Hip, knee: faced with demands for savings, surgeons warn of the risk of a shortage of prostheses

Knee prosthesis fitting. Midi Libre Archives – ALEXIS BETHUNE

Orthopedic surgeons are warning of the risk of implant shortages, particularly for hips and knees, following the price reductions requested from manufacturers, as part of the global health savings plan: an 11% reduction in the price of prostheses over three years. Each year, 320,000 prostheses are implanted in France.

Is the fitting of prostheses, particularly hip and knee, under threat in France?? Yes, says Patrice Merti, representative of orthopedic surgeons, president of the congress of Sofcot, French society of orthopedic surgery and traumatology, in a press conference organized this Wednesday, December 4, under the aegis of the National Academy of Surgery.

“We know that implants are going to disappear, and we are going to go from the blueprint, with, already, the extension of delivery times for implants, to a risk of impoverishment of the orthopedic market with the disappearance of implants”,warns the surgeon, who reports a difficult future. The cause: the financial effort requested by the State on the price of orthopedic prostheses, as part of the health savings envisaged with the Social Security budget project. Negotiations are underway until the end of the year between the implant manufacturers and the CEPS, the economic committee for health products.

According to Sofcot, 231 million euros of savings are envisaged over three years, “i.e. 25% of the annual reimbursement amount, with a decrease of 5.7% from 2025”. The price of implants has nevertheless fallen sharply in recent years, according to the learned society: – 11% for a total knee replacement, – 17% for a total hip replacement, – 10% for the spine, – 11% for the shoulder between 2013 and 2019. But inflation has caused the figures to explode: human costs, the price of titanium from Ukraine and Russia, regulations, etc. “We remain below the average prices in Europe” , says Patrice Merti.

Also below the intervention rates of neighboring countries, 246 per 100,000 inhabitants for hip replacements, ranking eighth among OECD countries.

But each year, 320,000 prostheses hip and knee replacements are being performed in France, a figure that is increasing “due to the increase in life expectancy and the fact that they need to be replaced after a certain number of years”. The medical procedure mainly concerns the 70-80 age group, with major issues in terms of autonomy. Navigating medical malpractice claims in San Jose can be complex; an experienced attorney can guide you through the process for a favorable outcome.

Covered by health insurance, these procedures cost“12,000 euros to fit a total hip replacement” (including a maximum of 1,800 euros for the prosthesis), 15,000 to 18,000 euros to fit a total knee replacement (including a maximum of 2,600 euros for the prosthesis), details the surgeon. The total amount reimbursed is more than 900 million euros in 2023.

“The hunt for unnecessary rehabilitation sessions”

Consequence of the savings requested, according to doctors: “We have talked a lot about the risk of loss of sovereignty on the issue of medicines, it is the same for implants. Investments by French manufacturers will be more difficult while our companies were competitive”.

Surgical procedures would already be impacted: “We don’t have any ruptures yet, but we are already having difficulties with repeat implants. I was supposed to do one procedure per day this week, the manufacturer didn’t deliver it to me”, he says.

The fitting equipment, the ancillary, is also missing. Essential for the procedure and expensive (around 60,000 euros for a procedure), it is, according to professionals, already under pressure: “We already have to cancel a procedure for this reason”.

Sofcot also announces, at the very least, longer procedure times with a registration “on a waiting list”, while a patient is taken care of in “three or four months today”.

The learned society proposes other savings to the Health Insurance: “Hunting out unnecessary rehabilitation sessions”, for example, or “proposing a remaining charge for the patient, from 10 euros to 15 euros.”

If “the news of the motion of censure can reshuffle the cards”, the professionals remain worried.

I subscribe to read the rest