A survey of more than 500 orthopedic doctors found that most had little grasp on the actual costs of common devices, despite their own beliefs that price should play a role in device selection.
Researchers asked orthopedic attending physicians and residents from 7 academic medical centers to estimate the costs of 13 common orthopedic implants, judging estimates within 20% of the actual cost as a correct answer. Attending physicians hit the mark 21% of the time and residents did so about 17% of the time, according to the study.
The majority of the 503 doctors surveyed rated their own pricing knowledge to be "below average" or "poor," although more than 80% said that pricing should be "moderately," "very," or "extremely" important during device selection. An April 2013 survey found that doctors consider themselves the most influential voice in a hospital’s device purchasing decisions, now and for the foreseeable future.
The findings highlight the need for access to pricing information, the researchers said. Pricing is a tricky area in healthcare, where prices may be negotiated per deal and the results are kept confidential.
A September 2013 report from industry lobby AdvaMed found that prices had dropped for major medical implants, with hospitals in 2011 paying an average of 34% less for drug-eluting stents than they’d paid in 2007. An August 2013 New York Times article chided medical device makers for "commanding inflated prices" for implants such as hip and knee replacement systems, noting that many of the same devices cost far less overseas than they do in the U.S.
A November study conducted by a team of U.S. physicians concluded that, although annual spending increases had slowed, higher prices play a major role in driving up national healthcare spending and growth in healthcare remains greater than any other industry and outpaces U.S. gross domestic product.
"The main element propelling increasings costs is not demand for services or intensity of those services, but rather the price of those services," study author Dr. Hamilton Moses said in a podcast interview accompanying the paper. "Price is the culprit."
The medical device industry has been on the defense, maintaining for years that its technologies are not the cause of the skyrocketing costs of care in the U.S. AdvaMed president & CEO Stephen Ubl has reiterated that sentiment, saying that the industry has taken pains to keep prices low, and ever lower, in an increasingly hostile medtech environment.
"Even as innovation and job creation in the industry remain under threat from the medical device tax and repeated reimbursement cuts impacting diagnostic lab tests, imaging services and durable medical equipment in particular, old-fashioned competition continues to ensure the strong value proposition of advanced medical technologies that save lives and improve patients’ quality of life every day," Ubl said in a September statement. "These average pricing declines reflect the intensely competitive marketplace for medical technology and underscore the tremendous value devices and diagnostics provide to patients and the overall health care system."