Allergan to purchase Neotract

Well, this is clearly getting repetitive and pointless. I understand everything you're saying and repeating it louder and professing your superior experience doesn't add anything to this thread or answer the basic question I keep asking. What other non-energy/non-destructive technique has been tried that showed safety, durability, and no sexual side effects? Really! I'm asking! Stop brow beating and show your superior knowledge here.

TURP, TUMT, PVP, TUNA, TUIP, Holep etc etc.. all involve tissue destruction. Yeah, I get it.. Dr's may want that and think its better, flow rates may be improved, patients may not be able to drive enough demand, your opinion is Urolift will not be profitable, etc. etc. etc. I get it, you've made those points enough already.

The difference I see is that Urolift doesn't involve tissue destruction and has the lowest risk of sexual side effects. That MAY or MAY NOT be enough to drive the company into profitability. Is there an analogous non-destructive technique that failed? What was it? In my mind that's still the variable. If you have something to add about that please do, otherwise don't bother to just tell me about my "obvious lack of experience".

 

You're right. Sticking your head in the sand is a better way to think about it. Is there a non-destructive technique that failed? No. The non destructive way is through Meds which are much less invasive than Urolift.

Your point makes so much sense. This non-destructive technique that has worse data than TUMT, TUNA, Holep, Greenlight, and all the TURPS, that pays less than all of those other techniques (about the same as a TURP), has the same perceived (key word)side effects as some of the MIN invasive (TUMT), more side effect than the surgical is the answer to BPH that will blow it past everyone else.

Go ask 100 Urologists what they don't like about the TUMT and TUNA? #1 answer if they are being truthful will be declining reimbursement (Which is still more than the Urolift). #2 answer will be not enough tissue destruction.

But your answer of no tissue destruction will solve all of those issues. I hat to break it to you, but behind closed doors the Urologists that matter are going to say no thanks to no tissue destruction at least on a mass level.

Thanks for the laugh.

 

BTW you may want to read this

http://www.practiceupdate.com/content/what-to-make-of-the-new-minimally-invasive-treatment-for-luts-bph-urolift-system-for-prostatic-urethral-lift/17743

The point? When you say no sexual side effects you are not being truthful. As you can see any competent doctor will never ever say no side effects. they will say minimal side effects, which is already what they say when they discuss other Min-Invasive procedures.


It is why experience in this ailment matters. Perceived side effects is what matters.

 

I see the link makes you sign in. This is what matters. Read #2. This is talking about Urolift specifically.

n balance, the urologist needs to understand three issues about this new technology:

Q#1) How well will this technique improve patients’ LUTS?

A to #1) As mentioned above, there are no comparative studies (ie, TURP vs PUL). However, the level of improvement may very well be in the range we expect from traditional surgery.


Q#2) What is the impact of this technology on sexual health?

Ato #2) There are many methods to improve LUTS, but all accepted therapies for LUTS (surgical or medical) can affect some aspect of sexual health, making it imperative that healthcare professionals understand their patients’ concerns and motivations in these two linked conditions. Additionally, sexual side effects of treatment for LUTS/BPH are likely underappreciated by urologists but could play a prominent role in patient decision-making, creating a disparity between provider and patient. PUL’s lack of impact on sexual health is likely the single biggest attribute of this technology.

Q#3) What treatment options are unavailable if a patient has PUL and needs something additionally?

A to #3) The information from the clinical trials suggests that having a PUL has no impact on the use of standard TURP or laser TURP.

If a physician guarantees no sexual side effects he is setting himself up for a lawsuit.

 

Yea no tissue destruction on a prostate that've will continue to grow....really? You would really think this has any long term play? All Uros will try new technology, honeymoon is over.

 

Yes, possibly. As the above poster points out, no future options are ruled out. So with the ability to preserve sexual function even if for a limited number of years, it already has strong interest. I think the determinant will be the longevity of the improvement.

Funny how some posters are so ready to strongly proclaim the death of this approach prematurely. Hardly open minded. Must have a personal agenda.

 

Verbatim from the above linked article:

With respect to sexual function, no PUL subject has experienced de novo anejaculation, ejaculatory dysfunction, or erectile dysfunction after the procedure.3,4 On the contrary, men have rated their sexual function significantly improved at 1 year.4 By sparing the prostatic and bladder neck tissue, perhaps by avoiding the local neurovascular structures, and preventing thermal injury, the PUL offers a safe, effective alternative for men not willing to accept the risks of more traditional BPH surgical interventions.

 

I read that however he still says below that all procedures have the possibility of side effects. Furthermore anyone experienced knows that BPH doe snot work in a vacuum meaning that other issues that may have arisen from BPH could lead to sexual side effects, thus no physician is ever going to tell a patient "Do this procedure you will have no sexual side effects or side effects at all." What they are more likely going to say is "Do this procedure. In my experience the patients who have had this procedure have the best chance of minimal side effects."

The problem Neotract faces is in reality this is what every physician says about any Min Invasive treatment currently, thus leading patients to believe that any Min-Invasive procedure has minimal side effects. Have you ever heard PVP, TURP, button, TUMT, TUNA , etc pitched to patients. I have. Make no mistake that physicians present whatever their treatment of choice is in the best manner possible. In fact I have heard many physicians tell someone after this MIT your sex life will be better or that it should improve. Furthermore I suggest you read the patient cards regarding Urolift. Urolift seems to claim instant results, back to norm within 48 hours. It simply has not been the case for some patients. That is OK, but this is not the silver bullet.

It is why in the end it is a doctor driven ailment. Again you can take whatever you have read and whatever experience you have and form an opinion. I know yours and you know mine.

In the end I simply have seen to many MITs that have come and gone and none have been able to be adopted on a mass scale. I laid out the reasons why. You can certainly say this time it will be different, but I don't think it will. I think that Urolift will be a niche player to the lower volume BPH doctor. The higher volume MIT guys won't do this. Takes too much time up, eats into clinic time (when they go to the OR), and they are not going to cut into their PVP time or button TURP time.

I do appreciate the discussion and that is what this board is for. I welcome any and all opinions and hope more people express an opinion or can provide a viewpoint that I may have missed.

 

As a person who came across this thread and is looking for BPH relief, I can you assure my experience with meds is a nightmare!

To Neotract: Hard to find any patient testimonials or narratives on Urolift outcomes except on your website. No one's going to view that as objective. Not willing to get roto-rootered yet and Urolift might be an answer for me and others if I could see more first hand accounts.

 

Here is a patient board I found

http://www.patient.co.uk/forums/discuss/the-urolift-procedure-patient-views-and-questions-300828

I do not work for Neotract, but am one of the posters above. I have only read these myself and have no affiliation with anyone or anything to do with BPH.

 

Many of the negative posters are greenlight sales reps. Neotract works. Period. The data is good. fewer and fewer docs are doing greenlight as reimbursement is flat, cost is up. Side effects are not really any different than turp. Maybe another price increase is needed to pad "increasing revenue" numbers. How about another mobile lawsuit?

 

I am the poster above who has posted many times and I can tell you I have nothing to do with Greenlight. I would absolutely agree that many of the side effects are similar to TURP. I would also say that it is slightly easier to do than TURP. Cost is not that big of an issue for one reason. Reimbursement for these physicians is a doctors fee meaning they don't pay for the cost like they do with the MIT treatments in office. From a rising cost standpoint it is similar to hip implants that keep going up in price. The only thing you can do is switch to a different hip. You can't make the patients not need or get a hip replacement. If a person needs a TURP it is either button, laser, or standard. No hospital is going to make a physician switch what type of procedure he does. Furthermore it is still profitable for the hospital even with the increasing costs of the fibers. If you want to argue that physicians may switch form Greenlight to some other laser or to a button no need to. They may and you get no argument from me. That is for the laser, turp guys to argue why once is better than the other.

No one said Urolift doesn't work. It does. It works (according to the data) slightly better than meds, less than the other MITs, and much less than the surgical procedures.

I think we would all agree that not everyone needs the huge relief that the surgeries provide because this come at a cost of massive side effects.

Having said that I was surprised the data was not better.

My question is why will a surgeon decide to steer his patients away from the MITs that they use now in office and do a Urolift in a surgery center or hospital when a) it is much less profitable, b) the data (according to the studies) shows better improvement with the other MITs, c) they are already pitching minimal sexual side effects and/or sex life improvement with their current modalities, and d) they are also already pitching for any MIT that it will get them off the meds and keep them out of surgery without limiting any possible treatments in the future should they need something else?

I am all ears and open, but I expect a real answer.

 

Your questions have already been answered by previous posters. You just have your mind made up in advance based on your own biases/opinions. Fine. Clearly many feel the PUL offers a new and better option in many cases:

http://www.businesswire.com/news/home/20150424005106/en/NeoTract-Receives-Edison-Award-Innovative-Treatment-Men#.VTwfV_C2rl4

 

And this proves?

Furthermore you have done nothing to answer questions. No posts have answered it which is why I asked. You have already been shown the landscape of the BPH market. If you choose to disregard it that certainly is your right. I have nothing to gain or lose if Neotract does well or if it fails. I am not in this game, but do know the landscape well. Do I hope it does well? Yes. More choices for patients is better than less choices for patients, but I have seen this episode before if you will. I know what drives this market and I know what the reality of this market is. I have no bias. I look at the data, the financial aspect, the behavioral aspects of physicians and form an opinion based on that. If the results were better (Say double what was in that study across the board) and reimbursement was 50% higher I would absolutely say this is the treatment of the future with nothing to stop it or get in its way. That is not realistic however.

Keep your head in the sand though.

 

Wow.. what an arrogant windbag!

The other guy doesn't have his head in the sand but you have yours planted firmly up your ass!

 

Really? About what?

I simply gave succinct answers and reasons why I feel this won't take off. Not one person has been able to say anything that can nullify any of the reasons. I surely hope you have better answers than this post.

The closest was minimal sexual side effects. You mean like they already pitch every other MIT there is. Got it. Hide behind the anonymity because its obvious that while my head may be planted firmly up my ass that head still knows exponentially more about this subject than you do.

 

As Confucius say: "Man with head up ass see only as far as his own navel."

 

AS they say: Ignorance is Bliss. You must be the most blissful person on this board.

 

In the Urolift study that I have read, a control group got scoped and the patients in that group did exhibit improved short term improvements in flow. However, the Urolift group had significant improvements over that of the scoped control group. Its clearly doing more than if one were to simply "run a scope thru the urethra."

If I can have a simple office procedure that gives me some noticeable improvement for another 3-5 years before I need to have a tissue removing procedure (with all of its associated sexual and urinary side effects), then I'm gonna do it.

 

Interesting to see they have made pretty much no impact on the BPH market. They still have a bunch of non major BPH docs using it, but the busy docs want no part of it.

Heard through the grapevine that they tend to rip the other MITs currently available. Ironic that those other MITs have better flow rate and symptom scores according to the studies. Oh and before you bring up the physicians who did those studies some are the same physicians who did Urolift's study.