Timothy E. Guertin, CEO, Varian Medical Systems talks about the huge advances in cancer radiation therapy
Sitting in the debilitating heat during a conference break, Timmy Guertin exudes professionalism and achievement in his discourse. As we sipped some much needed water in these torrid surroundings, I brooked the question on how Varian Medical Systems achieved 60 per cent of global market share for construction of state of the art cancer radiotherapy machines and other similarly related technology.
“Our company makes linear accelerators for cancer therapy so when you hear about radiation therapy, about 60 per cent of all this therapy is done on Varian equipment. This constitutes 85 per cent of our business but we also make information system, information storage business about the patient and we also devise radiation-planning schemes to be able to plan treatment better. We’re also a major manufacturer of X-ray tubes, probably the largest producer of these tubes and also flat panel images, security equipment and other similar high tech stuff”.
But what exactly is Guertin’s role in the company, was he placed there or did he work his way up the ladder?
“I’ve been with Varian for over thirty years, starting out as an engineer and one day I woke up as head of the oncology business eventually being promoted to CEO just a few years ago”.
With such a large market share and rapidly evolving technologies, the challenge for such a well established company to continue setting standards must be pretty immense. How does Varian cope with these challenges?
“Different markets that we are in behave differently. In the United States, you can get quick adoption of new techniques but again there are quite a lot of machines in the US with around 13 per million people. In Europe this goes down to 4-6 per million inhabitants whilst in Asia you have around 1 per million although this rises to about 4 in China and Taiwan. In the US so you have a lot of equipment that needs maintenance and eventual replacement but in Europe we are seeing lots of acquisitions of new equipment with tailor made features as technology continues to develop. So there’s what you might call a mix of attitudes within the global medical market”.
What exactly is the cost of these state of the art machines however and how can they be procured, especially within a local context where Malta has one cancer radiation therapy machine for the whole population?
“The thing with radiation therapy is that it is what one might term a ‘fractionated’ treatment where this is spread out over a number of weeks. When you have people going in for treatment every day, a machine cannot be so remotely located as patients would eventually choose some other form of therapy so accessibility is an issue. I’m not so conversant with transport in Malta but you have to look at the transport network but I’ve heard that the machine you have is quite centrally located. Ideally, two or three machines would be better for a population of 400,000 but since your hospital appears to be quite accessible then this shouldn’t be too much of a problem.
With a machine that is about 12 years old which is similar to the one operating in Malta at the moment, what would be the eventual lifespan?
“Machines generally lose their ‘state of the artness’ between 2 or 3 years from their installation. You also have to remember that state of the art therapy does apply to only a limited number of patients but with the equipment you have at the moment and according to your patient mix, then this should be fine. State of the art radiation therapy now is intensity modulated and image guided which creates images for the tumour and unless a machine built in 1992 is upgraded, then it is unlikely that it will have any of these new technologies, certainly not image guided facilities. So in Malta, you do have an opportunity to purchase a new machine that will provide up to the minute cancer radiation technology that would dramatically improve your health standards”.
But what would the investment in such machines be?
“The cost of such a machine would range from USD 1.5 to 3 million dollars but most probably, a machine costing in the region of 2 to 2.5 million would suffice for Malta. We have a European sales team who also provides advice on how to raise money either from loans or from some important donors. However, a cancer machine is quite easy to justify as radiation therapy is one of the least expensive methods in treating cancer available when compared to other medical sectors, at least in the United States”.
Has there really been a dramatic improvement in survival rates for cancer with the new technology available on the market?
“Certain cancers have a very good survival rates such as prostrate and breast cancers with a 90 per cent survival rate and a complete cure in around five years. However there still are some aggressive cancers, which we have not been able to be very effective as these mostly spread rapidly and treatment starts at a later stage when a cure is highly improbable. One of the things, which can be done to improve survival rates is to get patients in for treatment relatively early although this can be slightly more difficult with certain types of lung cancers that are not very symptomatic. That’s why people are urged not to smoke as you don’t have symptoms of the disease until this is quite far advanced”.
In the future, Varian hopes to mix radiation therapy with some types of drugs that attack the primary disease although the search of the magic bullet, so to speak has failed. It is also a fact that some chemotherapy drugs or what are also termed as biological agents don’t work very well either as they contain a lot of toxicity in them.
What are the health coverage predictions for emerging markets in continents like Asia and Africa where cancer deaths are still extremely high?
“Cancer is primarily a disease of older people so when you look at the incidence of cancer and the over 65 world population, these map quite nicely. We are seeing this happen in China and Asia although in Africa, the rather low life expectancy may have an effect on that market as already explained. I would say that we are going to see a considerable rise in demand for radiation therapy machines in countries such as China and India in the very near future with Africa coming on stream some years down the line although there is a growing demand from that continent”.
A final comment?
“Varian are in a number of business with radiation oncology being one of them. We are a 2.5 billion dollar company at the moment but we hope to work up to a 3 billion dollar company and there are a number of ways with which that target can be achieved. What I really hope is that cancer curing tools become more widely available as that would provide a great opportunity for sufferers and also an opportunity for us to continue growing within the global market”.