Intalere’s take on new technology
Tom Wessling
Journal of Healthcare Contracting: Can you name two or three ways in which the process of evaluating new medical technology differs today from, say, 10 or 15 years ago? What accounts for those differences?
Tom Wessling, vice president contracting operations, Intalere: There is much more of a focus on new technology today than there was 10 to 15 years ago. This focus has two components. Ten to 15 years ago, facilities were looking to bring in new technology; bringing it in was much easier, mainly because of the way reimbursements were handled. Facilities could “afford” the latest and greatest. Companies offering new technology went straight to the departments, bypassing sourcing, to get their products into facilities. Today, with reimbursement and security issues, new technology has a bit of a harder time getting to clinicians. Also, sourcing is more involved in the process, which means the products may get more scrutiny than 10 to 15 years ago. To address this issue, most of the major GPOs, including Intalere, have new technology shows that bring new technology to their facilities, and ask them for feedback. We also have member input groups in several different contract categories, which can help us identify new needs or opportunities.
Lori Pilla
JHC: When your sourcing team hears a vendor (or end user, such as a physician or surgeon) call a new device or technology “innovative,” what should their expectations be of that device or technology?
Lori Pilla, vice president custom contracting and supply chain consulting, Intalere: That it actually performs something or results in something that NO OTHER product is already doing. True innovation is few and far between; sometimes the supplier might change the color of the current product and call it new. To truly be an innovation, the product has to produce an outcome that has not previously occurred before or that no other supplier has provided to date.
JHC: Can a GPO do anything more than introduce its members to new technologies from early-stage or startup medical device firms? In other words, can a national GPO sign agreements with companies such as these, which tend to be small?
Tom Wessling: We can add the products to our contract mix, but whether it takes off is really up to the supplier. Many times, they don’t have “feet on the street” to market it properly and they are hoping we can help with exposure; we do that, but it is difficult to provide a lot of additional support when all suppliers are vying for our attention. We have a show annually where we bring “New Technology” suppliers in to a tradeshow where facilities can walk around and see the suppliers. Even if Intalere does not end up signing a deal, it does give facilities and suppliers an opportunity to see each other. It offers great exposure for the new tech firms.
JHC: What are the challenges in evaluating clinical evidence about a newly introduced product/device, which probably lacks a track record in the field? How should the provider (GPO, IDN, hospital, etc.) deal with those difficulties?
Lori Pilla: The best alternative is to identify a few key customers willing to undergo a beta test of the product to get some feedback directly. The challenge we have is in most cases, the testimonials new suppliers bring in are from tests they have done themselves to show outcomes. While they are certainly valid, they do not hold as much weight as independent studies done by facilities.
JHC: To what extent can the healthcare provider hold the vendor accountable for the performance of a newly introduced device after it is in use in the healthcare facility?
Lori Pilla: Providers should be protected by general liability and limited liability under the supplier, as well as whether it is [FDA-cleared]. If it results in damages, the supplier would be sued. I don’t think they could come to market without meeting those requirements.
Tom Wessling: Unless the facility gets a written guarantee of outcomes of savings on the product, there is not much they can do.
JHC: Does Intalere have a formal program – e.g., an expo, written reports, etc. – to expose members to new technologies that Intalere believes are truly innovative, and have a definite impact on patient outcomes, staff efficiency, cost-effectiveness and/or patient satisfaction? If so, can you describe it?
Lori Pilla: We have a new technology show as part of our member conference each year. We are able to see and observe all new technology products, and our members actually provide feedback on what/how the product will fare in the market, whether it is truly new technology or not, and if it would be useful in the space it is designated for.
JHC: Any final thoughts on the challenges and/or opportunities associated with evaluating new medical technologies?
Tom Wessling: No real difficulty in evaluation, but hard for the supplier/provider to market if they are a start-up with not much capital.
Just wanted to add a couple comments. A number of years ago I moderated a session for HIGPA (now HSCA) with a group of panelists, including Dr. Carolyn Clancy, who was the head of AHRQ. We discussed new technology/devices, etc. and how should GPOs address these issues and she stated that the GPOs would be a great place to evaluate the products for their members. If a product doesn’t deliver, why contract it? There is a need for Comparative Effectiveness and the development of a Comparative Effectiveness Committee (CEC) at the hospital/IDN level to look at ALL treatments and determine the the clinical and financial Value, as well as any other metrics that people would like to measure. The principles of a P and T Committee, where Efficacy is the first clinical measure, followed by safety, cost, then any other metric should be applied. If the product doesn’t deliver the efficacy/clinical outcome, etc. it isn’t considered for use or may be restricted to certain patient populations. This is the advent of the Clinical Supply Chain.