As healthcare reform continues to evolve, capped pricing and greater scrutiny on commodity spine products is becoming the rule and not the exception. Considering that our industry has become a waste land of "me too" products pedicle screws, cervical plates, interbody devices, including zero-profile products, and biologics (just look at all the announcements last week) how can the industry not expect for things to change in the not so distant future? Let's look at XLIF. As exceptional of a job as NuVasive does in educating surgeons on the benefits of an eXtreme Lateral approach, and utilizing champion surgeons, there are many companies that are going to make competitive inroads to NuVasive's market. There are other neuro-monitoring platforms, yet, to argue that yours is faster than the competitor's is a moot point considering that operating room time is budgeted as a fixed cost. Does Matson really believe that companies like Medtronic, Synthes, DePuy, and AlphaTec lack the intellectual, educational and financial firepower to arrive at an alternative modality of treatment?
It will be interesting to see how things change over the next year. As TSB has stated, many distributors are already feeling the effects of smaller companies cutting back on commissions. Obviously, those that do not agree keep singing the same old song, that this is a "relationship" business. Unfortunately, that song will only play so long, and survival will come down to pricing. Yes, readers, even companies like NuVasive will not be able to charge $5,000 for a piece of PEEK, especially when XLIF is an approach. TSB wants to know what our readers think is going to happen over the next few years.