Resmed To Raise Internet CPAP Prices 40%

Interesting debate. It has many merits.

I have had pretty good luck with my DME but it's true that I didn't have 100% choice in my CPAP machine. Only the masks do I seem to be able to pick whatever I want, and only once again from their selections.

On my last visit where I switched from a Swift to an Activa, I mentioned to the DME that I feel sorry for them because it must be an uphill battle to try and find the exact perfect machine/mask for the "patients" (customers). To which she replied that for some it's first try fits many and for others they have to work to find the right thing.

My DME handed me a Remstar Plus M Series with C-Flex right out of the gate. And so I didn't research the other companies to find out about other manufacturers. When I finally decided I wanted an auto, I asked for some sort of Remstar Auto w/C-flex and was told I they don't carry those and I would be getting a Resmed S8 Autoset Vantage. Fine. It's worked out great. It was working out great with the Respironics. So any fued between the brands seems immature to me. Different strokes for different folks. We can't all buy the same machine and get the same results. However, I would like to buy one of each and test them all out

Time will tell what happens. I can't believe the DME is charging the insurance company so much more for these machines. People need to contact their insurance companies and tell them and that way the DME doesn't make quite as much money. I want them to make a profit, just not crazy profit. And I'd like more choices in general. I can't imagine for 5 seconds why they don't have all brands and units available just like a local convenience store stocks several brands of soda or chips.

This issue isn't complex. But I can see where they might be trying to avoid having excess machines and masks lying around. I mean, what happened to my Remstar Plus? Is it now a loaner? What happens to my Swift? The more people that do what we're doing, the more the machines/masks kind've get wasted. Or correct me if I'm wrong. A used machine doesn't sell for as much as a new one right?

based on how much the dmes want for machines i doubt they are hurting any when a few come back. they just rent them out for a hundred bux a month for a few months and they done paid for themselves already.

and i also wasn't given a choice for my machine, the sleep doc prescribed it for me, according to the script i have here in my hand he prescribed an auto titrating machine with a range of 6-18 cms with c-flex set to 3. that worked for me.

Now, I'm left wondering about the doctors themselves, not just the DME's. Why not carry a complete line of several different products. Why do it like a hairdresser? They have their little products of the year. Next year they're selling a different product. Are there any doc's out there that actually prescribe many different brands depending on the patient? Or do most Doc's decide they only like 1 or 2 brands? And do they base any of this on patient reports?

unfortunately my doctor actually cares about his patients, and he made sure i got a machine that would stand to give me the best treatment and to have the best chance for compliance. he prescribed the auto with c-flex because in his expert opinion his patients tend to be more compliant with the pressure relief c-flex offers and he knew that having a straight cpap pressure would not work for me due to the nature of my osa,

I don't understand why you say unfortunately? Seems fortunate that he's picking the best treatment for his patients. Don't ya think? I'm well aware that you're sold on the Remstar, just in case you thought I might not be listening.

because obviously your insinuating that the doctors don't know flip about what machines do what and which machines don't. that they only prescribe 1 kind of machine. he knew i needed auto titrating capability and he also knew that i needed c-flex, which machines do that? your trying to say that the doctors are just writing scripts without knowing what they are doing.

All very true. Some other things that I would add:

1. All the major manufactures charge DMEs more for masks if they don't buy a certain number of machines from them, somtimes as much as double. Resmed makes the best masks overall and they know it. It's the demand for their masks that drives the demand for their machines. As Mike said, the mask is usually the most important aspect of successful therapy.

2. I have no idea why you guys are so upset with DMEs over this. Resmed is not a DME! Resmed's main concern is insurance companies will lower reimbursment and they will have to charge DMEs less for their machines.

3. As Mike said, Internet sales are a small percentage of Resmed's sales. Even if they lost all of their Internet business, it will hurt them a little, but not as much if insurance companies lower reimbursment rates.

4. Hopefully you guys are seeing what the DMEs have been dealing with. Resmed is charging about $30 more for a Swift than the Ultra Mirage. Looking at the two, the Swift has to cost much less to manufacture. You guys are all saying you just won't buy Resmed products and I think that's great. If DMEs say they just won't provide Resmed products because they charge too much, you'll say the DMEs are evil and greedy. Why are DMEs greedy for not wanting to overpay but you as the consumers aren't?

What a mess our health care system is in!

I'm starting to think that health insurance should only be for hospital or long-term care. If we all paid for out health care directly, instead of through an insurance company that keeps most of your money for themselves, costs would come down across the board. Keep Medicare for the elderly and disabled, and Medicaid for those financially struggling and let the market determine pricing for everyone else.



[quote="mikemoran"]Rastaman,

People on here actually get to make decisions and choices about the machine they end up with. Whether they buy them on their own or go to batle with Doctors and DMEs. The difference is they are informed and realize they can take control of their therapy. We are the exception, not the rule. The majority just blindly follow their doctors and insuarance companies because they don't know they have choices.

It is also the reason so many don't stay compliant. They fight with poorly fitted masks, machines that were titratred in the worst of circumstances ( the sleep lab) and finally after a few weeks of no support from anyone say the hell with it. This is the biggest crime of all.

So while it looks like Respironics is the favorite from on here it isn't the favorite of the DMEs or doctors. Resmed has marketed them very well and as long as they are the primary providers of equipment we really don't hurt them by voting with our dollars. The other thing to keep in mind is the CPAP is usually a one time investment but masks must be bought over and over. Resmed still makes the most popular masks so don't expect them out of the marketplace anytime soon.

My take is they finally figured out that there is less and less distinction between everyones blowers but people are dependent on their favorite masks. With a higher number of people buying replacement masks on the internet they see the opportunity to increase margins for the one device people will pay anything for if it is the thing that works for them. It is pure greed.

No I'm not. You're trying to put words into my mouth. And I'm not buying it. Sorry.

I'm saying why not have a complete line of products because different things work for different people. No amount of saying the opposite will change that. More than 1 person here has said they've tried C-flex and don't really need it. Yes, they can turn it off. But yet others have tried all three brands and prefer the PB.

Why assume that just because your doctor picks Respironics that it's got to be the best on the market and that surely it's superior to all the competition? I'm sure that any doctor knows alot of things. But they couldn't tell me that I would have one pressure with a Swift and yet another with an Activa. I had to find that out for myself. And the 9 seems much higher than the 15 to 17 I was experiencing before. And yet I slept like a baby. Even so. Hmmmmmm.

I had a unique problem with my mask. It would be silly to assume the Activa OR the Swift could work for every person. Some might prefer another. And it's logical to assume the same about the machines themselves. I keep hearing absolute statements by a few and absolutes are always wrong. Nothing is always anything.

What do you think the profit margin is for DMEs?

Rastaman wrote:
I can't believe the DME is charging the insurance company so much more for these machines. People need to contact their insurance companies and tell them and that way the DME doesn't make quite as much money. I want them to make a profit, just not crazy profit. And I'd like more choices in general. I can't imagine for 5 seconds why they don't have all brands and units available just like a local convenience store stocks several brands of soda or chips.

[quote="Rastaman"]No I'm not. You're trying to put words into my mouth. And I'm not buying it. Sorry.

I'm saying why not have a complete line of products because different things work for different people. No amount of saying the opposite will change that. More than 1 person here has said they've tried C-flex and don't really need it. Yes, they can turn it off. But yet others have tried all three brands and prefer the PB.

Why assume that just because your doctor picks Respironics that it's got to be the best on the market and that surely it's superior to all the competition? I'm sure that any doctor knows alot of things. But they couldn't tell me that I would have one pressure with a Swift and yet another with an Activa. I had to find that out for myself. And the 9 seems much higher than the 15 to 17 I was experiencing before. And yet I slept like a baby. Even so. Hmmmmmm.

I had a unique problem with my mask. It would be silly to assume the Activa OR the Swift could work for every person. Some might prefer another. And it's logical to assume the same about the machines themselves. I keep hearing absolute statements by a few and absolutes are always wrong. Nothing is always anything.

DME_Guy wrote:All very true. Some other things that I would add:

1. All the major manufactures charge DMEs more for masks if they don't buy a certain number of machines from them, somtimes as much as double. Resmed makes the best masks overall and they know it. It's the demand for their masks that drives the demand for their machines. As Mike said, the mask is usually the most important aspect of successful therapy.

2. I have no idea why you guys are so upset with DMEs over this. Resmed is not a DME! Resmed's main concern is insurance companies will lower reimbursment and they will have to charge DMEs less for their machines.

3. As Mike said, Internet sales are a small percentage of Resmed's sales. Even if they lost all of their Internet business, it will hurt them a little, but not as much if insurance companies lower reimbursment rates.

4. Hopefully you guys are seeing what the DMEs have been dealing with. Resmed is charging about $30 more for a Swift than the Ultra Mirage. Looking at the two, the Swift has to cost much less to manufacture. You guys are all saying you just won't buy Resmed products and I think that's great. If DMEs say they just won't provide Resmed products because they charge too much, you'll say the DMEs are evil and greedy. Why are DMEs greedy for not wanting to overpay but you as the consumers aren't?

What a mess our health care system is in!

I'm starting to think that health insurance should only be for hospital or long-term care. If we all paid for out health care directly, instead of through an insurance company that keeps most of your money for themselves, costs would come down across the board. Keep Medicare for the elderly and disabled, and Medicaid for those financially struggling and let the market determine pricing for everyone else.

mikemoran wrote:Rastaman,

People on here actually get to make decisions and choices about the machine they end up with. Whether they buy them on their own or go to batle with Doctors and DMEs. The difference is they are informed and realize they can take control of their therapy. We are the exception, not the rule. The majority just blindly follow their doctors and insuarance companies because they don't know they have choices.

It is also the reason so many don't stay compliant. They fight with poorly fitted masks, machines that were titratred in the worst of circumstances ( the sleep lab) and finally after a few weeks of no support from anyone say the hell with it. This is the biggest crime of all.

So while it looks like Respironics is the favorite from on here it isn't the favorite of the DMEs or doctors. Resmed has marketed them very well and as long as they are the primary providers of equipment we really don't hurt them by voting with our dollars. The other thing to keep in mind is the CPAP is usually a one time investment but masks must be bought over and over. Resmed still makes the most popular masks so don't expect them out of the marketplace anytime soon.

My take is they finally figured out that there is less and less distinction between everyones blowers but people are dependent on their favorite masks. With a higher number of people buying replacement masks on the internet they see the opportunity to increase margins for the one device people will pay anything for if it is the thing that works for them. It is pure greed.

CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, resmed, mirage, medicare, swift, CPAP, DME

I'm not upset with my DME in anyway. I might have a preference or two but that's not saying I had a negative experience at all. In my opinion they tried CPAP which works for most people. Then we went to APAP because "I" requested it. Whether or not I really need an APAP or not remains to be seen but I do like both machines I've used. I can speak from experience with both of them. Maybe someday I'll try other models or other brands and then I'll have even more experience to share with others.

Yeah, I'm not jumping on the brand bandwagon. I see absolutely no reason not to speak up about a good experience with a certain product and what worked best for YOU. But a few make so many assumptions about C-flex and have such a limited point of view on the subject that it's silly.

And if you'll notice there are a few people here who are just waiting to argue with you, not in a good way either. Not a debate. Some prefer guest rather than to identify themselves. Seems kind've chicken to me. It's not like I've attacked anyone or even said anything about any one person specifically. But I'm quick to point out that absolutes are absolutely stupid.

Truthfully, the end users are very helpful most of the time. And the DME's here are also very helpful. It must be tough to have them demonized all the time. But then again, you're one of the good ones right ?

You guys have been fortunate in that you have doctors and DMEs that atleast have the opportunity to listen to you and try to accomodate your needs. My experience has been quite different because I am with Kaiser in the Washington DC area. My DME's hands were tied. From an insurance provision base they can only provide a straight CPAP with passover humidifier and one mask. Kaiser will not allow them to do any more than that. So Resmed has them locked up for machines and they keep a store room full of S8s.

However, they were more than willing to give me any prescription I wanted as long as I was buying it on my own. When I told my RT the price of things on the internet, she said her prices would be double that and I should buy it online. This told me she was more interested in my therapy than selling a machine. Because of the volume Kaiser sends through her, she probably doesn't need to push any additional machines. Clearly it wasn't a case of her carrying a stock of different machines like other DMEs, she would have special ordered it for me if I wanted it.

Different circumstances, but you know a hell of alot of people go through the HMO system. Many would rather give up the therapy than put more money out of pocket to achieve better therapy. In my case I could afford to do what I needed to live with a CPAP.

There are as many business models out there as there are masks. Resmed is reactiing to their primary customers the storefront DMEs who fear two things. Lower Insurance re-imbursements if Internet sales take off, and the erosion of I am sure higher profit sales in add on equipment. While we react to their announcement, the DMEs are applauding them for fighting the battle they want fought. They can point to their actions and say who is looking out for you, Resmed or Res[ironics? what they lose fromt he patients they more than gain from the DMEs. Sad but true.

The way the market works is truly amazing. As many have stated, the market is not entirely free, however, in my lifetime I have seen that it is free enough to allow amazing things to occur.

I agree with those who believe that ResMed is shooting itself in the foot. What I suspect will happen is something like the following:
- ResMed's profits will go up in the short term
- Evil DME's will prefer ResMed causing a spike in market share
- ResMed's execs will congratulate each other
- ResMed will get fat and lazy
- ResMed will surprise investors with slump in sales
- ResMed will quickly become a bit player in the CPAP market

I'm guessing maybe three years max for this all to play out. ResMed does not really seem to have the lock on the marketplace that monopolies need to pull this sort of thing off long-term. As with their EPR (marketing gimmick), I believe this current move is very short-sighted. It appears that ResMed is not capable of long-term thinking, and that makes them very vulnerable to any competitors who are thinking long-term.

Southwest Airlines and Linux come to mind as examples where long-term thinking has consistently chopped away at short-term monopolistic practices. Southwest profits and customer loyalty are now the envy of the industry.

The "law of unintended consequences" is very much in play here. It is extremely rare for a business to succeed by raising prices arbitrarily. Although successful examples of it are legend, successful use of this tactic is extremely rare. The usual result, like road-kill, is unintended suicide.

Regards,
Bill

DME_Guy wrote:What do you think the profit margin is for DMEs?

Rastaman wrote:
I can't believe the DME is charging the insurance company so much more for these machines. People need to contact their insurance companies and tell them and that way the DME doesn't make quite as much money. I want them to make a profit, just not crazy profit. And I'd like more choices in general. I can't imagine for 5 seconds why they don't have all brands and units available just like a local convenience store stocks several brands of soda or chips.

[quote="RedThunder94"][quote="Rastaman"]No I'm not. You're trying to put words into my mouth. And I'm not buying it. Sorry.

I'm saying why not have a complete line of products because different things work for different people. No amount of saying the opposite will change that. More than 1 person here has said they've tried C-flex and don't really need it. Yes, they can turn it off. But yet others have tried all three brands and prefer the PB.

Why assume that just because your doctor picks Respironics that it's got to be the best on the market and that surely it's superior to all the competition? I'm sure that any doctor knows alot of things. But they couldn't tell me that I would have one pressure with a Swift and yet another with an Activa. I had to find that out for myself. And the 9 seems much higher than the 15 to 17 I was experiencing before. And yet I slept like a baby. Even so. Hmmmmmm.

I had a unique problem with my mask. It would be silly to assume the Activa OR the Swift could work for every person. Some might prefer another. And it's logical to assume the same about the machines themselves. I keep hearing absolute statements by a few and absolutes are always wrong. Nothing is always anything.