Minority of Orthopaedists Know the Cost of Implants They Commonly Use

When it comes to knowing the costs of the devices they implant, orthopaedic surgeons and residents are batting only .210 and. 170, respectively. More than 500 orthopaedic surgeons surveyed at seven US academic medical centers correctly estimated the cost of common orthopaedic devices only 21% of the time. Residents at the same institutions did so only 17% of the time. Many of these respondents (36% of surgeons and 75% of residents) admitted that their knowledge of device costs was “below average” or “poor.” All respondents tended to overestimate the price of low-cost devices and to underestimate the price of high-cost devices. The implication of that tendency, say the authors of the Health Affairs study, is that “physicians may underestimate the amount that could be saved by choosing the lower-cost alternative.” The biggest barrier to physicians knowing device prices is confidentiality clauses in the contracts between device vendors and hospitals. “Widespread dissemination of device prices is not an option at many institutions,” wrote the authors. It remains to be seen whether the proliferation of accountable care organizations, with their emphasis on cost-efficient care, will alter this situation. For more about cost variation in orthopaedic devices, see the JBJS article “Variability in Costs Associated with Total Hip and Knee Replacement Implants.”