New Resmed Move Makes Buying Even Harder

Snoredog · Post by **Snoredog** » Tue Oct 17, 2006 12:37 pm

does the FDA approve masks?
does it approve Headgear?
does it approve hoses, cushions etc.?

I wonder why I can run down to my local hardware store and buy the best AO Safety Respirator for $49 bucks and they never ask for a script. I even get a charcoal canister filters with it.

We know FDA approves machines, I've seen the approval letters.

But don't forget requiring a prescription from you for each and every item ensures their legal right to steal from you.

I buy my stuff from cpap.com, they have my script on file, every once in a while they ask to see it again so I send it when requested. But if the FDA police comes by for an audit and says you sold this customer a mask, headgear and 8 machines they have the script in my file. That is all that is needed by the law.

This is why you should:

1. Always obtain a copy of your PSG (substantiates the diagnosis).
2. Always retain the prescription orginal (send DME the copy).

When I asked for the above from my doc, they gave me the PSG copy, but was reluctant to give me the script. "Oh we fax it straight over to the DME for you..." maybe you didn't hear me, I WANT the original, you want to fax it someplace make a copy and you keep the copy, I want the original. She handed it over.

Guest · Post by **Guest** » Tue Oct 17, 2006 4:38 pm

Resmed's attempt to destroy cpap internet retailing is in full swing. What's funny is they claim they're doing this because they're concerned about patients being compliant and sticking with therapy. But, the compliance rate among patients of brick and mortar DMEs is abysmal. By comparison, what do you suppose the compliance rate is among patients who use cpap.com and read cpaptalk? My guess is it is significantly higher. I wish there was some way to prove that. Of course, even if we proved it, Resmed would still continue their efforts to eliminate internet retailing. They'd just have to come up with a better story for their reasoning behind it.

Guest · Post by **Guest** » Tue Oct 17, 2006 5:26 pm

I'm not sure Resmed will be successful. The precedent has already been set for obtaining prescription-required items via the internet for a lot less money than brick and mortar sources.

Take insulin, for example. You used to have to buy it from your pharmacy. Let's say a vial of 10ml is available through your pharmacy for $100.00, but you can get it via the internet for $22.00. Let's say XYZ Company gets a lot of complaints from their traditional clients, the pharmacies: "Hey! XYZ company! We're your best clients and we're losing customers to the internet retailers! Do something!" So XYZ Company decides to increase the amount the internet retailer must charge for their insulin in order to keep the price in line with what the pharmacies charge. The pharmacies are now happy, but the end-users are not. The end-user wants to buy the best-priced insulin, so he'll switch from XYZ Company's product to ABC Company's product and will continue to buy his insulin via the internet because it is substantially less expensive.

Ultimately, isn't this what will happen to Resmed? For the moment, they are trying to control the market, but how long can it last?

Wulfman · Post by **Wulfman** » Tue Oct 17, 2006 5:48 pm

Didn't the big drug companies do that with the Internet sales of prescription drugs from Canada?
Only it seems to me like they twisted the arms of the lawmakers to get that accomplished.

If somebody knows that story, please update me. I don't need any "drugs", but was just curious after reading the example in the previous post.

Den

Guest · Post by **Guest** » Tue Oct 17, 2006 6:27 pm

The U.S. internet prices are cheaper than the U.S. pharmacy prices. The Canadian internet prices are even cheaper than the U.S. internet prices. Prescription drugs mailed from Canada went untouched for years. Then, 11 months ago, the big drug companies convinced the current administration to start seizing prescription drugs imported through the mail from Canada.

With mounting pressure from Congress, this practice stopped one week ago on October 9th, 2006. Hooray!

The big drug companies are furious. They aren't used to their power being usurped. It's a good sign. If the large pharmaceuticals can't force inflated prices, then a peon (by comparison) like Resmed doesn't stand a chance of succeeding in doing it either.

US TO STOP SEIZING
CANADIAN MEDICINE

BY JOHN CARREYROU, Wall St. Journal
OCTOBER 4, 2006

Under pressure from Congress, U.S. Customs and Border Protection officials scrapped their 11-month-old policy of seizing prescription drugs imported through the mail from Canada.

The practice, implemented last November, had come under fire from lawmakers for depriving tens of thousands of American seniors of their drugs and protecting the high prices charged by U.S. pharmaceutical companies.

Lynn Hollinger, a Customs spokeswoman, said the seizures would stop Oct. 9 but declined to explain the policy reversal. "We're going back to operating procedures prior to November 2005," she said.

Although most prescription-drug importations are illegal under U.S. law, Customs had long turned a blind eye to small mail orders coming across the border from Canada, before launching the new policy of seizures late last year.

Prescription drugs are significantly cheaper in Canada because its national health-care system negotiates lower prices for its citizens. The U.S., by contrast, is one of the only markets in the world where the government doesn't exercise control over drug prices.

As a result, pharmaceutical companies earn the bulk of their profits in the U.S. market. Imports from Canada, which have surged in the past six years with the rise of online pharmacies, have been a sore point with drug makers. The Pharmaceutical Research and Manufacturers of America has argued that drugs imported from Canada are unsafe because they haven't been vetted by the Food and Drug Administration.

Upon learning that Customs would stop the seizures, Ken Johnson, senior vice president of the industry trade group, said he was disappointed with the policy reversal. "We're adamantly opposed to any importation schemes. Fake drugs are a very serious problem that is real and growing."

As of mid-July, Customs had seized more than 37,000 prescription-drug packages from Canada. The agency declined to say how many more packages its agents have seized since then.

Congressional pressure had been building against the seizures. At the behest of Sen. Bill Nelson, a Florida Democrat, the Senate Committee on Homeland Security and Government Affairs was investigating the new Customs policy.

"This is a huge victory," Mr. Nelson said. "For nearly a year, the White House has been punishing seniors for filling their prescriptions at lower Canadian prices. Now it looks like the government is getting out of the business of harassing these consumers."

Last week, Congress sent President Bush a Homeland Security appropriations bill that includes an amendment barring Customs agents from preventing persons from re-entering the U.S. from Canada with a 90-day supply of medicine. The amendment excluded packages sent by mail, but it represented a significant breach in the tight alliance between Republicans and the drug industry, which remains a major source of financial support for House and Senate campaigns.

Dan McLaughlin, a spokesman for Mr. Nelson, said the senator believes the seizures were politically motivated to bolster enrollments in Medicare Part D, the new drug benefit for seniors that took effect last January, and wants the Senate investigation to be completed.

Copyright © 2006 THE WALL ST. JOURNAL

You know what's funny? The big drug companies claim they want to prohibit the import of those drugs from Canada because they are concerned about the patients' health and not because of the money they're losing. Sound familiar?

Severeena · Post by **Severeena** » Tue Oct 17, 2006 6:43 pm

The irony of this with the drug companies is, they sell the same drugs to Canada that they sell here in the US. Now figure that one out.

Maybe we can buy ResMed products from Canada cheaper.

Wulfman · Post by **Wulfman** » Tue Oct 17, 2006 6:46 pm

AH HA!!!
THANK-YOU very much for the update!

Yes, it DOES sound familiar.
When that story was big in the news sometime back, what sounded weird to me was that the companies were SO concerned about the quality of the drugs. I kind of figured it was the companies' OWN drugs that were going north and then coming back across the border at cheaper prices.

Den

Guest · Post by **Guest** » Wed Oct 18, 2006 6:38 am

[quote="Severeena"]The irony of this with the drug companies is, they sell the same drugs to Canada that they sell here in the US. Now figure that one out.

Maybe we can buy ResMed products from Canada cheaper.

_Sorry, but resmed products are not cheap in Canada. However goverment insurance limits price of manchines if bought through gov programs_______________

[

ThunderSnorem · Post by **ThunderSnorem** » Wed Oct 18, 2006 2:54 pm

Snoredog wrote:does the FDA approve masks?
does it approve Headgear?
does it approve hoses, cushions etc.?

Yes, the FDA approves masks. Well . . . sort of.

See example: http://www.fda.gov/cdrh/pdf3/k030515.pdf

Guest · Post by **Guest** » Fri Dec 15, 2006 6:41 pm

I truly enjoy going to Tijuana and simply walking in a Pharmacy to buy a drug (in this case eye drops) without a prescription for 1/4th the price I would pay at Costco. Same drug, made in the same place (Virginia, USA). The American people are, on occasion, suckers and due to laziness, I think, like to believe the loads of BS shoveled out by the powers that be. Sure, I could get a counterfeit or a mistake, but I've gotten those in the USA, and choosing a reputable source and paying personal attention are the key points in anything.

I have an Autospirit S7 (which I like), and am really glad to see this thread. I was just going to get a new S8 and move the S7 to backup status (despite their need for perfect power), but these kind of marketing ripoff policies from Resmed disgust me. I have had nothing but misery, delays, wrong information, indifference, and dangerous and very expensive screw-ups from DMEs like Apria, etc, and want nothing to do with them.

My CPAP brand will be different. Too bad Resmed, good luck to your marketing plan. You will need it.

GoofyUT · Post by **GoofyUT** » Fri Dec 15, 2006 6:49 pm

[quote="Anonymous"]In their infinite wisdom, Resmed has decided to fight the most powerful tide in human history. The Internet is giving people more and better information so that they can more easily make the best buying decisions.

By trying to perpetuate monopolistic practices, Resmed will alienate their customer base......not immediately....but over time. The herd of buyers will simply gravitate toward those vendors who understand the power of a market that allows choice....and lower prices.

They (Resmed) will hang themselves....and ultimately lose the company....because buyers will abandon them. This process won't require any government intervention (it's already too busy helping the doctors perpetuate their monopoly on health care). "Time" will take care of the matter. People will see that Resmed no longer offers good value.

blarg · Post by **blarg** » Fri Dec 15, 2006 9:02 pm

I think given the usual uninformed state of the market, as long as ResMed keeps good relations with their DMEs, they'll do just fine. In fact this move probably strengthens that relationship. Sure, we're pissed, but we're a small chunk of the market. Time will tell, but it may very well be a good BUSINESS decision on their part. I certainly don't think it's a good decision for winning hearts and minds, or even a way to run a health based business.

sthnreb · Post by **sthnreb** » Fri Dec 15, 2006 9:18 pm

I'm sure they will lose 95% of the Internet purchasers that buy out of pocket with no insurance, like me. Now, as to what that percentage is related to DME's and total purchases I have no idea. I would think the Internet has/had a bigger market than some may think. Doctors, sleep labs, medicare, DME's and those type places will continue to use Resmed to suck up the inflated profits. I don't know why anyone would pay over twice as much for a machine when they don't have to. With a computer I call it a ID-Ten-Tee error. (id10t)

billbolton · Post by **billbolton** » Fri Dec 15, 2006 10:39 pm

sthnreb wrote:Now, as to what that percentage is related to DME's and total purchases I have no idea.

Last week I attended an IEEE Engineering in Medicine and Biology Society (http://www.embs.org/) meeting hosted by Resmed at their Bella Vista campus here in Sydney. During the presentation part of the meeting one of their senior operations managers said that their North American business is overwhelmingly with distributors (they didn't use the term DME as the audience as a whole would not have any recognition of it), of which there are approximately 3000, and of those 3000, the vast bulk of their business goes through just 6 distributors.

There was also a comment made about the nature of their North American business being very strongly driven by the structure of the Healthcare delivery system in North America.

The overall growth numbers in the sleep disorder treatment market they showed (sourced from external metrics) are amazing and its clear that all the suppliers are having trouble just keeping up with demand. During the plant walk through there was a lot of discussion about the sort of flexibility they have had to build into their production engineering in order to make the production processes continuously scalable, just to keep up with growth in demand.

Basically, the Internet sales area is a tiny fraction of the market for both Respironics and Resmed (who between them hold 80% of the North American maket, with that share split about 50/50), so like it or not, neither is going to be much impacted by what happens regarding sales volumes through the Internet...... unless there is a massive structural change in US Healthcare delivery.

By the way, Resmed and Respironics co-operate in jointly funding advertising to increase awareness of sleep disorders.

Cheers,

Bill

yardbird · Post by **yardbird** » Sat Dec 16, 2006 6:46 am

Anonymous wrote:Brick and Mortar DME companies have always been required to obtain a prescription for masks and headgear and any other supplies.

I beg to differ. I just bought a mask, headgear, and filters from a brick and mortar DME and was not required to have a prescription. I did have one local DME tell me they wanted a prescription AND a copy of my sleep study just to buy replacement pillows. I basically told them they could kiss my butt. I called my insurance company to find out what items required a prescription. They told me "only the machine itself requires a prescription".

New Resmed Move Makes Buying Even Harder

resmed in Canada

5 bux

Machine

Additional Comments: Resmed AirCurve 10 VAuto BiLevel with HumidAir

Machine	Mask

Additional Comments: Airmini, Medistrom Pilot 24, CMS 60C Pulse Oximeter, ResScan 6