Boston Scientific Sees Heart Study Helping Market; Shares Slip
01 Septembre 2009 - 6:45PM
Dow Jones News
Boston Scientific Corp. (BSX) backed on Tuesday forecasts for
how a 1,820-patient study could expand use of implantable devices
that treat heart-failure patients and emphasized a potential
positive impact on health costs, despite the devices' high price
tag.
The fresh "Madit-CRT" trial details built upon evidence released
earlier showing cardiac resynchronization therapy defibrillators,
known as CRT-D devices, can slow the course of heart failure in
patients with milder cases when compared with more basic
defibrillators.
The fuller data from the $38 million, Boston
Scientific-sponsored study were unveiled Tuesday at a European
heart conference and published online by the New England Journal of
Medicine. The study showed a more pronounced benefit than prior
analysis released in June, although analysts said there were no big
surprises.
Boston Scientific, which competes closely in the $6 billion
global market for implantable defibrillators with Medtronic Inc.
(MDT) and St. Jude Medical Inc. (STJ), believes the domestic market
for more complex CRT-D defibrillators will grow by up to $250
million in the next few years due to the study.
The global market could grow by $400 million to $500 million,
said Fred Colen, group president for Boston Scientific's
cardiac-rhythm business, on a call with analysts following the
Madit-CRT data release. The Natick, Mass., company has previously
cited such targets.
Boston Scientific is being conservative in its market estimates,
but "would love nothing more than to see actual results being much
better," Colen said.
Shares of heart-rhythm companies still moved lower following the
study's release and a downturn for the broader market. Shares of
Boston Scientific were down 4.3% to $11.23 while shares of
Medtronic declined 0.9% $37.97. St. Jude shares traded 1.7% lower
to $37.87.
Wells Fargo analyst Larry Biegelsen expects a "modest positive
impact" while JPMorgan's Michael Weinstein sees market acceleration
in the first half of 2010. Citigroup's Matthew Dodds called the
results "disappointing," on the other hand, and he doesn't see much
benefit.
Lazard Capital Markets analyst Sean Lavin does expect a market
benefit, though he noted that some doctors are worried about costs
or don't think there is enough data yet to expand usage. "While we
believe the large majority will greet these data with open arms, a
minority may be vocal and negative," Lavin said.
CRT-D devices provide power to synchronize beating in erratic
hearts and also have defibrillators on board to provide jolts when
needed to stop life-threatening arrhythmias.
Today only patients with more severe cases of heart failure are
typically given $30,000 CRT-D devices, but manufacturers would like
to expand their usage to patients with symptoms that haven't
progressed as far, and who might only get a cheaper defibrillator
under current guidelines. Because CRT-D devices cost on average
$7,000 to $8,000 more in the U.S., according to Boston Scientific
estimates, upgrading patients carries financial benefits.
It may also raise concerns in an environment of health-reform
debates and concerns about rising costs. Amid that backdrop, Boston
Scientific highlighted the costs associated with hospitalizing
patients for heart failure, which can cause fluid in the lungs or
legs.
Avoidance of heart-failure events was the difference maker in
the study for patients who had CRT-D devices instead of regular
defibrillators.
Official cost-effectiveness data from Madit-CRT are not yet
available. But Arthur Moss, a cardiologist at the University of
Rochester and the study's main author, said that CRT-D devices did
show cost benefits. The cost of hospitalizing sick patients far
outweighs the upfront cost of pricier devices, he said in an
interview.
"There's every reason to believe there will be a meaningful cost
benefit," he added on Tuesday's conference call. He has received
grant support from Boston Scientific and lecture fees from the
three device makers.
Boston Scientific plans by the end of this year to ask the Food
and Drug Administration to expand the approved usage of CRT-D
devices to less-sick patients. The company expects regulatory
approval in mid-2010.
-By Jon Kamp, Dow Jones Newswires; 617-654-6728;
jon.kamp@dowjones.com