Neuromodulation’s New Competitive Face

One of the most striking observations about the recent meeting of the International Neuromodulation Society in Montreal [see conference report, p7] was the addition of two new spinal cord stimulation system vendors as platinum level sponsors, joining the big three—Medtronic, St. Jude Medical, and Boston Scientific—that have dominated previous meetings. The emergence of the two new publicly traded neuromodulation firms, Nevro Corp. and Greatbatch’s Nuvectra subsidiary, was not only evident on the exhibit floor, but also in the technical sessions and social gatherings.

The presence of these two firms brings a new level of competition to the SCS industry. In a market that was at one time differentiated by RF vs IPG-powered devices, pain doctors and their patients can now choose from an almost bewildering array of therapeutic options. A variety of stimulation waveforms is available, including tonic, burst, and high-frequency, as well as targeting alternatives, power options, and different programming interfaces.

It remains to be seen whether the SCS market can sustain five major competitors, or whether consolidation will whittle that number down in the future. But if the cardiac device market offers any indication, both top-tier vendors—including the original big three players in the neuromodulation space—and second-tier competitors have been able to sustain a sufficient revenue base.

Of course, waiting in the wings are a host of smaller, more specialized pain neuromodulation vendors such as Stimwave, Mainstay, Neuros, SPR, and Saluda. Each of these players offer unique product attributes or therapeutic populations that could make them an attractive takeover target for one of the top-tier vendors.

The recent FDA approval of St. Jude Medical’s Brio DBS system [see article, p4] promises to inject a similar level of competition in that market segment. And as we report in our lead article on p1 of this issue, there is likely to be an intense level of competition in the market for neuromodulation devices to treat urinary incontinence and related disorders. More so than at any other time in this publication’s 15-year history, Medtronic’s continued dominance of each of the neuromodulation segments in which it competes seems less certain.

And there remains a significant core of large healthcare corporations sitting on the sidelines, including several who have made investments in neurotech startups. Device companies like Johnson & Johnson, Abbott, and Stryker, plus pharmaceutical giants like Pfizer, Merck, and GSK could very well alter the competitive landscape of the neuromodulation industry in a significant way in the years ahead if they choose to make a play.

James Cavuoto

Editor and Publisher

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