MD&M 2026 Keynote: $6.1B Advice From Ray Cohen and Tom West!

State of MedTech
State of MedTechApr 7, 2026

Why It Matters

The discussion reshapes how medtech entrepreneurs and investors approach product development and fundraising, influencing which technologies will ultimately reach patients and drive industry growth.

Key Takeaways

  • Define innovation vs iteration in medtech, challenge assumptions.
  • VC focus on quick returns drives incremental product strategies.
  • Large strategics risk stifling innovation post‑acquisition of assets.
  • Successful exits need clear differentiation and strong advisory board.
  • AI and big‑tech entry reshape medtech funding for moonshots.

Summary

The MD&M West 2026 keynote, titled “Disrupting the Status Quo: Are We Innovating or Just Iterating?”, brought together veteran deal‑maker Ray Cohen and former J&J executive Tom West to debate what true innovation looks like in medical technology.

Cohen warned that venture capitalists are primarily chasing rapid returns, which pushes startups toward incremental improvements that fit a tidy exit narrative. West highlighted how large strategic buyers can provide scale but often mute the original disruptive spark of an asset unless new leadership actively champions continued innovation.

Cohen cited his $3.7 billion Axonics sale to Boston Scientific and a recent $1 billion sales milestone that treated 300,000 patients, underscoring the payoff of clear differentiation. West recounted the $1.1 billion Intersect ENT acquisition by Medtronic and the $650 million Nalo exit, illustrating both the upside and the risk of integration.

For medtech founders, the takeaway is clear: articulate a unique value proposition, build a strong advisory board, and secure capital that aligns with long‑term innovation goals. As AI and big‑tech firms move into healthcare, companies that can balance speed, scale, and moonshot ambition will attract the next wave of funding.

Original Description

In this episode, Omar Khateeb brings you a powerful MD&M keynote conversation with Raymond W. Cohen, Chairman of the Board at Spiro Medical, and Thomas A. West, President and CEO of Nalu Medical, exploring one of the most important questions in medtech today: are we truly innovating or just iterating?
This discussion goes far beyond surface-level innovation. It breaks down what actually separates companies that raise meaningful capital from those that struggle to survive. From $6.1B in combined exits and experience, the conversation reveals why most startups fail not because of technology, but because they lack a complete story that connects product, market, reimbursement, and scale.
You will learn why raising small rounds can limit your trajectory, how top founders think about capital formation early, and why building something slightly better is no longer enough in today’s medtech environment. The episode also dives into how strategic buyers think, why crowded markets kill differentiation, and how to position your company for acquisition or even an IPO.
If you are building in medtech, this is a masterclass on thinking bigger, raising smarter, and creating companies that actually break through.
Episode Breakdown:
00:00 Innovation vs Iteration in MedTech
00:01 Capital, Big Tech, and the Future of Healthcare
00:03 The Real Challenges in MedTech Today
00:05 Meet the Speakers and Keynote Setup
00:10 Are We Truly Innovating?
00:12 What Happens After Acquisition?
00:14 Innovation vs Iteration in Startups
00:15 What Venture Capital Really Wants
00:18 Think Bigger and Raise Bigger
00:22 Why Capital and Board Matter
00:25 The Old MedTech Playbook Is Dead
00:27 How M&A and VC Have Changed
00:30 Strategic Investors and Real Examples
00:32 Scaling with Enough Capital
00:34 The Danger of Copycat Startups
00:37 Why Founders Default to Iteration
00:39 The Power of Narrative
00:40 Manufacturing and Early Strategy
00:42 What Investors Actually Look For
00:43 Raising Big for Disruptive Ideas
00:45 Is There Really a Capital Shortage?
00:47 What Investors Bet On
00:48 Building a Winning Story
00:50 Reimbursement and Market Reality
00:53 Why Founders Fail to Convince Investors
00:55 Should You Go After Bigger Problems?
00:57 Exit Strategy and Scaling Decisions
00:59 IPO vs Acquisition
01:00 Public Market Thinking
01:02 Storytelling Drives Capital
01:03 The Reality of Building in MedTech
01:04 Big Tech vs MedTech
01:06 Pharma and New Capital Sources
01:08 Why Disruption Wins
01:09 Owning the Full Business
01:11 Building the Right Team
01:12 Everything Comes Back to Capital
01:13 No Money No Mission
01:14 The Real Impact of MedTech
01:15 Closing Thoughts
Are you a medtech CEO in need of some marketing help attracting investors, growing sales pipeline, and more? Go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠GrowMyMedtech.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ to book time for a free analysis.
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