1. The Consequences of Secret Prices: The Politics of Physician Preference Items  Why Secret Prices of PPI’s Became a Political Issue  Prices of PPI’s Are Not Yet Entirely Confidential  Unexplained Variation in Prices  Some Reasons Why Prices May Vary  PPI’s and Increasing Transparency in the Health Sector  Alternatives to Opaque PPI Pricing ECRI Institute 5200 Butler Pike Plymouth Meeting, PA 19462 Phone: 610 825 6000 x 5142 jlerner@ecri.org www.ecri.org. Lerner JC, Fox, DM, Nelson T, Reiss JB. The consequences of secret prices: the politics of physician preference items. Health Aff 2008;27(6):1560-5.

2. What’s at Stake  $60 Billion annually and rising Jeffrey C. Lerner, Ph.D President and Chief Executive Officer ECRI Institute 5200 Butler Pike Plymouth Meeting, PA 19462 Phone: 610 825 6000 x 5142 jlerner@ecri.org www.ecri.org.

3. Trends in Prices of Total Hip Implants Adapted from Stan Mendenhall’s Orthonet News Percent increase is 132% From $2,841 to $6,584 Jeffrey C. Lerner, Ph.D President and Chief Executive Officer ECRI Institute 5200 Butler Pike Plymouth Meeting, PA 19462 Phone: 610 825 6000 x 5142 jlerner@ecri.org www.ecri.org

4. Smart Shoppers Pay Less  Prices for hip implant devices varied between $2,300 and $7,300 http://www.iha.org/mtorthc.htm Jeffrey C. Lerner, Ph.D President and Chief Executive Officer ECRI Institute 5200 Butler Pike Plymouth Meeting, PA 19462 Phone: 610 825 6000 x 5142 jlerner@ecri.org www.ecri.org.

5. S. 2221: Transparency in Medical Device Pricing Act of 2007  Quarterly Reporting of Sales Price Data for Implantable Medical Devices Average and median sales price Price shall include volume discounts, free goods and services that are contingent on any purchase requirement, chargebacks, and rebates, and any other discounts or price concessions the Secretary determines to be appropriate  https://www.ecri.org/Documents/Transparency_in_Medical_Device_Pricing_Act_of _2007.pdf Jeffrey C. Lerner, Ph.D President and Chief Executive Officer ECRI Institute 5200 Butler Pike Plymouth Meeting, PA 19462 Phone: 610 825 6000 x 5142 jlerner@ecri.org www.ecri.org

6. Transparency Supports Effective Negotiation  Without it—you’re in the dark Jeffrey C. Lerner, Ph.D President and Chief Executive Officer ECRI Institute 5200 Butler Pike Plymouth Meeting, PA 19462 Phone: 610 825 6000 x 5142 jlerner@ecri.org www.ecri.org.