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BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
BioEntrepreneurship: Life Science Business Models
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BioEntrepreneurship: Life Science Business Models

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Speakers:
Paul Chipperton, Vice President, Business Development & Marketing, matREGEN
Nina Chagnon, Director of Business Development, MaRS Discovery District
For more information and the webcast link: http://www.marsdd.com/Events/Event-Calendar/BioEntrepreneurship/2007/business-models-12192007.html

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  • Transcript

    • 1. Life Science Business Models
    • 2. Agenda:
      • The State of Pharma industry
      • Brief History of Biotech Industry
      • Pharma/Biotech Models
      • Diagnostics Models
      • Medical Device Models
      • Convergence Examples
    • 3. Agenda:
      • The State of Pharma industry
      • Brief History of Biotech Industry
      • Pharma/Biotech Models
      • Diagnostics Models
      • Medical Device Models
      • Convergence Examples
    • 4. Generations of Drug Discovery Source: Burrill & Company, Life Sciences: A Changing Prescription
    • 5. Stringent drug development funnel
    • 6. Risks and Uncertainty of R&D Source: 2001 Nature Publishing Group biotech.nature.com
    • 7. Pharma’s Blockbuster focus LMITED EXTENSIVE Cost Controls (pricing, access, volume) “ Wasteland”
      • High genetics penetration
      • Very limited unmet need
      • Weak pricing/limited access
      “ Market at Risk”
      • Significant genetics available
      • Limited unmet need
      • Pricing and access at risk
      “ Attractive Growth Potential”
      • Limited genetics in mid-term
      • Significant unmet need
      • Pricing likely to hold
      Oncology HCV Alzheimer’s Immunology/RA HIV Depression Neuropathic Pain COPD Diabetes High Cholesterol Hypertension Nociceptive Pain Anti-ulcer Asthma Anti-infectives (outpatient) Unmet Need LOW HIGH United States Japan UK Germany Canada Italy France Spain Russia India China Total 2005 Sales by Geo ($B) 252 16 19 32 14 20 30 15 5 6 12 *Source BCG Analysis
    • 8. Blockbuster Model: Issues
      • Pharma industry has been based on the blockbuster making it one of the most profitable industries and enabling large R&D spends.
      • Approx 80% of growth of the Pharma industry came from ~ 8 drugs in the last 10 years.
        • However the impact of the recall of Vioxx is an example of how something like this can dramatically decrease revenues coupled with the impact of lawsuits.
        • Growing concern that going forward healthcare will only pay for 1-2 drugs in each class.
        • Severe reduction in revenues in coming years as most blockbusters are coming off patent and replaced by generics ( $82B loss in revenue in 2007 alone)
      • Pharma currently suffering from innovation “dry spell”: few blockbusters in pipeline
      • Costs of development and difficulty to bring drug to market increasing
      • Large pharma in cost cutting mode ( out sourcing as much as possible)
      • Discussion model needs to be completely reviewed (e.g personalized medicine)
        • Future drugs will be based on smaller markets and more targeted therapies in hopes to protect themselves from damaging effects of recalls.
        • There is a shift away from blockbusters. Only 33 of the top 200 drugs are of blockbuster status.
        • This will call for more stream lined approach to R&D with a focus on fewer disease areas and more strategic partnerships.
    • 9. Pharma R&D goes “off balance sheet”
      • Pharma has increasingly been seeing its R&D spending going up but its R&D productivity dropping ( i.e fewer drugs coming out of pipeline)
      • Pharma R&D spend starting to take a toll on its earnings
        • More and more R&D investment but no new sales!
      • As public companies, pharma values are determined by a multiple of their earnings.
        • The higher the earnings, the better the value!
      • Pharma therefore increasingly motivated to do “off balance sheet” R&D
        • Shift the risk of R&D to biotech
        • Have VC cover the cost
        • Cherry pick what they want when they want it….
    • 10. Agenda:
      • The State of Pharma industry
      • Brief History of Biotech Industry
      • Pharma/Biotech Models
      • Diagnostics Models
      • Medical Device Models
      • Convergence Examples
    • 11. Brief (…very brief) History of Biotechnology Industry
      • Originally based on recombinant DNA technology to make human proteins
        • rInsulin, EPO, tPA, G-CSF, HGH
      • Started in San Francisco (Genentech ‘76) and Boston (Biogen ‘78). Today these areas still have the largest biotech clusters.
        • Today’s top biotech companies were the early pioneers and rival large pharmas as FIPCOs
          • Genentech, Amgen, Biogen Idec, Genzyme, Chiron (now Novartis)
      • High risk - High reward with long development cycle (10 years+)
      • Pharma didn’t have skills to do biotech and feared FDA approval, so mainly watched to see what biotech could do for them…
        • Roche was an exception and bought 56% of Genentech in 1990
      • Biotech tools began to help pharma drug discovery and development seeing the start of the biotech boom ( 1980s) and muddying of boundaries between the biotech and pharma worlds
    • 12. Biotech Today
      • Regulatory approval for biologics challenging, but have seen slightly higher approval rates than NCEs recently.
      • Biologics drugs still largely protected from generics, but being challenged hard…
      • Biotech responsible for both research platforms for pharma as well as drugs development on its own.
      • Pharma increasingly buying up biotechs large ( Merck and Sirna, AZ and MedImmune for $1B plus) and small ( Pfizer and Coley for $164M) in order to fill both pipeline and bolster research platforms needs…
    • 13. Agenda:
      • The State of Pharma industry
      • Brief History of Biotech Industry
      • Pharma/Biotech Models
      • Diagnostics Models
      • Medical Device Models
      • Convergence Examples
    • 14. No one model….
      • The biotech industry is not really characterized by specific business models; and neither is there one single model for success.
      • Enormous diversity and innovation driven makes predicting future development difficult.
      • Biotech “flexibility” is a strength that has helped them survive
        • In years of crisis, companies have managed to reorient themselves, change their business model or even switch market.
      • Regardless of model, common themes exist:
        • Strong IP
        • Regulatory Strategy
        • Commercial relevance
        • TALENT!!!
          • VCs often invest in jockey rather than horse
    • 15. Value Chain and Business Models
      • A business model typically consists of three components:
      • Value proposition : the benefit that clients and partners might have from doing business with a certain company
      • Value chain structure: describes the value creation chain and the different steps involved, i.e. the path from the idea and concept to the final product or service.
      • Revenue generation model: how revenue is generated. This means that future revenues of the company determine the value of the business model and its sustainability.
        • Sales of own drugs
          • Co-marketing
        • Royalties from drugs you developed but sold by others
        • Services
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING SALES/ MKT’ING/ DIST’ION
    • 16. Fully Integrated Pharma Company (FIPCo)
      • Value Proposition:
      • The experts in bringing drugs from bench to market.
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING SALES/ MKT’ING/ DIST’ION
      • Value Chain:
      • Have strengths in at every level of the development chain.
      • Revenue Generation Model:
      • Out license first few compounds to gain revenues then selectively bring to market certain compounds
        • Usually in indication and geographies with manageable distribution
    • 17. Fully Integrated Pharma Company (FIPCo)
      • Rare for newer biotech today except in some niche areas ( ex Gilead)
        • Today FIPCo biotech are original players.
      • Very challenging for start-up
        • Timeline to build expertise and capacity too long
      • Large existing biotech FIPCos suffering same challenges as large pharma ( i.e dry pipeline, reduced innovation, increased cost of development)
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING SALES/ MKT’ING/ DIST’ION Skills Needed Financing
      • Biotech: Amgen, Genentech, Biogen Idec,
      • Valera >Indevus ( urology and endocrinology)
      Examples
      • Need skills across the value chain, although increasingly much is being outsourced.
      • Deep pockets to run expensive Phase III clinical trials, and extensive sales and marketing operations.
      • VCs would probably find time to ROI too long…
    • 18. Virtually Integrated Pharma Company (VIPCo)
      • Value Proposition:
      • The experts in bringing drugs to the global market through greater operational flexibility
      • Rent…. Don’t own!
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING SALES/ MKT’ING/ DIST’ION
      • Value Chain:
      • Strong but very lean management team that outsources most if not all aspects drug development, manufacturing and distribution
      • Revenue Generation Model:
      • Own IP and clinically develop drug to point that pharma interested in buying it or sell drug themselves
      Lean Management
    • 19. Research Model
      • Value Proposition:
      • Able to discovery and develop drugs faster, most often in a niche expertise
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING SALES/ MKT’ING/ DIST’ION
      • Value Chain:
      • Usually take drugs to pre-clinical or phase I
      • Revenue Generation Model:
      • License out IP for milestone payments for development , and royalties
    • 20. Research Model
      • The basic model coming out of academia
        • Cost subsidized by Govm’t grants
      • Can be hard to get to Pre Clin package together
        • Easy to find yourself in the “valley of death”
      • Single compound or discovery pipeline
      • You need to be best in class in research
      • Business development
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING Skills Needed
      • VCs don’t “love” it
        • High Risk/ Low return
        • Licensing at earliest valuation
        • Need to be earth shatteringly new to get attention
      Financing
      • Neuraxon
      • Affinium…
      • Trillium
      • Ellipsis Neurochem
      Examples SALES/ MKT’ING/ DIST’ION
    • 21. Platform Model
      • Value Proposition:
      • 1 st Generation: Offering pharma access to research tools that they don’t have expertise in. Requires limited capitalization and potential for quick revenues
      • 2 nd Generation: Hybrid offering services and has own proprietary development program
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING SALES/ MKT’ING/ DIST’ION
      • Value Chain:
      • Most platforms were in drug discovery and early development
        • Genomics, high throughput screening, combinatorial chemistry
      • Revenue Generation Model:
      • 1 st generation platforms: fee for service with modest retained rights and royalty interests
      • 2 nd generation: started to drive own product development off of their own platform ( i.e potential out licensing of compounds for milestones and royalties) in addition to fee for service
    • 22. Platform Model
      • Limited capitalization but limited capital requirements
      • Products/services generate near-term revenues
      • Need multiple alliances to validate platform
      • “ Pick & shovel" - selling picks and shovels to gold diggers
      • After initial wave of interest (no pharma wanted to miss the next big thing)…
        • sales growth decreased
        • technology became largely commoditized
        • addressable market was smaller than anticipated
      • Those companies that rigidly adhered to the fee-for-service model usually failed (e.g. Cadus)
      • The companies that were enduring successes created proprietary development programs
      • Deep Science expertise. Usually affiliated with academia
      • Strong management, strong IP estates, strong balance sheet and ability to adapt
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING DISTRIBUTION Skills Needed
      • Platforms making slight comeback
      • VCs will only invest if they consider platform defensible
      • Need own development program
      • Financing probably more tranched…
      Financing Genomics - Celera, HGS, Millennium Antibodies - Cambridge Antibody, PDL Examples
      • Combinatorial chemistry - Cadus, ArQule
      • RNAi: Sirna, Analym
      1 st Gen. 2 nd Gen .
    • 23. No Research Development Only ( NRDO)
      • Value Proposition:
      • Pick up the innovation past the high risk stage of development and have focus to bring it to market
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING SALES/ MKT’ING/ DIST’ION
      • Value Chain:
      • Phase I to market but often out-license to large pharma for Phase III clinical trials
      • Revenue Generation Model:
      • Licensing and royalties
      • Co-promotion and direct sales ( usually in niche market)
    • 24. No Research Development Only (NRDO)
      • In-license technology developed elsewhere
      • Usually narrow their development to Phase II and Phase III, past the risky research and early clinical stage
      • Focus on developing products then sell to large pharma
      • Often focus on therapeutic indication ( e.g. Cardiac) or distribution channel ( e.g. hospital needs) often given them better focus and speed than large pharma
      • Often develop drugs for smaller indications and markets than of usual interest to large pharma
      • Strong in-licensing and deal making skills
      • Good networks in industry
      • Product development, the ability to identify what the product attributes need to be, where it fits into pharma’s pipeline
      • Development skills ( can outsource)
      • Been there, done that CEO
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING DISTRIBUTION Skills Needed
      • Considered the “risk reduced” model today
      • Very attractive to VC
      Financing
      • Transition Therapeutics
      • Cadence Therapeutics
      • Innovive Pharmaceuticals
      Examples
    • 25. Re-indication/Recovery
      • Value Proposition:
      • Finding new therapeutic uses for advanced compounds, particularly compounds which are very advanced but failed due to poor efficacy in the originally targeted disease. Recover lost assets
      • Finding new indications for drugs whose composition of matter patent has expired/about to expire
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING SALES/ MKT’ING/ DIST’ION
      • Value Chain:
      • Usually Phase II or pre-clin if doing a re-indication.
      • Revenue Generation Model:
      • Platform: Fee for service
        • GeneLogic: Earn success-based payments upon achievement of certain development milestones. Additionally, in the event that a partner returns a drug to the commercial market, the Company is entitled to earn royalties on sales.
      • Drug Dev Co: Sales or Licensing fees and royalties
    • 26. Re-indication/Recovery
      • In-license technology that has failed late stage for reason’s other than tox
      • Find new/better indication and jump into Phase II testing
      • Reduce development time to 2-3 yrs instead of 7-10 from discovery
      • Considered one of pharma’s solutions to its innovation struggles
      • Strong due diligence skills: dealing with known failed drugs
      • Strong in-licensing and deal making skills
      • Good networks in industry
      • Product development, the ability to identify what the product attributes need to be, where it fits into pharma’s pipeline
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING DISTRIBUTION Skills Needed
      • Wall Street seem to like it but VCs appear to be uncertain…
      Financing
      • Gene Logic
      • Aspreva
      • Melior
      Examples
    • 27. Combination Drugs
      • Value Proposition:
      • Derive new value by combining 2 known drugs ( usually generics) for new indication
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING SALES/ MKT’ING/ DIST’ION
      • Value Chain:
      • Phase I for dosing if using 2 approved drugs
      • Revenue Generation Model:
      • Sell back to large pharma
    • 28. Combination Drugs
      • Reduce generic competition, revitalize established brands, fill gaps in product pipelines, and enhance patient compliance
      • Lower regulatory risk but high financial reward because the resulting product comes with new patents that protect it from generic competition
        • Easiest when using 2 known approved drugs. Risk increases if using 1 known and 1 unknown. Risk very high if 2 unknown…
      • However formulating combination drugs not as easy as thought
      • Playing a big role in HiV, CV and other chronic diseases
      • Strong formulation and manufacturing skills
      • Strong BD
      • Stellar reputation of CEO
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING DISTRIBUTION Skills Needed VC not too keen… CPC or TSX-v Financing
      • Pharmas
      • Generics
      Examples
    • 29. Drug Delivery
      • Value Proposition:
      • Assist in delivering drugs to system
        • Existing drugs in novel ways
        • New difficult drugs ( i.e protein, RNA,
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING SALES/ MKT’ING/ DIST’ION
      • Value Chain:
      • Depends on novelty of drug delivery mechanism and drug being delivered
      • Revenue Generation Model:
      • License technology to pharma and collect royalty on sales
      • Sell drug delivery combo directly..
    • 30. Drug Delivery
      • Easiest when aiming to improve existing drugs. Regulatory more complicated if aiming for new drug/new delivery mechanism
      • Best if able to build platform delivery mechanism I.e drug delivery technology that could be applied to multiple drugs types in multiple indications
      • Used by big pharma to extend life cycle of soon to be off-patent drug ( eg time release formulas, injectable to oral )
      • Can license technology to multiple pharmas
      • However royalty rates often lower than expected
      • Chemistry
      • Pharmacology
      • Physio/Chem properties for each drug niche
      RESEARCH PRE CLINICAL CLINICAL PHASE I CLINICAL PHASE II CLINICAL PHASE III MANU- FACTURING DISTRIBUTION Skills Needed
      • Don’t love it… unless solve real problem ( e.g protein, iRNA )
      • Royalties often low and far out on horizon, IRR often low…
      Financing
      • Gastric Retention: Depo Med ( one a day metformin for type 2 diabetes and ciprofloxacin for urinary tract infections )
      • Protein Delivery: Nektar Therapeutics ( inhaled insulin)
      • Microspheres: Epic Therapeutics ( dry powder inhalers and injectables)
      • Advanced Trans Dermal delivery: Altea Therapeutics ( delivering hydrophilic drugs)
      • BioMaterials: pSivida ( bioSilicon for long-term controlled release of small molecules, nucleic acids/proteins)
      Examples
    • 31. Agenda:
      • The State of Pharma industry
      • Brief History of Biotech Industry
      • Pharma/Biotech Models
      • Diagnostics Models
      • Medical Device Models
      • Convergence Examples
    • 32. Value chain and revenue models
      • There is no clear value chain in diagnostic. Value not easily determined until it reaches market.
        • No “mid point” element such as clinical phases for interim valuation
        • Makes it difficult for VC
        • Business challenge in that valuation is based on multiple of revenue, but early stage diagnostics have no revenues…
        • However time to market shorter
      • Several revenues models
        • License diagnostic test to pharma
        • License biomarker to diagnostic manufacturers
        • Developed and sell diagnostic
          • Reimbursement the biggest issue
            • OHIP , Medicaid, Medicare, large insures ( getting re-imbursement code)
            • Employer
            • Consumer
    • 33. CLIA Model
      • Clinical Laboratory Improvement Act (CLIA) is only in the US
      • Created to help introduce novel diagnostics that weren’t FDA approved.
      • Tests done in large central labs that meet CLIA specification, but no FDA approval
      • Test validity build on research
        • IP based on proprietary biomarker and algorithms
      • Good strategy way of getting product to market directly
        • Novel technologies and smaller markets
        • Lab “sells” test directly to doctors/patients
          • Requires a lot of marketing…
      • Threat of regulatory tightening a risk
        • Large CLIA based companies all pursuing parallel regulatory strategies
      • Examples:
        • Genomic Health
        • Caris Health
    • 34. Diagnostic Device
      • Diagnostic devices are subject to FDA approval ( 510K)
        • Regulatory hurdles take time away from market access during patent life
        • Large lab based devices and Point of Care ( POC)
      • High turn-over in space
        • Constant incremental changes
        • Higher sensitivity and selectivity
      • Value rarely in the “box” but in tests that can be done in “box”
        • Machine often given away with revenue made on sales of tests that can be run on the machine.
          • Razorblade model
        • Challenge for start-up to acquire validated biomarkers to create new tests
      • Examples:
        • Abbot, Roche, Quest, Inverness etc etc…
    • 35. Theranostics: Targeted Medicine and Pharmacogenomics
      • Tools to help researchers identify biomarkers and develop related therapeutics
      • Therapeutics delivered to patients with the right genotype at optimal dosages
      • Targeted therapies market worth $5B in 2004 and expected to reach $20B in 2014
      Source: Ernst & Young
    • 36. Affymetrix GeneChip and Genentech’s Herceptin
    • 37. Agenda:
      • The State of Pharma industry
      • Brief History of Biotech Industry
      • Pharma/Biotech Models
      • Diagnostics Models
      • Medical Device Models
      • Convergence Examples
    • 38. Risk / Return Slope Level of risk/investment Potential Return
      • Improvement,
      • Existing market,
      • Efficiency benefit
      • Class 1
      • Improvement,
      • Existing market,
      • Safety benefit
      • Class 1 or 2
      • New technology
      • New market,
      • Care benefit
      • Class 3
      • Improvement,
      • New market,
      • Care benefit
      • Class 2 or 3
      • Improvement,
      • Existing market,
      • Cost benefit
      • Class 1
    • 39. Medical Technology Market and Technology Matrix Technology New Existing Existing Market New Market Easy to produce and demonstrate Costly and Longer term More costly to produce and demonstrate More costly to produce and demonstrate 1 2 3 4
    • 40. Value Creation Simple innovation – i.e. Safety syringe Idea Early design Initial test Redesign Clinical test Manufacturing prototype Make and sell 0 Need Initial Prototype Approval Proof Value Value demonstrated
    • 41. Value Creation Complex innovation – i.e. Medical electronics Idea Early design Initial test Redesign Clinical test Evaluation prototype Make and sell 0 Need Initial Prototype Approval Proof Value demonstrated Value
    • 42. Agenda:
      • The State of Pharma industry
      • Brief History of Biotech Industry
      • Pharma/Biotech Models
      • Diagnostics Models
      • Medical Device Models
      • Convergence Examples
    • 43. Combination Devices
      • 275 submissions to the newly created FDA Office of Combination Products (OCP) in 2005
      • Includes drug-device, drug-biologic, device-biologic
      • Drug-device combinations valued at $5.4B in 2004
      • Expected to reach $11.5B in 2010
        • $8B from drug-eluting stents
      • Drug eluting stents prevent restenosis
      • Antimicrobial coated surgical mesh thwart infection
      • Drug delivery devices
        • Pulmonary, oral, pumps
        • Exubera, the most recently approved OCP products, is the first noninjectable insulin for treatment of Type 1 and 2 diabetes
    • 44. Angiotech’s Paclitaxel Eluting Stent
    • 45. Pfizer and Nektar’s Exubera

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