The Voice in the Ear -- Burt's Blog
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June 2005 Archives:
June 23» Physician Developed & Monitored
June 22» Dear Fool
June 21» Stent Trials

June 23, 2005

"Physician Developed and Monitored"
That's what the tag line at the bottom of every web page on "" states. So what's a patient to think when they go to the Angioplasty article and the first thing they see is::

Yes, right under the article title "Angioplasty", but before the actual text, is an ad like the one above -- and yes, there's a small disclaimer link below it -- but it's the boldest thing you see on the page, and it's selling you the 21st Century equivalent of snake-oil. "Clean up your arteries with a liquid EDTA system". My body, my Chevy! Hold the stent and pass the Drano!

Sure, it's a free country. But my question is why CardiologyChannel places ads for unproven, unregulated, no prescription needed "remedies" in such prominence (we get patients writing in to our site, asking if such remedies are valid or scams). I'd also have to assume that since these types of ads run regularly, then someone's making a buck on this stuff (I've written more extensively about these pool-cleaner remedies in an earlier post). It's one thing to get these ads on search engines, etc. but quite another when seen in the context of patient education that is "physician developed and monitored". It would make you think that someone with letters after their name thinks this stuff might work.

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June 22, 2005

Dear Fool

Your piece about the J&J patent trial in today's Motley Fool, titled "Stent Wars: Jury Strikes Back", is just pushing the George Lucas thing beyond the point of interest (only George Lucas is allowed to do that, and he has). I mean your previous "Stent Wars" articles (Revenge of the Bypass and The Market-Share Menace) have appeared over the past year or so, but I first used the analogy way back in 2002 in my feature on Drug Eluting Stents, specifically to describe litigation and patent disputes. Therefore I claim damages for analogy copyright infringement! But having no high-powered legal team, I'll just use up the remaining three episodes and be done with it.

"Attack of the Clones" -- definitely coming soon to a cath lab near you. Medtronic, Abbott, Conor and more have drug-eluting/coated stents in trials and are looking for European launches in the next year or so.

"Return of the Jedi" -- In the early 60's, angioplasty Knights Bill Cook and Charlie Dotter met at a radiology conference in Chicago and out of this encounter came the guide wires and catheters that began this whole field of medicine -- but angioplasty started in the leg. Thirty years later Cook manufactured the first FDA-approved coronary stent, co-invented by Gary Roubin and Cesare Gianturco. Cook bowed out of the coronary business last year, but now has a peripheral paclitaxel stent in clinical trials that may prove to alleviate the symptoms of Peripheral Artery Disease (PAD) that have so far resisted both surgical and interventional therapies. Feel the Force.

And last, but it actually was first, "A New Hope" -- I believe that in the short run, bioabsorbable stents will be developed to do all the helpful things that metal stents now do (repair dissections, keep arteries propped open, keep arteries from restenosing) but will over time be absorbed into the tissue so that any late term lingering effects and threat of stent thrombosis will disappear. And then molecular biologists will discover the cause of vascular narrowing and prevent this disease that has become the number one killer.

By the way, Fool, some thoughts on your closing comment that there is concern about Boston Scientific's Liberte stent getting blocked from the market by J&J. In today's New York Times, Barnaby J. Feder opines that this could antagonize doctors and so there is a pressure to work out a financial agreement. I would add: can you imagine what might happen when patients (oh yeah, them!) found out that they can't be given a potentially superior second-generation stent because of a patent dispute. It won't be pretty.

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June 21, 2005

Stent Trials: You Know, The Kind With Lawyers...
At the March ACC, we got results from the clinical stent trials: the Taxus and Cypher drug-eluting stents from Boston Scientific and Cordis went head-to-head. Which was better?

But today the question was "which was first?" and a different kind of stent trial came to a conclusion in a courtroom in Wilmington, Delaware. After only three hours, the jury delivered a verdict in a much-awaited patent infringement case. And they found that Boston Scientific's stents (the Express, the Taxus and the new Liberte) all infringed on two patents owned by J&J / Cordis. Earlier this year, an earlier Boston Scientific stent, the NIR, also was found to infringe on the Palmaz-Schatz patent owned by Cordis.

Oh yeah, that NIR stent -- it was actually manufactured by Medinol, an Israeli company privately-held by Judith and Kobi Richter; the NIR was distributed exclusively by Boston Scientific -- until the relationship fell apart -- and yes, that lawsuit starts on Monday. It's full of bitterness and somewhat personal -- the Richters feel that Boston Scientific dealt with them in bad faith and Boston's fear was that the Richters might suddenly slow down the manufacturing supply if they weren't happy with the way things were going. And then there's "Project Independence", a secret company set up in Dublin by Boston Scientific to reverse engineer the NIR stent so they could manufacture it themselves if they had to.

And then there's the money. Damages to Boston Scientific on the Cordis suit may reach a billion bucks. The Richters also asked for a billion bucks during mediation, but Boston Scientific reportedly offered them $800 million; they said "no"! Can't we all just get along?

Think you're finished? Boston Scientific is suing J&J / Cordis because they say the drug-eluting coating on the Cypher stent violates a patent (called the "Ding" patent) that Boston Scientific holds. That trial starts tomorrow.

Mom and Dad, you were right. I should have been a lawyer!

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