Nevro











































There are multiple problems with this study, the biggest being PROCO isn't even testing Nevro's therapy. Boston just turned tonic up to 10K inside the only place they can, a clinical study. They did not use the programming algortihms, pulse widths or anatomical targets that Nevro uses. The study of 10k was 4 weeks long. WTF.

PROCO evaluates Boston's intentionally shitty attempt to copy Nevro's therapy with paid Boston consultants and programming personnel. The bias could not be more explicit.

They didn't achieve the pain relief Nevro patients achieved in the Senza RCT out to 24 months (2.4 on VAS for back & leg). The PROCO results contradict published and peer reviewed evidence, and data from Medtronic (Al-Kaisy & Provenzano) which show there is no difference between MDT standard tonic and their 1khz HDtherapy. Even if Boston patients choose to use 1khz their daily charge burden is 2.5 hours at 1khz. If Boston patients could ever run at 10khz commercially (the IP blocks it) the patients would be charging at least 4 hours a day. This, along with the absence of additional pain relief are why over 95% of the ~100 patients in a Kapural Study testing Boston's 1000hz therapy reverted back to tonic.

Nevro patients charge 30 mins daily at 10,000hz and get the relief that the FDA, CMS, Neurosurgery Journal and Anesthesiology journal has deemed clinically superior.

Boston's messaging to counter these realities has really become quite pathetic. Nevro and Abbott will be duking it out for market leadership in 2018. Abbott has a huge amount of built in battery replacement business that afford them a short term advantage. Medtronic and Boston will continue to decline, and new cans won't save them. Everyone knows the same waveform comes out of the new can.
 












explain why reps and doctors are leaving nevro? explant rates are approaching fda investigation, reps are saying little troll is horrible we just picked up 5 reps at sjm and they tell us nami is laughable, kb is laughing @ troll while playing earnings of the little joke speaking both sides of mouth poor little guy@4ft:pkb said vp from mdt turned down nami offer,said the little joke is arrogant and definitely small:oops: wall street knows you r doodo0:D
 






explain why reps and doctors are leaving nevro? explant rates are approaching fda investigation, reps are saying little troll is horrible we just picked up 5 reps at sjm and they tell us nami is laughable, kb is laughing @ troll while playing earnings of the little joke speaking both sides of mouth poor little guy@4ft:pkb said vp from mdt turned down nami offer,said the little joke is arrogant and definitely small:oops: wall street knows you r doodo0:D

Maybe you'll be promoted to a TM 1. Probably, you'll be a "Clinical Specialist" for a few more years.
 






explain why reps and doctors are leaving nevro? explant rates are approaching fda investigation, reps are saying little troll is horrible we just picked up 5 reps at sjm and they tell us nami is laughable, kb is laughing @ troll while playing earnings of the little joke speaking both sides of mouth poor little guy@4ft:pkb said vp from mdt turned down nami offer,said the little joke is arrogant and definitely small:oops: wall street knows you r doodo0:D

KB only knows that because he was a candidate also and got passed over. They're still looking.
 






KB only knows that because he was a candidate also and got passed over. They're still looking.

The fact that the VP slot is still vacant after several months does not reflect well on the organization. Executives usually don't just up and quit without establishing a plan for succession and minimal disruption. It would seem that Rami was either caught by surprise at the resignation, or that he gave X the boot without a back-up plan. Either way, not a good look for your engineer turned CEO...
 






The fact that the VP slot is still vacant after several months does not reflect well on the organization. Executives usually don't just up and quit without establishing a plan for succession and minimal disruption. It would seem that Rami was either caught by surprise at the resignation, or that he gave X the boot without a back-up plan. Either way, not a good look for your engineer turned CEO...

Unless of course the VP Sales had a diminished role to begin with. Other than recruiting top notch personnel early on, Clinical & Marketing are the key drivers here, like it or not. Clean, irrefutable data and patient experiences are the catalyst for sales. Imagine that!
 






Unless of course the VP Sales had a diminished role to begin with. Other than recruiting top notch personnel early on, Clinical & Marketing are the key drivers here, like it or not. Clean, irrefutable data and patient experiences are the catalyst for sales. Imagine that!

If the data was actually a major catalyst, Nevro wouldn't be struggling to hit the sales numbers promised to Wall Street. As for patient experience, unless you have docs that allow you to cherry-pick patients, you're probably not gonna achieve RCT-like results.

With "clean irrefutable data and patient experiences" certain folks at Nevro seem to think that HF10 practically sells itself. Only it doesn't, and the people calling the shots have never been on a sales call in their lives.
 






Unless of course the VP Sales had a diminished role to begin with. Other than recruiting top notch personnel early on, Clinical & Marketing are the key drivers here, like it or not. Clean, irrefutable data and patient experiences are the catalyst for sales. Imagine that!

A diminished role is quite possible from what I have heard of him. Aside from that, any good leader knows disrupting any executive position, especially one critical to driving revenue at a time when there is concern, is career suicide
 






If the data was actually a major catalyst, Nevro wouldn't be struggling to hit the sales numbers promised to Wall Street. As for patient experience, unless you have docs that allow you to cherry-pick patients, you're probably not gonna achieve RCT-like results.

With "clean irrefutable data and patient experiences" certain folks at Nevro seem to think that HF10 practically sells itself. Only it doesn't, and the people calling the shots have never been on a sales call in their lives.

Not to worry as wall street smells a poopy diaper with "nevro and the little troll" marketing and clinical teams are without any value everyday more sales people are leaving despite being offered big paychecks to stay
 






If the data was actually a major catalyst, Nevro wouldn't be struggling to hit the sales numbers promised to Wall Street. As for patient experience, unless you have docs that allow you to cherry-pick patients, you're probably not gonna achieve RCT-like results.

With "clean irrefutable data and patient experiences" certain folks at Nevro seem to think that HF10 practically sells itself. Only it doesn't, and the people calling the shots have never been on a sales call in their lives.

Data, as in market share gains. Nevro wins and everyone else loses. That’s all you need to know.
 






Not to worry as wall street smells a poopy diaper with "nevro and the little troll" marketing and clinical teams are without any value everyday more sales people are leaving despite being offered big paychecks to stay

Amazing how the players have responded to Nevro. Magically, their ASP continues dropping. Well, another losing strategy to blunt erosion of sales.
 






Nevro has played the long game from the beginning. Focusing on patient outcomes and innovation will win in the eyes of patients, payors and most doctors. Market leadership will come. Challenging docs who want to trial patients that are terrible candidates is a good thing for everyone. If other organizations actually had any balls they would do it to. Instead they dropped trousers, went to the lowest price, gave away RF equipment and are still going to lose. Can't blame them for trying.

If you want to get paid for a year or so St Jude is happy to buy you out. They aren't even buying business. They are buying turnover, hoping to disrupt Nevro. Nevro will endure and Wall Street agrees. When the dust settles the best outcomes still win.