The European market for abdominal aortic stent grafts will approach $300 million by 2015, according to the Millennium Research Group.

A report by the medtech market intelligence analyst notes that European doctors are increasingly using endovascular aortic repair (EVAR), rather than more invasive open surgery, to treat abdominal aortic aneurysms (AAAs).

The Endovascular versus Open Repair of AAA (EVAR-1) trial has established that long-term mortality rates for EVAR and open surgery are comparable, though EVAR has higher rates of re-intervention.

However, the shorter recovery times associated with EVAR are predicted to drive a rise in the number of aortic stent graft procedures performed each year in Europe to about 35,000 by 2015.

A number of new stent grafts from major medical device companies - such as Medtronic's Endurant device, Cook Medical's Zenith Fenestrated AAA Endovascular Graft and Gore's C3 Delivery System - are designed to overcome the limitations of older stent graft technologies such as migration, poor deliverability and failure to adjust to challenging anatomies.

"Competition in the European market for EVAR devices will increase over the next five years as new stent grafts by emerging competitors such as Aptus Endosystems and Cordis become available in addition to already-present products by other leading manufacturers such as Endologix, JOTEC and Terumo Medical," said Fareed Hameed, Analyst at MRG.

"The recent introduction of new devices will allow for more types of patients with AAA to be treated via EVAR."

Millennium Research Group is a leading global authority on medtech market intelligence.

 
Endurant stent graft

A new software product improves the communication and recollection ability of dementia patients, enhancing their quality of life and reducing the difficulties faced by care workers.

Digital Reminiscence Therapy Solutions (DRTS) from Dementia Life use digital photos, videos and music to help unlock the patient's memory and facilitate communication.

The software has been adopted by care homes in Liverpool and London, as well as NHS Fife and the Jersey Memory Clinic.

According to DH statistics, approximately 600,000 people in the UK suffer from dementia. That number is predicted to rise by 50% within the next 15 years.

Debbie Higgins, Manager of Green Heys care home in Waterloo, Liverpool, said that using the DRTS software, "The difference in the quality of communication and recollection was remarkable even with residents with end-stage dementia. The variety of images, sounds and archive footage means it never gets boring or repetitive.

"The beauty of the reminiscence therapy software is that all our staff now have a communication tool that is dramatically different to anything they've ever used before. Conversation flows much easier and residents thoroughly enjoy the opportunity to relive their youth."

"Recent advances in research and technology are revolutionising care provision," said Martin Valentine, Director of Dementia Life. "Our pricing model makes DRTS affordable for residential carers in the domestic home, as well as in care homes, NHS Trusts and similar, and it has proven to be a cost-effective solution to a growing need.

"The ease of communication provided by DRTS is beneficial to both carer and resident, taking some of the pressure off and encouraging engagement, communication and wellbeing."

A new electronically controlled knee joint can restore walking ability to patients suffering leg paralysis due to stroke or polio.

The award-winning E-MAG Active system from Otto Bock Healthcare is now available on the NHS.

Jane Rutterford, a retired mother of two from Essex, has become the first UK patient to benefit from this innovative device, experiencing a regular walking pattern for the first time since suffering polio at age nine.

The E-MAG Active uses intelligent sensor technology to monitor the position of the wearer's leg while walking, making sure that the knee locks and unlocks at the right times.

The device works independently of the ankle joint or sole of the foot, supporting mobility in patients with no ankle or foot functionality.

"Wearing the E-MAG is like having therapy while getting on with your life, offering me excellent support to do the things I love doing such as gardening," said Jane Rutterford. "It's essential for me as a person to be as independent as possible, and as it's so comfortable I can wear it all day every day. It's become an integral part of my life; the support it gives me is terrific."

David Buchanan, Business Development Manager of Otto Bock Healthcare, said: "Post-Polio Syndrome affects around 100,000 people in the UK, while approximately a further 300,000 people are living with moderate to severe disabilities as a result of stroke. Orthoses such as those designed by Otto Bock aid and enhance the recovery process."

E-MAG Active received the 2009 award for 'Prosthetic or Orthotic Product Innovation' from The Limbless Association.

Otto Bock is a leading supplier of innovative solutions for people with limited mobility.

 
Jane Rutterford

The world's first drug-eluting bioresorbable vascular scaffold for the treatment of coronary artery disease has received CE Mark approval.

The ABSORB stent from Abbott Vascular can open and support a blocked artery, dissolving within two years to leave the blood vessel free of any implant.

"The CE Mark approval for ABSORB in Europe is a significant accomplishment that validates the impressive clinical results that have been observed with this device," said Patrick W. Serruys, Professor of Interventional Cardiology at Erasmus University Hospital, Rotterdam, the Netherlands.

"Abbott's ABSORB has the potential to change the way patients with coronary artery disease are treated, as it does what no other drug-eluting coronary device has been able to do before - completely dissolve and potentially restore natural vessel function."

ABSORB is an everolimus-eluting stent made from polylactide, which is used in resorbable sutures. A blood vessel treated with ABSORB may retain the ability to move, flex and pulsate, and the need for long-term dual anti-platelet therapy may be reduced.

"Our ABSORB technology has the potential to revolutionize the treatment of coronary artery disease," said Robert B. Hance, Senior Vice President, Abbott Vascular. "Abbott is committed to building the clinical and economic benefits of this therapy in anticipation of making it widely available in Europe by the end of 2012."

A successful three-year clinical trial of ABSORB has taken place. To support European commercialisation and reimbursement, Abbott plans a further controlled randomised trial in Europe with 500 patients, comparing ABSORB with Abbott's leading drug-eluting stent XIENCE PRIME.

A full-scale European commercial launch of ABSORB is planned by the end of 2012.

 
Absorb stent

LifeSciencesUK, a new joint initiative for industries involved in healthcare, has been launched by the four leading UK life science trade associations to improve the commercial environment for life sciences in the UK.

Born from last year's Office for Life Sciences initiative, LifeSciencesUK will facilitate joint working between the medical devices, diagnostics, biotechnology and pharmaceuticals sectors. It will work with Chris Brinsmead, the Government's new Life Sciences Business Adviser, to support the DH and BIS in cross-departmental collaborative work.

The founder members of LifeSciencesUK are the Association of British Healthcare Industries (ABHI), the British In Vitro Diagnostics Association (BIVDA), the Association of the British Pharmaceutical Industry (ABPI) and the BioIndustry Association (BIA).

LifeSciencesUK intends to present a unified voice to Government, academia, patient groups and the media, enabling better collaboration with industry by all stakeholders. Key objectives include: to improve the investment environment for UK companies; to improve access to new medicines, devices, technologies and diagnostics; and to demonstrate the importance of life sciences to the UK economy.

The recent BIS report Strength and opportunity noted that employment and turnover in the medical technologies industry both grew in 2010: the sector now contains over 3000 UK companies with a turnover surpassing £11 billion; employment is up by 3% and turnover by 4% (for in vitro diagnostics, those figures are 4% and 8% respectively).

"Life sciences benefit our economy as well as producing innovative drugs and medical technologies to improve health outcomes for patients," said Health Minister Lord Howe. "This exciting initiative will allow the industries to work closely in helping the NHS provide quality care and improve productivity with new technologies."

Peter Ellingworth, Chief Executive of ABHI, commented: "It is important to both the life science industry and the UK economy that all four organisations work together to ensure that the UK is a fertile environment for life science companies. The work done by LifeSciencesUK will complement and support work being done across government by various teams concerned with the life sciences industries and health policy and I look forward to working with them to support the industry."

Doris-Ann Williams, Director General of BIVDA, added: "Better communication and coordination between our sectors has been of enormous benefit in highlighting life sciences' sizeable contribution to the UK economy and its vital importance in improving healthcare in this country. By aligning under the LifeSciencesUK initiative, BIVDA believes that our four associations can better work together to build on the good work we have already started in fully achieving the huge potential our industry holds for Britain."

 
Peter Ellingworth

The National Institute for Health and Clinical Excellence (NICE) has opened consultations on two new medical devices from UK companies: a mattress to prevent hypothermia during surgery and a topical photodynamic therapy for non-melanoma skin cancer.

The draft guidance provisionally supports the use of the Inditherm patient warming mattress (from Inditherm plc, based in Rotherham) to reduce the risk of inadvertent hypothermia in patients under anaesthetic. NICE estimates the average NHS cost saving for the device at £9770 per theatre per year.

NICE states that more evidence is needed to support the use of Ambulight PDT (from Ambicare Health Ltd, based in St Andrews) to provide photodynamic therapy for non-melanoma skin cancer in the community, removing the need for hospital-based treatment.

The two medical technology guidance drafts were produced by the Medical Technologies Advisory Committee (MTAC) within the Evaluation Pathway Programme for Medical Technologies. MTAC looks at whether a device offers increased benefits to the patient and the NHS for the same cost, or offers similar benefits for a lower cost.

Dr Carole Longson, Director of the NICE Centre for Health Technology Evaluation, said the provisional recommendation for the Inditherm mattress was based on evidence "that as well as benefiting patients by reducing a range of serious complications associated with inadvertent hypothermia, it also benefits the NHS by saving money".

"Whilst Ambulight PDT is an exciting and innovative device," Longson noted, "there isn't a substantive evidence base overall to determine the place for adoption of this new technology, relative to others." However, she emphasised, "this draft outcome doesn't mean that the device should not be used."

Following comments from health professionals, industry and patient groups, final guidance on both topics is expected in March 2011.

 
Inditherm mattress

The Department of Health has made an extra £162 million available to local health and care services to spend this year on helping people to leave hospital more quickly, access support services and equipment at home, and avoid unnecessary readmissions.

The announcement aims to address the health challenges posed by the winter period. It follows the publication of the NHS Outcomes Framework, which outlines how the NHS Commissioning Board will oversee the roles of GP commissioning and patient choice in achieving health outcomes.

The new funding will kick-start the collaboration of health and local authorities in using NHS funding to support social care - and in particular, the care of elderly patients. Anticipated measures include investment in equipment and services to address long-term conditions, disability and rehabilitation.

Health Secretary Andrew Lansley said: "Older people often need particular support after a spell in hospital to settle back into their homes, recover their strength and regain their independence. This money will enable the NHS and social care to work better together for the benefit of patients."

Lansley noted that over 2,500 hospital beds are currently unavailable due to delays in transferring care to social services.

Sending patients home

The new funding will be allocated to councils via PCTs, to be spent specifically on social care support in order to relieve the pressures on hospitals. Services that could be invested in include:

• short-term residential care places, respite and intermediate care

• home care support, including equipment, adaptations and telecare

• investment in reablement and rehabilitation services to reduce the need for ongoing care.

A further £300 million will be provided by 2014-15 for reablement and rehabilitation services, including homecare equipment services and occupational therapists.

Care Services Minister Paul Burstow said: "By reinvesting these NHS savings in social care we can offer more help more support to older people leaving hospital. This money will help cut the delays in getting the equipment and adaptations that people can need to enable them to live independently at home - saving them from an unnecessary stay in hospital or going into residential care."

Dr Ros Altmann, Director General of Saga, commented: "The fact that over 2,500 people are stuck in hospital for the want of a proper local authority care plan is shocking - and it is good news that the Government has at last recognised that more needs to be done to make the care system fit for purpose."

Measuring health outcomes

The first NHS Outcomes Framework, published in December 2010, follows the NHS White Paper in placing emphasis on patient outcomes rather than centrally-driven process targets.

The framework provides a national overview of what the NHS will aim for with regard to patient outcomes, and how the NHS Commissioning Board will be responsible for securing those outcomes by overseeing how the GP consortia commission services and respond to patient choice.

The priorities outlined relate to five aspects of healthcare: preventing premature death, care of people with long-term conditions, assisting recovery from illness and injury, ensuring a positive experience of care, and preventing avoidable harm to patients.

A consultation document on public health outcomes has also been published to complement the NHS Framework. Its priorities include protecting the population from major health emergencies and tackling factors that affect health and wellbeing.

Andrew Lansley commented: "We need to focus on outcomes and their robust, continuing measurement. Our focus on improving health outcomes will give the NHS, public health organisations and local government a benchmark for what the public expect to see from their health services."

 
New funding supports homecare and independence of elderly patients

New arrangements for filing patents in Europe will cut costs for UK businesses by reducing the number of records they need to provide.

The new arrangements will save companies money on the fees they pay agents for making an application.

The European Patent Office (EPO) allows companies to make a single application for patent protection in up to 40 European countries via a patent attorney.

From now on, applicants will not have to supply the EPO with the results of searches carried out by the Intellectual Property Office (IPO) in the UK: the IPO will automatically supply the information from its records.

Around 5,000 applications a year will benefit from this change. It will also help to reduce the huge international backlog of patent applications, which costs businesses an estimated £7.65 billion per year.

Baroness Wilcox, Intellectual Property Minister at the Department for Business, Innovation and Skills, said: "Reducing the burden of bureaucracy is essential in creating the conditions for businesses to grow and prosper. These new arrangements will make it cheaper and easier for UK firms to obtain patent protection as they look to expand into other European countries.

"The UK has been campaigning for greater work sharing like this. The quicker we deal with patent applications, the quicker firms can bring the latest innovations to the consumer."

 
Baroness Wilcox

Photo © Matt Faber/PA Wire

Boston Scientific Corporation has completed the sale of its neurovascular business to Stryker Corporation for $1.5 billion, following the definitive agreement made on October 28 2010.

The Company has also prepaid all $600 million of its 6.00 per cent senior notes due June 15 2011, using cash on hand.

"The sale of our neurovascular business and the prepayment of $600 million of debt significantly strengthen our financial flexibility and enhance our capacity to fund acquisitions and other investments that advance our strategy of realigning our portfolio through the execution of our priority growth initiatives," said Ray Elliott, President and CEO of Boston Scientific.

"In addition, this substantial debt prepayment highlights our continuing strong cash flow, commitment to debt reduction and progress in achieving our capital structure goals."

Boston Scientific and Stryker are among the leading global medical technology companies.

A leading UK provider of bariatric (weight loss) surgery has lowered the threshold at which it offers gastric band procedures.

Gravitas, an independent network of weight loss surgeons, said that patients with a body mass index (BMI) over 35, or over 30 with weight-related health problems, would now be eligible for bariatric surgery at its UK clinics.

Until now, gastric bands have only been approved for use in people with a BMI over 40, or over 35 with a serious weight-related health problem, who have failed to lose weight by other methods.

The change in threshold follows a recommendation by the FDA in the US that gastric bands should now be made available to people with a BMI as low as 30 who have obesity-related health problems.

David Kerrigan, MD of Gravitas and advisor to the UK Government on the current NICE obesity guidelines, said: "Our own audited research and clinical data is very much in line with the American recommendation that the gastric band is very safe and effective, so we are not surprised that the FDA Advisory Board has endorsed gastric band surgery for patients with lower BMIs.

"Any risks are likely to be outweighed by the potential health benefits, particularly for those who have already tried and failed to maintain weight loss using non-surgical means."

The change will apply only to private patients, as NHS provision of bariatric surgery will still be determined by PCTs.

Gravitas runs eight bariatric surgery units in the UK and Ireland. Its surgeons operate on both NHS and private patients.