Oct. 3, 2018
Dive
Brief:
- Researchers have found coronary stents and
pacemakers cost U.S. hospitals up to six times as much as their
counterparts in Germany.
- On average, U.S. hospitals reported paying $670 for
bare-metal stents, as compared to $120 in Germany.
- The dramatic divergence in the prices of stents and
pacemakers was the most striking finding from an analysis of what
hospitals in five countries pay for cardiac implants.
Dive Insight:
The global medical device market has grown
into $370 billion business that accounts for around 7% of all healthcare
spending. Yet, the confidentiality of negotiations between manufacturers and
buyers means little is known about how much devices cost. The secrecy creates
scope for manufacturers to vary their prices from buyer to buyer.
To shed light on the situation, two
London-based researchers analyzed survey data collected from hospitals every
quarter between 2006 and 2014. The findings, published in Health Affairs,
suggest the prices of cardiac implants vary significantly from market to
market.
Overall, the dataset suggests hospitals in
the U.S. and France pay more for cardiac implants than their counterparts in
Germany, Italy and the U.K. Typically, the researchers found prices to be
highest in the U.S. and lowest in Germany. While there was some variation from
product to product, hospitals in the U.S. reported paying significantly more
for most types of device every year from 2006 to 2014.
The differences in the prices of stents and
pacemakers was particularly pronounced. Prices of stents generally trended
downward in all countries across the years analyzed in the research paper but
the magnitude of the difference between the highest and lowest fees increased.
For example, in 2006 U.S. hospitals paid
around $1,000 more than their German counterparts for drug-eluting stents. By
2014, the average price paid in Germany had declined from $1,440 to $340. The
average price paid in the U.S. fell, too, but remained around $1,000 above the
German price in 2014. As such, U.S. hospitals paid 1.6 times as much in 2006
and four times as much in 2014.
Similar trends were seen in the analyses of
the prices of other types of stents. The data on the cardiac rhythm management
sector paint a slightly different picture. The prices of these devices held
steady from 2006 to 2014, potentially reflecting the relative lack of
competition in this market.
The authors of the study cite the level of
competition as a factor that may account for some of the country-to-country
variation. Historically, it has been harder for manufacturers to bring devices
to market in the U.S. When paired to differences in procurement mechanisms, the
use of health technology assessments and reimbursement requirements, this could
contribute to price differences.
These explanations are somewhat
speculative, though. Having calculated the variation in device prices, the
authors of the study want to see more research into the reasons for these
differences so policymakers understand the mechanisms that affect healthcare
costs.
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