After years of steady growth, the dialysis market is predicted to increase dramatically, and this growth will severely strain the current system of dialysis clinics where most of these procedures are performed. Home hemodialysis could help relieve this bottleneck but has not been a viable alternative to date because of the lack of effective device innovation. NxStage Medical has developed a system that makes home hemodialysis a therapeutic option, which could dramatically improve both the health and lifestyle of patients, along with the economic future of the dialysis market.

Ask any group of nephrologists what the biggest problem is in hemodialysis today and most likely they'll say vascular access. Vasca Inc. believes this is just the sort of problem that technology can address. The young company hopes to convince a fragmented group of physicians that its subcutaneous valve that bridges patients to the optimal, but less used, permanent type of access option, the arteriovenous fistula, will provide clinical and costs benefits across the continuum of dialysis therapy.

Dialysis prolongs the lives of patients with end-stage renal disease, but outcomes are still poor, with a 17% mortality rate in the US. Nephrologists and technology developers want to improve outcomes, but the economics of dialysis have stymied innovation. Medicare tightly controls pricing, and developers are hard-pressed to find therapies that increase clinical benefits but not cost. Recently, two major clinical trials in dialysis hint that the benefits of dialysis, as it's currently performed, are approaching their limits. Start-ups now have the ammunition with which to approach a technologically stagnant market. Small companies, however, face daunting competition: three giant players dominate the market, two of which own 40% of the service centers that provide dialysis therapies.

This section summarizes the technologies of several medical companies founded within the last year. Advanced Drug Delivery Technoloiges, founded with Novartis Venture Fund financing, is developing liquid and solid dosage formulations for NCE's and generic compounds. Altea Development Corp. has a patch to enable delivery of drugs through the skin. Institute for Diagnostic Research provides customized assay development for the pharmaceutical industry. Brain cells may be able to regenerate, believes NeuroNova of Sweden. Vasca has spun-out NxStage medical to improve dialysis treatment technologies.