Ascension and HOPCo partner together to develop a creative musculoskeletal care platform that could expand across the US

The shift to value-based care in orthopedics has fueled the ongoing debate about the appropriate site-of-care for musculoskeletal conditions – ambulatory surgery center (ASC) vs hospital. However, Ascension Florida and Gulf Coast (Ascension), a part of one of the US’ leading non-profit and Catholic health systems, has a broader more inclusive vision to expand musculoskeletal care in their Florida and Gulf Coast area at the highest possible quality.

Ascension’s vision led them to join forces with the Healthcare Outcomes Performance Company (HOPCo), a company that facilitates the shift to value-based musculoskeletal care, and with Southeast Orthopedic Specialists (Southeast), the largest independent orthopedic practice in the Jacksonville area. In July, Ascension and HOPCo signed an agreement to create and develop a continuum-of-care musculoskeletal platform.

Founded in 2012, Enhatch is a privately held venture-backed medical technology company that uses artificial intelligence (AI)-based software solutions to fill in the gaps medical device manufacturers face in enhancing implant design, developing patient-specific instrumentation and integrating communication among enabling technologies. The Company also incorporates machine learning to simplify clinical and logistic workflows for hospitals based on individual patient data through the entire surgical continuum of care.

Facing the prevailing headwinds of the pandemic, the MedTech industry presses on with product innovation and plans for the future. SmartTRAK reports daily on the challenges still ahead, covering all aspects of the Orthopedic market: Extremities, OrthoBio, Spine, Computer Assisted Surgery, Total Joints, Trauma, Soft Tissue Fixation and EU Extremities and Trauma.

The following is just a small sampling of the Orthopedic updates from around the world compiled, reviewed and posted in real time last week by our SmartTRAK analysts. We constantly monitor the worldwide MedTech industry, sifting through the noise to present to our subscribers the most relevant international news, trends, new products, patents, financial data and competitor developments in the global Life Sciences industry.

Tracking the surge of Spine M&A activity during COVID-19.

The med device market downturn related to COVID-19 has led to a notable uptick in M&A activity across the board, with a number of acquisitions that will impact the Spine market.

Recent Deals
Perhaps the most notable deal has been Medtronic's* (MDT) agreement to acquire Medicrea, a manufacturer of custom spine implants, for about €7.00 per share, a premium of 22% over the closing price of shares on July 14. The acquisition is expected to close by the end of 2020.

Although COVID-19 has disrupted the medical device market, with many elective procedures being postponed, SmartTRAK anticipates the Trauma market to recover in 2021 and beyond. We anticipate that US Trauma fracture fixation procedures will be only slighted impacted by COVID-19, resulting in nearly flat YoY growth from 2019 to 2020 and believe that 2021 procedures will return to normal. This will result in 2021 procedural growth rates being inflated at ~10% and 2022 experiencing normal growth trends as volumes begin to stabilize. 

While reverse TSA has grown in popularity, is it always the best option?

Reverse total shoulder arthroplasty (RTSA) was a hot topic during the Current Concepts in Joint Replacement (CCJR) Spring 2020 meeting, held virtually due to the COVID-19 pandemic. Several Orthopaedic Crossfire discussions revolved around RTSA, and surgeons debated several issues, including whether RTSA should be the standard of care for glenohumeral arthritis. The reverse shoulder market segment comprised 54.6% of US Shoulder Market revenue in 2019, compared to 37.1% for anatomic shoulders, according to SmartTRAK estimates.

The latest intel suggests the spine market is rebounding more quickly than expected, but certain new market dynamics will persist.

While much remains up in the air, early data suggests the spine market is rebounding more quickly than expected. Surgeons are beginning to perform cases that were postponed through March and April due to COVID-19. In conversations with WFS analysts,  NuVasive* (NUVA) management reported a mix of both deferred cases and new volume in May. NUVA’s spine business reportedly tracked ~50% below pre-COVID levels in May versus ~70% below in April. The Company’s current trajectory and consensus expectations for the quarter implies a recovery in procedure volumes to 35% below pre-COVID levels in June according to  WFS NUVA: Takeaways From The 2020 “Virtual” Bus Tour Report. Similarly, Canaccord Genuity estimates  Alphatec’s* FY20 US revenue will be down –9.7% YoY with an estimated -45.6% drop in Q220 sales. This assumes the impact from COVID-19 started in mid-March, April revenues were down ~60-70%, and notable improvement began in early May as more states resume procedures.

Strong start in Q120 was negatively impacted by the double whammy of postponed elective procedures and lag in capital equipment purchases as the result of the COVID-19 pandemic.

While adoption of robotics and other enabling technologies was gaining significant momentum quarter over quarter through year-end 2019, delays in elective spine surgery due to the COVID-19 pandemic resulted in declines in capital equipment sales and fewer computer-assisted spine surgeries in Q120. However, these declines are expected to be temporary and improve as surgeries rebound through the end of the year and into 2021.

Among the many topics covered in the comprehensive Q120 CAS Spine Market Recap* are:

COVID-19 halts the Trauma Market’s Q120 growth, leading to a -2.8% YoY decline globally.

Q120 was tracking as a stable quarter for the US Trauma Market, following Q419’s +3.8% growth, however, this was interrupted in mid-March by the COVID-19 pandemic. The US Trauma Market was down -1.2% YoY for the quarter, with WW revenues declining -2.8%. The non-elective trauma market experienced a reduction in trauma admissions due to the decrease in daily activities and limited driving for most of the US.

Among the many topics covered in the comprehensive Q120 Trauma Market Recap* are:

Spine’s solid start to Q120 was derailed in March by COVID-19, leading to a -10.6% YoY decline globally.

Q120 reporting gives us the first glimpse into the effect of COVID-19 on the spinal hardware market, with the impact in the US felt starting in mid-March. A multi-dimensional survey of 902 spine surgeons around the globe revealed that 67.1% of respondents saw the cancellation of greater than 75% of their surgical cases per week in late March/early April. Global Spine J.

The WW Spine Hardware market experienced a -10.6% downturn in the quarter, with the US down -11.2%. Several companies noted they were tracking for strong Q1 growth prior to the pandemic. At the end of February, SeaSpine* reported that it was looking at another quarter of double-digit US growth, but ended up with a slight overall decline in Q1 US revenue due to March procedures being down an estimated -18% vs March 2019. 

Among the many topics covered in the comprehensive Q120 Spine Market Recap* are: