Purchasing Insight: Bone-graft substitutes

Driven by an aging population and an expanding pool of younger patients, bone-graft substitutes are a $2.5 billion market, which should continue to rise as a result of minimally invasive procedures.

Bone-graft substitutes include both synthetic and natural materials used for the replacement of bone or bone tissues. Although harvested bone from the patient, or autograft, is the gold standard, substitutes were introduced to the market in 1995 due to quantity limitations and chronic pain associated with the donor site.

Most bone-graft substitutes can be categorized into one of the following areas:

• Allograft-based, also known as demineralized bone matric (DBM)
• Growth-factor based (BMP)
• Synthetic, including polymer and ceramic-based materials

Reimbursement codes vary, based on the use of autograft or a bone substitute but in general reimbursement rates have remained steady. However, as the market evolves and new grafts are introduced and prices increase, cost-benefit analysis will become critical. While the use of bone-graft substitutes does add additional cost to the procedure, it prevents the need for an extra incision site or second operative procedure, and the trouble caused by obtaining the donor graft.

Lower prices are usually achievable by introducing competitive bids but additional savings can require some creativity such as agreeing to market share commitments. These agreements tend to give providers a good amount of leverage to reduce prices, but ensure physician alignment to prevent physician/vendor relationships from compromising your negotiation leverage.

Bone-Graft Substitutes

5cc Demineralized Bone Matrix (DBM) Putty

Low                             High                           Average

$616.00                       $865.00                       $690.00

Recombinant Human Bone Morphogenetic Protein (rhBMP) Matrix

Low                             High                           Average

$3,450.00                    $5,000.00                     $3,477.00      

5cc Synthetic – Ceramic & Polymer–based

Low                             High                           Average

$893.00                       $2,100.00                    $1,320.00       

Data source: MD Buyline (Please note these numbers have been adjusted to exclude special deals, outliers and unique circumstances.)