Cook Medical Fares Well, Continues Double-Digit Growth

Cook Medical achieved double-digit growth and reached $1.5 billion in annual sales, and is continuing to build up its global reach with several manufacturing facility expansions and worldwide product launches. This year, the company made significant investments in its manufacturing sites in Ireland ($25 million euros), Australia, Denmark, and Shanghai, and is expanding Cook Pharmica by 100% and Cook Urological by 50%. Cook also opened new offices in Japan and acquired shonin, which enables the sale of the company's products in that country.The meeting focused on Cook's Peripheral Intervention and Aortic Intervention strategic business units (SBU). The company continues to achieve strong success by maintaining its basic core philosophy of working directly with physicians to create new products (as opposed to growth via acquisitions), said Rob Lyles, vice president and global leader of Cook's Peripheral Intervention SBU. For 2008, he projected up to 15% growth for the SBU and forecasted 20% growth for 2009. Within peripheral intervention, Cook holds the #1 and #2 place in inferior vena cava (IVC) filters (30% global market share), embolization coils, and accessory devices (29% global market share). The company's main competitors in this space are publicly-held Boston Scientific, Cordis, Abbott, Terumo, and Bard.Lyles sees a huge opportunity for Cook's convergent technologies in 2009. In September, the company completed enrollment for an international clinical trial involving its Zilver PTX, a drug-eluting peripheral vascular stent. While companies like Cordis and Abbott have expressed interest in this space, Lyles is confident that Cook will be the first to market and anticipates a product launch in Europe early next year. He called the 12 month data on the stent "awesome" and is awaiting the 18 month results.Another market opportunity for convergent technology is in the prevention of catheter-related bloodstream infections. With CMS no longer reimbursing for the condition (it is considered a "never event"), hospitals need to get serious about preventing these infections, said Lyles. He added that Cook's Spectrum PICC line (peripherally inserted central venous catheter) has the potential to be a disruptive technology in this area.Cook's hold on the endovascular aneurysm repair (EVAR) market remains strong as well. Of the $1 billion EVAR market, Cook has 35%, according to data cited by Phil Nowell, director and global leader of the company's Aortic Intervention SBU. Gore comes in second with 30% and Medtronic third with 27%. Although Cook holds the top spot in this arena, Nowell recognized several significant barriers to market--rising R&D and regulatory costs, issues related to royalties and intellectual property, and profitability challenges with the rising cost of manual production.