by Denise H. McClinton

In a market driven by price and fierce competition, it seems unlikely that manufacturers of manual wheelchairs would be interested in improving current products and developing new ones. Fortunately for providers and end-users, manufacturers — while cognizant of the restraints placed on them — continue to look forward, envisioning better products that provide greater independence to end-users.

Mike Serhan, vice president of Dr. K Healthcare Products, says manufacturers who are in the market for the “long-term” must differentiate themselves from others through innovation, faster response times and a commitment to serving their providers.

As Serhan and others know, competition among home medical equipment providers is increasing, and cost is the best bargaining chip for some providers. “Smart providers understand quality, reliability and service, but they will also say, ‘Look what I can get for 20 dollars or 50 dollars below your price,’” Serhan says.

Doug Strayer, general manager for Merits Health Products, agrees that pricing is important. “The pricing right now is very competitive,” he says.

In some cases, competitive pricing can impact providers' bottom lines in a positive manner. However, there is growing concern among industry experts that lower quality and lack of innovation might result from this intense focus on price. Some industry leaders fear that overseas manufacturing and importing will place pressure on price and quality.

“The supply chain has changed dramatically during the past few years, with the import business becoming more of a player. This also has driven many manufacturers out of the manufacturing business and into the distribution business,” says Dale Nash, director of product development for manual wheelchairs for Invacare. “Cost alone has become the driver for many of our competitors — many manufacturers have lost the ability to develop products, and are concerned only with copying and keeping pace with the cost battle.”

Fierce competition and overseas manufacturing are not the only factors affecting cost. “Competitive bidding and managed care compound the problem,” says Merv Watkins, president of Convaid. “Both systems — with the intent of holding costs down — encourage a decrease in the quality of products and services.”

Opportunity Exists

Amid new competition and pricing wars, opportunity still exists in the manual wheelchair market. The same drivers — an aging population, advances in medical technology and legislation that requires improvements in workplace and classroom accessibility — still are present, Watkins says.

“The growing volume of baby boomers taking care of aging parents — and [the baby boomers'] own entrance into the senior market — guarantees an increasing demand for geriatric products,” he says. “Advances in medical technology are saving the lives of many premature infants who otherwise would have died and [are extending] the lives of adults with severe medical conditions.”

Additionally, specialty markets are growing. For example, the market for bariatrics products is growing because of increased awareness of this population's needs and manufacturers' ability to address the end-user's product-performance demands, Nash says.

“The bariatrics market also is growing because of the willingness of providers to expand their focus,” he says. “In many cases [the market] has caused them to change or adapt their standard way of doing business to respond to these unique needs and demands.”

As the number of individuals who need mobility products grows, so does the challenge of meeting unique needs and wants. Often, what a person wants and what a person gets are two different things, manufacturers say.

“If consumers truly had the choice, they would go for the lightest wheelchair possible,” says Sue Jotblad, marketing manager of home care products for Sunrise Medical. “Often, they do not have that choice, unless someone uses the [Advance Beneficiary Notice] … and upgrades them.”

Nonetheless, it is crucial for providers to have the proper inventory for their customer base. In hopes that loyalty will ensure higher profits, manufacturers are expanding their product lines. “We have added chairs to cover a broader spectrum, where we used to be limited in the number of Medicare-approved products,” Strayer says. “We felt that it was necessary for us to carry a full line so providers would have an alternate choice.”

Important Elements

Manufacturers face the challenge of meeting not only the needs of their customers but also of their customers' customers.

For providers, reliability is a top concern. Providers want to rent and sell products that are well built, with interchangeable replacement parts, experts say. Wheelchair users and their caregivers, on the other hand, need a lightweight wheelchair. Manufacturers also say that adjustability and appearance matter.

Standard wheelchairs, which remain the staple of this market, still inspire manufacturers to improve functionality and appearance. Recently, manufacturers have added features typically found on higher-end products, without adding the higher cost.

“Having the ability to deliver a long-lasting product, loaded with features, at a competitive price, still is the best formula for a provider's total lifetime cost of doing business,” Nash says.

Christy Shimono, senior product manager for Sunrise Medical, says the exciting news for the standard wheelchair market is that the features and accessories designed for high-end products are filtering their way down — at an affordable cost.

Future Trends

In a market where opportunity and roadblocks often are present in the same scenario, many are optimistic about the future of manual wheelchair sales in the United States. “In general, we see further pressure for lightweight and compact folding products, combined with downward pressure on prices,” Watkins says. “Yet, while the pressure on one side of the spectrum is for low-cost, utility products, the more affluent users are interested in more complex, feature-driven products.”

Manufacturers who offer quality products at competitive prices certainly will be leaders in the field — but only if they support providers and listen to providers' needs.

Experts Interviewed:

Marty Ball, vice president of sales, TI Sport, Kennewick, Wash.; Sue Jotblad, marketing manager of home care products, Christy Shimono, senior product manager, Sunrise Medical, Longmont, Colo.; Dale Nash, director of product development, manual wheelchairs, Invacare, Elyria, Ohio; Mike Serhan, vice president, Dr. K Healthcare Products, Monrovia, Calif.; Doug Strayer, general manager, Merits Health Products, Cape Coral, Fla.; and Merv Watkins, president, Convaid, Torrance, Calif.

Titanium Emerges Strong, Accessible

During the past few years, companies that experienced little interest in titanium products have renewed their efforts to bring titanium into the mainstream wheelchair market. Sunrise produced its first titanium chair more than 12 years ago, according to Christy Shimono, product manager for Sunrise Medical, but while the interest was there, the market was not. Now, companies like Invacare, Sunrise Medical and TI Sport — a company that produces titanium chairs exclusively — are seeing enough interest in these wheelchairs to support the market.

“This is the type of chair that is good for the person who is willing to upgrade out of [his or her] pocket,” Shimono says. “There is clearly a market that is paying for this chair.”

Marty Ball, vice president of TI Sport, says the benefits of titanium are not limited to the younger users who have sustained an injury. “Not everyone can afford the chair, and not everyone feels the chair is appropriate for him or her,” he says. “But, we are seeing multiple sclerosis clients and muscular dystrophy clients show interest, and we are even seeing CVA stroke clients and elderly people pick up on the benefits of titanium.”

Cost, which is almost always the primary concern with titanium wheelchairs, is becoming affordable for some users. Models are available at just below $2,000, with most models in the $2,500 to $3,000 range.

Cost aside, the benefits of titanium chairs are overwhelming, manufacturers say. “The glide characteristics of titanium are much smoother than [with] other materials,” Ball says. “It doesn't fatigue — it doesn't tire like other materials eventually do — and it doesn't corrode.”

The most important feature of titanium, however, is its weight. “It is extremely lightweight, because we only have to use about half as much material as we did when building with aluminum,” Ball says. “It offers a lot of benefits to the end user.”