"We know the better an implant fits, the better it works," Hungerford says. "It's the difference between a tailored suit and an off-the-rack suit."
Though he says there is not enough data to support his theory yet, outcomes with 3-D-printed services should improve patient outcomes through a better fit after the implant.
Because the vendor charges the same amount for a custom-made implant as a traditional one, the hospital has approved the 3-D procedures. "If the implant was twice as expensive, the hospital would say no," he says. Knee replacements are a bundled service so implant costs are more or less expensive, but hospital reimbursement is fixed.
He says if custom-made 3-D implants ever prove to be of better quality and price than traditional implants, they could be mandated.
Some industry observers believe the prospect of better outcomes will resonate with employers who pay for bundled services. If recovery time drops by a week or two using customized implants, employers will consider them.
Becoming the better alternative
John P. Geibel, DSc, MD, AGAF, is Yale School of Medicine professor of surgery (gastrointestinal) and of cellular and molecular physiology. He says 3-D printing will become attractive to payers when they outpace the alternative, such as complicated transplants, expensive treatments, and recurring hospitalizations.
Geibel is researching how 3-D printing can be used to cure gastrointestinal conditions such as short gut syndrome, in which children are born with an intestinal malformation that prevents them from properly absorbing nutrients and secreting waste.
Currently these patients must receive complex and costly inpatient care to ensure proper nutrition and bowel movements. Although there are intestinal transplants that can be performed, they are rare—only about 100 are done every year, with 10,000 adults and children waiting for the procedure—and there are considerable complications, including rejection, he says.