Peter C. Farrell
Analyst · Deutsche Bank.
Well, I think people are recognizing that compliance is the ace in the whole. If you don't get compliance, everybody loses. In other words, a machine that's bought and gets stuck in a cupboard, you don't get replenishment and so on, so that's all obvious. But I would put it more strategically. What we do know is that patients have significantly improved quality of life. We also know -- and the data, I was referring to it in my initial comments, I mean, you've got the co-morbidities are not just heart disease and diabetes, it's peripheral neuropathy, it's cancer and so on and so forth. So it actually, treatment -- compliant treatment prevents disease progression. And we also have a significant amount of data internally. And there was a recent report about a year ago from McKinsey, which is on the Harvard website -- the Harvard Sleep Medicine website, showing that there's a return on investment in the first year for treating patients, and that is with a reduction in inpatient and outpatient services. So it's kind of like the holy grail, improve quality of life, reduce costs and stopping the progression of disease. People are becoming more and more aware of that aspect. And so compliance is the holy grail in itself for the patient. It's a holy grail, if you are compliant, for the reasons I just mentioned. I think that word is getting out, and it's -- the CMS -- actually the government did something senseful, it's sort of hard to believe, it's not often you see that. But by requiring this 90 days with 30 days continuous use, that's the CMS, this is forcing the DMEs and the HMEs to look very, very seriously at compliance because they don't get paid if the patient isn't compliant. So we've seen in some of the bigger customers, compliance sub-50 going to mid-70s. So we're seeing and maybe that's reflected also in the incredible growth that we're seeing in our replenishment program. It's getting better and better. And of course the other side of the coin is that our products are better and better. I mean, you've got much more like 75 gram masks, machines that are about a kilogram, 24 decibels, I mean, they're quiet, they're small, they're appealing and they're so much, so much easier to use. So everything is moving in the right direction. The technology is, the knowledge of the -- both the consumer and the physician, the improvements in technology and so forth. So we are seeing -- now I couldn't give you specific numbers, but I would say -- well I can give you a specific number, but it's not based on hard-nosed data, but it's somewhere around the mid-70s at one year. And once the patients are on after first month, we're seeing, even the first couple of weeks, we're seeing that, that's the way it tends to continue.