Global Spine Marketing Manager at Invibio Michael Veldman discusses healthcare trends that are making an impact on the spine device industry and how new innovations are addressing the needs of spine patients and surgeons today.
Q: What trends in the spine device industry are making the biggest impact on how spine procedures are performed?
Michael Veldman: In the United States market, you are going to continue to see fusion as the standard of care in the foreseeable future. That's being predicted in most of the market reports. I think you'll see minimally invasive spine procedures as another trend that is going to continue. At Invibio, we are seeing a trend in the interbody space with our more differentiated material offering to improve bone apposition onto the implant.
Fusion is the largest part of the spine market with more than 90 percent share in the United States. You'll also see some cervical arthroplasty predicted to grow in double digits, but I don't think it'll have the majority of the cervical market.
Q: How will spinal fusion fair? Are there opportunities in the fusion market still?
MV: What you'll see is some incremental improvements in spinal fusion. At the North American Spine Society annual meeting, we saw several titanium coated PEEK devices. Invibio has developed a new material that incorporates Hydroxyapatite into PEEK-OPTIMA®, which has almost 70 percent of the Interbody device market.
We started with PEEK-OPTIMA® as a baseline and looked for areas of possible improvement. Hydroxyapatite is used to improve bone apposition to metal devices such as titanium pedicle screws so we felt that it was logical to create a compound material that combines the strength and imaging advantages of PEEK-OPTIMA® with the osteoconductivity of hydroxyapatite.
Q: How are medical device companies growing and innovating to stay competitive today?
MV: I think the larger companies are still looking to emerging markets such as China and Brazil as opportunities for growth. Patient populations there are large and procedural growth rates are high. There is less uncertainty in these markets because you can take existing technologies and deliver them.
In the United States, companies are trying to compete with speed and product differentiation. Minimally invasive techniques are a way to differentiate. There are also new standalone PEEK devices with integrated screws that companies are using as a way to differentiate and stay competitive. Many companies are also looking at new materials or processes like titanium coatings as a way to add value and gain market share.
Q: As uncertainty and regulations grow in the U.S. market, do you think more companies will take their product development overseas?
MV: I think the U.S. will still be the primary market for the development and innovation in spine technologies. I just don't think you'll see companies placing real bets on breakthrough technologies. Instead, I think you'll see incremental innovations. They'll develop devices that have a clear reimbursement pathway.
Q: Where are the biggest opportunities in the spine device market?
MV: Millennium Research Group stated in their recent report that interbody devices are one of the few areas of innovation remaining for the spinal device market. I would agree with that assessment. Standalone devices in spinal fusion are continuing to grow, and they are projected to grow faster than the market average.
I think you'll see a shift toward standalone devices with integrated screws because the reimbursement is relatively straight forward and they enable fixation without additional plates or rods. The trend to achieve bone apposition to the interbody device is also likely to continue whether through titanium coatings or a new material like PEEK-OPTIMA® HA Enhanced.
Lateral procedures will also grow steadily. Many companies will likely round out their company portfolios with those devices.
Patients are also demanding more minimally invasive procedures as they get online and research. I think patient education will increase demand for the minimally invasive technology. It's really a challenging market for surgeons right now because patients are more educated than ever before, yet there are more demands on the surgeon's time as well.
Q: How do you see spine surgery evolving in the future?
MV: I think controlling costs while still providing value will continue to be important in the spine market. Building evidence for new projects, procedures and technology in the spine market will be the emphasis. There will be a continued increase in data collection and reporting to prove spine surgery works and improves QALY.
I think there's going to be more collaboration between spine surgeons and device companies because the industry as a whole needs to demonstrate to the payers that spine surgery is effective. I think we need to take on that challenge together.
Q: What is Invibio working on right now and where is the company headed over the next few years?
MV: As a company, we recently launched a new grade of material called PEEK OPTIMA® HA Enhanced for spinal fusion. The intent is to enhance bone apposition to the surface of the PEEK-OPTIMA® implant using hydroxyapatite. That has been our primary development in the material arena in the past year.
Invibio has also shifted our brand strategy to be more closely aligned with the markets that we serve and our customers. We want our portfolio to align with the markets we serve in order to better communicate the value Invibio offers with our material and processing expertise. Whether it's spine, trauma, orthopedics or other specialty device markets, Invibio aims to demonstrate that we offer product leadership in the medical device market.
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