This is a fascinating question, Ann - 

I've been studying this topic for the last couple of years in five countries. 
While I do not yet understand this complex phenomenon as well as I would wish 
to, these are my impressions about life here in the US. It is a ridiculous 
tale, but I will tell it to you...

The smartest shoppers who have the biggest contracts (you can guess who those 
might be) are paying $5-10 for their highest-volume slides  - ER, PR, HER-2 and 
a few others - but more like  $10-15 for most of their menus. The smallest IHC 
customers think they are paying 20-something per slide, but they are actually 
paying $30-$40 per slide - and more in many cases.

How this discrepancy? Two reasons: first, because the suppliers (I can't quite 
remember their names right now, please pardon my senior moment) are 
highly-skilled at making their price lists and service contracts as 
eye-glazingly complicated as possible. And second, because immutable human 
nature compels many mere mortals to underestimate their costs, particularly 
while they are still trying to rationalize a bad investment they made some time 
ago

I'm pretty sure that American labs (excluding Canada, mind you) spent  
$700-750m with the IHC companies in 2013. I think that between 28m and 32 
million IHC slides were run last year in the US. If you want to slice those 
estimates down the middle you'll come up with maybe $24/slide, once every penny 
of waste, service, and sub-optimal operating procedures are truly accounted 
for. 

There you have one of the most useless averages you'll ever hear. There are 
plenty of contracts out there in vast middle America at every price point 
between $7 and $30 per slide. You pay what your volume earns you, unless of 
course you happen to be in the market for a tissue processor or primary stainer 
at the time you're haggling with the IHC companies. I'll remember their names 
if you give me another a minute.

That's the way it was last year. WIth these new codes, lots of small labs will 
be priced out of the IHC business by summertime, and the big labs that remain 
will have negotiated prices within a narrower range. That'll be a fast-moving 
target. Since I didn't see you in the crowd at the funeral of 88342 last month, 
I am attaching below our chronicle of the event.

I'm always happy to banter about this with anyone who thinks the topic is 
interesting.

Sincerely,

Michael Farmer
McEvoy & Farmer Pathology
www.mcevoyandfarmer-pathology.com
415-994-8852

"Those who seek the truth doubt those who find it"
 - André Gide






On Feb 3, 2014, at 1:03 PM, Ann Specian wrote:

> 
> Can anyone tell me the average cost for preparing an IHC slide?
> thanks, Ann
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