Although many of the products have been around for up to 40 years, the electromedical market is garnering new attention, thanks to a growing awareness and acceptance of alternative therapies for pain management and rehabilitation.

“Even though [the electromedical] business is an old business, it's one whose cycle is coming back again,” says Mario Garcia, president of Electrostim Medical Services Inc.

According to Garcia, patients are much more receptive now to electromedical products than they used to be. “People are taking more control over their health care,” he says. “They don't want to take drugs as much or take as many drugs. People also want their freedom. They don't want the health maintenance organizations of the world controlling their destinies.

Electrotherapy gets people better faster and less expensively than more traditional treatment,” Garcia adds.

Another reason for the growing popularity of electromedical products is that many have gone mainstream. Julie Ostrom, president of Medi-Stim, says general public awareness has grown due to the popularity of “those ‘abtronic’ things,” referring to over-the-counter products that claim to use electrical stimulation to aid in weight loss and recently failed to receive U.S. Food and Drug Administration approval. Most of the products available for home care are used for pain management, muscle rehabilitation, circulation improvement and relaxation, and are FDA-approved.

“People are more open to the idea of using electrical stimulation and there seems to be a little less fear [about using it],” Ostrom says. “People used to think ‘electrical shock,’ but now they're beginning to consider using the equipment because of the popularity of alternative types of healing and alternative medicine.”

And then there's the Sept. 11, 2001, effect. “The increased need for stress management since [the Sept. 11 terrorist attacks] is well known,” says Daniel Kirsch, chairman of Electromedical Products International Inc., which manufactures cranial electrotherapy stimulators for the treatment of anxiety, depression and insomnia. “CES is certainly safer than drugs and is highly effective,” Kirsch says.

You Get What You Pay For

Unfortunately, increased interest in the electromedical market doesn't necessitate an increase in reimbursement for the products.

“Insurance companies aren't going to pay more for your product, so you can develop a nicer, fancier product, but getting someone to pay for it is the problem,” Garcia says. “The biggest obstacle is trying to implement new technology … without doubling or tripling the cost [of the product].”

“The reimbursement level could be better,” Ostrom says. “It's certainly not increasing at all-if anything, it keeps decreasing.”

Ostrom attributes decreased reimbursement partly to dealers who try to take advantage of the reimbursement system by selling units for a lower price than what they bill for. “Insurance companies are pretty smart,” she says. “They see dealers advertising [lower prices], and they don't want to pay.”

In response to low reimbursement, she says some dealers are turning to lower-priced imports.

“We sell imported products eight to one because of cost,” Ostrom says. But, she cautions, you get what you pay for.

“Imported products are okay and will fit the bill, but higher-end units are more compliant,” she says. Ostrom says dealers should remember that the ultimate goal of the provider is to provide patients with relief — not a low-cost product. But, she says, “if [insurance companies] are willing to pay only a certain amount [for a product], how can we expect the dealer to provide the best unit?”

Some domestic manufacturers, such as EPI, have lowered their own prices for products. “It is such trouble getting paid these days that we recommend our distributors not bother,” Kirsch says. “Rather, we have lowered our pricing through product redesign to where it is affordable for most people.”

Still, other industry experts maintain that the reimbursement level is fine. Ed Dunlay, director of marketing for Chattanooga Group, says reimbursement has been good for electromedical products, although it always needs to be addressed.

“The professions [served by the market] have to fight the battles to maintain good reimbursement levels,” Dunlay says. “Physical therapists seem to be more organized than they were in the past in fighting for good reimbursement.” In addition, Dunlay says, manufacturers need to be more aggressive with Medicare and insurance carriers in making their products known.

General Optimism

All in all, industry experts remain optimistic. “The electromedical market is definitely growing,” says Henry Lin, vice president of American Bantex. “We are aligning ourselves with companies that have the vision to see that this market has so much potential.”

“When you're passionate about what you do, people have a different attitude toward you,” Garcia says. “We're helping a lot of people. And, we're saving the insurance companies a lot of money.”

“We help people,” Kirsch says. “We hear the word ‘miracle’ every day. In good times and bad, that is the reason we are in business, and we will never forget that we are here to provide a service to people in need.”

Experts Interviewed: Ed Dunlay, director of marketing, Chattanooga Group, Chattanooga, Tenn.; Mario Garcia, president, Electrostim Medical Services Inc., Tampa, Fla.; Daniel Kirsch, chairman, Electromedical Products International Inc., St. Paul, Minn.; Henry Lin, vice president, American Bantex, Burlingame, Calif.; Julie Ostrom, president, Medi-Stim, Delaware, Ohio.

Growing at Lightning Speed

Electromedicine, also known as electrotherapy, falls under the broad term of neurotechnology, defined by industry analysts as “the application of electronics and engineering to the human nervous system.” According to an October 2001 market study, the overall worldwide market for neurotechnology products and services is $1.2 billion and is expected to reach $5.2 billion by 2005.

The report, titled “The Market for Neurotechnology: 2001-2005” and published by Torrance, Calif.-based Neurotech Reports, maintains that the overall worldwide health care market — which includes neural prostheses such as cochlear implants, therapeutic stimulation and neurodiagnostics — is the largest segment of the neurotechnology market.

“The way the numbers are growing should will tell the story [of the market],” says Mario Garcia, president of Electrostim Medical Services Inc. “More people are learning that [electrostimulation] is more beneficial than traditional treatment. It's noninvasive and it has no side effects — it's everything they have always wanted in health care, and it's always been around.”

Dealer Beware: Substandard Products Abound

Blame it on low reimbursement or the appeal of technological devices, but the electromedical market has been inundated of late with foreign imports and non-FDA approved devices — which sell for much less than standard products.

“A lot of new manufacturers in Asia are coming out with these products, trying to copy [them] for less,” says Henry Lin, vice president of American Bantex. This results in price sensitivity, he says, and “affects the manufacturing chain all the way down to the user. There will be price adjustments.”

According to Lin, electromedical products have become a price product rather than a quality product. “Everyone is caught up in price,” he says.

Competing for the price-conscious market are non-FDA-approved devices, says Julie Ostrom, president of Medi-Stim, an electromedical product distributor and importer. “Most companies in the medical realm try to do things legitimately, but the bottom line is, most people want to make a fast profit,” she says.

Experts Forecast Expanded Applications, Digital Technology for the Future of Electromedical

User-friendly” is the buzzword for the future design of electromedical products, experts say. Look for products that combine good looks with ease of use, as well as products designed for specific applications of electromedicine.

Younger users, in particular, are favoring the newer, digital products. “We're finding more digital equipment being produced, and I think that's due to a younger generation that likes that type of product,” says Julie Ostrom, president of Medi-Stim. “They want that ‘techno’ look, with all the bells and whistles.”

Ostrom also predicts the appearance of more pre-programmed devices, “where all the patient has to do is call up a certain protocol, turn [the device] on, turn it up and he's done.” According to Ostrom, therapists who have been working with the products have come to know what protocols, or levels of current, work best for certain conditions and are implementing these protocols as pre-programmed regimens.

Ed Dunlay, director of marketing for Chattanooga Group, sees the same trend. “The market is maturing to the point [where we know] what wave forms are used for what applications. There are many FDA-approved wave forms; it's just a matter of having the approved form positioned for specific clinical applications.”

Others in the industry are working on products for new therapies. Right now, Electrostim Medical Services, Inc. is negotiating patent rights to a bone-growth stimulator, says EMSI President Mario Garcia.