Explosive growth in demand for drug eluting stents has shaped a market worth more than 6 billion euros annually. According to figures published at EuroPCR (the annual European Paris Course of Revascularisation, Paris, France), some 2.5 million percutaneous coronary interventions will be performed globally in 2006 – and 75% of these procedures will employ drug eluting stents. Not bad for a medical technology less than five years old.
Dominating this market is Boston Scientific – its authority strengthened by April’s $27-billion takeover of Guidant Corporation, the largest transaction in the history of the medical device industry.
Boston Scientific showcased a wealth of data at EuroPCR, including the first clinical data from its second–generation DES, Taxus Liberté, durable three-year safety and efficacy data from the TAXUS VI clinical trial of the Taxus Express paclitaxel-eluting stent system in high-risk patients (long lesions, small vessels and diabetics); 12-month data from the MELODIE clinical trial of the Express Vascular LD Peripheral Pre-Mounted Balloon Expandable Stent in the treatment of narrowed or blocked iliac arteries; and safety and efficacy data from the RENAISSANCE trial of the Express SD stent for renal artery stenting. The company also announced funding for a new EU medical training facility – The Institute for Therapy Advancement – which will open in Brussels, Belgium, in early 2007.
A high profile at EuroPCR, coupled with the announcement of the new Brussels training facility, appears to signal that Boston Scientific’s centre of gravity is also shifting across the Atlantic – a perception that Chief Operating Officer Paul LaViolette did not dispel.
“Forty per cent of our revenues now come from outside the United States. European Taxus sales hit a record in the first quarter of this year – due in part to the launch of Taxus Liberté, our second-generation stent technology. We hit these record sales despite new competitors taking share at the lower end of the market,” he told PharmaTimes World News Online.
“Our European business today is larger than all of Boston Scientific was just five years ago. Furthermore, Europe tends to be a strong indicator for the rest of the world: technology reaches the European market early, and becomes an excellent testing ground for the competitiveness of our products. We are very pleased that the EU market is continuously assimilating new technologies and we intend to continue to bring new technologies to Europe first,” he added.
The Taxus Liberté DES will become Boston Scientific’s largest selling product, LaViolette predicted: “It is clearly an advance in terms of ease of use and deliverability. Since the start of interventional cardiology, the race has been on to make devices more deliverable so that physicians can challenge more complex disease. It is very clear that Taxus Liberté offers an optimum combination of mechanical improvements and superior drug delivery.” This is supported by the ATLAS data presented at EuroPCR.
New technology such as Taxus Liberté is undoubtedly driving the rapid growth of drug eluting stents in the EU, and there is still more potential for further growth. “Use of drug eluting stents has increased dramatically to more than half of all stents used in Europe, up to 80% in some EU countries, so the market place has spoken. Health economic issues have generally been resolved and for most patient populations, drug eluting stents are the first choice.”
Looking to the future, stent technology will continue to evolve: Boston Scientific has several offerings in the pipeline, including the platinum alloy Taxus Barracuda stent with narrower struts for greater conformability, and the AST Petal stent platform for use in bifurcated vessels. The latter is designed to expand into the side branch, permitting blood to flow into both branches of the bifurcation and providing support at the branch.
“Through our acquisition of Guidant, of course we will be integrating the Xience platform and launching that as well,” said LaViolette. “We will be the first company to offer both paclitaxel-eluting stent and everolimus-eluting stents side by side so that the customer can choose the drug that they prefer.”
“Our basic philosophy in this therapeutic area is to offer choice of stent platforms, choice of drugs, and continuous leadership in balloon delivery systems. With the merger, we have also created the leading cardiovascular device company, with cardiac rhythm management, electrophysiology, cardiac and vascular surgery, peripheral interventions, interventional neuro-radiology, carotid stenting platforms and, of course, leadership in interventional cardiology. We intend to continuously innovate in all of the new procedural areas in cardiology.”
He said that a priority was to restore the cardiac rhythm management franchise back to one of rapid growth and leadership. “The number two objective is to fully integrate the everolimus drug-eluting stent platform. Our third objective is to look for areas of cardiovascular disease that are not well treated today that we are uniquely positioned to attack, based on the breadth of our device leadership, spanning the full field of cardiovascular care.”
Boston Scientific also has ambitions in other areas of medicine, including growing their franchises in neuromodulation, gastrointestinal disease and neurovascular care. But that is another story. “The Guidant takeover created a company that is more diversified, faster growing, and one that will return greater shareholder value – but our work is just beginning,” said LaViolette. By Ian Mason.