Payer-negotiated pricing of the hypoglossal nerve stimulator

Bartholomew, Ryan A.; Russo, Mario V.; Xiao, Roy; Rathi, Vinay K.; Haleem, Afash; Huyett, Phillip

doi:10.5664/jcsm.10142

Cited by 2 publications

(2 citation statements)

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“…Differences in relative hospital or manufacturer market power may explain differences in negotiated prices. There was substantial price markup of over 50% (as assessed for Cochlear Ltd. devices), consistent with reports for other medical devices 11,12 . Although device prices were not bundled with physician fees for surgery and anesthesia, device markups may help subsidize costs of other critical but undervalued services, including patient counseling, device programming, and treatment monitoring 13 .…”

Section: Discussionsupporting

confidence: 59%

“…There was substantial price markup of over 50% (as assessed for Cochlear Ltd. devices), consistent with reports for other medical devices. 11,12 Although device prices were not bundled with physician fees for surgery and anesthesia, device markups may help subsidize costs of other critical but undervalued services, including patient counseling, device programming, and treatment monitoring. 13 Lastly, negotiated prices were lower when all 3 brands were offered at the same center; this was particularly notable for Advanced Bionics, as the average negotiated price for (A) (B) the same modern CI models was approximately $18,000 cheaper at these hospitals with the 3-manufacturer competition.…”

Section: Discussionmentioning

confidence: 99%

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Hospital‐Negotiated Pricing of Cochlear Implants

Bartholomew

Rathi

Suresh

et al. 2023

Otolaryngol.--head neck surg.

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Access to cochlear implantation can be restricted by financial burden, and little is known about the extent to which cochlear implant (CI) devices prices may vary between hospitals or manufacturers. We performed a cross‐sectional analysis of private payer‐negotiated prices for CI devices. In total, 161 hospitals were analyzed. Prices varied widely across hospitals and between payers. Despite clinical equipoise between manufacturers with regards to CI user outcomes, significant differences in prices were identified, with higher prices for MED‐EL ($38,478 ± 2633) than for Cochlear Ltd. ($34,150 ± 2418, p < .001). Markup analysis for Cochlear Ltd. devices revealed a mean 58.5% ± 7.4% markup in excess of the company's average sales price ($24,649). Negotiated prices were also at least $5000 lower when all 3 brands were offered at the same center (p < .05). Further research examining the influence of patient outcomes and hospital volume on prices are needed.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Hospital‐Negotiated Pricing of Cochlear Implants

Bartholomew

Rathi

Suresh

et al. 2023

Otolaryngol.--head neck surg.

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Implementing a Streamlined Hypoglossal Nerve Stimulator Pathway: Cost, Time to Surgery, and Outcomes

Lenze,

Garcia,

Vijayakumar

et al. 2024

OTO Open

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ObjectiveTo evaluate the costs, time to surgery, and clinical outcomes associated with implementing a streamlined hypoglossal nerve stimulator (HGNS) implantation pathway.Study DesignRetrospective cohort study.SettingSingle tertiary care center in the United States from 2016 to 2023.MethodsPatients with a lack of complete concentric collapse of the velum during volitional snore on in‐office laryngoscopy qualified for the streamlined HGNS pathway. This pathway consisted of confirmatory drug‐induced sleep endoscopy (DISE) followed immediately by HGNS implantation during the same surgical encounter. Outcomes were compared to patients in the traditional pathway (standalone DISE followed by HGNS implantation on a later date).ResultsA total of 68 patients (13 streamlined, 55 traditional) with obstructive sleep apnea who underwent HGNS implantation were included. Patients were predominately male (70.6%) and White (95.6%) and had a mean (SD) age of 63.5 (10.0) years. The streamlined pathway was associated with a significant reduction in both hospital costs (mean difference $9258, 95% confidence interval [CI]: 3690‐14,825; P = .002) and time to surgery (mean decrease of 3.82 months, 95% CI: 0.83‐6.80 months; P = .013) compared to the traditional pathway. Patients in both groups had reduction in apnea‐hypopnea index and Epworth Sleepiness Scale score, with no significant differences in comparisons between groups.ConclusionIn select patients, the streamlined HGNS pathway may expedite time to surgery and reduce hospital costs with comparable clinical outcomes to a traditional 2‐stage pathway. Further research is warranted to validate patient selection and better understand longitudinal outcomes.

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Payer-negotiated pricing of the hypoglossal nerve stimulator

Cited by 2 publications

References 5 publications

Hospital‐Negotiated Pricing of Cochlear Implants

Hospital‐Negotiated Pricing of Cochlear Implants

Implementing a Streamlined Hypoglossal Nerve Stimulator Pathway: Cost, Time to Surgery, and Outcomes

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