>Moreover, he takes direction from Tim Ring who takes direction from Bill Longfield.<
I thought Tim Ring reported to Benson Smith. What kind of executive is Tim Ring? Is he a yes-man?
FYI: to keep everyone abreast.
How does the Paragon stent compare to the MuliLink?
How well has the Paragon done in Europe?
What impact might USS have on pricing, given that they have nothing to lose and are interventional cardiology is purely incremental to them?
NORWALK, Conn., Jan. 8 /PRNewswire/ -- United States Surgical Corporation (NYSE: USS) today announced that its Vascular Therapies Division has completed its Phase II randomized clinical trial for the Paragon coronary stent. USS
anticipates filing its pre-market approval application (PMA) with the U.S. Food and Drug Administration (FDA) in July.
"The Paragon* stent's performance to date has been excellent and we are very confident that the six-month follow-up data will clearly demonstrate its benefits to patients with coronary artery disease," said Greg Cash, vice president and general manager, Vascular Therapies. "We look forward to submitting our data to the FDA and hope to receive marketing approval by the end of the year."
The Paragon coronary stent, a third-generation stent that USS believes is a significant improvement over other stent technology, has CE mark approval. It has been on the market in Europe since October 1997. It is made of martinsitic nitinol, a balloon-expandable material with unique properties that
enhance stent performance and provide flexibility. Interventional
cardiologists who have used the Paragon stent praise its lexibility, optimal radiopacity and excellent radial strength.
�RJFrailey, i sent an email to the Yahoo webmaster requesting directions as to how to add a website to the Yahoo finance page. Assuming they will respond, I'll pass the info along.
Also, can you share with us where the growth is in UM's plans? We know UM is already the market leader in intrauterine pressure monitoring. That's the good news. The less attractive news is that the company has to find a marekt segment above and beyond that niche to stimulate and sustain its earnings, unless there is significant growth remaining in the IUP segment.
From my cursory review of the product portfolio, the remaining products appear to be "yawners". Would like your feedback.
Particularly the umbilical cord product...don't physicians and other personnel wear gloves? And, if contact with blood were an issue in this environment, aren't they exposed to it far beyond the cutting of the cord? Seems like a "solution" in search of a "problem"?
You're right, however, I think the pressure is at an all time high for several companies that have a cardiology franchise.
MDT managment knows, by now, that the growth they were projecting from interventionla cardiology willnot happen, BCR is
completely out of the race, JNJ is going to feel like they've stepped on a banana peel, and BSX needs to find leverage somewhere, and
quickly. Thus, I don't think the initiative will come from within STJ, it will come from others that may feel that GDT has taken a
significant step forward.
My gut tells me that the basic difference between STJ and GDT is reflected in the leadership of the companies. Matricariah of STJ is more of a tactical leader while Dollens appears to be more strategic; i.e., as George Bush said; "it's the vision thing".
This comment would make Matricariah's blood boil because he perceives himself to be the quintessential "strategic thinker".
While he's, presumably, a good manager, I think he loves to "talk the talk" more than "walk the walk". The best example is STJ's
acquistion of Ventritex. They spent several years "studying and researching" the profile of their investors" in trying to decide what
future platforms would meet shareholders expectations, etc., while a "blind man" could see that Matricariah, rightfully or
wrongfully, was going to acquire Ventritex, based simply on his background with CPI. Thus, this was really little more than a tactical
manuever, a waste of time and resources. Likewise, the acquisiton and premium paid for DAIG suggests to me that he doesn't realize the
impact that interventional cardiology will have on STJ's competitive positon, once MDT and GDT are compelled to "bundle" across all
The bottom line, however, is that STJ may be an attractive stock because I think they will be acquired by either JNJ or BSX.
On the other hand, if Matricariah were a visionary, he'd acquire AVEI as soon as the stock drops to the 30's or low 40's, after having completed an intense review of the JNJ and GDT lawsuits. If they have merit, then it becomes less clear that this would be a good move.
�hooah66, I'm flattered. But, I do not follow any companies in orthopedics. Not for any particular reason, I'm just not aware of any opportunities. Would love to hear your suggestions, though.
The companies I follow on these boards are as follows: BSX, JNJ, GDT, AVEI, BCR, USS, STJ, MDT, ESON, CCVD, CRDM, MTIX, CRDM, ECSI, ABMD, CTSI, HPRT, GSII, AND UROQ.
With the exception of Uroquest (UROQ) these other companies have some relationship to interventional cardiology or radiology. My interest in UROQ is that Terry Spraker is the CEO. Terry was the former CEO of EP Technologies, which BSX purchased. I suggest you keep it in mind.
Other than the cardiology stent players, however, I can't seem to get a dialogue underway on most of these other boards.
>I don't know if the $900 is carried out "across the board" ie. a 2 vessel stent is 1800 more than a 2 vessel PTCA. I assume it is. Maybe someone on this board knows.<
Likewise, I hope someone that does know the answer will respond. We all know the way we'd like it to be, but I'm not sure that's they way it is.
>You can't ethically justify a PTCA just to keep the hospital happy. Most of us don't work for the hospitals and we want the security of a perfect stent result.<
I agree that your focus should be on the patient and not the hospital's bottom line. My interest, however, is based on the
assumption that, when clincially insignificant differences exist between stents, you will be pressured to use the stent that cost less.
The hospital's argument, of course, will be that if the outcome of the procedure is the same, then they should not continue to
lose money. The challenge will then shift to the companies to document that a premium price is commensurate with the outcome. If
they cannot do that, then the pricing war starts which, in turn, redefines the earning projections for all of the companies
�GP2b3a, you knew I'd jump on the invitation to offer my opinion. I think we'll see an erosion of $800-$1000 in the cost of a stent within 2 years. Of course, unless AVEI is acquired, it may not be reflected in the actual price of the stent. Companies are very creative at not letting the that happen. They way they'll avoid it is through some type of bundling schemes. The net effect to the customer, however, will be the same; i.e., huge cost savings.
The reason for the charade is to keep the investors in the dark for as long as possible. If you listen closely, you can hear the rationalization that companies always use to use when trying to deny the impact of price erosion on profits because the discounts were offered in a bundling program; i.e., "we made it up in more volume". Unfortunately, unless that is in fact true, and it seldom is for long, the company's earnings will suffer.
The key to watch is the incremental gross margin. When it approaches 60%, that is when the pricing war ceases. Thus, my premise is that the incremental gross margin on a stent will be about 60% when the price reaches about $500.
>How could they have gotten a monorail in the US if GDT was sitting on the patent? Or was the outcome of the patent dispute still in question at that time?<
No, you're correct in assuming GDT's Yock patent and Scheider's Bonzel patent were firmly in place and, from SciMed's experience, everyone knew that these patents were very well written.
The obvious choice for Cordis, BSX, and others was to try to find a way to engineer around the patents, much easier said
than done, if the end-result would be something competitive. That is what makes it all the more interesting, that Cordis' pledge
to have a competitive monorail would not be met with cautious skepticism. But, shareholders were virtually giddy with the
success that Cordis was achieving at the time and, obviously, believed every thing they were told. The joke is that that Cordis
never did have a competitive design and they "were betting on the come" that they could come up with one within 18 months. That
obviously hasn't happened.
Of course, there has been some speculation that Cordis recently negotiated with MDT the rights to MDT's Falcon monoral design. However, that has not only been challenged by GDT but, even more relevant, at its best it's not a very poor substitute for the GDT monorail.
Is the incremental $900 for the stenting DRG fixed or is it adjusted based on how many stents you implant?
Also, based on your feedback:
>So though the hospital may lose money compared to PTCA costs at first, the better outcomes makes angioplasty difficult to justify.<
This seems to imply that, at some point, the hospital ceases to lose money relative to PTCA. How would that happen? It seems to me that the loss is forever lost and each subsequent stenting procedure still incurrs a loss of $600, if the stent cost $1,500.
This, of course, remains to be seen. Bear in mind that the $2 billion was paid for Cordis, the cost of which must be evaluated independent of stents. JNJ developed the P-S and Crown stents internally, thus that cost is incremental to the $2 billion. These 2 projects, however, were merged into the Cordis division because of the obvious overlap in the market; i.e., same customers, etc.
The interesting observation is that it was believed that JNJ's lcok on stents would prove synergistic to Cordis and, as a
result, would pull through more of Cordis' PTCA products, primarily balloons. However, Cordis' balloon market share has actually
declined since the acquisition - thus one must wonder if this wasn't a $2 billion waste; i.e., JNJ did not need Cordis to increase or
maintain its stent business, they already owned 100% of the market. Therefore, one could argue the the loss in Cordis was the
"anticipated growth that has not occurred.
The stent business, however, is another matter. In owning 100% of this business, until very recently, the virtual collapse
of JNJ's market share is a "real P&L" loss to JNJ; that is, what profit contribution was there last year, won't be there this
year! The relationship to Cordis in this, other than the mere transfer to Cordis of the stent franchise, was that by the time
competitive stents arrived in the U.S., Cordis should have erected defensive barriers that would have insulated the stent business from
evaporating overnight. That, obviously, has not happened and, therein, lies the mystery: i.e., what has Cordis done during the past few
years other than to take orders on their existing PTCA business and JNJ's existing stent business? The answer appears to be
nothing. But, success makes for a good deodorant and JNJ's temporary success in the stent market appears to have masked whatever
scents JNJ corporate should have detected from afar.
>Medicare came up with a new hospital DRG code for stenting that was about $900 more than the PTCA code.<
Is the only incremental cost to the hospital in a stent case, above and beyond the costs otherwise incurred in PTCA, the cost of the stent; i.e., is it correct to assume that if a stent cost $1,500 and the hospital is reimbursed $900, they still lose ($600) per case when a single stent is implanted? Or, are there additional costs that a hospital incurs in a stent case; i.e., recuperative time, ICU time, etc. that must be added to the ($600) loss to the hospital?
Don't be so quick to give the Rube Goldberg award to BSCR's Telescoping balloon, bandit_sam_jewel. It seems to me that the "bifurcated stent" may offer some pretty heavy competition.
I was amused when I read the press release for both of these products. If you did not know the interventionla cardiology
market, you'd be led to beleive that BCR is a "technological leader" and looked at by its peers as having a major impact on the
market. For those that are not in tune to this market segment, BCR is not even an also-ran. While this market segment is highly
competitive, review the message boards for JNJ, GDT, BSX, AVEI, CCVD, MDT, USS, etc., and see how many times they are even mentioned.
To put out a press release with this kind of window dressing to me is a red herring, at best, and constitutes gross misrepresentation by BCR.
>Also the NIR stent is made by Medinol in Israel and I believe there is some friction between
Medinol and BSX.<
If that is true, the margins for BSX, as a distributor, cannot come close to the margins of an internally developed product. Also, I assume Medinol is a private company which may preclude BSX from buying their way out fo this siutuation; i.e., unless BSX has a better stent in the pipeline, why would Medinol sell at almost any price? Any comments? This is why I think it's not totally remote to include BSX among the companies that might acquire AVEI.
G2b3a, it has also been observed by many that products in interventional cardiology are oftentimes selected by physicians based on their relationship with the company's sales rep. While that is easy to conceptualize with a commodity product, is that the case with a product such as a PTCA balloon or a stent?
How much of a difference does a salesman make in the success of a critical product?
�G2b3a, in being a cardiolgist that actually places stents, I'm curious as to how you will proceed with the process of evaluating the stents that have overnight become available to you. If the information is at all accurate on the JNJ, GDT and AVEI message boards, it seems that the GS2, P-S, Crown and Wiktor stents all take a significant back seat to the ML, MS2 and the GFX.
Therefore, do you rely on the feedback from European physicians and proceed to evaluate what you think is the best stent and, thereby, avoid wasting your time evaluating the stents that have been perceived as subpar? I can only assume that your time is valuable and that there is little to be gained from evaluating stents that you know won't meet your needs as well as others.
Your perspective is appreciated.
In all fairness to USCI, the market will be the judge of whether this has any merit. On the other hand, if you ask me, I think it sounds like something that should be entered in the Rube Goldberg Machine Contest, at Purdue University. That's about the only recognition that it is likely to win. Translation, I think it will fall on its face!
>The TELESCOPE catheter also features Bard's unique patented Rely(R) balloon material which is widely recognized for its superior performance during difficult multi-lesion cases.<
Will this catheter be able to be used as a single-operator stent deployment system? Is the Rely balloon material capable of achieving high pressures?
Any comments as to the potential of this catheter? How will it be received in the market? Does it meet any unmet needs? Are there any negatives that were not mentioned in the press release?
Bard Receives Approval For The Revolutionary New TELESCOPE Angioplasty Catheter
MURRAY HILL, NJ--(BUSINESS WIRE)--December 23, 1997--C.R. Bard, Inc. (NYSE-BCR) today announced it has received U.S. Food and Drug Administration clearance to market the revolutionary new TELESCOPE(TM) Single Operator over-the-wire balloon catheter.
The TELESCOPE balloon catheter is the first fully interchangeable, single operator angioplasty device to combine over-the-wire performance with a standard length guidewire. This technologically superior TELESCOPE catheter revolutionizes PTCA catheter shaft design by providing the interventional cardiologist with a totally new level of flexibility and versatility.
As its name suggests, the unique shaft of the TELESCOPE catheter is constructed from telescoping segments, allowing the
physician to swiftly and easily shorten or lengthen the catheter according to the requirements of the procedure. In addition, the
TELESCOPE catheter offers a patented anti-backbleed and wirelock system which minimizes blood loss during the PTCA procedure. The
TELESCOPE catheter also features Bard's unique patented Rely(R) balloon material which is widely recognized for its superior
performance during difficult multi-lesion cases.
``Since our pioneering work in balloon angioplasty in the 1970s, our research engineers have continually strived to provide the interventional cardiologist with new and innovative devices to treat coronary artery disease. Now they have reached a new level of achievement with the TELESCOPE catheter system,'' commented William H. Longfield, Bard's chairman and chief executive officer.
``This unique catheter provides not only flexibility and ease of use, but also the potential to substantially reduce the
balloons required and cost per procedure.'' Bard plans to launch the TELESCOPE catheter in the U.S. market in early 1998, where
several patents currently limit the cardiologists' choice in single operator systems. Bard will continue to supply its markets
outside the U.S. with its latest generations of over-the-wire and rapid exchange catheters. The TELESCOPE will eventually be
launched worldwide when production volumes permit.