A fine line 

Am I the only one getting CPAP shortage vibes from the baby formula shortage? 

I’m not going to lie. The formula shortage wasn’t fully on my radar until recently. With a seven-year-old, my days of buying formula are long over. But seven years ago, it would have been a different story, as my daughter was 100% formula fed. (My breastfeeding story, by the way, is not uncommon. Difficulty with latching. Supply issues with pumping. There is no shame here.) 

I can’t imagine what it’s like to be a mother who relies on formula to feed their baby and not being able to find it. 

I know some CPAP users find themselves in a similar situation. 

Some CPAP users have a device that’s part of a recall and they’re unable to get it replaced or repaired promptly due to the sheer size of the recall, plus significant complicating factors from supply chain challenges and the COVID-19 pandemic that are affecting all devices. 

Both of these groups are having to make difficult decisions every day. Mothers are wondering, can I afford to pay $120 for a single can of formula, if I can find it; or do I try to make my own formula? CPAP users are wondering, is it better to continue therapy with a recalled device than to discontinue therapy for weeks if not months? 

I hope these are decisions they’re making with the help of health care professionals. 

How did we end up here? 

I’m sure there’s blame to cast far and wide, but in thinking about the CPAP shortage and the formula shortage, I keep coming back to this similarity: Too few companies making what can be a life-supporting product. 

Four companies control about 89% of the U.S. formula market, according to news reports. 

Three companies control the majority of the U.S. CPAP market. 

Even without supply chain challenges, would recalls in both of these markets have had a significant impact? I think so. 

When people in the HME industry talk about the CPAP recall – people like Boone Lockard, director of VGM Respiratory – they hope a positive outcome will be more companies making these devices. “Historically, there was ResMed and Philips in the CPAP market, and I feel like the recall has opened this up for other manufacturers to enter the space and I can see now there being a third or fourth major player in this market moving forward,” he said. And that’s what we’re seeing start to happen, with companies like React Health (formerly 3B), ResVent and RemSleep.  

We talk a lot about the significant consolidation in the number of HME providers in the industry, a lot of it fueled in the 2010s by Medicare’s national competitive bidding program. There are some warning shots from both the current CPAP shortage and formula shortage that, while a certain amount of consolidation has the potential to increase efficiencies and improve products and care, it’s a fine line.  

A fine line we probably don’t want to cross unless we can help it.