Background: Hospital revenues for orthopaedic
operations are not keeping pace with inflation or with rising hospital
expenses. In an attempt to reduce the hospital cost of orthopaedic
operations by reducing the cost of operating-room supplies, we developed
a Single Price/Case Price Purchasing Program for implants used in
total hip arthroplasty, total knee arthroplasty, and total shoulder
arthroplasty as well as for arthroscopic shavers and burrs, interference
screws, and bone-suture anchors.
Methods: The Lahey Clinic asked orthopaedic
vendors to supply all instruments, implants, and disposable items
related to these selected products for one single price per unit
or case. For example, a single price for total hip arthroplasty
implants included instruments, acetabular cups, acetabular liners,
acetabular screws, femoral stems, femoral heads, and stem centralizers,
if required. The hospital implemented the Single Price/Case Price
Purchasing Program with a competitive-bid request for proposal.
Surgeons evaluated the responses to the bidding process, and they
made final decisions on product selection.
Results: The Single Price/Case Price Purchasing
Program at the Lahey Clinic was successful in reducing the cost
of orthopaedic implants and supplies. In the present article, we
could not disclose the specific prices that we agreed to pay our
vendors. The specific cost reductions were 32 percent for hip implants
with a change of vendor, 23 percent for knee implants without a
change of vendor, 25 percent for shoulder implants with a change
of vendor, 45 percent for arthroscopic shavers and burrs without a
change of vendor, 45 percent for interference screws without a change
of vendor, and 23 percent for bone-suture anchors without a change
Conclusions: The Single Price/Case Price Purchasing
Program at the Lahey Clinic allowed the hospital to reduce its cost
of orthopaedic operations by lowering the cost of operating-room
supplies. This cost reduction is important in a health-care economy
in which hospital revenues per unit of service or care are decreasing.