Fresenius and XCorporeal- WAK Belt

Dear Dr. Agar:

What do you believe will be the result of Fresenius and their purchase of XCorporeal, regarding the WAK belt? I know that there are a number of companies working on a WAK belt.


Dear Mark

Unfortunately I do not have a business-acumen bone in my body … so, I guess my ‘take’ on any purchase deal - past, present or future - that has or may happen in the dialysis equipment corporate world is likely less to be useful than almost anyone elses!

In general, though, my inexpert overview of a corporate takeover is that when a big company purchases a smaller one, it is usually is with one of two aims:

  1. Because the smaller company ‘has something’ that the big company wants - but that ‘something’ is denied by patent except by acquisition.

or …

  1. Because the smaller company has something which, if developed, might threaten part or all of the market of the larger one and, thus, acquisition by the larger diminishes or negates the competitive threat of the smaller.

Sorbent-based systems are back in the research eye. My own view is that it is probable that sorbent-based systems will offer the best future chance of miniaturisation, portability and wearability - whether they are applied to HD or to PD or to both.

Hot-water sterilisation methods - as were patented and utilised by Aksys back in the late 90s to mid 00’s - may also offer a second (and potentially exciting) edge, if some of the technical issues that dogged Aksys can be sorted.

Both ‘systems’ - sorbent and heat-sterilisation, as I understand, again under the R&D eye.

The potential benefit of theacquisition of a smaller R&D project by a lerger group is that significantly more funds can be brought to bear on the project to hasten what is commonly a small, promising but cash-strapped program … this thus has the promise of speeding progress and accelerating research. The major threat to this approach, however, can be from the (sometimes) sheer size, complexity and beaurocratic slowness of megacompany which, though unintentionally so, can mire the flexibility of progress of the smaller but more responsive advantage of the R&D company and, by a too-many-cooks approach, actually slow development. This is a tendancy that needs to be resisted in the forward ‘push’.

A potential disadvantage, of course, is if the larger company simply wants to negate the progress or promise of a smaller competitor and bury the program. Though sometimes this has proven to be the motive in the historical annals of compnay takeovers, it is a very cynical assessment and is not, to my knowledge, an operative motive at all in the dialysis field.

As for the WAK, machine portability, wearability, simplification and miniaturisation … bring it on. I would personally love to see this eventuate. There is, however, still much water to flow under the bridge before those hopes become clinically-applicable realities.

I really have little else to offer you regarding this. Corporate shenanigans - whatever their underpinning motives - are not an area where I profess enough understanding to comment further.

John Agar