Chief Product Officer / Europe
Three decisions that took something away
- Group revenue
- €212m
- 2025; hip and knee implants, instruments and recovery software
- Hospitals using the recovery app
- 96
- About 18,400 patients enrolled each year
- Product colleagues
- 74
- Product management, human factors and digital recovery
Decisions & consequences
01Withdrawing an older knee system instead of recertifying it under the MDR
In 2021 our portfolio review reached a fixed-bearing knee system we had sold since 2004. It was still used by 52 surgeons in 31 hospitals, mostly in Belgium and France, and produced €7.4 million of sales in 2020, falling about six per cent a year. Regulatory colleagues estimated that certification under the MDR, including an updated clinical evaluation, new testing and a post-market clinical follow-up study, would cost about €3.1 million and occupy a small, stretched team for more than two years.
The commercial directors for Belgium and France argued hard for keeping it. Several loyal surgeons preferred its instruments, and the directors feared those surgeons would move to a competitor rather than to our newer knee. They were partly right. I recommended withdrawal, and the executive committee and board agreed in early 2022, on condition that no patient already implanted would be left without support.
We planned a thirty-month transition rather than an abrupt end. Every surgeon was offered training on our current knee, including proctored first cases. We announced the last order date eighteen months ahead. We set aside stock of the components and instruments surgeons might need when treating patients who already had the older knee, and kept its surveillance, complaint handling and registry follow-up running. My team wrote to each user hospital directly instead of leaving the explanation to sales representatives.
By the end of the transition, 38 of the 52 surgeons had moved to our current knee and 14 to other manufacturers. We estimate the net loss of annual sales at about €2.9 million, set against the avoided certification cost and the regulatory capacity released for our hip programme. Two hospitals told us the notice period was still too short for their tender cycle.
If I did this again, I would involve the most loyal surgeons in shaping the transition before announcing it. We consulted them about training but presented the withdrawal as settled, and several who left said that mattered more than the product.
Ending free-text messaging when nobody had been assigned to read it
When we launched the recovery app, patients could send free-text messages to their hospital team. Hospitals liked the idea in sales meetings and patients used it. In 2022 a physiotherapy lead mentioned that her department had found messages weeks old. We audited all 61 hospitals then using the app. In 23 of them, nobody held a named responsibility for reading messages. We found 412 messages unread after 72 hours, and 37 described symptoms such as calf pain, fever or a leaking wound. The hospitals reviewed those patients and found no lasting harm, but two had waited more than four days to be seen.
The patient advisory panel and our customer-success team wanted to keep messaging and train hospitals to staff it. Some hospitals used it well, and patients rated it the feature they valued most. I took the opposite view for most sites: a channel that looks attended when it is not is more dangerous than no channel at all. Our clinical safety lead agreed; the product decision was mine.
We removed open messaging as the default within ten weeks. Patients now answer short daily questions, and any red-flag answer shows the hospital's telephone number and advice on when to call emergency services, while the hospital sees the answer on a worklist. Messaging stayed available only to hospitals that signed a response agreement naming staffed hours and a responsible role. Eleven did. Regulatory colleagues assessed the change under our certified procedures and updated the risk file and instructions for use.
The app's satisfaction score fell from 4.4 to 3.9 out of five in the following quarter, and daily use dropped by nine per cent. Over the next year, at hospitals using the worklist, the median time from a red-flag answer to contact by the hospital was under one working day.
I now treat any feature that implies a human reply as a service the hospital must commit to before launch, not a software setting we can switch on during a sales conversation.
Opening the recovery programme to patients with another manufacturer's implant
Until 2024 our recovery app was available only to patients who had received a Merlicourt implant. The commercial team saw it as a reason for hospitals to choose our hips and knees in tenders. Physiotherapists saw it differently. A department treating patients with three manufacturers' implants had to run one pathway for our patients and another for everyone else, and several had stopped using the app for that reason. Adoption had stalled at 61 hospitals.
Our chief commercial officer opposed opening it, and his concern was reasonable: competitors would benefit from a programme we had paid to build, and tender teams would lose a distinctive argument. I proposed separating the two businesses. The app would support any patient after a primary hip or knee replacement, and hospitals would pay €38 per patient episode whatever the implant. The board accepted the proposal with a review after eighteen months.
The change went well beyond a commercial setting. Exercise protocols that referred to our own implant designs were rewritten with the advising physiotherapists. The app's intended purpose and labelling were updated, and our regulatory team confirmed that its risk class was unchanged. We built hospital-wide pricing, data-processing agreements suited to patients who were not our implant customers and a written rule that recovery data about other manufacturers' implants would never be used to compare products commercially.
Eighteen months later, 96 hospitals were using the programme, enrolling about 18,400 patients a year and paying roughly €0.7 million in annual fees. About 41 per cent of those patients had another manufacturer's implant. We cannot show that the app has won us implant business, and in two tenders our sales teams believe they lost an advantage they previously had.
I would publish the data-use rule at launch rather than leave it in contracts. Several physiotherapy leads assumed we were gathering competitive intelligence, and it took a year of explanation before they believed otherwise.