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Biotech / Medical : Genzyme Tissue Repair (GZTR) -- Ignore unavailable to you. Want to Upgrade?

To: Bob Jagow who wrote (2030)	7/20/1998 12:26:00 PM
From: lwd	Read Replies (1) \| Respond to of 2553

Bob: My husband has had the Carticel surgery and is an M.D.. When I read the passage that you quoted, my impression was that the author had incomplete knowledge of his subject, was comparing apples and oranges, and that his opinion should be taken with a grain of salt. The knee can be injured in many different ways: defects (potholes) in the cartilage covering the end of the femur (thighbone), tears in the meniscus, tearing of the ligaments in the knee, injuries to the tibial plateau ( the top of the lower leg bone on which the knee rests). Carticel is for holes in the cartilage at the end of the femur, to pass these injuries off as "small rents" is to understate the pain and disability they cause, and to imply that there is not a very large number of this type of injury in the populace. The defects is my husband's cartilage were quite large (his physician, Dr. Minas, referred to one of them as the Grand Canyon); he had been unable to bear weight on his knee for the nine months preceding the surgery and was in a great deal of pain even when sitting or lying down. The surgery was very effective for David. Regarding the size of the market for such defects, it is ample. I think that Robert Barry has provided the numbers in recent posts; those numbers are specifically for defects in the cartilage of the femur and do not include meniscus injuries. The challenge is getting the insurance companies on board and the orthopods educated enough to have confidence in the effectiveness of the procedure so that they will perform it more routinely. The number of companies covering Carticel has been growing strongly the last few quarters. It will be interesting to see on Wednesday how this is translating into the number of actual procedures performed. I don't know about you, but I'm going to be glued to my computer that day.<g> There are a lot of meniscus injuries. Carticel is not made for the meniscus. Other companies are developing such products. Whether they will work or not is far too early to tell. But this is a different market in which to compete. GENZL has not announced that they are working on a prefab meniscus or a matrix grown cartilage, but I would not rule that out in the future. It would seem a logical next step especially since they are working on a way of doing the Carticel procedure arthroscopically. This is all pure speculation on my part. I have no inside knowledge. As an aside to this, I strongly feel that the Carticel procedure is an example where patients should be able to sue their HMO's and insurance companies for pain, suffering, loss of work, etc. for withholding approval for this surgery. There is a large HMO in the DFW area, Harris HMO, which has told at least one appropriate candidate that they will never pay for the Carticel procedure because it costs too much. They don't care that it works and that there are no other good alternatives. They don't care that this person is in a great deal of pain and disability. They care about their bottom line, period. This denial of appropriate care is criminal and should be recognized as such by the laws of our country. If the executives of such companies threaten and whine that such legislation would increase the cost of premiums, perhaps it is time that we insist that they cut their own generous salaries and million dollar bonuses to improve that bottom line, rather than raising premiums.