The call for a transformation in the way healthcare is delivered has been brewing for years and reached new heights in 2012 when the National Academy of Sciences published its report on the state of the American Healthcare entitled “Best Care at Lower Cost.” The 437-page report notes, “what is concerning, however, is the unsustainable rate of growth in health care costs. For 31 of the past 40 years, health care costs have increased at a greater rate than the economy as a whole” (99). Dedicating a chapter to “Unsustainable Costs”, the report notes that 130 billion dollars is wasted each year on “inefficiently delivered services” (102) at healthcare sites.
When UCSF released its finding that Xenco Medical’s disposable, plastic surgical instrument outperformed a metal counterpart in a comparative strength study last October, the news spread quickly in the spinal device industry. What’s been of equal interest to those watching the company’s rise, however, is the rapid pace at which Xenco Medical’s interbody systems have been adopted at major hospitals across the United States. It may be time to examine the market forces that continue to fuel the company’s success.
The inefficiency of surgical trays, in particular, has become the subject of increased university research. In the 2015 paper “Assessing the Magnitude and Costs of Intraoperative Inefficiencies Attributable to Surgical Instrument Trays”, researchers at the University of Chicago argue “that significant cost-cutting may be achieved by reducing the unnecessary sterilization, wear and tear, and processing of instruments that are opened and exposed in the operating room but not actually used during a procedure” (2). The paper cites research from the Virginia Mason Medical Center by noting that it used data from “neurosurgical procedures to estimate potential institutional savings up to $2.8 million a year through a 70% reduction in instrument processing through sterile supply” (1). Could this be why Xenco Medical has gained so much traction? Ask the company’s CEO and he will tell that it goes beyond that. Xenco Medical Founder and CEO Jason Haider proposes that “the surgeon-centric design of the pre-loaded instruments and implants has been just as responsible for the company’s success as the materials science behind them.”
His point on functionality is well-taken, but it’s worth further considering the role materials science may be playing in Xenco Medical’s growing popularity. As UCSF demonstrated their remarkable strength, the composite polymer instruments have allowed Xenco Medical to differentiate itself from all of its competitors. It’s clear, from the outside, that the materials science has allowed a new kind of freedom for hospitals and surgeon-owned ASCs alike. Eliminating the time and costs of the autoclave process, the systems are simply disposed of after each surgery.
A study by researchers at Weill Cornell Medical College entitled “Management of Postoperative Spinal Infections”, notes a relationship between Surgical Site Infections following posterior spinal interventions and “the adherence of biofilm to metal implants” (184). One could speculate that reducing infection rates may be adding to the company’s allure. That said, addressing this issue is not unique to Xenco Medical. Though LDR’s use of sterile-packaging is limited to implants, the company has, nonetheless, demonstrated that Xenco Medical is not without peers in addressing spinal infections. Rather, it’s worth examining the company’s delivery of both sterile-packaged instruments and implants functioning at what it refers to as “peak condition” to fully explain its growing favorability among surgeons.
It’s possible that what makes Xenco Medical particularly compelling is the new paradigm it has forged. Engineering breakthrough instruments to work with its own interbodies and pedicle screws, Xenco Medical has offered a new model of the spinal device company: one that operates at the nexus between safety, cost-savings, and performance. Though we can speculate as to the precise reason for Xenco Medical’s success, the fact remains: the spine industry is changing quickly, and this new company just may take the lead.