«No» to a price register for medical devices

What’s the issue?

Discussions regarding the creation of a national register of purchase prices for medical devices – primarily implants – are taking place at the moment. If approved, the federal government (or a third party commissioned on its behalf) would develop an anonymised system to record and analyse the lowest, highest, and average purchase prices for implants. The aim is to create greater transparency, reduce healthcare costs, and improve patient access to medical devices. This initiative was sparked by reports of significant variations in the prices of orthopaedic and cardiac implants within Swiss hospitals.

Swiss Medtech’s Position

The debate surrounding healthcare costs has become quite heated recently. It is therefore all the more important to contribute facts that support an objective discussion: Medical technology accounts for less than 8% of total healthcare costs and this figure has been falling for years.

The medtech industry acknowledges, and is fully committed to sharing the responsibility to ensure healthcare remains financially sustainable in the long term. A price register for medical devices, however, will not help reduce costs. It would create additional bureaucracy and generate extra expenditure – which will ultimately be passed on to those who pay insurance premiums.

Swiss Medtech shares the view that prices must be reasonable and transparent. This, however, does not require new legislation, but rather consistent enforcement of existing laws. Health insurers must be able to perform mandatory cost-effectiveness assessments; service providers must therefore include all necessary details on their invoices.

Arguments

Not another bureaucratic nightmare! 
There are approximately 500,000 different medical devices available today. Even if solely implants were recorded in a price register, it would still require the management of thousands of products. To set up and operate such a register, the federal government (or commissioned third parties) would have to create new administrative systems. This would require considerable additional resources: many people within the federal administration, hospitals, medtech companies and health insurers would be tasked with data collection, maintenance, and verification. Furthermore, such a price register is likely to remain incomplete and outdated. 

Considerable investment – very limited informative value
Price differences can be attributed to factors such as varying purchase volumes; or to additional services such as technical or clinical support required for complex medical devices in the operating theatre. Furthermore, implants differ due to material, size, technical design, indication and clinical use. These variables make direct price comparisons considerably more difficult. Swiss Medtech shares the view that prices must be reasonable and transparent. However, a new registry of prices is not required for this; the existing legal instruments are sufficient.

Apply existing laws rather than creating new ones
Under the Health Insurance Act, service providers are required to report discounts and rebates to health insurers so the benefits can be passed on to policyholders. Invoices must also include all information needed for health insurers to conduct their statutory cost-effectiveness audits. If these requirements are not consistently met, the underlying issue lies with compliance and enforcement. A price register will not solve the problem.

Implant prices are dictated through competition between manufacturers, distributors, and hospitals or purchasing groups. No single manufacturer possesses enough market power to dictate prices unilaterally. Furthermore, hospitals are already able to buy collectively and to negotiate competitive terms.

Clinical added value, not just a focus on price 
A one-sided focus on the purchase price does not provide the complete picture. Medical devices differ not only in price, but also in clinical benefit, quality of care, reliability, and level of innovation. At the same time, the healthcare sector is evolving ever more towards personalised therapies, in which products and treatment approaches are tailored more closely to the individual needs of patients. The claim that a price register would improve care is misguided. A purely price-based comparison overlooks factors relevant to patients and threatens to penalise innovative solutions.