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Breathing New Life Into Pulmonology

Executive Summary

The development of medical devices and techniques that enable physicians to perform procedures less invasively has transformed the way medicine is practiced in many fields, including cardiology, radiology, neurology and orthopedics, and giving rise to thriving sub-specialties such as interventional cardiology. Pulmonx, a start-up launched by veteran physician/entrepreneur Rodney Perkins, MD, is looking to repeat that pattern through devices designed to spur the development of a new specialty, interventional pulmonology, while also improving the tools used in anesthesiology, internal and emergency medicine. While the company appears thus far to have the field to itself, Pulmonx faces major challenges in terms of the financing hurdles that come with a start-up's efforts to break new ground, as well as reimbursement issues in one of its primary product areas. Along with those challenges come major opportunities to capitalize on the advantages to patients, providers and payers that interventional procedures have brought to other clinical fields; and to become a market-maker in a new physician specialty.

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Pulmonology: The Next Interventional Cardiology

Pulmonologists, a group of device-friendly physicians without many tools at their disposal, treat large diseases with unmet needs like emphysema, asthma, and lung cancer. They thus represent an attractive, untapped market for medical device companies. Many companies targeting emphysema have been formed by executives from the interventional cardiology industry and aim to follow the tried and true path of that industry, of introducing new minimally-invasive versions of open surgical predicate procedures. Others are following the tougher route of working in diseases like asthma, for which no device predicates exist. Companies hope to offer high volume procedures that will grow interventional pulmonology from a niche specialty treating end-stage cancer patients to a specialty that routinely performs millions of procedures on patients with non-malignant diseases that are currently poorly managed by drugs.

Pulmonology: The Next Interventional Cardiology

Pulmonologists, a group of device-friendly physicians without many tools at their disposal, treat large diseases with unmet needs like emphysema, asthma, and lung cancer. They thus represent an attractive, untapped market for medical device companies. Many companies targeting emphysema have been formed by executives from the interventional cardiology industry and aim to follow the tried and true path of that industry, of introducing new minimally-invasive versions of open surgical predicate procedures. Others are following the tougher route of working in diseases like asthma, for which no device predicates exist. Companies hope to offer high volume procedures that will grow interventional pulmonology from a niche specialty treating end-stage cancer patients to a specialty that routinely performs millions of procedures on patients with non-malignant diseases that are currently poorly managed by drugs.

Lungs Expand Device Markets

It's more than a coincidence that cardiology company Boston Scientific has invested in Broncus Technologies and its rival Guidant, in Spiration Inc., two start-ups with minimally-invasive devices for the treatment of lung diseases. Interventional pulmonology could just be the next double-digit growth area to succeed interventional cardiology, which is maturing; what's more, it takes advantage of the core competencies of the big firms.

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