1. Treatment price vs treatment acceptance 11.01.2016 Alexandre Georjon GMT 45253 © Nobel Biocare Services AG, 2016. All rights reserved. Nobel Biocare, the Nobel Biocare logotype and all other trademarks are, if nothing else is stated or is evident from the context in a certain case, trademarks of Nobel Biocare. Please refer to nobelbiocare.com/trademarks for more information. Product images are not necessarily to scale. Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. For prescription use only. Caution: Federal (United States) law restricts this device to sale by or on the order of a licensed dentist. See Instructions for Use for full prescribing information, including indications, contraindications, warnings and precautions.

2. Topics of the session Understand the dentist’s conflict of interest Value vs. cost vs. price Idea to present the treatment plan Patient got a second cheaper offer… Next steps 2

3. Conflict of interest Patient…  has pain  is under time-pressure  can hardly assess the quality of the treatment options  knows that the practice makes money with treatment  expects that you are going to ‘hard’ sell your treatment. All good reasons for them to lose something in it 3 Discussion point: How can you help to minimize the perception of your patients that there is a conflict of interest?

4. Conflict of interest You and your team should avoid any behavior and message supporting this prejudice:  focus the conversation on clinical aspects  mention potential negative aspects for each treatment option e.g. clinical outcome, function, esthetic, price, time …  NEVER negotiate fees – price negotiation are part of a sales activity; whereas clinician’s role is to provide a solution to an indication  you and your team must show commitment to have happy patients that refer new patients, rather than short-term sales 4

5. Conflict of interest - Strengthen your clinical credibility In some cases, patients expect to be able to assess clinicians level of professionalism.  Use patient testimonials e.g. video on your website, in your practice  Patient-friendly before/after pictures of your cases – build a library of cases to match your patient’s indication (avoid technical details, blood,…)  Show professional certifications, membership with dental societies  Plan time to explain the treatment and the outcome  Encourage second opinions – it shows self-confidence 5

6. Partnering with Nobel Biocare gives you the right arguments 6 How can Nobel Biocare support your credibility in the practice? Use 3D digital tools – NobelClinician Hold patient seminars where you address a particular topic e.g. All-on-4 Use the full spectrum of patient communication material Leverage digital marketing material available on MyNobel

7. Partnering with Nobel Biocare gives you the right arguments 7 The exceptional QUALITY of original products is based on Medical Device standards. ASSURANCE of life-long follow-up on products Designing for quality of life WIDE RANGE of evolutive product and solutions Leader in INNOVATION and continual investment in research and development Solutions for all indications EXPERIENCED clinicians all over the world Assurance for patients to get HIGH QUALITY FOLLOW ups Wherever the patient is in the WORLD Worldwide network of experts DISCOVERY of osseointegration in 1952 and the first edentulous patient treated by Pr Brånemark in 1965. The implant will be an integral part of the patient’s body and are designed for LIFE-LONG USE. Pioneer in dental implants The largest scientific HERITAGE Over 40 years of documented EXPERIENCE Predictable and SAFE solutions Scientifically proven Discussion point: How can Nobel Biocare help you increase your credibility when you are in contact with the patient?

8. Topics of the session Understand the dentist’s conflict of interest Value vs. cost vs. price Idea to present the treatment plan Patient got a second cheaper offer… Next steps 8

9. Introduction to price 9 What matters for patients – cost or price?

10. Cost vs. price 10 Sales Price: $ 1mio Monthly cost: $ 2000 (mortgage) What is tougher for patients; +20% price increase or cost increase?

11. Avoid price discussion – lead the cost discussion 1.Patient is 70 years old and faces a treatment price of $15’000! 2.What is their life expectancy? 15-20 years 3.So the cost per month is $ 83 = $15’000 / 15 years / 12 months 11 Price Perspective Cost Patient got a competitive offer for only $ 60 per month. What is better?

12. Value qualifies the best deal Maximize the value perceived by the patient 1 :  Focus on communicating benefits that are tangible for patients e.g. feel free to smile, eat apples, do sports,…  Identify the barriers openly with the patient. These matters are ideally dealt by the treatment team rather than by the clinician 12 Price level Cash availability Travel time Understanding value of the treatment Time Risk of pain Fears … Smile Esthetics Eat apple Phonetics Social contact Longevity of treatment Warranty Peace-of-mind Short timeline Success rate … B ARRIERS B ENEFITS 1: adapted from http://www.yourdentistryguide.com/implant-procedures/ accessed April 15, 2013

13. Value qualifies the best deal  Value is linked to the relevant price level: the price must be set to reflect the amount of benefits the patient will get. 13 $ 100’000 $ 10’000 “Implants are stronger and more durable than their restorative counterparts, such as root canal treatments, or crowns and bridges that are cemented into place, or dentures that are removable.” 1 1: Torabinejad M et al. Outcomes of root canal treatment and restoration, implant-supported single crowns, fixed partial dentures, and extraction without replacement: a systematic review. J Prosthet Dent 2007;98(4):285-311

14. Topics of the session Understand the dentist’s conflict of interest Value vs. cost vs. price Idea to present the treatment plan Patient got a second cheaper offer… Next steps 14

15. How to get to the price? 1. Patient explains about their situation 2. Dentist seeks the higher motivation 3. Dentist reinforces problems that can be treated and highlights what must be addressed. 15 - “I miss a tooth in front” - “What makes you come today?” - “I am getting married in 1 year” - “So you want to get a nice smile for wedding pictures and be able to eat normally (crispy, hard things) again. The missing tooth led to a moderate bone resorption, this might lead to adjacent tooth losses.” - “This can be treated in different ways. I can treat your either with 1 implant or with a 3-unit bridge.” 4. Dentist lists the treatment options available ….

16. How to get to the price? 5. Dentist explains each treatment option (description, benefit/drawback, use show model or 3D picture of patient jaws) 16 - “Treatment with 1 implant - it’s a classic treatment that preserves adjacent teeth to be ground down and crowned. This is the most esthetic option with a long term success of 95-97%. It slows your bone resorption, meaning that adjacent teeth do not risk to be replaced. The day of surgery you might leave with a tooth. The total treatment time requires 6 visits over 6 months. A 3 unit bridge is cemented to adjacent teeth. Over a short term it is more cost-effective but would have a lower success rate of medium-long term. The bridge can be done in 2 visits over 3 weeks. For some patient with medical conditions, this option can be preferable.” Single implant shows 25% total cost savings over 20 yrs vs. 3- unit fixed prosthesis. Additionally, success rate increases by 22%. (Bouchard et al. 2009) - “The first option is $1500 and the second is $500. 6. Highlight the difference between the options 7. Presentation of the prices Single implant shows 25% total cost savings over 20 yrs vs. 3-unit fixed prosthesis. Additionally, success rate increases by 22%.

17. Train with your team 17 Role play: A lady, 60 years old 1 posterior tooth missing comes for the first time. Role play: A 68-years-old gentleman with dentures on Locator has issue masticating and looses the prosthesis. Role play: A 30-years-old man with missing anterior tooth comes back with a second cheaper offer from another clinic. The competitive treatment is using a Maryland 3-unit bridge.

18. Topics of the session Understand the dentist’s conflict of interest Value vs. cost vs. price Idea to present the treatment plan Patient got a second cheaper offer … Next steps 18

19. Your treatment is more expensive than your colleagues  React positively to the fact that patient sought a second opinion  Sit next to patient and compare the treatment approach of both offers e.g. one offer is implant-based whereas the other is a Maryland bridge  Do not engage in any price negotiation.  Potentially offer payment installments if patient has difficulties paying 19

20. Your treatment is more expensive than your colleagues 20 Discussion point: How do you communicate to patient the difference between the treatment offers. How do you differentiate their prices and their value?

21. Your treatment is more expensive than your colleagues  Acknowledge the premium price and highlight the differences in the treatment options:  Treatment time  Clinical and biological benefits for patient e.g. Masticatory, phonetic, esthetics and social benefits  Aftercare support e.g. network of Nobel Biocare professional globally, assurance of genuine product, warranty,… 21

22. Your treatment is more expensive than your colleagues If the total price is $1’500 for your treatment and only $500 for the other, breakdown the difference. e.g. $1’000 difference is explained by:  Quality – implant treatment has low biologic side- effects, whereas the bridge has an immediate biologic cost due to the need of grinding down. This can also require in any case implant or even grafting.  Time perspective – implant treatment last 20 years whereas bridge maybe 10 years. So this represents a value of $100 per additional year  …to be continued 22

23. Your treatment is more expensive than your colleagues  The cost can be spread over the expected restorative time. E.g. $ 1’500 for implant treatment lasts over 20 years. This is $ 6.25 per month  Translate the cost into very high value – are new premium teeth, allowing you to eat anything and look amazing not worth the price of a magazine each month? Footer23

24. Support your price NB footer24 Discussion point: For a $2’000 treatment, how can you justify a price difference of + $1000?

25. Last few options  Consistent stable prices over years and across indications. Patients do not understand when the prices vary, but the problem is the same  Easy price - Engage into Nobel Biocare programs that define competitive and clear prices with your lab and other partners for key treatments e.g. STEM, TEM 25 EUR 3 EUR 50

26. Topics of the session Understand the dentist’s conflict of interest Value vs. cost vs. price Idea to present the treatment plan Patient got a second cheaper offer … Next steps 26

27. Next steps 27 Involve your dental team, assess the actions that can be initiated immediately and others must be planned Increasing treatment acceptance is a continual improvement process 1.Where are price discussions happening in the patient journey? 2.List challenges related to prices 3.Define a training plan incl. role play for the full dental team 4.Implement corrective actions with your team and 5.Measure the impact. 1. Assess 2. Identify gaps 3. Develop corrective actions 4. Implement the actions

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