Tiger BufordYour Orthopedic Industry Expert (free today)

VACs have created subcategorizes that your new product must fit into... or Red Flags.

24 Aug 2025 · 1 min

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Medical device companies use narrow indications as a Trojan horse to slip past hospital Value Analysis Committees, but hospitals are fighting back with strict product buckets and capitated vendor models. Jefferson Hospital's deal with three spine vendors captures 80% of department spend, leaving almost no room for new entrants.

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One thing I've seen, and I would love Cope's feedback, I'm seeing it more and more on the field. The people develop one like crazy implant for a tiny indication that nobody cares about and they use it like, and that it's, you know, happens once every full moon or whatever. Have a, they have a case once every full moon and they have a patent for it and they use that to get through the VAC and as a Trojan horse and behind it. They bring all of the part numbers. I've seen a couple of companies in our space doing that a lot.
Yeah, I've seen some of it. I think it's— I have not seen as much of it, Mauricio, as we used to see. I just think like everything's under more scrutiny. In spine, they have such— they have buckets for every bucket. If you don't fit into one of their buckets, that product that you just described, it's still gonna go through value analysis. Than nowadays. Used to be able to pull stuff in through that, but now they're like, yeah, hey, listen, we capitated all that stuff and we picked 3 vendors. Here's what Jefferson's doing. Jefferson has picked, for example, because I think this is typical, picked 3 spine vendors. They're getting 80% of the spend. The surgeons can pick, but there's only 2 other vendors in that 20% that can walk in and start doing cases.