Chronic Lower Back Pain - the sleeping giant.

4 days out from an important company webinar focussing on CLBP, it's as good a time as any to have a look at the potential market opportunity and commentary around the MSB treatment.

The treatment offered by MSB is based on the same MPC cells that they recently completed the Chronic Heart Failure trials with.

The major difference between the two trials being from a cost perspective, for back pain treatment, they only used 6 million cells verses 150 million in the CHF trial.
This means every CHF patient treated represents 25 potential patients that could be treated for Back pain.
For example, the cells used to treat patients in the CHF trial, could have treated over 6000 CLBP patients.


For the consumer, this may manifest as cheaper than competing surgeries like spinal fusion, or disc replacement... or may end up being the same or more expensive, significantly more profitable per treatment for the company than CHF. Silviu mentioned in the previous quarterly that CLBP is the companies biggest indication they are currently chasing. The simplicity in the treatment is a huge bonus also. Being able to walk in / out of day clinic as opposed to having metal bolts or synthetic discs inserted and manipulated on your back will be preferential for a large number of people I believe.

The results shown in the trial- available on MSB website demonstrated an average pain reduction of 50 % with many participants 100% pain free, and many others ceasing opioid use. The last data I've seen on the company website had treatment effect out to 3 years, with 12 months demonstrating the highest efficacy. FDA have now agreed with MSB in allowing them to run a trial for 12 months, with pain reduction only as the primary end point. See the mesoblast press release about that.

They are also including a minimum number of European patients to allow Grunenthal the ability to try and gain approval in Europe while MSB chases approval in the USA.

A 2018 article on spinal fusions below had some interesting commentary. Costs being 80,000 to 150,000 USD per procedure.... it claims " most spine surgeons" state about 1 third of procedures reduces pain, 1 third makes no difference, and 1 third actually leaves more pain than prior to surgery. The article also states over 1.2 million spinal surgery are done each year, with 30 million Americans complaining of back pain daily....
. https://www.modernhealthcare.com/article/20180827/NEWS/180829918/health-insurers-look-for-ways-to-cut-costs-for-back-surgery

compare that with out trial results.... Average 50% pain reduction lasting years.... reduction in opioid use...simple walk in , walk out procedure.... no nuts and bolts or power tools used on your back.

Provided MSB repeats the result in the trial they said would commence this year....... it could easily become their biggest success story.... and at present no partner to dilute the profits with.

Look forward to the company update this week !