The US has modest growth potential for the orthopedic bracing device market. Since back brace are typically associated with aging process, increase in the shift of demographics of the American population toward the elderly brings about a corresponding increase in the incidence of conditions that orthopedic bracing devices are used in, some of them being carpal tunnel syndrome, osteoporosis, golfer’s elbow, and carpal tunnel syndrome. Post-injury and prophylactic use of back braces is also expected to increase as a result of the expanding demographic that engages in extreme sports because this demographic can fall and break down. In view of cost reduction measures through pricing, Data Processing, and Coding (PDAC), the efforts of producers are aimed at creating back braces that will offer further reimbursement.
For the last few years, back braces have seen a very active sector. An exclusive range of high quality surgical, hospital, and medicinal goods was accessible to them. Since it was put on the market, chiropractors and physicians have generally recommended patients the usage of back braces for back pain. Back injury is not an unusual occurrence, although through the years, the human and economic effects of suffering it have risen. For this cause, more and more organisations use initiatives with or without sound ergonomics systems. The wearing of back belts has become one of these steps. Although the decision to wear it is primarily a question of personal preference, the National Institute for Occupational Safety and Health (NIOSH) maintains that the decision to wear it can not be taken by employees and staff without the best knowledge available (CDC, 2014). Instead of focusing on back braces as a “cure all” device for back injuries, businesses can aim to decrease the privileges of the lifting activities by preventive initiatives.
In the US, the bracing and help demand is forecast to reach $2.48 billion by 2018. (PR Newswire, 2012). The US bracing and support industry covers bracing and support for knee, ankle, spinal orthoses, soft upper extremity and bracing devices, and soft back products. Any of the key reasons behind the projected modest growth of these industries are the ageing Our population, the rising usage of braces to reduce sports accidents, and increased osteoarthritis and obesity. Owing to the clear association that exists between the occurrence of lower back issues and the ageing population, development in the spinal orthosis segment is projected to supersede the growth of other markets.
Orthopedic bracing market in the US is highly competitive and fragmented. Being just more than a quarter of the total market, only DJO Global is a competitor in the US market whose share is up to 10 per cent. Some of the companies that are its competitors in the US include Spinal Technology, DeRoual Medical Products, Ossur, Bledsoe Brace Systems, Bird & Cronin, and Breg. 40 per cent of the rest of the market is accounted for by dozens of companies whose shares are even lower. This leads to a market that is increasingly commoditized and has a strong competition with respect to price. Product features in braces are similar and there has not been much innovation in the design of back braces. Most companies rely on such strategies as having contracts with group purchasing organizations, and discounting to gain competitive advantage in the market rather than focusing upon product differentiation. MRG Lead Analyst Deanna Venkessel said,
This is a big demand, and thus a major cost for insurance… They have been pushing back reimbursements, suppliers will get more prices for their pharmaceutical drugs. As a consequence, several designers design better-fitting and more practical off-the-shelf braces and sell them. And in recent years, soft braces have entirely withdrawn support from Medicare and Medicaid, causing suppliers to lower costs for them as well. Which has a severe effect on the product margins of the retailer, but obviously helps patients who have access to a wide selection of appropriately priced braces. (Cited in MRG, 2015 by Venkessel).
Back braces for patients without insurance range typically anywhere between $40 and $1000 depending upon a number of factors including the size, style, and material of back brace and whether the back brace is custom-made, custom-fitted, or prefabricated (CostHelper, 2014). The Aspen QuickDraw is a back brace that provides the wearer with the facility of adjusting compression and thus controlling it, and costs around $250 whereas the cost of elastic brace which is relatively simpler and is Criss Cross Lumbosacral Support is nearly #38 (CostHelper, 2014). Most traditional health insurers provide coverage for back braces provided that the back braces are deemed necessary medically and that they adhere to the criteria laid out for durable medical equipment. Certain insurers do not cover a new brace’s cost if the patient has been provided with one over the past few years. Some insurers only provide coverage if the back brace has been purchased from a particular company. Medicare Part B covers back braces that are deemed medically necessary “under the durable medical equipment prefabricated orthotics beneft” (Medicare.gov, n.d.). Personal insurance covers back pain as long as back pain cannot be traced to work, in which case, personal insurance will deny the claim thus suggesting to get it covered by the employer. Also, workers compensation insurance covers back pain provided the worker does not have a history of back pain and that it cause of back pain can be traced at work.
Back pain is among the health complaints that are most commonly observed in the US as well as across the globe. Fig. 1 shows that back pain is one of the top ten causes of disability in the adults in the US. Although back pain is experienced at least once by people of all ages in their lifetime, the group of people in which it is prevalent the most is women between 40 and 80 years of age (inthefaceofpain.com, 2013). The main reason of back pain is the aging process combined with a sedentary lifestyle that involves very limited physical activity. An individual’s susceptibility to experiencing low-back pain as a result of spinal degeneration or disc disease increases with the process of aging. Low-back pain happens to be the most common cause of disability related to job and commonly causes people to miss out work. At least once in a lifetime, 8 out of 10 individuals feel back pain (Medline Plus, 2013). At least 25 per cent of adults in the US have reported suffering from low-back pain that has lasted for a whole day at least in the preceding three months whereas another 7.6 per cent mentioned that they have had a severe episode of acute low-back pain for a period of one full year (Chou, 2007).
Fig. 1: Top 10 causes of disability among US adults (CDC, 2014b).
13,808 representatives of the internet community at MyVoice were included in a research from June 1 to June 5, 2008 of which 54% were female, 1% were teenagers, 15% were in their twenties, with 38%, 29%, and 17% being in their thirtees, forties, and fiftees respectively (Y-N, 2008). 38.9% of the research participants stated that they had chronic stiff shoulders’ back pain whereas 46.7% stated that they had occasional stiff shoulders’ back pain. The results are demonstrated by the pie chart shown in Fig. 2:
Fig. 2: prevalence of back pain (Y-N, 2008).
During the first five days of June 2008, 13,808 members of the MyVoice Internet network performed a private online questionnaire. 54% were female, 1% were adults, 15% were in their 20s, 38% were in their 30s, 29% were in their 40s, and 17% were in their 50s.
Top manufacturers of back brace in the US include but are not limited to Orthotech, Bauerfeind, Orthomerica, Restorative Care of America, DeRoyal, Sammons Preston, Allard USA, and Quinn Medical. The Control Fit Lumboscaral Orthosis is a relatively low profile back brace provided with thermoplastic panels at the back and front and elastic side pulls to provide adequate compression and support circumferentially, and a back panel with an opening designed and located in a way to release pressure from the lumbosacral spine. It can be purchased for $135.82 (RehabMart.com, 2015).
Braces and splints were supplied by many physicians several years ago as a convenience to the patients. However, as Medicare local payer policy had to reimburse up to 85 per cent of DME’s invoice cost, payments started to dwindle, thus causing the physicians to actually end up losing money. Consequently, most offices stopped that service and physicians started to write their patients prescriptions to get the braces on their own. For the patients, however, the more convenient option is to get the braces immediately from the very office of the physician. Among the variety of ways in which DME can be offered by a physician, two common approaches include ‘stock and bill’ and ‘approved supplier’ (Haralson, 2015).
One of the latest trends in back brace equipment that has been introduced is the BOA back brace that is a user-friendly compression technology. A special Lacer Feature is used in the BOA back brace that comes with a patent pending tear-drop channel to ensure a smooth and consistent adjustment of the tension panels from a single pull handle. The design of this back brace is low profile and lightweight which makes it comfortable for wearing between, over, or under the clothing as desired. The BOA back brace provides the user with an optional attachment of rigid shell to help offload the load placed upon lower back after sprain, strain, or injury. “The prevalence of back problems, and the products and procedures centered around the treatment of spinal disorders and pain, have made the spine segment one of the largest and fastest growing orthopedic markets. With the launch of the BOA back brace, we now offer a more complete solution for rehabilitation from spinal surgery and other back-related injuries” (Cross cited in DJO Global, 2004).
To conclude, back braces are becoming increasingly popular in the US and have a lot of use for all age-groups of people in general and older adults in particular. The US market for orthopedic bracing device comprises a range of bracing products useful for elbow, wrist, knee, lumbar back, and ankle. These braces help support the different orthopedic joints whether prophylactically, post-surgery, or post-injury. The orthopedic brace sector in the US is presently an already mature market. It is so rooted in American culture that, for a revolutionary invention, it is not easy to make a significant influence.
References
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- Chou, R. (2007). Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice
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- CostHelper. (2014). How Much Does a Back Brace Cost? Retrieved from https://health.costhelper.com/back-braces.html.
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- RehabMart.com. (2015). Back Braces. Retrieved from https://www.rehabmart.com/category/Back_Brace.htm.
- Y-N, K. (2008, July 7). Two in five have chronic katakori, back pain. Retrieved from https://whatjapanthinks.com/2008/07/07/two-in-five-have-chronic-katakori-back-pain/.