CPAP systems evolve to meet demand

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Tuesday, May 23, 2017

Greater public awareness of obstructive sleep apnea, ongoing technological advancements and stronger patient compliance are all contributing factors in the continued viability of the sleep therapy industry, market specialists say. If anything, they say the upside is still high and wide for providers.

The sleep market is barely out of its nascent stage, working to overcome obstacles like apnea patient compliance with CPAP therapy. Over the years, manufacturers have steadily focused on improving the devices, especially with regard to comfort and convenience for end users. Masks have been designed to provide a better fit, while smaller units can be more easily transported.

“There has always been a segment of the market that is very compliant with their therapy,” said Brian Palmer, director of marketing—sleep, for Somerset, Pa.-based Drive DeVilbiss Healthcare.  “As the overall market has grown, this segment has grown with it. Some patients don’t sleep well going even one night without therapy.  The smaller units reflect advancements and changes in technology, along with the growing consumer influence on product features.”

Amy Cook, director of product marketing, healthcare informatics, for San Diego-based ResMed says providers need to make compliance “priority number one for their patients,” which can be achieved by laying a solid foundation from onboarding through regular usage.

“Starting patients right is key, such as providing a new patient setup ‘kit’ that patients can take home with them to review,” she said. “Setups can take 45 minutes to an hour, and it is difficult for anyone to remember everything. So furnishing patients with references and guides to get them going right away when they get home can be helpful.”

Moreover, providers can consider doing group CPAP setups to onboard more patients at once, thus reducing the time it takes to dedicate to each individual. Finally, ongoing patient engagement through programs like ResMed’s myAir involve the patient more directly in their therapy while helping them stay compliant for the long term, Cook said.

Out of the ‘Blue’

Bluetooth monitoring has become a standard for many CPAPs now, added Tim Barber, president of Chantilly, Va.-based Barber DME Supply Group.

“Bluetooth monitoring provides direct upload of data from the machine for the physician’s review,” he said. “We’ve also found that by keeping regular contact with our patients, we’re better positioned to ensure that they’re using the equipment as directed.”

With Bluetooth, providers can pull data from devices through smart phones without incurring additional modem and cellular fees, Palmer said.

“Smart phone apps also have the advantage of providing some helpful features related to equipment or therapy, which reduces the number of service calls to the HME provider,” he said. “Our app has short videos to walk a patient through a number of routine activities related to their device. A simple color-coded dashboard helps patients easily understand how their therapy is progressing.”

CPAP on the go

One innovation that has led to higher compliance is the development of smaller-sized travel CPAPs, said Gary Long, chief business development officer for Lawrenceville, Ga.-based Brightree.

“Sixty-five percent of CPAP users say device size is the number-one reason they don’t take their CPAP every time they travel, breaking the cycle of adherence and exposing themselves to apnea’s chronic effects,” he said. “With smaller CPAPs, we believe there is a greater likelihood that patients will use them wherever they travel, benefitting both their sleep and their bed partner’s.”

ResMed recently introduced what it calls “the world’s smallest CPAP,” the AirMini, providing the portability patients are looking for, Cook said.

“By supplying patients with more solutions, they are less likely to have a disruption in therapy, and it allows the HME provider to become their advocate and support their patients in new ways,” she said. “Maintaining the habit of using therapy every night across the board provides more opportunities for HMEs to work with as many patients as possible, reducing costs through greater efficiencies.”

Likewise, Murrysville, Pa.-based Philips Respironics recently launched its first compact CPAP device, DreamStation Go, developed after talking with users about their cumbersome experiences traveling with standard-sized CPAP devices, said Jim Doty, North American marketing leader.

“We listened and created a packable, slim-profile device that is 50% smaller than our other CPAP platforms, yet has an internal power supply while providing the same clinically-proven therapy and comfort of their home PAP system,” he said. “At the end of the day, patients may feel they are sacrificing elements of their lifestyle to continue to use their therapy while traveling, despite knowing that when they miss therapy they can quickly return to baseline levels of sleepiness. Studies continue to emerge showcasing this boomerang effect of even short-term therapy withdrawal.”

Bundle up

CMS is considering the idea of bundling CPAP payments, a practice that occurs in other countries and is used for other Medicare product categories. If it is implemented for CPAPs, what impact could it have on HME providers and patients?

“There are many risks and some potential benefits of bundling,” Palmer said. “Ensuring the consumable requirements meet the patient’s clinical and lifestyle needs must be determined and accounted for in any bundled rate. If bundling reduces audit risk and exposure, reduces claim functions and allows patients to change providers easily, there could be some benefit.”

Larissa D’Andrea, director of government and regulatory affairs at ResMed, contends that the proposed CPAP bundling model is not based on an integrated care model, but involves bundling the cost of equipment, supplies and services into a single monthly rental payment.

“Bundling CPAP payments may lead to furnishing equipment and supplies that are inadequate to appropriately address beneficiary needs and to restricting patient support,” she said. “Bundling that encourages patient-focused quality care improvements across a relatively homogenous episode might improve outcomes. Bundling supplies used to treat a chronic condition is more likely to encourage limiting supplies and reduced quality and quantity of services.”