THE RACE FOR MARKET SHARE IS ON:

LAMARR’S FIGHT FOR A FINAL THIRD POSITION

Members of Team Python:

Timothy Knox
Noa Diaz Castro
Mitchel Morovati
Organization Chart
The organization chart below shows each member of Team Python that fully
participated in Game 1: Value proposition simulation - Surgical Robotics.

Figure 1. Team Python’s Organization chart

Each team member played a different main role but similar secondary ones:
The Driver:
● Main role: drive through game tabs, entering agreed forecast and yearly
decisions.
● Secondary tasks:
○ Summary preparation of each robotics company based on the reading
provided.
○ Establish possible strategies and goals and propose actions during the
game.
○ Act as devil's advocate before final decision.
● Report: team involvement, executive summary, brand, and competitors
positioning, goals and failures. Participating in discussion with all members on
game outcome, success, and failures and what we could have done differently.
The Scribe:
● Main role: take notes of each discussion during the whole duration of the game.
● Secondary tasks:
 ○ Provide good insight with regards to customer retention and brand
positioning.
○ Establish possible strategies and goals and propose actions during the
game.
● Report: investment decisions and evidence. Participating in discussion with all
members on game outcome, success and failures and what we could have done
differently.
The Timer:
● Main role: monitor that the team will meet each year's deadline.
● Secondary tasks:
○ Initiate discussions based on the different reports provided and focusing
on brand value, price, and perception vs importance.
○ Establish possible strategies and goals and propose actions during the
game.
● Report: final evaluation and conclusion. Participating in discussion with all
members on game outcome, success, and failures and what we could have done
differently.

Executive Summary
Open surgery and laparoscopy dominate the surgical market with 98% of the surgeons’
support. Laparoscopy has already surpassed open surgery due to several procedural
benefits that can reduce costs and improve patients and surgeon’s appeal.

Robotics surgery is trying to position itself in the general surgery market and more
specifically in the minimally invasive surgery one. Lamarr, Inc. was assigned to our
team to develop a value proposition that leads an eight-year investment plan. Lamarr,
Inc. is well established in the robotics market and well known by its customers, including
patients. But we are not alone in this market and our competition claims similar
performance.
Our first step is to understand our core competences, possible benefits derived from
those competences and the challenges we are facing. A second step involves our
competition with a similar exercise that helps us identify possible threats and
opportunities. Establishing who our competitors are is not sufficient, we also need to
define our customers and their possible preferences with respect to the products we are
offering. This will delineate our competitive advantage.

Lamarr, Inc. will be ready to discuss its strategy and goals over an eight-year period and
subsequently proceed with each year's investments. All investments decisions will be
outlined as well as the outcomes, and how those outcomes did satisfy or not our
expectations.

Based on our initial strategy of increasing brand value, enhancing flexibility and
precision, and attempting a new pricing strategy with possible operational cost
reductions, the outcome showed measurable success but was surpassed by two of our
competitors in the robotics market. Our aggressive reactions to some of our yearly
outcomes, allowed our competitors to gain more brand recognition, market and
customer share.

Competitive advantage
Lamarr, Inc. boasts about being the paramount player in the medical robotics domain,
primarily attributed to its well-recognized brand and substantial market presence.
Lamarr has an impressive track record of over 5,000 operational robotic units and has
become the only familiar name among hospital stakeholders, surgeons, and
administrators. Lamarr holds several key advantages:
● Market Recognition and Marketing Expertise: its distinct brand recognition is an
important asset and mainly among patients undergoing routine urology and
gynecological procedures. This familiarity significantly influences patient
preferences.
● Surgeon-Centric Approach with Advanced Robotic Systems: Lamarr
concentrated efforts on creating technology that enhances surgeon comfort,
 productivity, and precision, ranking as the top robotics company among open
surgeons. These systems are also designed to improve patient outcomes.
● Revenue Diversification: Lamarr’s revenue sources include the sale of its robotic
systems, tailor-made surgical devices and accessories for robotic use, and
service contracts for system preventive maintenance. This diversified income
ensures its financial stability.
● Existing Market Share: Lamarr holds a substantial market share in urology and
gynecology, areas where robotic surgery has seen widespread adoption.

In summary, Lamarr’s strategic assets include intellectual property with equipment and
patents, brand recognition with a well proven track record of successful robotic
surgeries and customer focus, which provides the undeniable benefits of a well-
established company like risk mitigation.

Lamarr’s position in the market is strong but there are also challenges that could impact
its future within the robotics market:
● Pricing and Reputation: hospital administrators do not feel comfortable with
having only one main player in the market. Lamarr offers its products and
services at a high price and its marketing and sales strategies are intimidating.
● Limited Procedure Diversity: Lamarr is currently concentrated on specific surgical
specialties like urology and gynecology, restricting its ability to address the
general surgery market.
● Competitive Responsiveness: competitors offering similar or new solutions into
the market, could and will respond aggressively to gain market share.

Lamarr’s primary competitors in the medical robotics sector encompass several

distinctive advantages and disadvantages.

Ada Robotics (by Trust Surgical Corporation) could be a hybrid sub-brand driven based
on having little to no information about its parent company:
● Advantages:
 ○ Intellectual advantage: Ada states that it has an exceptionally skilled team
dedicated to developing a robot capable of integrating the entire medical
field, expanding the procedural breath.
○ Innovative Approach: Ada Robotics aspires to go above and beyond
augmenting surgeon’s skills and delivering improved results in comparison
to conventional laparoscopic procedures.
○ Advanced Data Integration: they focus on integrating patient data and
real-time surgical guidance, which would enhance precision and
procedural outcomes.
○ Parent Brand Recognition: even though there is not much information
regarding Ada’s parent brand, we could consider this as an advantage,
either due to simple market recognition or as a financial cushion.
● Disadvantages:
○ Operational Flexibility: its new development is struggling with OR flexibility
and this could impede its market entry or at least become a setback.

Telkes Medical (by Health Corporation) could also be considered a hybrid brand, maybe
sub-brand driven, even though it was acquired by Health Corp and its intentions about
running Telkes from its minimally invasive business unit are unclear. Health Corp has
the most extensive laparoscopy and surgical portfolio in the market:
● Advantages:
○ Parent Brand Recognition: Health Corporation, the parent company of
Telkes Medical, has an extensive portfolio in laparoscopy and surgical
supplies, which it intends to adapt for the robotics landscape. This would
be considered the next step on its business plan and not a new category.
○ Market Relationships: related to parent brand recognition, Telkes Medical
has access to numerous surgeons and healthcare administrators,
potentially opening doors to the robotics sector.
○ Resources: Telkes can leverage Health Corp’s resources, distribution
channels and expertise to grow and expand its operations.
 ○ Instrument Integration: Telkes specializes in integrating instruments,
delivering OR flexibility and potentially leading to a distinct clinical
experience for patients.
● Disadvantages:
○ Legacy Knowledge: there is a lack of surgical robotics knowledge on the
Health Corporation side that will need to be addressed.
○ Launch Timeline: the timeline for fully integrating a robotics system
remains uncertain.

MediBot Labs is a startup with a distinct branding:

● Advantages:
○ Equipment Design: MediBot Labs offers a comfortable and intuitive design
of its surgical robot which could attract surgeons.
○ Competitive Pricing: MediBot Labs intends to offer its technology at a
slightly higher price than open surgery, with a per-procedure billing
approach, which could attract healthcare administrators and even patients.
○ Progress in FDA Approval: with units in the European market and its
progress in obtaining FDA approval, MediBot Labs is potentially closer to
entering the US market.
● Disadvantages:
○ OR Flexibility and Footprint: MediBot Labs’s surgical robot occupies a
significant footprint in the OR what reduces its flexibility.
○ Resources: MediBot Labs is financially disadvantaged with regards to its
competition. It will need a rapid market acceptance and embrace.

We should also consider open surgery and laparoscopy as competition, not necessarily
because Lamarr will be competing directly in the general surgery category or the
minimally invasive surgery but because of possible adoption of robotics technology by
surgeons within those markets.
As a summary, these are the main and possible benefits for each robotics surgical
competitor based on their core competencies and strategic assets indicated as
advantages:

Table 1. Main Benefits for each robotics surgical company

We can consider the following customers for each of those companies:

● Direct customer: healthcare administrators
● Indirect customer: surgeons
● Indirect customer: patients

There are different factors that can influence customer preferences depending on the
customer:
● Procedure cost: high pricing could potentially act against customer acquisition
and retention, considering healthcare administrators and patients.
● Learning curve: technologies that are easy to master for surgeons and/or
providing comprehensive and advanced training can be appealing.
● Flexibility and accuracy: technologies that increase surgeons’ skills and
ergonomics will also be more appealing.
● Patient attraction: the patient perception with regards to surgical outcomes and
procedure itself, can lead to a brand preference.
Lamarr and the other competing firms should follow their strategy and possibly make
slight changes in execution based on competitors’ reactions like pricing strategies,
marketing initiatives and customer approach.

Initial Strategy and Goals

There are key strategic decisions to make regarding the target market or category
where Lamarr will compete and the target customer.

As mentioned, Lamarr’s patient appeal is highly recognizable as a key benefit, and we

want to keep it that way. We will strengthen patient-focused marketing efforts to
increase brand value, patient awareness and confidence in robotics. This marketing
campaign could emphasize the benefits of quicker recoveries, reduced pain, and
improved outcomes.

Lamarr’s initial approach to robotic surgical procedures was concentrated on surgeon’s

comfort and productivity. A technological innovation goal will be considered by
continuing investing in research and development, which will enhance flexibility,
accuracy, and precision, following that initial path started by Lamarr.
Those two goals mentioned above, will keep our future investments highly conservative
to retain current customers.

One key strategic goal considered was Lamarr’s operational cost-effectiveness and
pricing strategy. Reducing overall per-procedure costs and revisiting its pricing strategy
to make robotic surgery more cost-competitive would attract a wider range of healthcare
providers or administrators and encourage future adoption and not only customer
satisfaction and subsequent retention. As we will explain below, this initial goal was only
partially executed with expected consequences.

Based on the previous goals, we wanted to mainly retain current customers and
potentially gain others within the minimally invasive surgery market.
Investment Decisions and Outcomes
Table 2 below, shows a summary of the investments completed for each of the four
years and how new investment options were incorporated into the mix.

Table 2. Investments versus decisions for the first four years

Year 1 Investment Decisions

● We invested in direct-to-consumer communications to increase patient appeal.
● Traditional learning investments were made to enhance our learning curve.
● We did not increase our price, as as it was already one of the highest prices in
the market and mainly in comparison to open surgery.
● Research and development investments were aimed at improving the services
provided to patients and surgeons, mainly with regards to equipment flexibility
and data integration and possibly procedural breadth.

Year 1 Investment Outcomes

Investment outcomes were favorable, with increased patient appeal and marketing
efforts. The big downside we saw as a result of our Year 1 investments was lack of
income. Due to overinvesting, we lost 5 million dollars of revenue in Year 2.
In terms of our goals, the marketing investment was a win. We wanted to attract more
customers. The R&D investment was a long-term investment that was not going to
provide benefits in the short term. Even though we had that in mind, our strategy
changed slightly in order to overcome the losses.

Year 2 Investment Decisions

● We faced challenges from long term investments.
● To balance profit loss, we increased prices slightly even though our price
strategy was not one of the most popular among our customers.
● Marketing expenses were reduced due to high patient appeal.
● Apart from a slight price increase, we made the difficult decision of outsourcing
our manufacturing to Finland, which would reduce our operational costs in the
medium to long term.
● We made no investments in the surgeon learning curve.

Year 2 Investment Outcomes

ROI was good, but investment in long term opportunities and pricing changes posed
challenges. Due to our large investment in outsourcing, we lost 48 million in revenue for
the following year.

Our previous year had moved us towards our goal of patient appeal. Due to this, we
reduced some of our investments in marketing. We also did not invest in training, which
was one of our initial goals we should have stuck with for this year. We also should
have looked at what our competitors were doing and how far we were falling behind.

Year 3 Investment Decisions

● This year was for recouping losses.
● A conservative price increase was implemented.
● Minimal spending to recover from previous investments.
● A focus on lobbying and no investment in learning curve.
Year 3 Investment Outcomes
A conservative approach helped recoup losses, but the learning curve and low amount
of lobbyists decisions were suboptimal. Despite this, in the following year we turned it
around and made 57 million in profit. Our initial high investments of tech and
outsourcing were bearing fruit. We were making money instead of losing money.

Since we were recouping, we did not maintain focus on our customer base and
attracting surgeons. Our marketability suffered because of these decisions. We
definitely should have invested in training this year.

Year 4 Investment Decisions

● We aimed for long-term investments.
● Added meetings to increase brand value and doctor numbers.
● Increased lobbyists despite ethical concerns.
● Invested in traditional learning but regretted not choosing enhanced learning.
● Increased prices, potentially losing healthcare administrators.

Year 4 Investment Outcomes

Long-term investments were made, and we increased prices. However due to a strong
foundation of previous years, we saw a ROI for our company. We could have invested
further in medical meetings. Six was a conservative investment. However, we were
hesitant to invest more given our high initial investments in the first couple years.

Figure 2 on the next page, shows the income statement for Lamarr, Inc. that provides
the outcomes of the investments explored over the years.

Overall Investment Outcomes

Throughout the years, we made various investment decisions that sometimes aligned
with our goals and at other times posed challenges. Our company managed to
strengthen patient appeal, invest in R&D for technological innovation, and maintain a
conservative approach to retain customers. However, there were instances of
overinvestment, missed opportunities in surgeon learning curve enhancement, and
conservative lobbying investments that may have jeopardized cost-competitiveness and
administrator satisfaction.

In retrospect, different strategies could have better balanced our short-term and long-
term goals. We were successful in the market and ended with significant and consistent
net income. However, we were outperformed by some competitors who made more
decisive and concentrated investments.

Part of our lackluster performance was due to losing sight of our initial assessment and
goals. If we had stayed the course on increasing marketability and attracting surgeons,
we may have outperformed our competitors. Since we spread our investments along
different lines of attack, we did not focus on our strengths as a company. We ended with
a smaller surgeon customer base compared to two of our competitors: 118 surgeons vs.
204 for Ada and 273 for Telkes. Low learning curve started as one of our greatest
opportunities, and then remained so throughout our years of decision making.

Figure 2. Lamarr’s income statement

Failure or Unexpected Outcomes
Our biggest failure was our low learning curve. We had poor investment in comparison
to the competition. Only traditional investment the first and fourth year with no
investment at all in between. This is probably the reason why Lamarr did not gain
enough support from surgeons and its brand value increased slower than the
competition. Not considering competitors’ reactions and investments regarding this topic
was a mistake (see Figure 3). There should have been more investment in training for
improving the learning curve. We ended with fewer surgeons than the competition,
causing a big cut to our overall profit. In addition to investing in more training, we could
have invested in more medical meetings. As previously mentioned, our six meetings per
year was a conservative investment.

Figure 3. Competitors investments

Another area where we struggled was procedure price. We were already established
at a high price in the medical robotics market. The progressive price increases made
over the first four years, together with a lower investment in professional training, could
have given more reasons to administrators to evaluate new options in the market.
Marketing investments that increase patient appeal alone, did not help with hospital
administrators' perception of Lamarr’s brand.
Furthermore, outsourcing manufacturing to Finland to reduce costs followed by a price
increase in year four, was not the most effective move. A reduction in price would have
made Lamarr more competitive and possibly improve brand value.

Our final area we needed improvement was precision and OR Flexibility. The first
year, we considered a moderate investment in research and development. This was
most likely not a high enough investment based on a medium interest in maintaining our
position in the market with regards to equipment repositioning and operations precision
on the surgeon side.

Figures 4 and 5 show the perception versus importance graphs for year 1 and year 8
respectively. They represent the general view of the benefits for our company Lamarr
Inc. versus our competitors, from its starting point. These figures provide a good
summary of the overall outcome that our investments generated.

Figure 4. Perception versus Importance Report - Year 1

Figure 5. Perception versus Importance Report - Year 8

Final Evaluation
Our team’s overall performance was good but not perfect and there were a few things
we could have done differently to have possible better results. First off as the game
went on, we slightly lost sight of our company's core competencies and our starting
goals.

We successfully increased our patient appeal through marketing which aligned with our
goals, and we invested heavily in R&D following our strategy of increasing accuracy and
flexibility, even though we were already well positioned in the market. This was a long-
term investment that caused an early revenue loss and made us rethink some goals.

We relied too heavily on being the only robotics surgery company well-known by
patients and tried to leverage that by increasing our prices to offset some of the revenue
loss we had from our R&D initial decision. While this did the job of offsetting some of
those investments, it did not improve our business as a whole and made us lose some
market share and brand value after that.
Further decisions helped us recover some of that market share and brand value, but our
growth ended up being slower than our competition.
While our goal of a heavy marketing focus was achieved, we relied on that success too
much and used our patient appeal as a crutch instead of using it to spearhead our
business further. Not addressing surgeons properly by investing in appropriate training
and knowing what our competitors were heading, also influenced our slower growth and
made us lose surgeons’ support.

Overall, our team's performance was relatively successful but there was also room for
improvement. Several things could have been done better to successfully achieve all
our starting goals as a company (see Figure 6).

Figure 6. Summary of main results after the full investment term

Conclusion
We started with a strong competitive advantage in the medical robotics market, driven
by our well-recognized brand, substantial market presence, and our track record of
successful robotic surgeries. Our company's patient-focused marketing efforts
contributed to its market recognition initially.

Our investment decisions displayed a mixed end result. Some of our larger investments
aligned with our goals of patient appeal and technological innovation. We did encounter
issues such as overinvestment and pricing changes that caused revenue loss.
Our biggest opportunity was not staying focused on our initial goals. If we had honed in
on marketability and expanding training, we may have performed truer to our strengths
as a company and seen better performance compared to our competitors. Since we lost
focus on our low learning curve, we ended with fewer surgeons than the competition.

In conclusion, our company still ended well-positioned in the medical robotics market.
Our strategic decision-making led to overall success. But we were outperformed by
competitors who had more decisive and possible data focused investments.