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A Different Kind of Drug-Device Convergence

This article was originally published in Start Up

Executive Summary

The recently-announced agreement between atherectomy leader FoxHollow Technologies and pharmaceutical giant Merck has highlighted what could increasingly be a lucrative opportunity for some deevice companies in the whole field of convergence: service-based collaborations with drug companies engaged in clinical trials for cardiovascular and other types of drugs to provide the kinds of analytical tools or materials to richly inform and make more efficient such trials.

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Volcano's Second Act

Launched in 2000, Volcano was a promising device start-up in what was seen at the time as one of the most exciting opportunities in cardiovascular medicine to come along in some time: vulnerable plaque. But the practical implications of vulnerable plaque have proved to be elusive, for both cardiologists and product companies. For one thing, while everyone agrees that vulnerable plaque is a fascinating concept, no one yet knows precisely what approach will work best, both in diagnosing the disease and treating it. . As the science of vulnerable plaque evolves, that evolution raises questions about the future relevance of a whole generation of tools to serve interventional cardiology. Thus, companies, like Volcano, that placed early bets on technology based on standard interventional cardiology tools, such as catheter- and guide wire-based devices, have had to hold somewhat contradictory thoughts in their mind at the same time: the benefits of conforming to existing approaches and methodologies in interventional cardiology and the likelihood that vulnerable plaque fundamentally changes certain basic assumptions of that specialty.

FoxHollow/Merck R&D Deal: The Value of Plaque

An unusual pharmacogenomics alliance between a device company a major pharmaceutical company opens up new markets for both partners.

FoxHollow: Reviving Atherectomy

The ideal treatment for coronary artery disease is to remove the obstructing plaque, for which several de-bulking technologies, including atherectomy, were developed. The stent revolution of the mid-1990s provided an easier-to-use therapy with more consistent outcomes, relegating de-bulking tools to niche technologies. Physician/entrepreneur John Simpson, who developed the initial atherectomy technology at Devices for Vascular Intervention, remains committed to the principle that it is better to remove plaque than stent it. He believes the next-generation atherectomy device developed at his new company, Fox Hollow, will be a viable treatment option to compete with stenting, including the new generation of drug-eluting stents. Fox Hollow recognizes the need to fight the atherectomy adoption battle on both the ease-of-use and the clinical outcomes fronts, with the latter being particularly important as interventionalists look increasingly to clinical trials in making their product choices. But drug-eluting stent proponents don't believe it is possible to achieve comparable outcomes.

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