Should a prescription be required for CPAP?

[GeoffD]

I think if no rx is required that Insurance companies will not pay for them, and they will no longer be medical equipment. I wouldnt like that.

The issue I have is that the Medical Cartel has taken a ~$100.00 manufactured cost APAP machine and turned it into a cash cow. If you walk in off the street to a DME with an Rx and no health insurance, they're going to try to gouge you for $125/month rental for the machine plus another $500+ for all the accessories like carrying case, hose, and mask. The FDA prevents them from being sold on the internet so a machine plus the accessories that should cost maybe $400 to $500 is 3x that at your DME. Thanks to this web site, we all know about Supplier #2 where you can buy an unused "open box" unit with case and hose for $699. That's still several hundred bucks higher than it would be if you could pop on that huge internet retail site, use your "Prime" membership, and get it delivered to your door for probably $400.00 including the mask. At that point, who needs insurance? It's less than most people would get nailed by their co-pay.

So I have a firm vote of "NO" against requiring an Rx for an APAP machine. I think the Rx should be for hourly service by a DME/Sleep Center to deal with people who aren't engaged enough to work through using and tuning their machine and mask. Most of the people here have no need for that service or the required yearly visit to the sleep center to prove to the insurance company that you still need the machine.

[GeoffD]

If they become non-prescription equipment, your "up-charge" will be full price, and the quality of machines will go down as profits decrease.

I disagree. ResMed is going to make their $100 gross profit on my S9 AutoSet and design/build it to the same quality level whether it goes through the funky multi-tier distribution channel ending up at your DME and with costly overhead for insurance billing as they would if they became a direct internet retailer on Amazon. If their machines are junk and break all the time, we'd all change brands. No different from any other consumer electronics.

[surferdude2]

I vote NOT also. After all, this is just a tiny fan with a processor to control how fast it runs. Even running it full bore will not kill or maim me since fan laws are clear in stating how much pressure these little fans can deliver with the power they have to drive them. I suspect the worse thing that could happen would be the motor would burn out and create enough smoke to asphyxiate me. I hope they have worried about that as much as they worry about my ability to adjust the machine.

I just hate it when people endeavor to control and protect me while lining their pockets and use some extreme example to justify it.

[Ghost1958]

I voted no theres a but in there. Im ok with a doc ordering a sleep test, determining what kind of SA one has and writing a script for that type of machine. ONCE. No yearly recerts no mask type scrips or mask scripts period. That by common sense goes with the machine. Cant use the machine without hose mask etc.

And the idea you cant get a machine without a script is like you cant get a gun without a permit. Sorry but yeah you can. Truckload if you want. Youll just have to poney up cash for it.

Now all that said if we are going the script route then if you test with mild you get a script for the type machine you need. No over 5 less than 5 blah blah. If you have it you have it and Doc has to script it and insurance has to pay for it or their part of it,

They are only dangerous if you have the wrong machine to treat your type of apnea so Im ok with a test to determine that.

After that settings manuals all the secret squirell stuff is money grubbing. Docs by and large know less about SA than the folks here do. Or how to treat it other than more pressure. Heck your 20 times more likely that your Doc kills you treating you for some ailment and goofing it up than you are to die from a single handgun bullet to the chest.

Doc writes a script for it once. Thats lifetime and thats it. Everything that is needed to run and use the thing goes with that script masks hose etc etc. Mild to severe apnea is apnea and Docs are required to script the machine to treat it.

Just my opinion but Docs nor DMEs should be allowed to dispense straight cpap machines. Autos can run either mode. No reason for a single pressure only machine to medically exist.

[2PAPs]

My insurance doesn't cover OTC items.

[Mosquitobait]

This is an old thread, but still a current subject. I don't think a prescription for cpap should be required unless insurance or Medicare is paying for it. Do we really need government to play nanny? You don't see people shooting up insulin or going wild with IVs do you? In most states, you do not need a prescription to buy ivs and needles. This is good because far more cats and dogs would be put down two or three years before their health required it because of the monthly costs to do subcutaneous fluids.

Thank goodness though they have that rule! As a result, many people are not getting the help they need from DME or doctor, can't go elsewhere and give up and sell their machines in Craigslist enabling the rest of us to get used machines and save money. Oh yes and masks! Masks are so dangerous! Holy cow, how can you possibly choose a mask without DME. They only cost $100 or more a pop.

[OMyMyOHellYes]

Need a "Depends" category in the poll.

For most existing pts, *maybe* not.
For most new pts, *probably* yes.

Or better yet, rather than a script, maybe a limited license as a pt diagnosed with apnea, once they have completed some basic training from an MD, DO or respiratory therapist, maybe with online refresher/test every 5, 7, or 10 years (technology and treatment standards DO change) in lieu of Rx.

OMMOHY

[AlanE]

Oh yes and masks! Masks are so dangerous! Holy cow, how can you possibly choose a mask without DME. They only cost $100 or more a pop.

I believe I saw on some supplier site that a script was not required for this one mask but one is required for the headgear for it.

Hmm duct tape

[Mosquitobait]

I believe I saw on some supplier site that a script was not required for this one mask but one is required for the headgear for it.

Hmm duct tape

Many uses for duct tape. However, federal law requires you to have a prescription for an assembled mask, but you can buy mask PARTS without one. That is how I got my mask and the online places make it really easy. You click that you want a mask part and they offer the other parts to make a complete one. yay!

Since I first asked for a referral to get a cpap, over two months have now gone by and I still have no prescription!

[Mosquitobait]

Need a "Depends" category in the poll.

For most existing pts, *maybe* not.
For most new pts, *probably* yes.

Or better yet, rather than a script, maybe a limited license as a pt diagnosed with apnea, once they have completed some basic training from an MD, DO or respiratory therapist, maybe with online refresher/test every 5, 7, or 10 years (technology and treatment standards DO change) in lieu of Rx.

OMMOHY

Until they start having something like the diabetes educator classes, I can't see this ever happening. You never know though. You'd think Kaiser or one of these other large insurance collectives shell out enough money that they would make an effort to provide additional educational opportunities rather than let patients fall by the wayside. Individual training beyond 10 minutes or so is probably not financially feasible.

That said, the DME that was part of our hospital system was quite excellent, but CPap and oxygen for Medicare patients was put into a bid program, so cost of units is down, but training, customer service and downright fraud by at least one of the bid winners is up.