Marc Hedrick
Analyst · Capstone Investments.
John, it's Marc Hedrick. Let me field that. The core issue is in each country, they have a variety of different regulations and then there are European body regulations. So we are able to navigate the APOLLO trial and the PRECISE trial relatively readily through the -- those different regulatory land mines. So, for example, our current ADVANCE trial is approved, and we are enrolling patients in the Netherlands, but the Dutch health inspector, after the trial had begun and we were enrolling patients, raised issues about good manufacturing practices, and how they uniquely apply in the Netherlands, and asked us to justify what's being done, so play that out, throughout all the countries in Europe, including the G5 in Germany, in Italy, and France and so forth, and so you've got different countries applying both the European and their own regulations in different ways. So it really caused us, starting at the end of 2011, as we noted its difficulty to seek ways to harmonize these various interpretations throughout Europe, which, that meant a lot of meetings, face-to-face, with an alphabet soup of country authorities throughout Europe and then based on those meetings, we think we've learned kind of what their hot buttons are, not only where the regulations are today, but how they are evolving in Europe. And we've -- we are in the process of amending the trial to ensure, to the degree we can, that we can speed those individual country approvals in the trial. Now there are things that we're doing by taking advantage of this, of this lull in the trial to improve the trial from the clinical and scientific perspective, and from the perspective of beefing up the supply chain relative to the device. So kind of, break it all down, the goal of the trial hasn't changed. The goal still is to go back to BSI, our notified body, and get expanded claims to treat acute myocardial infarction in Europe. First approval for that for Cell Therapy in Europe. The budgetary impact, all in, is not significantly impactful, it might even push out the spend. But I think in aggregate, what we've done is we've completely, to completely, to the degree we can, removed some of these regulatory ambiguities that are in Europe and put those into the trial and done as much as we can to derisk the trial to ensure that we meet the trial's end points.