Looks like MiMedx and Osiris are going to do very well in the months and years to come as they will take more and more market share away from the "has beens". I do own substantially more OSIR than MDXG at this time. Epifix will be used more so for the "standard of care" less critical and smaller size chronic wounds. Grafix probably for the much larger and harder to heal chronic wounds where other treatments failed.
From the recently published December 2013 Ostomy Wound Manage Journal:
A Retrospective Analysis of a HumanCellular Repair Matrix for the Treatment of Chronic Wounds
"A retrospective, single-center study was conducted at an outpatient wound care center to evaluate the clinical effect of a human cellular repair matrix (h-CRM) on chronic wounds that had failed to heal. Data from all patients who had received this treatment modality during a period of 2 years were abstracted. Standard care included weekly visits, regular debridement, offloading DFUs, compression for VLUs, and h-CRM for wounds 4 weeks duration. A total of 66 patients (30 male, 36 female, mean age 71.1 [± 8.8] years) received h-CRM treatment for 67 wounds (34 VLUs, 27 DFUs, and six other chronic wounds). The average wound size at baseline was 6.65 (± 9.68) cm2, and the average wound duration before h-CRM treatment was 38 (±70.8) weeks. Fifty (50) patients (74.6%) had failed to heal using other advanced therapies. After 12 weeks of care, 51 of the 67 wounds (76.1%) were healed: 23 of 34 (67.6%) VLUs and 23 of 27 (85.2%) DFUs. Average time to closure in these wounds was 5.8 (±2.5) weeks. No significant differences were found between proportions of VLUs and DFUs healed. No adverse events or recurrences occurred during an average follow-up time of 20.4 months (range 11 to 32 months). Overall, patients received an average of 3.8 applications of h-CRM, and 3.2 applications were used among patients that healed."
As previously stated many times, there is plenty of room for the best of the bests.
Epifix like Grafix are the primary money makers today and for the very near future. Other biosurgery products (and eventually FDA approved biosurgery drugs) will eventually have greater impact. I can see where certain biosurgery products will be either sold outright or will be marketed by larger pharmaceutical companies such as Medtronic and MiMedx maintaining exclusive royalty rights. Placenta fetal stem cells are key. The pipeline for both companies are very promising. When the timing and the price is right, both compainies will be sold. I am very content to be patient and wait for the very large payday.