Looking for Opportunity in a Tough Asthma Market

For some, the asthma treatment market is gasping for air. Yet, asthma and allergies strike one out of four people, and approximately 20 million Americans have asthma, according to the American Academy of Allergy, Asthma & Immunology. That means if you are a respiratory care provider, you have an opportunity to provide products and services to this population.

But do you want to? Not necessarily, according to Joe Lewarski, vice president, respiratory group, for Invacare, Elyria, Ohio.

“I think asthma management is one area frequently underrepresented in home care. For most HME providers, there is little to no financial support or reimbursement to fund asthma care in the home,” he explains. “The reimbursement for home nebulizers and respiratory medications has been cut so deep there is very little room for providers to support [such things as] very important patient education.”

Lewarski points out that the lack of economic incentive has driven away most of the clinical support that has historically been essential to improved asthma outcomes, including clinician-based education and disease management.

“The cost of the medications versus reimbursement is a concern. The profitability to provide the services required to help patients manage their asthma just isn’t there anymore,” agrees Tom Pontzius, president of the VGM Group’s Nationwide Respiratory division in Waterloo, Iowa.

“Providers are facing a challenge just to break even between acquisition cost and reimbursement. On top of that, they have to provide clinical support and deliver products. At the end of the day, there isn’t enough reimbursement to cover all of the expense a provider incurs for providing this service,” he says.

Although products to treat asthma have not been included in the first round of national competitive bidding, the program also will likely influence this market.

“Asthma care may be indirectly impacted by the national competitive bidding activities as providers reduce or eliminate clinical support and other asthma-related services that may have been supported by other therapies, such as oxygen and sleep therapy,” says Lewarski.

On a brighter note, Tim Gordon, director of marketing for Murrysville, Pa.-based Respironics’ respiratory drug delivery division, says the asthma market remains an area where HME providers can help themselves by pleasing physicians.

“[When providers offer products] that are reliable and easy to use, it is good for patients and it increases physician satisfaction,” he says. “Reliability and ease of use are what physicians want. They want to know that patients are using the products properly and want to have the confidence that this will happen.”

Gordon encourages providers to look at full-featured products that they can choose to sell on a retail basis.

“Home care providers can supplement their revenue and provide patients with products they need and that are portable and convenient,” he adds.

Gordon advises providers to offer options in product choice and to allow customers to purchase items that fit their lifestyles.

Increasing volume is another option.

“The biggest opportunity may be for providers who are able to withstand the decrease in reimbursement while increasing volumes to help reduce acquisition cost,” says Pontzius.

Every day in America:
40,000 people miss school or work, 30,000 people have an attack, 5,000 people visit the emergency room, 1,000 people are admitted to the hospital and 11 people die due to asthma.

Source: American Academy of Allergy, Asthma & Immunology