Corin Share Discussion Threads

[wan] 15/5/2012 08:40

Nearly all of my investments have at least some exposure to the very favourable world demographics factor. I would recommend those who have not already read it (registered readers only) to read John Baron's article, it is the 2nd most read article online. Although it does not mention CRG, the investment rationale is identical -

A CLASSIC OUT OF FAVOUR OPPORTUNITY
By John Baron, 01 May 2012

In many cases, the full investment ramifications of the rapid growth in the world's population have yet to be fully appreciated. The healthcare sector is one such example.

The population is set to grow from around 6.7bn to, according to the UN, 9bn by 2050 - a rate of growth unsurpassed in the world's history.

But the story doesn't end there. Increasingly affluent and educated societies in the emerging markets will prove lucrative markets.

Well worth registering and/or subscribing to read!

[wan] 15/5/2012 08:00

A very interesting read -

Product strategy update May 2012

[wan] 13/5/2012 11:54

I took further advantage of the recent lows (hopefully a double bottom reversal?), so I was very pleased to note an excellent IMS from Corin on Friday (in my absence).

[wan] 03/5/2012 07:13

I note that Corin has an impressive new website, in particular a website specific to the US –


Recall that Corin closed its China operation, so the following caught my attention –

Ageing population should see China and Australia joined at hip
DANIEL FLITTON
02 May, 2012

THERE are 8 million Chinese over 80 years of age and, by some estimates, there will be 100 million Chinese octogenarians by the middle of this, the Asian century.

And although old age may bring brittle bones, there is a view that Australia's ties to China could benefit from a hip replacement. Half a million even.

That's how many operations Stephen Leeder, the director of Sydney's Menzies Centre for Health Policy, estimates will be needed in China each year by 2050 - offering Australia a unique chance to foster closer links with Beijing by helping China cope with the consequences of an ageing population.



Corin has a very strong operation in Australia –

[wan] 24/4/2012 08:52

Judging by the share price performance, once again Corin is clearly out of favour, but not off a few radars it would appear. Anyway, I still believe there is value here for those looking at investments that spans beyond a few months. If anyone is genuinely interested in this highly respected and innovative company, I would recommend a read of the following –

Results presentation 2011

The AR (which has quite a lot of additional commentary)

Corporate Brochure

All available here –

[wan] 23/4/2012 16:10

Large volume being recorded here!

[wan] 18/4/2012 07:20

April 17, 2012, 6:36 p.m. ET

Stryker's Profit Jumps on Rising Hip, Knee Sales

By ANJALI ATHAVALEY
Stryker Corp.'s SYK +1.20%first-quarter earnings rose 14% as the medical-device maker saw sales of its hip and knee replacements increase, providing further evidence that the orthopedic market may be picking up

Recently, though, there have been signs that the joint-reconstruction market is strengthening. Last week, privately held rival Biomet reported modestly higher sales of hip and knee replacements for its most recent quarter, and Johnson & Johnson JNJ +0.38%said earlier on Tuesday that it was seeing early signs of positive trends in the market for knees.

Full story -

[wan] 29/3/2012 07:51

March 26, 2012
Hip fractures represent largest EU economic burden for fragility fractures

The direct cost of treating incident fractures for the 27 member states were €26 billion and the states spent €11 billion for long-term fracture care, according to the abstract.

[contrarian2investor] 27/3/2012 19:37

wan, the litigation for all companies historically involved in MoM could go on for years. Therefore depressing sp's.

[wan] 27/3/2012 07:39

I note that the investigation into the questionable practices of the large players has resulted in further action of fines and compliance monitoring, which as I suggested previously appears to be leveling the playing field. It is intersting how Biomet's activities/practices in China is particularly highlighted, and most will recall that Corin was forced to close their China operation due to its poor performance -

March 26, 2012 10:52 pm

DoJ fines Biomet $23m over bribery
By Andrew Jack in London

[wan] 22/3/2012 07:48

Global Orthopedic Prosthetics Market to Reach US$23.5 Billion by 2017, According to New Report by Global Industry Analysts, Inc.

San Jose, California (PRWEB) March 21, 2012

GIA announces the release of a comprehensive global report on Orthopedic Prosthetics markets. The global Orthopedic Prosthetics market is projected to reach US$23.5 billion by the year 2015, spurred by a multitude of factors including aging global population, rising incidence of degenerative joint diseases, and improving healthcare infrastructure in developing countries. Besides, development of durable and improved materials and implants is also expected to contribute to the market's growth.

Segmnet-wise Knee Prosthesis constitute the largest product segment. Expanding aging population facing higher risk of hip degenerative conditions, and rising instances of hip-related diseases are expected to enhance the demand for hip implants. The advent of advanced techniques and biomaterials, and the growing popularity of hip arthroplasty procedures among younger patients are enhancing prospects in the global hip implants market.

The full article is well worth a read -

[wan] 22/3/2012 07:42

Next generation vitamin E highly cross-linked polyethylene gains FDA clearance
21 March 2011

Corin adds the next generation vitamin E polyethylene to its high performance bearing options for the Trinity™ advanced acetabular system following FDA 510(k) clearance.


In February, Corin received 510(k) clearance from the FDA for ECiMa™ highly cross-linked polyethylene liners to be used in combination with the large diameter Cobalt Chrome and BIOLOX® delta ceramic heads (up to 40mm) for its Trinity™ acetabular system.


This announcement marks another significant step forward for Corin's hip portfolio in the US following a number of 510(k) clearances in 2011, which enables the company to offer a range of high performance bearing solutions within a versatile Continuum of Hip Care to surgeons across the country. Corin's Continuum of Hip Care offers the surgeon the ability to select the right implant for a broad spectrum of patient indications with a range of choices that focus on bone conservation, hip stability, fixation and wear. Today's patient population is placing greater demands on their hip replacements and the ability to address individual surgeon and patient requirements is a fundamental part of a modern day hip portfolio.


ECiMa™ represents the world's first highly cross-linked vitamin E polyethylene which is mechanically annealed, preserving the mechanical properties such as strength whilst achieving extremely low wear1,2. Studies show that ECiMa™ reduces wear in a 40mm bearing by 95% compared to a standard 32mm polyethylene bearing. When compared to a first generation highly cross-linked polyethylene, used by many major orthopaedic companies, ECiMa™ reduces wear by 83%1. The ultimate tensile strength of ECiMa™ is also comparable to that of standard polyethylene and is a 45% improvement on the first generation highly cross-linked polyethylenes2. These excellent wear characteristics and mechanical properties allow the use of optimised bearings to help restore function to the hip and help provide the potential for better long-term results for patients.


The ultimate benefit of ECiMa™ is generated through the active stabilisation provided by the blended vitamin E which has been shown through various studies to provide ongoing protection against oxidation of the polyethylene whilst in the hip joint. The free radical stabilisation effect of vitamin E provides a natural barrier to potential long-term oxidation which can occur in vivo. Test results show no evidence of oxidation following intensive ageing and cyclic loading in vitro where previous HXLPE liners have failed3.


Katherine Granger, Corin's Global Head of Hip Marketing, commented "ECiMa™ is an excellent addition to the Trinity™ acetabular system offering surgeons and patients the most advanced bearing technology within an innovative system. ECiMa™ is the next generation vitamin E-enriched technology and the most advanced polyethylene on the market, providing a high performance alternative to hard bearings. As such, future plans include the roll-out of ECiMa™ to some of our knee products, and others, across Corin's wider portfolio."

[wan] 20/3/2012 07:56

Many questions are answered on Corin's recently updated MoM website page and I would strongly recommend reading the entire (relatively short) document. The reader will note that most hip replacements in the United Kingdom are not metal-on-metal bearings and the very good clinical data being recorded in the UK and the US –

Metal-on-metal
Cormet hip resurfacing and Optimom large diameter metal-on-metal total hip replacement

Patients - Frequently Asked Questions

7. What is the ARMD rate for the Cormet hip resurfacing?
Multi-centre studies in the UK and USA report very low levels of adverse reactions to metal debris for Cormet patients. In a UK multi-centre study of 1743 hips, 4 (0.22%) were revised due to adverse soft tissue reactions(5). In a US multi-centre study, 1 patient of 1183 reported a soft tissue reaction (0.08%)(6). The revision rate reported on the UK National Joint Registry (NJR) for Cormet due to ARMD is 0.57%(7). Other devices which have now been recalled from the market have demonstrated catastrophic short term clinical results of a 25% and 48.8% failure rates at 6 years due to ARMD(8). In respect to these DePuy Johnson & Johnson devices there are a number of design characteristics that have potentially contributed to this.


Summary
There are a number of factors which influence the success of a metal-on-metal hip resurfacing or large diameter metal-on-metal total hip replacement. These include the patient's age, gender, activity levels, pre-operative diagnosis and general health. Metal-on-metal hip resurfacing and large diameter metal-on-metal total hip replacement remains a safe and effective surgical intervention for well-indicated patients. The clinical data shows there has been a low incidence of ARMD associated with Corin's metal-on-metal hip resurfacing and total hip replacement.

[smarkmmm] 19/3/2012 11:12

wan

You may be right with your bullish case for Corin.

It just makes me nervous with so much coming out about MoM - for which at one time Corin was a/the big player. More today:

"A recent investigation by the British Medical Journal and Newsnight is far more critical. Deborah Cohen, author of the BMJ report, says the risks of some metal-on-metal hip devices have been known for decades but "patients have been kept in the dark about their participation in what has effectively been a largely uncontrolled experiment". Trends come and go in orthopaedics and some suspect there is an element of "little boys and their shiny new toys" about the early enthusiasm for MoM.

If that is true that the risks have been known for decades then obviously the legal defence for MoM is less than robust.

[wan] 19/3/2012 08:46

Just to add a bit more meat to the bone with regard to my comment above that "Corin's other product developments are 'well advanced' too, which is no mean feat and provides for a very attractive aspect in my opinion".

In short, the regulatory environment has become more challenging and more stringent, resulting in fewer new products being approved, and yet for such a small company Corin's multiple product development is well advanced. On the other side of the spectrum the lack of innovation/product approval at the larger players (and their balace sheets) is likley to be mean that innovative 'advanced' product development becomes as important as approved products i.e. a very attractive ingredient. Some analysts are forecasting that 2012 will see an increase in M&A in the sector, so even with no direct approaches, this could be quite a supporting factor going forwards.

[contrarian2investor] 14/3/2012 18:26

smarkmmm and wan, great recent posts. I remain on the sidelines, whilst waiting to see where CRG eventually finds support. NB closed 30/12/11 @42.25p.

[wan] 14/3/2012 14:11

Smarkmmm...The main thrust was in fact severalfold.

1. That Resurfacing implants were not included in the surveys that highlighted the issues.

2. That the clinical data was good enough that Cormet is still recommended and used for certain patient groups.
(It must be much harder to justify litigation when the overall clinical data is very good)

3. That Corin were ahead of the curve with regard to product development away from MoM.

And perhaps most importantly MoM now represents only a small fraction of Corin's revenues and if this was not the case I would be very concerned. Nonetheless, recent media coverage will serve to affect all MoM implants, but at the same time drive the growth in non-MoM, fortunately we already have a portfolio that can address this likely 'increased' move away from MoM, but Corin's other product developments are 'well advanced' too, which is no mean feat and provides for a very attractive aspect in my opinion.

[smarkmmm] 14/3/2012 10:59

wan

You were spot on about the reliability of Smith & Nephew:



Smith & Nephew unveils the results of its FDA-requested metal-on-metal hip resurfacing implant study, finding that 99% of participants were either satisfied or extremely satisfied with their implants at 10 years.

"The fact is that the BHR hip is not like other metal-on-metal hip implants," global hip franchise senior vice president John Soto said in prepared remarks. "It really is in a class all its own – it's safe and effective, and is the best choice for the right patient."

[smarkmmm] 13/3/2012 11:26

Always glad to be brought up to speed ;)

(I would be surprised however if data presented in a company brochure was anything other than favourable!)

I expect you are right and there's nothing to worry about.

Still didn't like the dividend cut.

[wan] 13/3/2012 10:40

Smarkmmm...Well to bring you up to speed, data is certainly available from Corin, in fact the data is better than S&N with an implant survival rate as high as 96.2% -

Metal-on-Metal
A Clinical Overview

Adverse reactions to metal debris
In response to the earlier medical device alert published by the MHRA on all metal-on-metal hip replacements, Corin aims to provide clarity and perspective on the many publications that relate to large diameter metal-on-metal articulations. The alert discusses the reports of revisions due to soft tissue reactions which may be associated with unexplained pain. It recommends the follow-up of metal-on-metal hip replacements, including where appropriate blood metal ion measurement and cross-sectional imaging.

Over the last three years there has been much debate relating to the subject of adverse reactions to metal-on-metal wear debris (ARMD). This document aims to provide a balanced perspective and summary of the publications both against and in support of hip resurfacing and large diameter metal-on-metal articulations.

Click the MoM on the right hand side to download and read the full report or Product Overview for further information


In 2010 the MHRA advised that people fitted with the devices should undergo annual check-ups for five years following surgery, Corin has also reported good clinical evidence with regard to these follow ups. In fact I took this aspect up with Corin's FD including with regard to litigation etc, and hence he was able to confirm that they were not seeing any issues emerging with regard to this.

I think that Corin were ahead of the curve regarding MoM, and their portfolio strategy away from MoM is looking evermore insightful!

[smarkmmm] 13/3/2012 10:03

wan

The full sentence doesn't change the message I was trying to make - the environment is more litigious, and I fear anyone with a failed Corin hip will see all the publicity about the DePuy MoM fiasco, and join one of the class actions. I expect lawyers are beginning to salivate.

As I mentioned before, another MoM company is now implicated:
"Wright Joins DePuy in Metal On Metal Hip Lawsuit Club"


I have read that Smith & Nephew's Birmingham system have good success rates, but Smith & Nephew is not Corin. My understanding was that a different technology is used for the metal surfaces (double heat treatment?? I forget)

For all I know Corin's success rate may be better, but it cannot be assumed since the data is not available, and I fear the good companies may get caught up with the bad. Corin does not have the same financial muscle as Smith & Nephew, say, to fight any legal action.

It's a shame because Corin does have a growth story to tell, but MoM and LARS "muddy the water".

[smarkmmm] 13/3/2012 07:37

wan

Hear what you say, but feel that sentiment is against Corin at the moment. Dividend cut and FD leaving didn't help either. Here's the news today:



"overall, 6.2% of metal-on-metal hips had failed within five years"

Corin may well be better than that % but litigation risk still present and should be factored in. Corin's recent results: "the increasingly litigious environment in this sector"