Tyler Binney joined Relievant as President and CEO in 2021. We interviewed him to learn about Relievant’s breakthrough Intracept® Procedure, which could bring relief to tens of millions of US adults living with disabling vertebrogenic lower back pain.
Tell us about chronic lower back pain. How does it impact people suffering from it?
Chronic lower back pain (CLBP), affecting around 49 million adults in the US alone, exists in several forms. This chronic and debilitating condition can rob people of active and mobile lives. When simple things like sitting, leaning, and bending are painful, quality of life is severely reduced. The Intracept® Procedure specifically targets one type of CLBP called vertebrogenic (VB) pain, accounting for at least one-sixth of CLBP patients.
Can you describe Relievant’s Intracept® Procedure? How does it tackle vertebrogenic pain?
Let’s start with the pathophysiology of VB pain. With aging, we all experience disc degeneration in our spines. As discs degenerate, so do adjacent structures, specifically the endplates of vertebral bodies (bony structures on both sides of the disc). When this happens, the marrow inside the vertebral body interacts with the disc material, triggering an inflammatory response and causing pain.
Inside the vertebral body lies a nerve, the basivertebral nerve (BVN), that transmits pain signals to the brain. The Intracept® Procedure is unique: It’s the only of its kind to apply radiofrequency energy via specialised instruments to target and ablate this nerve, thereby blocking pain signals. Intracept® is a one-and-done, minimally invasive outpatient procedure, taking under an hour to perform.
What are the existing treatment options for CLBP? How does the Intracept® Procedure shift the paradigm?
Current treatment options for CLBP vary based on the origins of the pain, such as the facet or sacroiliac joints, spinal stenosis, neuropathic pain, disc herniation, or spinal instability. Patients need to be triaged to an appropriate treatment. To this end, a major pain society recently published a care pathway based on a treatment algorithm to help clinicians best advise their patients. Notably for Intracept®, to identify these VB pain patients, both a distinct clinical diagnosis and an objective radiographic biomarker on an MRI are required. Intracept® is the only therapy for CLBP calling for both identifications. Because we treat such a specific type of CLBP for which we are the only treatment on the market today, Intracept® has no competitors.
Your clinical studies have demonstrated consistently positive results for the procedure. Do you foresee further opportunities to innovate the technology?
Yes, we see a number of opportunities. Our current clinical publications (two RCTs and two meta-analyses) already validate our current indications as effective, durable, and safe. On top of that, indication and label expansion opportunities lie ahead, such as innovation on our existing instruments and radiofrequency generator. Many believe that the radiographic biomarker (referred to as Modic) is a late indicator of VB pain, so we have projects actively exploring this and other ideas for longer-term innovation.
What is Relievant doing to make the procedure available to more patients?
Currently, we are focusing on early adopters to create champions for the technology, following which we’ll aim for depth and adoption. Quality is as important as quantity now: great patient outcomes and full-practice integration are critical. With early adopters on board, we’ll aim for the early-majority segment.
Since you joined Relievant as CEO, 18 months ago, what have been your highlights?
Let’s first reflect on where Relievant was before I joined. It was mid-pandemic, with an interim CEO for over a year, no Current Procedural Terminology (CPT*) code, and a difficult pathway for physicians and facilities to seek reimbursement. In just 18 months, Relievant has rallied around a common vision: believing that what we do daily makes a difference. I’m proud to say that thanks to a thriving culture and high-performing team, we’re exceeding our financial goals, delivering on key milestones, and enjoying the journey.
A stellar moment for me as CEO was accepting the Most Promising Product award at the Phoenix Conference this October, on behalf of employees who’ve dedicated their careers to bringing a life-changing solution to millions of patients who desperately need it. I am extremely proud of the team and the culture we’ve created.
“Culture is what separates great companies from the rest!”
Can you tell us about what challenges, opportunities or milestones lie ahead?
In 2023, Relievant will be about commercial execution and accelerating payer coverage. This will enable us to develop a highly predictable, hyper-growth company to thrive in the future. Although opportunities are plentiful, commercial execution and payer coverage remain our priorities.
“We have our eye set on even greater success: becoming the standard of care for the treatment of VB pain.”
*Current procedural terminology (CPT) codes are used in the US to determine the amount of reimbursement medical professionals will receive after offering a procedure or service to patients