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Surgeon Leadership Essential to Influence Implant Purchasing Committees

By John B. Pracyk, M.D., Ph.D.

Editor's Note: How does your work impact the value created by your company’s products? This question should remain top of mind for all orthopaedic professionals, no matter where you fall within the supply chain. Purchasing decisions at the hospital and surgery center level continue to be driven by the clinical and economic value that products create for their systems. This means that product adoption will take teams of teams—suppliers and service providers to device companies included—to meet today’s demands. John B. Pracyk, M.D., Ph.D., Global Franchise Medical Director at DePuy Synthes Spine originally wrote on this topic for ORTHOWORLD in October 2014. At the time of original publication, Dr. Pracyk's titles included neurological surgeon, strategic healthcare consultant and neuroscience program architect. Today we republish his article as an introduction to the conversations he will moderate among surgeons, a value analysis committee member and an integrated delivery network leader at OMTEC® 2018.

Changes in hospital purchasing decisions directly impact the surgeon’s ability to freely select surgical implants. Often, surgeons find they may no longer have access to the implants they have always used, because of the healthcare system’s efforts to streamline purchasing decisions. One strategy is to reduce the hospital’s absolute number of “surgeon preference items,” such as implants handled by the facility. This reduction in implant variation drives efficiencies on a variety of levels.

The Changing Landscape of Hospital Purchasing

Hospitals realize that they clearly spend too much when it comes to purchasing implants. As a result, value analysis teams (VATs) or committees (VACs) have formed to study, review and ultimately decide which implants will be allowed into the hospital, and at what specific price point.

The traditional sales model involved a close relationship between the medical device sales representative and the surgeon. That relationship no longer drives purchasing decisions, as VATs decide the selection of implants from which the surgeon may choose. This formalized process serves as a checkpoint to prevent the surgeon from simply selecting a device based on personal preference, because that decision-making usually costs the hospital in the end. The latest device often commands the highest price, as manufacturers try to increase their production numbers through price increases each and every year.

Surgeons often get a letter from the hospital informing them that the device they have used for years may no longer be available. Naturally, they’re upset and left wondering, “Why is this taking place?” Once they realize that it’s no different than the constantly-changing number of drugs available on the hospital formulary, its starts to make sense. The pharmacy & therapeutics committee’s mission is to maintain the formulary for the hospital. By way of analogy, the VAT’s mission is to maintain a portfolio of surgical implants used at the hospital, and monitor its effectiveness.

Expectations and responsibilities placed upon surgeons are now even greater. If surgeons want to trial a new product, they need to be able to cite the implant’s clinical benefits, along with the economic value that it delivers. Is the product any different than others that are already “on contract” with the hospital? The preference product runs the risk of being commoditized—evaluated on price alone—if it lacks a unique differentiating factor.

Read more from Dr. Pracyk here.