My opinion on the Terumo partnership
When I saw this I thought the same thing. I am not sure why I didn't pickup on this earlier (probaby because it has been very quiet since 2016 on the Terumo front in Europe). I think there is more to this partnership than meets the eye.
Just a refresher, back in 2016 CTSO inked a distribution partnership with Terumo for six European countries: France and the Nordic countries of Denmark, Finland, Iceland, Norway, and Sweden, for cardiac surgery applications. There was some overlap with Fresenius who had distribution rights for acute care in most of these same territories before they CTSO negotiated getting those back in exchange for Mexico and South Korea. I think most would admit that it's been pretty quiet on the Terumo European front in terms of news but keep in mind they only had rights to distribute for cardiac surgery and in those territories there are 'only' about 70,000 heart surgeries performed each year vs worldwide there are over close to 2 million.
Baxter and Terumo are chief competitors in the medical device space. Terumo having about $5B in revenue compared to Baxter with $11M in annual revenue. In terms of revenue and size of the company (employees) Baxter is twice as big. Baxter obtained FDA EUA for Oxiris which is their own filter. Baxter also has an exclusive distribution agreement with Spectral for the U.S. and Canda for Toraymyxin which complements their own filter by removing endoxins.
In my opinion, both CTSO and Terumo came together on this to establish this partnership on COVID to fend off further expansion of Baxter's products into more U.S. hospitals, and a prelude to a much bigger partnership with a trial and potential exclusive rights for the removal of ticagrelor and other NOAC's. Remember that some of the risk has been removed for a strategic partner for the removal of NOAC's, whether that be Terumo or someone else, since the FDA has already granted the device breakthrough status. I am also sure Terumo Cardiovascular (this division) has been closely following what's been going on with the removal of ticagrelor and the recent breakthrough designation. As stated in the press release, Cytosorb fits nicely with Terumos other products specifically their CAPIOX ECMO machine and their Advanced Perfusion System heart lung machine. Terumo would also give CTSO access to Japan which is a significant market.
