08.11.20
Rank: #8 (Last year: #8)
$785.4 Million
Prior Fiscal: $713 Million
Percentage Change: +10.2%
No. of Employees: 2,000
Global Headquarters: Audubon, Pa.
KEY EXECUTIVES:
David C. Paul, Executive Chairman
David M. Demski, President and CEO
Daniel T. Scavilla, Exec. VP and Chief Commercial Officer
Keith Pfeil, Sr. VP and Chief Financial Officer
Kelly G. Huller, Sr. VP, General Counsel, and Corporate
For years, Chuck Scott and Greg Brown suffered in solitude, each unaware the other existed.
The two were neither friends nor relatives yet they led strikingly parallel lives, their paths conjoining in a tangle of physical torment.
They are similar yet different: Well past middle-aged, one is clean-shaven and balding, the other is bearded, bushy-haired, and bespectacled.
They are different yet similar: One is older and slimmer, the other younger and huskier. Back pain loomed large in their lives.
Not surprisingly, the pain itself was similar yet different: Affecting the lower back, it waxed and waned for one but regularly throbbed for the other.
The treatment, accordingly, was different yet similar: Injections for one, narcotics/surgeries for the other. All were unsuccessful.
Then came the robot.
Desperate to escape their collective misery, Scott and Brown turned to ExcelsiusGPS, a robotic-assisted platform that integrates navigation with real-time feedback, disc preparation, and implant insertion. Developed by Audubon, Pa.-based Globus Medical Inc., the system can tackle complex cases from a single lateral position with better accuracy, surgical efficiency, and reduced radiation exposure.
“It allows us to improve our accuracy with our instrumentation placement,” Joshua Bunch, M.D., said last fall in a University of Kansas Health System blog. “It allows us to decrease our operative times, decrease the blood loss for a given patient, hopefully speed their time, their intraoperative stay in the hospital, and also decrease the radiation they receive for a given case.”
ExcelsiusGPS debuted in late 2017, the same year it was sanctioned by U.S. and European regulators. Globus Medical intentionally designed the platform to address the limitations of previously released robotic systems, namely inaccurate navigation, tactile feedback loss, and increased operative time.
The ExcelsiusGPS features a rigid external arm for direct transpedicular drilling and screw placement (no K-wires needed). The platform also has a surveillance marker to quickly detect registration loss and a lateral force meter to identify skiving.
Globus’ robotic navigation platform gained market traction relatively quickly, accruing 3,000 pedicle screw implantations within seven months of its release. But clinical evidence was scant until the company shared study results last spring showing the efficiency of its robotic navigation over traditional screw placement techniques.
Published in the Journal of Robotic Surgery, the trial evaluated ExcelsiusGPS’s surgical technique, which combines three imaging workflows—preoperative CT, intraoperative CT, and fluoroscopy—with navigation and guidance to place pedicle screws using real-time feedback. The data revealed a 99 percent screw placement success rate, with no malposition or post-operative complications.
Five hundred sixty-two lumbar pedicle screws were placed across six vertebral levels during 55 single-position lateral, 16 anterior, and 29 posterior interbody fusions. Interbody placement was performed manually.
“This study highlights the system’s capability to transform the way lateral surgery is performed. ExcelsiusGPS enables surgeons to perform minimally invasive screw fixation with the patient remaining in the lateral position, compared to traditional lateral approaches where the patient is intraoperatively repositioned prone,” Kade T. Huntsman, M.D., a Salt Lake City spine surgeon, said upon release of the results. “Eliminating patient repositioning may lead to increased operational efficiency, cost savings, and improved patient outcomes.”
Those improved outcomes may be reciprocal, too: Globus Medical experienced its third consecutive year of double-digit growth in 2019, and its ExcelsiusGPS is largely responsible for the uptick.
“We continue to see robust adoption trends by surgeons who are experiencing the benefits of ExcelsiusGPS technology as they incorporate [it] into their practices,” Globus Medical President and CEO David M. Demski told analysts during a fourth-quarter and full-year 2019 earnings call. “...our innovative technologies have gained traction as a result of increased investments in surgeon education and we are seeing strong implant pull through from ExcelsiusGPS installations. We are well-positioned for continued strong growth internationally.”
That growth surged 15.6 percent last year, pushing Globus Medical’s international sales total to $137.7 million. The increase was driven primarily by higher sales in Japan and “other countries” (the company was not more specific), as well as strong demand for INR (imaging, navigation, and robotic-assisted surgery) technology. On a constant currency basis, international revenue expanded by $20.9 million, or 17.6 percent.
Worldwide sales jumped 10.1 percent to $712.9 million, with the bulk of the revenue beget domestically, as strong spine product sales bolstered U.S. proceeds 9 percent to $593.8 million. Gross profit ballooned 9.4 percent to $605.4 million, and operating income climbed 1.6 percent to $171.9 million, according to Globus Medical’s 2019 annual report.
Musculoskeletal Solutions revenue grew 11 percent in fiscal 2019, and the company’s spine business captured significant market share during the final quarter due to competitive sales rep recruiting and implant pull-through from ExcelsiusGPS installations.
Much of spine’s growth, however, also can be attributed to the bevy of new products launched in 2019. Last spring, Globus Medical debuted both a variable angle corpectomy solution and an expandable interspinous fixation system.
The FORTIFY VA expandable corpectomy spacer optimizes anatomical fit using either an anterior cervical approach or one of several thoracolumbar spine approaches. The device provides up to 16 degrees of angulation as it expands to self-align its variable angle endplate with a patient’s anatomy—a feature that is missing in most traditional corpectomy products.
“Endplate selection is an important factor in restoring sagittal and coronal spinal alignment and providing construct stability,” Mike Chen, M.D., a California neurosurgeon who performed the first FORTIFY VA procedure, said upon the product’s April 2019 launch. “FORTIFY VA removes the guesswork in choosing an ideal lordotic or kyphotic implant. The ability to provide a customizable implant in fewer steps that is designed to restore height and automatically adjust the endplate to the interfacing vertebra is a significant advancement in expandable corpectomy technology.”
Like the FORTIFY VA device, Globus Medical’s AERIAL system is designed for customization. The minimally invasive product features an expandable central core that provides continuous distraction for indirect decompression and a customized patient fit. AERIAL’s easy insertion and controlled expansion provides a simple MIS solution for interspinous fixation. Its independent locking plates help adapt to varying patient anatomies by optimizing spine engagement into each spinous process separately.
“It is an improvement over traditional spinous process devices because AERIAL expands to fit the interspinous space of the patient’s spine,” orthopedic surgeon David Bomback, M.D., said when the device debuted. He and Sumit Das, M.D., performed the first AERIAL procedures at Danbury Hospital in Danbury, Conn. “We now have the opportunity to help more patients, especially those with spinal instability from previous procedures, scoliosis, or who have poor bone quality due to age.”
Other additions to Globus Medical’s spine portfolio last year included the CREO NXT Stabilization System, SI-LOK Select Sacroiliac Joint Fixation, and the HEDRON line of 3D printed interbody spacers. The latter entrant, comprising the HEDRON IC (a cervical integrated plate and spacer system) and HEDRON IA (a lumbar integrated plate and spacer system) was released in the fourth quarter.
HEDRON spacers feature a biomimetic porous scaffold designed to promote bone formation onto and through the implant. Unlike first-generation 3D printed implants, the HEDRON portfolio balances strength and porosity through a sturdy frame and pore size distribution similar to trabecular bone.
The spine business, however, was not the only prolific innovator last year. Globus Medical also bolstered its Trauma offering, launching six new solutions, including the AUTOBAHN Nailing System. The platform of tibia and femur fracture treatments is comprised of the Intramedullary Trochanteric Nail, Antegrade/Retrograde Femoral Nail, and Tibial Nail; the lineup itself complements the company’s ANTHEM Plating and ARBOR External Fixation Systems.
The AUTOBAHN Trochanteric Nailing System treats trochanteric and femoral neck fractures via three different neck-shaft angles to accommodate various femoral neck anatomy. Streamlined instruments feature dedicated radiolucent aiming guides and unique fracture reduction forceps offer system efficiency and provide improved visualization of the femoral head. Radiographic markers embedded in the targeting arm allow nail anteversion alignment for optimal placement.
The AUTOBAHN Antegrade/Retrograde Femoral Nailing System enables greater trochanter or piriformis fossa surgical entry points. With the incorporation of reconstruction holes and transverse options, this nail was designed for more fracture patterns than others on the market, according to Globus Medical. The A/R nailing system provides fixation for common femoral shaft fractures as well as the benefit of reconstruction holes and reverse obliquity holes for fractures requiring more comprehensive fixation.
The AUTOBAHN Tibial Nailing System includes instruments for both the classic infrapatellar approach and the increasingly popular suprapatellar approach. The system features headless locking screws designed to decrease soft tissue irritation. SureStart threaded fixation is incorporated into the nail to facilitate extreme nailing for stable fracture fixation. Instruments including the one-piece Suprapatellar Cannula reduce the amount of procedural steps.
In an effort to diversify its offerings beyond spine, Globus Medical acquired StelKast last summer for $24.1 million (the price, however, could increase by $4.3 million if certain product and sales milestones are met, including a robot-assisted system for joint reconstruction that is expected to launch later this year). In purchasing the total joint arthroplasty systems manufacturer, Globus Medical affirmed its intent to expand its reach into the TJA market.
“The StelKast acquisition should serve as a platform to expand our products and services into the total joint arthroplasty market,” David Paul, executive chairman, said in a news release. “Globus Medical’s product development engine and history of innovation, when combined with our computer assisted technologies in Imaging, Navigation and Robotics, have the potential to improve clinical care for joint arthroplasty patients and create value for shareholders.”
$785.4 Million
Prior Fiscal: $713 Million
Percentage Change: +10.2%
No. of Employees: 2,000
Global Headquarters: Audubon, Pa.
KEY EXECUTIVES:
David C. Paul, Executive Chairman
David M. Demski, President and CEO
Daniel T. Scavilla, Exec. VP and Chief Commercial Officer
Keith Pfeil, Sr. VP and Chief Financial Officer
Kelly G. Huller, Sr. VP, General Counsel, and Corporate
For years, Chuck Scott and Greg Brown suffered in solitude, each unaware the other existed.
The two were neither friends nor relatives yet they led strikingly parallel lives, their paths conjoining in a tangle of physical torment.
They are similar yet different: Well past middle-aged, one is clean-shaven and balding, the other is bearded, bushy-haired, and bespectacled.
They are different yet similar: One is older and slimmer, the other younger and huskier. Back pain loomed large in their lives.
Not surprisingly, the pain itself was similar yet different: Affecting the lower back, it waxed and waned for one but regularly throbbed for the other.
The treatment, accordingly, was different yet similar: Injections for one, narcotics/surgeries for the other. All were unsuccessful.
Then came the robot.
Desperate to escape their collective misery, Scott and Brown turned to ExcelsiusGPS, a robotic-assisted platform that integrates navigation with real-time feedback, disc preparation, and implant insertion. Developed by Audubon, Pa.-based Globus Medical Inc., the system can tackle complex cases from a single lateral position with better accuracy, surgical efficiency, and reduced radiation exposure.
“It allows us to improve our accuracy with our instrumentation placement,” Joshua Bunch, M.D., said last fall in a University of Kansas Health System blog. “It allows us to decrease our operative times, decrease the blood loss for a given patient, hopefully speed their time, their intraoperative stay in the hospital, and also decrease the radiation they receive for a given case.”
ExcelsiusGPS debuted in late 2017, the same year it was sanctioned by U.S. and European regulators. Globus Medical intentionally designed the platform to address the limitations of previously released robotic systems, namely inaccurate navigation, tactile feedback loss, and increased operative time.
The ExcelsiusGPS features a rigid external arm for direct transpedicular drilling and screw placement (no K-wires needed). The platform also has a surveillance marker to quickly detect registration loss and a lateral force meter to identify skiving.
Globus’ robotic navigation platform gained market traction relatively quickly, accruing 3,000 pedicle screw implantations within seven months of its release. But clinical evidence was scant until the company shared study results last spring showing the efficiency of its robotic navigation over traditional screw placement techniques.
Published in the Journal of Robotic Surgery, the trial evaluated ExcelsiusGPS’s surgical technique, which combines three imaging workflows—preoperative CT, intraoperative CT, and fluoroscopy—with navigation and guidance to place pedicle screws using real-time feedback. The data revealed a 99 percent screw placement success rate, with no malposition or post-operative complications.
Five hundred sixty-two lumbar pedicle screws were placed across six vertebral levels during 55 single-position lateral, 16 anterior, and 29 posterior interbody fusions. Interbody placement was performed manually.
“This study highlights the system’s capability to transform the way lateral surgery is performed. ExcelsiusGPS enables surgeons to perform minimally invasive screw fixation with the patient remaining in the lateral position, compared to traditional lateral approaches where the patient is intraoperatively repositioned prone,” Kade T. Huntsman, M.D., a Salt Lake City spine surgeon, said upon release of the results. “Eliminating patient repositioning may lead to increased operational efficiency, cost savings, and improved patient outcomes.”
Those improved outcomes may be reciprocal, too: Globus Medical experienced its third consecutive year of double-digit growth in 2019, and its ExcelsiusGPS is largely responsible for the uptick.
“We continue to see robust adoption trends by surgeons who are experiencing the benefits of ExcelsiusGPS technology as they incorporate [it] into their practices,” Globus Medical President and CEO David M. Demski told analysts during a fourth-quarter and full-year 2019 earnings call. “...our innovative technologies have gained traction as a result of increased investments in surgeon education and we are seeing strong implant pull through from ExcelsiusGPS installations. We are well-positioned for continued strong growth internationally.”
That growth surged 15.6 percent last year, pushing Globus Medical’s international sales total to $137.7 million. The increase was driven primarily by higher sales in Japan and “other countries” (the company was not more specific), as well as strong demand for INR (imaging, navigation, and robotic-assisted surgery) technology. On a constant currency basis, international revenue expanded by $20.9 million, or 17.6 percent.
Worldwide sales jumped 10.1 percent to $712.9 million, with the bulk of the revenue beget domestically, as strong spine product sales bolstered U.S. proceeds 9 percent to $593.8 million. Gross profit ballooned 9.4 percent to $605.4 million, and operating income climbed 1.6 percent to $171.9 million, according to Globus Medical’s 2019 annual report.
Musculoskeletal Solutions revenue grew 11 percent in fiscal 2019, and the company’s spine business captured significant market share during the final quarter due to competitive sales rep recruiting and implant pull-through from ExcelsiusGPS installations.
Much of spine’s growth, however, also can be attributed to the bevy of new products launched in 2019. Last spring, Globus Medical debuted both a variable angle corpectomy solution and an expandable interspinous fixation system.
The FORTIFY VA expandable corpectomy spacer optimizes anatomical fit using either an anterior cervical approach or one of several thoracolumbar spine approaches. The device provides up to 16 degrees of angulation as it expands to self-align its variable angle endplate with a patient’s anatomy—a feature that is missing in most traditional corpectomy products.
“Endplate selection is an important factor in restoring sagittal and coronal spinal alignment and providing construct stability,” Mike Chen, M.D., a California neurosurgeon who performed the first FORTIFY VA procedure, said upon the product’s April 2019 launch. “FORTIFY VA removes the guesswork in choosing an ideal lordotic or kyphotic implant. The ability to provide a customizable implant in fewer steps that is designed to restore height and automatically adjust the endplate to the interfacing vertebra is a significant advancement in expandable corpectomy technology.”
Like the FORTIFY VA device, Globus Medical’s AERIAL system is designed for customization. The minimally invasive product features an expandable central core that provides continuous distraction for indirect decompression and a customized patient fit. AERIAL’s easy insertion and controlled expansion provides a simple MIS solution for interspinous fixation. Its independent locking plates help adapt to varying patient anatomies by optimizing spine engagement into each spinous process separately.
“It is an improvement over traditional spinous process devices because AERIAL expands to fit the interspinous space of the patient’s spine,” orthopedic surgeon David Bomback, M.D., said when the device debuted. He and Sumit Das, M.D., performed the first AERIAL procedures at Danbury Hospital in Danbury, Conn. “We now have the opportunity to help more patients, especially those with spinal instability from previous procedures, scoliosis, or who have poor bone quality due to age.”
Other additions to Globus Medical’s spine portfolio last year included the CREO NXT Stabilization System, SI-LOK Select Sacroiliac Joint Fixation, and the HEDRON line of 3D printed interbody spacers. The latter entrant, comprising the HEDRON IC (a cervical integrated plate and spacer system) and HEDRON IA (a lumbar integrated plate and spacer system) was released in the fourth quarter.
HEDRON spacers feature a biomimetic porous scaffold designed to promote bone formation onto and through the implant. Unlike first-generation 3D printed implants, the HEDRON portfolio balances strength and porosity through a sturdy frame and pore size distribution similar to trabecular bone.
The spine business, however, was not the only prolific innovator last year. Globus Medical also bolstered its Trauma offering, launching six new solutions, including the AUTOBAHN Nailing System. The platform of tibia and femur fracture treatments is comprised of the Intramedullary Trochanteric Nail, Antegrade/Retrograde Femoral Nail, and Tibial Nail; the lineup itself complements the company’s ANTHEM Plating and ARBOR External Fixation Systems.
The AUTOBAHN Trochanteric Nailing System treats trochanteric and femoral neck fractures via three different neck-shaft angles to accommodate various femoral neck anatomy. Streamlined instruments feature dedicated radiolucent aiming guides and unique fracture reduction forceps offer system efficiency and provide improved visualization of the femoral head. Radiographic markers embedded in the targeting arm allow nail anteversion alignment for optimal placement.
The AUTOBAHN Antegrade/Retrograde Femoral Nailing System enables greater trochanter or piriformis fossa surgical entry points. With the incorporation of reconstruction holes and transverse options, this nail was designed for more fracture patterns than others on the market, according to Globus Medical. The A/R nailing system provides fixation for common femoral shaft fractures as well as the benefit of reconstruction holes and reverse obliquity holes for fractures requiring more comprehensive fixation.
The AUTOBAHN Tibial Nailing System includes instruments for both the classic infrapatellar approach and the increasingly popular suprapatellar approach. The system features headless locking screws designed to decrease soft tissue irritation. SureStart threaded fixation is incorporated into the nail to facilitate extreme nailing for stable fracture fixation. Instruments including the one-piece Suprapatellar Cannula reduce the amount of procedural steps.
In an effort to diversify its offerings beyond spine, Globus Medical acquired StelKast last summer for $24.1 million (the price, however, could increase by $4.3 million if certain product and sales milestones are met, including a robot-assisted system for joint reconstruction that is expected to launch later this year). In purchasing the total joint arthroplasty systems manufacturer, Globus Medical affirmed its intent to expand its reach into the TJA market.
“The StelKast acquisition should serve as a platform to expand our products and services into the total joint arthroplasty market,” David Paul, executive chairman, said in a news release. “Globus Medical’s product development engine and history of innovation, when combined with our computer assisted technologies in Imaging, Navigation and Robotics, have the potential to improve clinical care for joint arthroplasty patients and create value for shareholders.”