Interviews of Clément (Synapse), Arnaud Rosier (Implicity), Christian Allouche (Gleamer)
- Clément Goehrs, CEO @ Synapse, specialized in drug information and provider of telemedicine platforms.
- Arnaud Rosier and Thomas Habib, respectively CEO and COO @ Implicty, platform simplifying cardiac remote monitoring.
- Christian Allouche, CEO @ Gleamer, editor of AI-based medical imaging software.
- 🛫 Prepare for launch
- 💭 Think US from Day 1
- 🇺🇸 Establishing a US culture within your team
- 📊 Market analysis
- 🔎 Generate leads
- 🛬 Setting up in the US
- 📍 Choosing your location
- ✅ The importance of a co-founder on site
- 🏢 Legal structure
- 🚀 Starting in the US
- 🔄 Organizing your teams
- 🆗 Obtenir un FDA Approval
- 🌐 Leveraging your network
🛫 Prepare for launch
💭 Think US from Day 1
Thinking about the product globally from the start encourages teams to create the product in a way that is modular and adaptable to any geographic area.
This allowed Synapse, a few months after developing the French product, to be ready to demo to US prospects. It was part of their roadmap from the beginning.
"I was able to start doing BizDev in the US early on to qualify the market" Clément, CEO @ Synapse
This was very beneficial as the health situation made the US market difficult to access, Synapse was able to launch UK, Germany, Spain and Italy versions of its product in less than 3 months.
🇺🇸 Establishing a US culture within your team
"It's difficult to force yourself to think about the US from the start" Clément, CEO @ Synapse
A few actions to force yourself to think about the US:
🇺🇸 To help with market understanding and US development, Synapse called upon Sandira Calviac, a French-American entrepreneur.
📊 Market analysis
Arnaud called on Mathieu Petitjean to conduct a medical-economic analysis.
"I recommend him to healthcare startups wishing to evaluate the value of their product in the US"Arnaud Rosier, CEO @ Implicity
💰 Price: 20k€
🔎 Generate leads
Arnaud, Clément and Christian all agree that it is necessary to have generated between 20 and 30 leads before launching in the US.
Ways to generate these leads in a COVID context:
- Identification of potential clients via LinkedIn
- Remote acquisition, "in Covid mode", thanks to digital marketing
- Use of Dropcontact to find contact details
⚠️ Digital marketing does not replace physical meetings at trade shows
"We had to provide an extra effort in digital marketing to achieve the result we would have obtained in 2 days of trade shows" Thomas Habib, COO @ Implicity
🛬 Setting up in the US
📍 Choosing your location
For obvious reasons of time difference, Arnaud, Clément and Christian all plan to settle on the East Coast.
According to Clément, if you have no particular reason to settle on the West Coast, you should settle on the East Coast due to the lower time difference.
To help you make your choice, here is a list of things to keep in mind.
Factors to consider | Why |
|---|---|
For example, the Boston airport is a few minutes drive from downtown, allowing you to reach Paris in 6.5 hours and is the closest to France. Miami, on the same coast, adds 2 hours of transportation. | |
Don't think that a 6 hours or 9 hours time difference is the same thing. This can make the relationship with the HQ very difficult. East Coast (Boston, New York, Miami) gives you 3 additional hours of working-day overlap versus the West Coast. | |
(Do not) believe that US culture is the same everywhere: north/south, east/west. The culture of the East Coast is closer to that of Europe than that of the West Coast, even though it is the same country. If we compare the coasts, there is more traditional business on the East coast than the West coast. | |
Ideally, you should not impose a precise city for the General Manager. People are always more important than location and they need to embody the development project. Moreover, it is this person who will live there on a daily basis (take into account family constraints too). If a CEO imposes a location, he risks losing his General Manager very quickly. | |
(although this should not be a driver) + payroll taxes (state + city) (State individual income tax rate: California: 9.3%+ / Texas: 0%; Corporate income tax rate: California: 8.84% / Texas: 0%) | |
More and more selling can be done remote. There is less need to be located in an "expensive" city. As a startup, you should not open in a city for prestige reasons especially as your prospects are spread out. | |
Tech is focused in the Bay Area, whilst Finance and Media are big in New York; Boston is known for Biotech startups. | |
Salary and rents are extremely high in New York, and even higher in the Bay Area. Using cost as a proxy for talent retention makes this even more critical. For example, NY is more expensive than Boston (+30% to 40%). | |
What is the availability of GTM hires you need – inside sales, enterprise sales, partnerships, growth? Where will you find executives with proven scaling experience for your business model and sector? NY is known for its digital talents. Boston is home to universities like Harvard and MIT attracting many digital talents. | |
You must be able to be in contact with them and even meet with them. |
If you want to be present on the West Coast, it is possible to send someone to Silicon Valley. This may be relevant if you plan partnerships with Facebook, Google, etc., for example.
✅ The importance of a co-founder on site
It is very important to have local contacts before setting up.
As soon as traction is sufficient, the presence of a co-founder on site is almost essential to carry the company, the value, the knowledge. It is very difficult to delegate this to someone else.
"Without the health crisis, I would probably be living 3/4 of my time in New York"Clément, CEO @ Synapse
Similarly, Arnaud, CEO @ Implicity plans to live most, if not all, of his time in Boston until the Series A.
Christian, CEO @ Gleamer considers that his presence on site is essential for at least 6 months - 1 year in order to sign the first key accounts, conclude a strategic partnership, obtain FDA approval, and raise funds with US VCs.
🏢 Legal structure
Clément preferred not to create a legal structure right away, considering that it is not relevant as long as the product is not ready to be sold and that the process is fast and inexpensive
When he started selling his product in the US from France, Arnaud wanted to create a legal structure on site.
He called on Axelia Partners for:
- Creation of the legal structure
- Visa for his salesperson on site
- Payroll
So all his contracts with the US go through this subsidiary, as do all those related to his employee on site.
🚀 Starting in the US
🔄 Organizing your teams
"At some point, you need Americans."Clément, CEO @ Synapse
The first 3 profiles Implicty is looking for in the US are:
- General Manager North America
- A Salesperson
- A Customer Success Manager
Once in place, the General Manager will be responsible for recruiting the other two profiles.
Arnaud is also considering hiring a person dedicated to US Marketing, for now, it is handled by the person in charge of European Marketing.
Also, he would like to use insiders who can play the role of business providers and are paid only on success.
We find the same organization at Gleamer:
- The Chief Business Officer is responsible for structuring all business in Europe
- He is supported by Account Executives coupled with Customer Success Managers (application engineers)
- For each country opening: hiring a Country Manager who takes on the CBO role accompanied by an Account Executive and a CSM
- A VP Partnerships is common to all countries
Christian prefers to use a recruitment firm to find a Country Manager quickly.
🆗 Obtenir un FDA Approval
Christian considers obtaining FDA Approval more "tough" than European regulations, the specifics are:
- Higher requirements for cybersecurity
- A larger clinical study
Christian also recommends having exchanges with the FDA, as they will clearly indicate the points needing improvement and those already meeting their criteria.
To manage the regulatory part, Arnaud and Christian have called on:
- Juniors in-house who do everything related to quality and CE marking
- Consultants for the entire FDA aspect
- A law firm in the US
Covington, a law firm
Christian recommends that the Principal Investigator conducting your study:
- Have a connection with France
- Be recognized in the US (High H Score)
Christian called on Ali Guermazi for his scientific and business qualities. He offered him a seat on his Advisory Board. He will contribute by giving credibility to Gleamer and sharing his extensive network.
The political context in the US can affect your strategy. Clément preferred to wait for the results of the Trump/Biden election since the results will have an impact on the functioning of the healthcare system.
→ The Go-To-Market can therefore be quite different depending on the political context.
🌐 Leveraging your network
Ways to use your network:
- Call on your investors for business introductions, feedback, KOL...
- Locate the French and European diaspora corresponding to your sector
- Locate the geographic hubs (e.g., Boston for BioTech) corresponding to your sector. You will find experts, KOL, talents...
- Visit US funds (without specifically looking for funding) specialized in your sector to request intros within their portfolio and make yourself known for a future fundraising
- • Participate in trade shows, events. Clément recommends all health startups to participate in the JP Morgan Week