CPAP Patients, Providers Hoping Comfort = Better Compliance

ATLANTA — Countless news stories over the past few years
have spread awareness of obstructive sleep apnea, and an article in
the Wall Street Journal Feb. 1 signaled that the media
push is far from over.

Publicity is a positive thing, but the article paints a
relatively gloomy picture of the CPAP mask and its perceived
discomfort. Comparing the masks to sleeping in scuba gear, reporter
Kris Maher wrote that “as few as 50 percent of people who are
prescribed a CPAP device actually use it regularly.”

Companies big and small have sought to address the issue of
comfort with a steady diet of consumer-friendly device
innovations. 

But Helen Kent, CEO of Carlsbad, Calif.-based Progressive
Medical, pointed out that compliance is often about more than just
comfort.

“Compliance will increase as we find lighter, simpler and more
user-friendly masks,” said Kent,
whose company focuses on sleep. “But compliance is not just
about the interface. The interface is important, but if
sleep-disordered breathing is not treated with urgency, and if the
customer has not been educated about the dangers of not treating
his or her condition, why would he or she go through the
life-changing process of being compliant?”

The Journal article, “The New Face of Sleep,” states that roughly 18
million people have OSA, but Maher added “some experts believe that
lack of awareness among some patients and doctors has led to
under-diagnosis and that the number of patients actually is closer
to 30 million.” Whatever the exact number, the lengthy feature was
another significant reminder that OSA market potential is more than
just hype.

In the eyes of Patrick Clevidence, RRT, the article’s
unfavorable portrayal of CPAP therapy was ultimately a disservice
to the technology’s proven benefits.

“I feel the article was very misleading,” lamented Clevidence,
vice president, respiratory service, for Cleveland-based Medical
Service Company. “Millions of patients around the world have
benefited from sleep therapy via the utilization of CPAP and the
mask they wear. Each year patient CPAP compliance continues to
improve.”

Part of that improvement can be attributed to manufacturers who
have heard the user complaints. San Diego-based ResMed and Philips
Respironics, Murrysville, Pa., have spent millions to improve the
CPAP’s image as an uncomfortable and complex apparatus.

With the recent introduction of its new EasyLife mask, its
latest in a move to simpler, lightweight masks, Philips Respironics
is hoping that greater comfort and ease of use will satisfy
patients. People now expect masks to be lighter and smaller, taking
up less “space on the face,” according to Gretchen Jezerc, the
company’s director of U.S. marketing, sleep disordered
breathing.

David Pendarvis, senior vice president of ResMed, said his
company “has worked hard for years to make our masks lighter,
simpler and more user-friendly. Continued media attention should
increase demand from patients to get tested and treated for this
serious medical condition. Because sleep-disordered breathing
affects at least 20 percent of the adult population, the market
remains under-penetrated.”

Despite its potential, the sleep market is not without
challenges. A new Medicare requirement for a face-to-face physician
exam between 30 and 90 days after beginning CPAP treatment amounts
to an additional burden for the therapy’s providers.

“I think [the face-to-face] is a great idea, but I think the
onerous task of making sure that this happens should fall on the
diagnosing and treating physician, and not on the HME,” explained
Kent. “CMS just made our job that much harder to obtain payment for
products that we have to purchase to treat patients.”

CPAP is also on the category list for Round 1 of competitive bidding, a situation
that could make compliance worse than ever, Kent believes, due to
lower reimbursements. The reduction in the original Round 1 bid
(2008) averaged 29 percent off then-current payments.

“More than 95 percent of the education that a customer receives
comes from the HME provider,” Kent noted. “If the HME provider
doesn’t provide that education to the customer, the customer does
not know why he has to wear the ‘monkey on his face’ or why he was
prescribed the therapy. Education is being cut short now by most
HME companies, and with low to no reimbursement, I can’t imagine
any HME educating the customer about his/her disease. If you think
compliance is bad now, it will certainly be much worse after Round
1.”