The orthopaedics industry has been waiting for a big innovation shift for years. Could generic devices be the answer? Maybe, but a move toward such implants isn’t without a strong opinion on both sides.

The concept of generic devices has been around for a while, but this doesn’t mean that it’s an accepted idea—at least not yet. “From the industry side, we’re not a popular organization,” says John Marotta, CEO of Emerge Medical (Denver), a company that provides generic devices to the orthopaedics industry. “There’s a lot of fat on the orthopaedic trauma and total [joint], spine, and sports medicine side. We believe we’re trimming the fat.”

By trimming the fat, Marotta means ditching the sales reps for certain devices. “We’re not getting to the meat, because we recognize that you still need sales reps for the high technology items and to continue to drive innovation through them," he says. "But on the legacy products, we believe that [sales reps are] adding substantial cost into the marketplace.”

Emerge Medical currently makes cannulated screws and drills bits for the orthopaedic trauma market, but the company has its eye on total joints (Marotta declined to offer a timeline but said that the company is aggressively pursuing this market). As hospitals put more pricing pressures on device manufacturers, generic total joint implants are an attractive option—especially as baby boomers are reaching the age of needing devices such as knee replacements. However, the orthopaedic device industry is already experiencing a slow rate of innovation, and generic implants could reverse the goal of discovering new materials that have better wear resistance and strength characteristics. Such devices could halt improvements to implant technology.

“I think that low cost manufacturers around the globe will let you believe that [an implant] is a commodity and I don’t believe that it is,” says Dean Hughes, director of knee development at Smith & Nephew (Memphis). “Especially with the knee, we’re not there yet, and generic implants are a step in the wrong direction. The literature says that only about 80% of patients who have total knee replacements are satisfied after surgery. That leaves 20% of the population that gets total knees and isn’t satisfied. As much work as we’ve done, we have a long way to go to improve design or materials selection.”

Many opponents of generic implants also say that these devices drive down cost by compromising on quality and using outdated product designs. “Recently, I’ve seen companies look at the patents that come off of protection and start copying the designs,” says Hughes. “[These are] 20-year-old systems that have a great clinical history. However, 20 years of design has come a long way since those knees were introduced. There have been improvements along the way for patient comfort and longevity, and materials have been a big part of that.”

Marotta stresses that generic implants aren’t low quality and the cost savings come from shrinking the distribution channel and supply chain—getting rid of the selling, general, and administrative expenses, which includes cutting out the middleman.

Emerge Medical is already working with a large network of hospitals and has some big partnership plans in the works. As hospitals squeeze orthopaedics manufacturers tighter, generic implants could forever change the way that manufacturers develop products and do business with hospitals and clinicians. Whether or not companies want to admit it, the orthopaedics industry must take generic devices seriously or else be at risk of losing traction to this new competition.