Competitive Bidding for Valve Suppliers

[lance]

Please explain "COMPETITIVE BID" from the following paragraph.

With regard to "letting the Surgeon Decide which valve to use" this statement needs a caveot. Note that MANY of the MAJOR Hospitals (including CC) have a LIMITED number of Tissue and Mechanical Valve Choices (usually 2 each) decided by COMPETITIVE BID. Until recently, CC Surgeons were NOT using the On-X Valve (and some others) for example.

Bottom Line: If you have a preference for ANY particular valve, you need to ask your surgeon if he is willing to agree to use your Preferred Valve as Option 1. It is also wise to have a Plan B in case that valve is not viable once he 'gets in there'.

If you have your 'heart' set on a particular valve and the surgeon you are interviewing is NOT willing to use that valve, you may want to consider finding another surgeon who is willing, preferably one with some experience with that valve if it has unique implantation requirements.

Regarding the CUMULATIVE RISK of Coumadin, I suspect there is a LOT of misuse of that word. YES, the Longer you are on Coumadin (or ANY drug), the higher the risk that you will suffered some side effect ONE TIME.

This is NOT the same as saying that you have an X% risk in year 1, 2X% in year 2, 33X% in year 33 etc. which is the more accurate definition of Cumulative Risk.

'AL Capshaw'

 

[ALCapshaw2]

Competitive Bidding for Valve Suppliers

I'm starting a new thread to answer a question from Lance, originally posted in HarleyGirl's thread

Here is his question and the background information from my previous post:

Lance wrote:

Please explain "COMPETITIVE BID" from the following paragraph.

Quote:

Originally Posted by ALCapshaw2

With regard to "letting the Surgeon Decide which valve to use" this statement needs a caveat. Note that MANY of the MAJOR Hospitals (including CC) have a LIMITED number of Tissue and Mechanical Valve Choices (usually 2 each) decided by COMPETITIVE BID. Until recently, CC Surgeons were NOT using the On-X Valve (and some others) for example.

Bottom Line: If you have a preference for ANY particular valve, you need to ask your surgeon if he is willing to agree to use your Preferred Valve as Option 1. It is also wise to have a Plan B in case that valve is not viable once he 'gets in there'.

If you have your 'heart' set on a particular valve and the surgeon you are interviewing is NOT willing to use that valve, you may want to consider finding another surgeon who is willing, preferably one with some experience with that valve if it has unique implantation requirements.

Regarding the CUMULATIVE RISK of Coumadin, I suspect there is a LOT of misuse of that word. YES, the Longer you are on Coumadin (or ANY drug), the higher the risk that you will suffered some side effect ONE TIME.

This is NOT the same as saying that you have an X% risk in year 1, 2X% in year 2, 33X% in year 33 etc. which is the more accurate definition of Cumulative Risk.

'AL Capshaw'

END QUOTE

I spoke with my contact at one of the manufacturers of Mechanical Valves. She used the Cleveland Clinic as an example.

CC puts their Valve Business up for "Competitive Bid". For some time this typically came down to a matter of PRICE as performance (morbid event rate) of the Second Generation Mechanical Valves (ATS, Carbometics, Medtronics-Hall, St. Jude) was relatively close.

Until recently, the Mechanical Valve Offerings from CC were ATS and St. Jude. Patient Requests for the (Third Generation) On-X Valve lead to it replacing ATS (after several months of study and investigation). The On-X valves were introduced to the World Market in 1996 and approved by the FDA for use in the USA in 2002 (or maybe 2001, I forgot).

I know that the Mayo Clinic sometimes uses Carbomedics Valves and I would *assume* they also offer St. Jude Valves, but do not know for certain.

'AL Capshaw'

 

[Karlynn]

Thanks Al.

An informed "consumer" is an empowered consumer. This isn't saying that there's evil, money-oriented motives for doctors, but these are businesses with a bottom line and we shouldn't be surprised that this is how things can operate. (no pun intended).

A related issue is that many of the major hospitals have surgeons on staff that have actually helped develop specific valves, or helped the companies do studies on them. This is another reason some facilities may lean towards specific valves, and why one hospital group installs more X and another installs more Y. New advances in medicine can only be successful if they can get hospitals and doctors to sign on to developing them.

No hospital or surgeon is going to knowingly push an inferior product and risk losing everything. But if an individual has done their research and wants a specific valve, it's helpful to know possibly why a particular hospital or surgeon says "We don't use that one.".