April 2006 Issues

American Society for Laser Medicine and Surgery (ASLMS)

Summary: Competition has increased, but individual doctors still reported an increase in laser procedure volume, particularly for hair removal. ♦ List prices are holding fairly steady, but some behind-the-scenes deals are being cut. ♦ The various IPLs are not well differentiated. ♦ Reliant’s Fraxel, Candela’s GentleLase, and Rhytec’s Portrait PSR3 appeared hottest, but interest is growing in endovenous ablation. ♦ There is little interest yet in cellulite treatments, such as Syneron’s VelaSmooth. ♦ Home lasers are viewed as a potential adjunct profit center, not a competitive threat.

American Association for Cancer Research (AACR)

Summary: Amgen’s panitumumab appears effective in metastatic colorectal cancer (mCRC), but questions were raised about whether the effect wanes with time. ♦ Analogs of the mTOR inhibitor rapamycin look efficacious in early studies, and sources were cautiously optimistic but generally not very excited about them. If they do pan out, they are likely to be used only in combination with other agents. ♦ Bristol-Myers Squibb’s dasatinib looks promising as a follow-on to Novartis’s Gleevec in CML, and in time may prove useful in combination with Gleevec or in lieu of Gleevec, but it still doesn’t address T315I mutations. However, TargeGen has an agent in early development which appears effective against T315I mutations. ♦ It is early, but Millennium’s MLN-8054, an oral selective Aurora-A inhibitor, looks promising as does MGI Pharma’s Paclimer, a microsphere formulation of paclitaxel.

American Academy of Neurology (AAN)

Summary: Half the neurologists questioned plan to use Tysabri for their MS patients when it comes back on the market, but usage may ramp slower than expected, with doctors estimating that on average only 15% of their MS patients will be on Tysabri in six months ♦ Neurologists are very anxious for an oral therapy, and Sanofi-Aventis’ teriflunomide and Novartis’s fingolimod (FTY-720) both look promising, but the FDA is imposing such tough monitoring on any U.S. Phase III trial that the future of fingolimod is in question ♦ A double-dose of Teva’s Copaxone did not prove better than the usual 20 mg/day dose ♦ No new data were presented from the MIST-I trial of PFO closure with NMT’s StarFlex, and neurologists were critical of the company for withholding data – and the principal investigator of the trial has been censured by the U.K. medical licensing board for improper conduct in another clinical trial ♦ Pseudobulbar syndrome is not a common disorder, but there is nothing very effective to treat it, and doctors are willing to try a new drug, like Avanir’s Neurodex, if it gets FDA approval and has data to show it works.

Business Sound for Ultrasound -- Quick Pulse

Summary: Ultrasound continues to be an expanding, high growth business, and the growth of computerized tomography (CT) scanning and magnetic resonance (MR) imaging does not appear to be marginalizing ultrasound. However, the ultrasound market is dividing into two segments – lower-end screening tools and higher-end diagnostics. Senior officals at each of the major companies involved in ultrasound were interviewed about the outlook for ultrasound technology.

Bausch & Lomb Pulls Contact Lens Solution from U.S. Market -- Quick Pulse

Summary: On Monday, April 10, 2006, the FDA announced that Bausch & Lomb was voluntarily suspending all U.S. shipments of ReNu MoistureLoc contact lens solution ♦ The action, which B&L officials characterized as “temporary,” comes after a report by the Centers for Disease Control and Prevention (CDC) of 109 cases in less than six weeks of a relatively rare but very serious fungal eye infection, Fusarium keratitis, in soft contact lens wearers.

American Society of Cataract and Refractive Surgery

Summary: Use of premium IOLs is increasing, but almost exclusively for cataract patients ♦ Alcon's ReStor dominates the U.S. multifocal IOL market, but interest in Advanced Medical Optics’ ReZoom is growing, and doctors increasingly believe that mixing and matching these two lenses in the same patient may be the best approach ♦ The data on Eyeonics’s accommodating IOL, Crystalens, continued to build, but it appeared to be somewhat lost in the noise of mixing and matching multifocal IOLs ♦ Competition in the femtosecond laser market is heating up, with FDA approval of Ziemer’s mobile Da Vinci laser ♦ LASIK volume and pricing are flat in 1Q06 vs. 1Q05 and the outlook is for 2006 to mirror 2005 -- even with many surgeons planning an increase in advertising.