Bariatric News talked to Letizia Ceccarelli, Head of International Marketing – Endobariatrics at Boston Scientific about the changes she has seen over the last decade in the endobariatric market. Letizia, who is a biomedical engineer by education, has been in the medical device industry for 21 years and joined Apollo Endosurgery (“Apollo”) ten years ago in March 2014. Boston Scientific acquired Apollo in 2022. In this interview, we discuss her career, the emergence of endobariatrics and the future of weight loss treatments…
“My career has been dedicated to marketing in both startups and very well-established multinational companies, and across multiple medical device sectors including wound care, spine surgery and ICU,” she explained. “When I joined Apollo, the company was in the process of acquiring different weight loss device products. Although these products were already well-established in the market, we had to create the rest of the company from scratch. I was proud that Apollo became one of the real pioneering companies in the endobariatric marketplace. All of this was achieved with the support of a group of visionary surgeons and gastroenterologists who saw the opportunity to bring to patients living with obesity new minimally invasive endoscopic weight loss therapies. In my case, I had to create the international marketing department from the ground up, while we were also launching the Overstitch™ Endoscopic Suturing System. Of course, I didn’t do everything alone because I’ve been incredibly lucky to meet exceptional and passionate marketers who have been instrumental to our success.”
According to Letizia, perhaps the most significant change she has witnessed within the endobariatric market in the last decade has been the acceptance of the technology into the very well-established bariatric community. She explained that ten years ago, although physicians could see the potential of the technology, the real challenge was to turn that potential into a success - by providing the evidence to demonstrate the technology was safe but also effective in helping people living with obesity to lose weight.
“I would say another pivotal moment was the publication of the Multicentre ESG Randomised Interventional Trial (MERIT) data (1) that showed the efficacy of endoscopic sleeve gastroplasty (ESG) performed with OverStitch™ combined with lifestyle modifications, in achieving and maintaining important weight loss. This first randomised control trial provided safety and efficacy data on an endoscopic gastroplasty performed with OverStitch™ up to two years follow up. The third pivotal moment has been the publication of five guidelines, position statements and recommendations that have been published both at the international and country level. This is a highly significant alignment of consensus from the obesity community, agreeing on the pivotal role that can be played by endobariatric procedures for patients living with obesity. Finally, I would add that over time we have seen an incredible increase in patient interest for the procedure.”
So looking to the future, what does Letizia see as the most challenging aspects of treating obesity? Without hesitation she states that increasing access to all weight loss treatments is the number one priority. She explained that until recently only 1% of people living with obesity worldwide were treated, according to the American Society for Metabolic and Bariatric Surgery (2).
“The real problem we have is that only a very small fraction of the people who could benefit receive treatment. According to our market research and external third-party surveys that have been conducted in recent years, patients are apprehensive about surgery and they prefer minimally invasive options. They are largely not aware of what treatment options are available. And that's why we believe that the recent positive guidance by the UK’s National Institute for Health and Care Excellence (NICE) of ESG for weight loss management is such great news, because it represents an expansion of patient choice regarding treatment to facilitate weight loss, and the fact that NICE considers ESG may particularly benefit those living with obesity (Class I to III).”
She believes that endobariatric procedures should be part of the armamentarium of every centre that takes care of patients living with obesity and will play an ever more important role in treating this disease.
A second important change to the market has been the emergence of the new generation of GLP-1 medications. She explained that these new treatments options have increased the focus of patients and the media on obesity and shone a light on obesity as a disease that has been neglected for many years.
“We know obesity is a progressive and degenerative disease, so there is no one ‘magic’ solution that will solve all cases. The winning strategy is to make sure that every obesity care unit has the possibility to offer patients all available safe and effective therapeutic options, basically building a multimodality care pathway which is patient-centric and based on the specific expectation of the patient, their medical history and clinical needs.”
In November 2022, Boston Scientific announced it was in discussions to buy Apollo and the acquisition was completed in April 2023. So, we asked Letizia how she adjusted to work for one of the leading medical device companies in the world?
“The most important point for me is that both Apollo and Boston Scientific share very similar core values. From that perspective I felt at home from day one. The culture of any company is super important from an employee standpoint, because you need to be onboard 100%, especially when you are acquired. In 2014, Apollo as a startup was perfect to build a new market with an agile and flexible structure that could quickly adapt to the market conditions and take quick decisions to be able to move the business forward. As the company grew, a more articulated and structured approach became essential to serve customers in the best way possible. Boston Scientific’s global footprint provides an opportunity for an accelerated and sustainable geographic expansion through a direct presence in many markets and a stronger understanding of the specific country and market needs.”
“I believe in a marketing team that is as close as possible to both the salesforce and to the customers to be able to understand market dynamics, market trends and customer needs directly. The main challenge for me is to find the right balance in between my internal stakeholders and meeting customers and learning from them with every single interaction.”
Having been in the sector for ten years, what does Letizia find the most enjoyable part of her job? She instantly replies meeting with customers no matter what the circumstance. Whether it’s at a training event or a congress, she is so grateful for their time with her in the last ten years.
“There is also another very important part of my job that I want to mention, for which I think I’m full of gratitude. I feel incredibly honoured and lucky because I have the chance to talk to patients and listen to their stories. This is such an incredible and emotional experience that I even find hard to describe, because when you listen to them, you have a door that opens in front of you. They let you enter a world that is completely new to you because you see it through the eyes of a person who lives with the guilt of their illness and the stigma they experience every day. They share with you the most intimate details of their life, letting you understand their feelings, their fears. You understand how much they have emotionally invested, looking for an effective solution that can change their life. So, you understand how much hope they have to be able enjoy the simplest moment of their lives - such as walking with their children in the park. I think that we take so much for granted. Until you listen to them and read this hurricane of emotions in their eyes: weight loss for a patient is a transformational experience. It’s also a transformational experience for us when we listen to them. And this gives purpose to everything I do every day in my job.”
“I think that what’s important is that as Boston Scientific we keep focused and continue to repeat the message that that obesity is a prevalent, complex, multifactorial, chronic, relapsing, progressive disease process. The fact is that people living with obesity not only face substantial bias and stigma, but they're also exposed to a higher risk of death. We know that a higher than optimal body mass index caused an estimated 5 million deaths in 2019 from non-communicable diseases such as cardiovascular disease, diabetes and cancer – and often the comorbidities are related to obesity, (3)” she concluded. “Our commitment as a company is to support healthcare professionals involved in tackling weight loss challenges associated with obesity and to help them support their patients who are motivated to lose weight through our innovative, minimally invasive technologies and solutions. We can only succeed if we stand united and work collaboratively towards achieving the same common objective - which is ultimately improving patients’ lives.”
References
Abu Dayyeh BK, et al. Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomised trial. Lancet. 2022 Aug 6;400(10350):441-451. doi: 10.1016/S0140-6736(22)01280-6. Epub 2022 Jul 28. PMID: 35908555.
https://asmbs.org/news_releases/after-30-years-new-guidelines-for-weight-loss-surgery/
Body-mass index and risk of obesity-related complex multimorbidity: an observational multicohort study - The Lancet Diabetes & Endocrinology
Commentaires