She kind of failed the first time. She really is a very nice person.

Lyn Jakeman is back to moderate some questions for the last 2 speakers. Back to Matt’s Conestoga Wagon analogy.

There was a lot of work leading up to the neural stem cell trials, a lot of handing off of

Q for Dr Huhn: Given that we have to spend so much money on ANY kind of cell, how do we choose? Which wagon gets its wheel repaired?

A: If you’re an investor you look at embryonic stem cells and certain adult stem cells … our cells came from a donated fetal brain after an abortion. if you’re an investor, that’s a factor you have to think about. There’s also risk factors. With embryonic cells, you’re always going to get some contamination of tumors forming. And these cells also come with societal issues. Then there’s the commercial cost of developing the cells. The idea of pluripotent cells, where you take one of your own cells and turn it into a kind of cell that you need, is super expensive.

Q: Lyn asks about efficacy of one cell over another …

A: He says basically that there are cells that are very safe (mesenchymal cells) but that don’t end up doing much, and cells that are less risky but potentially more effective. It’s a very, very difficult question.

Q: Is the patient population in a system like the Freehand limited by our existing infrastructure?

A: We have lots of experience with things like pacemakers and pain stimulators and baclofen pumps. When you get a pacemaker, you know that you’re going to be going in every six months. There’s a business model around followups … but because the one company that was making Freehand failed, no such thing exists for the patients who had it installed. We’re working on giving our patients the ability to make small adjustments on their own.

Q: I have Brown Sequard Syndrome; would cells work for me?

A: No reason to think not, but we don’t have data yet. (Dr Huhn) We actually test our patients to make sure the device will work.

Q: How does our healthcare changes help?

A: The technology has to fit into whatever the clinical paradigm is … we can’t just hope that there will be reimbursement.

Q: Isn’t there an opportunity for money to be sihifted if there are good outcomes?

A: Example of this would be how trunk strength, for example, might reduce incidence of pressure sores. We can bake that thinking in at the front of a study instead of having to do multiple studies because we didn’t think to measure it up front. A question that investors ask is, “How much are you going to charge for this?” And the answer has to do with how much money will be saved.

Q: Dr Huhn, did you see changes in the MRIs after implantation?

A: We were seeing functional improvement without that kind of change.

Q: Please talk about whether investors or philanthropy seems like a better path. And how much money we’re talking about.

A: We needed another $35 million to keep our study going. Some of that is trial, some is related to the clinical infrastructure. Stem cells burn on average between 2 and 3 million per month. Investors have been losing confidence in the regenerative space, because those outcomes were just not enough. But remember that for a big company, that’s a rounding error in the budget. The challenge that analysts and investors have is that there’s not much to go on when they’re calculating what ANY product is worth to the market. There’s no precedent because nothing has worked.

Followup: What if the community had been satisfied, excited about your results?

A: It’s still a hard case to make for investors. An investigator might take a 2 or 3 in 10 chance of a good outcome … but an investor probably would not. We also have to look at how investors get fatigued after a time.

Q: if i were an investor with 20 or 30 million, I could have kept Stem Cells Inc going?

A: You could have bought the company.

Time for the afternoon break! Made it.

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