Tuesday, September 14, 2010
Has NuVa Caught The Recession Flu?
It seems like chicken soup, nor even red beet borscht is going to help NuVasive's projections for fiscal 2010 . Today, the Wall Street Journal reported that Alex Lukianov has notified the Street that NuVa intends on cutting its forecast for sales growth and reductions to its top line 2010 guidance. Of course since there is no rhyme or reason to the market, NuVa's stock jumped 5% and closed at $33.13 per share. Tomorrow morning may be the time to sell off some of this stock, its hard to image that it will not take a hit when the market opens. TSB must admit, a little humble pie will go a long way for some of the people at NuVa. Seems like XLIF's shoulders have gotten tired of carrying the rest of the portfolio. I guess the Bear will have to limit himself to only one bottle of the 1998 Petrus.
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With every single hospital in Southern California capping their spine pricing including XLIF, It's no surprise to me that this is happening to NUVA since this is their backyard. Im sure this is happening not only in SoCal, but nationwide as well. Since their reps are expected to fill Monitoring, Hardware and Biologics "buckets" to make maximum payouts I think it's a bad sales practice. I say sell what you can and sell the hell out of it. Not to mention Osteocell is just a piece of shit. I would hate to have to order that shit in before the case, make sure it is temperature monitored etc. I have seen maybe 5-6 cases where the rep is scrambling around trying to find where the fedex guy left the package. Not to mention it is barely cheaper than Infuse and has NO, I repeat NO published, peer reviewed level one clinical data period.
ReplyDeleteThat was a horrible acquisition for them. If the ankle biters are swirling the drain, its only fair to assume that the Majors and Mid-majors are feeling some pain.
Arrivedurci Bitches!
P.S. Shout out to my man Todd Stanaford!
Osteocel isn't working - period. All my surgeons who have used it have said not again. If it doesn't work in the neck, thats terrible
ReplyDeletePUREGEN
ReplyDeleteWhat's not to work? It's DBM and cancellous bone even without the cells.
ReplyDeleteI use Osteocel plus in the cervical spine with good reults. I had always used allograft with good results as well, but switched to PEEK cages for the larger footprints. After over 200 levels I am happy with the fusion results.
ReplyDeleteHere's a new twist on NuVa. Your article prompted me to do a little research. NuVa, along with many other companies that market facet fusion devices, were sued on July 19th by Minsurg Corp. NuVa was let out of that suit just last week, but all of the other defendants still remain. I found all this information via PACER and Justia.
ReplyDeleteWith Minsurg receiving a patent in May on an arthroscopic type portal facet surgical method (whatever that is), let's play out this scenario.
Minsurg, who has also sought an injunction against the remaining defendants, say possibly wins on the injunction. Then, NuVa is looking for a device to use posteriorly with their XLIF and so they buy Minsurg.
Crazy? I don't know, but that's a possible scenario, I guess? When doing a search on this lawsuit, which was prompted by the NuVa search, I found an interesting fact that surfaced just yesterday. Bernard Guiot, who I believe is a well-known neurosurgeon and once worked with Minsurg as their Chief Clinical Officer, has sued Minsurg in Pinellas County, Florida for Breach of Contract. (Pinellas Court case Number 10013590CI)
Spine.....it's a crazy world.
Who needs Osteocel for an ACDF? If you can't make a successful fusion there with just a simple scaffold, you need to get trained again. Where Osteocel (and Trinity) should work, i.e. lumbar interbody and posterolateral, they just don't. They are not even as good as DBMs, just 2 to 3 times as expensive. Snake oil. That's not to say I don't wish Nuvasive, the slighly less evil offspring of Danek, all the best...
ReplyDeleteCosmo Kramer could drop a Junior Mint in a cervical and it would fuse as well as Trinity/Osteocel. Until the newer stem cells are available (such as amniotic or placental) forget about it. The cadaver derived or adult are nothing more than overpriced, frozen DBM
ReplyDeleteagree w 8:24 & 7:49
ReplyDeleteShoe leather fuses in the neck boys. Nuvasive is a one trick pony.
ReplyDeletethe end.........
I work for Nuvasive and we hope that you think we are a one trick pony! Our growth is unmatched, our innovation is unmatched, or clinical training is unmatched, etc. We most certainly will not buy Minsurg, most reps in our company do not even know we have a facet dowel. Who in the world backs up an XLIF with facet dowels???
ReplyDeleteSimple Question, for those that use Osteocel or Trinity in ACDF's
ReplyDeleteHow much better can we make Anterior Cervical Discectomy Fusions using Osteocel or Trinity by increasing the cost of the procedure? Can it get any better than what is historically substantiated in the literature. 94-96% is pretty damn good. Come on, this isn't a lumbar fusion. For years less expensive substitutes have been used with great results. Surgery is an art, it involves meticulous preparation of the disc space. Unfortunately, there are surgeons that are not good carpenters, or are in too much of a rush to get to their next case, or hurrying to go nowhere. TSB would love to be hear the rationale from any NuVa or Orthofix spine rep convince me that the literature states otherwise.
Watch out for PUREGEN Stem Cell
ReplyDeleteLive donor that is young
9:12 -- Your innovation is unmatched? Would that be your cervical uni-plate (Synthes, DePuy, etc.) or your pedicle screws that have unmatched innovation? It sure isn't Osteocell, and don't think for a minute that more of the big dogs aren't coming after the XLIF business. I'm sure Globus will be next, following closely on the heels of DePuy's full release of a lateral fusion system.
ReplyDeleteFrankly, the arrogance of the Nuva reps needs to be tempered. Glad Alex did it. You are not God's gift to spine.
Well, I'm not a NuVasive or Orthofix rep, but with respect to literature, I think we all need to take a closer look. If one studies the Level 1 data on ACDF procedures, clinical success rates (which include fusion + NDI Improvement + Lack of revision) is in the low 80s% range. Fusion success is not the only standard to measure success...
ReplyDeleteI'm suprised nobody has mentioned the issues with reimbursement. NuVa gets the ax, if there is any guidance from payors that says this is something other than a 360 DEG Fusion.
ReplyDeleteI do feel bad for NuVa. This is a fantastic technology...on paper
I hoped they learned something from the Osteocell debacle (who wants to buy a fourth hand technology anyways!?!?!?!) -- DO NOT GO AFTER MINSURG.
NUVA gets what it deserves. Alex' ruthless behavior and the ridiculous amount of $$ he has harvested from the company is absurd. It's simply a microcosm of the god awful environment that is spine metal.
ReplyDeletedoesnt anyone feel sorry for Roger Y? who will pay for for his corrective cross-eye surgery if he cant keep milking coin from NUva?
ReplyDelete5:26, please do us the courtesy of referencing that Level 1 data you refer to. Having followed the literature for quite a while, I don't remember your numbers, and it is really funny that all of a sudden FDA mandated success criteria are being quoted here. As we all know, FDA wants a patient to have a successful fusion (although strangely enough their definition overestimates fusion rates), and be a success for pain, and be a success for function, and have no complications and have no further interventions at the same spot before they can be called a success. Using those, even autograft barely breaks the 50% mark, and that may have a lot to do with patient selection, patients' other problems and surgical skills.
ReplyDeleteWhen it comes to playing by the rules, NuVa is as clean as SoCal tap water...
ReplyDeleteI find these post funny. It's clear NUVA has taken business away from these people
ReplyDeleteATEC is taking over STEM CELL's
ReplyDeletePUREGEN!!!
Target price of $51, not in this economy, what are these analysts snorting
ReplyDeleteReally Puregen? Wake up! The stuff is only to be sold with cancelleous chips which are crap and don't stay around long enough for the cells to do the job! Here comes the off label claim huh! Let me guess it's better cells right? A cell is a cell!
ReplyDeleteATEC-u kidding me! Adult stem cells0-come on! Where did BOD go?
ReplyDeleteNice press release regarding ATEC's new stem cell, touted as "ELA" or Embryonic-like stem cells, then mentions that the product comes from medical waste, I'm asking who has the extra chromosome in their marketing department?
ReplyDeleteHow do you know the medical waste they use is from young patients? "Stem Cell" is buzz! The technology will be available and some companies are on the right path but come on mr. atec!
How long do we need to wait for clinical studies that go beyond a mouse or a rat? BTW, where is the product info? Can't even find anything on Purcell Spine.
Trust me ATEC will screw this one up big time watch! They never can bring a project or a good idea full circle IMO.
ReplyDeleteMedical waste? So you are saying that ATEC gets their products from the dumpster in the alley?
ReplyDeletehttp://ryortho.com/companyNews.php?news=374_Parcell-Brings-Stem-Cells-to-Alphatec
ReplyDeleteThere's the press release 7:57, "usually discarded as medical waste" is the key phrase.
Puregen has not been released yet. Stay tuned!
ReplyDeleteGreat product!
Impossible to sell for many many reasons! Watch
ReplyDeletePioneer's nonOass is the way to go.
ReplyDeleteIt's amazing how quite things got at Nuvasive as they have had to lower their guidance for the remainder of the year. No chest pumping, press clipping at OTW or Orthospine News, matter of fact how quickly did DeAngelis take down the post Nuvasive poised for strong results dated September 7th. Biased? Based on the look of things, evidently so.
ReplyDeletepioneer nonOass? in a couple years you might have what etex already has. nothing new there....
ReplyDeleteATEC has always been and always will be a loser. They keep trying to say that it is a "new company". Bullshit. I heard the marketing vp most recently came from the plasma tv industry. What a joke!!!
ReplyDelete"Medical waste" and "usually discarded as medical waste" are two vastly different statements. One describes stuff in the bottom of the dumpster, the other describes donor material that is collected in a controlled environment instead of being discarded. You big box reps are way too easy to spot behind the anonymous label. You just can't fathom the idea that somebody would come out with something that your beloved company didn't think of first. Your arrogance is the reason behind the market share slide that is taking place while you continue to demand respect for being number 1. Keep it up, it's good for my business.
ReplyDeleteELA does not stand for "embryonic like stem cell". Just wait for it and stop showing your ignorance and paranoia.
ReplyDeleteAs far as stem cells being "buzz", consider this: the goal o ALL bone grafting is to create an environment where osteoblasts will mature and lay down new bone. Stem cells are the most direct route to achieving that goal. More so than BMP and much more so than a scaffold (particularly a synthetic). And you are dead wrong about cancellous chips not being around long enough. Cancellous chips are probably the best scaffold you can get right now. But PureGen is not limited for use with cancellous chips only. Again, this is your ignorance and paranoia talking.
Isn't Puregen derived from synovial fluid? From diseased knees at that? ATEC really shows their ignorance in Biologics thinking that it will be considered a HCT/P 361 from the FDA. ATEC's current FDA warning letter wasn't enough? My advice for ATEC is to leave the Biologics space to people with a clue. ATEC should stick with their me-too metal strategy. They don't have the leadership or the brains to do otherwise.
ReplyDelete