Mandatory joint pay model slashes spending in just eight months

By Virgil Dickson  | September 6, 2018

A mandatory pay model aimed at reducing Medicare spending on joint replacement surgeries was able to save money in its first year. The CMS in recent years has scaled back and canceled mandatory models.

Under the Comprehensive Care for Joint Replacement program, average total payments decreased by 3.9% or $1,127 compared to hospitals not participating in the model, according to federal data released Wednesday. At the same time, researchers observed no statistically significant changes in the quality of care as measured by readmission rates, emergency department visits, and deaths.

The program gives hospitals a fixed payment for all services related to joint replacement surgeries from admission to 90 days after the procedure, with no additional payments for complications, readmissions or post-acute services.

“Possibly the most notable outcome during the first CJR model performance year was that statistically significant changes in utilization and payments occurred so quickly,” the report said.

The study analyzed results from 731 CJR participant hospitals and 841 hospitals not in the experiment, which lasted from April 1 to Dec. 31, 2016.

Last year, the CMS scaled back the CJR program citing the burden of the program and the belief that models should be largely voluntary. The CJR model is now only mandatory in 34 geographic areas compared to 67 geographic areas when it first launched.

The agency estimates that 465 hospitals are participating in the effort. That figure is down from 800 acute-care hospitals that were expected to participate in the program.

After interviewing hospital staff, researchers said there may not have been a change in the practice of medicine at these facilities had the experiment not been mandatory.

“These findings suggest that a mandatory model may impel action across a broad range of hospitals that may not otherwise have acted to reduce episode payments,” the report said.

Proponents of value-based care hope the results will encourage the CMS to reconsider the use of mandatory models. Many of the hospitals in CJR are ones that chose to skip other pay models such as the Bundled Payments for Care Improvement Initiative, according to Andrew Ryan, an associate professor in the department of health management and policy at the University of Michigan’s School of Public Health.

 

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Hospitals Prepare To Launch Their Own Drug Company To Fight High Prices And Shortages

September 6, 2018 / 

Sometimes IV bags are hard for hospitals to come by. Other times it’s injectable folic acid to treat anemias. Right now, the tissue-numbing agent lidocaine is in short supply.

Shortages of commonplace generic drugs have plagued hospitals in recent years. And with short supplies and fewer suppliers for key drugs, there have been price increases.

Hospital purchasing agents keep searching for new sources for the medications that patients need, while clinicians scramble to find alternatives.

“Every day at Intermountain we manage more than 100 drug shortages, and most of them are generics,” said Dr. Marc Harrison, president and CEO of Intermountain Healthcare, a system of 22 hospitals based in Salt Lake City. “The impact on patient care, in terms of trying to find alternatives and scurrying around and trying to find necessary drugs, is incredibly time-consuming and disconcerting.”

Now Intermountain, along with several other major hospital systems and philanthropies, is taking the problem in hand. They are launching a nonprofit, generic drug company to help fight rising costs and chronic shortages.

The company, called Civica Rx, will be independent. But the board will include so-called governing members that include Intermountain, the Mayo Clinic, and for-profit HCA Healthcare, among others. The companies are unveiling the new venture’s name, structure and leadership on Thursday. The intention to start it was announced in January.

The new company plans to market 14 common generic drugs that have been in short supply and whose prices have risen in recent years. Harrison declined to name the drugs.

“As we decided on the drugs we were really practical,” Harrison said in an interview. “We looked for drugs that were now in short supply. We looked for drugs that were on the lists of essential medications, and we looked for drugs that have had huge spikes in their prices.”

Drug shortages have become so widespread that Food and Drug Administration Commissioner Scott Gottlieb in July created a task force to come up with solutions. And last year the Justice Department, along with 45 states, accused a group of generic drug makers of price fixing.

 

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Photo: Courtesy of Intermountain Healthcare

LimaCorporate Announces Milestone-based Acquisition of TechMah Medical LLC to Expand Digital Footprint in Orthopaedics

SAN DANIELE DEL FRIULI, ItalySeptember 6, 2018 /PRNewswire/ —

LimaCorporate, a pioneer and leader in 3D printing of Orthopaedic implants, announces the milestone-based acquisition of TechMah Medical LLC (“TechMah Medical”), a medical device software company located in Knoxville, Tennessee, to complement its hardware portfolio with digital applications.

TechMah Medical was founded in 2014 and focuses on digital technologies dedicated to orthopaedic surgery that impacts the quality of care and fits into today’s cost constraints.  Dr. Mohamed Mahfouz, Professor of Biomedical Engineering at the University of Tennessee, is the founder of TechMah Medical.  Dr. Mahfouz has over 20 years’ experience within Orthopaedics and holds over 300 publications on implant design, imaging, kinematics, sensors, anthropology and forensics. Dr. Mahfouz will continue to be involved with TechMah Medical and will become a long-term partner to LimaCorporate.

The team at TechMah Medical consists of world-class researchers and engineers in bio-wireless electronics, biomechanics, imaging, as well as software and will focus on the release of software and smart instruments which will be used in combination with LimaCorporate implants.

This investment in software know-how, together with the internal 3D printing expertise, brings LimaCorporate to the forefront of digital transformation of the Orthopaedics industry through highly-innovative digital solutions that will change the approach to surgery and standard instrumentation.

Under the terms of the agreement, LimaCorporate will provide funding to TechMah Medical and complete the acquisition as key product development goals are achieved, becoming the sole shareholder of TechMah Medical over time, while Dr. Mahfouz and his team will remain involved with the business.  Financial terms have not been disclosed.

“LimaCorporate is the most innovative and agile company in Orthopaedics today and the ideal partner for us to develop our technology and advance the digitization of the industry,” said Dr. Mahfouz from TechMah Medical.

Luigi Ferrari, CEO of LimaCorporate, commented, “We are excited about this transaction and the partnership with Dr. Mahfouz. Combined with our proven implant technology and 3D printing capabilities, this acquisition will allow LimaCorporate to develop a strong foothold in all digital applications surrounding Total Joint Replacement by offering surgeons a new intra-operative experience and by providing their patients flexible personalized care.”

About LimaCorporate

LimaCorporate is a global medical device company providing reconstructive Orthopaedic solutions to surgeons who face the challenges of improving the quality of life of their patients. Based in Italy, LimaCorporate is committed to the development of innovative products and procedures to enable surgeons to select ideal solution for every individual patient. LimaCorporate’s product range includes large joint revision and primary implants and complete extremities solutions including fixation.

About TechMah Medical 

TechMah Medical LLC is a technology company focused on delivering orthopedic solutions. We build innovative applications designed to improve patient and clinician experience throughout the joint replacement process. Based in Knoxville, Tennessee, our team of scientists and engineers are driven to improve quality and efficiency through customization.

For additional information on the Company, please visit: limacorporate.com

Limacorporate S.p.A.

Via Nazionale, 52

33038 Villanova di San Daniele

Udine – Italy

T: +39-0432-945511

E: info@limacorporate.com

SOURCE Limacorporate S.p.A

St. Mary’s Medical Center Selected to Study Use of TOPS™ System

SAN FRANCISCOSept. 5, 2018 /PRNewswire/ — The Spine Center at Dignity Health St. Mary’s Medical Center, has been selected to participate in a FDA/IDE pivotal study, sponsored by Premia Spine, Ltd., studying the use of the TOPS™ System. St. Mary’s Medical Center is one of 30 spine centers throughout the U.S. taking part in the study to evaluate the efficacy and safety of the TOPS™ System compared to traditional lumbar fusion.

The TOPS™ System is a mechanical device designed to restore motion of the spine in all directions. Instead of permanently locking the two vertebrae with a fusion, the device allows the two vertebrae to continue moving. If approved, TOPS™ would potentially be the first posterior arthroplasty device for the treatment of degenerative Grade I spondylolisthesis and spinal stenosis.

“We are very excited to be selected as investigators in the TOPS™ System study because it offers a unique opportunity for patients who meet the study’s criteria to potentially receive a motion preserving device for the surgical treatment of degenerative spondylolisthesis and spinal stenosis,” said Dr. James Zucherman, orthopedic surgeon and medical director of the St. Mary’s Spine Center.

Patients participating in the study will either undergo surgery with the TOPS™ System or lumbar spinal fusion. Patients are randomly placed into one group or the other with a 67 percent likelihood of undergoing surgery with the Premia device.

“There are countless people suffering from debilitating back pain caused by a slipped disc or narrowing of the spine who must either manage the pain through physical therapy and injections or undergo surgery,” added Dr. Zucherman. “We believe that this study will provide us the scientific data needed to support the continued use of technologies that aim to correct underlying spinal conditions while helping to restore range of motion.”

Study participants must be experiencing:

  • radiating leg pain,
  • greater leg or buttock pain than back pain,
  • severe pain after walking as little as 100 yards or 2 minutes,
  • and/or pain that reduces when sitting, bending forward, or leaning over a shopping cart.

These symptoms could be signs of degenerative spondylolisthesis, spinal stenosis and additional spinal conditions. Patients can learn more about the TOPS™ System study by calling (415-750-5836) or visiting http://www.ClinicalTrials.gov, search NCT03012776.

About Dignity Health St. Mary’s Medical Center

Dignity Health St. Mary’s Medical Center is an accredited, not-for-profit community hospital that has been caring for the people of San Francisco since 1857. Located across from Golden Gate Park, it is the longest continually running hospital in San Francisco. For three consecutive years, from 2014 to 2016, St. Mary’s received the Distinguished Hospital Award for Clinical Excellence from Healthgrades. St. Mary’s also was recognized as one of the Top 100 Orthopedic Programs nationally by Becker’s Hospital Review and is a Certified Stroke Center by the Joint Commission. St. Mary’s state-of-the-art Cancer Center offers the full-range of oncology, radiation, and imaging services. Offering the most comprehensive breast imaging services in San Francisco, St. Mary’s has been designated as a Center of Excellence by the American College of Radiology, a recognition that represents the national gold standard. For more information, call 855.970.2938.

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SOURCE Dignity Health St. Mary’s Medical Center

Positive Commercial Payor Policy Covering coflex® For The Surgical Treatment Of Lumbar Spinal Stenosis

NEW YORK, Sept. 6, 2018 /PRNewswire/ — Paradigm Spine, LLC, a leader in providing solutions for the treatment of lumbar spinal stenosis, announces issuance of a BlueCross BlueShield of South Carolina Medical Policy, entitled “Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers)” dated August 2018.

Lumbar spinal stenosis (“LSS”), affecting 1.6 million patients annually, is a debilitating and degenerative disease in older patients (>50 years) often associated with significant leg and back pain, leg numbness and weakness, causing a significant reduction in an active lifestyle.  Traditional surgical treatment options for LSS includes a decompression that removes bone and soft tissue and may also require a fusion to stabilize the spine.  The coflex® device is a non-fusion, motion-preserving stabilization implant, that is FDA PMA approved for the treatment of lumbar spinal stenosis and is used in conjunction with a decompression, or used in lieu of a spinal fusion.

To learn more about coflex® Interlaminar Stabilization®, please visit www.coflexsolution.com.

Marc Viscogliosi, Chairman & CEO – “With more than 90 peer-reviewed published articles, including landmark long-term follow-up clinical studies, spine medical society guidelines, and now with additional commercial insurance coverage, it is wonderful to be able to expand patient access to the coflex® technology.”

About Paradigm Spine, LLC

Paradigm Spine, LLC, founded in 2004, is a privately held company and remains focused on the design and development of solutions for the disease management of spinal stenosis.  The Company’s signature product is the coflex® Interlaminar Stabilization® device, which is currently used in over 60 countries worldwide. coflex® is the only lumbar spinal device that has produced Level I evidence in two separate prospective, randomized, controlled studies against two different control groups, changing the standard of care for lumbar spinal stenosis treatment.  For additional information visit www.paradigmspine.com or www.coflexsolution.com.

SOURCE Paradigm Spine, LLC

(PRNewsfoto/Paradigm Spine, LLC)

The coverage policy may be found here: http://www.cam-policies.com/internet/cmpd/cmp/mdclplcy.nsf/DispContent/A50CA6ABF1D50CAF8525811E0062FC38?opendocument

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Reston Hospital Center Launches Training Program for Robotic Guided Spine Surgery

Reston, Virginia, Sept. 06, 2018 (GLOBE NEWSWIRE) — The Virginia Institute of Robotic Surgery at Reston Hospital Center has announced the launch of its Visiting Clinician Program (VCP) for robotic assisted spine surgery using the Mazor X Robotic system, a partnered program with Medtronic. The VCP at Reston Hospital Center will be led by Dr. Christopher Good, spinal surgeon at the Virginia Spine Institute (VSI). As the Director of Scoliosis & Spinal Deformity Surgery at VSI, Dr. Good is at the forefront of spine surgery and has performed the Mid-Atlantic’s first and most advanced procedures using robotic assisted technology at Reston Hospital Center.

“Our team has been leading the way in implementing the latest in surgical innovations for years,” said John Deardorff, President and CEO of HCA’s Northern Virginia Market and Reston Hospital Center. “Consistently providing excellent patient care and superior results, Reston Hospital Center has become recognized as a destination that surgeons from around the world come to train.”

The VCP at Reston Hospital Center is designed to enable spine surgeons from around the world to see the technology while learning best practices for implementation in another facility or surgical program.

A visit to the program includes a case observation, as well as an opportunity to complete a training curriculum and to spend time with Dr. Good, learning the technology and how its best applied in complex cases. Visiting surgeons will also be exposed to the daily operations of running a comprehensive robotic surgery program from the administrative perspective, while having the opportunity to speak with leadership from the surgical services area.

Our research is showing that this robotic technology can decrease radiation to patients in the operating room, as well as improve the safety for patients having spine surgery,” said Dr. Christopher Good. “The launch of this Visiting Clinician Program at Reston Hospital Center is just one more step toward ensuring that our patients have the safest and most advanced treatment available to them; and, now, I have the pleasure of giving the same opportunity to surgeons around the world.”

The robotic assisted technology is used for pre-planning minimally invasive as well as complex spinal reconstruction procedures. It allows spine surgeons to precisely plan out the desired surgery and to carry out the procedure with a high degree of confidence and accuracy.

About Reston Hospital Center

Part of HCA Virginia Health System, Reston Hospital Center is a 187-bed, acute-care medical and surgical facility that has garnered high honors for attentive patient care and nursing excellence.  Reston Hospital Center is home to the region’s newest Level II Trauma Center and the most comprehensive robotic surgery in the Mid-Atlantic. Statewide, HCA Virginia Health System operates 14 hospitals and more than 30 outpatient centers and is affiliated with 3,000 physicians. It is Virginia’s fourthlargest private employer, provides $190.8 million in charity and uncompensated care, and pays $72.6 million in taxes annually. For more information about Reston Hospital Center visit www.restonhospital.com

Erin Echelmeyer
Reston Hospital Center
703-689-9030
Erin.Echelmeyer@hcahealthcare.com

Baxter Announces U.S. FDA Clearance of New Bone Graft Substitute, Actifuse Flow

Deerfield, Ill. – September 6, 2018

Baxter International Inc. (NYSE:BAX), a global leader in advancing surgical innovation, today announced U.S. Food and Drug Administration (FDA) clearance of Actifuse Flow Bone Graft Substitute for use in a variety of orthopedic surgical procedures. As the newest addition to Baxter’s growing osteobiologics surgery portfolio, Actifuse Flow offers accelerated bone growth in a new, easy-to-use, prepackaged delivery syringe for precise placement into small bony voids or gaps in the skeletal system.

Actifuse Flow utilizes the proprietary silicate-substituted technology of Baxter’s Actifuse Bone Graft Substitute, which enhances silicon levels to accelerate bone formation[i]Actifuse Flow comes ready to use with no mixing or preparation involved and maintains its flowable consistency throughout surgery. The bone graft substitute is delivered directly from a pre-loaded syringe with the ability to start and stop delivery, making it compatible with open and less invasive surgical techniques and well-suited for filling small bone defects and complex geometries. As the graft substitute resorbs, it is replaced by the patient’s own bone during the body’s healing process. Baxter expects Actifuse Flow to be used in a variety of orthopedic surgeries in the pelvis, extremities, and posterolateral spine.

“Baxter’s Actifuse Bone Graft Substitute has been demonstrated in preclinical models to show greater new normalized bone volumes over other available bone graft substitutes. As the graft resorbs into the body, it is replaced by natural bone during the healing process. Actifuse Flow offers that same reliability in an easy-to-use delivery device. I am pleased to count on the science behind Actifuse Flow to accelerate bone formation in my patients,” said Robert Norton, MD, an orthopedic spine surgeon serving patients in Boca Raton, Florida.

“As part of our growing product portfolio, Actifuse Flow builds on the extensive clinical experience of our Actifuse Bone Graft Substitute,” said Wil Boren, president of Baxter’s Advanced Surgery business. “We strive to pioneer products that provide surgeons innovative and dependable tools to help enhance healing, improve outcomes and reduce the total cost of care.”

Actifuse Flow is the latest addition to Baxter’s osteobiologics surgery portfolio, which also includes Actifuse ABXActifuse ShapeActifuse MIS and Altapore. These products are based on a proprietary silicate-substituted technology designed to accelerate bone growth and come in varying configurations to accommodate different surgical needs. Baxter expects Actifuse Flow to be available to U.S. customers by year-end. It will be sold in three convenient sizes: 5 mL, 3 mL and 1.5 mL.

About Baxter

Every day, millions of patients and caregivers rely on Baxter’s leading portfolio of critical care, nutrition, renal, hospital and surgical products. For more than 85 years, we’ve been operating at the critical intersection where innovations that save and sustain lives meet the healthcare providers that make it happen. With products, technologies and therapies available in more than 100 countries, Baxter’s employees worldwide are now building upon the company’s rich heritage of medical breakthroughs to advance the next generation of transformative healthcare innovations. To learn more, visit www.baxter.com and follow us on TwitterLinkedIn and Facebook.

Actifuse Flow Bone Graft Substitute Indication

Actifuse Flow is a bone void filler intended only for orthopedic applications as a filler for gaps and voids that are not intrinsic to the stability of the bone structure. Actifuse Flow is indicated to be packed gently into bony voids or gaps of the skeletal system, i.e., extremities, pelvis, and spine, including use in posterolateral spinal fusion procedures with appropriate stabilizing hardware. These defects may be surgically created osseous defects or osseous defects created from traumatic injury to the bone. The product provides a bone void filler that resorbs and is replaced by bone during the healing process.

Important Risk Information for Actifuse Flow Bone Graft Substitute

Actifuse Flow is contraindicated where the device is intended as structural/load-bearing support in the skeleton system. Actifuse Flow bone graft substitute has not been cleared for vertebroplasty.

Attempts should not be made to modify the size of the granules or to change their shape. It is important to maximize contact between existing bone and the implant to ensure proper bone regeneration.

The effect of mixing Actifuse Flow with substances other than sterile saline/water, autologous blood or bone marrow aspirate is unknown.

Rx Only. For safe and proper use of this device, refer to the full Instructions for Use.

This release includes forward-looking statements concerning Actifuse Flow, including potential benefits associated with its use [and anticipated launch dates]. The statements are based on assumptions about many important factors, including the following, which could cause actual results to differ materially from those in the forward-looking statements: satisfaction of regulatory and other requirements; actions of regulatory bodies and other governmental authorities; product quality, manufacturing or supply, or patient safety issues; changes in law and regulations; and other risks identified in Baxter’s most recent filing on Form 10-K and other SEC filings, all of which are available on Baxter’s website. Baxter does not undertake to update its forward-looking statements.

Baxter, Actifuse Flow, Actifuse ABX, Actifuse Shape, Actifuse MIS and Altapore are registered trademarks of Baxter International Inc.

 


[i] Hing KA, et al. Comparative performance of three ceramic bone graft substitutes. Spine J. 2007; 7(4):475

CORRECTING and REPLACING – Misonix Reports Record Fourth Quarter and Fiscal Year 2018 Revenue

FARMINGDALE, N.Y., Sept. 06, 2018 (GLOBE NEWSWIRE) — On September 5, 2018, Misonix, Inc. (Nasdaq: MSON) (“Misonix” or the “Company”), issued a press release announcing financial results of its fourth fiscal quarter and fiscal year ended June 30, 2018. The sales performance supplemental data table in that release included a classification error between international consumables and equipment revenue for the three and twelve months ended June 30, 2018. Total, domestic and international revenue was reported correctly in all periods. A corrected supplemental data table and updated percentages within the text of the press release are included herein. Please note these changes when referencing the transcript of the quarterly results review conference call the Company held on September 5, 2018.

Misonix, Inc. (Nasdaq: MSON) (“Misonix” or the “Company”), a provider of minimally invasive therapeutic ultrasonic medical devices that enhance clinical outcomes, today reported financial results for the fiscal 2018 fourth quarter and year ended June 30, 2018 as summarized below:

($ in millions) Three Months Ended Year Ended
June 30, June 30,
2018 2017 2018 2017
Revenue $   8.6 $   7.9 $   36.7 $   27.3
Gross Profit $   6.1 $   5.5 $   26.9 $   19.1
GP Percentage – product revenue 70.8% 69.9% 70.0% 69.9%
Pretax loss from continuing operations $   (1.8) $   (1.1) $   (2.4) $   (2.9)
Net loss $   (1.8) $   (0.4) $   (7.6) $   (1.7)
EBITDA (1) $   (1.1) $   (0.9) $   (0.8) $   (1.6)
Adjusted EBITDA (1) $   (0.2) $   (0.3) $   4.2 $   (0.5)
June 30, June 30,
2018 2017
Long Term Debt $   – $   –
Cash $   11.0 $   11.6
  1. Definitions and disclosures regarding non-GAAP financial information including reconciliations are included on page 6 of this press release.

Stavros Vizirgianakis, President and Chief Executive Officer of Misonix stated, “Our fourth quarter and fiscal 2018 top-line financial results mark the conclusion of another year of significant company-wide improvements and growth for Misonix. The ongoing and successful execution of our strategies to aggressively expand our leading ultrasonic medical device platform resulted in a 35% rise in annual revenues to a record $36.7 million, exceeding the high-end of our fiscal 2018 guidance. Record top-line growth drove a 41% increase in annual gross profit, while maintaining our healthy gross margin on product sales of 70%. The significant improvement in our fiscal 2018 top- and bottom-line financial performance reflects the added value we are generating from our growth investments and our continued progress in positioning Misonix for ongoing sustainable growth and future profitability. With the positive operating momentum across our business and a strong balance sheet, Misonix has a solid foundation to continue pursuing a range of near- and long-term growth opportunities that we are confident will deliver enhanced returns for our shareholders.

“The demonstrated clinical benefits of Misonix’s ultrasonic surgical devices are a key driver behind the strong demand for our products and improved competitive position across our domestic and international markets. Robust growth in both consumables and equipment sales drove a 20% increase in product revenue for fiscal 2018. We are also very pleased to see continued double-digit revenue growth in our consumables business, a high-margin recurring revenue stream that brings added predictability to our results. Excluding license revenue, consumables accounted for 71% of total sales for the fiscal fourth quarter and 72% of sales for the full year. And, with over 62,000 surgical procedures performed with Misonix consumables, we exceeded our goal for fiscal 2018 and remain on track to meet or exceed our goal of 100,000 annual procedures world-wide within three years.

“In line with our commitment to radically improve patient outcomes through medical technology innovation, we continued to invest in R&D to support the development of new ultrasonic surgical solutions and products, including our next generation Nexus platform product. We have received an overwhelmingly positive response from physicians who tested early prototypes and have incorporated their feedback to make further enhancements to the Nexus product line, which will be unveiled at the NASS conference in September. Nexus presents a compelling value proposition to hospitals and physicians, allowing Misonix to further penetrate operating rooms by expanding our addressable markets.

“As we pursue the next phase of growth for Misonix, we will continue to focus on actively managing our capital structure, driving sales, improving productivity and increasing efficiencies. We are confident that the direction we are headed in will enable us to meet our goal of enhancing long-term shareholder value as we move through fiscal 2019 and beyond.”

 

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4WEB Medical Announces Substantial Growth of its Lateral Product Offering

DALLASSept. 5, 2018 /PRNewswire/ — 4WEB Medical, the industry leader in 3D printed implant technology, announced today substantial growth driven by its Lateral Spine Truss System™.

“We are extremely pleased with the adoption of our Lateral Spine Truss System™.  4WEB has achieved double digit growth YTD 2018 compared to 2017 in revenue, users, cases and units sold.  Most impressive is the 73% increase in surgeon users,” said Jim Bruty, 4WEB Medical’s Senior Vice President.  “We expect this trend to continue as demand for our lateral offering will be strengthened by the launch of 4WEB’s Total Lateral Solution at NASS 2018 in Los Angeles.”

4WEB’s proprietary Truss Implant Technology™ consists of a web structure at the bone interface that resists subsidence by distributing load across the entire vertebral endplate.  Subsidence is a concern in lateral fusion with literature showing that cages with narrower widths and shorter lengths correlate to increased subsidence rates.  A subsidence study performed by The University of Toledo compared the performance of the 4WEB Lateral Truss Implant to a competitive ring shaped implant.  The study showed that the smallest footprint 4WEB Truss Implant outperformed the largest footprint ring shaped implant across all bone density models, including osteoporotic bone models, further demonstrating the importance of the maximizing endplate contact.

Tasha White, 4WEB Medical’s Marketing Director commented, “Lateral access procedures are the fastest growing segment in spine fusion surgery.  We are committed to this market and offering surgeons the best solution for their patients.  4WEB’s proprietary bone interface web structure provides superior resistance to subsidence which is imperative in lateral spine surgery.  The results of the University of Toledo study prove our innovative implant design outperforms ring shaped designs and demonstrates the superiority of 4WEB’s technology.  Improved clinical outcomes have a tremendous appeal to surgeons and will be the driving force in the growth of our lateral product line.”

4WEB Medical is an implant device company founded in 2008 in Dallas, Texas. Thirty years of research in topological dimension theory led to the discovery of a novel geometry, the 4WEB, that can be used as a building block to create high-strength, lightweight web structures. The company leveraged this breakthrough along with cutting-edge 3D printing technology to develop 4WEB Medical’s proprietary truss implant platform. The 4WEB Medical product portfolio for spine includes the Cervical Spine Truss System, the Anterior Spine Truss System, the Posterior Spine Truss System, and the Lateral Spine Truss System. 4WEB is actively developing truss implant designs for knee, hip, trauma and patient specific orthopedic procedures.

For more information about 4WEB Medical, 4WEB’s Truss Implant Technology™, and the Spine Truss Systems™, please visit www.4WEBMedical.com.

SOURCE 4WEB Medical

Photo: (PRNewsfoto/4WEB Medical)

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Histogenics Announces Top-Line Results From Phase 3 Clinical Trial of NeoCart® in Patients With Knee Cartilage Damage

WALTHAM, Mass., Sept. 05, 2018 (GLOBE NEWSWIRE) — Histogenics Corporation (Histogenics) (Nasdaq: HSGX), a leader in the development of restorative cell therapies that may offer rapid-onset pain relief and restored function, today announced that its Phase 3 clinical trial of NeoCart did not meet the primary endpoint of a statistically significant improvement in pain and function in a dual threshold responder analysis one year after treatment as compared to microfracture.  In the modified Intent to Treat (mITT) population (which excludes those patients who were randomized but not treated with NeoCart), 74.2% of the NeoCart patients exhibited clinically meaningful improvements in pain and function compared to 62.0% of microfracture patients at one year (p=0.071).  However, in this mITT population, patients treated with NeoCart achieved a statistically significant improvement in pain and function (p=0.018) six months after treatment as compared to patients treated with microfracture.  Both NeoCart and microfracture were well tolerated and exhibited strong safety profiles.

“Based on the totality of the data generated in the Phase 3 clinical trial, we continue to believe in NeoCart’s potential as a treatment for knee cartilage damage.  When we designed our Phase 3 clinical trial in 2009, we set a very high clinical bar for NeoCart and narrowly missed hitting the trial’s primary endpoint with statistical significance by only two microfracture responders out of the 249 patients that participated in the trial.  While the NeoCart treatment group exhibited a response as early as three months after treatment that continued through two years, the microfracture response rate was better than expected, which impacted the statistics.  We are encouraged by the results and believe we have a meaningfully differentiated product that, if approved, can compete effectively and provide physicians and patients with a beneficial treatment option that may grow the market,” said Adam Gridley, President and Chief Executive Officer of Histogenics.  “We continue to analyze the data and are in the process of scheduling a meeting with the FDA to discuss the results and prepare for a potential submission of a biologics license application for NeoCart.  We wish to acknowledge and thank the patients and investigators who participated in the trial and shared their positive experiences with NeoCart,” stated Mr. Gridley.

The NeoCart Phase 3 clinical trial is believed to be the largest and first prospectively designed, randomized clinical trial in North America evaluating the safety and efficacy of a restorative cell therapy to treat knee cartilage damage.  It is also believed to be the only trial with a dual threshold responder analysis endpoint.  As part of the prospective data analysis, Histogenics collected a variety of patient reported outcome endpoints, including all measures of the Knee Injury and Osteoarthritis Outcomes Score (KOOS) and the International Knee Documentation Committee (IKDC) score, which are validated, patient-centered assessments of pain and function that are commonly used in current clinical trials of cartilage therapies.  On all but one of these measures, two of which are being utilized as primary endpoints in ongoing clinical trials by third parties in the U.S. for other therapies, NeoCart demonstrated statistically significant superiority versus microfracture at one and two years.

The Phase 3 clinical trial is the first study prospectively enrolled consistent with current U.S. Food and Drug Administration (FDA) guidance, which provides for the use of microfracture as a comparator treatment in trials to repair knee cartilage damage.  The published FDA guidance also specifically calls for a study population that, given the clinical limitations and variable results of microfracture, we believe provides more favorable results than what is typically seen in microfracture in both the literature and a real-world setting.

“We are pleased with the overall performance of NeoCart in this Phase 3 clinical trial and the data confirm the feedback we have received from several of the investigators who participated in the trial.  Most importantly, patients treated with NeoCart displayed an early and sustained recovery from pain and return to function that was clinically meaningful.  The data from this trial are also consistent with results seen in prior clinical trials of NeoCart as well as the biomechanical data generated as part of our collaboration with Cornell University,” said Lynne Kelley, M.D., Chief Medical Officer of Histogenics.  “While we are continuing to analyze the data, we have already seen a number of important results, including a statistically significant improvement of NeoCart compared to microfracture in lesion sizes of greater than 2 cm and patients with higher body mass index.  We think that results such as these will be an important part of our planned discussions with the FDA, as well as with clinicians if NeoCart is approved,” continued Dr. Kelley.

There are approximately 1.2 million arthroscopic procedures conducted each year to treat knee cartilage defects in the U.S., with less than half of eligible patients currently electing to receive treatment.  Based on the data generated to date, NeoCart may offer many of these patients a safe and effective alternative, subject to FDA approval.

“As a physician who treats patients with knee cartilage damage, I am keenly aware of the limitations of current treatment approaches for this common and underserved condition,” said David C. Flanigan, MD Associate Professor, Department of Orthopedics, Director, Cartilage Restoration Program at The Ohio State University Wexner Medical Center, and a high-enrolling investigator in the Phase 3 clinical trial.  “The pain and loss of function associated with uncorrected knee cartilage lesions can significantly limit these patients’ ability to maintain their daily routines and often leads to other more serious comorbidities over time.  The rapid recovery for patients who received this cartilage tissue implant compared to those who underwent microfracture indicates that implants, such as NeoCart, may be an attractive alternative for patients seeking a better quality of life and faster return to function,” continued Dr. Flanigan.

The primary endpoint for the Phase 3 clinical trial was a dual-threshold responder analysis measuring the improvement in KOOS pain and IKDC function scores for each patient treated with NeoCart compared to those treated with microfracture one year after the time of treatment.  Dual-threshold responders were defined as patients who, relative to their baseline measurements, had at least a 12-point improvement in the KOOS pain sub-score assessment and a 20-point improvement in the IKDC subjective assessment.  The trial also evaluated additional pain, quality of life, and function outcomes using all five measures of KOOS subscales, including Sports and Recreation.  The change from baseline and the relative change between the NeoCart and microfracture arms was also measured at one year which contrasts with clinical trials of other products, either on the market or in development, that measured these changes at two years.  Efficacy and safety will continue to be followed out to three years, and Histogenics expects to further track patients for future planned analyses, including patients from prior clinical trials who received a NeoCart treatment.

Demographics for both study arms were similar and represent a patient population that was intended to ensure that microfracture would respond favorably, including patients with an average age of approximately 39 years old and a Body Mass Index (BMI) of approximately 27.  Furthermore, the mean lesion size was 2.1 cm in the NeoCart arm and 1.8 cm in the microfracture arm.  There were no other significant differences between the treatment arms.

The results with respect to the primary endpoint (dual threshold responder analysis one year after treatment) are summarized below:

  NeoCart Microfracture    
  Positive
Responders
Responder
Rate
Positive
Responders
Responder
Rate
Difference
ITT 121/170 71.2% 49/79 62.0% 9.2 p=0.1877
mITT 121/163 74.2% 49/79 62.0% 12.2 P=0.0714
As Treated 120/162 74.1% 50/80 62.5% 11.6 p=0.0735
Per Protocol 118/155 76.1% 43/65 66.2% 10.0 p=0.1362

Key additional findings from the clinical trial include:

NeoCart demonstrated statistically significant improvements in pain and function at both one and two years after treatment as measured by changes in the KOOS and IKDC scores.

KOOS pain score (mITT Population)
Change from Baseline
(NeoCart Baseline = 54.0; Microfracture Baseline = 52.4)
NeoCart Microfracture
Visit N Mean N Mean P-Value
3-months 160 24.1 75 22.4 0.0487*
6-months 157 28.6 75 27.0 0.0819
1-year 158 31.4 72 28.7 0.0239*
2-years 87 32.2 34 28.9 0.0080*
3-years 39 34.3 16 30.7 0.1071
* Statistically significant

IKDC subjective knee exam score (mITT Population)
Change from Baseline
(NeoCart Baseline = 40.3; Microfracture Baseline = 40.0)
NeoCart Microfracture
Visit N Mean N Mean P-Value
3-months 159 13.7 76 14.5 0.9686
6-months 156 24.4 74 22.4 0.1572
1-year 158 33.1 71 28.3 0.0126*
2-years 87 35.3 34 30.2 0.0366*
3-years 38 39.9 16 32.6 0.2691
* Statistically significant

NeoCart, the most advanced therapy from Histogenics restorative cell therapy platform, is functional cartilage that combines breakthroughs in bio-engineering, biomaterials and cell processing to enhance the autologous cartilage repair process.  NeoCart, which is one of the most rigorously studied restorative cell therapies for orthopedic use, merges a patient’s own cells with a fortified three-dimensional scaffold designed to accelerate healing and reduce pain.  NeoCart’s ability to function like cartilage at the time of treatment may enable patients to return to work and daily activities more rapidly than currently available treatment options such as microfracture.

Histogenics is in the process of requesting a meeting with the FDA to discuss the data and a potential BLA submission.  In addition, Histogenics intends to present the complete study results at upcoming medical conferences and will seek to have the data published in one or more peer reviewed journals.

Conference Call and Webcast Information

Histogenics management will host a conference call on Wednesday, September 5, 2018 at 8:30am EDT.  A question-and-answer session will follow Histogenics’ remarks.  To participate on the live call, please dial  (877) 930-8064 (domestic) or (253) 336-8040 (international) and provide the conference ID 8764946 five to ten minutes before the start of the call.

To access a live audio webcast of the presentation on the “Investor Relations” page of the Histogenics website, please click here. A replay of the webcast will be archived on Histogenics’ website for approximately 60 days following the presentation.

About Histogenics Corporation

Histogenics (Nasdaq:  HSGX) is a leader in the development of restorative cell therapies that may offer rapid-onset pain relief and restored function.  Histogenics’ lead investigational product, NeoCart, is designed to rebuild a patient’s own knee cartilage to treat pain at the source and potentially prevent a patient’s progression to osteoarthritis.  NeoCart is one of the most rigorously studied restorative cell therapies for orthopedic use.  NeoCart is designed to perform like articular hyaline cartilage at the time of treatment, and as a result, may provide patients with more rapid pain relief and accelerated recovery as compared to the current standard of care. Histogenics’ technology platform has the potential to be used for a broad range of additional restorative cell therapy indications.  For more information on Histogenics and NeoCart, please visit www.histogenics.com.

Forward-Looking Statements

Various statements in this release are “forward-looking statements” under the securities laws.  Words such as, but not limited to, “anticipate,” “believe,” “can,” “could,” “expect,” “estimate,” “design,” “goal,” “intend,” “may,” “might,” “objective,” “plan,” “predict,” “project,” “target,” “likely,” “should,” “will,” and “would,” or the negative of these terms and similar expressions or words, identify forward-looking statements.  Forward-looking statements are based upon current expectations that involve risks, changes in circumstances, assumptions and uncertainties.

Important factors that could cause actual results to differ materially from those reflected in Histogenics’ forward-looking statements include, among others:  NeoCart’s potential as a treatment for knee cartilage damage; expectations regarding the timing and success of discussions with the FDA regarding the submission of a biologics license application for NeoCart; the timing, associated expenses and ability to obtain and maintain regulatory approval of NeoCart or any product candidates, and the labeling for any approved products; the market size and potential patient population in markets where Histogenics’ and its partners expect to compete; updated or refined data based on Histogenics’ continuing review and quality control analysis of clinical data; the scope, progress, timing, expansion, and costs of developing and commercializing Histogenics’ product candidates; the ability to obtain and maintain regulatory approval regarding the comparability of critical NeoCart raw materials following its technology transfer and manufacturing location transition; Histogenics’ expectations regarding its expenses and revenue; Histogenics’ ability to obtain additional debt or equity capital and other factors that are described in the “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” sections of Histogenics’ Annual Report on Form 10-K for the year ended December 31, 2017 and Quarterly Report on Form 10-Q for the quarter ended June 30, 2018, which are on file with the SEC and available on the SEC’s website at www.sec.gov.  In addition to the risks described above and in Histogenics’ Annual Report on Form 10-K and Quarterly Reports on Form 10-Q, Current Reports on Form 8-K and other filings with the SEC, other unknown or unpredictable factors also could affect Histogenics’ results.

There can be no assurance that the actual results or developments anticipated by Histogenics will be realized or, even if substantially realized, that they will have the expected consequences to, or effects on, Histogenics.  Therefore, no assurance can be given that the outcomes stated in such forward-looking statements and estimates will be achieved.

All written and verbal forward-looking statements attributable to Histogenics or any person acting on its behalf are expressly qualified in their entirety by the cautionary statements contained or referred to herein.  Histogenics cautions investors not to rely too heavily on the forward-looking statements Histogenics makes or that are made on its behalf.  The information in this release is provided only as of the date of this release, and Histogenics undertakes no obligation, and specifically declines any obligation, to update or revise publicly any forward-looking statements, whether as a result of new information, future events or otherwise.

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