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.
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.