Soviet sales require deft touch

Medical imaging vendors hoping to sell scanners or imaging suppliesin the Soviet Union must learn which Soviet institutions havethe authority and funds to purchase medical equipment. Keepingtrack of this purchasing authority in the whirlwind of Sovietbureaucratic and political change is no small task, accordingto Feliks Rosen, executive vice president of Comed.

Comed is a U.S./USSR joint venture established in 1989 to facilitatetrade of medical and computer products between the two countries.It has offices in Los Angeles and Moscow. Rosen and Comed presidentYuri A. Agapov, both Soviet participants in the venture, attendedthe 1990 Radiological Society of North America conference in Chicagofor a first-hand look at state-of-the-art medical imaging technology.

While the state continues to own most Soviet companies, theexecutive power in those companies has been rapidly decentralized.Concurrently, regulatory and budget control is moving from thenational government to the republics.

"It is hard to say exactly how the (purchase) approvalprocess works, because whatever it was yesterday, tomorrow itwill be different," said Morgan W. Nields, chairman and CEOof Fischer Imaging. "It has changed rapidly in the last 24months. Every three months there is a new major decree, anotherministry is dissolved, or another agency is now responsible."

Fischer Imaging of Denver is the only medical imaging equipmentcompany with an equity position in Comed (see following story),although the venture sells imaging equipment for other vendors,including Diasonics and Picker International (SCAN 6/6/90).

While the state still holds the assets of individual enterprises,the concept of central bureaucratic control is fading fast. Thishas resulted in a curious situation in which the heads of largecompanies report officially to the state but in fact make mostdecisions themselves and do not report to stockholders as in acapitalist system.

"What you end up with is an almost freestanding businessthat has thousands of employees but is headed by a general directorwho has total control over its operation. It is almost like afeudal lordship," Nields said.

Although individual enterprises can determine how to spendtheir funds, the purchase of medical equipment is controlled bythe ministries of public health in the republics. This systemis similar to the state certificate of need process in the U.S.,Rosen said.

VENDORS IMPORTING MEDICAL IMAGING equipment into the Soviet Unionmust recognize that quality components and accessories are scarce.Scanners will not function reliably or produce quality imagesif imaging supplies are insufficient.

"We can give them (the Soviets) the instrumentation, butif they don't have the film and processing capabilities, we havenot given them a good total system," Nields said.

Nields brought a box of Soviet x-ray film back to the U.S.last year after finding that a Fischer mammography system wasproducing substandard images. Kodak technicians analyzed the sampleand pronounced it comparable to 1940s technology, he said.

Fischer and Kodak held discussions at the RSNA meeting aboutpossible ways to package entire imaging systems, including multiformatimagers and film, for the Soviet market, Nields said.

Comed helped Picker sell a computed tomography system to theSoviet Union, which was shipped late last year. Comed sent a largesupply of film cassettes along with the CT system, said JeffreyStevens, president of Phoenix Radiology of Van Nuys, CA.

"We shipped enough (film) to keep them running for sixmonths to a year, because we don't know when they will have hardcurrency again. That is the way it has to be done," he said.

Phoenix Radiology officially holds the U.S. half of Comed'sequity. The firm is charged with tracking down companies thathave appropriate technology for export to the Soviet Union. Ifno U.S. company is found in a particular technological niche,Phoenix will use foreign suppliers, Stevens said.

While the Soviet Union earns massive amounts of foreign exchangefrom oil sales and other source, the country also has more needsthan funds. This limits the amount of medical equipment, componentsand accessories that can be imported.

"Hard currency is a limiting factor in working with theSoviet Union at this time, but they have found some monies forparticular projects. We are also looking at barter," Stevenssaid.

The central government formerly distributed hard currency,but individual enterprises can now earn and spend their own foreignexchange. If the ruble becomes convertible in two to three yearsas hoped, hard currency supplies will be a less constraining factor,Rosen said.

The current scarcity of foreign exchange, however, createsa problem for companies that need to buy accessories and spareparts for their imported equipment, he said.

"If a company spends $1 million, which is all (the hardcurrency) it has, it cannot get an additional $20,000 to buy afilm processor," Rosen said.