Today, not one but 2 different companies talked to me about their new anti-biofilm treatment. Their mechanisms of action are entirely different. The only things they have in common are that they are both colorless and applied topically. Both companies (who had no knowledge of the other’s product) told me that they expected their product to have a price point less than $100 for a reasonably generous multi-use container. The sales rep for one product was very well informed about how the product WORKED but didn’t understand anything about how products get reimbursed (or not reimbursed) in wound care. It always surprises me when a manufacturer sends sales reps into the wild without any of that information—the sales rep version of that ridiculous “naked and afraid” reality show.
“Is the product a prescriptive agent?” I asked. The rep said that it wasn’t so that means I can’t write a prescription for it, which means it’s not covered under prescription drug benefits. “Is the product considered a wound dressing ‘filler’?” No, the sales rep didn’t think it was classified as a “filler.” That means it’s not covered under outpatient DME benefits as a dressing. My next question: “So, you think that the wound center is going to buy this at $X dollars per tube and give it to patients?” I explained we can’t pass charges on to the patient since we can’t sell things to them without a DME license, that we can’t give things away that ARE covered because that is an “inducement to treat”, and we can’t afford to buy things and give them away just because we think they are good for patients because we haven’t got that much profit margin in a visit.
“So, how did you think this was going to work?” I asked. There is only one way, of course, the outpatient wound care setting. The patents are going to have to BUY it with their own money. We do have patients who buy things, and a product that works well and is not very expensive might be one that I will recommend for patients to buy with their own money. However, what amazes me is that the rep didn’t know beforehand that this was really the only option we were going to be able to offer in the outpatient wound center. There are care settings where the math might work differently. For example, home health or an LTAC might be convinced that a product can take days off a course of care and they might buy it. But the outpatient wound center does not work that way right now.
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
