Gianluca Fontana, CEO & Co-Founder of Prova Health

Julio Martinez-Clark (00:01.265)
Welcome back to another episode of the Global Trial Accelerators Podcast. Today we have Gianluca Fontana. is the CEO and co-founder of Prova Health, accelerating digital health innovation with rigorous clinical and economic evidence. A former McKinsey consultant and UPT director at Imperial College London's Institute of Global Health Innovation, he led the NHS Digital Academy

and the two million participants react COVID-19 study. With 260 plus research citations and degrees from Volcani University, Gianluca helps global pharma and meta companies generate evidence 40 % faster while building internal capabilities for sustained growth. Gianluca, it's really a pleasure to have you here. Welcome.

Gianluca Fontana (00:54.592)
Real pleasure to be with you, Julia.

Julio Martinez-Clark (00:57.277)
Excellent. All right, Gianluca, let's get started here. Let's talk about your journey, your personal and professional journey. How is it that you got to where you are today?

Gianluca Fontana (01:06.382)
Yeah, so look, healthcare has been part of my life from the very start. So I come from the Northeast of Italy, small town. My dad was the local GP, right? The primary care doctor. So it's been there from the start. From a very early age, people have been asking there for whether I was going to become a doctor myself. They asked me too much.

Julio Martinez-Clark (01:19.855)
Okay.

Julio Martinez-Clark (01:31.505)
Mm-hmm.

Gianluca Fontana (01:34.446)
It turned me off, I have to say, and I never felt like I had the same vocation for it as my dad had. So I went off and did something entirely different. I studied business and economics and I went into management consulting. Somewhere at the back of my head though, that interest remained and I decided to pursue it once I was

Julio Martinez-Clark (01:35.696)
You

Gianluca Fontana (02:03.85)
once I was in management consulting. So I joined McKinsey's Health Systems Institute, which was an innovative initiative predicated on health systems around the world, sharing data and comparing performance to support their improvement. It was an amazing experience with colleagues from all over the world working with 20 plus countries that really gave me one of the main elements

of my experience in healthcare, which is that knowledge of how health systems and clinical pathways work. So from there, I went on to Imperial College London, which is an unusual step from a management consultant to go to a university. But I had one of, for me was one of the best jobs in the world.

Julio Martinez-Clark (02:51.195)
Hmm.

Julio Martinez-Clark (02:56.923)
I'm sure.

Gianluca Fontana (02:57.588)
focusing on leading a center for our policy within the broader Institute of Global Health Innovation, together with world leading clinicians, policymakers, and people from all sorts of backgrounds. So there is where the second big element of my career really came in, which is the desire and the focus on accelerating innovation.

Julio Martinez-Clark (03:26.905)
Hmm.

Gianluca Fontana (03:27.118)
You know better than me about how slow the process of incorporating innovation in healthcare is. Obviously healthcare is a delicate industry. There are a lot of risks, but things change at a really glacial pace. So the other element and kind of mission of my career is around accelerating innovation. And my unique angle to that is related to the understanding of the

Julio Martinez-Clark (03:34.416)
Yes.

Julio Martinez-Clark (03:51.653)
Hmm.

Gianluca Fontana (03:57.334)
health system dynamics, the health policy priorities and the clinical pathways in which the innovations need to fit.

Julio Martinez-Clark (04:06.766)
Excellent.

Gianluca Fontana (04:07.694)
So, you know, that part about supporting innovation, you can do within a university up to a certain point. And in 2020, with a few colleagues, after trying to work effectively from within a university with businesses and innovators, really, and struggling to do that effectively, we started Prova Health. And Prova Health...

Julio Martinez-Clark (04:32.955)
Mmm.

Gianluca Fontana (04:36.086)
health's mission is to improve health for all by facilitating and supporting innovation. So we're not there to add one more drug or one more digital solution to the large number that already exists. We are there to help innovators achieve scale and widespread adoption quicker.

Julio Martinez-Clark (04:52.164)
Mm-hmm.

Gianluca Fontana (05:01.934)
So that has been my journey in the past few years, working with pharma companies, working with digital health and AI companies. And it's what I like doing. I like helping others succeed and I get to do it every day with a fantastic team. that's, yeah, I love it. And it's nice to work on something that you truly believe in.

Julio Martinez-Clark (05:19.003)
So I'm sure you have a great job, very rewarding job.

Gianluca Fontana (05:31.534)
And I think I've always been quite lucky in my career. I've been able to do that, but probably no more than now.

Julio Martinez-Clark (05:39.899)
Good, so just a little bit on your background, your personal background. You moved to the UK from Italy, is that correct? Okay, to study or to work on McKinsey? How was your transition from Italy to the UK?

Gianluca Fontana (05:48.578)
Yeah, yeah, yeah, so...

To work, I started at McKinsey in Italy, but McKinsey at the time did not have a healthcare practice. So I got to do very interesting and important work in banking, in the retail sector, in the manufacturing sector, but I had a big interest in healthcare and a desire to try my hand at it.

Julio Martinez-Clark (05:58.156)
Okay, in Italy.

Gianluca Fontana (06:21.432)
And there was no opportunity for that at McKinsey in Italy. So it was to then join this initiative in London that I moved. And honestly, my plan, I'll tell you how delusional I was. My local health system from my town, right, from my region was part of this network that McKinsey

Julio Martinez-Clark (06:21.882)
Okay. Mmm.

Julio Martinez-Clark (06:33.664)
Okay.

Gianluca Fontana (06:50.666)
had set up. So I was like, I'm going to go to London, I'm going to learn about healthcare, I'm going to, you know, I'm going to get to meet the people that lead healthcare in my region. And then, you know, after I stop in London, I can probably move back home, work in healthcare, this is going to be fantastic. It was 12 years ago, I'm still in London, I married a British woman, I'm not going anywhere. So

Julio Martinez-Clark (06:54.25)
Okay.

Julio Martinez-Clark (07:06.529)
Yeah

It never happened, yeah.

Julio Martinez-Clark (07:17.474)
Okay.

Gianluca Fontana (07:18.722)
Things didn't quite go to plan, but it was a very important and fateful decision.

Julio Martinez-Clark (07:29.434)
I'm sure it's also a cultural shock, British people are very different from Italians.

Gianluca Fontana (07:34.83)
I mean, but particularly at the time, pre Brexit, London was like, I think London was the fifth biggest Italian city in the world. So there were literally hundreds of thousands of Italians in London, including some of my best friends from university. So actually, my first few years in London, I lived an Italian life in London outside of work. I only

Julio Martinez-Clark (07:39.224)
Yes.

Julio Martinez-Clark (07:44.841)
Really?

Julio Martinez-Clark (07:51.043)
Wow. Okay.

Gianluca Fontana (08:02.862)
I only spent time with Italians outside of work and went back home very, very frequently. It's changed a lot. It's changed a lot now, but that was the initial. that kind of helped manage the transition. And now I don't feel British, but I feel like I get the place a bit more. But you're based in the US, Julio, right?

Julio Martinez-Clark (08:09.249)
I see.

Julio Martinez-Clark (08:27.041)
Yes. Yes, I'm based in Miami.

Gianluca Fontana (08:30.732)
Yeah, so, you know, frankly, I learned my English on the US. I've always been a lot more interested in the US. It's sports, it's politics, you know, in a way also it's healthcare. So it's not what I expected in many ways to end up in England, but here I am. But luckily we get to work with the US quite a lot. And that's one of the places where we opened a Prova Health office now. And so we get to work.

Julio Martinez-Clark (08:35.608)
Mmm.

Julio Martinez-Clark (08:40.577)
Okay.

Julio Martinez-Clark (08:51.467)
Yes, I'm sure.

Julio Martinez-Clark (08:59.223)
Yeah, you have an office in Indiana or somewhere. Doesn't really matter, yes, I know. It just caught my attention when I saw the address in the US.

Gianluca Fontana (09:02.286)
Yeah, well, it's 2025. Where we are physically located doesn't matter hugely. But I tell you what, tell you what, we started our business in the US with someone that I've known for a long time, and he happens to be based in Indiana. And trust was the key factor in that decision. But within three hours,

Julio Martinez-Clark (09:25.688)
Okay, sure.

Gianluca Fontana (09:29.582)
of South Bend, is where it's based. There are more life sciences companies and big businesses than in all of the UK. know, have Chicago as a big center, you have a kind of a diagnostic valley and orthopedic valley really in Indiana. You have Eli Lilly and Roche Diagnostics in Indianapolis. So it's a great place to be actually for the work that we do.

Julio Martinez-Clark (09:33.26)
Yes.

Yes, yes, yeah.

Julio Martinez-Clark (09:40.94)
Yes, yeah.

Julio Martinez-Clark (09:46.818)
Mm-hmm.

Julio Martinez-Clark (09:54.261)
Yeah, yeah. And you also have Cook Medical in Indiana, is that correct? Cook Medical is also in Indiana.

Gianluca Fontana (10:00.622)
Sorry.

Yeah, there are a lot of companies there. There are a lot of diagnostics, pharma and digital health companies. it's a good fit for what we do. But we are certainly have the ambition to be more than just a regional US company. So we work across the US, wherever our clients are and whatever market they want to enter.

Julio Martinez-Clark (10:05.675)
Yeah, yeah.

Julio Martinez-Clark (10:23.618)
Sure.

Julio Martinez-Clark (10:26.978)
All right, so let's talk about trends before we talk about your company and what exciting projects you guys are doing. But let's focus a little bit on industry trends and what trends see happening that are relevant to the discussion today, Gianluca?

Gianluca Fontana (10:45.602)
Yeah. So one big area that is not new anymore, but it's important and relevant to the topic of clinical trials, is the emergence of solutions and innovations that are not necessarily drugs that needs trialing. Right? So we work a lot on digital health and AI solutions.

Julio Martinez-Clark (11:06.219)
Hmm. Okay.

Gianluca Fontana (11:14.2)
those pose entirely different challenges in terms of how to trial them and how to generate evidence for them, than what is the established way of doing things for drugs and the pharma industry, right? So I think that's a very interesting emerging area around trial methodologies and trial approaches, where the biggest mistake we can do is try to treat

these new solutions as if they were a drug, right? They are different in many ways, both in terms of the nature of the solution and in terms of what is required, right? For drugs, you have a very established process that has been around for decades. You have very clear requirements. We know what methods we need to use to trial a drug and there's always a level of innovation, right? But there are established methods

clear requirements, and then you have a product that for the most part stays the same, right? For digital solutions and AI, it's an entirely different world, right? The requirements are not clear. In fact, until recently and still in many places, there are no requirements, right? So when we started the company and digital health and AI was a big area of focus, four out of five

Julio Martinez-Clark (12:33.301)
Hmm.

Gianluca Fontana (12:41.428)
of the top funded digital health companies had no evidence whatsoever. Imagine entering the market with a drug with no evidence. It's impossible, right? But because digital health is a disintersection between tech and healthcare, it started off very much using the

Julio Martinez-Clark (12:46.944)
Hmm.

Yeah, exactly. Yeah.

Gianluca Fontana (13:09.602)
the methods of tech fail fast, fail hard. It does not work in healthcare. So what we've seen in the past five years is an increasing level of clarity about what's needed, what evidence is needed for digital health solutions to enter the market and really to make it in the market. I think that's an important distinction because

Julio Martinez-Clark (13:17.141)
Mmm.

Julio Martinez-Clark (13:33.312)
Hmm.

Gianluca Fontana (13:36.738)
there are some digital health solutions that don't really require regulatory approval, right? So there's no regulatory need to try them. But adoption is still heavily dependent on solid data that show that the solution has impact. And I think digital health innovators often make the mistake of overlooking the importance of evidence. The second point is around methods, right?

Julio Martinez-Clark (13:41.44)
Hmm.

Gianluca Fontana (14:07.07)
methods that for drugs are the standard, you know, running RCTs are not always the right thing to do for digital solutions. You need appropriate methods and trial approaches for digitalized solutions that are oftentimes different than what you need for drugs. And that has been a big interest of mine of like, what can we do to

trial digitalized solution faster and in a more flexible way with, know, adding evidence and generating evidence, but the appropriate standard of evidence. You don't want to have too little evidence, but also you don't want to require too much evidence and stifle innovation. Right. And then finally, and very simply, as I said, a drug stays the same. A digitalized solution will have a V1, a V2, a V3. It changes. Right. So

Julio Martinez-Clark (14:50.805)
Sure. Yeah.

Gianluca Fontana (15:03.66)
You don't trial it once and then it's going to stay the same. So how do you adapt the infrastructure and the approach to trials to reflect that constant evolution? So these are some of the themes in terms of trialing of solutions other than drugs that I find very interesting. And I think there is a lot still to be figured out in that space globally. That's true globally.

Julio Martinez-Clark (15:07.434)
Yeah.

Julio Martinez-Clark (15:32.711)
exciting times for digital health. mean, looks like and very good insights. Thanks for that, Gianluca. So the first trend is probably the trend that intrigues me the most because I think it's a trend not necessarily driven by regulators, but driven by the industry, right? So payers.

the market is requiring more more evidence for you to have acceptance, right? Is that correct?

Gianluca Fontana (16:09.952)
It's true. think regulators also play a role. And again, they are still trying to figure out exactly what role they play and for what type of solution. But it's not just regulatory needs that create the need for evidence. So you're absolutely right on that point. Payers, they just want, you already they don't understand digital very well. If they can't frame it appropriately and say,

Julio Martinez-Clark (16:29.277)
OK.

Julio Martinez-Clark (16:34.483)
Yeah.

Gianluca Fontana (16:38.484)
Okay, I understand that this makes this much difference on outcomes, whether the outcome is clinical or operational. And it costs me this much, which means, you know, I have this net saving. You need a very clear business case and you need a very clear evidence for that to have any chance of getting used and getting widespread adoption.

Julio Martinez-Clark (17:00.447)
Yeah, yeah, yeah. So now that we're talking about regulatory matters, do you see more countries adopting updated laws or new laws to incorporate these newer technologies like software as a medical device, AI solutions? What's your take on that?

Gianluca Fontana (17:23.658)
Absolutely. I think it's a global trend that we see across a number of markets in one way or the other across most markets, really. And I think there is one part of it, which is about clarifying the regulatory requirements exactly as you say, the risk classifications of software as a medical device, for example, which entails making the criteria clear, but then

constantly managing the loopholes and managing the emerging technologies, right? So now the debate is like, what about an LLM powered chatbot? Is it a software as a medical device? When does it become one? Those are all questions that remain partly unanswered.

Julio Martinez-Clark (18:05.947)
Yeah, exactly.

Yeah, good point.

Gianluca Fontana (18:18.318)
And there are some brilliant thinkers on this point, sometimes with conflicting views, right? And it always comes down to this balance between those that see regulation as a barrier to innovation and stifling innovations, and those that see it as a provider of clarity on the market. That means that digital and AI solutions can truly succeed, right?

I feel like I have a foot in each camp, but definitely I think we are at a stage now where clarity of requirements is fundamental. And I think in healthcare, you can't just say it's a free for all. You need to be a bit more structured than that. And I think companies need to accept that they will need to go through some hoops and demonstrate some things to be able to play in the market.

But to be honest with you, I think the most innovative, the most successful companies are the ones that go a step beyond what the regulator requires and just try to turn evidence into a competitive advantage because they can then say, I'm the only solution of this type that has reached this level of regulatory approval, right? That makes them distinctive in the market. So instead of going for

Julio Martinez-Clark (19:29.243)
Yes.

Julio Martinez-Clark (19:34.063)
Exactly. Yeah.

Julio Martinez-Clark (19:46.353)
Yeah.

Gianluca Fontana (19:48.162)
the minimum possible standard, they see evidence and regulatory status as a way to differentiate and create a barrier to entry. Frankly, those are the people that we are most excited to work with. And I think, in my opinion, that have the best chance of succeeding in a market like ours.

Julio Martinez-Clark (19:50.298)
Exactly.

Julio Martinez-Clark (19:58.609)
Yeah.

Julio Martinez-Clark (20:08.903)
Great point. Yes, agree. All right, so now that we're talking about the topic of how to design studies and how to create evidence, let's talk about your company. Let's talk about Profile Health. What is it that the company does? What makes it different from the others? What's really your impact?

Gianluca Fontana (20:31.118)
Yeah. So it's twofold. And obviously we've spoken a lot about digital health and not as much about what we do in pharma, but we do both at Prova Health, first of all, right? Our core DNA is that we are clinical and health systems experts, right? Everyone on our team has either worked clinically, the majority of our team has worked in clinical roles.

Julio Martinez-Clark (20:42.543)
Okay.

Gianluca Fontana (20:58.726)
or has worked in health system leaderships, leadership or policy leadership positions. So we intimately understand how healthcare works from the big picture of health policy to really the small detail of clinical workflows and clinical pathways. And what we help companies with is to truly integrate

Julio Martinez-Clark (21:05.65)
Okay.

Gianluca Fontana (21:27.852)
their innovation in health systems and achieve that peak widespread adoption, a higher peak and achieve it sooner, right? So the form it takes is slightly different across sectors because the needs are different, right? So for digital health and AI solutions, apart from navigating the system and understanding, you I have a solution that works in the breast cancer pathway, right? For example.

Julio Martinez-Clark (21:55.089)
Yeah.

Gianluca Fontana (21:56.396)
Where is it going to fit? What changes does it require from clinicians, from patients? And how likely is it that those changes will happen? How can I facilitate those changes, right? Helping companies understand that detail is something we do at a granular level across both pharma and digital health. But then in digital health, the biggest gap we've seen and what we help companies on the most and where we see

Julio Martinez-Clark (21:58.385)
Exactly.

Yeah.

Julio Martinez-Clark (22:07.654)
Mm-hmm. Yeah.

Gianluca Fontana (22:25.612)
the most demand is with that evidence generation, right? In a world in which the requirements are not really clear, the methods are not really clear, you need a partner that truly understands both sides of it and can be pragmatic, right? So we help understand what the evidence requirement is for a certain goal. And then we find the most pragmatic but robust solution to generate that evidence, right?

And that could be clinical evidence, it could be economic evidence, and it entails quite a lot of methodological innovation, right? Again, because you can't just apply the way you do pharma, the way you generate evidence in pharma to digital health, this has led us to develop new methods like clinical simulation for the trialing of digital health and AI solutions.

Julio Martinez-Clark (23:25.745)
Hmm.

Gianluca Fontana (23:27.584)
Where we help pharma the most is on what I've already mentioned. that true deep understanding of the clinical pathway and the health system and all of the potential barriers that could emerge to launch an adoption of a drug, which I think is something that actually should be taken a lot more into account even in the process of clinical trials. At the very least in the context of

evaluating a pipeline, right? It's not enough for a drug to show that it can have a positive impact on clinical outcomes. Even when it does, there are factors that could prevent its success as a blockbuster. And we think that with that in-depth analysis of clinical pathways and with a more effective engagement with health systems and providers,

Julio Martinez-Clark (24:12.548)
Mm-hmm.

Gianluca Fontana (24:25.538)
the potential for drugs can be significantly increased. So we do a lot of that and then that often turns also into capability building. So some of this is a new way of thinking for pharma, right? And they may feel like they might agree on the importance of this approach, but they need to learn.

Julio Martinez-Clark (24:37.596)
Okay.

Gianluca Fontana (24:52.974)
how to do it and they need their teams and their country teams to learn it. So we help a lot translate these insights and these strategies into actual skills within their team.

Julio Martinez-Clark (25:07.3)
Yeah, it's surprising, you're touching on an interesting point, surprising how pharma companies and also medical device companies that I've seen, they may have a sales force in a specific market, but they don't really understand the market. They don't really have market access strategies, well thought out strategies to penetrate it. They just think that because they have a great product, it's going to sell magically.

That's not the case.

Gianluca Fontana (25:38.082)
No, think the data shows 60 % of new drugs fail to meet forecasts. So, and you know, our analysis is that even blockbuster drugs really reach maybe a third of eligible patients. So there is clearly a lot of potential that is left on the table here. And I think that one of the main drivers is to really understand

Julio Martinez-Clark (25:43.138)
Really? Wow! Interesting.

Julio Martinez-Clark (25:55.567)
Wow.

Gianluca Fontana (26:08.077)
Ultimately, the market, as you say, much better. The decision makers much better and also the patients.

Julio Martinez-Clark (26:15.916)
Yes, exactly. And who's going to pay for it? mean, that's a key point. mean, really understanding who has the money and who is willing and able to pay for it. Who needs to pay for it? In other words, who needs to pay for it?

Gianluca Fontana (26:33.87)
Well, that is the fundamental question that faces pharma companies, digital health, med tech. And again, it's a process where you think you're in and you're ready for success because you got regulatory approval, for example. But it's only the start of a journey, right? Getting paid, understanding how to get paid.

Julio Martinez-Clark (26:37.454)
Yeah.

Julio Martinez-Clark (26:57.773)
Yeah. Yes.

Gianluca Fontana (27:03.734)
And even when you know how to get paid to drive adoption, the best example of this is one of the most advanced schemes in digital health in the world, which is Germany's DIGA, right? So as I said, regulation of digital health is coming along. More and more countries are clarifying those risk classification and what evidence is required. We're getting there, right?

Then the next problem is like, fine, I got regulatory approval. I need to get paid. This system has not set up any approach for me to get paid even for an innovation that works in digital health and AI. Germany has. Germany has developed a scheme where you can get your digital health or AI solution for lack of a better word on a form, formulary.

Julio Martinez-Clark (27:48.323)
Yeah, agree. Exactly.

Gianluca Fontana (28:03.232)
almost, right? You need to show evidence that it works. You need to negotiate a price and then doctors can prescribe it, right? Effectively. So you think, well, fine, I had regulatory approval that I thought that was sorted out. It didn't. Well, now I am on this registry. There is a price attached to my solution. Well, that's it. It's success. But in reality, what the data shows is that

Julio Martinez-Clark (28:11.181)
Hmm.

Julio Martinez-Clark (28:20.111)
You

Gianluca Fontana (28:33.066)
even for companies that have gone through this process, then they just don't get prescribed. The innovation, the clinician is not aware, is not confident, and there is a relatively low level of uptake of these solutions, even though you have addressed a lot of the facilitators. And I think the companies that are succeeding and the innovations that are getting uptake are the ones that are

Julio Martinez-Clark (28:37.677)
Hmm... Hmm?

Gianluca Fontana (29:02.126)
taking that challenge of adoption more seriously, understand the market and push. And it's an expensive process. It means educating thousands of clinicians that have only been used to prescribe drugs to suddenly and having to prescribe something very different that they don't fully understand. And obviously you see that in pharma, right? You have a new therapy come up.

Julio Martinez-Clark (29:21.558)
Yeah. Yeah.

Gianluca Fontana (29:28.538)
You know, you need clinicians to switch behavior to the drug that they are used to. There are barriers to that. But imagine switching from a drug or from another established way of doing things to prescribing a software. It's quite a leap, right? And it requires a lot of deep understanding of that end user and a lot of education of them for it to have a chance to really succeed.

Julio Martinez-Clark (29:43.042)
Yeah, yeah, yeah.

Julio Martinez-Clark (29:57.281)
Fantastic, great. So Gianluca, before we end the show, I have one final question. What's the outreach of your companies? Is global? Is it European? In what countries you guys have worked or want to work? What's your take on

Gianluca Fontana (30:17.954)
Yeah. Look, the answer is very simple and is we want to be global and we are global. So we started the company in the UK. Ninety percent of our work has been outside the UK. We started as we discussed an office in the US that's certainly a market that we see as very important. But we want to be a partner.

Julio Martinez-Clark (30:24.022)
Okay.

Julio Martinez-Clark (30:44.705)
Yes.

Gianluca Fontana (30:47.182)
for innovators that have global ambitions, right? Roche, Novartis, or some of our big clients, for example, they don't just focus on UK or US, they focus globally, right? And certainly they have those 10, 15 big markets that are a core priority, right? From all over the world, really. And so we need...

Julio Martinez-Clark (30:54.869)
Excellent.

Gianluca Fontana (31:15.054)
to play and we want to play in all those markets. In addition to that, we are in this business also to just facilitate innovation for everyone, improving health for all by supporting innovation. So we have a very, very strong interest and desire to help

support innovation also in emerging economies, in lower income countries, working with partners that can be different. We've worked with global health funders, right? We, can see ourselves working with governments or international organizations, something that we have a lot of personal experience of. So we want to be truly global. And the way that we can do that is that

Julio Martinez-Clark (32:01.121)
Mm-hmm. Yes.

Gianluca Fontana (32:11.374)
we have a proprietary network of over 600 experts in over 40 countries across really all therapeutic areas, all kind of aspects of healthcare. So there's no market where we don't feel comfortable. We can put together a really top-notch team and have very in-depth understanding. Just in the last few months, our work has spun from

Julio Martinez-Clark (32:15.52)
Wow, okay.

Julio Martinez-Clark (32:20.692)
Excellent.

Julio Martinez-Clark (32:32.972)
Hmm.

Gianluca Fontana (32:40.13)
the US to Japan to Italy to the UK to India and Uganda. So it's it's truly global.

Julio Martinez-Clark (32:49.664)
Wow, fascinating. Congratulations. Yeah.

Gianluca Fontana (32:53.964)
No, it's that I wouldn't want it any other way. You know, it's I'm not made to just focus on one country and one market. It's not it's not my personal story, going back to what we discussed before. And, you know, I've lived and worked in four continents. So that's that's the type of spirit that we have.

Julio Martinez-Clark (32:58.004)
Hahaha!

Julio Martinez-Clark (33:06.644)
Yeah, exactly.

Julio Martinez-Clark (33:20.439)
So Gianluca, what makes you guys different from other people trying to do the same market access consulting thing?

Gianluca Fontana (33:29.548)
Yeah, I think that, you know, that in-depth clinical DNA is one of the things that I think is very, important. The truly deep understanding of various types of health innovation, so our expertise, for example, specifically on digital health and AI, and the fact that while we are global, we are still relatively small.

Julio Martinez-Clark (33:50.196)
Mm-hmm.

Julio Martinez-Clark (33:57.068)
Yeah.

Gianluca Fontana (33:57.078)
And I think that what I've seen is a lot of fatigue with bigger organizations that might have a lot more footprint than us, but where the quality is very variable, the relationship can feel more transactional. And we have had a hundred percent client retention rate, right? Like we keep working with the people we work with.

Julio Martinez-Clark (34:06.154)
Yeah.

Julio Martinez-Clark (34:11.145)
Mm-hmm.

Yeah.

Julio Martinez-Clark (34:21.9)
Hmm.

Gianluca Fontana (34:25.25)
because we invest in the relationship. And to be honest, we can say many things about our capabilities. Someone else might say similar or bigger things, but being able to establish those personal relationships and cultivate them and being flexible around them is what ultimately for us has led to growth and continued work with clients and success.

Julio Martinez-Clark (34:27.532)
tour.

Julio Martinez-Clark (34:37.78)
Mm-hmm. Yeah.

Julio Martinez-Clark (34:42.412)
Yes, I agree.

Julio Martinez-Clark (34:52.875)
X engine Luca. Well, we're close to the end of the show. I would like to ask you some final words of wisdom. What would you say to the CEO of a new AI digital health company that are just exploring options to get to have market fit?

Gianluca Fontana (35:13.154)
Yeah, well, two things, just do it fully and do it well. Really understand how your solution fits in clinical workflows and pathways. I think that's absolutely fundamental. And ask yourself the right questions. Don't deal with the question of who's going to pay down the road.

ask yourself from the start because really that's a key driver of the sustainability of your solution and try to turn what may feel like a barrier, evidence, regulatory approval into a true competitive advantage. I really think that that's what's going to make the difference.

Julio Martinez-Clark (35:43.295)
Mmm, mmm.

Julio Martinez-Clark (36:01.791)
Yeah, that's a great point. Yeah.

Yeah.

Gianluca Fontana (36:09.822)
for those that do it, I think that will make those solutions stand out.

Julio Martinez-Clark (36:15.818)
I agree. Excellent. All right, Gianluca, thank you so much for being in the show.

Gianluca Fontana (36:20.398)
It's a real pleasure. Thank you very much for having me.