Any Canadians out there

[datara]

Has anyone looked up their CPAP supplier on the Better Business Bureau, couldn't find any listed in my area

[Julie]

Why would you want to look up a particular company - do you suspect problems?

[datara]

Yes sadly I do, with the entire industry in this country, I suspect that this industry is totally self regulated, with very little oversight.
The sales approach used on me was completely fear based, not on the health issues, but that it could possibly cost me my license if I didn`t buy their machine.

In my first consultation , my first question was about masks, I wasn`t shown pictures or told about any other types other than the one used in my study (Which i didn`t like)
Now from what I understand there are numerous types, but I was brought a mask, told that I am buying it, and there`s no option.

I am also beginning to understand that mask problems are a large reason for non compliance. So I have called other suppliers and as soon as they here that I just have some questions, they no longer have time for me.

Shouldn`t the main goal be to achieve compliance, and maybe a satisfied client.

Not to mention the very similar ludicrous prices of machines at every supplier in Canada

Thank goodness I`ve adapted well to the therapy, the only positive part of my experience so far.
My insurance doesn`t cover these machines, so the price is a bit of an issue for me, and where I live there are only two suppliers and two choices Pricy with only 1 year warranty left, no bells and whistles and pricier $1400 and $2400 respectively not including mask "$250.00 and they have made sound as if it is against some law to buy on line or used.

[Hawthorne]

You are right about the sitution with the cpap providers in Canada. I am in Ontario and, even though we have the Assistive Devices Program, which gives some help with the first machine and any new one after 5 years IF you can get a recent prescription. The prices for machines, masks and parts is outrageous.

I was diagnosed in 2002 and found this forum a few years after that. In 2008 I began to buy almost everything online. I have bought a couple of new machines and one slightly used since then and several masks both new and slightly used on cpap.com and cpapauction.com using my original prescription. I also buy mask parts online. The cost is so much less and it is certainly not against the law. The shipping is reasonable.

Just be sure that the company you are ordering from ships via the Postal Service and not by courier or you will have to pay a brokerage fee.

Resmed will not allow any online suppliers to ship outside the US now so you can't buy Resmed online if you are in Canada unless you know someone in the US where it can be shipped and sent on to you by that individual.

[tschultz]

...
Not to mention the very similar ludicrous prices of machines at every supplier in Canada

Thank goodness I`ve adapted well to the therapy, the only positive part of my experience so far.
My insurance doesn`t cover these machines, so the price is a bit of an issue for me, and where I live there are only two suppliers and two choices Pricy with only 1 year warranty left, no bells and whistles and pricier $1400 and $2400 respectively not including mask "$250.00 and they have made sound as if it is against some law to buy on line or used.

You may want to contact Clinical Sleep Solutions http://www.clinicalsleep.com/.
They don't list all they have on their website but are reasonable for pricing and practically in your back yard.

[nanwilson]

Morning from sunny southern Alberta
We are pretty much all in the same boat, some provinces pay for cpap but not Alberta. I went through the same boat as you, paid $1600 for a non-data brick of a machine and a mask. I now buy from clinicalsleep.com or cpap.com. Clinical is in Burnaby and you have to ASK for a quote, prices are good and there are no shipping charges. Cpap.com is in the US, and they are good too, their prices are stated , but you have to pay shipping...usually about $17. WE have to take charge of our OWN therapy as no one else will.
Cheers
Nan

[WestCoastCdnGrl]

BC doesn't pay either, unless you meet their ultra stringent criteria.

I paid CAD 275$ for my Quattro FX from Sleep Tech in Surrey. Since they expedited my paperwork with Pacific Blue Cross in December (I got it for covered @ 100%), I thought that I'd go with them for the mask (PBC won't cover it, I asked when I heard about the FX).

You can imagine my sticker shock when my RT told me how much it was.

In the future, I'll likely be buying most (if not all) of my equipment from our hosts... my Climateline has a small hole in it (that I've got a temporary patch on), and even when I figure in the shipping and 12% H.S.T., I'm saving $$ by ordering it and having it shipped from the U.S... the Canadian DME's want CAD 85$/USD 89$ for the hose. I'm close enough to the border that I could use one of the parcel holding companies south of the border as well (mind you, my time is worth more than the 17$ shipping charge).

[Ms Piggy]

Hi fellow Canadians, Cdn. suppliers I have checked out are a total rip off. From what I could gather some , if not all, cpap supplies come in via
Quebec so guess that is another profit margin added if they do - I was told that was the reason I could only get Breeze pillows in
two, or was it three, sizes - as that's whats available!
When first diagnosed, and knowing nothing but how awful I felt, I got supplied at great expense with a big black out of the ark looking
basic machine and a crucifying mask, both of which I took returned to the Cdn supplier. Then went to a different Cdn. company and guess what, the same big black machine and even more money out of pocket to upgrade to something better. The Govt. Grant would be great if we could we could spend it in the U.S. I wonder if you could just buy a mask with the grant which would then, hopefully , cover the complete cost of it. Think we get another grant every 10 yrs, ?? but maybe not!
I find it best to do your own thing via U.S. suppliers and let the govt. keep their offer.

[BlackSpinner]

The Govt. Grant would be great if we could we could spend it in the U.S.

Provincial! Not federal. Quebec does not cover it.

When you go online to hunt for Cdn supplies you must call to ask for the prices. The manufactures don't allow them to adverstise on line. Resmed supplies are not allowed to be shipped to Canada due to manufactures contracts. ClinicalSleep's online site is just about a match for the US prices when you calculate the shipping costs into it. Brick and Mortar DME's - forget them - their prices are way out of the stratosphere and the supplier VitalAire has horrible service.

[nanwilson]

[quote="Ms Piggy"]Hi fellow Canadians, Cdn. suppliers I have checked out are a total rip off. From what I could gather some , if not all, cpap supplies come in via
Quebec .

If you would check out clinicalsleep.com you would find out a different story. They are based in Vancouver, B.C. and will give you a quote on anything you want. I bought a RESMED mask from them and it was the same price as our best U.S. online supplier. AND I received it in 4 days, not the 3 weeks it takes for U.S. suppliers. U.S. supplies come through Sault Ste Marie, ONTARIO, not Quebec. Sault Ste Marie has the largest customs receiver in Canada, so anything that comes from eastern or south U.S. gets routed through there. I am not affiliated with either clinicalsleep or Sault Ste Marie or Ontario or Quebec.........I"m just giving you a better perspective on purchasing your supplies in Canada.
Nan

[datara]

Thanks Nan, I know you mentioned them before, but I had actually ordered the day before I joined cpaptalk Wish I had joined a day earlier, your guys are alot closer to me.
Back to this whole buying in Canada thing though. I have actually done some research. I have composed a rather lengthy letter that I'm planning on sending to;

Michael De Jong - Minister of Health BC
Melanie Aitken - Commissioner of Competition
Leonard Krog - Local MLA
The Better Business Bureau (I couldn't find any CPAP providers locally or otherwise accredited)
BC Society of Respiratory Therapists, requesting a copy of their code of ethics - the industry is self regulated in BC
Resmed and Phillips Respironics as I was told by one provider something that I think they should want to hear
W-5
My wife's cousin (Writes for Vancouver Sun)
A local reporter who has my wife on speed dial (My wife is president of DPAC in our area and 1st Vice of BCCPAC, she sits on School Districts Business Committee, she's a real pain in the but to them but she keeps them honest, so she's quote heaven for this local reporter (you should hear some of the ideas they come up with to try to meet budget)
My wife knows Mr. Krog, and he knows her, she says he's a real stand up guy who will really fight for the rights of families (she told me to emphasize that I am a family man who has been threatened with my license, which is true, by the RT, my GP turned all sorts of shades of Purple when I told her that, she's a very pleasant and caring woman, I don't think I've ever seen her that aggitated. She looked at me and said that it is her job to determine, and my responsibility to report it, if I didn't she may be forced to but only if I refuse treatment, which I am not, she also told me that all I have to do is show her the machine and that is set in acccordance with my prescription, she does not care who sets it. I go in to the hospital for a overnight sleep study with my machine to prove that the therapy works and Bobs your uncle.

Wow I'm good at rambling, sorry. Anywho if anyone is interested at having input on this letter, it's still in rough draft, and kinda choppy, but let me know and I'll PM you. I don't want to post it in case I'm making a fool of myself. I don't think I am, I don't watch a lot of TV, I have some weird hobbies, one of which is reading about competition law, I found it interesting in College and just kind of check it out once in a while.

[Julie]

Hi - I just thought I'd tell you that I have written to my local MP's a couple of times, and those notes were forwarded to Ottawa, but the response was not exciting - the minister actually wrote me afterward and said that Cpap's were considered to be 'assistive' devices (like canes?) rather than anything more meaningful, and therefore not categorized as worthy of getting help with. I wrote back asking that someone draft a bill emphasizing that the equipment was more serious than they've labelled it, but as of 18 mos. or so ago, have not received any reply.... Good luck with yours - you sound like you have a lot of good people backing you up.

[cortez356]

Medical supply companies are one of the last stronhgolds who somehow think that prices in Canada just have to be higher. In the last few years many companies including car mfrs. have learned that we can just walk across the border and save 20 to 50%. I dont mind paying a litle extra. Shipping and distribution costs are higher in Canada but the DME's are nuts. In Manitoba the gov. will supply you with your machine and mask at no cost. BUT until recently they only supplied a cheap F&P. No full data machines. I wrote our local MLA and he had the opposition health critic look into this matter. Other CPAP users did the same. Now you can get any machine that the only approved DMA sells. But you must pay the difference. Naively I thought I could get an S9 for maybe $300. WRONG. Try $900 plus! I think they are learning from their American counterparts. I guesss it is the price we pay to be a Canadian!!!

[datara]

Isn't it sick that for the past week I am losing sleep due to my anger over the practices in this industry, when I should finally be getting sleep? I finally realized today that this is a microcosm of our western society as a whole, and one person is not going to change what has taken over 100 years to develop into a pretty comfortable lifestyle relatively speaking to some third world countries. Having said that, still think that corruption where it exists, needs to be stopped, and if our "Public Servants" won't help then we must help ourselves, much like our own health. So I have decided to post my experience on this site to see if it is similar to other peoples experience.
It is what was the origional conception of my letter, very point formish, very rough as the thoughts came to me, some of it is reaching (due to anger) but I believe that my overall experience is similar to what other people have gone through and thought about, and because it is raw and because it stretches it is honest. The only way to fight this is to educate future newbies. This sight is fantastic, but it may take hours or days to find pertinent info, given that you may not know what your looking for. I wish there had been a simple website, not a forum , with the myths and truths of sleep apnea and cpaps and cpap suppliers laid out in simple and easy to navigate form. I suspect that the Cartel that is this industry would be quick to have it shut down.

I have my machine I'm going to move on but others should know their rights, have their fears relieved and not have to deal with anger, frustration and deceipt.
The only way to change the system is to understand it and use it against itself.
Nan , I checked out clinicalsleep, and you're right the prices are very reasonable. Other people need to know, I saw them when I first looked up machines in Canada but because you had to request a quote I I thought they were just like every other in Canada who suck you in to a "free consultation". The law forbidding the Canadian suppliers to advertise pricing is actually all but proof that this is indeed a cartel by it's very definition.

So here it is, pick it a part , agree with it, disagree with it, it'll make you laugh, it'll make you cry, it's the feel good mumbo jumbo of the year...

*In case you're wondering when you get to it, I was able to find out the raw cost of a Resmed S9 auto with humidifier

The DME providers that I have contacted in Canada( I have not contacted all) limit their offering to the most expensive models offered by the two top manufacturers of CPAP Machines (Phillips Respironics and Resmed) .These machines sell for (approx.) $2400 for top end, and earlier models with shorter warranty for $1200, not including mask
At the high end, mark up on these machines is 370%. There are at least 3 other manufactures that provide reliable machines that do the job. The Probasics ZZZZ PAP is one example at$179.00 US on line yet not one DME provider that I have contacted in Canada has mentioned this affordable choice.
** Reviewers of this machine note that this is one of the most durable machines, even more so than that of higher end machines
Obviously there is a significant disparity between mark up on &650.00 vs. $100.00 at that rate.
if the reason for not offering this option is the "Common Standard" defence, it should not be admissible for this industry as this is a necessary medical device and the standard should be set by an independent regulatory authority, which is currently not possible due to the fact that the industry is self regulated
This, in my opinion is deception by inconspicuous absence, I was not aware of the disease let alone the device or therapy, as I am sure most people are not, how could I know without the guidance of a professional?( who also happens to sell the machine)

I have called several DME providers to ask about my rights as far as purchasing a machine elsewhere (online/used), some of the answers are as follows (paraphrased)
If you buy a machine online we can't help you with it (understandable, but fear based)
It is illegal to buy on line (Not true, as long as you have a prescription)
It is illegal to sell used machines (debatable, but so far have not been able to find proof for, or against)
The machines sold in the states are not the same quality as we sell here (Not true, and I think the manufacturers would love to hear this one)
You must have your machine set by us and we don't set machines that we don't sell. This is probably the most powerful motivator to buy, yet is untrue.
1) Diabetes patients are taught to and encouraged to monitor and self medicate,
2) The only law I have found states that a qualified professional cannot set the machine (outside of small increments) without a prescription.
3) If I am prescribed a medication and take more or less of said medication than prescribed, am I going to jail?
These comments are deceptive.
Resmed has prohibited the shipment of their products from The US to Canada via online vendors, I thought this would be something that Competition Bureau should be aware of, however it appears to be protected by NAFTA (article 309)
I was referred to a DME by the Doctor at the sleep clinic, when I went back to the sleep clinic to ask about the legalities etc I was told that I would have all sorts of problems by buying out of the US, but the RT is the one you should ask. This in itself did not spark any suspicion, however when I went to rate your doctor, most reviews were glowing, but one patient reports how upset this doctor became when the patient did not buy from the DME provider he referred them to. Plus, I did not take my prescription to the DME provider (conveniently next door to the Doctor in semi detached building), but received a call from them stating that they had my prescription. I do not believe it is unreasonable for me to find this suspicious. Who owns MY prescription, me, the Doctor, the Province...
It is not uncommon for suppliers to reward for referrals, but if deception is used to obtain a desired result, this is fraud.
The most common reason for non compliance of therapy, according to the studies I have been able to find is discomfort of the mask, but this is based on the data from the cpap unit and admission by the patient. What about non compliance because the patient could not afford the machine.
On one website there is a sales trends page which shows sales by: Manufacturer, Model and Price
For Q1, 2011 43.6% of the basic machines sold to self pay patients was the Probasics ZZZ PAP, of the two most commonly offered machines in Canada, the resmed S9 Elite ranks 6th in sales at 4%, while the Respironics PR System One rounds out the 10th spot at 2.5% of sales.
The Probasic sells for $179.00 on line, I cannot find it offered in Canada.
The PR Sytem One PRO sells for (Avg) $2300.00 in Canada and (Avg) $546.00 on line(Q1, 2011)
The Resmed S9 series sells for (Avg) $2400.00 in Canada and (Avg)$805.00 on line (Q1, 2011)
these prices are low, but not the lowest, so I am not using a best case scenario from the US, and a worst case scenario from Canada
Although this is only one company I believe this to be fairly telling stat. How many people diagnosed with sleep apnea of any degree in Canada are refusing therapy due to affordability, and not other reasons. Should it not be the responsibility of the professionals, charged with the well being of other people to ensure compliance any way they can, and offer every viable option available.
Ministry of Health website search brings up a page that provides info on how to ensure “ Your assurance of Comptetent and ethical Health care” , What could be less ethical in the medical profession than lying. RT’s fall under the governance of the Ministry of Health
Further to the mask, when I went in for my consultation, knowing that mask comfort is fairly important, it was the first thing I asked about, and although there are at least a dozen options from Resmed and Respironics alone, I was told that the one I was shown was my only option. These sellers (I can not call them professionals in this context) also tell the prospective buyer that part of the reason for the higher cost is the service they provide. If this is an example of the service, it is not worth it. I found more support and answers from online support groups. If a diabetic can and must monitor their condition daily, surely a person with sleep apnea can do the same. The software, including interpretation help is sold for private use. Pharmacies have self blood pressure monitor's free for use (again COMPETITIVE ADVANTAGE), if this industry were free to evolve via natural progression. I could see free readers of the data from the CPAP machines SD card at pharmacies as well, especially since high blood pressure and sleep apnea are closely linked, although even this is not necessary as the machines (typically) store 6 months of compliance data internally as well, and are portable enough to pack to your GP.

At every level of the health care system you are made very aware of the dangers of not using the therapy, which can have fatal consequences, I would like to hear the response from these health professionals to the people who lost family members who were diagnosed with this deadly disease and could not afford treatment, and passed prematurely. If the answer is that it was only possible that there was a link, then this should not in any way be used in the sales presentation, as this is taking advantage of the vulnerable. Given that treatment IS available at a fraction of the cost of the top end units.

I strongly suspect collusion in this industry, but at the very least gross negligence.

Has the pursuit of the almighty dollar clouded our judgement so drastically that we will deceive and deny before considering the quality and longevity of another human life.

I can suggest three fairly simple solutions:
1) The decision by the Health Professionals Association to recommend self regulation be thoroughly reviewed with the above information in mind.
2) Doctors be mandated to honestly and accurately and without bias make every patient aware of ALL of their options including pros and cons to various purchase options, rights and legal obligations.
3) Article 309 of The North American Free Trade Agreement be amended to exclude necessary medical equipment.

Why are these prescribed items not sold like almost every other prescribed item in BC, Walmart, Save On Foods, Pharmasave etc. would surely compete to gain competitive advantage on any product possible.

The results would result in less competition, yes however, in the case of Commissioner of Competition v. Superior Propane Inc. the Competition Tribunal decided unanimously that the result of lessening of competition was outweighed by the increased efficiency and lower cost benefitting the majority of Canadians. I disagree with this decision due to the fact that the propane industry was mature if not already in decline, resulting in lower volume of sales and higher prices. It is hard to argue, at this point, whether the gain in efficiencies has been realised or if the result of trying to become more efficient has resulted in a degradation of service, devoid of viable national competition.
However, Sleep Disorder diagnosis is relatively new, with a growing and aging population , and the need for related medical equipment is projected to grow for the foreseeable future, in this instance, the rationale in the Superior case would indeed benefit the majority of Canadians, as well as any DME providers that provide quality service in a competitive, fair and open market. Saturation means less customers per vendor, resulting in higher margin required per unit. Higher cost per unit means less Canadians affording the equipment. Lower costs also would result in less burden on insurance providers, more equipment sold due to affordability, and hopefully a reduction in insurance premiums for Canadian businesses.
The industry is actually hindering it's own growth, how can this be beneficial to the economy?
Given the inherent risks to health that sleep apnea poses (Congestive heart failure, high blood pressure to name but two),how is it possible that more people affording treatment not be beneficial in combating the ever increasing cost to the government for medical services?
The current oligopoly is doing nothing to discourage a potential "Black Market" which in the long run could result in the spread of disease and unauthorized purchase, I can't imagine what kind of uses the illegal drug trade could find for these machines.

[DaveL]

You are right about the sitution with the cpap providers in Canada. I am in Ontario and, even though we have the Assistive Devices Program, which gives some help with the first machine and any new one after 5 years IF you can get a recent prescription. The prices for machines, masks and parts is outrageous.

I was diagnosed in 2002 and found this forum a few years after that. In 2008 I began to buy almost everything online. I have bought a couple of new machines and one slightly used since then and several masks both new and slightly used on cpap.com and cpapauction.com using my original prescription. I also buy mask parts online. The cost is so much less and it is certainly not against the law. The shipping is reasonable.

Just be sure that the company you are ordering from ships via the Postal Service and not by courier or you will have to pay a brokerage fee.

Resmed will not allow any online suppliers to ship outside the US now so you can't buy Resmed online if you are in Canada unless you know someone in the US where it can be shipped and sent on to you by that individual.