Medical Device Daily Executive Editor

Greatly simplified, the formula for business success involves identifying opportunity and moving to meet it. For those seeking opportunity, take a look at the peripheral vascular disease (PVD) sector.

That's the view of Scientia Advisors (Cambridge, Massachusetts), which has just released a new study identifying opportunities for medical device companies within the PVD space. Scientia is a global management consulting firm focused on growth strategies for companies in healthcare and the life sciences.

Bob Jones, a Scientia principal who led the study, said, "There is a huge market for new ways to diagnose and treat PVD in order to eliminate recurrence and reduce overall healthcare costs."

He noted that the diagnosing and treatment of PVD present opportunities that are largely being overlooked by major med-tech players.

Jones told Medical Device Daily that Scientia decided to do the study after it had touched on the PVD sector in preparing a "pitch" to a potential client. Its curiosity in potential opportunities for companies in the peripheral vascular sector led to the decision to do further research.

"We talked with clinicians and patients, and found considerable dissatisfaction with available therapeutic approaches," he said. "Patients, in particular, are becoming increasingly vocal about it."

The opportunities, then, lie in treatments that are "less invasive, take less time, and offer much faster recovery times," Jones said.

He noted that, based on its research and analysis, Scientia determined that, at current growth rates, revenues in the endovenous ablation and thrombectomy markets, each valued at about $100 million in 2007, would triple by 2011.

But, Jones said, "If companies choose the right strategies, we believe those numbers could rise far higher," possibly approaching $1 billion for catheter ablation and $2 billion for thrombectomy.

One segment offering lots of growth potential, he told MDD, is developing effective ways to diagnose chronic venous insufficiency (CVI), which causes blood pooling and increased blood pressure in the veins. CVI affects some 5% of the population in the U.S. and Europe.

With symptoms ranging from unattractive (but not medically serious) spider veins and painful varicose veins to infection-prone venous ulcers, CVI causes the loss of almost 6 million work days per year in the U.S. alone, the Scientia report said. But it noted that current CVI diagnostic methods such as angiography, d-Dimer and ultra-sonography often are risky or inaccurate.

Another area of need, Jones said, is better methods for diagnosing blood clot formation, or thrombosis, which can lead to pulmonary embolism, the cause of 200,000 deaths each year in the U.S. Deep vein thrombosis affects 2 million Americans each year, Scientia said, but goes undiagnosed in roughly two-thirds of them.

The need for safe, effective thrombosis treatment has led to advances by several emerging companies, he said. "While several emerging companies have recently received approval for cathete -based technologies that break down and remove clots, we believe that this market should also be addressed by major firms."

Harry Glorikian, Scientia's managing partner, said, "Major companies are missing possibilities that could significantly improve the health and well-being of aging global populations, cut healthcare costs, and boost their own bottom lines."

Smaller, emerging companies are developing technologies for the PVD sector that likely will turn into market-entry opportunities for the larger med-tech players, as exemplified by Covidien's (Mansfield, Massachusetts) $440 million acquisition of VNUS Medical Technologies (San Jose, California) earlier this month (Medical Device Daily, June 19, 2009).

"There clearly is room in this sector for innovative companies to get in and offer new technologies," Jones said, "and for VCs [venture capitalists] to see a clear exit strategy for their investment in such companies."

He added, "It's really interesting to see what's [happening] on the road less-traveled."

Because the endovenous ablation and thrombectomy markets are still small in terms of their appeal to the "big guys" of med-tech, whose thinking often is in terms of billion-dollar markets, the smaller companies have room to make an impact with innovative technologies, Jones said.

"There certainly are going to be opportunities for larger companies to identify and acquire these technologies as they make an impact on these sectors," he said.

Another, decidedly less high-tech segment of the peripheral vascular disease market is compression stockings, which the Scientia report characterized as "a potentially high-growth market."

With the stockings currently on the market generally seen as being so hot, bulky and ugly that many patients refuse to wear them, Jones said, "We see a great opportunity for the company that comes up with compression stockings that are lightweight, comfortable and attractive."

In the long run, he said, "more patients and the healthcare system will benefit if companies develop better methods to prevent or halt PVD and its complications thus averting the need for costly long-term therapies."

Noting that the old therapies for chronic venous insufficiency "only address the symptoms, where the new therapies address the cause," Jones said that by addressing the causes, the new therapies have a much lower recurrence rate and thereby also lower the overall cost of care.

"Given the emphasis that the Obama administration is placing on lowering our unsustainably high costs of healthcare, therapies that lower the cost of care will be more speedily adopted," he said. "These emerging treatments not only improve patient care but they can lower the overall cost of care, which will speed their adoption."