National Government Services

[Anonymous]

No and the potential is huge.

Nobody questions the potential, but everybody questions the Company’s capability to capture that potential. Remember, even WITHOUT NGS the market was very, very, humongous (25 plus million OAB patients), yet the company has hardly made a dent in capturing that potential. Selling 4,000 to 5,000 lead set boxes a quarter to treat that many patents in a quarter hardly constitutes much of a penetration in a 25-million patient market. And the growth of penetration has stalled in recent quarters, as witnessed by relatively flat to declining sequential, quarter-over-quarter growth (a better measure of the trend than year-over-year growth comparison).

Sure NGS approval will provide some growth, but what is different with NGS that leads you to believe that in the NGS areas the outcome will be any different from the dismal, poor penetration in other areas where approval has been in existence for a long time?
This is a legitimate question we should be able to discuss without getting defensive or emotional, or being branded as nay sayers or disloyal. Or being told that we now have new management, or a new team, or better training, or better accountability……all that is getting a bit too old now; repetition of that mantra does not contribute to a meaningful discussion. It is all too easy to focus on and tout about quota and stating that I met or exceeded my quota, as that would be a myopic view. We need to remove our rose-colored glasses for this discussion.

My sense is that with reimbursement of about $130 per treatment, many Docs do not consider this worth their while to put up with the hassle of the TRx. Plus, long term there is always that looming threat of reduction in the reimbursement amount, as is with all other procedures. But when you start out with a hassle filled TRx with an already low amount of reimbursement, further reduction in the reimbursement amount makes adoption of this TRx dicey. That is what I am hearing from the business-minded Docs in my area. It is unclear if the GPs will see this any different if the company chooses to expand there.

 

[Anonymous]

It is not only about the reimbursement, it is about the patient. PTNS helps them and has a place.

 

[Anonymous]

It is not only about the reimbursement, it is about the patient. PTNS helps them and has a place.

Stop being Pollyannaish, stop being naïve!!

If the Doc is not going to make money on the TRx, or make enough money to justify the hassle, that TRx is not going to gain widespread acceptance. Because of that we are seeing a low penetration rate even in areas where reimbursement has been in place for a long time. Now couple that with the looming threat of reduction in the reimbursement amount.

These Docs are not non-profits, or working for a charitable organization. They have big mortgages on their fancy house, private school tuition to pay for their kids, and an expensive life style to support. Are there exceptions to this? Sure. Are there Docs who have somehow made this TRx fit in there practice? Of course.

But you can’t rely on exceptions to gain widespread acceptance of this TRx.

Will there be some more sales from the NGS territories? You bet, but there is no reason to believe that the Docs in NGS territories are any more or less altruist than those in other areas. Will NGS provide any greater penetration than what is experienced in other territories? No, it will not, and I hate to tell this to those of you who are already counting on your commissions to come.

You do not gain deeper penetration on a hope, wish or prayer. Yes, the TRx has to work, but you also have to show me the money, baby. This must come as sad news to you, but that is how our capitalist system works.

 

[Anonymous]

Nobody questions the potential, but everybody questions the Company’s capability to capture that potential. Remember, even WITHOUT NGS the market was very, very, humongous (25 plus million OAB patients), yet the company has hardly made a dent in capturing that potential. Selling 4,000 to 5,000 lead set boxes a quarter to treat that many patents in a quarter hardly constitutes much of a penetration in a 25-million patient market. And the growth of penetration has stalled in recent quarters, as witnessed by relatively flat to declining sequential, quarter-over-quarter growth (a better measure of the trend than year-over-year growth comparison).

Sure NGS approval will provide some growth, but what is different with NGS that leads you to believe that in the NGS areas the outcome will be any different from the dismal, poor penetration in other areas where approval has been in existence for a long time?
This is a legitimate question we should be able to discuss without getting defensive or emotional, or being branded as nay sayers or disloyal. Or being told that we now have new management, or a new team, or better training, or better accountability……all that is getting a bit too old now; repetition of that mantra does not contribute to a meaningful discussion. It is all too easy to focus on and tout about quota and stating that I met or exceeded my quota, as that would be a myopic view. We need to remove our rose-colored glasses for this discussion.

My sense is that with reimbursement of about $130 per treatment, many Docs do not consider this worth their while to put up with the hassle of the TRx. Plus, long term there is always that looming threat of reduction in the reimbursement amount, as is with all other procedures. But when you start out with a hassle filled TRx with an already low amount of reimbursement, further reduction in the reimbursement amount makes adoption of this TRx dicey. That is what I am hearing from the business-minded Docs in my area. It is unclear if the GPs will see this any different if the company chooses to expand there.

This is an objcetion i hear. I also know the business-minded Docs in my area see the TRx as $130 x12 weekly TRx plus monthly TRx next.