derma sciences' ceo hosts analyst day conference (transcript) - where to buy super absorbent polymer powder
Analyst conference call at 4: 30 p. m. on June 12, 2013, etexecutiveward Quilty-
Barry Wolfenson, vice president of sales and marketing-
Bob Cole, president of Senior wound care and drug development group-
President of traditional wound care and corporate accounting group
Executive Vice President, Finance and CFOGeorge Omburo-
Jeffrey Jensen-vice president of product and clinical development
Dean and Professor of foot medicine and foot surgery, University of Bari; Inventor TCC-
Izzy Christine in Grieg Rick
Greg Bohn, clinical nurse specialist at Massachusetts General Hospital-
Director, Trinity Wound Care and the Trinity Regional Medical Center at the hyperbaric oxygen medical clinic, IowaAlan Dalton-
Founder of Laura Bolton Danius Limited
Associate Professor of Surgery (Bioengineering)
University of Medicine and Dentistry, New Jersey;
Chief Scientific Advisor, skin science and wound healing specialist-
Professor, obstetrics and gynecology, University of Southern California, USA; co-
Inventor dscour Peter Balingit-
Director, Medical Department, Olive View Hospital-
University of California, Los Angeles Medical Center
The clinical researcher at Phase III analysis QuiltyI of DSC127 wanted everyone to stay on time.
I have been accused of presiding over board meetings for many years, which have never ended on time, so I work harder.
I would like to thank all of you for taking the time to visit Derma science here on our analyst and investor day.
We are looking forward to keeping you updated on Derma science and what is happening, and there are a lot of exciting things happening in Derma science these days.
Today, we have invited some of the leading experts in our field to help us with our presentation.
First of all, I would like to introduce the senior management team members who are with us today.
So far, we will begin Maurice Donnelly;
He is vice president of marketing and sales at Morris, our advanced wound care business.
Next to him is Barry Wolfenson.
Barry is the group president of our advanced wound care and drug development business.
Next to Barry is Bob Cole, the group president of our traditional wound care and corporate account business, and next to me is John jot, our vice president and chief financial officer, executive vice president and chief financial officer.
So we're glad you're all together.
There are other key employees of Derma science in the audience, George Omburo is our vice president of drug development, and we have [Joe Sullen]
Who is behind and who is our senior product manager at Medihoney; Beth Joy-
Doherty is in the corner and our marketing manager is here too.
We are fortunate that two of our directors can succeed today.
Steve Wells at the back is our lead director, next to him
Richard Stafford has been a director for about 10 years at Derma science.
So I think we 've been together for a long time.
Today's form is that we will start by talking about the role of the company and people in the company.
John is going to make a report on our financial situation.
Bob will talk a little bit about his business, and then Barry will talk a little bit about his business.
After that, we will go into the panel format and we will have two panels for 45 minutes, the first panel will be on our advanced wound care business will be hosted by our marketing and sales executive, Maurice Donnelly, and specifically, we will focus on the Medihoney product line and our TCC-
The EZ Cast product line is frankly two pillars of our advanced wound care business and we are doing a great job.
The members of this group will be doctors.
Jeffrey Jansen stands in front of him, the inventor and founder of our acquired TCCEZ cast. Dr.
Greg Bowen from Iowa is with us and we are happy to have you as well.
There is also one person in this group, Christine grigarrick from general Boston Volkswagen, who is also one of our very important media accounts, and we are glad that you can also spend some time with us.
Then after the Medihoney panel, we will have a DSC127 panel discussion and Dr
George Omburo will chair the group. Dr.
Dr. Alan Dunton is one of our main MD consultants who will be in this group
The inventor of DSC127, Gere dizerfeld, will be on this panel; Dr.
Laura Bolton has been a consultant for Derma science for many years and has played an important role in our ultimate right to DSC127, Barry is the original man who found it, but Laura, we are glad you are here, barry Wolfenson will be working in these two groups;
He will sit on the panel for advanced wound care and also on the dsc127.
So it's going to be a form, we'll wrap it up after we 've done all this, we'll also have some snacks and cocktails that we'll enjoy, we even have a chance to talk to each of you.
Let's skip forward-
The right to look for statements and genuine leather science.
I think most of you know a little bit about human science.
We are already a medical technology company focused on developing and providing advanced wound care management solutions.
At Derma, we work in three industries, the first one is pharmaceutical, and we are developing what we call DSC127, a drug for treating diabetic foot ulcers.
The project is now at the stage of our key research.
We have two key studies, one with two arms and the other with three arms, with 211 patients per arm, so there are 1,055 patients in both studies.
We are also working on a long-term use study that Barry will discuss more with other drug development issues.
Our advanced wound care business consists of equipment and dressings for the treatment of chronic non-woundshealing wounds.
The business, which grows by 30% to 40% per year, is the growth engine of genuine leather science;
Over the past few years we have spent most of our sales and marketing money, we have developed a field sales team with 55 people in the US now, we have been able to grow, we will continue to grow by 30% to 40% per year.
Outside of the US, in the UK we have six sales reps and in Canada we have a direct sales team and we have dealers elsewhere in the world.
So this is a business that we expect to be profitable in the near future, and we will continue to look to add new products to our sales force and increase the sales force.
It is important that you know that if the DSC127 is approved, it can be sold by the same sales team, so this is the same issue as what they are calling for today, so, we will be able to scale up the sales force and hopefully launch the DSC127 sometime in 2016.
The last part of our business is the traditional wound care business.
This is made up of so-called merchandise dressings and bandages we sell under our own brand Derma science, and we also have a strong private-
The same goes for the label business, and Bob Cole will tell you some exciting things that are happening there.
This is our three businesses.
That's what we're looking at today.
Today, we're going to focus on DSC127, Medihoney and TCC-
EZ cast is three key projects that we are currently working on at the company.
So I will give it to John ute. John yetlock
Good afternoon. my name is John Yetter. I am the chief financial officer of Derma science. I have been working for 13 years.
I won't tell you what Derma science was 13 years ago, but rest assured that we have actively changed ourselves many times since then.
I am happy to be here to tell you where we are now, and I will give a brief introduction as a finance person.
So first of all, here's the next slide.
Our goal over the past few years is to invest and develop advanced wound care business.
This is our growth engine, as Ed mentioned.
When I started our merchandise business 13 years ago, our goal was to stay stable and positive cash flow helped us grow our program in terms of investment, then we obviously have the development of our promising pharmaceutical product dsc127.
Let's take a look at the sales.
We have achieved our goal.
As far as advanced wound care at the bottom of this slide is concerned, you can see that we started from around $3 million, there are some traditional advanced wound care businesses that we have developed to, and I can't even see, further slides, it's here, we grew from $3 million last year and $25 million to now, and we want to reach or exceed $35 million in 2013.
From 2007 to 2012, the compound annual growth rate was 53%.
Let's stick to the traditional wound care, which is our goal, and starting with $31 million in 2008, we have an acquisition to cheer it up and we have been stable since then.
With a compound annual growth rate of 9%, the company totaled $34 million in 2012, reaching $73 million, and we hope to reach or exceed $83 million this year.
What is $83 million, advanced wound care 30% to 40%, traditional wound care remains stable.
Consistent good growth trends with what we have told you in the past few years are consistent with our strategy. Okay.
As Ed mentioned, let's take a look at advanced wound care, which is our engine of growth.
We have traditional wound care as well as pharmaceutical R & D costs.
2012, we have increased by $24.
8 million from $15. 3.
Our contribution in 2011 was negative 1.
5 and rise to 5. 2.
You will find that this trend is consistent with the past year. to-
Tell the date of what happened.
This is our growth investment, and in 2012 we increased from 20 sales reps to 38 to 42.
Expenses are usually income.
What we would like to see in the senior wound care department is that in the remaining three quarters of the year, sales growth and loss of departmental contribution have gradually decreased.
The traditional wound care is hung there, 11. 46 million, 11.
47 and 2013 are the same as 2012, so there are no surprises.
Obviously, it's not surprising that pharmaceutical companies are developing.
We spent about $7.
It was $2 million last year.
1 million in 2011, this number has started to rise, mainly because we have done a good job in tox work and CMC work.
Now, we 've just started all of our clinical trials, thus launching the more expensive aspects of the trial, so you can expect that number to increase.
What does all this mean?
The overall financial performance is in line with our expectations.
Sales were 63,73, up 18 in the first quarter. 8 over 15.
This is a big number and you will get some applesto-
We acquired Orange from oranges in last April, but the organic growth of 23%, excluding TCC, was 12%.
Our profit margin is improving, which is consistent with our advanced wound care products, which have a profit margin of about 50% compared to the traditional wound care I mentioned in 25% to 30%.
A net loss of $12 million last year, excluding R & D, was $7.
1 million, it's $4.
9 million and our adjusted EBITDA as it includes equity
The cost based on comp is $1.
$8 million to $1.
2 million, it's not surprising there.
We are investing in growth.
Our losses have increased a little.
In line with these three-month trends, you have similar trends. Sales are up. Margins are up.
Margin percentage increase.
Net losses increased due to R & D and some equity
Based on the comp fees that we incurred in the future and will occur, there is also a large chunk of amortization fees related to our acquisition of medeicency in April.
We are pleased that the due date was paid by MEDIHONEY at $1 million this year on October, when we hit last month-
Rolling base per month, TTM base, sales of 10 million, then we also got the acquisition license from BIOGUARD in last July, which also has a little intangible assets.
Our balance sheet, our liquidity is very good.
If I had brought you back for 13 years, I would have been ecstatic about it.
We have about $44 million in cash on hand.
Our accounts receivable are in good condition.
To support the growth of our business, our inventory is in place.
Other current assets and other current liabilities have not changed much.
We are not a user of large capital expenditures between about $0. 715 billion a year, with no major changes expected and based on our long term
Long-term strategic plan, we feel that we have enough liquidity to achieve the goals we want in the growth plan through the success of dsc127.
For those who are interested, we have about 6 capital structures.
8 million shares, common stock issued.
Our diluted shares are about 5 shares.
6 million consists mainly of warrants and stock options.
The good news for Derma science is that in the last two equity financing that took place in 2012, there is no warrants associated with it, and you can see the weighted average price relative to our stock price today.
Historically, we have not given much guidance, but we have begun to make progress over the past few years.
You hear this a lot.
Ed has just mentioned that advanced wound care has grown by 30% and 40%, which is a global number and we should be between 34 years old. 2 and 36. 8.
Traditional Wound Care, we are facing challenges, it is always a challenging thing, it is a commodity business, we are not a major player, but we are a player, we have done a lot of good work to create the opportunities we think we have.
We therefore expect zero growth to 2% per cent.
We are about $47 million, $48 million, $49 million.
Our SG & A fee consisting of distribution, marketing, sales and G & A will be between $39 million and $41 million.
The R & d I mentioned earlier is accelerating and we spent $7.
1 million Clinical Trials, 2013, 2014, cost $45 million to $50 million in total.
We can expect that this will be between $17 million and $19 million.
If we can push this further through the success of this project, we will do so.
Then the cash flow is positive and our goal is not to include R & D that we will not, we are a hybrid.
We are an existing business.
We have sales and marketing.
We have advanced wound care, but we also have the development of dsc127.
You can see it in a row of $17 million to $19 million.
So we won't make a profit, that's it--
One way we measure our business is by not including positive cash flow including R & D.
We are very close to this, and then as the AWC business grows based on growth strategy, we want more and more, we want to be profitable for a long time in the core business, OK
So without further questions, I will introduce Bob Cole, our executive vice president and president of traditional wound care group.
Bob Colwell, thank you for coming.
First of all, I have been working in Derma science since 2003, and I have (inaudible)
From 1978. okay.
35 years, it was very interesting when we expanded our sales organization in the US last year.
S, I interviewed people who were not around when I met Ed, which made me sad.
So, we 've been together for a long time and it's been a good run since 2003.
In terms of where we are now, I can't tell you how excited I am.
What I want to do is talk about the traditional wound care business now.
John is well arranged.
It's boring, okay.
So I appreciate it.
But in any case it challenges. It’s a $47.
We did 8 million businesses in 2012.
You know there's a goal to keep it level, or to grow it a few points, and I guess that's OK, but I'm more proud of that, so I'm going to do better in that regard.
The advantage of traditional wound care is that its breakdown is 50% private
Label, about 50% of our branded products and private-
The label is great because you just do it for the customer, it really doesn't cost sales or marketing, you write their name on it, you give it to them and then you go to the next customer, we have done very well in the last seven years, like a small footnote, we just got two new customers with private clients
The label may recently make a donation this year, but it is unlikely that it will make an additional contribution of $1.
Income is 7 million.
So we want to keep a good growth model in the fairly stable business you know, what's going on with that, okay.
Another good thing about private --
The label is, these are our own products made in Canada, we focus on the products we make in Canada, this will really absorb the huge amount of overhead there can keep a very good profit between 25% and 28%, OK
We just hired a private Director recently.
Label sales really focus on this.
This is something we didn't have in the past.
This person is only 60 days short, but we have found a lot of opportunities, okay.
Our branded products are products that we sell through distributors and two years ago there was a gentleman in our sales organization and we would promote him if you would like to be vice president of sales at dealers.
The good thing about this is that we are busy with advanced wound care and a lot of people don't know everything else we have or just have one there and say, hey, by the way, we got a 4 by 4 and ABD mode and we said it was a good idea, what do you think we're doing?
So that's how it's broken down anyway.
Corporate accounts, well, this is the most responsible, and it is essential to support the development of our advanced wound care because we have advanced wound care.
As we all know, GPOs, the group purchasing organization, has five main ones, one in the United States. S.
Well, that's innovation, Prime Minister, Amerinet, HPG and MedAssets.
The good news is that we are now four out of five products with one or more products in the contract.
This is really critical because all of our advanced wound care, hospitals, IDNs or other goals that are more important than each time, the first question I ask you is do you have a contract?
In this particular case, by working with these GPOs, well, it gives our sales organization a chance to really, really pursue the business, OK.
Other than that, I mean, IDNs I mean, we hired so many goals just to focus on IDNs, okay.
We have a vice president of corporate customers, and we have a corporate customer director who focuses on IDNs.
We have recently added another person who will focus on the VA hospital at the wound care clinic, and as you can see, I mean, the goal is to have three or four people fully honest, but I do think we are in a good position and that will support the continued growth of advanced wound care.
So what do we do with all this? okay?
As I said, we will be successful in getting a contract for advanced wound care, which will obviously support our investment in the sales organization.
We have to attend with TCC-
EZ cast at VA hospital.
As you can see, I mean the goal there is astronomical numbers, which may be the main contributor to the bottom line of income, and finally, we will focus on continuing to focus on IDNs and clinics, we focus on our products and build it all together with our support staff, which we didn't have in the past.
We really think we can drive sales through our sales organization.
So I know we have a lot of information to introduce here, so we will get together at the cocktail party if there are any questions, but thanks for everything, OK, thank you.
Thank you for coming.
I'm Barry Wolfenson.
I have also worked in this company for about 10 years.
I agree it's interesting and there are a lot of challenges and changes.
So we're going to have these two panels, one for advanced wound care and one for DSC127, and in the next few minutes I'm going to talk to you about advanced wound care and
So I won't be too detailed.
I think what I will do is give you some basics of level set so that when the panel is here maybe you understand better what they are talking about, then we will go into some details.
So basically, the first is diabetic foot ulcers, venous leg ulcers, arterial ulcers, and pressure sore, which are the basic chronic wounds that our sales reps go out every day to help their clinicians manage.
So these patients have a lot of co-existing diseases, their blood circulation is very poor, and their body is unable to heal the wound normally due to one reason or another, so they are stuck in stagnation and chronic.
Other wounds that we usually focus on, and we go deeper as we continue to burn and then operate the wounds.
What you most often hear is diabetes ulcers, Burns and surgical wards, because these are life and death situations, so for diabetic foot ulcers, we will discuss them in more detail, they need to amputate and eventually die.
For Burns, they have a very, very high risk of infection, the death of the patient, of course, for the surgical site, certain postoperative
Surgical wounds, the proportion of infection is very, very small, but when they are infected, it can lead to death, in fact, we are talking to a woman at lunch today, and her husband died of golden yellow grape infection.
So diabetic foot ulcers, only a million, but life and death, burn things are interesting, and of course terrible for patients, but from a business point of view, these numbers are much smaller.
3 million, we might want it to control 300,000 to 500,000, but the burn area is very large, so from a, how many dressings will they use is a huge opportunity, but we haven't done much so far, Burns are a very special target and we are actually looking for some burn dressings specific to the area, we will discuss it more next year.
So, what is the address and product type in the space?
These are different things when you hear about advanced wound care, and these are the categories that will appear in the analyst report.
Think of it as a $6 billion global market, probably less than $6 billion, $5.
8 billion. The market we have played so far is 510 (k)
Type of dressing in exemption category-
Class 1 and above, Class 2 CE logo dressing;
Another replacement for something that makes up 510 (k)
PMAs and the new, not new, but now the dressing that enters the market uses this 361, these are human cells, I mean tissue products, from human products, has been manipulated to a minimum.
Drugs and biological products like DSC127 (inaudible)
And then the negative pressure wound therapy and the way these outbreaks are basically, again, called Not exactly $6 billion, but $6 billion. 510(k)
This Runze wound dressing, $3 billion, is about half of the market, like negative pressure, is about ($1. 5 million)[$1. 5 billion]
It may be a little bit more, a little less than $2 billion, and the price of skin substitutes and drug biologics combined is just over $1 billion.
This is really thinking about how they fit into it.
Interestingly, we discussed why we were with DSC127 and the efforts we made there.
The largest part of the 510 Market (k)
Of these, $3 billion of dressings are the most unverified and inspected products on the market, and they do not have a critical Research Foundation;
We are already among us, and should be in the group of Laura Bolton, who knows more about the advanced wound care field than anyone I know, and has always been the champion of evidence-based medicine.
This is a very interesting dynamic, because these are products that clinicians use day after day, and because of this, because they don't have these key studies, they have to try it out on their own, they don't have an FDA review, yes, they say, you can use these to treat the one you will achieve great success.
So they can read the case studies or some small ones, but in the end they need to try out the products themselves.
Skin Substitutes, PMA, drugs and biological products, they have verified the key research behind them and FDA recognition, which makes it easier to sell, from a reimbursement perspective, the adoption rate is much better to get more, so we have 510 of most of our business (k)
The dressing is linked with us and we will get $35 million this year, which is a huge achievement in this field.
You'll see some of Morris's slides on how we can build up in this wet and seasoning market in the US.
We have $35 million in drug listings, which will be a huge failure, so, totally different market potential for treating the same type of disease or managing the same type of disease.
So the market itself is a good market.
The growth rate of many of our competitors is a bit low.
They are very big companies, so it is very difficult for them to achieve leapfrog growth, but we all know that people have a longer life span, and unfortunately obesity has not disappeared and diabetes is increasing.
So these again provide a very good market demographics for patients who will have these wounds, especially in the United States, responsible care concepts, you know, spend less money in the health care system, spending more money is already dominant and will only get bigger.
One thing I think you will see in our product is that we are very consistent with this, especially TCC.
Some of our products are agnostic and they are extensive and you know MEDIHONEY treats or manages many different types of wounds but, we do pay a lot of attention to the treatment of diabetes-related ulcers, diabetic foot ulcers.
So both of our products, TCC and DSC127 in particular, are focused on these products and you will hear a lot about them today.
Why, this is another matter of life and death, so these figures have about 900,000 diabetic foot ulcers every year, about 15% people have diabetes, and the incidence rate is 25% to. they will suffer from diabetic foot ulcers in their lives.
The median cost of treatment in the first few years was $40,000.
It's not cheap to take care of these diabetic foot ulcers, and what happens next is that the statistics show 14 to 24 years old, but I did math earlier and it could be a bit high, I have about 10% people, and about 100,000 people are related to diabetes every year. like the diabetes foot ulcer associated with each year, the mortality rate is related again (inaudible)
These amputations are huge, 45% higher than many cancers.
So it's a life-and-death situation with a lot of focus, a lot of the time, when you hear about a new drug, a device, or a new skin replacement going on the market, you will find that they do nine studies at a time and it will focus on diabetic foot ulcers.
But as John mentioned he does not have this exact chart just to show the ramp
Looks good, when we catch up with 35 million at the maximum rate at the end of this year, our growth rate can compound around 50%, it's just because of these, we have very good products, this is for these five 10-
K products have a wide range of popular choices.
So every time there's a clinician that lets them take your dress and hopefully once they take your dress they tell their friends and they start using it that way too, they get more comfortable over time and they use it more and more often.
So we have some sales reps and our products are doing better and we are getting very, very strong growth.
So far, we have at least not seen the end of this growth.
Let you know more about the kind of production
Because we are a global company, our sales have increased.
Our main focus is on the United States. S.
Most of our infrastructure is here, but basically it's $ 83% and $ 17%, respectively. S. and ex-U. S.
Normally, if you are at an analyst meeting, we are a large multinational global company with direct sales organizations all over the world, you will hear 33, 33; 33 in the U. S.
33 people in Europe and 33 people in other places.
So these numbers are inherent, although we have a very small direct selling organization in the UK and a small direct selling organization in Canada, otherwise solved by distribution.
We have a lot of room for growth.
We have just picked up a Korean client and we think there is a good chance that they will be one of our biggest clients in a few years.
So when we get into these markets and we're going to put in more assets, we'll mention some of our new employees.
We have just hired a vice president of international business development focusing only on Latin America and Asia.
So when we add these types of resources to the appropriate locations, it is expected that this number, especially in some regions, will exceed the growth rate of the United States.
Especially outside the United States. S.
This is split, so most of it is in Europe.
We bought a company.
When we get MEDIHONEY's global rights, it is also the foundation of our business and we are growing.
Most of what you see in the Middle East is a new industry, it's a very, very good market for us, and frankly, we believe that as we go international, this will be one of the key markets for our entire exposure to casting.
Earlier this year, we had just acquired the rights of the product in the international arena.
We have a traditional wound care center in Canada.
We use this to achieve sales.
Latin America is growing.
I mentioned Asia again.
So there is a lot of room for growth, which is a basic component.
Our mission is to be a global leader in advanced wound care solutions, so that this is basically taken into account.
The treatment is the main dressing on the wound, if you wish, and the auxiliary material that the patient needs.
Obviously, our goal is to be a lean and efficient sales organization.
So, we can hand over all the high-margin products to our sales representative, who can take these products to the same exact call point and get a good profit, we're going to wear it.
So these include a lot of different things that we are looking at, hopefully we can do it one day, and we can post some announcements to tell you where we are from a technical point of view.
Now it's just dressing, but you want it to go beyond dressing over time.
On top of that, we are developing this dug, and as I said before, it is not the market itself, it is the market potential and the revenue potential, what can we do with 510? NYSE:K)dressings.
Therefore, our goal is why we are developing this advanced wound care business based on this 510 (K)
Products, increase the number of sales reps, want to have this drug on the market and be part of the R & D focus company where we can really start looking at other assets.
Will be able to browse our products soon, I will take a little time to get to know this, MEDIHONEY is our key seasoning, it is separated from this special honey from New Zealand, this honey is called active hook-end essence or manuka honey.
It has very interesting properties.
It has a very low pH value and a high penetration concentration.
We sell antibiotics worldwide. In the U. S.
We do not have this claim and do not claim it to be an antimicrobial, nor do we mean that clinicians do not necessarily use it this way.
It is written most in journal articles, one of the key attributes.
But it is a very interesting product, there may be a few [snickers]
When we started it for the first time, but actually, when you bring it to a clinician with this terrible wound, is it using a very, very expensive way to try and get them to heal, but the wound is stuck.
By the way, when I say stagnant wounds, chronic wounds I have discussed before diabetic foot ulcers, pressure sore, venous leg ulcers.
If you look at all of them, generally standard care, maybe half of them will heal, depending on the cause, but in the middle.
The other half is these chronic stagnant wounds, which are very, very difficult to heal, and they start to become biological, followed by skin substitutes and negative pressure, which is where MEDIHONEY works.
Our reps go to these doctors every day, they put MEDIHONEY on three or four, they have five of their worst situations, they usually get consistently good results, this is also the reason to help build the business.
So this is a real product and it does a good job.
This is an order of magnitude number, and MEDIHONEY's revenue will exceed $10 million this year, making it a very, very elite class of these 510 people (k)
Products in the United States.
According to the system used by clinicians, there may be 10 brands that exceed these e2000 brands, but there may be 5 to 10 brands in the United States that exceed $10 million, so MEDIHONEY is definitely the only company with 38 sales reps, 38 regions, and the smallest company with the largest brand.
TCC, you will hear a lot, so I will pass.
XTRASORB, it's MEDIHONEY's sister dressing, very high absorption dressing, and one thing MEDIHONEY does is that it has penetration potential, so it takes a lot of liquid out of the wound, we need it very much from the beginning and cover it with a very, very absorbent dressing.
So we have developed this whole line of products that contain high water absorbent polymers, and it has gained some good appeal in the market, and it does interesting things that other dressings don't have.
Most absorbent dressings are like sponges.
So, if you imagine cleaning up the dishes in the kitchen and finally having a sponge, you can bring in the moisture.
Well, all these wounds, pressure sores, diabetic foot ulcers, venous leg ulcers are one thing that links them together, and that's the stress.
So obviously their name is pressure sore.
Venous leg ulcers, you need to compress them, so you're actually putting pressure on them.
Diabetic foot ulcers are always under pressure because you are walking on them and the goal is to eliminate this stress.
As a result, all of these dressings are constantly under pressure and push the liquid back to the wound.
As a result, they embedded a highly absorbent polymer in it.
What makes it different is that it transforms as water enters (inaudible)
Lock it in place
Therefore, it will not push the moisture back no matter the pressure, which is very beneficial to the wound.
Ed mentioned that BIOGUARD is an antibacterial dressing that, frankly, is a more rigid cell that is preventive.
At MEDIHONEY, you can give three or four patients enough dressing to the doctor, they can put them on the patient, call you back in two weeks and say hey, here is the place to do well, there are no patients here and I am either interested in continuing to use Medihoney or not.
With Bioguard, the infection rate at your surgical site is 1.
5% how is it possible for you to hand it over to a clinician and have them evaluate it with enough money you know, which is very difficult and theoretically difficult.
Where we are going is where it is infected with life and death, so the burn center and the burn center apply silver cream and ointment to the patient and then wrap the patient with gauze, gauze dressings will still turn green from all of the P. , and there are a lot of bugs that will still be caught, whether through the air or on the patient's wounds, when they use Bioguard dressings, they are nice and white and have no smell.
So this is an agent that tells the burn surgeon that if I use this dressing, the possibility of cross infection and wound infection also decreases, so, we don't need to do very, very big research to show this benefit, so we get some traction there.
From the DSC127 point of view, you will hear a lot about it.
We did achieve some very, very good results in the second phase of the study.
I'll leave it for the group discussion, but that's enough, we raised a lot of money and we're running the third phase of the program ourselves.
It is protected by some good core intellectual property rights and, in fact, we had two new patents last year that extended that protection until 2032.
So we look at the composition of our essential uses and patent matters and the expansion we would like to get from the government's new chemical entity, we will have at least seven years of exclusivity and then bully it by 2032.
I did put our model in because people ask you, we said before, how do we get $0. 3 billion in the US, which is basically the way we think, you know I will be honest with you. we will conduct market research.
We are now looking for licensing partners outside the US and supporting market research to show what we think sales will look like.
So I tell you that any market research we do will show a much larger number than that.
But this is a real number.
It's hard to say, the reason is that there are some patients here and some patients with diabetes, some patients with ulcer, some patients with applicable, so even TCC, i'm using 75% or so 25% of the patient's blood vessels will get so bad, it doesn't matter what you put on once you move the pressure that the wound can't heal, so you have to re-
Route the veins but call it 75% and you can find some patients.
Then start with 1, even in very low market share.
5%, torn, only 13% of our sales of about $0. 3 billion over the last few years;
This is also a very high profit.
Now, why do we only stick to around 12%, 11%, 13%, which is a lot of the problem I get from the modeling point of view.
This is only based on the fact that if we have seen other products already on the market and it is very difficult to get a market share of 5%, 10%, 15% in these patients.
It's not like you have a situation where there is no other therapeutic mortality, and then a drug comes out and it gets a 50% market share immediately.
I mean, diabetic foot ulcers are being treated well, like I said, half of them will be cured with standard care therapy, so it's hard to think about it with medication, although it's good, but you will have a huge market share.
So again, we are humbly assuming that this could be a fair number as a model.
So I will introduce Maurice Donnelly, who will convene the first group to discuss advanced wound care. Thank you. [
Now we are in the fun part of this project;
You know, if we can get up all day and tell you about our products and how well we think they work, but let our customers come to you and talk about our products, and how they are used in the market, and how they are used in practice, is another matter.
What I'm going to do is introduce each group member and I'm going to have a short three to five minute presentation that tells you something about themselves and how they use our products.
But I would like to tell you that I joined Derma as sales executive about two years ago;
It was a great trip to start marketing in the last January.
I have more than 20 years of experience in the wound care industry, there are some companies and there are some really good companies like Integra lifescience and ConvaTec which give me
My big project has been building a sales team for the past two years.
At this time we have over 54 employees on site, 38 product managers and a support staff to support them.
But I asked over and over how the team was, and about four years ago Barry and Ed simulated how the sales reps should do when they joined the company, more than 18 months is the break-even time when the sales rep is starting to make money or more or less paying for himself is already on board.
We now have about 10 to 13 months of new sales representative data, and we find that they are better (inaudible)
So this is really good news.
Barry mentioned earlier our performance as a company, well, we are now ranked seventh in market share in this huge industry, but we are also the fastest growing wound care company.
Now I want to introduce it to you.
My doctor is on the left.
Jeff Jansen, professor of foot Medicine and Surgery at Barry University, inventor of TCCEZ product.
Jeffrey Jensen, thank you, Morris, for your good afternoon.
I would like to give you an overview of the resulting TCC
EZ and the market forces that really need to open up different loading channels.
If you look at this slide, we need to address a lot of variables in people with diabetes to heal them, and if you look at infection control, we know that antibiotics progress every day.
If you look at profusion or vascular problems, we know there is progress in getting more blood into the foot every day to promote healing, and of course there are a lot of wound environmental products, but for decades, some of the things that are really behind have been unloading, and the total contact casting has been considered the gold standard for many years.
But whenever you see total contact casting, the term "total contact casting" is followed by the word "underutilized", so the market needs casting that works like total contact casting, and used for full contact with the barriers to casting, because from the patient's point of view, it is difficult to have a gold standard product that the patient always needs, but they do not have this product in the doctor's office.
Therefore, unloading or complete reduction is TCC and TCC-
EZ is on the table, and our patients have a lot of potential to benefit from these, as long as they are easy to use and are repayable, and all the things that real leather science has put forward are sending troops to countries --EZ.
On the right, you can see the traditional full-touch cast.
This is an underutilized process that we often talk about, a process of 10 to 14 steps;
We will discuss some other issues in a few minutes.
But over the years, there have indeed been some clinics and clinicians across the country that use and use these fully exposed castings very effectively.
With troop-contributing countries
EZ was developed by our clinic in Denver, Colorado, and released in 2007, we did ease the barriers to customization and removal of crafts.
So, of course, the goal of developing this casting is to develop an equivalent casting in terms of efficacy, unloading and total reduction, but, we really need to make it easier to use and more patient.
To be more personal, I put a couple of pictures and we 've been looking at numbers, but the wounds you see on the patient, the upper left corner is the wound, like it appears in the clinic.
Before they get infected, they are harmless, patients walk around in their shoes and don't get hurt or hurt because they have a neuropathy.
Long periods of diabetes can make the feet feel less, so they can step on their nails, they can develop wounds, they can do anything, they can't feel it.
So there's no incentive to make it better.
It's not a problem with it being infected, then the first domino is pushed, the patient is infected, they go to the emergency room, they are taken to the hospital, they are brought in for surgery, they take long-term antibiotics and many of them lose a limb in the process.
So what we really have to do is intervene in advance, intervene before the wound is infected, so that we can get the results as you can see in the lower right corner of the picture.
More dramatically, this is a patient who has been in the wound for two years and this patient has been treated with hyperbaric oxygen and every advanced product that clinicians can buy, until this patient removes the wound so that it can be cured by using the total contact casting that the patient sees progress.
So what I want to do is reiterate what Barry said before that there are so many products that can be used, but there is very little evidence --
Basic Medicine that supports their use, in fact wound care centers across the country are rarely included in clinical practice guidelines.
This is incorrect for full contact casting.
It is not only established by the leaders in the field, but certainly by CMS, and of course other insurers see it as a viable way, they hope that clinicians will not only help heal patients, but also reduce the cost of care.
When we looked at the evidence, the first-level evidence was the highest level of evidence we had, and we looked at the randomized controlled trial where eight supported the use of full contact cast.
Usually what we see is that if you average those numbers, yes, 90% of patients do recover within 36 to 52 days.
But if you put them all together to see what the FDA is really focused on, CMS may be more focused on whether it will heal in 40 or 50 days, they are interested in what the patient really happens for a long time, because as Barry mentioned earlier, 50% of the patients will meet the standard of treatment.
The obvious question is what happens to the other 50% people, that is, they risk and develop infections that lead to a series of events that I have discussed.
So when you look (inaudible)
Analysis, you will hear many people talk about the accumulation of total contact casting and many trials, and you will see about 88% healing in about 43 days, which is comprehensive.
I put a couple of slides to isolate each one just to show you the repeatability of the results, but that's really true.
If your wound or foot wound is obviously 85%, it will heal if you put them in about 90% of the time in six weeks.
This is repeated over and over again.
It's also important that this is average data healing, and if you average out all the different trials, it's 43 days in this lineup.
This is the background.
I would like to put a slide that says we know full contact with casting before full contact, the traditional version is well worth it, but actually, why is it not being fully utilized.
I'll go to the bullet below right away.
Because these patients don't feel it, if something is applied (inaudible)
This creates a stress point and guess what happens because the patient does not feel a new wound.
Therefore, when the traditional total contact cast appears a learning curve for a long time to supply, and the doctor wants to refer to it ,(inaudible)
It's really hard to get patients to have doctors use full contact plaster for their patients.
So all of these things are combined, resulting in the emergence of a new device, TCC.
EZ eased many obstacles.
So, let's talk about this in a few minutes.
First of all, cast must be functionally equivalent to the traditional total contact cast, and functionally, we mean that the best data we have is direct stress-related research.
There are several systems, scanning and email
Med measures pressure.
The actor is as good as the traditional full contact actor.
Application is minimum training.
If clinicians wear one or two pieces of clothing during a training session, they can actually go straight to their patient and apply this casting.
We did a study of the 100 consecutive applications of the actors and the actual scrolling of the actors for about 89 seconds, if you compare this to the 30 to 45 minutes of the traditional actors, you can see why it's easier for clinics to use TCC-EZ.
Another interesting thing is some clinics across the country, and as we saw earlier, there are 1100 to 1200 wound care centers, but they are all under the responsibility of different doctors.
They don't just report on doc. Well, the TCC-
EZ, every doctor in the clinic, whether it's four or five doctors working in these clinics, can easily use the total contact cast EZ, and usually before EZ cast, there is only one doctor with a total contact actor and the doctor is not available, these actors will not be applied.
So it's important.
Therefore, the overall contact with the foundry market is definitely very large.
Providing to patients through a doctor's application is key.
Reimbursement through CMS is great.
I don't expect that to change soon.
When we move to more a, we need to get better results from the final cost.
This is where the rubber is on the road.
Whether calculated by head or by case rate, we would like these patients to recover as soon as possible with minimal complications and minimal cost.
Full contact with cast EZ is certainly in line with the bill in this regard.
As a slide to the end, I just want to give you a picture of the diabetes epidemic, a slide from 2006, posted [Frank Vinicar]
As you can see at the Centers for Disease Control, who is it, but really talking about millions of people with diabetes, but it really makes me happy.
Seven days a week, 4100 patients were diagnosed with diabetes every 24 hours, and 230 patients received lower limb amputations every day.
120 of these patients with diabetes eventually entered the dialysis program, and 55 lost patience, which will last for a long time.
There is no shortage of patients.
What we need to do is to develop clinical practice guidelines through evidence-based medicine that support the use of care for these patients as efficiently as possible, and of course, genuine leather science has the ability to do foot ulcers for patients with diabetes
So I will be there for a while or (inaudible).
Maurice DonnellyNo, we will continue to rest and we will answer questions.
I 'd like to introduce Dr.
Greg Bowen, director of Trinity College wound care and high pressure medicine center, Trinity College Regional Medical Center Clinic, Iowa.
Thank you, Greg boenwell. Good afternoon.
I am happy to talk to you here about my background, wound care and healing of diabetic foot ulcers.
I am a trained general surgeon, but I found out that I ended up treating a lot of wound patients and was involved in our wound center and therefore became the medical director there, part of my work is to ensure the quality of care and practice within what the evidence teaches us or tells us to do in the clinical practice guidelines.
So I have also done a lot of work on the training of wound care physicians and I would like to share some with you on unloading and contact casting.
You 've heard a lot of things this afternoon about the history.
The problem of diabetes is becoming more and more serious.
In the United States, this is a big problem. our business in wound care centers accounts for about 30% of these diabetic foot ulcers, so this is a big problem and a problem that we are very concerned about.
25% of people with diabetes develop into ulcers that need to be treated at some point in their lives, and 50% or more are amputated because of diabetes.
When this happens, most of the time it is caused by an ulcer that cannot heal.
If the ulcer persists or we do not cure the ulcer, the longer the ulcer takes, the greater the risk of infection, which can lead to infection of the bone, which is called orchitis and amputations.
Before I became more involved in wound care, what I did not know as a practicing general surgeon was the mortality rate of amputations.
Studies have shown that mortality may be as high as 45% to 55% after this infection has stopped.
Everyone will be worried if I tell you that you have prostate cancer or breast cancer.
The mortality rate of prostate cancer is about 7% or 8%, and the mortality rate of breast cancer is about 10% to 11%.
We did a good job in treating these.
It's more like when I sit down and tell someone they have colon cancer and I'm going to take a piece out of their colon and their five-year mortality rate is about 35%.
So today's disease is the same as colon cancer.
We just don't think so, I don't think so even as a practicing physician, so it's very important.
So someone will ask, this is by (inaudible)
A few years ago.
She asked a question about why it was difficult to do the right thing in wound care if we knew it was a serious problem.
So she looked at her database of more than 300,000 patients, and she found that even in her database, she only educated doctors for about 6% of the time, they use gold standard contact casting.
When they do, the good thing is that the cost of care is half, so we save money and are very effective clinically.
However, one of the obstacles they are talking about is that everyone thinks that contact casting is time consuming and reimbursement is poor, and one of the things she is talking about is the lack of familiarity with where the evidence of clinical practice guidelines is, what should we do.
When THEY "with TCC contact casting when here a little rupture they about 12,000 dollars of price cure the these ulcer if they don't to it as an uninstall about 10,000 dollar about 22,500 dollars.
So you have to ask yourself why it is so difficult for clinicians to do the right thing in wound care and use things like contact casting, once you attribute it to three factors, one is the complexity of the treatment, the more complex it is, the more we have to think about it, the more doctors don't want to do it, and they want something quick and simple.
How much cognitive effort we go through, every time we go through those efforts, we have to rethink things, do we have to organize our ideas, and then the pay system, so that if we can solve these three things, it is more likely to be adopted.
So in my practice we use that we will use contact casting, I go to the foundry closet and collect everything I need to put on contact casting, and then a few years ago MedE-
Kast this is a good little kit, it's all independent, it's the same every time, I find I can use that casting kit and am very good at putting on these models, but it took me about 10 may be 15 minutes and then back in 2007, I spoke to Jeff at a meeting when they introduced TCC --
That's what we do.
This is the first actual photo to show them doing where the sales rep actually teaches the nurse to wear the contact actor, she never wore it before, I stood there and listened to them and took her through.
It's easy, I took a picture and I think you know this is something we can do at the clinic and this is something we can adopt and it will help change the way things are done in the US.
But we went back to my clinic and in my clinic I had two and we had 10 different types of doctors working in the clinic and I said OK, if contact casting is the gold standard, why don't we do that and why don't we use it so much;
Well, I have all sorts of excuses that might take between 20 and 25 minutes.
I'm not trained in the cast so I don't want to do that and my time isn't worth it, meaning they're not compensated for the investment time.
Then I spoke to the nurse at the clinic and my project director and they found that although I had made the kit easier, it was still too complicated in the app, the nurse was just not very familiar and didn't want to do it.
So we solved all of these issues, and I talked to Jeff, and we set up a webinar in Denver at the time to discuss the Doctor Maureen who we applied, then we are also training our nurses at the same time as the nurses will be involved in the app, thus helping to improve the time efficiency of the app.
Then the nurse would put on the clothes, the filling and everything, and the doctor just came in and rolled the cast sleeves down.
I told my doctor this is what we found and I want you to put on 10 plaster and I won't talk after we do it and I won't force you to do it again, but I want you to put on 10 plaster and tell me what you think.
While they were doing this, I also had my nurses record how much time it took them to come in and do it, and we also thought it was easy or complicated.
Then we also followed the nurse's investment in time, how long it took for the nurse to enter the room and prepare things for the doctor so that this lineup could be applied, and that's what we found in the chart, after about four or five applications, the doctor did a very good job in this regard.
I pointed out this slide to them, even with the first plaster, it's like 120 plaster from 10 different doctors and about five and a half minutes to apply it, not the 20 minutes they told me before we did this our product trials will be going on and you can see here when they go out and cast 10 times, it only takes a few minutes for the doctor to put this on.
So it's just for me to talk to my doctor and change the way my clinic is doing.
This is what we found clinically, the day of healing at that time, because we used less effective unloading equipment, the day we heal the wound is the day CMS can now measure the day of the wound clinic, which is a real number.
They can compare who is cost effective and who is cost high, and we know that the cost of care is linear.
The longer the patient takes care of the wound, the more the cost will be.
So what we do is reduce the healing time from 41 days to 15 days, and that's how I broke out, and my project director likes it too, because it makes the clinic more efficient, and there are actually, at the end of the day, contact casting is a little profitable for the clinic.
There are very few profitable things in the wound clinic, and contact casting is one of them.
We also found that it saved time because it took my nurse about 26 minutes to cut off these little felt foam, so we insert these shoes with felt foam in contact with the cast we can say that we have foam every two times and we can see another patient in the clinic
In this way, more patients can be seen and the income of the clinic can be increased.
So by changing the practice of the clinic, we are also more cost-effective and efficient there.
Why not use TCC?
This device, invented by Jeff, solves all these obstacles, which is easy.
There is really no learning curve there;
My doctor and I have proved this.
When you consider what my nurse has done and what the doctor has done, the time to apply is shortened and the total time is about 7 minutes.
Not at all.
It will continue soon and is included in the kit.
Patients like it.
Patients love it because they can take off their boots while they sleep and don't drag all the dirt that traditionally touches the casting, it's lighter and easier.
So the foam is cool.
So my patients like it.
It has all the features
That's why it's a great device.
So my doctor also saw reimbursement and when they applied they were paid $96 and there were very few things in the clinic that doctors could get paid;
My clinic also made a bit of money on this and we also achieved some efficiency in time.
So I don't have to grab my doctor's hair anymore and drag them to contact the casting and I 've convinced these patients that this is the right thing to do and we're going to get good results, cost-effective.
With this I will stop.
I will always apply it, and in short, some of them are the three puppets you mentioned, which I think is great.
I would like to introduce you to Kristin griglick, a clinical nurse specialist from the Massachusetts General Hospital and a user from Medihoney, who will brief her experience using the product at a top hospital in the country.
Good afternoon, thank you very much for coming here.
So I just want to say that it really speaks to the fact that it is important to have a clinician come and tell you the best way for these products, not to conform to the path.
I am from the general public hospital and I believe many of you know that this is an academic medical center with 1,100 beds and we are praised as the first hospital in the United States
American News and World Report
We are as good or bad as any other academic, excellent academic medical center we have in this country.
Our patients are very sick, so we are a good proof. As a last resort, people come to us and the size really matters, especially when we see Medihoney as a potential product to help our patients.
I have been a general public for three years, a lot of academic medical centers, including the general of the general public of traditional practice, not just evidence, clinicians like me need to bring evidence to our practice, in order to make the very needed changes.
At Mass General, the person in charge of wound care is a clinical nurse specialist, where the clinician prepared by the doctor is at the bedside.
We have a wound care task force that reviews patient cases every two weeks and comes together, 53 of us are at the mass assembly and we are gathered to compare notes.
By observing our patients, knowing that we need something else, we are able to communicate with our representative and with our (inaudible)
Who is the representative of Medihoney who brought Medihoney to our facility.
We also found that Medihoney is being used in our facilities that provide rehabilitation and long-term acute care to patients, but we do not because we are still practicing traditional medicine.
Therefore, we have made a product trial from June to August 20, with a total of five units participating in various hospitals.
We used MEDIHONEY gel and seaweed calcium square, and we looked at all of our patients and at our quarterly epidemic stress to identify patients who needed to change the product.
So I have some bloody pictures for you.
I do apologize for them in advance, but I would like you to see the difference this product makes in our patient population. This is a 65-
One year old woman with coronary artery disease, high blood pressure, you have heard from my colleagues that many of our patients today have so many partners
If you are really sick, you have to go to the hospital.
This is a chronic wound on the left heel.
This is quite large, with a lot of scars that you can see in the picture on the left.