Defense Secretary Leon Panetta recently expounded upon the tough choices policymakers will face as they attempt to scale back the Pentagons budget. As Panetta put it, our leaders will have to consider not just the weaponization, modernization side of the military but the human side as well.
Ensuring the availability of top-notch medical care for our service members is crucial to fortifying the human side of our armed forces. Unfortunately, policies in place at other government agencies may deprive the military of some cutting-edge medical technologies that are particularly useful on the battlefield.
Such an outcome is not acceptable.
At issue is an innovative technology known as Negative Pressure Wound Treatment (NPWT) that treats and heals wounds, ulcers, and severe trauma injuries.
In todays brand of warfare, soldiers often sustain soft tissue injuries from high-velocity gunshot wounds and explosive blasts. During Americas recent engagements in the Middle East, such injuries accounted for 96 percent of American casualties.
Soft tissue damage is particularly prone to infection. That makes wound management challenging.
Standard gauze dressings, while readily available and inexpensive, require close maintenance and additional nursing time. Removing them causes considerable pain, impedes healing, and can increase the risk of infection.
NPWT technology, on the other hand, delivers immediate and continuous care to severe tissue wounds. A vacuum applies negative pressure, drawing the wound together. The external stress encourages the formation of granulation tissue, which is essential for healing. Continuous cleansing draws out infectious materials, keeps out new contaminants, and saves limbs and lives.
Even better, some NPWT devices can be used during aeromedical transport. This simplifies treatment en route and improves care compared to older bandaging options. Its no wonder that air-approved NPWT is the first-choice treatment in the Department of Defenses Advanced Operational Wound Care Formulary.
Of course, this Wound-Vac technology isnt just useful on the battlefield. Its also an asset for civilians. Patients can receive treatment at home rather than in a more expensive institutional setting, like a hospital or nursing home.
But military and civilians alike may soon lose access to this critical treatment because of flaws in the way that the Centers for Medicare and Medicaid Services (CMS) purchase medical devices.
The agency procures medical supplies and equipment through poorly designed auctions.
For starters, bidders dont have to follow through on their offers. So they can win auctions and then back out of their commitment to deliver the products promised without penalty. That can lead to shortages for key types of medical devices.
The system also encourages bidders to compete solely on price not on quality. Game-changing technologies like NPWT may be at a disadvantage versus less advanced products simply because of cost.
Because of these and other flaws, the auction process generates prices that are one-third to two-thirds below what might be expected in a truly competitive marketplace. If firms must sell their products below cost in order to win the auctions, they wont be able to participate in them for long.
Now what does CMS have to do with the military? The agency accounts for an outsized share of the medical-equipment marketplace about a third of the nations expenditures. Firms that cant successfully sell to CMS dont have many other prospects.
Consequently, innovative and effective but comparatively pricey devices may disappear. And that may leave patients including members of the military with subpar treatment options.
The Wound-Vac is just one example of an innovative technology that may vanish because of the flawed auction design. Other cutting-edge therapies may similarly become unavailable.
Worse, the next generation of treatments may never be discovered at all. Artificially low prices for medical technologies discourage investments in research and development.
Annual R&D investment into new medical technologies between 2011 and 2020 may decline between 12 and 15 percent, or between $2.1 billion and $3.1 billion, thanks to the CMS auction procedures. And thats a conservative estimate.
Americas brave men and women in uniform deserve the best medical care around. With its flawed auction process, CMS is undermining that goal leaving our countrys soldiers vulnerable and jeopardizing future developments in medical technology.