Dr. Wald: We've really focused on three subsectors in the med tech space. One is cardiology, another is neurology and the third, something we're calling biologic, is really associated with bone growth factors, stem cells and therapies along those lines.
TWST: We'll start with the cardiac side. As you look back at 2007, what were the
highlights in this cardiac space from your perspective?
Dr. Wald: If you're talking about highlights and mean to imply something good,
there really is not much to talk about, because markets, in particular, the
drug-eluting stent market and the cardiac rhythm management markets were both
weak. The companies tried to reestablish growth in those markets, but really
weren't able to do that.
These markets have still not recovered from safety scares and concerns caused by
reliability problems that surfaced two years ago. Confidence eroded in the
benefit of using drug-eluting stents because clinical data from the Courage
trial and a number of smaller meta-analysis that raised concerns that drug-
eluting stents weren't safe mostly because of late stent thrombosis, an
unlikely, but deadly outcome. Cardiac rhythm management devices experienced a
number of recalls, a weakening of referrals, and a change in physician and
patient behavior as real growth moved from secondary to primary prevention.
These changes really drove the market growth rate down from about 18% or 20% to
a growth of about 5% or 6%.
There wasn't really much positive in the cardiovascular space, at least in the
companies that I was covering. However, if there was a bright spot it was that
the stent market seems to be stabilizing and perhaps beginning to improve. We
haven't seen much of a change in the cardiac rhythm management market, though.
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