For the past 25 years the main model for selling a robot has been
Sell the robot as capital
Sell an annual service contract
Sell the consumables and disposables per case
But my guess is... that's all about to change. And read to the bottom of the article to get the full insight of what is about to radically change.
The shift to alternative commercial models in surgical robotics
This is the point where I'm going to claim a small part of history here. Back in 2016 I was brought in to build the commercial model for a small Cambridge Start Up called Cambridge Medical Robotics. It was clear to me at the time that one of the biggest barriers to a wider adoption of robotic surgery was clearly the "Cost".
But what was more clear to me was that the bigger barrier of the struggle to get the $1.5 million up front capital that was needed to purchase the robot. Now to be fair, I had already seen the glimmer of "rental" models and "early lease" models. But I'd understood way back then, that most places outside of the USA could not get together the vast sum of money needed to justify a robot. So that lack of capital was a barrier.
At that point I created a model where you could buy what was effectively a "managed service.". The concept was easy. Commit to a multi year contract, at a set volume and you were provided with hardware, servicing and all the consumables you needed to complete those cases. But in the early model - that also included a grant to allow the hospital to have a full time employee to run the robotics program. Unfortunately few hospitals back then really understood the need to have a dedicated robotics coordinator as part of the service.
Since that time, there has been great success in adopting the "Service" style model - and the market has seen Intuitive react and move to a much higher ratio of long term lease deals (Which grows quarter on quarter according to their quarterly reports.)
Great insights Steve
''With the new models (and I think this is why Intuitive and Medtronic are going this way) the balance sheet of the company carries all of those installs.''
Not exactly; companies work with external financial institutions exactly not to have the units on their books, it would be foolish to finance MES programs internally. As financing is external, the entry barrier for small player is not particularly high under a pure financial point of view -it is of course under a business point of view