Dr. Barbara Phillips and whether CPAP should require a prescription

[jnk...]

Since Dr. [Barbara] Phillips considers CPAP therapy to be relatively safe, she thinks it should be more accessible, and that means deregulating CPAP usage by not requiring a prescription. This would reduce the number of traffic fatalities, and help improve public health overall. -- https://www.cpap.com/blog/sleep-special ... p-therapy/

All in favor, say aye.

[palerider]

Since Dr. [Barbara] Phillips considers CPAP therapy to be relatively safe, she thinks it should be more accessible, and that means deregulating CPAP usage by not requiring a prescription. This would reduce the number of traffic fatalities, and help improve public health overall. -- https://www.cpap.com/blog/sleep-special ... p-therapy/

All in favor, say aye.

AYE!

[chunkyfrog]

Oh, hell yes!
Aye × 1,000,000.

[Dog Slobber]

AYE

CPAP should definitely be more accessible without a prescription. This secret hand-shake to get into the config, and refusal to sell devices to non-prescription holders absolute bull.

Having said that, many insurers will not cover the device and supplies without it being prescription based.

There's got to be some middle ground.

[zonker]

AYE

CPAP should definitely be more accessible without a prescription. This secret hand-shake to get into the config, and refusal to sell devices to non-prescription holders absolute bull.

Having said that, many insurers will not cover the device and supplies without it being prescription based.

There's got to be some middle ground.

one brick at a time, i say. maybe once a prescription isn't required, the insurance companies will catch up?

oh and in the meantime, AYE!

[Pugsy]

one brick at a time, i say. maybe once a prescription isn't required, the insurance companies will catch up?

Don't hold your breath on that one in hopes insurance will still be useful.
Once the cpap machine (and I assume masks) no longer have that RX required sticker on them then you can count on insurance bailing immediately...they won't pay for a damn thing.
They will be dancing in the street with the money they save on not paying anything for cpap stuff.

Won't matter if the doctor actually writes a RX for it or not...still OTC and the cost will be quite high IF you can get any coverage at all.
Ever go try to buy Nexium with a RX and use insurance....you can buy more of it cheaper OTC without insurance that with using insurance.

[jnk...]

more of it cheaper OTC without insurance

Same should happen with CPAP, IMO.

[Arlene1963]

A very interesting article and thanks for linking to it, JNK.

So I vote AYE, but have a few concerns:

When folks have a diagnosis of OSA and are presented with their sleep study results and a prescription from a doctor they take it seriously. I wonder how many folks would actually go out and buy a CPAP themselves, and continue through the often very difficult adjustment phase when many so frequently say 'forget this" and give up?

A massive educational campaign would need to be launched. And then many would just see it as another one of those medical ads/tactics that scare us.

I know that there are exceptions and we see folks here who buy a machine on their own and actively pursue very successful treatment, but how common is this?

Insurance is a big factor as well. Not sure how this would play out but I would be concerned that insurance companies would rapidly find a way to no longer cover XPAP even on doctor's prescription, if it was not by prescription only anymore. So then the prices would have to drastically fall because as we know XPAPs are ridiculously overpriced along with the masks and all the other items needed, and there would be those who simply could not afford it without coverage.

If OSA/SDB is advertised as being very, very common as we age (which it is) many might conclude "why bother to treat a condition that almost all of us have to some degree or another? I'll take my chances, TYVM"

Just putting these thoughts out there for some discussion, and trying to figure out some of the possible consequences.

Maybe an idea would be to have a screening program? An overnight home study for all men over a certain age, and post menopausal women. I don't know, maybe not the best idea but I will just put it out there.

[Pugsy]

I would be concerned that insurance companies would rapidly find a way to no longer cover XPAP even on doctor's prescription, if it was not by prescription only anymore.

Having a doctor's prescription for anything doesn't guarantee insurance will pay for it.
Insurance deny doctor's prescriptions all the time. If all it took was a RX to get insurance to pay for something I would have a nice little hot tub courtesy of my insurance. Getting a doctor to say something is medically necessary doesn't always equal "here we will help you out paying for it"... They can and will tell you "so sad but you are up the proverbial creek"....we just went through this with some stuff my mom needed and got her doctor to state it was needed and insurance still said...nope, not paying for it...you are sol and no one will do a damn thing about it.

You bring up some valid points...some people won't go buy the cpap stuff on their own either because they don't have any extra money for it (and even if costs come down...it still won't be cheap) and other people will just blow it off.
But we are sort of in a similar boat now with insurance paying a share...people still blow it off and the "I quit cpap rate is still quite high". I dunno...maybe if they paid for it all out of pocket then maybe they would try harder????

more of it cheaper OTC without insurance

Same should happen with CPAP, IMO.

I am not going to hold my breath on the prices coming down all that much but I would love to be proven wrong in that regard.
Sort of like all the things that got "deregulated" and was supposed to make things cheaper in the long run for the consumer....I am still waiting for that benefit to come to me directly. Anyone see any drop in prices at the grocery store when the trucking industry got deregulated??? I didn't. Some people did end up putting some extra money in their pocket but it sure wasn't me.

Though I would love for the cpap machine makers to have to actually deal with patients directly instead of them kissing ass to the the DMEs and doctors and all we get told is "contact your DME" because they don't consider us their customers.


Anyway I vote "aye" but I do understand the good and bad side of it happening. Nothing is ever a perfect solution for everyone but it is just air and unless someone has some sort of contraindicated health issue going on...there's nothing with cpap that is going to hurt someone and no way to abuse it that I can think of...and it needs to be RX free and OTC.

[jnk...]

Some people need docs for help with their breathing and sleeping, no doubt. I am not an advocate for avoiding docs for important health issues.

But some don't need doc involvement for all time for CPAP. For those who don't, it would sure be nice to my mind if a free market determined the price of the equipment rather than price being determined by what is tantamount to a cartel. And there are too many hoops to jump through to get good sleep, I think--especially for those who don't want to go through the entire process. Response to treatment is a valid enough yardstick for the majority, IMO.

But all your points are more than valid to my eyes, Dog Slobber, zonker, Arlene, Pugsy.

I must say, though, that I truly admire Dr. Phillips' willingness to speak frankly and to think outside the industry's box!

[Janknitz]

I really don't think most of the general public is able to self-treat their apnea unless they stumble on a place like this where we can teach them to do it. And I agree that insurers will quit covering CPAP machines if they are "over the counter". So for that reason, I'm a "no" on CPAP machines.

BUT, I think it's crazy to require a prescription for hoses, filters, humidifier chambers and masks with their supplies. Masks aren't cheap, but if insurance companies stopped paying for them, then most people who are motivated to use CPAP could and would still find them and use them. Competition MIGHT drive prices down but I wouldn't hold my breath.

Since I lost my DME coverage I've been paying out of pocket for those things and buying them on Amazon (no rx is ever requested) and been quite happy--decent prices, accurate billing, 2 day delivery, good quality, good return policy. And the lack of DME and insurance hassle is PRICELESS.

So put me down for a mixed result--no on the CPAP machine, yes on the supplies.

[Hamguy515]

I really don't think most of the general public is able to self-treat their apnea unless they stumble on a place like this where we can teach them to do it.

Janknitz, I think you hit the nail on the head here. While the risk/benefit equation is a no-brainer in my opinion, getting treatment "right" takes some work and a fair bit of patience. For me, I'm paying everything out-of-pocket due to high-deductible insurance coverage. I think that's part of why I've been very engaged in my treatment and fortunate to have finally found a path forward in treating my long-time OSA that doesn't 'break the bank' even though it's still far from inexpensive.

I honestly think that the prescription requirement for masks and other similar supplies really serves only the interests of the DME world. By restricting the ability for users to shop around and try out different products to find out what works for them, the patient is really done a disservice.

[palerider]

Not sure how this would play out but I would be concerned that insurance companies would rapidly find a way to no longer cover XPAP even on doctor's prescription,

They already do.

Some don't cover durable medical equipment *at all* and others just screw you by not paying a penny till you're into the thousands of out of pocket expense.

[palerider]

I really don't think most of the general public is able to self-treat their apnea unless they stumble on a place like this where we can teach them to do it.

I have to give credit where it's due... I learned to self treat right here, just me, obsessively reading thread after thread after thread.

[Lucyhere]

So put me down for a mixed result--no on the CPAP machine, yes on the supplies.

+1