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Articles from 2017 In July


Is There a Method to Stryker’s Mako Madness?

An orthopedic surgeon wanting a Mako Total Knee robot today would likely have to wait about five months before being able to start performing total knee surgeries with the robot. But, there is a method behind Stryker's Mako madness.  

Amanda Pedersen

Stryker certainly can't be accused of rushing its rollout of the robotic-arm assisted total knee arthroplasty application for use with its Mako system. FDA approved the company's Triathlon Total Knee System for the use with the Mako robot in August 2015, but the company made the market wait more than a year for the full commercial launch, which finally happened this past March. Stryker wanted to release the product at a measured pace in an effort to maximize its chance of success.

Now, the company is working through a backlog of new Mako orders and upgrade requests from current Mako customers wanting the total knee application.

Katherine Owen, vice president of strategy and investor relations at Stryker, provided an update on the latest Mako product during the company's recent second-quarter earnings call. She said Stryker installed 26 new Mako robots globally during the quarter, and continued to see "solid uptake" for upgrades. She said she expects all of the U.S. Mako upgrades will be completed by the end of 2018.

"I think the biggest gating item right now is our ability to identify, hire, and train the Mako specialists, who are critical to ensuring that not just the surgeon, but his entire OR staff is prepared to have a really successful experience as they start to adopt the Mako robot," Owen said.

So a surgeon wanting the Mako total knee robot today would be looking at roughly a five-month wait before being in a position to start performing the procedure. That wait time does vary somewhat, CEO Kevin Lobo added, based on the surgeon's location in relation to the nearest Mako specialist.

"The issue isn't us being able to build and get you a robot, the issue is getting you in the queue and getting you trained and through that process as we hire additional Mako specialists," Owen said.

Lobo said the company is prioritizing investment to make sure the wait list is not too long for its customers, and that the pacing is appropriate. But so far, more than 400 surgeons have been trained on the new application and are having "a very good experience" with it, he said.

That training pace has driven utilization of the procedure to more than 5,000 since it was launched, Owen said.

She also said the company continues to collect data comparing the Mako Total Knee to a traditional knee surgery, both using the Triathlon device. These studies are looking at outcome measurements including the length of hospital stay, how soon patients return to work after the surgery, the range of motion in the knee, stability, discharge to rehab time, and patient satisfaction, she said.

"We expect to begin to see some of the data at key orthopedic conferences starting in 2018 and beyond as we track these patients over time," Owen said.

Amanda Pedersen is Qmed's news editor. Contact her at amanda.pedersen@qmed.com.

[Image credit: Pixabay]

Change Is Afoot at NuVasive

Wall Street analysts were shocked by news of the impending departures of two high-profile executives amid a restructuring effort. 

NuVasive surprised Wall Street analysts Thursday with word that two C-suite executives will leave the company as it embarks on a corporate reorganization.

Hours before its second-quarter earnings call, the San Diego-based maker of spine surgery products announced that president and chief operating officer Jason Hannon, a 12-year veteran of the company, is leaving "to pursue other interests." In conjunction with Hannon's departure, NuVasive is implementing changes to its operating structure intended to improve product development and commercialization efforts, integrate U.S. and international sales, and drive operational efficiencies.  

Don't miss MD&M Minneapolis, November 8-9, 2017.

The company also divulged that chief financial officer (CFO) Quentin Blackford is leaving in late August to pursue an opportunity outside of the spine industry, a move it said was unrelated to the reorganization.

"These changes/transitions were unexpected and all came at once, so it is a lot to digest," Leerink analyst Richard Newitter wrote in a research note. "But, ultimately we do not think any of these moves/transitions will necessarily be all that disruptive to [NuVasive's] day-to-day business or sales force."

Blackford, who left Zimmer to join NuVasive in 2009, has served as the company's CFO since 2014 and was well respected by Wall Street analysts.

"While we are disappointed that Mr. Blackford is leaving, we do not believe this is a signal that [NuVasive] is losing momentum or that spinal market trends are deteriorating," RBC Capital markets analyst Glenn Novarro wrote in a July 27 research report. He added that although there may have been some softening in the spine market in the second quarter, RBC attributes the dip to "normal seasonality" and expects it to pick up in the second half of the year. "Moreover, we continue to believe that [NuVasive] will remain a share gainer in the global spine market," Novarro wrote.  

The company reported mixed results in its second-quarter earnings call on July 27, growing constant-currency revenues by 11% year over year but missing Wall Street's expectations by around $1.5 million thanks to lower biologic and neuromonitoring sales.

Although NuVasive's stock plunged more than 12% the following day, analysts seemed to look past the doom and gloom, focusing instead on new product launches--including the LessRay image enhancement platform, expandable interbody cages, and 3-D printed interbody cages--and sales force growth.

"The company added the most net new reps in company history in [the second half of 2016]," Novarro wrote. "These reps should become productive starting in [the second half of 2017]." 

Chairman and CEO Gregory T. Lucier also put a positive spin on the company's second-quarter results.  

"NuVasive delivered better than expected operating profitability and earnings per share results in the second quarter 2017, along with continued strength across our International business, growing at more than 20% for the third quarter in a row," Lucier said in a press release. "In addition, several of our industry-disrupting technologies completed alpha and beta testing this quarter and will commercially launch over the next few months, giving surgeons and patients access to some of the most innovative technologies to address spine and trauma conditions, as well as radiation reduction in the operating room."

Jamie Hartford is director of content for medtech brands in UBM's Advanced Manufacturing Group. Reach her at jamie.hartford@ubm.com.

[image courtesy of STUART MILES/FREEDIGITALPHOTOS.NET]

How Shark Skin Inspired an Antibacterial Surface Technology

Sharklet Technologies has been acquired by a Chinese medical device firm, as it prepares to bring its surface technology into clinical trials.

Kristopher Sturgis

When it comes to truly unique surface technologies, you needn't look any further than the innovative design introduced by Sharklet Technologies Inc., known simply as the Sharklet. Created by Anthony Brennan, chief technology officer and chairman, the technology features a pattern inspired by shark skin and was designed to fend off harmful microorganisms and biofilms. 

This patterned surface, inspired by shark skin, is designed to inhibit bacterial adhesion and growth.

The material is comprised of a highly-ordered series of bars arranged in an interlocking diamond fashion that creates a surface that prohibits microorganisms from attaching to and growing on the surface. Now that the material has undergone several studies, Brennan believes that the material's unique properties will enable it to find a variety of different applications where it can help reduce the accumulation of bacteria.

"Sharklet surface technology basically creates a surface that inhibits bacterial adhesion and growth by limiting the organism from touching the surface through minimizing the available water required," Brennan said. "Our experimental studies demonstrate clearly that bacteria adhesion and biofilm formation is inhibited by the Sharklet microtopography or micropatterns. The potential exists to use the micropattern to reduce the accumulation and transference of the bacteria between surfaces. We are currently evaluating several products that we anticipate will benefit from the use of Sharklet micropatterns."

The company announced at the beginning of the summer that Peaceful Union, a Chinese equity medical device firm, would acquire Sharklet Technologies to accelerate the development of the Sharklet for medical devices where chemical-free inhibition was desired. The recent acquisition also aims to help the company move forward with pilot studies for the material, as well as major clinical trials while exploring other products down the line.

"We have several products that are both in the works, and worth keeping an eye on," Brennan said. "Recently, the Sharklet micropattern was evaluated in a limited clinical pilot study and the results were promising. Pending advisement of the FDA on subsequent trials, a larger clinical trial is planned. In addition, there was an announcement of our application of the microtopography to high-touch surfaces that we anticipate will be available in the near future. Sharklet Technologies is worth keeping an eye on for the many advances that we make each year and the new products to be introduced in the near future."

Brennan created Sharklet technologies back in 2007 when he began a research program at the University of Florida funded by the Office of Naval Research. The program began as a means to investigate the influence of micro patterns on biofouling of marine surfaces, like Naval ships. The research eventually led Brennan to investigate which marine animals did not foul, a search that eventually led him to sharks and their unique structure of denticles.

"The structure represented a roughness that met the needs of my model structure, and so through trial and error, I arrived at the Sharklet pattern," he said. "It was highly effective at inhibiting green algae zoospores, and later, I determined it also inhibited barnacles and tubeworms. Interestingly, the tubeworms I studied required bacterial biofilms for adhesion to surfaces. By trial and error, we discovered that the biofilms were not forming on the sharklet patterns, which led to the discovery that E.coli did not adhere to our Sharklet patterns -- and so we began Sharklet Technologies Inc."

The company has come a long way since, having found numerous applications suitable for the integration of the Sharklet material to help create cleaner surfaces. With the recent partnership with Peaceful Union, Brennan said the material should soon find its way into clinical use.

"I do believe that Sharklet is a technology that will find a place in the clinic," he said. "It is a paradigm shift that requires appropriate levels of testing, validation, and certification for approvals prior to use in the clinic. We are working diligently to meet the rigorous standards of our health systems around the world, and the requirements of regulatory agencies that provide oversight for the safety of all patients. Sharklet Technologies is committed to providing products like Sharklet that help people and the environment by using bioinspired technologies."

Kristopher Sturgis is a contributor to Qmed.

[Image credit: Sharklet Technologies Inc. and Pixabay]

Supplier Stories for the Week of July 23

Here’s what’s new in the world of medical device suppliers during the week of July 23.This is a compilation of the latest news from suppliers in the medical device industry. If you have news you’d like to submit for potential inclusion in this weekly roundup, please send a press release and any related images to marie.thibault@ubm.com with the subject line “Supplier Stories”.[Image courtesy of STUART MILES/FREEDIGITALPHOTOS.NET]

Here’s what’s new in the world of medical device suppliers during the week of July 23.

This is a compilation of the latest news from suppliers in the medical device industry. If you have news you’d like to submit for potential inclusion in this weekly roundup, please send a press release and any related images to marie.thibault@ubm.com with the subject line “Supplier Stories”.

[Image courtesy of STUART MILES/FREEDIGITALPHOTOS.NET]

When Robots Become Specialists

When Robots Become Specialists

Virtual Incision's robotically assisted surgical device is inserted completely into the body to perform colon resection.

In the medical profession, you have generalists and specialists. So too, with robots. Although the generalists--most notably Intuitive Surgical's da Vinci systems--perform the bulk of robotic surgery, procedure-specific systems show promise in areas the require micrometer precision, such as ENT microsurgery, cochlear ear implantation, MRI-guided biopsy, and vitreoretinal eye surgery.

According to an ECRI Institute survey, surgeons performed 570,000 da Vinci procedures worldwide in 2014 alone, most of these (79%) in the United States. However, the systems range from an average quoted price (according to ECRI Institute) of $1.79 million for a da Vinci Si to $2.31 million for a da Vinci Xi dual console. Add in clinician training and machine servicing, and you've got a major investment decision for budget-conscious hospitals.

Specialized robots have the potential to provide a cost-effective solution. Most products in development are a fraction of da Vinci's size, which makes them easier to operate and move between operating rooms. And most come in at less than half the cost.

Smaller components and snake-like instruments give some specialist robots the ability to perform feats not possible before. Medrobotics recently received FDA clearance for its Flex® Robotic System, a shapeable, steerable device, to be used in colorectal procedures. Flex is the first robotic surgical platform to offer ScarfreeTM access to hard-to-reach anatomy in otolaryngology and colorectal procedures.

In September 2016, Robert MacLaren, University of Oxford Professor of Ophthalmology, assisted by Dr. Thomas Edwards, a Nuffield Medical Fellow, used a remote-controlled robot developed by Preceyes BV, a Dutch medical robotics firm, to perform the first-ever robot-assisted eye surgery.

During the retinal surgery, surgeons lifted a membrane 0.01 millimeter thick from the retina at the back of the eye. "Imagine trying to do that with a manual instrument," said Dr. Rob Morgan, vice president, medical for global product development company Sagentia. "The use of robots in eye surgery has opened up new possibilities." 

A robot at the University Hospitals Leuven is used to perform retinal vein occlusion surgery.

In January, eye surgeons at University Hospitals Leuven, in Belgium, became the first to use a procedure-specific robot to perform retinal vein occlusion surgery. Treatment for this condition, which can cause blindness, is currently limited to injections that only reduce side effects. The robot-assisted procedure addresses and treats the cause, a blood clot in a retinal vein.

To dissolve the clot, the surgeon uses a needle that's about 0.03 millimeters in diameter to inject medicine into the vein--which is only 0.1 millimeter wide. "Retinal vein catheterization requires tremor-free microneedle placement for a period of 10 minutes, which is only possible with a specialized robot," said Morgan.

Because robotics hold such promise in eye surgery, Cambridge Consultants developed Axsis, a soda can-sized robot that makes the microscale movements needed for procedures such as cataract surgery. The device uses flexible instruments 1.8 millimeters in diameter. This eliminates the need for large ranges of motion outside the body.

In addition to using articulating instruments, Axsis bases its instruments on a parallel mechanism, which uses several chains to control a single platform. "No motor carries the weight of any other motor," said Chris Wagner, head of Advanced Surgical Systems for Cambridge Consultants. "That means our motors can be a lot smaller. We use a transmission element to connect the motion of the motors to the articulation at the tip of the instrument."

Cataract surgery already has a success rate of 98% or higher, but if a robot, with its tremor reduction and minimally invasive access, could reduce the complication rate by another percent or more, those improved patient outcomes could make the investment worthwhile, especially as health systems adopt value-based care models.

One company with potential to bring a product to market in the near future, Virtual Incision, completed successful in-human use of its miniature robotically assisted surgical device (RASD) in 2016. RASD specializes in colon resection, a procedure used to treat patients with colon polyps, cancerous and precancerous lesions, Crohn's, and other gastrointestinal diseases. The company is currently working toward FDA 501(k) clearance.  

RASD works differently than most, as surgeons insert the entire device into the body through a single abdominal incision. Virtual Incision expects the device to be less expensive and more portable than existing laparoscopic surgery robots, which may make it a more feasible investment for some hospital systems.

About two-thirds of colon resection procedures are performed via open surgery, which involves an eight- to 12-inch incision, and up to six weeks of recovery time. RASD promises to change that.

"If you can remove three to eight days of hospital stay and associated costs, per surgery, the hospital benefits," said Virtual Incision cofounder and chief technology officer Shane Farritor, PhD. "We intend to have cost parity with current manual laparoscopic procedures."

Morgan explained that for any specialist robot to have commercial success, it must provide an added benefit that existing technology can't provide.

"You need it to be used by surgeons who are willing to pioneer new procedures or applications with robots," he said. "The robots also have to be engineered correctly so they perform the right functions."

Morgan added that robotics developers need to prove that the clinical benefit will apply to a reasonable number of patients so the procedures are frequent enough to justify the investment. "Commercial success will be dependent on broader applications in existing vitreoretinal surgery or use in new therapies."

Heather R. Johnson is a freelance writer based in Oakland, California.

[Top image courtesy of VIRTUAL INCISION; Second image courtesy of UNIVERSITY HOSPITALS LEUVEN]

In Pursuit of a Noninvasive Diagnostic for Bladder Cancer

German company numares AG is developing a noninvasive test to diagnose bladder cancer, and executives believe the technology can be used to generate other diagnostic tests. 

Nancy Crotti

A German company has developed a system that uses patients' metabolites to diagnose and monitor certain cancers and indicate the probability of kidney transplant rejection.

The Regensburg company, numares AG, developed magnetic group signaling technology, integrated test-specific software and reagents to perform up to 300 diagnostic tests per day on a qualified nuclear magnetic resonance (NMR) spectrometer.

The company holds the CE Mark for the kidney rejection test, and plans to submit a paper based on the test's technical aspects and clinical outcomes shortly, according to company executives. Numares also recently reported "promising" results from a retrospective study to noninvasively diagnose bladder cancer by evaluating metabolomic biomarker networks.

For the retrospective study, numares evaluated approximately 300 urine samples from patients with and without bladder cancer to identify metabolites that could be developed into a bladder cancer-specific metabolomic network. Based on the results, numares has enrolled patients in a prospective study to confirm and further refine the metabolomic network. The company is pursuing the CE Mark for this in vitro diagnostic test and plans to launch it in Europe next year.

Bladder cancer can be challenging to diagnose. Traces of blood in a urine sample, called microhematuria, are associated with bladder cancer, but only 2% to 5% of patients with microhematuria are diagnosed with bladder cancer, according to a study published in the New England Journal of Medicine by Johns Hopkins University researchers in 2003. Most patients presenting with microhematuria undergo cystoscopy, an invasive test to rule out bladder cancer as a cause.

Zucker

Numares' Axinon NMR technology provides an in vitro diagnostic by separating and quantifying these metabolic biomarkers and then recombining them into one marker that indicates the presence or absence of bladder cancer, according to numares chief medical officer Philipp Pagel.

"That's novel, because typically the physician would be left with a bunch of numbers and would have to make his own ideas about that," Pagel said.

"There is a real medical need for this type of diagnosis," added physicist Maximilian Zucker, chief technology officer at numares.

Numares also developed a machine learning software model to determine which compounds to put into a diagnostic test for a particular disease. In addition to diagnostics, Axinon can perform risk assessment, assess a pathology's origin, indicate the extent and aggressiveness of diseases, monitor therapy, and perform research into physiological processes, according to the company.

Axinon was developed to provide lab personnel with an easy-to-use system standardized to lab requirements. Standardization is essential to lab testing equipment, and achieving that standardization on an NMR took years, Zucker said. The company was founded in 2004 as a spinoff from Regensburg University's biophysics department. It secured a patent that year for a test to determine lipoproteins in body fluids (lipoprotein profiling) and secured the CE Mark for two NMR-based lipoprotein profiling tests in 2015.

The company's system is designed for central labs and large hospital-based labs that can accommodate an NMR machine and afford the price tag of up to $1 million or more for the machine, the software and the reagent kits. Numares had a "positive" non-binding pre-review with FDA at the end of May and is preparing a 510(k) application to submit by the end of 2017, Zucker said. The company would have to submit each test it develops for CE and FDA approval.

Numares is collaborating with Oxford University on the development of a diagnostic test for multiple sclerosis, according to its website. The company has a "broad pipeline" of other tests it is considering for development, Zucker said, including one for early detection of acute kidney injury. 

Numares employs 70 and has offices in Boston and Singapore in addition to its home city in Bavaria. It is in the midst of a second fundraising round and has no plans for another. Zucker declined to reveal how much money the company has raised.

"The important portion is that it's a platform technology. We're not talking about one test; we're talking about a whole pipeline of tests, so the possibilities are very large," Zucker said. "It might become a very long story. You can go further and further and further, and there is no end, actually."

Nancy Crotti is a contributor to Qmed.

[Image courtesy of NUMARES AG]

The Year’s 10 Biggest Medtech Recalls So Far

There have been millions of recalled units for various medtech products so far this year. Here are the 10 recalls that impacted the most medtech product units in the United States.Marie ThibaultWe reviewed FDA's medical device recall database to find the largest device recalls initiated this year. These recalls were categorized as Class I recalls, the most serious type, by the agency.Of the recalled units in the first quarter of 2017, 10% were categorized as Class I recalls, according to a Q1 report from the Stericycle ExpertSolutions Recall Index.The 10 recalls listed here were ranked by the number of units affected in the United States. [Image courtesy of GERALT/PIXABAY.COM]

There have been millions of recalled units for various medtech products so far this year. Here are the 10 recalls that impacted the most medtech product units in the United States.

Marie Thibault

We reviewed FDA's medical device recall database to find the largest device recalls initiated this year. These recalls were categorized as Class I recalls, the most serious type, by the agency.

Of the recalled units in the first quarter of 2017, 10% were categorized as Class I recalls, according to a Q1 report from the Stericycle ExpertSolutions Recall Index.

The 10 recalls listed here were ranked by the number of units affected in the United States. 

[Image courtesy of GERALT/PIXABAY.COM]

Zimmer Is Kitchen-Sinking Its Guidance. Will It Work?

Zimmer Biomet has thrown in all the bad stuff at once, except for the kitchen sink. Will this commonly-used business strategy work to focus attention on the company's turnaround prospects?

Amanda Pedersen

Zimmer Biomet seems to be employing a common business tactic known as "kitchen sinking" its guidance. In other words, by throwing all the bad news at investors at once, perhaps they'll see the company's future prospects in a brighter light.

"Our sales growth fell short of our expectations, due in part to production delays of certain key brands and slower-than-expected sales recapture from previously affected customers in the United States," said Daniel Florin, the company's interim CEO, senior vice president, and CFO. "These factors have informed our updated outlook for the full year."

Zimmer lowered its 2017 EPS guidance to between $8.20 and $8.30 from its previous guidance of $8.50 to $8.60.

"Looking forward, we remain focused on fully restoring product supply to enhance our commercial execution, while continuing to closely engage with our customers and take advantage of the opportunities in front of us," Florin said.

The lowered guidance should not have come as a surprise to anyone, considering the recent resignation of David Dvorak as CEO, a move that was generally warmly received among investors. The Warsaw, IN-based company has struggled since it completed its $14 billion merger two years ago. Last December FDA hit the company with an unusually long Form 483 based on quality control problems at its legacy Biomet facility. In late January Zimmer Biomet decided to throw some money at its problems, with a commitment to invest $170 million to "harmonize and optimize" its supply chain and manufacturing and quality systems.

Mike Matson of Needham & Co. issued a relatively optimistic report after Zimmer Biomet's second quarter earnings call Thursday, calling the company an "early-stage turnaround story." But the CEO's departure has increased the potential for more significant strategic changes, he noted.

Matson said the company still has the potential to eventually reach 4% revenue growth or more, narrowing the 38% price to earnings discount to its peers.

Amanda Pedersen is Qmed's news editor. Contact her at amanda.pedersen@ubm.com.

Edwards Has Resumed Mitral Valve Implants

After pausing its trials for its CardiAQ transcatheter mitral valve replacement earlier this year, Edwards Lifesciences announced implants are now being performed.

Implants of the CardiAQ transcatheter mitral valve system are underway again.

Early this year, transcatheter aortic valve replacement (TAVR) maker Edwards Lifesciences said it was pausing its trials for it CardiAQ transcatheter mitral valve system (TMVR). Just a few weeks later, the company noted in a public filing that it was poised to start screening for enrollment in the trials again. Now, the device is once again being implanted in patients.

"We're doing [CardiAQ] implants again, which not only helps these patients that really don't have many options, but it also allows us to learn, which is really important," said Michael Mussallem, Edwards Lifesciences chairman and CEO, according to a Seeking Alpha transcript of the company's second quarter earnings call. "And it helps us not only in the design of our product, but also in the selection of patients and the procedure itself and understanding anticoagulation protocol and a long list that becomes important for the long-term success of this therapy."

At the time, the decision to pause implants was explained as a chance to perform additional design validation testing based on information from the U.S. early feasibility study. The decision resulted in a voluntary enrollment halt for that early feasibility study and a delay for the CE Mark trial.

Now, patients are being implanted as part of the U.S. early feasibility study. The CE Mark trial is still expected to begin enrolling patients this year, to help support a CE Mark and commercial launch of what Mussallem has previously called a "more refined system" in 2019.

In addition to replacement, Edwards Lifesciences has a transcatheter mitral strategy that also includes repair options. Its acquisition of Valtech Cardio brought it the Cardioband System for transcatheter mitral and tricuspid valve repair. The device has CE Mark for the transseptal mitral repair indication, but Mussallem told analysts on the earnings call that the European commercial launch is not going as quickly as hoped because of the time needed to develop a clinical support team. Adding that sales are expected to reach $2-3 million in the fourth quarter--lower than initially projected--he explained that the company is not planning to borrow from its TAVR team, instead choosing to build a team specifically for the Cardioband procedure.

"These are clinical specialists that are in the procedures. They actually do training, they do proctoring, they actually try and help these clinicians in these very early procedures get outstanding clinical outcomes . . . the opportunity is significant enough that we wanted a focused and dedicated team that could grow with the procedure," he said.

A CE Mark trial for Edwards' in-house PASCAL system for transseptal mitral repair--another piece of the company's wide-ranging mitral strategy--is now enrolling. In addition, a U.S. early feasibility study has also recently been approved.

In a July 27 research note, Canaccord Genuity analyst Jason Mills wrote, "While we do not believe the transcatheter mitral market will develop as quickly as TAVR, we believe a decade from now, EW will possess a broad portfolio of transcatheter mitral devices (both repair and replacement, mitral and tricuspid, that could drive revenue, and operating leverage) that rival its TAVR business."

With that years-long perspective, the impact of short pauses and extra time to build a clinical team may not matter much in the end.

Marie Thibault is the managing editor at MD+DI. Reach her at marie.thibault@ubm.com and on Twitter @MedTechMarie.

[Image courtesy of EDWARDS LIFESCIENCES]

Which Medtech CEOs Made the Most Last Year?

Gorsky may have seen a 5% dip in pay from 2014 to 2015, but his total compensation last year more than made up for that difference.Total Compensation in 2016: $26,871,720Previous Fiscal Year Compensation: 23,795,866Percent Difference: +12.93%Base Pay in 2016: $1.6 million

A Qmed analysis of the largest medtech companies’ most recent proxy statements filed with the SEC revealed that many CEOs in the industry saw a bump in pay last year. Many of them also received more than $5 million in total compensation, and several made more than $10 million. Want to know which CEOs raked in the most? Here is a look at the top 10 most compensated CEOs in the industry. Download the full list of 34 CEO salaries here.