Philosophical CPAP questions for a Saturday afternoon

For your Saturday entertainment:

1. Recently read a eBay buying guide for CPAP machines -- it was penned by secondwindcpap.com. (To find the article, enter in "ebay buying guide cpap" as the search engine query.) Claims that some DME's mark up CPAP machines by 500% So, does anyone know the wholesale cost of these machines? Sounds worse than buying a car. The article also states that Resmed set minimum pricing guidelines for internet sellers -- what were the online prices for Resmed machines previously?

2. Auto PAP machines could learn an individual's patterns and adapt the algorithm accordingly over time to address an individual's needs in a predictive manner. Instead, we are stuck with a generic algorithm that does not adapt day after day. Any research out there to create adaptive machines that would be superior to these generic algorithms?

Thanks!

Never had a non-auto. Remember when I got my m-series, I would wake up and wonder if it was on, it had synced up with my breathing it was hard to tell.

1) just compare the price on our host site with your brick and mortar DME. I can assure you that our host still has a good mark up.
Most manufacturers set a preferred retail price. Due to its size of the market, resmed can enforce it. They also enforce their ban on shipping out of country by threatening not to sell to online suppliers.

2) You are not the customer - neither the DME, sleep labs or the manufacturer are interested in you or your needs, only their profits. Apaps that adapt would cut into their profits.

I don't remember ever seeing a ResMed product at anything but the MSRP that they make a supplier use.
ResMed's policy on that has been around a long time....at least since I joined the CPAP community in 2009 I think.
Respironics enforcement of MSRP posting is more recent though as in last couple of years maybe.
I have no idea what the wholesale prices might be.

In a normal retail market, the markup would be between 30 -50% for goods. However that assumes a straight sale. It doesn't include stuff like setup and training, insurance paperwork and certified staff (who are paid higher then minimum wage). If they were actually providing those services to patients I wouldn't quibble but I get better service in a shoe store from some minimum wage teenager then I ever got from some RT fitting a mask.

InsomniacGuy wrote:For your Saturday entertainment:

1. Recently read a eBay buying guide for CPAP machines -- it was penned by secondwindcpap.com. (To find the article, enter in "ebay buying guide cpap" as the search engine query.) Claims that some DME's mark up CPAP machines by 500% So, does anyone know the wholesale cost of these machines? Sounds worse than buying a car. The article also states that Resmed set minimum pricing guidelines for internet sellers -- what were the online prices for Resmed machines previously?

2. Auto PAP machines could learn an individual's patterns and adapt the algorithm accordingly over time to address an individual's needs in a predictive manner. Instead, we are stuck with a generic algorithm that does not adapt day after day. Any research out there to create adaptive machines that would be superior to these generic algorithms?

Thanks!

To use a worn out quote from one of our dubious politicians and former government officials......

"What difference, at this point, does it make?"

But, I'm not going to bother looking up that claim from secondwind......however, I wouldn't be surprised if there was that much difference between the "manufacturing costs" and the end-user (or MSRP) or "whatever" costs.
They have significant investments in their equipment manufacturing designs and costs, so that wouldn't be surprising.

The problem with the machines "learning our individual patterns" is that we don't sleep or breathe the same from one night to the next. I sure wouldn't want a machine anticipating one thing and then being totally FUBARed when it wasn't that way.
And, if someone else was to eventually use the machine (other than the original owner), what would you do to reset the algorithm? That's just too "goofy" to be meaningful or logical.


Den

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BlackSpinner wrote:In a normal retail market, the markup would be between 30 -50% for goods. However that assumes a straight sale. It doesn't include stuff like setup and training, insurance paperwork and certified staff (who are paid higher then minimum wage). .

Don't forget the MEDICAL MARKUP!$$$

Wulfman... wrote: And, if someone else was to eventually use the machine (other than the original owner), what would you do to reset the algorithm? That's just too "goofy" to be meaningful or logical.

now, Den, you have to remember that technology has marched on (some would say "galloped") since the days of the windup cpaps that you still prefer, where you have to get out the big key and wind 'em up like a clock each night, then fall asleep to the quiet ticking that they make as they inflate your lungs...

now-a-days, there's this thing called "factory reset" that wipes out all the old data and settings, and resets everything to defaults...

quite simple, really.

*snort* I thought you said "infiltrate your lungs" at first glance. My bad. Carry on.

palerider wrote:

Wulfman... wrote: And, if someone else was to eventually use the machine (other than the original owner), what would you do to reset the algorithm? That's just too "goofy" to be meaningful or logical.

now, Den, you have to remember that technology has marched on (some would say "galloped") since the days of the windup cpaps that you still prefer, where you have to get out the big key and wind 'em up like a clock each night, then fall asleep to the quiet ticking that they make as they inflate your lungs...

now-a-days, there's this thing called "factory reset" that wipes out all the old data and settings, and resets everything to defaults...

quite simple, really.

Flattery will get you..........everywhere! Thank you! I love my old wind-up toys. They don't require new software or other crap to use.


Den (proud to be considered an "old relic")

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In some cultures, I think that means that you two are engaged.

Tatooed Lady wrote:In some cultures, I think that means that you two are engaged.

I hardly think I'm his type.......

But, that jogged my (warped) sense of humor and memory and brought up this exchange of dialog from the movie "Stalag 17" (which cracks me up every time I see the movie)

Price: Are you questioning me?

Sefton: Getting acquainted. I'd like to make one friend in this barracks.

Price: Well, don't bother, Sefton. I don't like you, I never did, and I never will.

Sefton: A lot of people say that, and the first thing you know it, they get married, and live happily ever after.


Den

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Wulfman... wrote:But, that jogged my (warped) sense of humor and memory and brought up this exchange of dialog from the movie "Stalag 17" (which cracks me up every time I see the movie)

Price: Are you questioning me?

Sefton: Getting acquainted. I'd like to make one friend in this barracks.

Price: Well, don't bother, Sefton. I don't like you, I never did, and I never will.

Sefton: A lot of people say that, and the first thing you know it, they get married, and live happily ever after.

I know NOTHING! oops, sorry, wrong stalag.

InsomniacGuy wrote:2. Auto PAP machines could learn an individual's patterns and adapt the algorithm accordingly over time to address an individual's needs in a predictive manner. Instead, we are stuck with a generic algorithm that does not adapt day after day. Any research out there to create adaptive machines that would be superior to these generic algorithms?

Thanks!

Some of the PRS1 machines do "Auto-check and Auto-trial" to adjust to your needs from day to day. I may have the exact terms wrong. They also do "optistart" that basically raises the minimum pressure from day to day based on the results.

It's at least a small step in the right direction. They're also optional selections.

I think there could be a lot better solutions in that vein. In particular, I think it would be useful for the doctor to specify something like a multi-day ramp. i.e. the test shows the patient needs 12 cmH2O, but it's uncomfortable. It would be good to have a setting that starts at 8 and adjusts upwards .2 cm per day or some such until it gets to 12.

Wulfman and PaleRider, it's a thought,
But we are not here to judge.
Live and let live.