Liquid Prep Testing Market Causing Much Aggravation

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SEVERAL RECENT ISSUES of THE DARK REPORT addressed issues that resonated with our clients and regular readers. The mailbag has been plenty full of late.

These responses are interesting in their own right. Among those with a point to make is Laboratory Corporation of America Holdings. It wanted to respond to a recent opinion and commentary column titled “Why There’s ‘Bad Blood’ Against the National Labs.” In that column, R. Lewis Dark, our Publisher Emeritus, tackled a touchy subject.

His topic was the collaboration between hospital labs and the national public laboratory companies—or the lack thereof. Within the laboratory marketplace, some hospital labs view the national public lab companies as a useful resource. However, there exists a sizeable number of hospital labs that have no interest in doing business, in any fashion, with public lab companies they view with “disdain” (Mr. Dark’s characterization).

Frustrated Efforts At Amity

As an example of how such polarization occurs, he offered the story of a major tertiary center hospital laboratory in the South. This lab, which competes for physician office lab testing, has been frustrated in its attempts to establish an amicable working relationship with one of the two blood brothers. (See TDR, January 20, 2003.)

Essentially, the story is this. Hospital lab uses one brand of liquid prep Pap smears, national lab uses another brand. When a physician mistakenly misdirects a liquid prep specimen to the national lab that was intended for the hospital lab, the national lab refuses to cooperate in getting that specimen rerouted to the hospital laboratory. Instead, it returns the specimen directly to the referring physician with a note stating that “the wrong liquid prep specimen collection kit was used.”

As most laboratorians know, long-standing professional practice in most communities is for lab competitors to cooperate in getting misdirected specimens to the correct laboratory. Not surprisingly, the hospital lab folks in this particular Southern town are disappointed that, at a minimum, this practice of their public lab competitors across town delays the misdirected specimen, which affects patient care by increasing turnaround time. Additionally, such extra handling increases the odds that specimen integrity could degrade, also a patient-unfriendly outcome. In his opinion and commentary, R. Lewis Dark did not identify the offending “blood brother.”

Not long after publication of this story, THE DARK REPORT heard from LabCorp on this issue. They wanted to put their company’s position into the public record.

“Since we are headquartered in the South, we were concerned that your readers might conclude that the incident you wrote about involved LabCorp,” stated Bradford T. Smith, Executive Vice President at LabCorp. “It did not. First, we are proud of the hundreds of mutually beneficial relationships we have with hospitals.

“Second, for years, LabCorp has offered both the Cytyc ThinPrep® and Tripath Imaging SurePath® brands of liquid preparations technologies for Pap smear screening,” he continued. “Offering both of these technologies allows the physician to decide which method is best for his/her patients.

“Our policy for misdirected lab specimens works in in tandem with this support of physician choice. Whenever specimens and requisitions meant for another laboratory are received by us, LabCorp’s corporate practice is to notify that lab and cooperate in efficiently getting those specimens to them,” explained Smith.

“Our goal is to minimize the amount of disruption experienced by physicians and patients created by unexpected situations,” he added. “Patient care should always be the guiding principle.”

Voted With His Feet

Liquid preparation Pap smears were also the topic of another letter in our mailbag. However, this writer wanted to add his comments to observations about Cytyc Corporation that THE DARK REPORT recently published in its February 10, 2003 issue. This letter was written by William Pesci, Jr., Executive Director of the Carolinas Lab Network in Charlotte, North Carolina.

Dear DARK REPORT,

Again you are accurate in your evaluation of the lab marketplace. In the most recent issue, you stated that “one interesting development in the marketplace may also be a quiet revolt by Cytyc’s laboratory customers against certain of its business practices” and that “some of Cytyc’s customers may be voting with their feet when contracts [for liquid prep test kits] come up for renewal.”

Count our laboratory as one of those who took a hike! We’ve completed our validations and are switching over from Cytyc’s ThinPrep to TriPath Imaging’s SurePath. The primary motivation for evaluating an alternative was Cytyc’s basic business approach. On pricing, for example, despite increasing our annual volume of liquid prep tests, we were not offered lower pricing. That’s probably not news to other labs using this test.

But what we’ve learned is that Cytyc itself is willing to compete against our laboratory in the markets we serve. Once Cytyc suspected a switchover was eminent, we understood that competing labs were approached and asked if they could handle additional Pap test volume from Charlotte. Cytyc representatives have historically marketed directly to our clients, sometimes creating confusion and problems for our lab. This has often left us on the hook to repair relationships with our clients. I’d like to know if any other laboratories are experiencing this same type of issue with Cytyc.

It is fortunate that we have competition in liquid prep Pap tests. It allowed us to vote with our feet and move our business to another vendor. Once again, THE DARK REPORT confirmed a marketplace trend that we are experiencing first-hand. Thanks for insightful reporting!

Editor’s Response: Market share is won or lost by the sum total of individual customers like Carolinas Laboratory Network. THE DARK REPORT is interested to learn about other examples of questionable business behavior that might help lab administrators better understand unfolding trends.

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