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Nevro or Nuvectra

Discussion in 'Nevro' started by anonymous, Dec 30, 2016 at 10:32 AM.

  1. anonymous

    anonymous Guest

    I have an opportunity to leave a position that I've been in for 6 years. I'm in spine and it's very competitive. I'm looking at two opportunities in neuromodulation that would allow me to stay in my current geography and leverage my relationships. Would someone please give me an objective view point of Nuvectra an Nevro. Both are interviewing in my area. Thank you
     
  2. anonymous

    anonymous Guest

    Strictly from a product perspective, Nevro's technology is changing the SCS space, whereas Nuvectra is basically a conventional stim with a few bells and whistles.
     
  3. anonymous

    anonymous Guest

    Thank you, I appreciate the no bs response. Have a safe New Years!
     
  4. anonymous

    anonymous Guest

    Nevro is labeled as clinically superior for back and leg pain to the other stimulators by the FDA. Nuvectra probably won't make it another 3 qrts they have no value proposition and have embarrassing sales. No question, Nevro all the way. Good luck to you.
     
  5. anonymous

    anonymous Guest

    Does nuvectra also have HF like Nevro? Does anyone?
     
  6. anonymous

    anonymous Guest

    Nope
     
  7. anonymous

    anonymous Guest


    Maybe, except Algovita does have the HF capability. GreatBatch bought CCC in 2014, which provides Nevro the IPGs for their HF10 therapy. and Greatbatch is obviously the brainchild behind Nuvectra. And not really bells and whistles - they solved serious problems in the neuromod space (smaller, steerable lead tips; stretchy lead body which means fewer lead breakages/migrations; 12 electrode lead tips w/ independent power sources to cover all affected dermatomes, etc), and made their device more attractive to all stakeholders (pts, docs, payers). The HF10 is a good idea, but the technology isnt there yet - note battery size, battery overheating, and daily recharge requirements. And I've read that HF10 isn't right for most potential SCS patients, just a sub-set of the addressable market.
     
  8. anonymous

    anonymous Guest

    Well except for that pesky little recall nuvectra had on those stretch mark leads I think you're on to something.
     
  9. anonymous

    anonymous Guest

    And where did you read that? Nuvectra marketing manual? Nevro HF10 therapy is proven superior for neuropathic low back and leg pain. That is not a sub set, that is the largest set. Also your "battery overheating" claim is unfounded. If there was such an issue, there would be a recall - the only recall I'm aware of involves Nuvectra.
     
  10. anonymous

    anonymous Guest

    Incredible, after what HF10 has done and what Nuv HASNT done, your really saying that? Nuvectra will be gone by year end. No one using it
     
  11. anonymous

    anonymous Guest

    just look at their sales and market caps. Nuvectra has nothing. Not sure I'd leave spine for Nuvectra, but would for Nevro. Nevro is here for the long term, Nuvectra has not proven itself.
     
  12. anonymous

    anonymous Guest

    Go ahead, go work for NEVRO and watch 45% of them get explanted because they DON'T work after 6 months. Also, their programming is a "black box" to physicians so when it doesn't work, they have no way of responding to their patients. Watch Nuvectra start to eat into everyone else. This is the best system I have ever implanted and it kicks Boston's ass!!! The power, fidelity and capability of the Nuvectra IPG far exceed the capabilities of everyone else, including NEVRO. The spiral-wound leads are by far the most robust and their 15-20% stretch capability reduces breakage and migration. I'm not saying that NEVRO or Boston are going to die, but seriously watch Nuvectra start to wow everyone. I know because I have used all of these devices and have never seen results like Nuvectra's.
     
  13. anonymous

    anonymous Guest

    Interesting, you seem to be a minority among your peers. Most of the people I know are having a hard time understanding the advantages of Nuvectra...if there are any. With several recalls and dismal earnings, I would not expect them to be around much longer. Most of their reps have come and gone, only 10 months into commercialization. I just don't see it and I would argue that others would subscribe to my belief and not yours
     
  14. anonymous

    anonymous Guest

    Please provide evidence to substantiate these claims? Big claims require big evidence. Let's hear it.
     
  15. anonymous

    anonymous Guest

    Textbook example of alternative facts! Is Spicer on the Nuvectra payroll?!?
     
  16. anonymous

    anonymous Guest

    Nuvectra? Really people? That company is trying to get someone to buy their crap product. That company is not looking to sustain a long term pain program. Wayyy to cumbersome. Only problem is the product is not good enough. All the other companies have upgrades on the way, or have already launched. Either way, that company will not do well. One by one, their reps will walk away from the job and then its lights out.
     
  17. anonymous

    anonymous Guest

     
  18. anonymous

    anonymous Guest

    sounds like someone's been at berkshire and fairfax ;)
     
  19. anonymous

    anonymous Guest

    Look, first off, for the people talking Nevro up, just go to an SCS patient forum. spine-health.com seems to be pretty good for SCS stuff. I've never seen complaints like you'll read there. Yeah the IPG is huge - i think it's twice the size of the competitors. A couple people complained that it was so big that it actually cut through their skin from the inside. And people there also complain about hot batteries - theyre big, and have to be recharged daily. And the intense post-surgical pain (probably because it's so big). And, no, Nevro is not a mass market device. Their system is aimed at a particular niche - I'll look it up and see what I can find.

    So, for NVTR, nobody else's leads are stretchy. Some significant portion of people don't convert to permanent from trial, b/c complications or poor efficacy (e.g., poor lead placement). NVTR fixes that problem - first, leads are stretchy, so won't break/migrate -> less complications during this trial phase. And they have really awesome electrode technology - they basically figured out a way to make an electrode array that was much smaller, but with the same impedance as the competitors' larger arrays (important so it doesn't use more power). So it's easier to steer into the epidural space. And also, theyre the only one with 12 electrodes on an array (b/c coil-in-coil lead body), which means the doc doesn't have to pick which of the 3 dermatomes to cover - this is huge, by the way - you just cover all dermatomes, and then it's to programming to see which ones to turn off (and they can turn them off, b/c they have triphase electrodes; the other company with independent power sources is only biphase, i believe, which means only positive or negative charges). Between steerability and full dermatome coverage, algovita's efficacy should be relatively high compared to the competitors. And then, once we've converted to permanent, obviously fewer complications (from lead breakage/migration, or roughly 22% of patients) is something that payers, doctors, and patients would all react to positively.

    One of the big things here is their platform. So, just filed for SNS approvals today. Have a development agreement with Aleva, which does DBS. Aleva's DBS crushes the current options. The current options have a cylindrical lead tip, and they apply stimulation around the entire cylinder (e.g., the electrode is a single ring). Aleva has a lead tip that's also cylindrical, but they've placed 3 separate electrodes around the ring, instead of having one ring-shaped electrode. And with nvtr's independent power sources, they can offer directional stimulation, which is pretty darn important when we're talking about pumping electricity into the brain.

    Once the 12 electrode lead (full 3 dermatome coverage) is placed, then it's just a matter of programming, and they have algorithms that assist here - very doctor friendly. the patient key fob is small and discrete, and the thing only needs to be charged twice per week, despite the fact that it's smaller (volume wise) than the competitors.

    Regarding HF, they already go up to 2000 hz or w/e. As mentioned, Greatbatch bought CCC. And mgmt has indicated that their IPG has capabilities that they haven't requested approval for yet, b/c they wanted to approve the simplest device (to get a literature based approval). So, fairly certain that the device does have the ability to go up to 10, where nevro is, but they haven't activated that feature. MRI compatibility coming out in the first half of this year, I think. Accelerometer might be included in that upgrade, too. And, b/c the platform device is constant across indications, I think they'll be able to upgrade all of them without actually having to do multiple product upgrade and fda approval processes (not certain here, but fairly sure). So, they'll be able to upgrade their whole portfolio at once - talk about improving time to market.

    They actually do have a number of breakthrough technologies, including the stretchy lead body and the tiny electrode array. There's alot of detail i haven't gone into b/c space constraints, too. And these are things the industry has been after, and hasn't been able to get. I know this from reading Medtronic's patents - they call out what the "long felt needs" of the industry are. But they're not engineering bells and whistles, which it seems you guys are looking for. It is truly an advanced, differentiated product. It's just that the differentiation / tech aspects aren't really glittery. But if you read those patents of theirs, it's pretty impressive. I think it's just a question of "Can they sell it?" Too early to tell, but i guess we'll see.
     
  20. anonymous

    anonymous Guest

    That's not evidence. That's a rambling potpourri of opinions, nonsense and falsehoods. Nevro is the only company that can run HF because they have a patent from 1500hz and up.

    Nevro market cap: 2.5-3B.
    Nuvectra market cap: 60-80M.

    That's all anyone with a brain needs to know.