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Getting New Products Into the Hands of Surgeons

Continuing in the theme of sharing your thoughts and voices, this month, we’ve gathered to the table four professionals from device company manufacturing firms to discuss the challenge of getting new products through hospital committees and into the hands of the customer. They are:

William Warrender
Senior Vice President of Global Sales
Ascension Orthopedics Inc.

Bill Warrender brings more than 25 years of sales, marketing and general management experience to Ascension. Prior to his current position, Bill was most recently based in Pennsylvania as President of Medartis, Inc. and has held management positions with Encore Orthopedics, Smith & Nephew and Zimmer, among others. Warrender holds a B.S. in Marketing and Management from LaSalle University and an M.B.A. in Management and Finance from the University of Notre Dame.

Thomas D. Prokop
Vice President of Sales
OMNI life science

Tom has held his current position for three years. Prior to that, he served eight years as Area Business Manager for Plus Orthopedics, five years as a distributor for Stryker in Pennsylvania and 16 years as a distributor for DePuy in New York City. Mr. Prokop holds B.S. and M.B.A. degrees from Long Island University.

Jess Jackson
Chief Executive Officer
OrthoPro LLC

Mr. Jackson partnered in starting OrthoPro, The Foot and Ankle Company, in 2003. His prior positions include two years as Vice President of Sales & Marketing for Encore Orthopaedics, 28 years with Zimmer USA as a distributor in 13 Rocky Mountain states and three years with Richards Manufacturing (now Smith & Nephew). Jess graduated from the University of Utah with a degree in Biological Science.

Todd Usen
Senior Vice President, U.S. Business
Smith & Nephew Endoscopy

Mr. Usen is responsible for U.S. sales, marketing commercialization, national accounts, customer service and finance of an $800 million global business unit. During his time with Smith & Nephew, he has overseen the complete restructure of the U.S. selling organization – converting a 100% indirect organization to an 80% direct, implementing a new quota and commission plan and creating entirely new market development and sales training teams. Prior to joining Smith & Nephew, Mr. Usen spent 12 years at Boston Scientific in various sales and marketing roles of increasing responsibility. Before Boston Scientific, he held sales and marketing roles with Arrow International and Kendall Healthcare. Mr. Usen earned a B.S. in Marketing from the University of Massachusetts at Amherst and did his M.B.A. work at Pepperdine University.

We are grateful to these gentlemen for sharing their expertise.

Question #1: Device makers are challenged in getting new products through the committees at hospitals and into the hands of surgeons. Can you elaborate on the specifics of this challenge and how it is (or isn’t) impacting your business processes and resources?

William Warrender, Ascension Orthopedics: Hospitals are actively creating barriers to entry for OEMs in order to reduce confusion and complexity in their facilities and streamline their processes for efficiency and profitability. These barriers require companies to expend sizeable resources to meet the prerequisites in order to even be considered for product review and approval and to allow representatives entry into the facility. In some cases, surgeons must spend their time and energy to champion or present the products for review on the committee’s agenda.

    Device manufacturers are requested to offer discount structures with no usage commitments and also term lengths dictated by the institutions. These challenges, coupled with the possibility of an insurance company’s rejection of payment for implants, require device companies to have precise plans to engage the surgical institutions.

    Expending these extra resources may facilitate institutions not being approached and thus, not benefiting from research and development of innovative products and new material science that could ultimately produce better patient outcomes and cost savings to the hospital.

Thomas D. Prokop, OMNI life science: The most difficult part of this process, in most cases, is the lack of access to the committee meeting. Most institutions only allow written material to be submitted for review, and it rarely is seen by the members prior to the meeting.

    Our resources would be best utilized by having a user surgeon or engineer present the design rationale and patient benefits of the product, as well as answer any questions the committee members may have.

Jess Jackson, OrthoPro: When I first started selling orthopaedic devices in the late 1960s and went to a hospital, there were probably 30 salesmen who called on the materials manager and there were only a few orthopaedic companies. Better yet, in the states that I sold in the west, I was the only fulltime salesman who sold orthopaedic implants. Can you even imagine that scenario?

    Today, there are over 2,000 salesmen calling on a hospital and hundreds of companies selling thousands of products.

    There is no magic pill you can take that will allow you to walk into a hospital and say, “Please use my new bone screw system.”

    The product has to be a lot better at what it claims to do, be cost effective, have more benefits for the patient and have the support of surgeons.

    Hospitals have major committees and systems set up to stop you, the salesman, from getting that new product into the hospital, and you must follow their policies, procedures and time frames and meet their financial expectations to get that new product into the hospital in the big cities and large buying groups.

Todd Usen, Smith & Nephew Endoscopy: There is a perception that hospitals are specifically setting up new product committees to eliminate doctors from evaluating a new product and then the hospital receiving an invoice for the new technology.

    This may be partially true, but it should be in the hospital and industry’s best interest to make sure the proper people approve a technology so the best patient outcomes can be achieved. It only impacts the business of those sales professionals who are not paying attention to the process.

    Depending upon the facility, the process can vary. Many institutions need the actual code numbers and product descriptions two to three months in advance based on their new product committee meeting schedule. Often a surgeon will learn about an impending new product and request that the product be available for a specific case.

    The challenge arises when the new product committee has not seen the product yet, and the next meeting may not be scheduled for another few months. In order to make the system run the smoothest, hospitals should be prepared to hold special new product committee meetings when the need arises.

    The hospital, industry and most importantly, the patient may suffer if a new technology is available, but the hospital either postpone, or does not have a planned meeting for several months.

    Representatives who assume that surgeons are their only customers vs. the entire hospital or ASC staff are the ones who face the biggest challenge.

Question #2: How can industry best address this challenge? Are there opportunities?

William Warrender, Ascension Orthopedics: Every challenge is an opportunity. A device manufacturer that can assist the surgical institution in understanding their goal of balancing patient benefits with the hospitals’ fiduciary responsibilities will garner benefits.

    Products alone do not make a device company. We provide a wealth of education, training and services that these various committees need to understand, as well as what value is being derived when evaluating a product for the institution.

    Device companies have many methods to present to the customer, and the customers are varied: patients, surgeons, OR staff, materials management, supply chain, hospital management of the institution. It is our directive to help these committees understand that the world is getting smaller and the patient is better educated, thus demanding more from surgical institutions.

    Everyone, including the committees, is striving to do the best for the patient and the health of the institution, thus producing the optimal outcome for patient, surgeon, institution and device company.

Thomas D. Prokop, OMNI life science: I believe that industry can develop some standards for new products to meet as a guideline for the committees at hospitals to use in their evaluation process. Some of these would be patient benefits, better long term outcomes, ease of use and preparation for the hospital staff, as well as cost effectiveness.

    When new products meet some or all of these basic criteria, hospital committees would be more willing and comfortable in evaluating the product specifics.
Jess Jackson, OrthoPro LLC: Be creative. Start with a small hospital or surgical center, and get the support of a few surgeons in a small town before you go into a big city.

    Remember, the world does not need another total hip, total knee or spine system. A total hip is just a stick with a ball on the end of it and you can only make so many different designs of that stick and use so many different materials before everyone says, enough is enough.

    The product has to be better, and sales reps must be more creative and professional in dealing with the large hospitals to be successful.

Todd Usen, Smith & Nephew Endoscopy: Top representatives have regularly scheduled meetings with materials management as well as key “new product committee” members. Materials managers see product names come across their desk every day, but very few have the opportunity to see and truly understand what the technologies are intended to do.

    A quality representative sets up routine in-service time with materials managers to educate and explain the technology that is available today, and also future technology and the benefits that will provide. This becomes a true ”value add” to the purchasing organization.

    The representative should also routinely discuss the new product process with the purchasing people so that when a product is needed, but has not gone through the committee, there is a communication and action plan that can be implemented on a “one off” basis, such as a special new product meeting.
    New product committees should be a mutual benefit to the hospitals as well as industry. It is comforting to know that a product is being utilized for its merits and patient benefits vs. a sales rep promising some extremely low pricing or other noncompliant avenues to get products in the door.

    Industry can either complain about the process or embrace it, and put together the proper business plans to meet the needs of the institutions.