Category Archives: medtech

topic is about medical technology of different types, describing specific products under development, the market for them or their impact on healthcare

Sealants, Glues, Hemostats, Anti-Adhesion: An Evolved Market

In a forthcoming report on advanced technologies associated with the acute phase of wound management — specifically, hemostasis, closure and sealing — MedMarket Diligence will be revealing the state of the art and the industry for fibrin and other surgical sealants; cyanoacrylate and other synthetic and naturally-occurring high strength glues; a wide range of products providing hemostasis; products that prevent the formation of post-surgical adhesions; and the increasingly varied types of physical wound closure, including sutures, staples, clips, tapes, and other mechanical wound closure types.

Our analysis in 2012 illustrated the scope and depth to which these advanced wound closure products had penetrated the realm of many areas of clinical practice that, up to a scan decade ago, had been dominated for a millennia by simple physical methods to manage acute wounds — sutures and tapes. Below is an illustration of the size and growth in e sales of these products, showing that the advanced products are being adopted at accelerated rates, yet a sizable volume of wound closure remains in the hands of very traditional closure (sutures/staples).

Size and Growth of Surgical Securement Product Segments Worldwide 2010-2019

Source: “Worldwide Surgical Sealants, Glues, Wound Closure and Anti-Adhesion Markets, 2008-2015.”  Published by MedMarket Diligence, LLC. See updated Report S192.

Of course, the field of sutures and staples is not exactly stagnant, devoid of innovation. Sutures, staples and clips innovation have been driven by the commensurate innovation in surgical technique. Traditional surgery via laparotomy has long since been revolutionized by laparoscopy, and endoscopic procedures in general have become the standard for minimizing surgical trauma and faster recovery. The endoscopic format has demanded new suturing and stapling technologies, and industry stalwarts like Ethicon, Covidien and others have been happy to provide the solutions.  And even more recently, natural orifice transluminal endoscopic surgery (NOTES) procedures are pushing the minimally invasive principle to a greater extreme.

Medtech fundings for July 2014

Fundings in medical technology for the month of July 2014 have reached $364 million, led by the Intersect ENT $55 million IPO and fundings of Advanced Cell Technology ($30 million), Rotation Medical ($27 million) and Amedica Corp. ($26 million). Below are the top fundings thus far in the month.

Company, funding Product/technology
Intersect ENT, Inc., has raised $55 million in an initial public offering according to the company Drug-eluting sinus implant
Advanced Cell Technology, Inc., has raised $30 million in an equity round of funding according to the company Human embryonic stem cell and adult stem cell for a range of treatments, including macular degeneration
Rotation Medical, Inc., has raised $27.2 million in a Series B round of funding according to press reports Collage scaffold for the treatment of rotator cuff tears
Amedica Corp. has raised $26 million in debt and equity funding according to the company Orthopedic implant materials

For an updated list of medtech fundings in July 2014, revisit this post (refresh your browser) and see link. For a full list of the fundings in medtech, by month, since 2009, see link.

Wound market CAGRs by segment and region, worldwide

Gauze dressings, bioengineered skin, alginates, negative pressure devices, cellular growth factors, hydrogels, antimicrobial dressings — all of these products (and more) represent the practice of wound management for the entire spectrum of wound types and severities. Practice patterns, regulatory requirements, price pressures, healthcare delivery system gatekeepers, demographics, cultural sensitivities — all of these, and more, combine in the forces that dictate the size and outlook of the markets for different wound management products in global markets.

Screen Shot 2014-05-13 at 9.20.35 AM

It’s no surprise, then, that product sales are growing (and in some cases declining) at different rates in different regions of the world, but the data is clear on this. MedMarket Diligence researched and published this data in its global wound management market Report #S249, which details the clinical practice of wound management, the products on the market and in development, the current and forecast markets for each worldwide and regionally and the competitors vying for market presence now and in the future.

Researched from primary and secondary sources, the global wound market data illustrated above (which is also detailed by country) and presented in Report #S249, “Worldwide Wound Management, Forecast to 2021: Established and Emerging Products, Technologies and Markets in the Americas, Europe, Asia/Pacific and Rest of World.”

 

Biological growth factors in wound care drive big revenue growth, too

Extensive research has demonstrated that wound fluid is rich in growth factors. Growth factors are naturally occurring proteins found primarily in platelets and macrophages. They are needed for normal wound healing to promote growth and migration of fibroblasts, endothelial cells and keratinocytes. The functions of growth factors include; attraction of cells to the wound site (chemotaxis), stimulation of cell division/ proliferation (mitogenic competence/progressive), differentiation of cells into specific phenotypes (transformation), and stimulation of cells to perform functions or secrete other growth factors. Growth factors bind to receptors on the cell surface where they activate cellular proliferation and/or differentiation. There are a number of growth factors which are involved in wound healing at different points in time. Many are quite versatile and capable of stimulating cellular division in different cell types; others are specific to a particular cell type.

Below is a list of the growth factors involved in wound healing:

  • Epidermal growth factor
  • Transforming growth factor-α
  • Hepatocyte growth factor
  • Vascular endothelial growth factor
  • Platelet derived growth factor
  • Fibroblast growth factor 1 and 2
  • Transforming growth factor-β
  • Keratinocyte growth factor

(The origins, effects and companies pursuing development of these growth factors are described in link.)

Since the market for growth factors in wound management is very new, there are as yet only a few players, but with compound growth in this market pushing well over 20% annually, the lucrative market will stimulate a burst of new entrants over the next few years. Currently, Smith & Nephew holds a dominant position due to its acquisition of Healthpoint Biotherapeutics (pre-acquisition market shares shown separately, below).

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Additional companies include Citagenix, Cytomedix, Daewoong Pharmaceutical, Macrocure and others.

Source: MedMarket Diligence, LLC; Report #S249.

And, then, Medtronic bought in to wound care

With Medtronic’s pending $42.9 billion purchase of Covidien, the company now has bought itself a seat at the global wound management table. No, this is not a “current” concern for other active wound market companies, since Covidien is not dominant a contender in wound management — the aggregate of its Covidien and Kendall branded products’ presence is a meager 6%.

Screen Shot 2014-06-16 at 2.33.34 PM
Source: MedMarket Diligence, LLC; Report #S249.

However, Medtronic never settles for low market share, so it is fair to assume that Medtronic’s planned future involvement in wound management and other of Covidien’s markets is likely to be anything but the “status quo”.

Stay tuned…

Glucose monitoring research drives more promises than answers

If I had a nickel for every headline like this that ultimately failed, like the technology, to actually achieve the promise, I would be on a tropical beach sipping pina coladas:

“Glucose monitoring for diabetes made easy with a blood-less method” (link)

Technologies in development for less-invasive or non-invasive glucose monitoring are legion, and many are very promising, but you can’t fill out a deposit slip with these promises. Frequently, such alternatives are based on the premise of quantifying blood glucose by sensitively detecting glucose in other fluids (interstitial fluid, tears, saliva, urine, etc.) that do not require the use of lancets to draw blood. However, despite their sensitivity and other sophistication in detecting minute quantities of glucose, their “arm’s length” to actual blood glucose compounds the challenge by requiring that the test reproducibly correlate the sample values with actual, current blood glucose levels.

The challenge stands unanswered, while the burgeoning population of endlessly finger-pricked diabetics remains painfully unsatisfied.

As a practical reality, continuous blood glucose monitors like those from Dexcom and Medtronic offer far more to the diabetic population, not only by avoiding finger pricks but also by revealing the patterns in blood glucose levels over time as a result of activity, carbohydrate intake, insulin bolus, insulin basal rate, stress and countless other patient-specific determinants.

Medtech fundings for June 2014

Fundings in medical technology for the month of June totaled $445 million, led by fundings of Benvenue Medical ($64 million) and InSightec ($50 million).

Below are the top fundings in the month.

Company funding Product/technology
Benvenue Medical, Inc., has raised $64 million in a round of funding according to the company Minimally invasive implants for spine surgery
InSightec, Inc., has raised $50 million in a Series D round of funding according to the company MR-guided focused ultrasound
Pixium Vision has raised $46.7 million in an initial public offering according to press reports Implants to treat blindness
OrthoPediatrics Corp. has raised $39 million in a round of funding according to a regulatory filing Orthopedic implant technologies designed for pediatric use
Cheetah Medical, Inc., has raised $33.85 million in a round of funding according to a regulatory filing Non-invasive hemodynamic monitoring
Spinal Kinetics, Inc., has raised $33.85 million of a planned $34.77 million round of funding according to a regulatory filing Motion preservation systems, including artificial discs, for degenerative disc disease

For a complete list of medtech fundings in June 2014, see link.

For a full list of the fundings in medtech, by month, since 2009, see link.