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Purchasing Insight: Coronary Artery Stents

The delivery of coronary artery stents is a procedure that affects over 1 million patients each year in the United States. With an aging population, the declining cost of stents and reimbursement tracking with the consumer price index (2-4 percent margins), the market for stenting continues to grow.

Two main types of stents are currently offered in the U.S. market: bare-metal stent (BMS) and drug-eluting stent (DES). DES, which were developed to combat the restenosis issues of the BMS, account for the majority of stenting procedures done today.

Pricing for both BMS and DES are listed below. Lately we’ve been seeing a downward trend in terms of cost. The original BMSs were priced at $1,595, and DES prices were set at a sky-high price of over $3,000. With the stiff competition spread over three main vendors, prices have seen a sharp drop to as low as $450 for BMSs and $1,300 for DESs.

Bare Metal Stents (Quoted System Prices)
Low            High             Average Price
$560          $1,100          $706.73

Drug-Eluting Stents (Quoted System Prices)
Low            High              Average Price
$1,375        $2,225          $1,526

[Data Source: MD Buyline. Please note these numbers have been adjusted to exclude special deals, outliers and unique circumstances.]

In the outpatient setting stent reimbursement for bare-metal stents (BMS) will see a small increase of approximately 4 percent, while drug-eluting stents (DES) will remain stable for 2014. In the inpatient setting, reimbursement will see a small, negligible increase for 2014.

Against that backdrop, purchasers need to know how to get the best price on these critical items. Lower prices are often achievable by introducing competitive bids and obtaining and negotiating based on an external analysis. Additional savings may require some creativity by agreeing to market-share commitments, and/or agreeing to bulk purchases. Rebates have been offered in multiple ways, but these can be very complex and require a significant number of hours to ensure compliance.