Economic Considerations on Costs and Pricing of Two Surgical Techniques for Treating Cranial Cruciate Disease in Dogs

SIMPLE SUMMARY: Rupture of the cranial cruciate ligament in dogs is a very common condition in veterinary medicine. Surgical treatment is well established and several procedures provide very good clinical results. However, surgical treatment is associated with a high financial burden for patients’ owners. Veterinarians are bound to charging services according to a mandatory fee schedule, which gives a range in pricing. In this study, we examine the prices for two surgical interventions. We found that one technique is slightly more expensive; however, it also creates greater costs in the veterinary practice setting. Therefore, it is questionable whether the more expensive procedure provides a greater scope for profit. Pricing strategies are identified and may either be based on costs or a promise of quality in terms of a better clinical outcome. ABSTRACT: In surgical treatment of cranial cruciate ligament disease in dogs, Tibial Plateau Levelling Osteotomy (TPLO) and Tibial Tuberosity Advancement (TTA) are commonly established procedures and have proven effective in restoring limb function. Unlike clinical outcome, economic aspects have not been studied as extensively. However, the surgical intervention poses an enormous financial burden on patients’ owners. In a veterinary practice setting, this study compares prices for TPLO and TTA and examines prices differences as well as potential cost drivers. Charges for veterinary treatments are based on the Gebührenordnung für Tierärztinnen und Tierärzte (GOT), which is mandatory for veterinarians in Germany but allows a certain range in billing. This study found that TPLO is charged at a higher price than TTA; however, this might not cover the additional costs of this procedure. The price is also associated with weight, heavier dogs being more expensive. The underlying strategies for pricing decisions may be based on costs, as efforts for TPLO and heavier dogs are higher in terms of a prolonged surgical time, the number of staff involved and in surgeons’ training. Price setting may also be based on a quality promise, suggesting better clinical outcome in a more expensive procedure. Future investigations should involve economic considerations and consider cost-effectiveness analysis when evaluating surgical treatment options.