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Biotech / Medical : Biotech Lock-Up Expiration Hell Portfolio
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To: tuck who wrote (262)7/13/2001 10:30:24 PM
From: Biomaven  Read Replies (1) of 1005
 
tuck,

<<GERD>>
]
This is an area I follow closely for personal as well as investment reasons. First, this is an absolute epidemic in the US. One hypothesis is that H. pylori incidence is declining sharply, and H. pylori paradoxically reduces acid levels (while causing stomach ulcers).

Second, virtually everyone is currently treated medically. The PPI's work wonderfully, and the initial worries about long-term side-effects seem to have faded. The lap surgery (Nissen fundoplication) is pretty tricky and it's still a fairly major operation, even though much better than the open surgery. There was a recently published retrospective study that showed a mysterious and unexplained increase in long-term mortality in people who've had the surgery, which is now further clouding the picture.

So at this point the "market" has come down in favor of the medical approach. However, there is clearly huge pent-up demand if someone can demonstrate a simple and safe alternative to daily pill-popping for a lifetime.

As far as these "new-fangled" techniques like the Stretta and the "endoscopic sewing machine," my feeling is that it's much too soon to tell. People will only use them in large quantities once they have a much longer track record. You'll get some early adopters now, but the vast majority of doctors and patients will sensibly wait to see how the procedures turn out on others. They'll be looking hard at complication rates, methods of figuring out who is a good candidate, and durability.

Peter
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