Replies to post #63930 on Biotech Values

[DewDiligence]

Xience/Promus is now the leading drug-eluting stent in Western Europe. Source: ABT CC.

[DewDiligence]

Xience Ramp Exceeds Forecasts

[Competing with such entrenched products as JNJ’s Cypher and BSX’s Taxus, Xiensce is rapidly gaining share because it is simply better. Please see #msg-30452522 for notes on the distinction between Xience and Promus.]

http://online.wsj.com/article/SB122162464075847091.html

›SEPTEMBER 17, 2008
By JON KAMP

Abbott Laboratories' Xience drug-coated stent is exceeding the company's expectations following its introduction in the U.S. in early July, Abbott's chief financial officer said.

"We are rapidly gaining market share," said Thomas C. Freyman during a Bank of America conference. Abbott's products compete against devices made by Boston Scientific Corp., Medtronic Inc. and Johnson & Johnson.

"We expect to be the market-share leader by the end of the year, if not sooner," Mr. Freyman said, referring to the Xience platform, which includes a Boston Scientific-branded version of the stent.

Xience became the fourth-coated stent to hit the U.S. market when the Food and Drug Administration approved the device this summer.

Xience arrived with high expectations after clinical-trial data showed it topped the market-leading Taxus stent, from Boston Scientific, on certain measures of performance. Boston Scientific also sells Xience under the name Promus and then sends 40% of Promus profit back to Abbott. [This odd arrangement is a consequence of the divestiture of Guidant’s stent business as a condition of BSX’s acquisition of Guidant two years ago.]

Abbott, of Abbott Park, Ill., had projected upon Xience's U.S. introduction that Xience alone -- excluding Promus -- would comprise 25% to 30% of the U.S. market after 12 months. Some Wall Street analyst reports tracking Xience's progress have suggested, however, that Xience's uptake is outpacing forecasts.

Mr. Freyman didn't issue a new target, but said Xience "is exceeding our expectations" in the U.S.

The market split between Xience and Promus has been about 60% Xience and 40% Promus, said Mr. Freyman, who said Boston Scientific has been marketing its version aggressively. There is room for Abbott's position to improve, he said.

"We're very comfortable with the combined platform with Xience and Promus gaining so much share so quickly in this market," Mr. Freyman said.

Xience also has taken the market-share lead in Western Europe, where it went on sale about two years ago, Mr. Freyman said. The European market features more products, and also newer versions of some of the stents on sale in the U.S.‹

[Preciouslife1]

Drug-Eluting or Bare-Metal Stents for Acute Myocardial Infarction

http://content.nejm.org/cgi/content/short/359/13/1330?query=TOC

Volume 359:1330-1342 September 25, 2008 Number 13
Laura Mauri, M.D., M.Sc., Treacy S. Silbaugh, B.Sc., Pallav Garg, M.B., B.S., M.Sc., Robert E. Wolf, M.S., Katya Zelevinsky, B.A., Ann Lovett, R.N., M.A., Manu R. Varma, B.S., Zheng Zhou, M.D., Ph.D., and Sharon-Lise T. Normand, Ph.D.

PubMed Citation
ABSTRACT

Background
Studies comparing percutaneous coronary intervention (PCI) with drug-eluting and bare-metal coronary stents in acute myocardial infarction have been limited in size and duration.

Methods
We identified all adults undergoing PCI with stenting for acute myocardial infarction between April 1, 2003, and September 30, 2004, at any acute care, nonfederal hospital in Massachusetts with the use of a state-mandated database of PCI procedures. We performed propensity-score matching on three groups of patients: all patients with acute myocardial infarction, all those with acute myocardial infarction with ST-segment elevation, and all those with acute myocardial infarction without ST-segment elevation. Propensity-score analyses were based on clinical, procedural, hospital, and insurance information collected at the time of the index procedure. Differences in the risk of death between patients receiving drug-eluting stents and those receiving bare-metal stents were determined from vital-statistics records.

Results
A total of 7217 patients were treated for acute myocardial infarction (4016 with drug-eluting stents and 3201 with bare-metal stents). According to analysis of matched pairs, the 2-year, risk-adjusted mortality rates were lower for drug-eluting stents than for bare-metal stents among all patients with myocardial infarction (10.7% vs. 12.8%, P=0.02), among patients with myocardial infarction with ST-segment elevation (8.5% vs. 11.6%, P=0.008), and among patients with myocardial infarction without ST-segment elevation (12.8% vs. 15.6%, P=0.04). The 2-year, risk-adjusted rates of recurrent myocardial infarction were reduced in patients with myocardial infarction without ST-segment elevation who were treated with drug-eluting stents, and repeat revascularization rates were significantly reduced with the use of drug-eluting stents as compared with bare-metal stents in all groups.

Conclusions
In patients presenting with acute myocardial infarction, treatment with drug-eluting stents is associated with decreased 2-year mortality rates and a reduction in the need for repeat revascularization procedures as compared with treatment with bare-metal stents.

Source Information

From Brigham and Women's Hospital (L.M., P.G., M.R.V., Z.Z.), the Harvard Clinical Research Institute (L.M.), Harvard Medical School (L.M., T.S.S., R.E.W., K.Z., A.L., S.-L.T.N.), and the Harvard School of Public Health (S.-L.T.N.) — all in Boston.