Envista, a global dental products and technologies company, has been present in India for more than two decades, beginning with the introduction of Nobel Biocare in 2004. The company has since expanded its presence across implantology, orthodontics, clear aligners and dental imaging, and recently forayed into dental consumables with the launch of Kerr products in India.
Paul Keel, CEO, Envista, spoke about the company’s long-term India strategy, the country’s dental demand-supply gap, growing demand from Tier 2 and Tier 3 cities, clinical education, as well as the possibility of local manufacturing as the market expands, in an interaction with Lakshmipriya Nair. Excerpts from the interview.
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How long have you been in India?
A little over 20 years. 2004 was when we first introduced Nobel Biocare.
India is a cost-sensitive market. How do you deal with that? What changes are you seeing in the Indian dental market?
Every market is value-sensitive, or cost-sensitive. So, there are multiple tiers in every geographic market.
Our strategy is typically to work on the higher-end, more clinically demanding solutions. Here in India, that particular part of the market is no more value-sensitive than anywhere else. The cost of clear aligner therapy here is not that different from China, and not that different from North America.
Typically, with dentistry, especially in a country like India, where clinicians are globally minded, many will have done part of their training in Europe or North America. They will be well aware of clinical practices in other parts of the world.
So, in a country like India, what is considered state-of-the-art in one part of the world is immediately understood here, and is typically demanded by some group of clinicians. Nobel Biocare is a good example.
That would be a typical first product because the best Indian implantologists or oral surgeons will want to work with the very best product, and they will demand Nobel Biocare. Same thing with orthodontists.
They will all be familiar with all of the different clinical procedures around the world. They were aware of Dr Damon (Dr Dwight Damon) and said, we want the Damon system here. And then, as awareness of available dental procedures becomes more widespread, more specialised categories came into demand.
So, today, with our launch of Kerr, we are bringing general dental products, which are used by general dentists. They’re, of course, now very aware of Envista through their experience with Nobel and with Ormco, and so it’s natural that we bring the consumables. That is a more price-sensitive category than the first one, and this is pretty typical of how dental markets develop around the world.
How key is India to Envista’s global growth strategy, and what can we expect in the next five years?
We have been around for a long time, 135 years, and our company focuses both on the near term, what does India need today, and really on the long term. We think in decades or multiple decades. And so, a global company like ours can’t have a successful future without having a big presence in all of the big markets.
We need to have a strong presence in North America, Europe and China, and of course, we need to invest in India today if we hope to be a winner five, 10, 15 years down the road. For us, our participation in India is not just about the market.
It’s not just about selling products. We work very closely with the clinical community in identifying new solutions. So, our clear aligner system was developed in Australia by an Indian orthodontist.
And so, we were very interested in India, not just for the end-user market, but for the clinical expertise. We also invest in India because of the technology expertise. All of our IT infrastructure is managed in India.
So, for companies that want to have a future, you need to be in India.
Do you also have manufacturing plants here?
We don’t have any manufacturing in India yet.
Are there plans to do so in the near future?
As the market grows, it will be common for us to put in local manufacturing.
We were just in China, for instance, before this trip, and we cut the ribbon on a manufacturing facility in China. Our China businesses may be a decade ahead of our Indian business. So, I would expect India to follow that same sort of progression.
Do you see a problem that’s very specific to India?
There are multiple challenges. The first is the insufficiency of supply for the vast need. The industry is not equipped to say that this is a challenge that we’re all working together to solve.
The second is balancing the different challenges that the clinician has. So, many of the clinicians are aware of the highest quality care, but they’re also cognizant that that may not be the best for their patient population. They balance cost with availability, and then they balance sustainable growth for their clinics with the presence.
So, they could all get the most expensive product, many of them trained in the very best dental schools in the world. They could give the very best care, but that might not be what their community really needs. These are complicated challenges and may take years to resolve, with working together in the dental community.
Do you see a lot of demand for your products coming from Tier 2 and Tier 3 cities? Or is it majorly centred around urban areas?
Yes. There are three changes happening in the marketplace. One is, people are becoming more aware of oral health. The second trend we see is greater demand. People want to feel good and look good. There’s a greater demand for restorative and aesthetic procedures.
The third trend we see is there’s a greater demand from clinicians to be as efficient as possible. So, there is a demand for digital workflows that enable clinicians to complete procedures in the most effective and efficient way. And finally, there’s actually a large demand from Tier 2 and Tier 3 cities.
You have people today who are travelling to metros that don’t mind spending the money. So, as part of our growth plan in India, we are factoring all of these items, including putting more feet on the ground in Tier 2 and Tier 3 cities.
Are there any pockets where you’re seeing significant growth?
Yeah. In the South for sure, there are pockets. In the interior parts of certain states like Maharashtra, we can see more demand. But I think it’s all over the place if you ask.
How big is your share in India’s dental market?
We are a top-three player in most categories, although it differs by category and by country. We are the number-one player in traditional orthodontics and dental. We are the number-two player in clear aligners.
That is probably not exactly right, but for the most part, globally, we are a top-three player in almost every category in the main markets.
In India, we are a top-two player in implants, number-one player in orthodontics. We just started with our consumables, so we will have to catch up there.
We are also a very strong player in both 2D and 3D imaging.
Any big investments that you are planning in India?
Our investments are typically threefold. The first is what we are doing today, which is clinical education i.e. teaching clinicians to use the procedures that best match their patient demand.
When you do clinical education, it almost always leads to an innovation demand. You speak to clinicians, they tell you about new needs, and you invest in new product development to create solutions.
When customers understand the procedure and you can bring them a solution, it leads, hopefully, to a need for more sales and marketing.
So, that means more sales reps to commercialise that product. But it all begins with one question: what does the clinician need? And then our business model is to focus on innovation to create a differentiated solution. Hopefully, the demand comes and the sales rep takes ownership.
lakshmipriya.nair@expressindia.com
laxmipriyanair@gmail.com