US & Global Prices of Artificial Disc Replacement

[trkdoc714]

I assume the insurance companies will use their "suggested list price" strategy for ADR as they do with mainstream procedures.

The total bills from both my diskectomy and recurrent disc procedures came to over $45,000. The total paid after Aetna's "negotiated price" was less than $9,000 for each, including my deductible/ co-pay.

This a practice started during WW1 by Henry Ford. A law was passed freezing prices. Henry's car prices shot up dramatically for his cars. He then discounted those prices to acceptable levels so he, dealers and consumers could afford the transaction. The end result was the cars cost stayed the same (in relation to production cost/ inflation increaes) and the "discounted" prices left a profit instrument for dealers as well as giving the customer had the perception of getting a "great" deal.

It makes one wonder which figure (suggested retail or actual payment) the insurance companies report to the government agencies to villify the medical community for high costs.

I've also wondered how the surgeons can accept the reduced payments from insurance companies. Do they receive other forms of payment such as reduced malpractice premiums? Discounted diagnostic equipment? Reduced facility usage fees at participating hospitals/ surgical centers? All of these are beneficial when April 15th rolls around.

For accuracy sake, I'd guage pricing using the surgical cost tables/ estimates from the German surgical centers.

Now, if we could only raise the value of the US Dollar vs the Euro........

[Slackwater]

Originally Posted by Harrison

Some context here: in 2004, I actually met the CFO at New England Baptist Hospital in Boston and practically begged him for this procedure cost information, but got no where. It was a sad day. But maybe capitalism, competition and common sense will prevail and help patients figure this stuff out!? We are eight years into ADR in the United States, so can we patients at least get the prices of procedures that WE MUST PAY, since our insurance companies will NOT pay for the procedure?
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Global Cash Price for Artificial Disc Replacement (performed at Loveland Surgery Center):

Lumbar & Cervical ADR Pricing http://www.rmsas.com/globalpricing.html

I applaud the move by RMSAS. Suggest Rocky Mountain Spine Arthroplasty Specialists (RMSAS) is already following the suggestions in the below abstract, ...

May I suggest 2004 was too early to ask and it goes against the grain for many medical professionals to put fixed pricing in writing. I have never met a lawyer that gave me a fixed price for an undefined task.

The perspective of some medical professionals is written below. The caveats, there are risks with surgical procedures, long term outcomes need to be assessed, ... make the longest list you can, add legal language from corporate counsel here .... I may agree with the below authors in general, but it's an abstract somewhat on point for patients looking at RMSAS, or other alternatives.

May I suggest the DDD, Spondylolysis, Spondylolisthesis, Disc Herniation patients' need for valid alternatives is a different version of reality, pain pills, muscle relaxants, limited Activities of Daily Living (ADL), social life going futzz, than that of a medical professional, possibly attempting to adjudicate what is and is not appropriate (no rant, just ...). I want to read the perspective. I agree there may be future guidelines, just as there are when discussing research results with corporate sponsorship.



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2008 MEETING ABSTRACTS ISSLS
International Society for the Study of Lumbar Spine
Abstract Specific Link

AN EVALUATION OF INFORMATION ON THE INTERNET OF A NEW DEVICE: THE LUMBAR ARTIFICIAL DISC REPLACEMENT
Garcia, Ryan; Messerschmitt, Patrick; Ahn, Nicholas University Hospitals Case Medical Center, Case Western Reserve University

Introduction:
Patients widely search the internet for health care related information while orthopaedic device manufacturers and physician groups utilize the internet for direct-to-consumer marketing. Recent approval of the lumbar artificial disc replacement (ADR) has led to the emergence of numerous websites offering information about this procedure. Patients can be influenced by the internet; therefore, information should be accurate, compete, and honest. The objective of this study was to evaluate the content and quality of information available to the public on the internet pertaining to lumbar ADR.

Methods:
Three commonly used search engines were used to locate 105 (35 per search engine) websites providing lumbar ADR information. Each website was evaluated for authorship, content quality, and accuracy of information.

Results:
59% of websites reviewed were authorized by private physician groups,
9% by academic physician groups,
6% by industry,
11% were news reports, and
15% were not otherwise categorized.

72% of all websites reviewed and 96% of physician group websites offered a mechanism for direct contact in order to make a patient appointment. Only 30% of websites provided clear selection criteria for ADR, 30% offered surgical details, and 32% stated that lumbar ADR is approved for single-level disease.

Benefits of lumbar ADR were expressed in 87% while risks were described in 28% or less. European experiences were noted in 53% while only 22% detailed the infancy of American experiences.


Conclusion:
The results of our study indicate that the content and quality of internet derived information pertaining to lumbar ADR is incomplete and misleading. Without long-term follow-up, website claims are questionable. The majority of websites reviewed appear to be for direct-to-consumer marketing rather then educational purposes.

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slackwater_sf
mva, 2-level lumbar surgical candidate

[Sandra L]

For accuracy sake, I'd guage pricing using the surgical cost tables/ estimates from the German surgical centers.

Too bad we can't get pricing like Germany

Pre-op (included disectomy w/all related charges) - 1,040.00 Euro
Surgical treatment (all doctors) 12,870.00 Euro
Hospital fee (surgery/recovery rooms) 12,100.00 Euro
Physiotherapy (no limit) 100.00 Euro
Implants (4) 18,000.00 Euro
Room 6 days @ 85.00 (included anything needed) 500.00 Euro
TOTAL 44,620.00 Euros - even with the horrible exchange rate of 1.576, much less than US quote, which was supposed to be lowered because of no insurance. Also got a refund of approx. 2,000.00 Euros

[builder5840]

I'll be having a two level ADR done next month in Malaysia. I'll be paying 25,000 for the two level surgery that price includes a 5 day hospital stay and 11 days in a 5 star hotel. I just have to add travel and food cost which i'm figuring to be about 7,000 would be more if I had paid for first class but i'm cheap.

I'll let you know how it turns out


__________________________________________________ _____
Fall from ladder 05 lots of pain and lots of test
DDD C 5,6,7 opted for two level surgery
Malaysia using Discover disc January 09

[JudyW]

I believe mine was total billed of $108,000 for one level L4-5 and four days in the hospital. Of course, that is Marina del Rey, California.

[Sandra L]

I believe mine was total billed of $108,000 for one level L4-5 and four days in the hospital. Of course, that is Marina del Rey, California . . . JudyW in 2008

My two-level (cervical) was around $52,000 USD . . . Dave C 2008 in Germany

I'll be paying $25,000 for the two level surgery . . builder5840 2009 in Malaysia

My four-level cervical with Dr. B in Germany was approx. $67,000 USD in 2008.

I believe the approximate quote (the doctors price was set but the hospital's wasn't completely calculated) from Dr. D in Santa Monica, California for three-levels cervical was $140,000 and we still had to fly and pay room and board for hubby.

So until our insurance companies will step-up and pay, it's much cheaper to go abroad. It's really criminal that we in the good ole U.S. of A. have to go to Europe and Asia for cutting edge treatment, especially after FDA approval. Plus thinking about their enormous profits . . . !

Excuse the ranting, but I love the USA and wouldn't want to live in Europe or Asia, but . . . give us a break. Sandy

[Harrison]

In this community, we’ve seen patients have surgery in most U.S. states; Germany, France, Malaysia and many others. And we’ve seen that the costs for these procedures vary wildly, for a long list of complex reasons.

As most of you know, I am not a big proponent of patients going overseas for surgery. But the simple fact is that half of the people in this community have two or more diseased levels causing them chronic back pain which compromise their way of life. And who can fight insurance and the FDA for “compassionate use” approval? Many have tried, few have succeeded.

Whatever the patient’s choice, it’s a tough road to understand the surgeon’s expertise, the choice of hardware, the facility providing medical services….the list is endless!

Any way, I just tripped across yet another low-cost medical institution that provides artificial disc replacement services in India. The whole deal for a one-level ADR at the Taj Medical Group? $7000.

Listen, I don’t endorse or “sell” any particular institution. It makes me sad and angry that we patients have to work so damned hard to find the best solution for our nasty back problems.

In summary, a one-level ADR will cost $7000 to 110,000 depending on where you live. And that’s an appallingly wide price range!

[hezeronek]

I'm sure my situation won't apply to everybody, but I'm actually doing this price shopping now. My lawyer is sending me to get out-of-pocket cost estimates for these surgeries in the US, (to make our settlement case). I'd be glad to share these with all of you when they're done! At the very least, it will give people a starting point.

[Harrison]

Thanks Hez, that's very nice of you. I look forward to the information; it may help others as well.