The Effect of Price on Surgeons’ Choice of Implants: A Randomized Controlled Survey

Wasterlain, Amy S.; Melamed, Eitan; Bello, Ricardo J.; Karia, Raj; Capo, John T.; Adams, Julie E.; Vochteloo, Anne J. H.; Powell, Andrew; Marcus, Alexander; Platz, Andreas; Miller, Anna N.; Berner, Arne; Altıntaş, Burak; Sears, Benjamin W.; Calfee, Ryan P.; Ekholm, Carl; Fernandes, Carlos Henrique; Porcellini, Giuseppe; Jones, Clifford; Moreno-Serrano, Constanza L.; Manke, Chad; Crist, Brett D.; Haverkamp, Daniël; Hanel, Doug; Merchant, Milind; Rikli, Daniel; Shafi, Mohamed; Patiño, Juan Martín; Duncan, Scott F. M.; Ballas, Efsthathios G.; Harvey, Edward J.; Walbeehm, Erik T.; Schumer, Evan D.; Evans, Peter; Suarez, Fabio; Lopez-Gonzalez, Francisco; Seibert, F. J.; DeSilva, Gregory L.; Bayne, Grant; Guitton, Thierry G.; Nancollas, Michael; Lane, Lewis B.; Westly, Stephen K.; Villamizar, Harold Alonso; Pountos, Ippokratis; Hofmeister, Eric P.; Biert, J.; Goslings, J. Carel; Bishop, Julius A.; Gillespie, James; Filho, José Eduardo Grandi Ribeiro; Huang, Jerry I.; Nappi, James F.; Rubio, Jorge; Scolaro, John A.; Yao, Jeffrey; Chivers, Karel; Jeray, Kyle J.; Lee, Kendrick; Rumball, Kevin M.; Mica, Ladislav; Adolfsson, Lars; Borris, Lars C.; Benson, Leon S.; Austin, Luke; Richard, Marc J.; Kastelec, Matej; Costanzo, Ralph M.; Kessler, Michael W.; Palmer, M. Jason; Pirpiris, Marinis; Grafe, Michael; Akabudike, Ngozi M.; Shortt, Nick; Kanakaris, Nikolaos K.; Wilson, Neil; Levy, Ofer; Althausen, Peter L.; Lygdas, Panagiotis; Sancheti, Parag; Parnes, Nata; Krause, Peter C.; Jebson, Peter J.L.; Guenter, L.; Peters, Robert W.; Ramli, Radzeli Mohd; Shatford, Russell A.; Rowinski, Sergio; Gilbert, Richard S.; Kamal, Robin N.; Zura, Robert; Rodner, Craig M.; Pesantez, Rodrigo; Ruch, David S.; Kennedy, Stephen A.; Hurwit, S.; Kaplan, Saul; Kronlage, Steve; Meylaerts, S.A.G.; O'Mara, Timothy J; Swiontkowski, Marc F.; DeCoster, Thomas A.

doi:10.1016/j.jhsa.2017.05.005

Cited by 42 publications

(26 citation statements)

References 13 publications

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“…Finally, in a randomized trial involving orthopedic surgeons and OR costs, surgeon awareness of the costs of implants resulted in reduced costs of 9%-11% for orthopedic implants. 13 These studies demonstrate how surgeons are responsive to cost information and are able to adjust their practices to increase value. Although surgeon cost feedback has been shown to reduce overall OR supply costs, there are also studies that show no effect on cost estimation accuracy.…”

Section: Discussionmentioning

confidence: 93%

Surgical Supply Cost Awareness Is Associated With Lower Costs: A Single-Center Experience

Tseng

Sax

Gewertz

et al. 2020

The American Surgeon

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Surgeons are often unfamiliar with the costs of surgical instrumentation and supplies. We hypothesized that surgeon cost feedback would be associated with a reduction in cost. A multidisciplinary team evaluated surgical supply costs for laparoscopic appendectomies of 7 surgeons (surgeons A-G) at a single-center academic institution. In the intervention, each surgeon was debriefed with their average supply cost per case, their partner’s average supply cost per case, the cost of each surgical instrument/supply, and the cost of alternatives. In addition, the laparoscopic appendectomy tray was standardized to remove extraneous instruments. Pre-intervention (March 2017-February 2018) and post-intervention (March 2018-October 2018) costs were compared. Pre-intervention, the surgeons’ average supply cost per case ranged from $754-$1189; when ranked from most to least expensive, surgeon A > B > C > D > E > F > G. Post-intervention, the surgeons’ average supply cost per case ranged from $676 to $846, and ranked from surgeon G > D > F > C > E > B > A. Overall, the average cost per case was lower in the post-intervention group ($854.35 vs. $731.11, P < .001). This resulted in savings per case of $123.24 (14.4%), to a total annualized savings of $29 151.

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Section: Discussionmentioning

confidence: 93%

Surgical Supply Cost Awareness Is Associated With Lower Costs: A Single-Center Experience

Tseng

Sax

Gewertz

et al. 2020

The American Surgeon

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“…Congruent with this conclusion is a recent report suggesting that surgeon cost-awareness of distal radius implant options may decrease projected implant costs by 9–11%. 13 This, combined with our observation that implants are the costliest component of the surgical encounter for distal radius ORIF, may influence decision-making to decrease the overall cost of distal radius fracture ORIF. Additional cost-savings may be expected if hospital systems utilize bargaining and purchasing power to reduce the cost of individual implants and share pricing data with their surgeons.…”

Section: Discussionmentioning

confidence: 95%

“…Despite prior studies raising concerns about distal radius fracture treatment costs, 13 the main drivers of cost variation for the distal radius ORIF surgical encounter are not clear. Specifically, it remains unknown whether demographic-, injury-, or treatment-specific factors contribute to variations in total direct costs for distal radius ORIF.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Factors Driving Cost Variation for Distal Radius Fracture Open Reduction Internal Fixation

Kazmers

Judson

Presson

et al. 2018

The Journal of Hand Surgery

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“…Generic implant utilization could be coupled with price transparency initiatives to bolster competitive bidding, drive down costs in the healthcare system, and aid in eliminating the variability of implant costs. Simple awareness of implant price has been demonstrated to influence surgeons’ choice, with many surgeons opting for lower priced models in the same implant class [17] . The inclusion of generic implants may thus enhance surgeon autonomy in dictating their surgical practice preferences.…”

Section: Arguments In Favor Of Generic Implant Usagementioning

confidence: 99%

Policy and ethical considerations for widespread utilization of generic orthopedic implants

et al. 2019

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The Effect of Price on Surgeons’ Choice of Implants: A Randomized Controlled Survey

Cited by 42 publications

References 13 publications

Surgical Supply Cost Awareness Is Associated With Lower Costs: A Single-Center Experience

Surgical Supply Cost Awareness Is Associated With Lower Costs: A Single-Center Experience

Evaluation of Factors Driving Cost Variation for Distal Radius Fracture Open Reduction Internal Fixation

Policy and ethical considerations for widespread utilization of generic orthopedic implants

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