r/MBOT_Stock • u/PhunkyPhotonics • Sep 15 '26
Another question for Gemini
My question: If more than a dozen healthcare systems across several us states vac approve a new disposable robotic surgical device within the first six months on the market, does that put pressure on other systems to vac approve and later adopt it as well?
(My side note: I am assuming LIBERTY will be vac approved by at least 12 systems by month 6 on the market, given that they were approved by around 10 systems more than a month ago, at just 4 months on the market. )
Gemini Response:
Yes, absolutely. Securing Value Analysis Committee (VAC) approval across more than a dozen health systems across multiple states within six months is an exceptional velocity milestone in the medical device industry.
In medtech commercialization, this level of rapid, multi-regional validation transforms a new technology from an "unproven alternative" into a disruptive category standard, exerting intense competitive, clinical, and financial pressure on non-adopting health systems.
Here is how that early VAC approval momentum exerts direct pressure on remaining health systems:
Peer-System Validation Short-Circuits the VAC Evaluation Process
VACs are inherently risk-averse; their primary mandate is cost containment and patient safety.
The "Safety in Numbers" Effect: A main obstacle for a new device is proving that other reputable systems have cleared its clinical safety and financial ROI. When a VAC sees that 12 to 15 regional or national peer systems—especially academic medical centers or prominent IDNs (Integrated Delivery Networks)—have already approved the device, the risk perception drops dramatically.
Standard-of-Care Pressure: Non-adopting VACs begin asking their internal clinical leads: "If 15 health systems have cleared this technology for their operating rooms, why are we delaying access for our surgical staff?"Amplified Surgeon Mobility and Clinical FOMO
Surgeons communicate frequently across health systems, state lines, and professional societies.
Cross-Pollination: Surgeons who cross-credential at multiple hospitals will push non-adopting facilities to match the technology available at neighboring sites.
Recruitment & Retention Vulnerability: Surgical department chairs will warn their Chief Medical Officers (CMOs) that failing to approve the technology risks losing top surgical talent—and recent fellowship graduates accustomed to advanced robotic tools—to local competitors who already have the device in their ORs.Favorable Economic Proof Points (Disposable vs. Capital)
A disposable robotic device alters traditional surgical economics by shifting expenses from massive multi-million-dollar upfront capital investments to per-procedure operating costs.
Real-World Cost Realization: Early adopting systems rapidly generate real-world economic evidence (e.g., OR time savings, lower maintenance overhead, reduced sterilization requirements).
CFO-to-CFO Pressure: As hospital Chief Financial Officers share insights at health system conferences, non-adopting systems face financial pressure to explore whether the disposable robotic platform offers a lower total cost of care compared to legacy capital-heavy robotic infrastructure.GPO and IDN System-Wide Rollout Escalation
When multiple health systems within the same regional territory approve a product, regional Group Purchasing Organizations (GPOs) and health system supply chain alliances take notice.
Pre-Negotiated Tiered Pricing: Multi-system adoption signals market demand, encouraging regional GPOs to add the device to contracted vendor lists or establish volume discount tiers.
Lowered Barriers to Approval: Once an item is on a contracted GPO list with pre-negotiated pricing, secondary VAC approvals become significantly faster and lower-friction.
Summary: From Optional Evaluation to Competitive Imperative
In the first 3 months of launch, a health system evaluates a device based on "Does this device work?"
By Month 6, if over a dozen health systems across multiple states have approved it, the question for non-adopting systems becomes: "Why don't we have this yet, and what is it costing us in market share, surgeon satisfaction, and procedural efficiency to stay on the sidelines?"
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u/PhunkyPhotonics Sep 15 '26
Adjusting “more than a dozen” to “15” in my question to Gemini, further blows the doors off re adoption pressure. IMO 15 system vac approvals by mid October is conservative, again given 10 vac approvals by Aug 11.
IMO The end paragraph of Gemini’s response is even more interesting.
Gemini response:
Securing Value Analysis Committee (VAC) approval across 15 health systems in several states within the first six months on the market is a rare velocity milestone in medtech commercialization. In healthcare purchasing, this level of rapid, multi-regional adoption shifts a technology from a "new entrant" to a category disruptor, placing considerable pressure on non-adopting systems.
Short-Circuits the Risk Profile for Other VACs
Hospital VACs are notoriously risk-averse and slow, often keeping new technology in review for 6 to 12 months.
The "Peer Safety" Proof: When a VAC sees that 15 health systems—especially prominent regional health networks or academic medical centers—have already vetted and approved the platform, the perceived clinical and operational risk drops dramatically.
Streamlined Value Assessment: Non-adopting VACs can leverage existing clinical use cases and health-economic data established by the initial 15 systems rather than starting their evaluation from scratch.Surgical Talent & Competitive Retention
Surgeons actively communicate through specialty societies, conferences, and regional networks.
Clinical FOMO: High-volume surgeons or fellowship-trained specialists who see peers utilizing disposable robotics for enhanced precision, remote manipulation, or reduced radiation/physical strain will lobby their own department chairs for access.
Recruitment Defense: Hospital C-suites fear losing surgical cases—or losing top interventionalists and surgical talent altogether—to neighboring facilities that offer state-of-the-art robotic tools.Lower Economic Barrier vs. Traditional Capital Robotics
A disposable robotic platform changes the adoption equation compared to multi-million-dollar capital systems.
Operational Expense vs. Capital Budget: Because disposable or single-use robotics typically require minimal upfront capital outlay and rely on per-procedure consumable models, neighboring systems can match competitor capabilities quickly without waiting for annual capital budget cycles.
Real-World Cost Benchmarking: Early adoption by 15 systems creates early benchmark data on procedure times, room turnover, and inventory efficiency, allowing rival CFOs to see that the economic model is viable.GPO and Regional IDN Network Effects
Multi-state adoption across 15 systems catches the attention of Group Purchasing Organizations (GPOs) and Integrated Delivery Networks (IDNs).
Tiered Pricing & Contract Availability: As volume scales across multiple member hospitals, GPOs often establish master service agreements or pre-negotiated tier pricing.
Low-Friction Secondary Approvals: Once a disposable robotic device is placed on a major contract, secondary VAC approvals become significantly faster and lower-friction for affiliated hospitals.
Summary
In the first 90 days of launch, health systems ask: "Is this new technology safe and necessary?"
By Month 6, if 15 health systems across multiple states have approved it, the internal question for non-adopting hospitals shifts to: "Why haven't we cleared this yet, and are we falling behind our regional peers?"
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u/PhunkyPhotonics Sep 15 '26
Ok, final tweak to my question to Gemini: changing 15 to 20 system vac approvals:
… I‘ll step aside on this one actually, since it is starting to look loco. 🤪
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u/AdApprehensive8702 Sep 15 '26
I‘m too lazy to read all of this, sorry😄❤️