Sound sleep market eyes growth

Sunday, January 23, 2011

Despite challenges with Medicare guidelines, CPAP compliance and low obstructive sleep apnea (OSA) awareness, the sleep market continues to be promising, manufacturers say.

The key to the market’s growth, they contend, is reaching the still vastly undiagnosed population with OSA and a medical community that is becoming increasingly receptive to understanding sleep disorders. That’s an ongoing project.

Kelly Rudolph, president of Shawnee, Kan.-based Hans Rudolph, maintains that “market growth should continue to be very good due to public and professional awareness from advertising, publications, testimonials and daily contacts at work.”

Still, in Maura Weis’ view, approximately 80% of sleep apnea sufferers haven’t been diagnosed with the condition, which presents a major opportunity for CPAP manufacturers and providers.

“When you look at other chronic diseases like diabetes that are well managed, more than two-thirds are being diagnosed and treated,” said Weis, director of sleep marketing for North America at Murrysville, Pa.-based Philips Respironics. “That is our opportunity for growth.”

While the typical demographic profile of a sleep apnea sufferer is an overweight male in his 40s, Weis contends that potential CPAP clients go beyond that description and can include just about anyone in the population.

“There needs to be more understanding that anyone with certain symptoms of fatigue could be afflicted with apnea and screened for it,” she said. “For instance, I know a marathon runner who is very fit—he definitely does not fit the typical profile. But he felt fatigued and his wife said he snored. After screening, it was found he had apnea and was put on a bi-level unit.”

Educating medical professionals remains a high priority, Weis said, and Respironics has been engaged in a joint awareness effort with San Diego-based ResMed that she calls “encouraging and working, but we still have a long way to go.”

National television exposure has the potential to expand public awareness in a big way, says Bruce Benner, vice president of sales for Export, Pa.-based Circadiance. Popular talk show host Regis Philbin reached millions of viewers when he talked about his experience going to a sleep lab and being diagnosed with sleep apnea, Benner said. Although Philbin’s show is watched mainly by female viewers, they represent “the sleep mates of apnea sufferers and persuade them to get tested,” he said.

Circadiance is also working with AARP to promote CPAP therapy to its membership, of which approximately 12 million are estimated to be potential candidates, he said.

“No pun intended, but we’re doing everything we can to get people to ‘wake up’ to the benefits of CPAP therapy,” Benner said.

Medicare’s ‘new normal’

Patient compliance with CPAP is at the heart of Medicare requirements implemented two years ago. Under the CMS guidelines, sleep providers must demonstrate CPAP patients’ adherence to therapy. To receive payment, providers must show patients use their CPAP devices at least four hours per night.

Although Weis says the Medicare rules are challenging, providers must find ways to contend with them. It is up to providers, she says, to intervene with patients at the appropriate time to continue utilization. She points to telehealth technology as a way for providers to get data on compliance faster and easier for documentation purposes.

“What we’ve seen recently at sleep conferences is modem technology that plugs into the patient’s phone line and downloads data daily, reporting utilization and efficacy of therapy,” she said. “It can do that in a way where anyone can access the data through the Internet. What is encouraging is some studies that show patients on a modem are 8% more compliant. Data shows an increase in adherence after 90 days and that average hours of use per night greatly increased to the ‘four hour’ Medicare gold standard.”

Improving replenishment

The awareness campaign also extends to product replenishment, Rudolph says.

“Providers need to make their patients aware that there are many interfaces available to them and that they can get a new mask or other interface every three to 12 months, depending on their insurance plan,” she said. “Every day we hear patients say that they did not know our masks existed or that they could get another mask paid for.”

Rudolph also advises providers to inform CPAP patients about mask options beyond what they carry in stock.

“Patients sometimes tell us about how hard it is to get a different mask than the DME has on the shelf,” she said. “Providers are constantly trying to offer the best service and need to inform the patients of all the choices available.”