Not a viable business. Needs to register as a charity.
Pros
Patients and clinicians are wonderful. SCS is a fantastic rabbit hole of learning you can indulge in.
Cons
I do not understand the business model. The company makes no profit. Nevro sells an alleged better product for pretty much the same money as its 'worse' competitors. The Nevro device has been shown to last over ten years. Competitor devices reportedly last only a few years. Nevro have to service and reprogram these patients for the duration their device is inserted, only making money at the stage of initial implantation. There are no ongoing servicing revenue for reprogramming during the lifespan of the product (which is multiple times of the competition). This means that for every patient, our competitors are likely to make 3+ times the revenue in a similar time frame when they need a new battery. Nevros repeated programming continuously eats into the profit made at implantation. I would not want to run the numbers off the first implanted patients, see how many times they had been re-programmed by a Nevro employee and assign some cost of this service (staff often drive hours or even fly to see one patient). I worry that it is very likely that, by the time the device is a few years old, much of the profits may have been eroded by the invisible and undeclared cost of the service burden. This is only going to get worse the more patients we implant. I do not understand how this is viable, there are key issues which I can only assume is contributing to the shocking share price. For something so clear cut from a hospitals perspective in terms of cost saving, its a miracle that Nevro do not have 100% of the market. I do not understand what is going on, but I do not see how this business model can survive. They have also bought an orthopaedic product. Orthopaedics are notoriously difficult to work in, namely due to the unpredictability of cases - if there is a crash on the motorway, all elective cases are pushed back or cancelled. Fine if you work at Stryker and are bouncing in and out of ortho theatres anyway but for those who have come in specifically to do a case, an absolute waste of a day and unnecessary burden on an already stretched team. Again, very risky product, totally different set of clinicians (customers). I was confused to read that in one of our public reports, an excuse given for reduced SCS implants was clinician attendance at the SI fusion product launch. Firstly, I can't imagine this launch went on for more than a few days and secondly, I have no idea what a neurosurgeon or anaesthetist (who implants SCS) is doing at a Vyrsa training (SI fusion) for orthopaedic surgeons. Call me a cynic.
