Today’s vendor technology is no longer siloed into a specific classification. For example, an ALIF (anterior lumbar interbody fusion) device used to be just an ALIF. Today, that same ALIF can be used as a spacer, lumbar stand-alone assembly, or an ALIF with buttress assembly.
Assigning pricing to the assembled device is a challenge as vendor’s will typically request a much higher price than average for ALIFs that can be used as assemblies.
Where do you start?
Review your current pricing.
- If you don’t have construct/component pricing, calculate your average cost for an ALIF and a stand-alone lumbar assembled device; and,
- Determine which vendors have the biggest discrepancies from the average cost and focus on a deep dive into that vendor.
Research your technology: Current vendor websites may not delineate the spacer as having multiple uses.
- Request the surgical technique guide from the vendor; and,
- Review the technique guide to better understand how the technology is assembled.
The first place to start is to price all of your ALIFs at the same price – no matter if they are used as just an ALIF, a stand-alone lumbar integrated device, or an ALIF with a buttress assembly. The average cost for an ALIF is $3,500 or less.
Example 1 illustrates how the vendor priced an ALIF as a lumbar stand-alone assembly price of $5,500. The ALIF in Example 1 can be used as an ALIF or as a component in a Stand-Alone Integrated Device. A typical stand-alone lumbar assembled device consists of an ALIF, plate/cover plate, and screws with an average assembled cost of $5,200 or less. As different integrated devices have different components depending on the vendor and technology, standardizing the price of the ALIF, and adjusting the remaining components to total $5,200 is the easiest way to price any assembled device.
Example 1
To throw in several curveballs, the way in which an ALIF is used in an assembly can change the assembly’s categorization / classification:
Stand Alone Lumbar Assembly:
- ALIF + screws + plate
- ALIF + screws
ALIF with Buttress Assembly – Requires supplemental fixation (pedicle screws, rods):
- ALIF + anchors and/or plate
- Hyperlordotic ALIF + screws or anchors with/without a plate – typically the lordosis is >20° but may vary by vendor (lordosis is the curvature of the spine)
The takeaway from this exercise is twofold: 1) establish the ALIF price first so everything else that could be included can be priced to total up to your average price for that particular category / classification, and 2) classification of the individual implants is key to managing your implant pricing.
For more information, please contact Kim Nilsson at KNilsson@AskPHC.com or 980-721-2637, or John Ossowski at JOssowski@AskPHC.com or 801-209-3304 or Andrew Arreola at AArreola@AskPHC.com or 480-510-7940.
