Where Does It Hurt?

Any provider’s current customer base certainly needs pain management products; pain often accompanies the same ailments and problems that HME providers address every day. “Offering pain management products in HME stores allows providers to fully cater to their current customer base,” says Rob Baumhover, director of VGM Retail Programs. “Carrying pain management products allows HME providers to truly give their customers the excellent service they deserve by providing items that meet all of their health needs.”

New customers may also come into a provider’s location seeking pain management products. Pain affects people of all ages, from middle-age boomers to young adults to teens and even children. “By carrying and marketing a variety of pain management products, you are likely to bring these new types of customers into the store,” says Baumhover. New customers are also good prospects to buy other products. The opportunity is to win them over with exceptional customer service, says Baumhover. Tighter controls on prescription pain medicines, not to mention the downsides of possible complications and addiction, are leading baby boomers to look for 
alternative types of pain relief, says Mariah Griffith, vice president, sales and marketing, BioMedical Life Systems, Inc. There is a built-in demand in any provider’s core customer base; for example, neuropathy is a side effect for about 50 percent of diabetics, she says. “Consumers are looking for relief,” says Matt Garver, Brownmed’s director of marketing. “Providing that relief means steering them to the right product. If you recommend the wrong product or it doesn’t work as anticipated, they will think they went to the wrong place.” Providers should also recognize that customers have lifetime value, says Garver, and pain management products are a new category that can pave the way to maximize that value for providers.

Understand the Customer

A challenge HME providers face when entering the new category is to choose 
the right products. But, where to start? There are also concerns over educating employees about the new products and how to sell and merchandise them. VGM’s pain management initiative seeks to alleviate these concerns by helping providers identify pain management products that will sell well. VGM also works closely with manufacturers to develop educational and marketing pieces to help providers train their staff members and start growing their sales. VGM Retail Services has a team to assist members with visual merchandising of these and other retail products to ensure they capture maximum customer attention and result in maximum sales. When evaluating products, Baumhover says that assessing quality is first and foremost. “It’s important to sell products that work and actually relieve the pains and discomforts of customers,” he says. In contrast, poor products will cause customers to lose trust and switch to another provider. “The best thing to do before purchasing pain management products for your store is to research the products and vendors as much as you can, read customer reviews and even try them out yourself,” says Baumhover. Many supplier companies offer educational pieces to train employees about how to use and demonstrate their products to customers, as well as how to sell them. Several manufacturers also offer marketing and display pieces to help merchandise the products and draw attention to them. Providers should research and understand the needs and demographics of customers when looking to enter the pain management category, says Baumhover. Online research can help a provider learn about local demographics. He urges providers to ask questions such as: What is the average age of my customer? What are the most common complaints that my customers have in regard to aches and pains? Are my customers fairly active? Could they benefit from products related to sports/fitness injuries? VGM has continually partnered with manufacturers offering pain management products. Within the last two to three years, however, changes in the industry have forced HME providers to rethink the way they do business, with an increased focus on diversification to retail or cash-and-carry products. Pain management products became a natural focus for VGM, as they tie perfectly with other more traditional HME product 
offerings and provide a powerful solution to the aches and pains of a growing customer base. “Going forward, we plan to continue to seek the highest quality, most effective pain management products on the market and provide our members with the products and solutions that give them the best chance of success,” says Baumhover.

Provide Product Knowledge

Garver of Brownmed sees a trend toward more patients self-diagnosing and looking for solutions beyond what a doctor might recommend. “People want to have the education to understand how products work and the treatment protocol. Having knowledge is key,” he says. Meeting the need for knowledge and building relationships can enable HME providers to earn repeat business for additional products. “Some products are designed to completely eliminate pain; others to mask pain. Some are designed to use for a limited amount of time. Understanding where the products fit and work well is important,” says Garver. Brownmed has 85 different Class I medical devices, maybe 35 of which are related to pain management in one way or another, from acute pain and injury to chronic issues such as arthritis or osteoporosis. Products include splints for repetitive stress injury, compression products and products for plantar fasciitis. Most of the items sell for cash, although a couple of them are reimbursable. Garver sees a trend toward smaller, more portable items that are lower cost and easier to use. A notable Brownmed product is the Intellinetix vibrating glove, introduced at the end of 2013, incorporating the benefits of full body vibration into a device that is portable and provides pain relief to the hand. It can be used for arthritis aches or other chronic pain or for acute injuries. The device helps mask the pain 
by stimulating circulation and nerves. “We’re getting patient feedback that the pain relief lasts 90 minutes or more after you take off the glove,” says Garver.
Five minutes of vibration therapy is 
the equivalent of 15 minutes of massage,
and low-level vibration can be used as often as needed—the glove only requires a quick recharge after use. Garver says technology is on the verge of providing new, targeted advertising opportunities that could apply to the pain management sector. New smartphones use global positioning systems (GPS) to track a person’s location, so advertisements might be targeted, for example, to anyone who goes into a local podiatrist’s office. “You could serve up an ad about a foot splint that might help, or an Internet site could pop up. It’s a service and an opportunity out there through various providers,” he says.

New Wave of TENS Products

Since Medicare stopped covering most uses of transcutaneous electrical nerve stimulation (TENS) for chronic low back pain in 2012, TENS suppliers have been developing over-the-counter TENS units that can be sold for cash, which are a relatively new option for consumers and retailers. TENS uses electrotherapy to block pain signals to the brain and to trigger release of pain-fighting endorphins. ExcelHealth Inc.’s iReliev Pain Management System is an FDA-approved over-the-counter TENS unit. The dual-
channel device features eight preset therapy options. iReliev is designed to be highly portable and is offered in attractive retail packaging. ExcelHealth provides HME retailers specialized support including blind drop-ship capability and electronic marketing tools to attract customers. Providers should create systems to evaluate customer data and processes to market to customers, keeping applicable pain relief products consistently in front of an audience, says Mike Williams, iReliev CEO, a former DME provider and retailer for 10 years. Social media, a company’s website, a search engine optimization (SEO) campaign, email marketing and the press are all important components of a marketing strategy. An advantage HME suppliers have over e-commerce retailers is product expertise, says Williams. Providers should educate customers on the features and benefits of devices, and also on the history of OTC TENS—the demand, clinical benefits and advantages of a drug-free alternative.

TENS units have been used all over the world as a drug-free alternative to manage pain. Back pain is a leading cause of disability in Americans, and retailers can also target patients who have had orthopedic, surgical procedures such as knee arthroscopies, total knee replacements or anterior cruciate ligament (ACL) or rotator cuff surgery. Other chronic pain conditions such as arthritis or those in physical therapy and rehabilitation for a strain or sprain may also benefit, says Williams. Electrotherapy also provides retailers additional sales opportunities for supplies such as electrodes, leads, batteries, etc. Serving these follow-up needs keeps providers in touch with customers who may be candidates for a new unit down the road. Providers should have different strategies for OTC versus prescribed medical devices, and should create a strategy specific to the type of products offered, says Williams. They should strive to offer a mix of OTC and non-OTC units with various features, benefits and price points. For OTC TENS, a dual-channel and a single-channel unit might be offered. Some OTC TENS have one preset program; others offer eight or more. Offering options creates value for the customer.

Simplicity and Ease of Use

BioMedical Life Systems has received FDA approval to sell its non-prescription TENS device. The REBOUND sells for $64.99, a price point roughly equivalent to the Medicare co-pay in the days when Medicare covered TENS devices. Created with the HME/DME/pharmacy market in mind, the unit is simple and easy to use—just turn it on and place the electrodes surrounding the pain site. There are no extra buttons and settings to decide, and charts and a video tutorial help to guide usage. A refill kit includes three packs of electrode adhesive pads and replacement wires and sells for $19.99. BioMedical Life Systems offers the REBOUND in a countertop display that includes the device and a refill kit; Griffith says providers who use the display are selling double the volume. The company also puts QR (Quick Response) codes on the side of the product; scanning the code with a smartphone brings up a Web site to view video tutorials and interactive Web features. The REBOUND was a winner in the 2014 Innovative HME Retail Product Awards, sponsored by HomeCare magazine, at Medtrade Spring. The LaserTouchOne from Renewal Technologies combines TENS functionality to block pain temporarily with a cold laser that facilitates repair and healing. FDA-approved for over-the-counter sales, the dual modality works better than either modality individually, and clinical trials have confirmed an overall effectiveness of 93 percent, says Sperduti. The LaserTouchOne retails for $489 and a required conductive gel retails for about $13. Mike Sperduti, president of Renewal Technologies, manufacturer of the Laser-
TouchOne, emphasizes the advantages of a drug-free approach to dealing with pain. Across the United States, there is an untapped opportunity in the 80 to 100 million people who suffer from chronic or acute pain. “There are tens to hundreds of millions of dollars available in this space,” he says. He urges HME providers to “step up and become a pain management specialist,” and take the message to referral sources and the community. “Every provider has the opportunity to help people in an underserved market,” Sperduti says. “What better thing to do for someone than eliminate their pain?” Sperduti urges providers to hold free pain management demonstrations to communicate the benefit of the product—
experiencing it turns customers into believers. Sperduti says that some HME providers have doubled their business by selling the LaserTouchOne, a combination of selling to existing customers, attracting new customers to buy the product and also new customers later buying other categories of products from the HME. Valerie Yaple used that approach when she turned around Gerould’s Pharmacy in Elmira, N.Y., transitioning it from a business dependent on the government to one that makes a good profit on retail sales. Now working for Renewal Technologies, Yaple helps providers who sell LaserTouchOne, offering one-on-one telephone conferences, staff training webinars and in-person selling to move the product.

Opportunities at Point of Purchase

Core Products offers a variety of pain management products, including point-of-purchase (POP) displays that encourage impulse purchases. Core’s Omni Massage Roller is a massage tool that sells for $19 each. Philip Mattison, president of Core Products, says a dozen of the products could sell each week, and the 40 percent margin could make a difference in cash flow. Other pain management products include Core Packs hot and cold therapy products available in a POP display that explains the benefits of hot and cold to relieve pain. Core Products’ pain management offerings cover every part of the body, including the neck, shoulders, ribs, abdomen and down to the knees and ankles. The idea is to improve an HME store’s appeal to walk-in customers and have them buy items off the shelf that don’t require custom-fitting. Location in a retail center is more desirable than in an industrial complex, where HMEs have often been situated. Mattison says middle-
aged women are a key demographic 
because they buy not only for themselves, but for their children, their husbands, their parents, their husbands’ parents and other family members. In contrast, men tend to buy only for themselves. Core Products also offers the WiTouch and WiTouchPro wireless remote-control pain devices incorporating TENS technology to target back pain. The device, which sells for $149, can be worn under clothing and remotely controlled to provide treatments throughout the day. A new belt/support fits over the WiTouch to create upward and inward pressure to relieve tension in the lower back. Core Products sales tools inlcude a series of posters that highlight topics such as hot/cold therapy, back support braces, orthopedic pillows and the Back Saver wallet, which goes in a front pocket rather than the hip pocket. Wallets in back pockets cause a 10-degree tilt that aggravates back pain, says Mattison.

Benefits of Soothing Analgesics

Topical analgesics are another pain management opportunity for HME providers. Non-invasive pain management treatments like topical analgesics can complement almost any existing product mix, says Lauren Hinton, product manager, DJO Global. They are a quick and simple point-of-purchase solution, and they generate a new revenue stream for providers. DJO Global’s Fast Freeze is a natural topical analgesic, providing soothing, deep, penetrating pain relief from sore muscles and joints, backaches, arthritis and tendonitis. The clear and non-greasy formula, containing menthol, aloe and ilex, is available in a gel tube, roll-on, pump spray and continuous spray. Demand for such products is increasing as baby boomers age, more people are active, and with the obesity epidemic in the United States, says Hinton. Topical 
analgesics work well at the point of purchase because they are easy to understand and apply. Combining POP with samples and marketing materials enables the product to sell itself. Samples can be coupled with other products, such as orthopedic bracing, to provide a full pain management offering to the customer. Another topical analgesic, Biofreeze by Performance Health, also provides short-term pain relief to promote faster long-term healing and recovery. Providers can begin with the Biofreeze Sales Starter Kit ($89.95), which includes free brochures, product samples and countertop display filled with product—and Performance Health will refund any unsold product. Topical analgesics don’t affect the gastrointestinal tract, heart, kidneys, or cognition, as can oral pain relievers. Low levels of system absorption mean less risk of toxicity or drug interaction. Performance Health says Biofreeze can work together with the company’s TheraBand Professional Resistance Bands to promote the four components of an active lifestyle—flexibility, strength, balance and cardio. Performance Health will provide up to 100 free customized product samples (with HME provider’s name and contact information) each month. The company also supplies window clings, posters and T-shirts to wear on marketing days—all free of charge. Samples can work like a business card, says Jim Beuoy, inside sales and customer service, Performance Health. “We invest in your marketing 
efforts to increase store traffic and acquire new customers,” he adds. Performance Health’s online where-to-buy referral services helps customers find HMEs in their area that sell Biofreeze. More than 1.2 million consumers have come to the site to find where to buy Biofreeze. Engaging with customers and getting to know the root cause of their pain can open the door to selling additional products to manage their pain, restore strength and improve their overall condition and health, says Beuoy. Making only product claims that are consistent with what is allowed by the FDA provides patients and providers confidence and protection. The FDA 
allows topical analgesic to claim the following: “Provides temporary relief of minor aches and pains of muscles and joints, which may be associated with simple backache, arthritis, strains, bruises and/or sprains, providing penetrating or cooling pain relief.” Beware of any topical analgesic that claims to do more, says Beuoy. It’s against the law.