I risk offending, but truth be told, the main factor is US...

I risk offending, but truth be told, the main factor is US capital mkts are just far more supportive and embracing of new innovations than Australia. They can be fickly ruthless as well to ventures that don't make it, but US equity mkts are somewhere around $50 trillion in overall capitalization, depending who you reference. There is just very simply a lot more money looking for returns. How many times have we seen OCC's Remplir or ATI in the Australian media (and every time hope this should at last generate some momentum")?

Vericel also had an established burns side product as well. OCC is similar with CelGro - of course CelGro came about because Prof. Zheng couldn't find a decent collagen membrane fit for purpose in ACI, so developed his own - its just that unlike Vericel, OCC has now realised the original supportive product has far more commercial application than the original treatment it was meant to support. ACI and indeed ATI have taken third and second place to management's CelGro ambitions.

They are also in the US domain - much easier to get Fed approval when you are domiciled there. But there is no argument for ACI and ATI not being available more generally outside of the Special Access Scheme over a decade after ACI and ATI became available in Australia. ACI was added to the TGA's Australian Register of Therapeutic Goods (ARTG) in mid 2017 and we have not heard much since.

Before the last results (of the final lateral epicondylitis trial data) on ATI we were told it was going to be progressed with the TGA. At the actual results we essentiually got told they were shpping ATI to big Pharma' and then heard nothing on the TGA. I am p*ssed. I want them to partner in the US where they can make big$$ but ATI should have been orgnaically growig in use in Australia under the SAS and now be available more generally as a Medicare billed item - it is already available (or at least was in the past) on workers comp' via SAS from all reports.

Vericel has pushing 7,000 surgeons for MACI in a few years. How is ATI and ACI not known to Aussie Surgeons across the board after over a decade a poot reflection of many things, primarily a poor sales and marketing performance particularly IMO.