Manufacturer Pricing Policies

My opinion:

-What Resmed is doing is simple price-fixing (or gouging which ever way you want to look at it).

-We pay thru-the-nose for anything having the FDA's blessing attached to it, get your product approved you now have a legal license to steal from consumers.

-We pay thru-the-nose as a result of Medicare. Some dickhead in Washington decided that if you were going to sell anything to Medicare that by doing so you will never sell it to anyone else cheaper. All that did was screw every other American that didn't use Medicare.

-We see cpap.com get beat up all the time by the likes of that POS Resmed for selling their product at what they feel are reasonable prices. If you have Medicare, you won't use them for purchasing your equipment. If you have insurance you won't use them for insurance purchases. If you are buying out of your own pocket with half a brain you'll use them to save money.

-Resmed Preferred Internet Provider ...jacked up the price you pay by >40% under the guise to give Resmed customers better service....what a bunch of horse sh*t, nothing could be further from the truth, there are more Resmed complainers that visit here with problems than any other brand. It may not seem to be working right because it most likely don't have the stinking feature to begin with. If it was working so great why is it there are so many showing up here asking why their AHI is so high. Why don't we see a mix of F&P's, 420e's and others with problems? The Remstar users that show up usually have a machine with basic settings or some dysfunctional DME setup their machine just as it came from the factory, gave them a mask and sent them on their way.

But the bottom line is:

- We pay thru-the-nose for this equipment as a result of Medicare policies
- We pay thru-the-nose for this equipment due to Insurance company good-ole-boy network polices.

-As patients & consumers, we should be legally able to shop around for services and equipment where WE choose to do so and with which vendors we elect to do business with and not have that dictated to us by doctors and insurance coverage.

-competition is what holds prices down.

NiceDMEDude wrote:.....
The posts last week by "Guest" (under the ResMed Preferred Internet Provider thread) were so obviously coming from a person with a financial interest in MAP as to be laughable. ...

I went back and read the Guest's posts and entirely disagree with you assumption that he has to have a financial interest in MAP.

I have been against MAP since the early 1970s when I was involved as a consumer in a famous case about Schwinn Bicycles trying to enforce MAP at Schwinn Dealers. I believe, in general MAP, is a bad policy for manufacturers' long term sales growth and financial health.

However, I agree entirely with Guest's posts that manufacturers have the right to use MAP as long as they abide by laws dealing with MAP (which the Supreme Court recently made quite confusing). Guest may be a free marketer, like me, who believes businesses should be able to take whatever actions they want to (legal and ethical ones, that is). We also believe consumers should be able to act freely in the market and have the right to let businesses using MAP run themselves straight into the bankruptcy due to lack of customers!

On another point regarding Guest, I stand by my policy of discounting by 99% anything a "guest" posts here.

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CPAPopedia Keywords Contained In This Post (Click For Definition): resmed

I too have stocked up and I too have no need for the service even if it was half decent. Learning how to use this equipment was not that hard for me (though I realize it can be for some) but I will admit that this forum is probably what made the difference for me. So IMO, I think the missing piece of the CPAP puzzle is the EDUCATION ... not the service.

Online vendors have an edge for providing education if they so desire. B&M DME's simply cannot provide the education without making the treatment unaffordable.

FreeLancer74 wrote:Is it called "collusion" when two manufacturers get together to set pricing? Didn't some computer memory companies get sued in a class action lawsuit over this in the past couple of years?

And Guest, I see the point you are trying to make, but after reading several DME posts on this forum, here is my example:

Gas stations used to charge more for full service gas because they would come out, pump your gas, clean your windshield, check your fluids, and check your tire pressure. You paid and left without having to get out of your car.

NOW, you pay the higher price but only get the gas pumped for you and maybe your windshield cleaned. NOTHING like the service you USED to get, but you still have to pay the same (adjusted) higher price.

More money, less service. That is the problem. Everyone wants the quick buck but doesn't want to work for it. We are not asking for anything free, just reasonable or if we pay more, give us better service so we don't go down the street. It sounds to me like the DMEs are selling xPAP equipment as an afterthought to bring up their bottom line, but are not properly prepared or educated on it and the patients (customer) requirements for it.

Yep! ... I have noticed that trend over the last 30+ years too.

FreeLancer74 wrote:Is it called "collusion" when two manufacturers get together to set pricing?

Price fixing...an anti-trust violation.

Greetings CPAPtalkers,

Does anyone else find it interesting that CPAPtalk is the only medium in which DMEs, Guest Manufacturer, and CPAP users have gathered to discuss and debate this very difficult and controversial issue?

Lets look at why this is.

#1. CPAPtalk is free, which is important because anyone can say nearly anything.

#2. CPAPtalk is open, which means that the ideas you do put forward are exposed to the light of day.

#3 CPAPtalk is active, which means that through the process of many people putting ideas in and having them exposed to the light of day, the truth emerges.

If this works for a debate on MAP, doesn't it follow that it would work great for new CPAP users having trouble using their equipment?

We find it does. Great customer service doesn't have to be traditional customer service. The test is if it helps people. I think the one-two punch of CPAPtalk.com and CPAP.com pass the test with flying colors. A lot of people on the board would agree.

Guest Manufacturer, you and your ideas are welcome on this board and I encourage you to keep hanging around, learning and exchanging beliefs and war stories. These are real people and many of the things you here are authentic experiences of those who have walked the walk.

Many come here in need of help and have an experience where they learn they can make CPAP work. I'm hoping you may have an experience where you come to believe from what you see here that the internet can provide real, effective service for CPAP patients.

On the other side, this is an open place, so if you've got the logic to lay me low, you've got the forum and visibility to do so and I'd be glad to debate it in public.

Johnny

CPAP_Guy wrote:If you want to shoot someone, shoot the postmaster, in this case Resmed.

The postmaster in this case is the overall US healthcare delivery approach, not the vendors.

Cheers,

Bill

Amen, BillBolton, Amen.

FreeLancer wrote:Gas stations used to charge more for full service gas because they would come out, pump your gas, clean your windshield, check your fluids, and check your tire pressure. You paid and left without having to get out of your car.

NOW, you pay the higher price but only get the gas pumped for you and maybe your windshield cleaned. NOTHING like the service you USED to get, but you still have to pay the same (adjusted) higher price.

Hey, FreeLancer!!! Finding a gas station in Michigan that still pumps your gas for you is like pulling hen's teeth!!!!

If any new readers want to catch up, here's a link to discussion threads beginning last year, when resmed led the charge to try to force online cpap vendors to fall in line with "minimum required pricing":

LINKS to discussions about resmed's internet sales policy
viewtopic.php?p=98895

Snoredog wrote:My opinion:

-What Resmed is doing is simple price-fixing (or gouging which ever way you want to look at it).

........

The Pittsburgh Post-Gazette wrote one of the better news stories about the 2007 Supreme Court decision. It was a stupid decision in that it left every case "to be decided on its own merits". Here we will go into court again, time after time, at taxpayers' expense, for the government to make more arbitrary decisions. Sheet! ----------------------->

Supreme Court rules minimum pricing lawful again
5-4 decision lifts decades-old bar, making it harder to discount goods
http://www.post-gazette.com/pg/07180/798061-28.stm

This quote is from a forum about comic books and minimum pricing. DCBS is an internet supplier of comic books:

I wonder sometimes how my comic habits would be different if I had a good local shop. The shops in my area have absolutely horrible customer service, while DCBS has had very wonderful service for me.

Sound familiar to members here?

Wow, lots of strong feelings on this subject, as expected.

Jupmalis, I think you hit the proverbial nail. The manufacturers are truly at a loss as to how to appease the DME companies without alienating the internet companies, while at the same time not running afoul of laws against certain types of pricing policies. They also know who runs each and every website selling their products, and this is typically a (gasp!) B&M DME. Usually a very strong local or regional DME, but as far as I know none of the nationals have an online ecommerce presence.

Rested gal, to be honest, I did not know of your pet peeve, but am glad I did not get off on the wrong foot with probably the most well-thought-of member on this forum!

I agree with you and wulfman and others who want the best technology at the best possible price. You and I feel that manufacturers should make the equipment, support it for warranty issues, etc., but leave the end-user pricing to the free market. The manufacturer's take on it is that they need to have control of their product pipeline, and the internet has thrown a wrench into the way things have been done for years.

The most irritating facet (for me at least) is how disingenuous they are about their reasons for wanting a minimum price on their products. If they would simply say "LinCare, Apria, and American Home Patient hate the internet, and we have to bow to their wishes", it would be more palatable (but still wimpy, haha!).

Freelancer74 and Suz-E-Q make a point I see repeated over and over on these boards, if local DMEs gave decent service they would not be losing nearly as much business to the internet retailers. But the online buyer of CPAP equipment is still a small percentage (I usually hear between 5-7% from the mfrs); the fracas is mostly due to reimbursement cuts from insurance companies because of low internet prices.

Until insurance companies recognize the service component (I know, I know---what service component?) provided by DMEs, reimbursement will continue to decrease.

Wahooker, I see what you mean about a "no-name" manufacturer. I guess it would take a while to establish yourself; but like RG said about PB, a few tweeks and they have virtually the entire spectrum of xPAP covered. An Auto-bilevel would be nice. I truly believe that as the smaller companies like AeioMed get a large influx of capital from increased online sales that they will launch a wider variety of devices.

Guest, once again (if you are the same guest as before) you use an extremely poor analogy. Vacuum cleaners do not usually provide treatment for a disease state. Also, and you know this very well, the manufacturers rely on you and me (assuming you are a DME) to distribute their devices and be their local PR people. Or perhaps you work for a manufacturer, it would be nice if we at least know your occupation. Your agenda, though, is crystal clear.

Snoredog, you are right on with some points. However, Medicare does not mandate that no one else gets products cheaper than do they. In fact, most insurance companies pay at a rate of 70-80% of MC allowables. For most DMEs, Medicare is the BEST payor source of all!

Rooster, you may very well be right about "guests" financial interest in MAPs. I also feel, like you, that the manufacturers absolutely have the right to set policies for distribution of their products, within legal and ethical limits. But, jeez, let the free market decide. I am constantly getting better and better prices from ALL of the manufacturers, because they are in fierce competition with each other. I mean, some of the deals I get are silly! But if I attempt to lower my online price, I get a phone call from a midlevel person at the manufacturer telling me they are getting too many complaints, would I kindly bump up my price a few bucks? This is not a free market tactic.

To further their cause, a certain manufacturer was recently paying a bonus to their sales reps to get the DME companies, and especially their clinical people, to write letters to Respironics and F&P in support of MAPs. Apparently, it worked.

OK, I have children to bathe! Take care all, thanks for the input.

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

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CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, medicare, CPAP, DME, AEIOmed, auto

Rooster, again you are on top of this.

Minimum prices are now much less likely to create a big legal mess due to the recent ruling. But ResMed implemented theirs prior to that ruling; there are "vertical", "horizontal" "Colgate", and several other types of minimum pricing, some of which have always been legal and some that still are not.

But these are large, publicly-traded companies. They know what they can and cannot get away with on MAPs, and will not do anything to open themselves up to a suit.

NiceDMEDude wrote:Rested gal, to be honest, I did not know of your pet peeve

Ah, all the better!

All the better that your polite "or customer if preferred" was a pristine thought, completely untainted by my rebellious little attitude.

<--- (Mentally adding another "good'un" to the list of good DMEs.)

I am a newbie... but thanks to this site I was an educated customer.
I am in Canada ( Ont.) I finally got my machine today.
Because of what I read here I asked for a Res.auto with A-flex
appartently it had to be ordered from the US because the local supplier doesn't carry them in Canada.
Anyway I got my bill today for the APAP with HH and an Opus 360 mask.
the cost for this from an online supplier would be about $700-$800.
my bill is only a mere $3330.00, I was told oh well we let you try for 30 days and you can exchange masks if you don't like it.
Now our heathcare system, pays a lot of it, so my cost would be $1100.
and my coverage at work will pay 90% of the $1100. So my cost is not too bad. But why is over 500% markup ok? I don't think it's right and I am thinking at the end of my month, I will just return the machine to them and buy it online. I also noticed the price they are charging for the opus mask is $299, I have seen it online for $99 ( and they kept the nasal pillows that were the wrong size, I was thinking I would just donate them to someone who could have used them, instead someone else is going have to buy them from the ripoff artist at a cost of $50)