Chapter 1: Why hasn't 3D printing reduced prosthetic limb costs?
It's been a decade since 3D printing came to the prosthetics industry, and it still hasn't brought costs down. From American Public Media, this is Marketplace Tech. I'm Megan McCarty Carino. Prosthetic limbs can be pricey, costing thousands to hundreds of thousands of dollars. So the industry seemed ripe for disruption when 3D printing came along.
The technology requires little labor and uses economical materials. But the reality of 3D printing prosthetic limbs isn't that straightforward, according to writer Britt Young, who uses a prosthetic arm and wrote about this recently for IEE Spectrum magazine.
Around 10 years ago, people started approaching me and asking me for my opinion on 3D printing because I've been wearing, at the time, prosthetic limbs or a prosthetic arm for my whole life. And it was around 10 years ago when it started to enter the public consciousness as a revolutionary way to cut costs and increase accessibility.
You could potentially, out of your own garage, make your own high-tech Iron Man-esque prosthetic limb, and that would be a fraction of the cost than a conventionally available prosthetic limb. And this is sort of kind of true, not quite true. A lot of these designs are not very durable. They're not very comfortable. They are made of pretty cheap plastic.
And obviously, they're not made by professionals. So they're not professionally fitted. 3D printing now... is giving you more sophisticated sockets at the professional level at your prosthetist, but it has yet to cut the costs. So why hasn't this lowered costs? So for one, what we're really dealing with is something called additive manufacturing. And at the professional level, that means a
over $1 million machine. And that machine requires a tremendous amount of upkeep. The firm also must pay for, just like the rest of us, licensing and subscription fees to software. And they also have to pay an enormous air conditioning bill to keep the 3D printer in a climate controlled environment. And all of this is adding up to quite a bit of cost for the prosthetics firm.
However, they are able to see more patients. And while they are asleep, they are able to print multiple prosthetic limbs overnight. But at the moment, the costs to them are still a bit higher than the traditional methods.
One of the factors that you describe as being a barrier to reducing cost actually has nothing to do with the actual devices, but how insurance is covering them. Can you tell me more about that?
In the prosthetics space, it is very difficult to be approved for relatively new technologies. And by relatively new, I mean... within the last several decades. For upper body prosthetics, insurance is fickle. In my own experience, I try to get approved for a very cheap, very simply made plastic attachment for what is called an activity arm. So this is not a chargeable electronic device.
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Chapter 2: What are the limitations of 3D printed prosthetics?
And I think that it's not that 3D-printed prosthetics are better. It's not that they do something or are capable of doing things that traditional prosthetics could never dream of. It's not that. It's just that... There's a new material out there. And because there's a new material out there, that can increase the availability in the market.
It's good that the 3D printed devices are joining the market. There's just more to be had. But the barriers are the same regarding insurance.
We'll be right back. You are listening to Marketplace Tech. I'm Megan McCarty Carino. We're back with writer and UC Berkeley lecturer Britt Young. So what do you think would need to change in order for 3D printing to actually deliver on the promise of cheaper prosthetics?
I think the greatest barrier to access in prosthetics right now has to do with our working legal definition of medical devices. So the reason that I am requesting my insurance to pay for an ABS plastic prosthetic attachment is because these devices are billed at around $700 or $800.
I don't imagine they cost more than $20 to produce, but because they are medical devices, that is how they are billed. But if we were able to, in ways that allowed people to stay safe, especially for implants, for prosthetics like artificial hips, we of course want those devices to be safe and tested by the FDA. But for external devices, the kinds of things that I use in my day-to-day life,
I think we need to be thinking about them as more similar to the sorts of things that you can buy at Walgreens, like walkers, like wrist braces or knee braces. We have an aisle in Walgreens for these types of devices, and yet they're not considered medical devices and they're not considered prosthetics. There's a strange artificial boundary around some of these things.
And if we were to change the legal definition of them, we would actually be able to increase accessibility.
The American healthcare system obviously has its own idiosyncrasies, but I'm curious if sort of on a global level you think that 3D printing will ever deliver on, you know, the promise of reducing the cost of these devices.
So that's what's actually really interesting about 3D printing. For a while, the dream has been bringing 3D printing, and I mean the kinds of hobbyist devices that have been in people's garages for a little bit now, to the global south. And there are a number of charities and development organizations that are doing this.
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