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<p>[QUOTE="anonymous, post: 5814752"]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.</p><p><br /></p><p>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.</p><p><br /></p><p>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. </p><p><br /></p><p>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.</p><p><br /></p><p>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.</p><p><br /></p><p>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.[/QUOTE]</p><p><br /></p>
[QUOTE="anonymous, post: 5814752"]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.[/QUOTE]
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Cafepharma Message Boards | Pharma Sales, Device Sales, Lab Sales
Home
Forums
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Medical Equipment/Device Sales
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Nevro
>
Nevro or Nuvectra
>
Cafepharma Message Boards | Pharma Sales, Device Sales, Lab Sales
Home
Forums
>
Medical Equipment/Device Sales
>
Nevro
>
Nevro or Nuvectra
>