From The Editor | January 15, 2014

Survey Finds Most Surgeons Are Unaware Of Implantable Device Costs

By Clinton Shaffer


A recent survey found that a staggering percentage of surgeons are unaware of the costs of the implantable medical devices (IMDs) they use.

Led by Dr. Kanu Okike, an orthopedic surgeon at the Kaiser Moanalua Medical Center in Honolulu, and conducted from December 2012 to March 2013, the survey sampled 503 physicians, 217 of which were senior orthopedic surgeons. The participants were asked to estimate the prices of 13 implantable orthopedic devices commonly used in their field. A response was considered correct if the estimation was within 20 percent of the device’s actual cost.

Even with the generous leeway, only 21 percent of the senior surgeons and 17 percent of the residents answered correctly.

Additionally, a portion of the physicians were asked to rate their knowledge of device costs. While 80 percent of the participants acknowledged that cost should be an important aspect of selecting the device, a substantial number of the participants (36 percent of senior physicians and 75 percent of residents) admitted to having “below average” or “poor” knowledge of the costs.

In regards to the results, Dr. Okike told Reuters Health, “My suspicion was that knowledge would be low, but I think we were all surprised by how little we knew about the price of the devices we were implanting.”

There are two key factors that contribute to these surprising statistics. The first factor is that surgeons are not required, or incentivized, to know the cost of a device. Second, hospitals sign confidentiality clauses with their vendors, and those agreements hide the costs of devices—even to the surgeons who are responsible for selecting the device.

With approximately $20 billion spent on IMD procedures per year (most of which goes towards the actual devices), and consistently climbing IMD costs, public opinion is calling for greater transparency.

Jeffrey Lerner, CEO of the ECRI Institute, echoes those sentiments. While he was not involved with this study, Lerner has done extensive research on IMD costs. Like many others, he believes that “there should be price transparency so people can compare costs and quality.”

Proponents of non-disclosure agreements claim that the healthcare industry is more complex than other, more transparent marketplaces, and that price transparency would not necessarily benefit the industry.

Outcry for greater transparency has been a lingering topic. The Transparency in Medical Device Pricing Act, which called for greater transparency in the IMD market, was proposed in 2007, but it never passed.

Regardless, the transparency issue will not simply disappear.  The recently unveiled survey adds yet another layer to the snowballing IMD cost transparency controversy.