Controlling VTE occurrence through medication
After surgery is complete, one way to prevent clotting in patients (depending on the invasiveness of the surgery) is to use a combination of surgery compression stockings on the legs and blood-thinning medications. Of course, physicians need to be careful with the amount of blood thinners they use because anticoagulants can be just as dangerous from the potential of causing unabated bleeding.
The staple of all DVT- and PE-preventing medications up until last year had been Sanofi SA (ADR) (NYSE:SNY)‘s injectable Lovenox, which delivered $2.8 billion in net sales in 2011 but has since fallen in relevance because of the loss of patent exclusivity in 2012. Instead, Momenta Pharmaceuticals, Inc. (NASDAQ:MNTA), in partnership with Novartis AG (ADR) (NYSE:NVS), has been selling a generic version of Lovenox, which it received approval for from the Food and Drug Administration in 2010.
However, both branded and generic Lovenox may cede market share in time to Johnson & Johnson (NYSE:JNJ)‘s Xarelto, which is taken orally instead of injected, and is primed to treat DVT and P/E for high-risk patients, as well as a preventative measure for those who’ve had hip or knee replacement surgery. Sales of the drug have absolutely taken off, rising 266% in 2012, and I suspect with Lovenox now completely off patent, this next-generation all-in-one drug could see sales romp even higher. More importantly, it means improved patient care for the some 900,000 persons with hospital-acquired VTE each year.
Looking down the road, Pfizer Inc. (NYSE:PFE) and Bristol Myers Squibb Co. (NYSE:BMY)‘s Eliquis may unseat all of these drugs. While only currently approved to mitigate the risk of developing a blood clot for patients with atrial fibrillation, Eliquis demonstrated superiority over the placebo in a long-term recurrent VTE study. In the trial, the 2.5mg and 5mg doses of twice-daily oral Eliquis reduced recurrent VTE or death to 3.8% and 4.2%, respectively, from 11.6% for the placebo, after a year. Furthermore, the safety profile was comparable to that of the placebo. Don’t be shocked if this soon-to-be blockbuster adds this additional preventative indication in the future.
Identifying high-risk VTE
The final factor that can help prevent a rise in VTE occurrence is in recognizing which patients are at higher risk for developing VTE. Currently, patients who are predisposed to high-risk VTE are given ultrasounds if they’re suspected of developing DVT, or a CT scan if they’re suspected of developing PE.
One possible diagnostic tool for the future that’s currently being underutilized in many hospitals is genetic or molecular analysis. A quick and cost-effective turnaround in personalized genetic analysis could reveal clues to physicians as to whether someone is more susceptible to clots because of their genetic factors.
The takeaway
While it appears that VTE is simply a risk that surgery patients have to come to terms with, it’s comforting to know that better surgical standards and innovative new blood thinners are being introduced to help curb its occurrence. Hopefully in a few years we can look back and see a major decline in hospital-acquired VTE occurrences.
As an investor, I would be encouraged by the potential that robotic surgical device maker like Intuitive Surgical offer, but I’d keep a close eye on Pfizer Inc. (NYSE:PFE) and Bristol Myers Squibb Co. (NYSE:BMY)’s Eliquis as it has game-changing potential written all over it.
The article This Is the Leading Cause of Preventable Hospital Patient Deaths originally appeared on Fool.com is written by Sean Williams.
Fool contributor Sean Williams has no material interest in any companies mentioned in this article. You can follow him on CAPS under the screen name TMFUltraLong, track every pick he makes under the screen name TrackUltraLong, and check him out on Twitter, where he goes by the handle @TMFUltraLong.The Motley Fool owns shares of, and recommends, Intuitive Surgical, Johnson & Johnson, and Momenta Pharmaceuticals. It also recommends MAKO Surgical.
Copyright © 1995 – 2013 The Motley Fool, LLC. All rights reserved. The Motley Fool has a disclosure policy.
