While suppressed sales of new equipment negatively impacts tube sales to OEMs, the other side of the equation, glassware for the installed base, remains a healthy market.

Dunlee is the other major manufacturer that supplies both new tubes for OEM equipment as well as replacements for X-ray tubes, CT tubes, and image intensifier equipment and components.

"If new equipment sales are down, that means sales of new tubes going into that equipment are also down. But clinical utilization of equipment has not decreased, it's actually increasing," observed Thomas T. Spees, Director of U.S. Sales for Dunlee, a division of Philips Healthcare. "It means that the demand for maintenance - and that includes replacement tubes on the installed base - is going to increase. And we're seeing that already."

Many independent service providers get their replacement tubes directly from Varian or Dunlee at wholesale prices and their hospital customers benefit.

"We keep talking about reducing health care costs. Don't go directly to the OEM for replacement tubes and image intensifiers. Go to a third party because you are going to save loads of money and get the same quality if not better," said Sal Aidone, Vice President, Deccaid Services Inc. Deccaid is a member of a consortium, the Association of Medical Service Providers, which negotiates favorable rates for its members with tube makers, passing the savings to health care providers.

Reloaded Tubes Another Option

In addition to new X-ray tubes, some quality remanufactured glassware is also available. Hospitals and imaging centers can save 30% to 60% by opting for a reloaded tube.

The "slice race" toward more capable CTs of 64 slices or more has resulted in a market flooded with older CT scanners. These scanners are sometimes sold for parts. As a result, replacement tubes and parts are available for older equipment. They are remanufactured to OEM specifications, but it's still a good idea to get a warranty.

"We see a lot of competition for used tubes. Hospitals are trying to save money. So they often look at used tubes in lieu of new tubes," said Ralph Babcock, General Manager, Imaging Affiliates. "Some people consider a 'remanufactured' tube one in which just the oil has been changed. To qualify as a remanufactured tube under our definitions, components of the insert must be replaced. You need the right skills and technology. The tube must be properly labeled as remanufactured and come with a warranty."

Reloaded tubes can be as good as new, according to Greg Kramer, C&G Technologies, Inc. "It depends on what the re-loader does when installing a new insert. If it has a new oil pump, new bellows, and new High Voltage tube wells (candlesticks), then it is very close to new and probably will last as long," he noted.

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