Zimmer Biomet Holdings, Inc.
Zimmer’s robotics platform, ROSA, is currently available for knee surgery only but, say both management and Wall Street analysts, will be ready for spine surgeons in the first quarter of 2020.
How do Wall Street’s analysts think it stacks up against market leaders Globus and Medtronic?
Wells Fargo’s Biegelsen and Singh, wrote that timelines for ROSA in spine had been pushed back “due to instrument integration and the company’s focus on manufacturing of ROSA TKA (total knee arthroplasty), which is built on the same line as ROSA spine and brain. The instrument integration required software changes to improve workflow and is complete.”
ROSA is made in in Montpellier, France, although Zimmer will eventually be manufacturing the systems, at least in part, in Memphis.
Finally, according to Wells Fargo, Zimmer’s bionic arm offering, WalterLorenz® Surgical Assist Arm, is being well received and, at an ASP of under $100k, a very affordable alternative to other robotic arms.
Other Trends at NASS
Aside from the public company meetings, Cantor’s Bijou picked up on three important trends:
First, the rising importance of spine surgery in the ambulatory surgery (ASC) setting. According to Bijou, “The number of spine procedures performed in the ASC setting continues to increase. We expect the emergence of the new wave of enabling technologies to facilitate more minimally-invasive surgeries, lowering the risk of complications and allowing for those procedures to be done outside of the hospital.”
Second, 3D-printed implants. Bijou certainly noted the hype, but as he wrote to clients, “3D implants have become somewhat ubiquitous across spine, as most of the larger spine companies now have their own implants. The companies are talking up the implants’ unique characteristics, such as porosity or shape, which drives better bony ingrowth, but we are not sure there is a meaningful difference.”
Lastly, Bijou raised the prospect of a renaissance in cervical disc replacement implants. In his view, “The cervical disc market has largely been out of favor since its pinnacle when LDR Spine, maker of the Mobi-C disc, was acquired for $1B by Zimmer Biomet.” But may be ready to come roaring back on the basis of a number of factors specifically:
- “Centinel Spine and Simplify Medical, are both investing or will soon invest in clinical trials.”
- “Centinel Spine acquired the full Pro Disc portfolio from JNJ (NC) in 2017 and expects to start clinical trials with new discs soon.”
- “Simplify Medical has completed four of its six PMA modules and next steps would be to submit for approval for one-level and two-level, likely in 2020.”
- “Additionally, OFIX received approval for its M6 cervical disc (acquired from Spinal Kinetics [private] in 2018) and has recently expanded its launch. MDT has also called out the success of its Prestige LP cervical disc.
As a result, said Bijou, the cervical disc market may be accelerating in 2020 and beyond. For the record, Bijou pegged the U.S. cervical disc market at $200+MM, growing mid to high teens.
