Given that medtech products (consumables and capital goods) make up such a significant proportion of acute care, it is astounding how much variation there is across Europe in prices.

Stents are 2-2.5 times more expensive in France than the UK for the same product from the same suppliers, according to a recent study.

Dutch hospitals are typically paying 20-25% more for medtech products than their German counterparts, according to AT Kearney.

We suspect that reagent prices vary with diagnostic test tariff prices - this would suggest differences of a factor of 2-3 times across borders. No wonder that Swiss labs are now buying in Poland!

Overall, we think that for most categories price differences of 100% across Europe are probably the norm, rather than the exception. Big differences even exist for large capital goods. We are told that imaging equipment is usually 30-40% cheaper in the USA, than in Europe.

All these price differences reflect the fact that reimbursement in some countries are tariff fixed. (This is the case for stents in France, for instance).

It also reflects the different purchasing paths in different countries. It is clear that, particularly in the public sector, most surgeons are still free to specify the product they want to use. This is true, for instance, in the English NHS and the 100 big Dutch not-for profit foundation hospitals.  This means hospitals and payors are unable to leverage volume.

As we report here, this is all likely to change. Procurement and logistic hubs are growing - particularly private operators such as DHL. Payors are also beginning to be involved. In the Netherlands, the Dutch statutory healthcare insurers fresh from achieving eye-watering price cuts of 50-80% in generics, are now keen to achieve the same in medtech.

It is clear that where the products are commodities, such as bandages or most reagents, then canny purchasers are already effecting huge savings. But, wherever support is needed, the picture changes. AT Kearney tells us that manufacturers latch onto this fast. They are also adept at talking about how they can add value whenever anyone suggests a cut!

The potential is huge. But there is a shocking lack of transparency. People in procurement usually have no idea of what is going on in neighbouring countries.  So the evidence for these price discrepancies is anecdotal and limited. The initiative from Martin Whitbread at Proceur who is comparing prices across Europe for hospital groups can change that - if people are prepared to share the data.