Surgeon researchers including Sohrab Pahlavan, MD, Sigurd Berven, MD, and Stacey Samuel Bederman, MD, sought to find out and published their findings in Spine. They examined purchasing records from 45 academic medical centers over a one-year period. They determined cost variation across the centers through the relationship between purchasing volume and unit price.
Here are five key notes:
1. Hospitals and academic medical centers typically sign a nondisclosure agreement as part of the price negotiations with implant companies. The lack of transparency contributes to price variation in the field. However, physicians are becoming more interested in value-based care and looking for transparency in managing implant costs.
2. The researchers found implant costs at academic medical centers varied from center-to-center and manufacturer-to-manufacturer for pedicle screws, anterior cervical plates and transforaminal lumbar interbody fusion. The variation was similar to the difference in joint replacement implant price.
3. Each 10-fold increase in purchasing volume realized a unit price decrease:
• Pedicle screws: $126
• Anterior cervical plates: $242
• TLIF: $789
4. There was a negative relationship between purchasing volume and cost.
5. The researchers concluded, “Transparency in cost negotiation, surgeon awareness of cost and alignment between surgeon and hospital goals may help decrease the cost of spinal implants and the cost of care for patients undergoing instrumented fusions.”
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