Costs, Consignment, and Waste: A Q1 Look Inside the U.S. Perioperative Healthcare Supply Chain

As hospitals navigate rising costs, staffing shortages, and relentless supply chain disruption, the reality of U.S. healthcare supply logistics is increasingly defined not just by what’s missing—but by what’s quietly sitting in stockrooms.  

For this Q1 2025 report, we analyzed over 64,000 perioperative inventory line items across U.S. hospitals and outpatient surgical centers, totaling $40.4 million in inventory value. Each item was scanned using SxanPro's proprietary mobile technology using its Unique Device Identifier (UDI), allowing us to trace identical products across different locations.

What emerged is a revealing snapshot of healthcare’s hidden spend: OR bins stacked with millions in product, consignment devices quietly expiring, and stunning variation in what facilities pay for the same item—all signs of a system where operational clarity hasn’t quite caught up with data potential.‍

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OR Bins: High Spend, Higher Risk

The operating room continues to dominate inventory value, with over 54% of total dollars tied to OR-designated bin locations.  

That’s understandable: the OR is the revenue generator of most hospitals. But this volume comes with risk. OR bins were also home to the highest volume of expired inventory, including multiple line items worth $5,000+ each that had already passed expiration.

In one facility, a single OR specialty cart held more than $1.1 million in product—more than the annual supply budget for many critical access hospitals.

And yet, this isn’t isolated. According to a 2023 Johns Hopkins study, U.S. hospitals waste up to $15 million per year in unused OR surgical supplies. When expiration meets inertia, the losses add up fast.

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Same Product, Vastly Different Prices

By linking UDIs across facilities, we identified dozens of products where price variation exceeded $1,000 per unit. In one of the most extreme examples, a low-volume rural hospital paid $459 for a surgical device that a larger system partner sourced for just $44—a difference of over 10x for the exact same product.

This isn’t a one-off. Of the 17,956 unique UDIs in our dataset, more than 15% appeared across multiple facilities, and among those, price variance was consistently wide.

What this tells us is that pricing transparency, enabled by UDI comparison, is more essential than ever. Benchmarking across facilities isn’t just smart; it’s strategic.‍

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Consignment: High Cost, Low Ownership

Consigned items,stocked by the vendor but paid for only upon use,represented 8.5% of all inventory lines. But they carried outsized value: the median price for consigned items was $800, compared to $44 for non-consigned items—an 18x difference.

Consignment is designed to reduce upfront capital burden, especially for high-value implants and surgical devices. But it’s not without pitfalls.

• 15 consigned items expired on shelf, totaling nearly $10,000 of loss for the manufacturer.

• These were implants and specialty tools—precisely the items hospitals rely on vendors to manage.

• While a small count, it reveals a gap in oversight,underscoring the need for vendor audits and shared replenishment accountability.

According to Vizient, nearly 30% of hospital executives say they lack visibility into consigned inventory performance, and many are rethinking how these programs are monitored.‍

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Waste: The Cost of Inaction

In Q1 alone, hospitals in our dataset reported 875 expired items, valued at $245,415. These weren’t just small-dollar consumables:

• Nearly 20% of expired items had unit prices above $500

• Several were in the $5,000–$9,000 range

• Most were tied to specialty implants and low-volume surgical products

This aligns with industry research from Becker’s, which estimates the average hospital loses $10,000–$25,000 per month to expired or obsolete inventory—translating to $120,000–$300,000 annually, even in moderately sized hospitals.

And yet, much of this waste is preventable. Hospitals that implement UDI-based technology and auditing have reported expiration reductions of up to 60% within one year.‍

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Duplication: The Hidden Cost of SKU Sprawl

Our analysis uncovered dozens of UDIs stocked across 5+ facilities—yet with a combined quantity of 10 or fewer across all sites. These are ultra-low-use products duplicated system-wide, likely ordered “just in case” but rarely used.

This SKU sprawl:

• Bloats formularies

• Increases expiration risk

• And ties up capital in slow-moving, decentralized stock

Hospitals facing this pattern often use UDI to launch item master rationalization projects, removing redundant or rarely used SKUs and aligning inventory with clinical need.‍

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High-Cost, Low-Margin Inventory: Big Price, Small Window

Some of the highest per-unit costs in hospital inventory are tied to specialty devices used in cardiology and surgical procedures. We found some of these items costing $10,000–$16,000 per unit, being stocked in low quantities.

They’re not frequently used, but they carry significant financial risk. A single expired, misplaced, or unaccounted-for device in this category can result in a five-figure loss.

That’s why leading hospitals deploy safeguards such as:

• Vendor-managed inventory programs

• Quarterly cycle counts

These aren’t about restricting access—they’re about protecting capital and maintaining visibility and accountability for the most financially sensitive assets in the supply chain.‍

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Final Thoughts: What the Data Really Shows

This Q1 dataset reflects a supply chain in motion—one where price, availability, and oversight are still catching up to complexity. What stands out is not just how much is spent, but how much is at stake.

• OR inventory represents over half of total spend—but also the highest risk of expiration.

• Pricing variation remains unchecked in many facilities—even for identical products.

• Consignment is misunderstood: beneficial in theory, costly if unmanaged.

• SKU sprawl and shelf waste continue to drain budgets quietly, but steadily.

• High-dollar manufacturers require specialized protocols—not just contracts, but controls.

If there’s one clear takeaway, it’s this: data must be operationalized. Hospitals already have the information—UDI, expiration dates, usage logs. The challenge now is turning that visibility into action. Because in healthcare, every dollar saved on supplies is a dollar that can be reinvested in care.