Full Article Reprinted from Start-Up - September 05, 2008
Find out why investor interest in the urology space waxes and wanes...
Full Article Reprinted from Start-Up - September 05, 2008
European Markets for Benign Prostatic Hyperplasia Therapies
Investor interest in the urology space waxes and wanes; it's attractive because as a niche specialty it has some pretty big patient populations. Benign prostatic hyperplasia (BPH), the benign enlargement of the prostate over time, affects 90% of men by the time they're 80, and half of men at age 60. In Europe, according to European Markets for Benign Prostatic Hyperplasia Drugs, Devices, and Therapies, a report recently published by FDC-Windhover Information's Medtech Insight division, that's 28 million men. But urology goes out of favor from time to time because so many drugs and device therapies that initially looked promising failed to address the majority of BPH sufferers, or worse, caused side effects in a very sensitive part of the body. This cycle of excitement and disappointment goes all the way back to the introduction of Merck & Co. Inc.'s finasteride (Proscar) in the early 1990s, which, far from becoming a multibillion-dollar blockbuster as it was fted, ended up helping only half of the patients who took it.
There are signs that interest in BPH is picking up though, in both the device and pharmaceutical segments. Start-ups continue to find financing; for example, the past few months saw the successful start-up financing of Vantia Ltd. in the UK, which raised $38 million to advance a vasopressin agonist for BPH, and in August 2008, HealthTronics Inc. made an unsolicited $27 million bid for Endocare Inc., developer of a minimally invasive cryoablation platform for BPH.
These companies are operating in a crowded space because the potential market is so large, and because much room remains for improvement. Prescription drugs are typically the first-line therapy for treating mild to moderate BPH, including alpha blockers and 5 alpha-reductase inhibitors. Alpha blockers quickly alleviate lower urinary-tract symptoms by relaxing smooth muscle tissues in the prostate and bladder neck, while 5 alpha-reductase inhibitors relieve symptoms by inhibiting production of dihydrotestosterone to reduce prostate tissue volume. However, compliance is a problem: a large percentage of men stop taking the drugs because of their side effects, which include loss of libido and erectile dysfunction.
Minimally invasive BPH treatments are usually performed on an outpatient basis, and, similar to drug therapy, are symptom-palliating alternatives to prostate surgery. Procedures include transurethral microwave thermotherapy, transurethral needle ablation by radiofrequency, holmium laser ablation of the prostate, and a large variety of other energy-based modalities.
According to the Medtech Insight report, in 2007, nearly 1.8 million men with BPH in Europe were treated with prescription drug therapy, a number that's expected to rise to 2.5 million by 2011, with increases driven by improved medications and drug combinations that will be introduced in coming years. Drug therapy continues to dominate the field, but device therapies will grow rapidly over the next five years.
In 2007, an estimated 27,500 minimally invasive procedures were performed on BPH patients in Europe, and this represents only 0.4% of all BPH patients in Europe, giving device companies a growth opportunity. The volume of minimally invasive therapy procedures in Europe is expected to increase at a compound annual rate of 9.8% to approximately 40,000 procedures in the year 2011.
Mary Stuart
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Companys Mentioned in this Article
Merck & Co.
Endocare,
Healthtronics
