Additive Manufacturing: Manufacturing Competitive Advantage in MedTech at Stryker

Medical device technology is widely recognized as a competitive industry, with pressure from technological advances and broader cost pressure in healthcare. How can industry leaders such as Stryker leverage new technologies like additive manufacturing to build a long-term competitive advantage?

Competitive Advantages from Additive Manufacturing in the Medical Device Industry

Stryker (NYSE: SYK) is Michigan-based manufacturer of technologically-advanced medical devices. In 2017, the company earned $12.4 billion revenue and $1.0 billion net income, primarily from its “MedSurg” (medical instruments, endoscopy, etc.), Orthopedics, and Neurotechnology & Spine market business segments.[1] For a complex manufacturer such as Stryker, additive manufacturing offers an unparalleled opportunity to revolutionize the product development and production processes.

For product development, additive manufacturing increases speed-to-market and simplifies the multi-stage prototyping processes. The technology makes it possible to create samples in hours, rather than days or weeks.[2] This provides Stryker with a competitive advantage in creating novel products, such as their additive manufactured Tritanium spine implants, which were launched in 2014.[3] Successfully transitioning R&D to into new products improves patients’ health outcomes, fulfilling the company’s overarching mission to “enhance patient care”.[4]

In comparison to traditional manufacturing processes like forging or CNC machining, additive manufacturing reduces capital investments and volume requirements for a product line.[5] This enables medical device manufacturers to produce a broader assortment of devices (improving patient and physician choice) without adding overhead from extra product lines or more set-up time from switching between low-volume SKUs. Additionally, additive manufacturing significantly reduces material waste inherent in traditional manufacturing processes, improving Stryker’s margins to offset industry-wide cost cutting pressures in healthcare.[6]

 

Management’s Short- and Medium-Term Strategy

Stryker has publicly recognized additive manufacturing as a driver of orthopedic innovation, a key part of the company’s mission. Short-term, Stryker has demonstrated a commitment to pursuing R&D. The company collaborates with Ph.D. programs to develop innovative applications of additive manufacturing to orthopedics. For instance, the company has applied porous printing techniques to knee, spine and hip implants to improve an implant’s ability to integrate with human bones post-surgery, reducing the risk of rejection and infection.[7]  In addition, Stryker has formed partnerships with cross-disciplinary industry leaders (e.g., GE Additive) to accelerate innovation.

The company is also significantly investing in additive manufacturing over the medium-term time horizon. Stryker opened an additive manufacturing-focused global technology center in 2017. The Cork, Ireland-based facility, called the AMagine Institute, provides best-in-class manufacturing resources and signals the company’s strong commitment to investing in this topic.

 

Recommendation for Additional Steps

Building on Stryker’s existing commitment to additive manufacturing, I recommend that Stryker expands its additive manufacturing initiative through partnerships, thought leadership, and market engagement.

By expanding its diversity of partnerships (e.g., contract manufacturers, 3D printing start-ups), Stryker can benefit from diverse perspectives and broader subject matter expertise. Additionally, partaking in joint ventures and strategic minority investments can increase Stryker’s access to cutting-edge additive manufacturing technology (e.g., range of printable materials, printer hardware).

Participating in industry thought leadership and advocacy, such as to increase insurance coverage for additively-manufactured implants and to set best-in-class quality protocols, will perpetuate Stryker’s reputation in the medical device industry. The FDA is actively involved in developing guidelines for additive manufacturing; Stryker can further cement its market leadership by assisting in these efforts.[8]

Finally, engaging key opinion leaders (KOLs) and patients will facilitate successful market entry. Starting a dialogue to ensure stakeholders understand the benefits of additive manufacturing, such as improved product choice and design elements that lower the risk that the human body rejects the implant post-surgery, can accelerate how quickly the market adopts these products, improving Stryker’s revenue opportunity.

 

Open Topics for Discussion

Additive manufacturing represents an exciting opportunity for Stryker and other medical device companies to accelerate product development and improve patient choice. However, as with most innovation, the new technology raises several broader questions.

For one, devices manufactured using additive manufacturing may have higher production costs versus mass produced devices. How should the benefits of additive manufacturing be balanced with other industry considerations for healthcare, such as escalating cost of care?

Secondly, as additive manufacturing creates an opportunity to manufacture individually customized devices in the distant future, who should be responsible for interfacing with patients and handling their data – medical device manufacturers, physician practices, or other industry groups?

(791 words.)

[1] “Stryker Annual Review, 2017.” Link: https://stryker.gcs-web.com/static-files/8ba65de6-2145-45da-a2ea-82a6d83fdff8

[2] “How Additive Manufacturing is Transforming Medical Manufacturing.” Medical Product Outsourcing (July 29, 2015). Link: https://www.mpo-mag.com/issues/2015-07-01/view_columns/how-additive-manufacturing-is-transforming-medical-manufacturing

[3] “Information for healthcare professionals: Tritanium In Growth Technology.” Stryker. Link: http://www.stryker.com/builttofuse/

[4] “Our Company.” Stryker. Link: https://www.stryker.com/us/en/about.html

[5] Banerjee, Dr. Preeta M. “3D opportunity for technology, media, and telecommunications.” Deloitte (December 7, 2015). Link: https://www2.deloitte.com/insights/us/en/focus/3d-opportunity/3d-printing-in-technology-media-telecom-tmt-industry.html

[6] “Stryker Tritanium Manufacturing Overview.” Stryker. Link: http://www.stryker.com/builttofuse/media/assets/TRITA-BR-2%20Tritanium%20Manufacturing%20Overview%20FINAL.pdf

[7] Matassi, F., Botti, A., Sirleo, L., Carulli, C., & Innocenti, M. “Porous metal for orthopedic implants.” Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases (October 11, 2013). Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3796997/

[8] “The 3Rs of 3D Printing: FDA’s Role.” U.S. Food and Drug Administration (December 21, 2016). Link: https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm533992.htm

 

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10 thoughts on “Additive Manufacturing: Manufacturing Competitive Advantage in MedTech at Stryker

  1. I think that additive manufacturing will really have the ability to transform the medical industry and greatly help with product innovation. Thinking through your second question, I can’t imagine that additive manufacturing will have the ability to replace doctors. I would recommend that the medical device companies form partnerships with leading research hospitals so that the physicians are well versed and on board with their new products. This will also help companies like Stryker prove the efficacy and safety of their products. Without buy in from the physician, who is typically the person a patient trusts and interfaces with, I think it would be tough to really disrupt the industry.

  2. I think that additive manufacturing will undoubtedly play a huge role in the medical industry. My question is at what cost, and how can companies tackle that. You raised the point of additive manufactured items being more expensive upfront. I wonder if we are to the point where the efficiencies gained from doing this on a large scale can be predicted. If so, is it possible to use a program accounting method and sell devices at a loss up front in the expectation that costs will ultimately come down and generate more comfortable margins? This will certainly be an interesting space to watch given the concerns around healthcare today.

  3. I agree with the other comments that additive manufacturing will be very important in the medical industry and also agree that Stryker should focus on partnerships and thought leadership to continue advancing the technology. These seem like the most cost efficient and impactful ways to improve their product development without requiring their company to spread itself too thin and outside its expertise. You raise a good question about the additional costs of manufacturing through additive manufacturing and I hope that this cost does not slow down the rate of innovation – hopefully researchers and key interest groups are able to separate the short term costs from the long term opportunity to continue investment in the area.

  4. It is great to read that Stryker is not only using additive manufacturing to prototype its products more quickly but that it is also able to create superior products using AM (e.g. the implants that reduce risk of rejection and infection). I think the cost issue that you raise is an important one. How do we weigh the benefits of reduced infections, for example, with the additional cost of manufacturing implants using AM? I agree with prior comments that I think these costs will come down over time, making mass producing medical devices using AM more feasible. With regard to your second question, I think that physicians will likely need to continue to interact with the patients in order to ensure that that medical devices are appropriate for their condition but I think that medical device manufacturers will need to create close relationships with the physicians and/or industry groups in order to ensure that it is capturing the data it needs to improve its products.

  5. I agree with the other members of this discussion that additive manufacturing is a key technology for the medical device industry; however, this technology seems more suited to the research and development phase rather than the production phase. 3D printing is already widely used for rapid prototyping in the medical devices industry, which leads me to disagree with the notion that it currently lends Stryker a competitive advantage. I would be interested in seeing whether the company applies this technology in some unique way–whether that be at a lower cost, shorter lead time, or other innovative application–in order for additive manufacturing to truly be a differentiating factor for the firm. Scaling this process for production will likely become more efficient over time, but whether this is a worthwhile investment for Stryker in its current state depends on whether it also innovates the additive manufacturing process itself, instead of just using it as a tool to build its product pipeline.

  6. Additive manufacturing in the medical field seems promising; however, you bring up a really good point regarding costs. As we try to contain costs in health care, what role will 3D printing play in medical device manufacturing? The quality of produced instruments is also very important to consider. It appears that smaller, more intricate, designs might be more difficult for additive manufacturing to produce.

  7. I believe that additive manufacturing for Stryker right now is best positioned to deliver increased speed of innovation in prototype medical devices, and not in mass production. However, I think there are opportunities to use 3D printing to provide medical devices in remote areas or in crisis situations to deliver help at a faster pace.

  8. A thought-provoking read – thank you, Caitlin. I’d like to respond to the question you posited on production costs, as it’s a critical issue, as you highlight. Much like we’ve seen with other novel technologies, my suspicion is that as competition increases and firms climb up the learning curve, production costs will decrease. While that poses challenges in the short-term because adoption must increase for the learning effects to take hold, I am optimistic that longer-term, this will actually become a cost-effective solution. In fact, we’re already seeing that 3D-printed prosthetics can be produced for significantly less[1]. As you highlight, getting the FDA on-board and comfortable is key, because if it presents insurmountable regulatory hurdles, it will disincentivize experimentation.

    In a world where that’s not the case and it remains a more expensive technology, I still think there could be a future for additive manufacturing in the medical device world, even in a bundled payments or fee-for-value paradigm. For me, it will hinge on the eventual cost-benefit trade-off. That is, perhaps 3D-printed devices offer cost-saving benefits, such as more durable, more precisely made equipment, which avoids downstream replacement or repair costs, or possible complications. Or, they may permit less costly, more rapid innovation, and so device companies are willing to use it to gain a competitive edge against competition and compress product development cycles. Either way, I’m a big believer in the future promise of this technology. Thank you for drawing attention to it!

    [1] Pando, Alexandro. “How 3D Printing Could Change The Health Industry.” Forbes, Forbes, 17 Jan. 2018, https://www.forbes.com/sites/forbestechcouncil/2018/01/17/how-3d-printing-could-change-the-health-industry/#1decf81751ce.

  9. As I consider the costs of additive manufacturing within the med devices community, I wonder if there is a better way to create these devices. Perhaps leveraging additive in varying parts of the process can reduce overall spend and ensure predictability within the process. I also gree with many of the above comments, that direct patient care needs tyo be done by doctors, nurses and technicians.

  10. I believe there are substantial benefits for medical device companies that use additive manufacturing effectively. Medical device product development is a very iterative process, and products going through FDA approval have to be shown to consistently perform within very tight statistical parameters. As a result, frequent modification and experimentation is needed until a design is satisfactorily proved out from a safety and efficacy perspective. Being able to iterate quickly will provide Stryker with a keen competitive advantage.

    With respect to creating customizable products for individuals, I believe it best to have patient data staying with doctors / hospitals to the extent possible, as patient confidentiality protections are already in place with respect to medical professionals and institutions. I would think that sufficient data could be transmitted to medical device companies in a patient blind / non-identifiable way, so that only the details necessary for product specification and manufacturing were transmitted without patient identifiers (i.e. Social Security numbers, birthdays, etc.).

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