Key Themes to Drive Industry Shift
Minimally Invasive Treatment is Large and Underpenetrated: Balloon sinus dilation (BSD) is a minimally invasive alternative to functional endoscopic sinus surgery (FESS). The procedure was introduced in 2005, but remains underpenetrated (we estimate 20% today). We view penetration increasing to 26% in 2021 lead primarily by continued economic and clinical data.

From the Operating Room to the Physician’s Office: We believe an increasing number of chronic sinusitis procedures will shift from the operating room to the physician’s office setting moving forward. This shift provides benefits to all: patients, physicians, and payors.

DB Survey Supports View of Market Growth and Penetration
We conducted a survey of 30 US based, board certified otolaryngologists. We asked our survey respondents to comment on volume expectations, procedure settings, and market share trends. Our results indicate increased volume across procedure types, a move toward office based procedures, and further penetration of minimally invasive treatment options.

Opportunities for Technologies that Lower Costs and Improve Outcomes
New technologies that further enable minimally invasive procedures and the shift to physician’s office based care are also garnering more attention. Medical supplies and devices companies have taken note with recent launches of more compact navigation systems, steroid eluting stents, and more compact surgical tools and technologies.

Eoin Treacy's view

Here is a link to the full report.

Technology is evolving at a pace that is difficult for many people to keep up. That is the challenge of living in a time where exponential growth in understanding innovation, technology and science are competing and complimenting one another. I’m heading to San Diego this afternoon for Singularity University’s ExMed conference where the primary topic of conversation will be what the future holds for the healthcare sector. I look forward to sharing any insights I gain with you when I get back. 

The development of minimally invasive treatments for sinusitis where previously a surgical procedure was required is just one example of the pace of technological innovation. Making sure those cost saving are passed on to consumers, rather than shareholders, is one of the big challenges facing the US healthcare system as it now stands. 

Medtronic remains in a broadly consistent medium-term uptrend. 

Stryker also remains in a reasonably consistent medium-term uptrend. 

Johnson & Johnson continues to revert towards the mean but a sustained move below it would be required to question the consistency of the broad uptrend. 

Smith & Nephew broke out of an 18-month range in June and has now returned to test the upper side of the underlying trading range where it will need to find support if medium-term scope for continued upside is to be given the benefit of the doubt. 

Entellus Medical and Intersect ENT (Ear, Nose, Throat) both IPOed last year. Entellus lost downward momentum from early this year and has been trending higher since April. 

Intersect ENT has been trending lower since July 2015 and is now testing the region of the trend mean. A sustained move above it would begin to signal a return to demand dominance beyond short-term steadying..