Monday, June 30, 2003

ST. PAUL, Minn. - Although Advanced Respiratory scored the brass ring at Medicare earlier this year, securing a HCPCS code worth $1,063 per month for its percussion therapy device called the Vest, the distribution channels for this device will continue to bend around the home respiratory provider.

Why? The difficulty of selling funding sources.

“We have a large reimbursement team that’s very skilled in working with case managers to help them understand the benefits of the therapy,” said John Foster, director of respiratory for the manufacturer. “That’s probably a more skilled team than the average DME dealer would have at their disposal.”

The Vest is just that, an inflatable vest attached to an generator, that rapidly inflates and deflates, compressing and releasing the chest wall 5-20 times per second to create airflow in the lungs. That pressure moves trapped mucus from smaller airways to larger airways where it can be removed through coughing or suctioning.

Advanced believes nine million Americans are candidates for the kind of therapy the Vest provides. Until two years ago, the majority of its market was comprised of cystic fibrosis (CF) patients. Now more than 70% of its targeted market are non-CF patients and include COPD patients.

The original Vest was cleared by the FDA in 1988. The 17-pound version, now being introduced by the company, was cleared by the FDA in February.

Advanced’s Vest technology is an alternative to manual chest physical therapy (CPT). Until five-to-six years ago, Total Home Care in Elgin, Ill. had a regular CPT business. The company rented basic percussion machines. Today, doctors never call on Total for CPT.

Alan Kirk doesn’t buy Advanced’s argument that HMEs are not sophisticated enough to sell the Vest. “We can set up a ventilator patient with 22 different pieces of equipment and the 100 disposables associated with it and figure out to get paid, and we can’t sell a vest?” said Kirk, Total’s vice president and general manager. HME