1. Impact of the economic downturn in the medtech industry. Mr. Dickson says first with the initial credit crisis squeezing facility spending and later with the drop of consumer confidence, most publicly-traded healthcare firms suffered share price declines and some experienced layoffs. Mr. Dickson says the economic downturn, the biggest story of the year, will affect medtech firms different, depending upon their reliance on hospital spending and elective procedures. Companies producing items requiring large capital outlays will be hurt more. He predicts cardiovascular markets will be less affected because of the nature of cardiovascular conditions and the critical necessity of most cardiovascular devices. But emerging interventional devices could be hit. And companies — dependant upon elective procedures — could also suffer. As the prospect of people losing their jobs increases, they will become more concerned about taking time off, he says.
2. Pres. Obama’s health plan. Mr. Dickson says healthcare reform comprised an important part of Sen. Obama’s election platform. “It may have to be adjusted, given the current economic situation, with some components delayed or revisited,” he says. “But Mr. Obama recently reiterated his pushing to change healthcare, saying it can’t be put off because we’re in an emergency, it is part of the emergency.” He says forcing employers to provide healthcare coverage will likely be postponed, but his plan to invest in healthcare technology, expand children’s health insurance coverage and subsidize and support state Medicaid programs stand a better chance of passage.
3. Medical devices increasingly treating diseases traditionally treated by drugs. Mr. Dickson says that while devices to date have made small inroads into drug-dominated diseases, the market for devices to treat arthritis, depressive disorders and chronic migraines will continue to grow as neural stimulators, already used in treating Parkinson’s Disease, and other devices, improve. “There are real opportunities for growth,” he predicts.
4. Proliferation of single incision laparoscopic surgery. A new era in minimally invasive surgical devices has arrived using natural body orifices for scarless surgery, Mr. Dickson says, quickly becoming the procedure method of choice. He says the single access point techniques can go through belly buttons and other entries, thus increasing convenience, recovery and reducing risk.
5. CMS cuts reimbursement for medical errors. While Mr. Dickson predicts that the loss of revenue to hospitals from treating “never events” like wrong site surgery, which are estimated to cost an average of $64,000, could harm hospitals financially, he says CMS’ action is likely to force hospitals to treat patients more safely. He says medical errors cost $29 billion annually, most of which is borne by outside payors. But he says that it will also incentivize hospitals to invest more in healthcare information technology, such as physician order entry systems, electronic medical records and other improvements.
6. European Union standardizing regulations for advance therapy products. The EU removed a significant barrier to innovation in developing and marketing advanced therapy products. Growth in advanced therapy products, like artificial bone and tissue products used in orthopedic prostheses and other products, has been rapid in the United States but slow in Europe because of multiple sets of regulations from individual nations. “In the past, that’s made it difficult for big companies to introduce new products,” he says. But centralizing those standards “is expected to fuel the growth in tissue engineering and other biomedical products.”
7. Renewed interest in device registries. Mr. Dickson points out that the United States has no nationwide registry for medical devices. He recalled last year that device giant Zimmer suspended sales of an implant after complaints. “A device registry, which tracks device failure rates, could have saved many U.S. surgeons from implanting them,” he says. Registries in other countries have alerted surgeons to problems early on. “We think device registries are likely to garner more attention.”
8. Transition to pay for performance reimbursement models. Mr. Dickson says this represents a shift away from the traditional fee for service model that encourages over utilization and a lack of accountability. “This will align incentives,” he says. “It’s steering us in the right direction and holding doctors and hospitals accountable for the care they provide.”
9. Single injection hyaluronic acid (HA) treatments. HA viscosupplementation treatments are used to treat osteoarthritis in the knee to lubricate the joint, but are typically administered in multiple injections. Single HA injections “could shift the market landscape away from multiple injections, minimize patient risk and reduce pain,” Mr. Dickson says. In December, the FDA approved the Synvisc-One single injection kit.
10. Digital dentistry. Mr. Dickson says this is emerging as an increasingly popular way to improve dental treatment results. The global computer assisted design market is currently $1.3 billion and expected to see 25 percent annual growth.
