Contributing Member of the Healthcare Councils

All News Analyses by this Author

Sales of Infuse product will likely decline with closer scrutiny of off-label use

December 1, 2008

Analysis of:Medtronic Says Device for Spine Faces Probe | online.wsj.com

Medtronic might see a significant drop in its sales as a result of closer scrutiny of off-label use of its products.  Infuse has been a cash cow for Medtronic, and if sales drop, it will reflect deeply in the sales numbers.

Accuray Cyberknife Sales About to Go Through The Roof

December 1, 2008

Analysis of:Experts Debate CyberKnife for Prostate Cancer | www.washingtonpost.com

Prostate cancer can be treated by Cyberknife, and the numbers of patients treated and the number of units sold by Accuray (ARAY:NASDAQ) will very likely increase dramatically over the next 5-10 years. 

Mixed Blessings for Medtronic in Professional Spinal Surgery Organizations

October 10, 2008

Analysis of:Letter to CMS from a Coalition of Spine Care Professional Societies | www.spine.org

The data presented by multiple professional societies does not lend clinical support of many Medtronic products in the Medicare population.  The data does not support the use of disc arthroplasty in the Medicare population, and does not find any clinical advantage of kyphoplasty over vertebroplasty.  This may mean reduced sales of the Kyphon line of products as well as reduced sales of the Prestige implant, should CMS adopt some of these recommendations.

New electrode may expand the capabilities of the Advance System from Neurometrix

October 9, 2008

Analysis of:NeuroMetrix Receives FDA 510(k) Clearance For UNIVERSAL(TM) Electrodes Used In The Performance Of Nerve Conduction Studies | www.medicalnewstoday.com

New electrode will increase the capabilities of the Advance device from Neurometrix, potentially leading to more sales of the disposable electrodes The increased capabilities may also increase the number of practicioners interested in the Advance system, generating more sales for the company

Proton beam therapy has no proven advantage

September 25, 2008

Analysis of:Proton Radiotherapy: A Review | www.nytimes.com

The cost of proton beam installations is massive, and is not justified in light of available litterature regarding the superiority of this therapy. There are only a handful of tumors, such as chordoma, where the proton beam therapy is recommended over other types of radiation.  The higher compensation for this radiation is probably playing a part in the decision making for these new projects.

Overmedication, and underdiagnosis, are commonplace in the dementia patient

June 30, 2008

Analysis of:Doctors Say Medication Is Overused in Dementia | www.nytimes.com

Aricept, Namenda, Risperdal are grossly overused in the treatment of patients with suspected dementia Many patients with dementia have not received proper diagnosis, and do not receive proper treatment Better public and medical education will hopefully reverse this glaring deficit in our medical systems

This acqusition, and others, represent a significant upgrade of Alphatec's portfolio

February 11, 2008

Analysis of:Alphatec Holdings, Inc. Acquires An Exclusive Worldwide License for Innovative Dynamic Anterior Cervical Plate Technology | www.healthpointcapital.com

Alphatec product line will expand and increase their market share The cervical plate from Progressive is much more promising than the Trestle plate developed by Alphatec, and should increase sales and improve the cervical implant portfolio

Medtronic loses litigation to DePuy over polyaxial Vertex screws, what is the significance?

December 26, 2007

Analysis of:U.S. Federal Court Issues Permanent Injunction Against Medtronic's Vertex And Vertex Max Screws | www.medicalnewstoday.com

the use of Vertex polyaxial screws is only a minor part of the spinal implant protfolio at Medtronic (MDT:NYSE).  This should not affect the bottom line to any significant extent.

New medicare regulations might result in better care, but at what cost?

October 19, 2007

Analysis of:Nonpayment for Performance? Medicare's New Reimbursement Rule | content.nejm.org

-The new regulations will probably result in quality improvement in the selected targeted areas -It is unclear whether the cost of implementation and monitoring will offset the savings to the medicare system -Medicare will likely introduce further quality measures to fall under similar payment cuts. 

For persistent back pain treatment, call a specialist

October 15, 2007

Analysis of:Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society | www.annals.org

If back pain persists, the patient should be referred to a specialist so further diagnosis and workup can be undertaken.  Patients with back pain are treated with a variety of interventions and medications in the hope that they will return to their normal activities.  Too often, the initial diagnosis is non-specific, and the treatments ineffective.  The appropriate timing of the referral to a specialist may avoid unnecessary delays and treatments. The key issue is to avoid unnecessary treatments and diagnostic studies by focusing on the correct diagnosis as early as possible in the process

House calls fulfill the needs of a narrow niche segment in the health care market

September 24, 2007

Analysis of:The New York Times | www.nytimes.com

House calls are not likely to expand to subspecialties, except in circumstances where a followup visit is required, and the primary doctor recommends specialized care.  One exception might be expanding the scope of house calls to cover all non-emergent care for the elderly who can afford an in-house evaluation for routine complaints.  While certain house call practices might thrive in metropolitan areas, the scope of such practices will be limited in the big picture.

Medical tourism will continue to flourish

August 20, 2007

Analysis of:American's Gamble for Bargain Surgery Abroad | www.medpagetoday.com

-There is no reason to think that medical tourism will decline in popularity.  Certainly for cosmetic procedures, there is no insurance-related issues that might curb the rise of offshore surgery.  -As for overseas experimental treatments, they will continue to be attractive to the U.S. consumer as long as our FDA continues to lag behind international regulatory agencies in their approval process.

Nimotuzumab holds promise for glioma patients

August 20, 2007

Analysis of:Oncoscience AG, the european partner of YM BioSciences, announces completion of patient enrollment in phase III brain cancer trial of nimotuzab | www.pipelinereview.com

-If this trial shows significant clinical benefit, it will bring this drug one step forward towards approval in the US.  This drug has already shown benefit for pancreatic and colorectal tumors, with minimal side effects.  There is strong scientific and preclinical testing testifying to the in vitro efficacy of this antineoplastic agent. -Further future studies should be aimed at Glioblastoma Multiforme patients, as these tumors are the most common primary malignant tumors, and larger studies can be designed with high statistical significance.

Availability of primary care physicians will only improve if the financial bottom line improves

August 13, 2007

Analysis of:Doctor Shortage Hurts A Coverage-for-All Plan | online.wsj.com

-State, or federally-funded universal insurance willl continue to exist in a vacuum until it is coupled with fixes for other illls of the health care system.  These fixes might include tort reform, or subsidized malpractice coverage for physician practices. -Universal health insurance is not enough to fix the problem of physician access.  -Primary care will continue to be a problem as long as physician reimbursement continues to dwindle. -The Massachusetts experience is a lesson in health care economics, one that should be carefully studied before investing in a national universal health care system

studies of low back pain therapy lead to mixed findings

August 8, 2007

Analysis of:Statistical Significance Versus Clinical Importance: Trials on Exercise Therapy for Chronic Low Back Pain as Example | www.ncbi.nlm.nih.gov

Low back pain is a major public health problem.  While there is no single therapy that can be prescribed to every patient with this problem, the ubiquitous prescribing of physical therapy is frequently misguided.  The causes of low back pain are myriad, and the treatment algorithm needs to be tailored to the specific patient.  All patients with back pain persistent for more than one month should be referred to a spine specialist in order to make further decisions regarding diagnosis and treatment.

Multidetector CT technology will replace conventional angiography

August 8, 2007

Analysis of:Faster And More Accurate Imaging Technique For Aneurysm Detection And Therapy Planning | www.medicalnewstoday.com

Multidetector CT technology will likely replace conventional angiography and Digital Subtraction Angiography in the diagnosis and treatment of aneurysms. MDCT technology is safer and nearly as sensitive as DSA, and can be used reliably in making treatment decisions for intracranial aneurysms.

Medtronic's acquisition of Breakaway Imaging is a significant step forward

August 1, 2007

Analysis of:Medtronic to Acquire Breakaway Imaging, LLC | wwwp.medtronic.com

Medtronic will see increased sales of their navigation platform, and probably a secondary increase in thier spinal implants as a result of the acquisition of Breakway Imaging. Sales of the O-Arm have been increasing rapidly, adding to Medtronic's sucess in the field of spinal surgery

Cigna covers lumbar disc replacement

July 31, 2007

Analysis of:CIGNA Covers CHARITE® Artificial Disc, USA | www.medicalnewstoday.com

As insurers continue to cover the Charite and other disc replacement products, the hope for coverage for other disc replacement technology will encourage further refinement and investment in motion preservation technology

Medtronic is one step closer to finalize study of deep brain stimulation for epilepsy

July 31, 2007

Analysis of:Medtronic Completes Implants In SANTE Trial Of Deep Brain Stimulation For Epilepsy, USA | www.medicalnewstoday.com

If the SANTE trial is successful, Medtronic will be able to dramatically expand its market share in the ever-growing neurostimulation market.

Surgery for spondylolisthesis is better than non-operative treatment

July 30, 2007

Analysis of:Surgeons discuss validity of SPORT data after release of spondylolisthesis arm | www.orthosupersite.com

This study confirms the clinical impressions of the majority of spine surgeons.  Patients with degenerative spondylolisthesis fare better with surgery compared to non-operative management. If this study results in an increase in the utilization of fusion surgery to treat spondylolisthesis, the device manufacturing companies, such as Medtronic, DePuy, Nuvasive, and others, may see increases in their sales. CMS may see a significant increase in the number of fusion surgeries performed as a result of this study. CMS may see less variability in the rates of fusion surgery around the country as a result of this study. 

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