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According to a new series of reports on the U.S. market for minimally invasive (MIS) spinal implants by iData Research, the overall average selling price (ASP) for an MIS interbody fusion procedure is greater than that of a single-level procedures alone, because the average number of levels treated per procedure is greater than one. Lateral lumbar interbody fusion (LLIF) procedures have the highest ASP and are the fastest growing market among the various MIS interbody fusion segments due to higher interbody device costs and a higher average number of procedure levels.
MIS spinal procedures are treated in a multi-level fashion. Compared to traditional posterior lumbar interbody fusion (PLIF) procedures, minimally invasive posterior lumbar interbody fusion (MIPLIF) procedures experience a significantly lower average number of levels treated per procedure. However, pricing pressure still occurs, driven by hospitals and insurance providers. Insurance payers do not distinguish between MIS and traditional fusion when determining coverage, and often do not provide additional reimbursement for these more complex procedures. The related policies for such procedures are tracker using iData’s real-time Reimbursement Tracker™ service.
“The major driving force behind growth in MIS interbody procedures is the perceived physiological benefit to the patient, including reduced trauma, shorter hospital stays, lower post-operative medication use and earlier return to motion,” explains Dr. Kamran Zamanian, CEO of iData.
Minimally Invasive Transforaminal Lumbar Interbody Fusion (MITLIF) procedures comprised the greatest portion of the total MIS interbody procedures performed. NuVasive’s popular XLIF® approach, which accounts for the vast majority or NuVasive’s revenue, is the most popular product in the LLIF segment. Despite rapid growth in the LLIF market, MITLIF procedures are expected to remain the largest segment by 2021.
The LLIF market share is disproportionate to its procedure share due to the higher procedural costs demanded by LLIF procedures compared to MIPLIF and MITLIF procedures. Declining ASPs experienced in each segment will moderate market growth. LLIF procedures, however, are expected to experience the largest ASP decline, leading to far lower market growth of the LLIF market value when compared to its procedural growth.
Medtronic leads the total MIS interbody fusion market due to its large MIPLIF/MITLIF presence. Medtronic also competes in the LLIF market with its Direct Lateral Interbody Fusion (DLIF®) procedure. The company thrives in the MIS spinal implant market as a result of its minimal access spine technologies (MAST) systems. These include the Minimal Exposure Tubular Retractor (METRx™) system, the CD Horizon® Sextant™ percutaneous cannulated screw system, the CD Horizon® Legacy™ percutaneous PEEK rod system and the CD Horizon® Longitude®. Medtronic’s MIS spinal fusion technologies are further complemented by its other MIS procedures such as the X-Stop® interspinous spacer and the Kyphon® balloon kyphoplasty system.
Despite its strong lead in the LLIF market, NuVasive is the second leading competitor in the total MIS interbody fusion market. While NuVasive continues to expand its presence in other areas of the spinal market, the XLIF® procedure is the company’s flagship product and will remain its largest revenue generator. The procedure also makes use of NuVasive’s proprietary NeuroVision® neuromonitoring software to protect nerve bodies. NuVasive’s expanding MIS product portfolio will continue to augment the company’s share in this market. A number of NuVasive’s products can be used in conjunction with the XLIF® procedure, such as the XLP® Plus lateral plating system, the Radian® facet screw system and the Affix® II spinous process plating systems. Other competitors in the minimally invasive interbody fusion market include DePuy Synthes, Globus Medical, Stryker, K2M, Zimmer Biomet, Pioneer Surgical, Alphatec Spine, and Aurora Spine among others.
For Further Information
More on the MIS interbody fusion market in in the United States can be found in a report suite published by iData Research entitled the U.S. Market for Minimally Invasive Spinal Implants. The suite covers reports on the following markets: Spinous Process Fixation, MIS Interbody Fusion, MIS Pedicle Screws, and MIS Sacroiliac Joint Fusion.
The iData report series on minimally invasive spinal implants covers the U.S., Australia, Japan, South Korea, China, Taiwan, Argentina, Brazil, Mexico, and 15 countries in Europe including Austria, Belgium, Denmark, Finland, France, Germany, Italy, Luxembourg, Netherlands, Norway, Portugal, Spain, Sweden, the U.K., and Switzerland. Reports provide a comprehensive analysis including units sold, procedure numbers, market value, forecasts, as well as detailed competitive market shares and analysis of major players’ success strategies in each market and segment. To find out more about MIS spinal implant market data or procedure data, register online or email us at [email protected] for a U.S. Market for Minimally Invasive Spinal Implants brochure and synopsis.
About Procedure Tracker
Procedure number data is available from iData’s Procedure Tracker service, which allows subscribers to define and analyze procedure data segmented by state, region, hospital, surgery centre, and physician. A customizable dashboard sorts procedure data for further analysis and research.
About Reimbursement Tracker
iData Research’s Reimbursement Policy Tracker enables medical device, dental, pharmaceutical and healthcare professionals to receive real-time policy updates from hundreds of insurance companies and 60,000+ policies across all therapeutic areas in the United States.
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