OTA 2012 Posters

Scientific Poster #17 Hip/Femur OTA-2012

Clinical and Economic Impact of Generic Implant Usage for the Treatment of Femoral Neck Fractures

Justin R. Kauk, MD1; Peter L. Althausen, MD1, MBA; Daniel J. Coll, MHS, PA-C2; Timothy J. O’Mara, MD1; Timothy J. Bray, MD1;
1Reno Orthopaedic Clinic, Reno, Nevada, USA;
2Renown Regional Medical Center, Reno, Nevada, USA

Background/Purpose: In today’s climate of cost containment in the healthcare industry, exploring generic implant alternatives represents an interesting area of untapped resources. Traditional implant companies develop their proprietary implants and are in direct competition with each other. However, unlike the pharmaceutical industry there are no generic equivalents available to help lower the implant costs to hospitals, insurance carriers, and patients. The purpose of this study was to examine the costs, implementation, and outcome of a cost containment program utilizing generic implants of equivalent quality.

Methods: The trauma panel at our institution adopted the use of generic 7.3-mm cannulated screws in January 2011. Despite a much lower cost, these screws were biomechanically tested as equivalent to major implant company products prior to the initiation of the project. Review of our trauma database identified patients with minimally displaced femoral neck fractures treated with generic 7.3-mm cannulated screws. These patients were compared to patients treated in a similar manner from 2010 with conventional implants. Chart review was undertaken to obtain basic demographic variables such as age, sex, and American Society of Anesthesiologists (ASA) status. Operative records were reviewed to identify any intraoperative complications, operative time, estimated blood loss, and need for conversion to arthroplasty. Radiographs were reviewed by a blinded author to record fracture type, healing time, screw cutout, varus collapse, and shortening. Hospital financial records were accessed to determine operative costs, and total hospital charges.

Results: Review of our institutional database identified 54 patients treated with generic 7.3-mm cannulated screws in 2011 and 58 treated with conventional implants in 2010. There were no significant differences in age, sex, ASA status, or fracture pattern between the two groups. No increase in operative time, estimated blood loss, complication rate, varus collapse, shortening, screw cutout, or conversion to arthroplasty was noted. Overall our hospital realized a 62% reduction in implant costs, resulting in $44,226 savings for the calendar year.

Conclusions: Use of generic 7.3-mm cannulated screws in the treatment of femoral neck fractures has been a very successful endeavor at our institution. Hospital implant costs were decreased significantly without any associated increase in complication rate or radiographic outcome. This has profound implications for the treatment of trauma patients as patents have expired on many other products such as intramedullary nails, locking plate,s and disposable items such as drill bits. Generic implant usage has the potential to markedly reduce operative costs in a manner similar to the generic pharmaceutical industry. As long as quality products are utilized, patient care is unaffected and cost savings can be realized. A portion of savings from such a change can be reinvested in the hospital trauma program to support OTA/AAOS position statement guidelines and positively affect the cost of hip fracture implants in the future.

• The FDA has not cleared this drug and/or medical device for the use described in this presentation   (i.e., the drug or medical device is being discussed for an “off label” use).  ◆FDA information not available at time of printing. Δ OTA Grant.