Stents: Johnson & Johnson Reports Significant Decrease in Stent Sales

July 19, 2007 by Scott P. Williams [mailto:swilliams@perfuse.org]

Although healthcare conglomerate Johnson & Johnson reported a 9% increase in its second quarter profits compared to one year ago, the company saw a 20% decrease in sales within its recently troubled stent unit.

On a conference call reviewing the sales numbers, a Johnson & Johnson executive attributed the decrease in sales to the following trio of trends: 1.) [f]ewer stent procedures, amid a growing sense that the devices have been over-used 2.) [a] growing preference for bare-metal stents, in response to concerns about the safety of the drug-coated kind 3.) [m]ore competition overseas, where Medtronic and Abbott Labs are getting into the stent business.

These three trends were complimented by Johnson & Johnson’s May 2007 announcement that it would not seek federal approval for CoStar, its most recent drug-eluting stent. The announcement was made after a trial comparing CoStar to Boston Scientific’s drug-coated stent Taxus Express produced an unfavorable result for Johnson & JohnsonThe study found that patients receiving the CoStar stent had a higher rate of the composite of death, myocardial infarction or need for repeat stenting procedure within eight months. Additionally, the angiographic data showed a greater degree of narrowing of the stented artery due to scar tissue in the stent. Boston Scientific executives suggested that the unfavorable results stemmed from CoStar’s drug delivery method, not the drug itself, but Johnson & Johnsonhas turned its focus to CoStar’s drug rather than its delivery method.

Though Johnson & Johnson’s second quarter sales reports are hardly surprising given CoStar’s failure and recent market trends surrounding a decline in stent use, the outcomes stand in stark contrast to the conglomerate’s results and expectations over the past five years. In January 2003 to herald the arrival of Cypher, the New York Times ran an article with the optimistic headline “A Rare Chance to Take Back a Market; Johnson & Johnson’s New Stent May Dominate Angioplasties.” In line with the predominant thought of the time, the article states that Cypher “keeps coronary arteries open more successfully and much longer than… plain metal devices.”

Claims about the benefits of drug-eluting stents boosted Johnson & Johnson’s earnings through early 2006. According to the International Herald Tribune, the company reported “that its earnings rose 16 % in the first quarter based on sales of medical devices like its Cypher coronary stent.”

However, recently the merits of drug-eluting stents have been intensely challenged and debated. The discussion was brought to the forefront of cardiology in 2006 when the BASKET-LATE study and the Camenzind meta-analysis suggested that drug-eluting stents had higher rates of death and myocardial infarction than bare metal stents. In this past quarter, Johnson & Johnson was hit the hardest by the decrease in revenue generated from Cypher, which saw its sales dip by 41% in the United States and 30% abroad.

References

1.http://query.nytimes.com/gst/fullpage.html?sec=health&res=9405E2DF1E3FF930A35752C0A9659C8B63

2. http://www.iht.com/articles/2006/04/18/bloomberg/bxjnj.php

3. http://www.fda.gov/cdrh/news/091406.html