Are we selling out to the Americans?
Shai Policker is fixing that problem.
If you care about Israeli innovation and the long-term future of Israeli medtech, this week’s post — and this week’s episode of Life Sciences Today — is for you.
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This week on Life Sciences Today
What if the central weakness in Israeli medtech is not scientific invention, but the system that is supposed to turn invention into enduring companies?
In Israel. Not in the US.
That was the question at the center of my conversation with Shai Policker, GP at Edge VC this week on my podcast Life Sciences Today.
I came into the discussion with a deliberately sharp thesis:
Israeli medtech does not have a science problem. It has an ecosystem problem. Israel continues to produce exceptional science, engineering talent, and clinically informed innovation.
But too few of those assets are converted into durable, revenue-producing companies with the operating depth required for sustained growth, at home, in Israel.
Too often, the technology is created in Israel while the commercialization capability, managerial infrastructure, and long-term value capture relocates to the US.
In my view, the Israeli medtech industry loses its optionality in commercialization.
Losing optionality in commercialization
For years, early-stage funding often gave companies enough capital to advance the technology, but not enough to build the US commercial infrastructure needed to become serious standalone businesses.
The result is 5-10 years of development that lead to many Israeli medtech companies becoming walking-dead - generating just enough revenue to stay alive.
The outcome is an ecosystem that generates a great deal of innovation that loses its optionality 5-10 years later.
What made the conversation worthwhile is that Shai did not merely disagree in principle. He offered a different operating model.
Shai pushed back
Shai has seen the industry from multiple vantage points: as an electrical engineer trained at the Technion, as a medtech operator with more than 25 years in the field, as someone who spent a decade in the US, and now as an investor. Before joining Edge VC, he led the IAA-backed Medics incubator. That background gives him an unusually practical perspective on the distance between invention and commercialization.
What Edge does differently is not simply a matter of sector focus.
Their model begins with validated unmet needs from large strategic medical device companies, rather than with an entrepreneur looking for capital.
From there, they assemble teams — engineers, physicians, and operators — around those needs.
The model is designed to reduce one of the chronic weaknesses of Israeli medtech: the gap between technical ingenuity in Israel and commercial execution in the US. Edge’s answer is to bridge that gap deliberately, with American operating infrastructure and commercialization capability built into the company formation process.
Shai offered a useful example in Synchrony Medical.
The company developed a wearable vest for airway clearance in COPD and bronchiectasis patients. The original insight came from a respiratory physiotherapist at Sheba Medical Center. The team licensed the patent, built the company, ran clinical work in Israel and the US, secured FDA approval, and reached first commercial sale with only $2.5 million invested.
Whether one treats that as an exception or a template, it is a concrete demonstration of Shai’s broader point: the right product, regulatory pathway, and commercialization design can produce a real business without requiring endless capital.
The big anti-pattern
He also identified what may be the most important anti-pattern in the sector: the pursuit of highly complex PMA-pathway products, especially in interventional cardiology, with decade-long timelines and enormous capital demands. There are undeniable successes in that category. But there are also many more companies that disappear into the long valley between technical promise and commercial viability.
His proposed alternative is notably less glamorous and much more practical: build more companies around 510(k)-pathway products, where $10–15 million can plausibly carry a company to approval, first revenue, and operating viability.
That, to me, is what made this conversation valuable. It was not just a debate about whether Israeli medtech is underperforming. It was a debate about what kind of institutional and commercial design actually gives innovation a chance to compound.
If you care about medtech, venture creation, commercialization, or the future structure of Israeli innovation, I think you’ll find this episode worth your time.
Visit Edge VC
Listen to the episode here.
OpenCRO
This conversation also touches a theme I think about a great deal in my own work: commercialization is not something to “add later.”
Revenue assurance has to be designed into the company’s value proposition.
That is the premise behind OpenCRO, my latest company. We help medtech teams build development and commercialization programs in which the revenue logic is legible early — before companies discover, too late, that regulatory progress and commercial readiness are not the same thing.
One of the most common mistakes I see is treating the product label as a regulatory output rather than a commercial input. By the time payers ask, “How do you measure benefit?”, the pivotal trial is often already enrolled and the protocol can no longer be changed. At that point, commercial failure is no longer hypothetical. It is simply delayed.
I have seen variations of this problem across more than 40 medtech commercialization programs in the US.
If that sounds familiar, I’m offering a free 30-minute stress test of where your next deal is most likely to break: FDA review, hospital IT, procurement — or all three.
I’d love to talk to you - grab a time here. No strings.