At PCR, Drug-Eluting Stents From Asia, But At What Cost?

Article preview from IN VIVO - June, 2013

No one would place drug-eluting stents among the hot technologies showcased at this year’s EuroPCR, not with all of the buzz around renal denervation, percutaneous valves, and bioabsorbable stents and scaffolds. But an early morning session on DES from India and China underscored how the technology debate is changing in a world of cost constraints and emerging markets, particularly for mature categories.

 

At PCR, Drug-Eluting Stents From Asia, But At What Cost?

Article preview from IN VIVO - June, 2013

No one would place drug-eluting stents (DES) among the hot technologies showcased at this year’s EuroPCR, not with all of the buzz around renal denervation, percutaneous valves (aortic and mitral), and bioabsorbable stents and scaffolds. (See related article,"EuroPCR 2013: The Calm After The Technology Storm" — IN VIVO, June 2013.) Once the darling of technology showcases at interventional cardiology conferences like PCR, TCT and JIM, DES have clearly become a mature technology – mature both in terms of market dynamics, which is seeing slowing growth and price pressures, and of technology itself, as fewer truly novel, breakthrough DES are coming to market (especially if you count bioabsorbable stents as a separate category). Gone are the days when the late-breaking clinical trials sessions at meetings like PCR featured a never-ending parade of new DES technologies and follow-on studies for the market leaders. But an early morning session on DES from India and China underscored how the technology debate is changing in a world of cost constraints and emerging markets, particularly for mature categories.

Most device executives still think about markets like China and India as tempting geographies into which they’ll sell products – markets difficult to ignore given the enormous populations and rapidly rising health care costs that are creating opportunities that could dwarf Western, developed markets. But as we’ve noted in past reports from PCR, that may not be the most helpful way to think about the potential and role of emerging markets in cardiovascular devices, particularly stents. Indeed, unlike Europe a decade or so ago, where US-based cardiovascular device companies made early and rapid inroads into the stent markets – both bare metal and drug-eluting stents – it’s becoming clear that outside competitors are finding cracking the domestic emerging markets, particularly China, not as easy as they thought. In China, for example, three native Chinese companies control more than 80% of the DES market, and there are many who doubt whether US-based market leaders can and will achieve the kinds of market share gains in these exploding markets that they did in Europe.

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