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Cost-Effectiveness of Magnetically Controlled Growing Rods: Who Really Benefits?

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Abstract

Study Design

Retrospective case analysis.

Objectives

Evaluate the cost difference between magnetically controlled growing rod (MCGR) and traditional growing rod (TGR) surgeries at initial implantation and determine the recipient of cost savings.

Summary of Background Data

Treatment of early-onset scoliosis is challenging and costly, with growing rods (GRs) becoming a standard treatment. Although both effectively control deformity, TGR requires repeat surgical lengthening and MCGR does not. Previous cost analyses have suggested that MCGR results in lower overall cost after 3 years because of the elimination of repeat surgeries; however, the benefactor of these savings is unclear.

Methods

All patients who underwent initial GR implantation from May 2011 to January 2016 at a tertiary care children’s hospital were included (37 cases: 16 MCGR and 21 TGR; 4 TGR to MCGR conversions). Financial information was analyzed including insurance provider, and amount billed to and reimbursed from payer. Charges at the time of implantation were divided into categories (surgery time, room/board, anesthesia, implant cost, lab, radiology, therapy, medications, neuromonitoring, operating room materials, and recovery room). Variables were compared using t-tests to determine differences overall and per category.

Results

The average overall charge for MCGR implantation was 1.5 times greater than TGR implementation (p = .04). Average charges were statistically similar across all categories, except implant costs, which were significantly higher for MCGR (MCGR: $31,621 vs. TGR: $8,966, p < .0001). The average percentage reimbursement of total charges were similar between surgeries (MCGR 43% vs. TGR 46%, p = .26).

Conclusions

MCGR implantation has a significantly higher charge than TGR, secondary to the higher expense of MCGR implants. Despite this, total institutional reimbursement is similar between the two procedures. Although MCGRs have been shown to be “cost effective” after 3 years, our findings suggest health care institutions bear the cost of this new technology while payers gain the long-term financial benefit.

Level of Evidence

Level III, economic analysis.

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Author information

Authors and Affiliations

  1. Division of Orthopaedic Surgery and Sports Medicine, Children’s National Health System, 111 Michigan Ave NW, 20010, Washington, DC, USA

    Matthew E. Oetgen MD, MBA

  2. Princeton University, 08544, Princeton, NJ, USA

    Elise M. McNulty

  3. Eastern Virginia Medical School, 825 Fairfax Avenue, 23507, Norfolk, VA, USA

    Allison L. Matthews MS

Authors
  1. Matthew E. Oetgen MD, MBA
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  2. Elise M. McNulty
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  3. Allison L. Matthews MS
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Corresponding author

Correspondence to Matthew E. Oetgen MD, MBA.

Additional information

Author disclosures: MEO (none), EMM (none), ALM (none).

Source of funding: None.

IRB approval: Ethics approval for the study was obtained through institutional IRB.

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Oetgen, M.E., McNulty, E.M. & Matthews, A.L. Cost-Effectiveness of Magnetically Controlled Growing Rods: Who Really Benefits?. Spine Deform 7, 501–504 (2019). https://doi.org/10.1016/j.jspd.2018.09.066

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  • DOI: https://doi.org/10.1016/j.jspd.2018.09.066

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