Building Lifelong PAP Customers

Competing in the PAP market requires that HME providers do more than dispense machines—much more. Providers must take a broad-based and unified approach to maximize ongoing patient compliance for more successful treatment of obstructive sleep apnea, experts said.

This requires attention to details, such as how a mask fits, along with continuing education and patient outreach. Because obstructive sleep apnea is being diagnosed at younger ages, the reward for this good service is building a base of lifetime customers.

The PAP market is still predominantly CPAP. Fisher & Paykel reports that CPAP is the usual standard for OSA (obstructive sleep apnea) treatment, with VPAP and BPAP respiratory assist devices meeting the needs of 5 to 10 percent of patients.

Manar Sleiman, associate product manager of North America OSA marketing for Fisher & Paykel, noted that despite competitive bidding, HME providers still must differentiate themselves in the market by helping customers acquire effective and cost-efficient solutions and technologies.

To help offset decreasing reimbursements, providers should reduce inventory management costs, augment existing revenues and improve staff efficiencies, she said.

“As an industry we need to continue to educate and provide awareness about OSA so that it doesn’t go undiagnosed and untreated, which results in greater health risks,” she said.

For example, the industry must battle outdated perceptions that OSA is a male sleep disorder, Sleiman said. That can lead to under-diagnoses of women who suffer from common OSA symptoms such as fatigue, daytime sleepiness, mood changes and headaches.

Mitch Yoel, executive vice president of business development and government affairs at Drive Medical, sees cost savings driving an increase in home sleep testing, most likely resulting in fewer and fewer in-lab PAP titrations.

“Combined with more primary care physicians becoming involved in OSA diagnosis, the generic prescription auto-titrating PAP market will continue to grow,” he said.

Comfort and fit are critical

The PAP interface is critical, and achieving a comfortable and effective fit on the first visit ensures compliance and profitability, Yoel said. The Drive Medical Freedom PAP Mask and Max Full Face Mask address market needs to maximize user compliance and provider reimbursement and to minimize the need for multiple provider visits for a good fit.

Drive Medical includes all cushion sizes in each mask package to help a provider avoid “resizing calls.” There are also some direct-to-consumer opportunities, which shift emphasis to considerations such as retail packaging and freight expenses.

“Once you have a product that meets or exceeds the market demand for comfort and quality, then the fewest SKUs in the nicest looking package in the smallest box wins,” Yoel said.

The comfort and fit of the PAP mask is critical to compliance, agreed Robert Rutan, CEO of Naturs Design and developer of RemZzzs CPAP Mask Liners. He cited estimates that six out of 10 patients discontinue PAP therapy, often because of their inability to adjust to wearing the mask.

“Any HME provider who wants to expand his market needs to address the reasons for such a low success rate,” Rutan said. Providers who offer high quality care and an innovative product offering will retain more customers, he added.

RemZzzs CPAP Mask Liners are disposable cotton liners, reimbursable using HCPCS codes A7031 and A7302. They serve as a barrier between the face and mask. The liner absorbs facial moisture and oil, eliminates air leaks, prevents skin irritations and pressure sores, secures the mask comfortably, allows for use of bedtime facial products and promotes a full night’s sleep. They can enable focused and distraction-free operation of well-engineered PAP machines, Rutan said.