DENVER – The push/pull – or push/push-back – of medical technology received a different approach this week. The flat/unflat treatment.

That was the approach of Ralph Ives, executive vice president of global strategy and analysis for the Advanced Medical Technology Association (AdvaMed; Washington) Wednesday on the opening day of the BioWest 2006 conference. Ironically, his message was delivered on the flatlands of metropolitan Denver, surrounded by the decidedly unflat Colorado landscape, renowned for its multiple “Fourteeners” (mountains of more than 14,000 feet).

Providing a worldwide overview of the medical device/ med-tech environment, Ives probably offered nothing startlingly new to a well-attended room of device and biotech executives, but he gave his views an interesting slant by borrowing the best-selling perspectives of Thomas Friedman in his book, The World is Flat.

Ives' take on the increasingly “flat” environment of growing globalization was appropriately bullish (delivered at the newish Colorado Convention Center, where Biowest 2006 is being held, a structure fronted by a three-story blue bear peeking in at the attendees, another small irony of location).

Among the “flatteners” in the new push to globalization enumerated by Ives are the demise of communist countries and their subsequent accelerated economic growth, the expanding financial power of developing countries, the outburst of new digital technologies and the faster communication provided by the Internet.

Ives pointed also to the aging process – accelerating even faster in other countries than in the U.S., he noted – but he also pointed out that this “graying” is linked to changing expectations: since many of us are aging more athletically and, thus, more slowly, we are asking more from healthcare to partner in this effort. This, he said, has also highlighted the gap between what people expect from healthcare, what they actually receive, and the resultant future opportunities that this gap offers.

On the American scene, he noted the growing numbers of the uninsured but also the counterbalancing concern that U.S. citizens tend to put affordable healthcare at the top of their list of priorities.

Among what Ives called the “anti-flatteners” of the healthcare/med-tech environment are governmental regulations and reimbursement “delays,” calling the latter government's covert way of holding down costs and also delaying the delivery of new technologies to patients.

He put the worldwide monetary output of the medical device industry at $220 billion annually.

Within this range, the U.S. accounts, at No. 1, for $86 billion, followed by Japan and Germany at $26 billion and $22.5 billion respectively, with South Korea bringing up the graphic caboose at just $1.3 billion.

As a corollary to the global expansion of medical technologies, consumers are “voting with their feet,” Ives said, patients often traveling to other countries for receiving faster or less-expensive treatments (although he did not use the term “medical tourism,” one of the sub-sectors of this phenomenon) and hospitals doing their outsourcing and procurement via the Internet.

Throughout his treatment of various flattening effects, he noted the varieties of international reimbursement that confuse this landscape and make it more difficult.

Thus, as Friedman ultimately does in his book, Ives acknowledged that the world is really not all that flat – that the differences in governmental regulations and reimbursements worldwide impede the spread of med-tech; that the Internet and new digital technologies are far from being universal; that even with the Internet, consumers are getting “only a small bit” of the information that they should have; and that med-tech is seen by governments as a problem.

“Medical technology is not the problem; medical technology contributes to the solution,” Ives said (flatly, we can't help but say).

Ives put med-tech at just 5% of the U.S. gross national product and cited research finding that each dollar put into med-tech produces $2 to $3 in return.

Though not announcing it as his text, Ives' theme ultimately was the importance of information in providing a smoother and better-flattened environment for med-tech and healthcare.

Governments, he said, must have the information that will give them the longer – rather than a constricted, next-year's-budget – view of the benefits and cost savings from med-tech to avoid “undermining innovation.”

And there is a need for broader collaborations among and between companies in providing information to pati-ents and sharing policy information, he said, this observation providing a segue to what he acknowledged was an overt plea for participation in associations such as Adva-Med.

And such as the Colorado BioScience Association , organizers of the two-day BioWest 2006 conference, would certainly say as well.

In its fourth year, BioWest 2006, co-sponsored by the Colorado Office of Economic Development and International Trade , has grown from small groups gathering in the meeting rooms of a local hotel, to attracting about 850 attendees and 70 companies from the Colorado region and beyond.

Its goal, of course, is to enhance the profile of Colorado as an environment that not only attracts tourists, “Four-teener” climbers, bicyclists and skiers, but also an environment that attracts the small-footprint, big potential of biotech firms and the well-rooted legacy and not-so-large but highly innovative players in medical device manufacturing and assembly.

Next: Gambro BCT – gathering, separating, cleaning blood.