to date created an issue with us supplying customer demand. But there is a risk, and it's a real risk."

From a cost perspective, Mohr said Intuitive did encounter increased material costs in the third quarter, although he said they were not significant. The company also incurred some expediting fees associated with freight, but those were not significant either. Going forward, he said Intuitive does expect increased cost that will probably hit the margin in the fourth quarter of 2021, or the first quarter of 2022.

"It's a difficult environment right now," he said.

Article source: Qmed and MD+DI

 

伴随着人工智能兴起,起步较晚的国产医疗机器人正在加快发展,逐步扩大应用场景。5月26日,第十一届中国生物产业大会在武汉光谷发布本土健康企业的7项最新成果,首先推介的便是武汉兰丁公司的宫颈癌检测智能机器人。

 

《每日经济新闻》记者在大会现场了解到,多家企业正在推广医疗机器人,应用范围涵盖胃镜检查、腹腔手术、美容抗衰等,并且已有成熟产品进入国内医院,打破进口机器人在医院应用的垄断局面。

 

 

据主办方介绍,“LANDING”机器人通过筛查样本拨片进行自动化诊断,每月有108万例的样本检测能力,效率远远超过人工。目前,武汉兰丁公司与阿里巴巴的合作,使“LANDING”机器人在中国各地基层终端收集的大量细胞特征参数及数据,在云平台上完成分析诊断工作。

 

 

科技颠覆想象力,机器人在医疗领域的应用范围更加广泛。《每日经济新闻》记者注意到,多家企业在生物产业大会上重点推介医疗机器人产品。

 

患者吞下一粒胶囊,在胃里变成机器人进行螺旋式扫描,将检查图像实时传输至医生电脑,这便是安翰光电技术(武汉)有限公司研制的磁控胶囊胃镜机器人。该公司展位负责人程先生介绍,目前全国已有1000多家医疗机构应用了胶囊胃镜机器人,包括三甲医院、大型体检中心等,涵盖专业医疗和常规健康体检领域,年消耗量达50万粒。

 

据了解,这粒胶囊仅重5G,但包含了80多项科技创新专利,集成400多个精密元器件。上述负责人表示,在检查方面,胃镜机器人可以替代传统的电子胃镜,不过电子胃镜可以做小型的腔镜手术、切片等,胶囊机器人还不具备这些功能,但在进一步研发中。

 

苏州康多机器人有限公司则在大会上重点推介腹腔镜手术机器人系统,该公司展位负责人张辉介绍,这款手术机器人由医生控制台、支撑臂、手术器械三部分组成,通过机器人操作可以起到防止手抖、放大病灶视野等精确治疗的效果。

 

其实,在“机器换人”升级过程中,国产医疗机器人起步虽晚,但发展很快,不少上市公司将其作为下一风口进行布局。

 

2015年,制造装备公司楚天科技(行情300358,诊股)(300358,SZ)表示正在研发医药机器人和医疗机器人,一年后,首台医药无菌生产智能机器人下线,步入医药装备4.0时代;2017年11月,科大讯飞(行情002230,诊股)(002230,SZ)研发的医疗机器人“智医助理”通过临床执业医师综合笔试,目前已进入合肥基层卫生中心,辅助全科医生进行诊疗;2017年,埃斯顿(行情002747,诊股)(002747,SZ)收购美国Barrett 30%股权,全面进军康复医疗机器人市场,并计划与Barrett共同出资在中国境内成立一家新的合公司。

 

国产机器人拥有成本优势 在多家企业布局的背后,是医疗机器人巨大的市场潜力。普华永道中国发布的《医疗机器人宏观应用趋势与研究方向》显示,2014年,全球医疗机器人的市场价值是26亿美元,到2020年预计会达到76亿美元。

 

人均可支配收入的增加会促使高质量医疗需求的增长,而医疗机器人正好有出血少、精准度更高,恢复快的优势。整个发展趋势显示医疗机器人市场潜力巨大。

 

目前,国内医院的医疗机器人仍依赖进口,最为广泛应用的就是美国直觉外科公司制造的达芬奇手术机器人,2016年国内手术量突破1.5万台。

 

但是,进口医疗机器人价格昂贵,使得医疗费用也居高不下,如一台达芬奇机器人在国内售价2000万元左右,附带长期的耗材费用。

 

“进口机器人就算不用,一年的保养费都得80~100万元,每天开机费用就达1万元左右。”张辉表示,国外的机器人设备,主要包括维修费、保养费、耗材费等费用,所以价格居高不下。

 

随着国产医疗机器人发力,这一局面有望打破。此前,楚天科技研发的医药无菌生产机器人定价500万~600万元,而国际同类机器人定价800万~1000万元左右。

 

张辉告诉《每日经济新闻》记者,国产医疗机器人的优势是小型化、便捷化,还有国内的服务体系,针对三甲医院、县级医院等机构,可以实现分级应用,因此价格应该会比进口设备低一半左右,降低医疗成本。

 

来源:每日经济新闻

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