NEJM studies lead to drop in vertebroplasty and vertebral augmentation procedures

Dec 10 2009

Millennium Research Group (MRG), the global authority on medical technology market intelligence, finds that vertebroplasty and vertebral augmentation (which includes kyphoplasty) procedures have dropped 10% following the August 2009 publication of two studies in the New England Journal of Medicine (NEJM). The studies compared outcomes for osteoporotic vertebral compression fracture (VCF) patients treated with either vertebroplasty or a sham procedure, and showed similar improvements in pain for patients in both arms, calling the benefits of vertebroplasty into question.

According to MRG's new Physician Forum report, entitled Vertebral Compression Fracture Treatments at a Crossroads: What do the New England Journal of Medicine Studies Mean for Vertebroplasty and Vertebral Augmentation?, the drop in procedure volumes has been due in large part to decreased patient referrals. Despite widely publicized shortcomings in study design, referring physicians have reacted more strongly to the study results than the specialists who actually perform the procedures. The report, based on a survey of 245 US physicians, finds that around 70% of specialists who perform VCF treatments disagree with the NEJM study findings, compared to only 30% of referring physicians. Even among vertebroplasty advocates, however, there is consensus that the NEJM studies highlight the need for more robust clinical effectiveness data.

"The magnitude of the drop in procedures has been larger than industry originally expected," says Kevin Flewwelling, Manager of the Orthopedics division at MRG. "Although industry leaders and medical organizations have pointed to several potential flaws in the design of the two NEJM studies, it appears that physicians, particularly referring doctors, are not ready to dismiss the studies outright. Our findings indicate that only 36% of surveyed referring doctors would be as likely to recommend VCF treatments as they had been before the results were published. For industry players, restoring referring physician confidence will be key to ensuring market recovery."

Vertebral Compression Fracture Treatments at a Crossroads: What do the New England Journal of Medicine Studies Mean for Vertebroplasty and Vertebral Augmentation? is based on a US survey of 75 referring physicians, 70 orthopedic surgeons, 70 interventional radiologists, and 30 neurosurgeons to assess differences in perceptions of the NEJM studies, expected impact on clinical practice, and future market outlook.

MRG's new report, Global Markets for Minimally Invasive Vertebral Compression Fracture Treatments 2010, provides critical insight into the long-term outlook of VCF treatment markets in the US, Europe (France, Germany, Italy, Spain, and the UK), and Asia Pacific (Australia, Japan, and South Korea) through 2014. The report provides a five-year forecast of trends in procedures, average selling prices, and revenues.