Ventral hernia repair:  Market Evaluation of Synthetic Meshes and Biologic Implants

A Survey of Forty General Surgeons

Panel Intelligence, LLC

January 2007

STUDY DESCRIPTION

OBJECTIVES

Evaluate the current and future US market for synthetic meshes and biological implants used in hernia repair surgeries

• Identify the features of a “complex” ventral hernia repair procedure.
• Gauge trends in the volume of routine and complex surgeries.
• Clarify the types and manufacturers of meshes and implants used for ventral hernia repair.
• Evaluate the factors involved in choosing synthetic meshes and biologic implants for complex ventral hernia repair.
• Compare the sales representatives from several manufacturers in regards to customer satisfaction, frequency and types of customer interactions and product knowledge.

Companies and Products Mentioned in This Report 

Key Findings

• Respondents perform an average of 18 ventral hernia repairs per month.
• Approximately 90% of surgeons included significant loss of abdominal fascia and presence of mesh product from a previous repair as factors that contribute to a ventral hernia repair being classified as complex.

• 85% of surgeons selected infection or bowel contamination.

• Two-thirds of the ventral hernia repairs that are performed are classified as routine.
• In the next year:

• 43% of surgeons anticipated that they will increase the number of routine ventral hernia surgeries that they perform.
• Increase in referrals and growing practices were the most commonly mentioned drivers.
• 48% of surgeons anticipated that they will increase the number of complex ventral hernia surgeries that they perform.
• Increase in referrals and growing practices were the most commonly mentioned drivers.

Inclusion Criteria and Respondent Demographics

quantitative survey detailed findings by question

SECTION ONE: Surgery Classification

Question 1.

Which of the following would you include in a definition of “complex” or “challenging” ventral hernia repair?

Question 2.

Of all ventral hernia repair surgeries that you perform, approximately what percent fall into the following categories?

Question 3.

Of the complex ventral hernia repair surgeries that you perform, approximately what percent involve or exhibit the following characteristics?

Question 4.

Thinking back to approximately one year ago, please estimate the number of routine and complex ventral hernia repairs that you performed in an average month.

Question 5.

Thinking ahead to approximately one year from now, please estimate the number of routine and complex ventral hernia repairs that you will perform in an average month.

Question 6.

For each surgery category, please explain why you anticipate that the number of procedures you will perform one year from now will increase, decrease, or remain the same as compared to today.

Section two: Product Comparison

Question 7.

Which of the following types of meshes or implants have you used for ventral hernia repair?

Question 8.

Please indicate the manufacturers of the synthetic meshes and/or biologic implants you currently use for ventral hernia repair.

Question 9.

For each manufacturer, please indicate which synthetic meshes and/or biologic implants you currently use for ventral hernia repair.

Question 10.

In what percent of ventral hernia repair surgeries do you currently use these synthetic mesh products?

Question 11.

In what percent of ventral hernia repair surgeries do you currently use these biologic implants?

Question 12.

Please rank the following features/attributes of synthetic meshes and biologic implants in order of importance in regards to product selection for complex ventral hernia repair. (1=Most Important, 2=Second Most Important and so on)

Question  13.

What is the primary reason you would choose synthetic mesh over AlloDerm for use in complex ventral hernia repair?

Question 14.

What is the primary reason you would choose AlloDerm over a synthetic mesh for use in complex ventral hernia repair?

Question  15.

What is the primary reason you would choose AlloDerm over another Biologic Implant (such as Bard’s Collamend) for use in complex ventral hernia repair?

Question 16.

What is the primary reason you would choose another biologic implant over AlloDerm for use in complex ventral hernia repair?

Question 17.

In your opinion, what level of impact will the availability of Bard’s Collamend have on the usage of Alloderm?

Question 18.

When using biologic implants, how important is it to you to select a product from the following sources?

Question 19.

For each of the scenarios below, please indicate which type of product (synthetic mesh or biologic implant) you most prefer.

Question 20.

Of all the ventral hernia repair products that you have used, which has consistently yielded the best patient outcomes?

Question 21.

Looking ahead 2 to 3 years from now, what do you anticipate will be your trend in the use of the following products?

Section Three: Cost Considerations

Question 22.

In your opinion, which category of product is most cost-effective for ventral hernia repair?

Question 23.

Please estimate the average cost (per patient) of the following products when used in a ventral hernia repair procedure.

Question 24.

Please rate the importance of a product’s price on your willingness to use it for ventral hernia repair. Use a scale from 1 to 5 where 1=Not at all Important and 5=Extremely Important.

Question 24a.

Why do you feel this way?

Question 25.

Which of the following best describes your product options when selecting a product for ventral hernia repair?

Question 26.

How often, if at all, are your product choices reviewed by hospital administration or an oversight committee?

Section four: Comparisons of Sales Representatives

Question 27.

Previously you indicated that you currently use synthetic meshes and/or biologic implants from the following manufacturers. In the past year, have you met with sales representatives from these manufacturers?

Question 28.

Please rate the manufacturer(s) on the following attributes using a scale of 1 to 5 where 1=Poor and 5=Excellent.

Question 29.

Which of the following types of interactions have you had with manufacturer’s sales representatives in the past year?

Section Five: Alternative Product Applications

Question 30.

In the spaces below, please indicate other types of surgeries (besides hernia repair) where synthetic or biologic mesh may be appropriate for use. If you do not feel that these products are appropriate for use in any other procedures, type “none in the first row in each column.

Question 31.

Are there any other mesh/implant technologies, materials, or products that you are currently using in ventral hernia repair that we have not covered already? If yes, please describe the product in the space provided.