May 6, 2010
Abbott and other device makers have something to celebrate as stents are shown to be equally as safe as surgery.
There's long been a debate as to whether stents are just as effective and safe as heart bypass surgery for patients with blocked heart arteries -- a recent study shows that both procedures are equal.
A South Korean study from the University of Ulsan College of Medicine of 2,240 patients with a heart blockage called unprotected left main coronary artery stenosis who had received either bypass surgery or a stent showed no difference in rates of death, heart attack, or stroke five years after the procedure.
While surgery is still the recommended treatment for patients with this severe condition, the study could be a major boon to those companies that are in the stent business like Abbott Laboratories (ABT), Boston Scientific (BSX), Johnson & Johnson (JNJ), and Medtronic (MDT).
A drug-eluting stent is a small metal piece of scaffolding covered in a therapeutic drug that's used to keep the arteries of the heart from collapsing while slowly releasing the drug to keep the blockage from returning. The US market for drug-eluting stents had reached $1.8 billion by the end of 2008, accounting for 43% of global returns, according to a report by Medtech Ventures.
A report published in the New England Journal of Medicine this week showed that Abbott’s Xience V stent is superior to Boston Scientific’s Taxus stent. The Spirit IV trial was a randomized clinical trial comparing two drug-eluting stents with 3,690 US-based patients. The study showed that one year after a stenting procedure, patients treated with Abbott's stent were significantly less likely to have a major adverse event such as a heart attack, repeat procedure, or cardiac death compared to patients treated with the Boston Scientific stent.
"With more than 3 million stent procedures being performed annually worldwide, determining the safety and efficacy differences between various drug-eluting stents has important implications for societal health," said Gregg W. Stone, MD, professor of medicine at Columbia University Medical Center and principal investigator of the Spirit IV trial.
Another bonus for patients: the Abbott stent turned out to be more cost-effective than its competitor, producing lower overall medical costs one year after the procedure.
Xience comprised 30% of the US market in 2008, with Promus at 24%, Taxus at 2%, Medtronic’s Endeavor at 13%, and J&J’s Cypher at 11%. Abbott makes a private-label version of Xience called Promus that's marketed by Boston Scientific under an agreement between the two companies.
The stent market had been under pressure over the last year as investors worried that health-care reform as well as pricing pressures during the downturn affected sales of the stents. Yet, sales of the mesh-wire devices seem to be stabilizing.
Abbott announced in January that Xience V has received approval for use in Japan, where approximately 200,000 stent procedures are performed annually -- making it the second-largest market behind the US. According to Millennium Research Group, Xience and Promus have both picked up a share of the market in Japan from competitors. In its peak sales month, the research group showed that Xience was used in half of the stenting procedures done in Japan.
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