confidential, copyright td medical april 2011 an experienced distribution organization of medical...

Confidential, copyright TD Medical April 2011

An experienced Distribution Organization of

Medical Products in The Netherlands.

Specialized in the Sales and Marketing of

Cardiovascular and Endovascular Products.

1

History at a glance

• June 1, 1982 Foundation of TD Medical bv, by Will Thehu and Jack Deuss. Jack Deuss retired in 1996. Will Thehu is still managing the Company.

The foundation of TDM was based around the interventional products from ACS (Later Eli Lily, Guidant, Abbott) staring with the first over the wire PTCA balloon (Simpson – Robert)

• March 1, 1983 Foundation of TD Medical bvba in BelgiumExit Belgium in 2003

• May 1, 2003 – May 1, 2007 Merged with AB Medical into AB & TD bvAdding Cardiac Surgery product lines to our Interventional Cardiology and Endovascular product lines.

• July 26, 2007 Name changed back to TD Medical bv

• Today 10 employees covering mainly the Netherlands

Confidential, copyright TD Medical2

Since the start of TDM we operated in many Medical disciplines, Cardiology, Interventional Cardiology and Radiology, Vascular Surgery, Endovascular, Urology, General Surgery, Anesthesiology, Gynecology, Electrophysiology, Neurology.In all disciplines we started with new innovative products.In the period 1997 – 2003 we scaled down the Company to exclusively Interventional Cardiology and Endovascular.

Confidential, copyright TD Medical

Our Marketing successes

Our Marketing successes in the last 28 years

We have represented many Manufacturers of high tech Medical Products in the Netherlands.With most Manufacturers we have had a long-lasting business relationship. We have assisted several Manufacturers in entering the Dutch market. For others we have developed an entry and exit strategy. Whatever the cooperation is based on, we always strive for a win-win situation for all parties involved.


Cardiology


Cardiac AssistCardiacAssist, Inc. TandemHeart 2002 - nowAbiomed, Inc. Cardiac Assist 1987 - 2000St..Jude / Bard Intra Aortic Balloon Pump 1995 - 1998Thermo Cardio Systems, Inc HeartMate Assist Device 1994 - 2001

Cardiac Rythm Management

Pacesetter, Inc. Pacemakers 1982 -1987Arzco, Inc. Oesophageal Pacing 1983 - 1987Cardiac Pathways, Inc. Cardiac Mapping 1995 - 1998Angeion, Inc. Implantable Defibrilators 1996 - 1997Irvine Biomedical, Inc. EP Catheters 1997 - 1998

Interventional Cardiology


Therapeutic

Advance Cardiovascular Systems, Inc. PTCA 1982 - 1995

Devices for Vascular Intervention, Inc. Coronary Atherectomy 1986 - 1995

Advance Interventional Systems, Inc. Eximer laser 1990 - 1993

Possis, Inc. Coronary Thrombectomy 1993 - 1998

Eclipse, Inc. Eximer Laser 1997 - 1999

Biocompatibles, Ltd. PTCA - Coronary Stents 1997 - 1998

Phytis, LDA PTCA - Coronary Stents 1998 - 1999

Intraluminal Therapeutics, Inc. CTO 1999 - 2001

Sorin Biomedica PTCA - Coronary Stents 1999 - 2004

Endicor, Inc. Coronary Thrombectomy 1999

Onset Medical Solopath 2010 - now



Diagnostic

Cardiovascular Imaging Systems, Inc. IVUS 1989 - 1995

Cardiometrics, Inc. Coronary Flow Measurement 1991 - 1996

Mallinckrodt, Inc. Diagnostic Catheters 1994 - 1998

Radi Medical Systems, AB Pressure Wire 1995 - 1999

LightLab Imaging Inc OCT 2007 - 2010

Closure Devices

Instromedix, Inc Compressar 1987

Perclose, Inc. Suture Closure Device 1995 - 1998

Radi Medical Systems, AB Femo Stop 1995 - 1999

Sub-Q, Inc. Collagen Stop 2002

Datascope SafeGuard 2003 - 2006

Advanced Vascular Dynamics Compressar 2003 - now

Access Closure Mynx 2010 - now

Interventional Cardiology & Endovascular


Advance Interventional Systems, Inc Eximer laser - Hot tip 1990 - 1993

Mallinckrodt, Inc. Diagnostic Catheters 1994 – 1998

Micro Therapeutics, Inc. Catheters 1994 - 1998

Peripheral Systems Group, Inc. PTA - Smart Needle 1988 - 1998

Sorin Biomedica PTA – Stents 1999 -2004

Possis, Inc. Thrombectomy 1993 - 1998

Bacchus Vascular Trellis Thrombectomy 2003

IDEV Technology SUPERAtm Stent 2008 – now

Ymed Inc. Vascutrak2 FFA balloon 2008 – 2009

Pathway Medical Technologies, Inc. Jetstream G2 2009 - 2010

Square One ArchStent 2008 - now

Onset Medical Solopath 2010 - now

Endovascular


Sulzer Vascutek Ltd. Grafts 1984 - 2000

Applied Medical, Inc Catheters, Clamps 1989 - now

EVT EVAR 1995

Vascular Architects, Inc. MollRing Cutter - aSpire 2003 - 2007

Vascular Surgery


Micro Therapeutics, Inc. (EV3, Covidien)

Catheters 1994 - 1998

Micro Interventional Systems, Inc. (Medtronic)

Catheters 1994 - 1998

Interventional Neuro Radiology


Biovascular, Inc. Patches & Coronary Grafts 1986 - 1987

CTS, Inc. Minimal Invasive CS 1997 - 1998

General Surgical Innovations, Inc Vein Harvesting 1998 - 1999

Acorn CV, Inc CorCap 2000 - 2007

Heart ValvesAutogenics, Inc. Autologous Heart Valve 1994 - 1995

Medical, Inc. Heart Valves 1997 - 1999

Sorin Biomedica Heart Valves 2001 - 2004

Cardiac AssistAbiomed, Inc. Cardiac Assist 1987 - 2000

St..Jude / Bard Intra Aortic Balloon Pump 1995 - 1998

Thermo Cardio Systems, Inc (TCI) HeartMate Assist Device 1994 - 2001

Cardio Thoracic Surgery (1)


CardioVision

Cardiosonics, Inc.

Chase Medical, Inc.

Fehling GmbH

Guidant (Boston Scientific)

ITC

MCRI , Inc.

Medos GmBH

Quest, Inc.

Vivolution AB

Welch Allyn (Cogent Light)

Wexler

Cardio Thoracic Surgery (2)

These manufacturers were represented by us at the time of merger with AB Medical from May 2003 thru April 2007. We transferred the distribution rights of these manufacturers in May 2007 to the owner of AB Medical.


General SurgeryHaemoscope ACT Blood Test 1994 - 1999Horizon Medical Ports 1995 - 1997Fusion Medical, Inc. Glue 1996 - 1999Boazul Bloodless Cuffs 1996 - 2001Medafor, Inc. Arista Hemostasis 2003 - 2009Mast Biosurgery Anti Adhesion Sheet 2005 - now

AnesthesiologyLaryngeal Mask Company (Intavent) Larynx Mask 1990 - 1995Portex Ltd. 1995 - 1999Augustine Medical Inc. Bair Hugger – Heating 1991 - 2000

GynecologyGynecare Uterus Abblation 1995 - 1997Conceptus Fertility 1993 - 1995CL Médical, srl Incontinent Band 2006 - 2007

Surgery


Sophysa Hydrocephalus 1985 - 1987

Peroneus Drop Foot Stimulator 1986 - 1987

Pain treatment

Agar TENS 1983 - 1987

Staodynamics TENS & Muscle Stimulation 1986 - 1987

Nikomed TENS Electrodes 1985 - 1987

Neuromed Implantable Neuro Stimulator 1985 - 1987

Physion Physionizer - EMDA 1995 - 2002

Neurology



Market Data

Location

Visiting AddressTD Medical b.v.Meerenakkerplein 125652 BJ EindhovenThe Netherlands

Correspondence AddressTD Medical b.v.P.O. Box 70455605 JA EindhovenThe Netherlands

Telephone (+31) 40 252 54 45Fax (+31) 40 255 04 55E-mail [email protected] www.tdmedical.com

Toll free numbersTelephone 00800 8368 3683Fax 00800 8360 7337


Eindhoven

Amsterdam

LeidenDen HaagRotterdam

Leeuwarden Groningen

Enschede

Zwolle

Nijmegen

Breda

Maastricht

Utrecht

Nieuwegein

Groningen

Amsterdam

Eindhoven

Düsseldorf

Brussels

17

Market Data

The Netherlands

Area 41,500 km²Population 16 MillionMedical Budget 11% of GNPNew DBC reïmbursement system (2007)Most Doctors employed by Hospital

115 Hospitals 19 Cardiac Surgery Centers, Including 8 University Centers 96 Peripheral Centers (19 major)

23 PCI Centers 60 Endovascular Centers


Market Penetration

19 Top Clinical Centers, Including 8 University Centers15 TD Medical Customers79% Market Penetration

96 Peripheral Centers52 TD Medical Customers54% Market Penetration

115 Total Centers, Including 8 University Centers67 TD Medical Customers58% Market Penetration


Interventional Cardiology - procedures


PCI Procedures 40,000

PCI’s per Capita 2,500

PCI’s average per Center 1,300

Total Stent Procedures 30,000

Total Stents implanted (1.35) 40,000

Drug Eluting Stents (70%) 28,000

Bare Metal Stents (30%) 12,000

Bioabsorbable

Increasing

Abbott, Biotronic

Decreased in the last years due to extension of number of PCI Centers.18 in 2009, 23 in 2011

Interventional Cardiology - procedures


Rotablators 100

DCA/PAC 70

Cutting Balloon 350

Laser 40

Trombectomy/ suction 400

Pressure Wire 900

IVI (IVUS) 500

OCT 700

CTO 900

PFO ‘s 250

Reopro 600

FFR (12%) 5.760

Increasing

Decreasing

Increasing

Average Selling Prices € US $

Drug Eluting Stents 750 - 1000 1000 - 1400

Bare Stents 200 - 450 275 - 555

PTCA Balloon 125 - 275 175 - 400

Guide Wires 60 - 110 85 - 150

Closure devices 80 - 110 110 - 150



Physicians

Radiologists 680

Interventionists 200

Neuro Interventionists 10

Interventional Radiology


PTA

Centers 96

Diagnostic Procedures 18.000

PTA Procedures 11.200

PTA per Capita 700

PTA per Center 117

Interventional Radiology 2


Procedures Stents % Stents

Iliac 5.200 80% 4.160

SFA 4.000 60% 2.400

BTK 250 40% 100 Increasing

Carotics 760 50% 380

Renal 1500 3% 45 Decreased from 70% to 3% stenting due to outcome of STAR trial.

Others 100 50% 50 Subclavian/Mesenterica

11.210 7.135


Our Organization

Our Staff


Willem ThehuManaging Director

Dirk Reemers

Sales Manager

Agnes Lock

Sales Representative

Open possition


Nico Meeuwis

Finance & Controller

Corné Jonkers

Clinical & Technical Services

Maikel Scharis

Customer Service

Heleen van Hout

Bookkeeping

Medical advisors in

Cardiology & Radiology

Esther Pustjens

Secretary

Nynke Wiersma


26

Open possition


Our Objective


Our objective is to maintain a professional multi disciplinary medical distribution organization, providing the market with top-of-the-line products and establishing long-lasting relationships with manufacturers and customers.

We achieve our objectives by means of knowledge, respect for our customers and investments in people and means.

Clinical support, training of our customers and the coordination of clinical studies are some of the activities to introduce new products and technologies into the market place.

We adapt to market changes and try at all times to look after the interest of all parties involved in the selling process.

27

Our Customer Policy


Looking after the interest of all parties involved in the purchasing process.

Clinical Hospital

• Innovative top quality products

• Clinical data

• Clinical studies and support

• Training and education

• Application support

• Knowledgeable sales staff

• Open and fair price policy

• Permanent twenty four hour service

• Tailor made hospital purchasing agreements

• Multi-disciplinary purchasing agreements

• Emergency deliveries

• Toll free telephone and fax numbers

• Technical service

28

The quality policy of TD Medical is to supply products and services which meet the needs and expectations of our customers and suppliers.

This will be controlled through the contract review process.

The organization assesses its objectives and value to the customers and the health care sector through the management review process and will continually strive for improvement.

TD Medical is committed to maintain the quality system NEN-EN-ISO 9001 and to ensure that all employees are fully familiar with our quality policy and objectives.

Our Quality Policy


ISO 9001: 2000

29

Technical Service


We have our own ISO certified technical service facility, offering our customers:

• Annual service contracts

• Callibrations

• Repairs

• Software Updates

30


Our Manufactureres

Manufacturers, Interventional Cardiology


The MynxVascular Closure Device

Compressar™Closure Device

SideguardCoronary Sidebranch Stent & Delivery System

Tandem Heart™Temporary Cardiac Assist Device

SoloPath™Balloon Expandable TransFemoral Catheter

Potential Manufacturers



33


• DES, BMS, Bioabsorbable stents

•Atherectomy

• CTO Catheters

• Drug Eluting Balloons

We recently separated from Biosensors (Coronary Stents) and Lightlab Imaging (OCT)

We are in contact with 8 Manufacturers to expand our product portfolio.

Most of these Companies are start ups with new innovative products.


The MynxVascular Closure Device

Compressar™Closure Device

Embolectomy CathetersThrombectomy CathetersClamps and Inserts, Clips

Supera VeritasSelf-expanding nitinol stent

SoloPath™Balloon Expandable TransFemoral Catheter

ArchStent Ostial System

Manufacturers, Endovascular




•Atherectomy

•CTO Catheters

•Drug Eluting Balloons

•EVAR

•Neuro Interventional

Endovascular

The endovascular market is growing rapidly in the Netherlands.

Most patiënts are treated today by the Interventional Radiologist. In several Hospitals the Vascular Surgeon is also performing the interventional procedures.

EVAR procedures are always performed by the two specialities.


Market introduction of new Products

Introduction new products into the Dutch Market

We follow a more or less standard procedure in orderto successfully build up a market for new products.


1.Preparation

2.Phase 1, Introduction

3.Phase 2, Full Market Introduction

4.Reporting

37

1. Preparation

• Before we decide to distribute any new product we have done our homework on

the market, the competition, the procedures etc. We work closely together with our

Medical Advisors in this process.

•A solid distribution Contract.

• Clear agreements with the Manufacturer on:

- Sales strategy and Forecast

• Product training, features benefits, competition etc.



38

2. Phase 1 Introduction Limited introduction (3 weeks max)

• Meeting with our medical advisors

-Determination of positioning

• Meeting with our other resources

-Positioning of price

• Introduction and clinical cases in one or two Clinics

-Documentation and reporting of cases (special form)

• Sales in the same clinics



39

3. Phase 2, Full Market Introduction

• Mailing to all PCI Physicians (80)

- Letter of the Manufacturer announcing TD Medical as its exclusive distributor.

- Product Brochures,

- Literature

- Website

- Follow up within 2 weeks by sales calls

- Presence on both National and International congresses



40

4. Reporting

We have an internal report system whereby all the essential elements of our sales calls are centralized and discussed with the sales team on a regular base.

Every quarter we report to the manufacturer:• The highlights in the market place• The sales results• The customers• The Forecast



41


Thank you for your attention.

Your partner in business

confidential, copyright td medical april 2011 an experienced distribution organization of medical...

Documents

ab medical

foundation of td medical

medical disciplines

interventional products

radi medical systems

endovascular products

advance interventional

coronary atherectomy1986