EBI v. Exogen

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Anonymous said:
EBI does not
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Exogen Reps do not either. We no longer "give away". Been a tough year with deductibles being so high. Can't wait to find something else. These devices should go rental through distributors. Within the next 2 years this landscape will be totally different. As a rep who isn't all about the money, I take offense to the person who slams all equipment reps for being greedy and smoozing the drs. Patient care is very important to me. All of these products are pretty good to help people with non-unions. I really don't even talk about our indicated FF that much because most fxs heal on their own. Where the specific FF inidacation does come in handy is for athletes, active duties who smoke and people who have co-morbidities and really need to get back to their job.

I see a lot of greedy reps in the business. One can only look at the top 20 reps in the company and pretty much know that they are doing something shady, in most cases.
I'll let my boss yell and pressure me, before I'll do anything shady.
 












Anonymous said:
Exogen Reps do not either. We no longer "give away". Been a tough year with deductibles being so high. Can't wait to find something else. These devices should go rental through distributors. Within the next 2 years this landscape will be totally different. As a rep who isn't all about the money, I take offense to the person who slams all equipment reps for being greedy and smoozing the drs. Patient care is very important to me. All of these products are pretty good to help people with non-unions. I really don't even talk about our indicated FF that much because most fxs heal on their own. Where the specific FF inidacation does come in handy is for athletes, active duties who smoke and people who have co-morbidities and really need to get back to their job.

I see a lot of greedy reps in the business. One can only look at the top 20 reps in the company and pretty much know that they are doing something shady, in most cases.
I'll let my boss yell and pressure me, before I'll do anything shady.
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I doubt you sell Exogen and if you are you're probably on a plan.
 






Anonymous said:
I doubt you sell Exogen and if you are you're probably on a plan.
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Yes and No. Do quite well by staying compliant and respected by surgeons. Good growth and on top of the numbers year after year. I seem to thrive better when I am honest and do things by the book. Surgeons appreciate that I am trying to keep them in compliance as well. Because as well all know our friends at Orthofix have had to drag some of their surgeons as instructed by the DOJ. Last thing many of us SN reps would do is pay surgeons money for referrals.

I have a business formula which works well and keep me in compliance.
 






Anonymous said:
Yes and No. Do quite well by staying compliant and respected by surgeons. Good growth and on top of the numbers year after year. I seem to thrive better when I am honest and do things by the book. Surgeons appreciate that I am trying to keep them in compliance as well. Because as well all know our friends at Orthofix have had to drag some of their surgeons as instructed by the DOJ. Last thing many of us SN reps would do is pay surgeons money for referrals.

I have a business formula which works well and keep me in compliance.
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Unfortunately, you will never be in compliance as long as your company continues to overbill Medicare and other insurances, by billing as purchase, indicating a documented ten month usage. Rentals will soon be required by all as it is fundamentally wrong to bill for something not medically necessary, as many a BGS is utilized only a few months. Forget single patient use, Class III device, as this is irrelevant to billing standards, which companies have attempted to use to cleverly disguise there ill ways. Glad you ortho reps are starting to understand you can't pay docs for referrals. However, please do not preach compliance if selling BGS. The product line is skeptical clinically and billed fraudulantly EVERY time since inception. Time for EBI and S&N to give back these ill gained obscene profits
 






Anonymous said:
You are FULL OF SHIT. Your marketing feeds you trash.

86% comes from 2 Gold standard studies and it is NOT only tibias/radius. I guess you guys have not read the Nolte studies looking at Non-unions of 10+ different fractures of different bones, some with internal fixation, etc.

You are also incorrect about the penetration. It will penetrate through all bones no matter the "size" of the person. Dumbass FYI ultrasound penetrates through water and fat is no issue so lard asses will also get the healing.

Keep telling those docs that as we continue to take your share and take over #1. I hear you guys in NYC got it real good by the FBI to try to maintain share. YOU guys crack me up.
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To set the record strait. The only level I (i.e. gold standard) studies exogen has is for fresh fracture accelleration of the tibial diaphysis and distal radius. The non-union data is considered weak (Level II/III) as it was retrospective without a placebo. Nolte is also a weak study without a placebo and if you present it as a gold standard to a physician who knows his stuff he will know that is crap. Exogen's high heal rates are all based off retrospective data (read your own PMA and package insert). Many insurance companies refer to the data as weak or experimental. Smith and Nephew's marketing team is great at pushing less than steller data and many of the reps take that as bible. Some exogen reps convolutes the situation by referencing the accelerated healing studies to lead physicians to believe that Exogen has great non-union data and is indicated for all fresh fractures.
 






Anonymous said:
To set the record strait. The only level I (i.e. gold standard) studies exogen has is for fresh fracture accelleration of the tibial diaphysis and distal radius. The non-union data is considered weak (Level II/III) as it was retrospective without a placebo. Nolte is also a weak study without a placebo and if you present it as a gold standard to a physician who knows his stuff he will know that is crap. Exogen's high heal rates are all based off retrospective data (read your own PMA and package insert). Many insurance companies refer to the data as weak or experimental. Smith and Nephew's marketing team is great at pushing less than steller data and many of the reps take that as bible. Some exogen reps convolutes the situation by referencing the accelerated healing studies to lead physicians to believe that Exogen has great non-union data and is indicated for all fresh fractures.
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Will take Exogen studies any day over the 30 year old crap from EBI. Your technology is outdated and all your marketing materials are smoke and mirrors.
 






just received 3 orders for EXOGEN in the past week. patients had already used EBI stim for months without any success and STILL had non-union. I will post follow up when patient is healed after Exogen intervention. Last 2 similar cases healed up just fine. So long EBI.
 






Anonymous said:
just received 3 orders for EXOGEN in the past week. patients had already used EBI stim for months without any success and STILL had non-union. I will post follow up when patient is healed after Exogen intervention. Last 2 similar cases healed up just fine. So long EBI.
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just following up....Did your patient heal? Did you just sell them another unit? If these stims were rented as they should be, then different products could be reimbursed for 3 months at a time and the best product would then dominate the market. Market forces at work, the way the law was intended. Too bad it has been bastardized by fraudulant billing and reps saying anything to anyone to make a deal. The whole stim biz needs an overhaul.
 






Anonymous said:
just following up....Did your patient heal? Did you just sell them another unit? If these stims were rented as they should be, then different products could be reimbursed for 3 months at a time and the best product would then dominate the market. Market forces at work, the way the law was intended. Too bad it has been bastardized by fraudulant billing and reps saying anything to anyone to make a deal. The whole stim biz needs an overhaul.
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You got that right! What a slimy business. Devices need to be rented. Payers need to start demanding rented units and so does the government. Enough is enough!
 






Anonymous said:
just following up....Did your patient heal? Did you just sell them another unit? If these stims were rented as they should be, then different products could be reimbursed for 3 months at a time and the best product would then dominate the market. Market forces at work, the way the law was intended. Too bad it has been bastardized by fraudulant billing and reps saying anything to anyone to make a deal. The whole stim biz needs an overhaul.
Click to expand...


You got that right! What a slimy business. Devices need to be rented. Payers need to start demanding rented units and so does the government. Enough is enough!
 






Anonymous said:
To set the record strait. The only level I (i.e. gold standard) studies exogen has is for fresh fracture accelleration of the tibial diaphysis and distal radius. The non-union data is considered weak (Level II/III) as it was retrospective without a placebo. Nolte is also a weak study without a placebo and if you present it as a gold standard to a physician who knows his stuff he will know that is crap. Exogen's high heal rates are all based off retrospective data (read your own PMA and package insert). Many insurance companies refer to the data as weak or experimental. Smith and Nephew's marketing team is great at pushing less than steller data and many of the reps take that as bible. Some exogen reps convolutes the situation by referencing the accelerated healing studies to lead physicians to believe that Exogen has great non-union data and is indicated for all fresh fractures.
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Yes, sn reps carry around marketing pieces and studies outside of indications.
 






All of SN marketing seems to be geared towards accelerating the heal time of fxs. Most surgeons find that their sales reps are unethical. To keep hasseling the surgeons to write for acute fxs is wasteful and irresponsible.
 






Anonymous said:
All of SN marketing seems to be geared towards accelerating the heal time of fxs. Most surgeons find that their sales reps are unethical. To keep hasseling the surgeons to write for acute fxs is wasteful and irresponsible.
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You're kidding, right?
You do realize that pemf has absolutely no effect on acute fractures, yes? You just proved this with your own recent clinical trial.
And that Exogen accelerates healing with acute fractures? By 38% ?
And your non-union trials show substantially lower heal rates than Exogen, with an 8-10 hour wear time vs 20 minutes?
And that a large Jbjs meta analysis questions whether electric stim has any effect on fracture healing at all?
Now what would you give your loved one if they had a non-healing fracture?
 






Of all the things to argue about...bone stimulators, really guys?! :)

I'm in the UK and have just recieived an EXOGEN machine to speed up a slow healing fracture. It's not a cheap option - but well worth a try to avoid surgery - although I wonder if they'd be adopted more widely if the business model was adjusted to being a "rentable service" rather than a device to buy outright...?
 






EBI device failed to promote growth on my fractured tibia. Had painful non-union and was given Exogen unit from rep after insurance deinied for what they called a self pay. One month later...my fractured healed.
 






Ebi is the leading bone stimulator. They have over 300 studies on there devices. The ebi bone healing system has a lower success rates because they used a true double blind placebo control. Exogen lacks a placebo controlled pma study. also they market 20 mins per day. That's Great I guess. Ebi markets 10 hours per day. Ebi heals 60 faster than exogen. Exogen can only treat for 20 mins because the FDA only allows 20 mins. It's believed that the ultrasound with damage the soft tissue. So there no problems with ebi. More stim is better because people heal fast. Also exogen has be found not to be effective with internal fixation. The study they funded found that. They're only FDA approved for distal tibia and distal radius fractures. There is a depth of penetration issue with that device. Also the field only covers a small area. Ebi stimulators cover a much larger area. They have no problems with depth of penetration. They work well with internal fixation. Beware of exogen big marketing but doesn't deliver as much. ebi also has a device called capacitive coupling which can be worn for 24 hrs. This device works well I've seen its results. Patients heal faster.
 






Anonymous said:
You're kidding, right?
You do realize that pemf has absolutely no effect on acute fractures, yes? You just proved this with your own recent clinical trial.
And that Exogen accelerates healing with acute fractures? By 38% ?
And your non-union trials show substantially lower heal rates than Exogen, with an 8-10 hour wear time vs 20 minutes?
And that a large Jbjs meta analysis questions whether electric stim has any effect on fracture healing at all?
Now what would you give your loved one if they had a non-healing fracture?
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Hey that study your talking is incorrect and they clearly stated that we have a positive effect on non unions. Also there was a lot wrong with that study. Hey ebi has 3 technologies if you don't like pemp with have capacitive coupling which can be worn for 24 hrs and patients will heal faster. Much faster than exogen. More is better
 






Anonymous said:
Ebi is the leading bone stimulator. They have over 300 studies on there devices. The ebi bone healing system has a lower success rates because they used a true double blind placebo control. Exogen lacks a placebo controlled pma study. also they market 20 mins per day. That's Great I guess. Ebi markets 10 hours per day. Ebi heals 60 faster than exogen. Exogen can only treat for 20 mins because the FDA only allows 20 mins. It's believed that the ultrasound with damage the soft tissue. So there no problems with ebi. More stim is better because people heal fast. Also exogen has be found not to be effective with internal fixation. The study they funded found that. They're only FDA approved for distal tibia and distal radius fractures. There is a depth of penetration issue with that device. Also the field only covers a small area. Ebi stimulators cover a much larger area. They have no problems with depth of penetration. They work well with internal fixation. Beware of exogen big marketing but doesn't deliver as much. ebi also has a device called capacitive coupling which can be worn for 24 hrs. This device works well I've seen its results. Patients heal faster.
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I'm sorry you are terribly misinformed. Exogen is the #1 prescribed Bone Healing device in the world. In fact, Exogen is an OrthoBioligic Device proven to accelerate osteogenisis at every stage of fracture healing. It's sad Exogen gets mentioned on the same level as EB and classified as a "Bone Stimulator". Can you even explain how EBI works? What exactly does old school PEMF technology do to promote fracture repair? There are plenty of studies that indicate low intensity ultrasound is safe with metal fixations. There are no contraindications with use of the device. Exogens LIPUS operates around half the strength and frequency of a fetal sonogram. Depth of penetration is well over 26.5 cm. The fact that you claim EBI heals faster than Exogen is refuted in the recent JBJS study which indicated "We do not recommend the use of pulsed electromagnetic
field stimulation (EBI) for the treatment of acute tibial
shaft fractures" Funny the reason EXOGEN received FDA approval to treat fresh fractures was from a JBJS study on acute midshaft tibia healing. I've never heard of a patient yet that would want to wear a device for 10-24 hours for a 63% success rate. Hands down EXOGEN wins at 20 minutes per day with the highest heal rate reported in the category at 86%. Not to mention, with acute indication, Exogen is approved immediately from the carrier. EBI does not get approved nearly as often and if it does, the patient is stuck with an inferior device that needs to be lugged around with them all day.
 












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