Neurotech Professionals Discuss Future at Cleveland Clinic Innovations Summit

by James Cavuoto, editor

More than 800 neurotechnology industry representatives, clinicians, and researchers attended the Cleveland Clinic 2006 Medical Innovation Summit in Cleveland, OH earlier this month. This year’s event was devoted to the neurosciences and the event featured a number of presentations and panel discussions from neurosurgery, neurology, psychiatry, neuroimaging, and other departments at the institution.

One of the most valuable and unique elements of this conference was the live surgery presentations, which featured two-way video feeds from four different operating rooms at the Cleveland Clinic. Attendees were able to interact in real time with surgeons—and patients—undergoing surgery for implantation of bilateral and unilateral deep brain stimulation systems, a spinal cord stimulation system, and an intrathecal pump. Ali Rezai, a renowned neurosurgeon at the Cleveland Clinic, moderated the discussion while the surgeries took place.

Rezai later moderated a panel of executives from the neuromodulation device industry, which included Christopher Chavez from ANS/St. Jude Medical, Richard Kuntz from Medtronic, Alan Levy from Northstar Neuroscience, Ed Northrup from Advanced Bionics/Boston Scientific, and Tim Surgenor from Cyberkinetics.

Kuntz listed as key technology developments miniaturization, anti-microbial coatings, sensing capabilities, and programming enhancements to neuromodulation devices. Chavez predicted that neuromodulation would become the “gold standard” of treatment for Parkinson’s disease and other disorders. Levy noted that some of the barriers currently confronting implanted stimulation devices would break down as they got better and smaller, reducing the stigma to the patient. Northrup said the industry would need to break down the treatment “silos” within institutions, and increase communication across clinical specialties.

Another productive session at the summit featured four pairs of venture capital professionals and CEOs from their portfolio firms. These included executives from Concentric Medical and their investor New Enterprise Associates; NeuroPace and Kleiner Perkins; BioNeuronics and Foundation Medical Partners; and Saegis Pharmaceuticals and Technology Partners.

During the session BioNeuronics CEO John Harris gave some preliminary though sketchy details of his firm’s closed-loop treatment for neurological disorders, indicating that the company would exploit large databases of EEG data for seizure prediction in a device targeting the epilepsy market.

NeuroPace CEO Frank Fischer said that clinical trials with neuro devices are more difficult than cardiac device, adding that his firm will have spent $160 million by the time of its IPO. Andy Firlik from Foundation Medical Partners said that the “individualization of therapy” represented a unique opportunity for neuro device vendors, enabling them to address the issue of whether a given intervention works in an individual patient, as opposed to a population.

Clinical trials and the regulatory approval process was a much-discussed issue at the conference. Though many participants voiced support for evidence-based medicine, several panelists and attendees were openly critical of the FDA’s requirement for randomized control trials, which they said are better suited to pharmaceutical therapies. Rezai mentioned that there needed to more emphasis on the economic benefits of neuromodulation compared to a lifetime of medication, and on quality of life issues for device recipients.

Reimbursement was another major theme at the event, and several presenters offered their perspective on the problem. Former U.S. Senator David Durenberger, who currently chairs the advisory board for the Medical Technology Leadership Forum,S gave attendees a glimpse of the policy making process in Washington, D.C. Referring to a $29 billion “medical arms race,” Durenberger pointed out that technology is growing faster than the health system’s capacity to maximize its value.

Larry Glasscock, CEO of medical insurance giant WellPoint, pointed out that healthcare spending was slated to double by 2015, representing 20 percent of U.S. GDP, and highlighted his firm’s efforts to reduce costs without sacrificing quality, restricting choices, or shifting costs elsewhere. Among his priorities were evidence-based medicine, patient-centered practice, and consumer-driven health plans.

Though the conference was dedicated to neurosciences, it featured presentations from experts from other disciplines. On the opening day, futurist and inventor Ray Kurzweil spoke about how neuronanotechnologies will lead to the melding of mind and machine. James Tobin, CEO of Boston Scientific, gave a luncheon talk about how his firm handled the acquisition of Guidant Inc. And Sanjay Gupta, senior medical correspondent for CNN, spoke in a wrap-up session on the final day of the summit.