Medical Device Link.

MX magazine recently called on a panel of industry experts to get their views about how current and future trends are likely to affect the medical technology marketplace in 2008. The conversation—the expanded online version of which is available at www.devicelink.com/mx/archive/07/11/roundtable_x.html—covered hot topics in a variety of sectors, including the ongoing controversy over physician payment practices in the orthopedics sector and the heavy mergers and acquisitions activity in the in vitro diagnostics sector. Panelists also discussed recent recalls and product efficacy concerns in cardiology markets, which have seen decreases in the markets for both cardiac rhythm management and interventional cardiology products—especially implantable cardioverter-defibrillators and drug-eluting stents.

	Cohen: A more discerning future.

“In their initial use, these products were probably deployed in a too widespread a manner,” says Richard S. Cohen, president of the Walden Group Inc. (Tarrytown, NY). “But the therapeutic value of drug-eluting stents, and implantable defibrillators and pacemakers, is compelling in many cases. There’s no doubt that these are essential, lifesaving technologies.

“But as with any new technology, there’s a maturity cycle that takes effect,” Cohen adds. “So now some refinements and more critical decision-making are in order. Manufacturers will need to be a little bit more discerning with regard to quality control. And surgeons will need to be more discerning about the types of indications that warrant the use of such devices.”

Rajan: Increased physician skepticism.

Venkat Rajan, an industry analyst in the healthcare group of Frost & Sullivan (San Antonio, TX), says the real impact of recent turmoil in the cardiology sector is going to be on new technologies. “Clinicians accepted the initial assessments of drug-eluting stents as a great technology, and they really went gung-ho into prescribing their use,” he says. “But now, many believe that they were in some sense duped, and that they are only now beginning to appreciate the true risks and benefits of these devices.

“In the future, new products are likely to meet with a much more skeptical reception,” Rajan adds. “Physicians are going to question what the appropriate niche for a new product is. And we’ll see more of that sort of evaluation, instead of physicians just jumping in with both feet.”

	Laskaris: Promising new developments.

Regardless of physicians’ growing skepticism surrounding new devices, there are a variety of new technologies on the horizon in the cardiology field, says James X. Laskaris, a senior emerging technology analyst at MD Buyline (Dallas). “Some are looking at ways of regrowing heart tissue and regenerating vascular systems—but those are still a way off,” he says. “Closer to reality—and supported by funding from the Centers for Medicare and Medicaid Services and the National Institutes of Health—is the approach of keeping coronary artery disease from ever happening, or catching it in an early enough phase that statin drug therapy or a change of lifestyle can prevent its affects. That’s why one of the primary focuses of current research is on new detection devices or technologies such as cardiac computed tomography. Advanced screening or early-identification applications of positron emission tomography and single photon emission computed tomography technologies are also being developed to permit clinicians to see cardiac problems before they require intervention.”

According to Rajan, the surest road to success is to develop technologies that address emerging markets where there are few commercialized products on the market, yet there is a high clinical need. “Good examples of these types of companies on the cardiovascular side include firms like Abiomed, which is developing an artificial heart,” he says. “That company is playing in a market with a significant clinical need, it has a revolutionary technology, and it is not directly pitted against any of the large market giants.”

In addition, Rajan says he expects to see a lot more combination devices and integrated technologies come to market, such as medical devices with onboard imaging, or medical devices with diagnostics onboard. “As early as last year, for instance, Medtronic was developing an ICD with an in situ sensor for monitoring the fluid status of congestive heart failure patients,” he says. “In the future, I think you’ll see more and more combination systems that provide both diagnostic and therapeutic capabilities, and enable doctors to get faster diagnostic feedback.”

Rajan says there may also be opportunities for consumer-oriented products in the diagnostic and imaging areas of cardiology. “For instance, it is likely that more companies will release ICDs that incorporate remote home monitoring functions,” he says. “Such systems can transmit patient data to the doctor automatically or on request, thereby minimizing the need for office visits, enabling the doctor to track the performance of the device regularly, and reducing healthcare costs.

“In the near term, we can expect to see more consolidation among cardiology companies, and more of the big companies looking for the next big-growth sector,” he adds. “Candidates may include robotic assist devices and the peripheral vascular segment.”

© 2007 Canon Communications LLC

Return to MX: Issues Update.