Dr. Barbara Phillips and whether CPAP should require a prescription

Dog Slobber wrote: ↑

Mon Jan 14, 2019 1:38 pm

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.

There is at least one medication that my insurance will cover (100% even) that is also available over the counter. The insurance company considers it worth it to get people to use it. It would be great if cpap machines could be both, OTC, and prescription. So, either way would be available.

Thanks for the info re the insurance companies in the US, Pugsy and PR. I've only ever had Canadian style health care and must admit that I fear that if XPAPs were OTC our provincial program might be affected which is currently rather generous at least with the machine portion.

If these were ever to be OTC how these machines would be advertised would be quite a challenge.

Would there be advertisements of folks who are exhausted and falling asleep during the day, who then try XPAP and feel wonderful and refreshed in a week? This is such an inaccurate portrayal that it makes me want to laugh. I can see a problem. How to tell folks that this takes lots of persistence and patience. It is not an overnight miracle. It isn't a spray or capsule that gives you immediate results (for most of us). Or as Pugsy says would paying for it oneself be an additional motivator to persist?

Anyway, it is great to see someone like Dr Phillips thinking about this and considering it as a possibility, and I personally would love to see XPAP available OTC but not sure if the public will take to it like we hope. Of course I could be wrong and XPAPs could be the new "big thing" with all the cool folks using it.

Arlene1963 wrote: ↑

Tue Jan 15, 2019 6:16 am

Would there be advertisements of folks who are exhausted and falling asleep during the day, who then try XPAP and feel wonderful and refreshed in a week? This is such an inaccurate portrayal that it makes me want to laugh. I can see a problem. How to tell folks that this takes lots of persistence and patience. It is not an overnight miracle. It isn't a spray or capsule that gives you immediate results (for most of us).

Well, it seems to work for SoClean! As much as I fought the whole process at the start, mainly due to how the whole process was handled by the DME and Sleep Study stuff, I KNEW after my first night I would have to learn to use it all the time. Didn't want to admit it to anyone for a few days, but I felt better after one night than I had in years!

I assume my Doctor gave the DME a prescription. Never seen it.

Aside from the initial setup with ResMed Airsense 10 Auto set and full face mask ( wrote them a check for over $1200 for those two items as my insurance deductible is high ), I have bought both machines and masks without a prescription.

I have seen brand new ResMed 10 Autosets for under $550. I have yet to pay over $80 for a new mask delivered. Then there is the used market. I doubt that eliminating the RX will have an effect on pricing right away. But it will change. I have NO doubt ResMed and Phillips will set price limits ( price fixing at its finest ). So those that are getting "retail" price for equipment will start having to lower prices or they will go out of business. DME's would be negatively effected. Soon after there will be a Chinese made machine for half of the others.............

Perhaps the flu-shot model for coverage without Rx applies?

Except that the coverage for the CPAP machine would be paid every five years instead of every year for this harmless but important life-saving treatment for what is already a runaway public-safety-related epidemic.

Just a thought.

Pugsy wrote: ↑

Mon Jan 14, 2019 3:18 pm

Anyone see any drop in prices at the grocery store when the trucking industry got deregulated???

https://www.npr.org/sections/thesalt/20 ... han-you-do

Nice little graph CG...does it relate to trucking industry deregulation which was my original question?
Or just people's spending habits in general?

I haven't seen prices go down...but I have cut back on my spending when I can because I need the money to pay for increases in utilities or my cell phone or my dish tv or my internet service. Gotta get my priorities right.
Pretty sad when a pound of hamburger costs more now than I used to pay for a really good steak.

Pugsy wrote: ↑

Tue Jan 15, 2019 9:15 am

I haven't seen prices go down

Between 1981 and 2018, the price of raw ground beef increased 2.6% average per year. The overall inflation rate was 2.8% during this same period. ( http://www.in2013dollars.com/Uncooked-g ... ation/1981 ) So, the price of ground beef actually fell. It's our currency that is being debased.

Don't forget about the Federal Reserve. They work tirelessly to reduce the value of a dollar. The Fed has debased our currency to where what would cost $100 in 1970 now costs $664.64. ( https://data.bls.gov/cgi-bin/cpicalc.pl ... ar2=201812 )

This is not the fault of anyone in the supply chain of food.

The citizens are victims of the Fed. People with low incomes are hurt the most. End the Fed.

ChicagoGranny wrote: ↑

Tue Jan 15, 2019 9:39 am

End the Fed.

Feds just called. You have approximately 10 minutes before the black helicopters arrive.

Why in the hell did I go an open that can of worms?
I don't feel like arguing the point...

The price of hamburger is still higher now than the price of steak not even all that long ago...no matter what the dollar value is or who is to blame.
I still pay more for stuff at the grocery store and have less to spend on what I want instead of necessarily "need".
And still has nothing to do with my original comment which was about the deregulation of the trucking industry which was supposed to reduce the overall end costs of goods at the consumer level...and I sure as hell never saw it and truckers sure as hell didn't bring more money home...but someone somewhere pocketed some extra dollars.

Pugsy wrote: ↑

Tue Jan 15, 2019 10:18 am

Why in the hell did I go an open that can of worms?

Oddly enough, the price of canned worms has almost tripled during that same time frame.

jnk... wrote: ↑

Tue Jan 15, 2019 10:33 am

Oddly enough, the price of canned worms has almost tripled during that same time frame.

I noticed that the last time I bought night crawlers to go fishing with....more money...and less worms...and skinny ass little buggers at that...quality went in the toilet.

Pugsy wrote: ↑

Tue Jan 15, 2019 10:18 am

And still has nothing to do with my original comment which was about the deregulation of the trucking industry which was supposed to reduce the overall end costs of goods at the consumer level...and I sure as hell never saw it and truckers sure as hell didn't bring more money home...but someone somewhere pocketed some extra dollars.

Deregulation did reduce costs and did a lot more positive things. Unfortunately, de-unionization meant that truckers' income did not keep pace with the debasement of the currency by the Fed. (But, this seems to be changing because of the shortage of truck drivers.)

the impact of deregulation on the trucking industry was significant:

- The number of trucking companies increased dramatically. Existing carriers expanded into new services with new routes, and new smaller carriers entered the business. The number of interstate motor carriers increased from 18,000 in 1975 to over 500,000 in 2000.

- The industry restructured itself. Truckload (TL) carriers, no longer restricted to set routes and commodities, merged and consolidated to provide national coverage. Less-than-truckload carriers (LTL), under attack from TL carriers intent on carving off large-lot shipments, shrank and streamlined their operations. And the use of private carriers (i.e., company-owned or "in-house" trucking fleets) declined as companies chose to take advantage of the lower rates and improved services offered by newly competitive for-hire carriers.[15]

- Lower trucking prices benefited the U.S. economy as a whole. Prior to deregulation, trucking expenditures were 5.7 percent of GDP, while in 1997 they were less than 5.0 percent. This is the equivalent of $60 billion saved in national income.[16]

- Trucking's share of the freight market expanded. Today, the trucking industry has 80 percent of the U.S. freight transportation market by revenue although the railroads still carry the largest share by tonnage.

https://web.archive.org/web/20090414142 ... hm8_v4.htm

One other thing about OTC CPAP machines--most people have run of the mill OSA that will respond to treatment with a CPAP/APAP. It's not that hard to self-diagnose and treat. But SOME people have more complex sleep apnea, and without proper diagnosis and testing will not be properly treated. They may think their do it yourself treatment is sufficient, or they may give up because it doesn't work. There is something to be said for a proper medical assessment and prescribed treatment.

....and here I am, just a dumb cop, wondering why there is a discussion about beef going on in a CPAP forum.

Speaking of which, I need to go watch the old Wendy's "Where's the beef" commercials on YT.

Pugsy wrote: ↑

Tue Jan 15, 2019 10:18 am

Why in the hell did I go an open that can of worms?

You're off your game lately, first the nose thing, and now this... *hugs*