Comment

Comment by Judy on February 6, 2009 at 10:46am

The problem is whilst Resmed and other manufacturers research, develop and introduce newer, more progressive products, the sleep doctors remain in the dark and actual access to and use of these newer products remains in the hands of the local DME suppliers who are more interested in their profit margin than the welfare and therapy of their clients - US!!!

Unless we, as the patient and client, are fortunate enough to find apnea support forums such as sleepguide, cpaptalk, apneasupport and TAS, etc. BEFORE we get our first equipment and then have an idea of what device or equipment we prefer.

The manufacturers, at least Resmed and Respironics, have developed fully data capable xPAPs that allow us to view a good share of our therapy results (data) via the LCD screen - BUT - the patients don't have access to that data UNLESS the doctor is aware that access can be granted when they write the equipment order (script). AND, since these fully data capable xPAPs cost more than a compliance data only xPAP, the DME suppliers are reluctant to reduce their profit margin by providing them.

There too many sleep doctors out there who don't really WANT their patients to have a fully data capable xPAP. Too many sleep doctors who DO NOT look at or pay ANY attention to the data that is available from these fully data capable xPAPs when the data IS presented to them. Too many sleep doctors who pooh-pooh the value of this data. I think we patients all understand and acknolwedge that a fully data capable xPAP is NOT as reliable as a full polysomnography (PSG) in-lab sleep evaluation or even titration - BUT - the data they can provide can be invaluable in "tweaking" our therapy and making the difference between success and failure, between making therapy adjustments "by guess and by gosh" (which too many sleep doctors prefer to do) and in avoiding unnecessary AND EXPENSIVE in-lab PSGs.

Conversely, we really can't expect sleep doctors to be comfortably familiar w/every brand and model xPAP and their "comfort options" and its not reasonable to expect the local DME suppliers to keep a large supply of various brands and models of xPAPs on their shelves waiting to be "sold" to a client. That would be a HUGE outlay of moneys upfront w/most reimbursement coming in as a monthly trickle.

What I would like to see is the local DME suppliers buy mostly fully data capable CPAPs from one manufacturer in order to get a bulk price to stock their shelves with including a FEW bare bone CPAPs for those clients w/poor insurance, no insurance and limited means. That could well mean that if a client needs and is scripted a more sophisticated xPAP such as a bi-level there could be a wait for the client while the DME supplier orders it specifically from the manufacturer for them. The supplier should still get a better price from their usual manufacturer than if they have to purchase an xPAP from another manufacturer.

I'm sure Daniel Levy or other local DME suppliers or supplier RTs and give us some more insight into this as well.

Frankly, I applaud the manufacturers. There are times I get the feeling they are the ONLY ones who really have an interest in the welfare of xPAP users. Even DeVilBiss and Fisher & Paykel are starting to get on the fully data capable xPAPs bandwagon. Puritan Bennet (now Covidien) has been for quite awhile as well. They've just not developed and utilized the LCD data access capability.

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