Boston Scientific Corp. (NYSE:BSX) may have set the bar higher with its new Promus Element stent, at least according to one physician at the American College of Cardiology’s annual meeting, but Wall Street remains unmoved by the success.
Despite positive two-hear results from a five-year study of its next-generation Promus Element stent, the Natick, Mass.-based medical device maker’s stock slipped 1.2 percent yesterday and opened even lower today, at around $7.18.
That may be because Boston Scientific and its main stent competitors — Abbott Laboratories (NYSE:ABT), Johnson & Johnson’s (NYSE:JNJ) Cordis Corp. and Medtronic Inc. (NYSE:MDT) — have already reached the outer limits of what the technology can do.
Results from the Platinum trial of the Boston Scientific stent, which uses the same anti-stenosis drug, everolimus, as Abbott’s Xience V stent, showed that the BSX device delivers outcomes comparable to the ABT DES.
“The bar is set very high now,” said Dr. Charles Davidson of Northwestern University’s Feinberg School of Medicine, a panelist at the ACC conference. “There are ways we can continue to improve, but this will require larger trials, with long follow-up, in high-risk patients such as those with ACS, STEMI, and left main.”
“Our procedures continue to get safer; our equipment and devices are getting better. New stents will have to be as safe as approved devices, and when it comes to deciding which stent is better than another, it will come down to nuanced aspects, and these don’t come to light until you are using these devices in lots and lots of people, not in these small trials designed for regulatory approval,” noted Dr. Edward McNulty of the University of California, according to the heartwire blog. “This is the sort of information you get from large registries and from feedback from operators.”
“So how do you choose?” added Dr Martin Leon of Columbia University, according to the blog. “It’s like anything else in life. When you get up in the morning, do you choose a black jacket or a gray jacket? You don’t look for a randomized trial. You’ve got some very good devices that may have subtle differences that may appeal to one individual or another, but it’s going to be difficult to distinguish these devices as being meaningfully different.”
That view of limited possibilities for a new blockbuster stent may have dimmed Wall Street’s ardor for Boston Scientific stock. For its part, the company said it’s chuffed that the Promus Element’s novel alloy proved easier to see during implantation.
“We are extremely pleased that the highly opaque platinum chromium alloy Promus Element stent significantly reduced both inadequate lesion coverage (‘geographic miss’) and the need for unplanned (bail-out) stenting,” said Hank Kucheman, president of Boston Scientific’s cardiology, rhythm and vascular division.