Sunday, May 23, 2010

Hey Medtronic.....It's Time to Move......Over

With the controversy surrounding vertebroplasty/kyphoplasty procedures for VCFx, TSB thought it would be interesting to ask our readers, which company has the best system and why, what has transpired since the infamous paper subsidized by a government agency critiquing vertebroplasty, and, have their been additional issues surrounding reimbursement.

It seems that Medtronic/Kyphon is taking on an assault in the marketing place from companies like Osseon, DFine, and Orthovita regardless of the subtle differences in technologies. In addition much has been said about AlphaTec's Osseo Fix which is currently being used in Europe. Will this product make its way across the pond? So in the spirit of debate, we want to know what our readers have heard and know. Who know's, maybe we will influence some poor soul's decision to opt for the best delivery system the industry has to offer.

10 comments:

  1. In my opinion, it won't much matter soon as I believe that the codes for PV and PVA will soon be changed to only be coded for a VCF procedure. All of these products will either disappear or will have to lower their price (and margins) to less than $700 for a total system.

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  2. 5:54, I dont know that you can put a ceiling or a floor to what the total costs for a system will be. Companies market and develop new products for profit, not so that they can make pennies on the dollar. Will all vertebral augmentation codes be lumped together for the same reimbursement??? Maybe. But the fact remains that competition will inevitably lower cost. Where? Who knows... As fir the studies that are government propaganda (my opinion), they will eventually fail the sniff test both by referring md's and md's who treat any and all conditions. And it will ultimately be the healthcare system (rather they value the surgeons input or not) who makes the ultimate decision in caring for the patient.

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  3. 5:54 here again. I agree with you. I was just setting a hypothetical price. I believe that it will all come down lower to the PV pricing, not the 2500-4500 for some PVA devices. More importantly, you hit the nail on the head. The healthcare system and government will indeed be more price conscious, not only for this, but for all spine, orthopedic, cv, etc. For those of us in sales, it's time to check our egos (and pocketbooks), find a job we like doing and stick to it... for the benefit of the patient not for our bank accounts. The industry as a whole will get a shake up soon.

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  4. I've seen a number of the PVA systems in use and they all seem to have their handicaps. Although Kyphon seems still has the best business proposistion (reimbursement vs cost), there are some emerging competitors- CafeFusion and Stryker have entered the balloon space. Though their products are kind of flimsy, the margins will be higher for the hospitals and that might make a difference to some.

    Then there is Orthovita, whose marketing a softer compound said to reduce adjacent level fractures. Very interesting, but the price was insane until recently and the delivery is quirky. Hospital have been giving them the Heisman until recently, when they dropped their price significantly.

    In the end, reimbursement is the key, and Kyphon has understood this the best so far. That "understanding" also got them a $75MM fine.

    Those gov't studies are a whole nother matter- sketchy at best. almost criminal. Basically scared referring docs and patients into not having a procedure and resulted in quite a few vertbra planas and retropulsions into the canal. What a way to save money....

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  5. Osseon, Define, Arthrocare, Parallax, Osseofix, you name it, anything PMMA based is indeed a subtle and often insignificant difference in technology. Orthovita should not be included in that list. They at least deserve credit for creating a really novel material that brings tangible and measurable benefits over good ol' PMMA. No doubt the quirky delivery will be solved in the future, if the evolution from Jamshidi needle and 3 cc syringe for PMMA is taken as an example.

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  6. The Confidence system owned by Depuy has a superior cement and when coupled with the Spartan system of bone tamping does a superior job in vertebral augmentation.
    The Spartan system is not yet widely avaialble in the U.S.

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  7. CONFIDENCE by DePuy Spine. Shorter set up time, larger "workable window". High Viscosity.

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  8. Where can the Spartan system be found?

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  9. Cross Trees Medical?

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  10. Does anyone actually use Arthrocare's Plasma Disc Decompression technique?

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