Competition, technology, demand drive sales of mattress overlays

Health Industry Today, July, 1993 by Damon Braly, Brian Boney

Sales of mattress overlays are rising rapidly and are expected to continue growing at a fast clip each year for at least the next five years. Fierce competition is forcing manufacturers to improve products, while technology is enabling suppliers to develop more effective, lower-cost products. At the same time, demand for overlays that prevent pressure sores keeps increasing, in tandem with the nation's aging population.

The outlook is extremely strong for sales of traditional and new styles of overlays to hospitals, nursing homes and particularly the home care industry.

The hospital market for overlays is estimated at $100 million to $150 million a year. The home care market for overlays is estimated to be a $100-million-a-year market, and growing rapidly. The home care market for overlays is growing faster than the hospital market because patients are leaving hospitals after fewer days of inpatient care to continue recovery at home.

Hospitals have purchased more mattress overlays per admission in recent years as they realized that preventing pressure sores was far less expensive than treating them once they occurred. Overlays are likely to benefit dramatically from health care reforms because of added pressure on hospitals to prevent ulcers.

Nationally, the cost of treating pressure sores is estimated to be as high as $9 billion annually. Medicare alone spent an estimated $6 billion to $7 billion in 1992 treating pressure sores, as indicated by third-party reimbursement data. Pressure sores cost between $2,000 and $30,000 per patient to treat, says the National Pressure Ulcer Advisory Panel.

Other estimates put the cost of treating a patient with pressure sores at $24,000 to $54,000. These figures represent the cost of overlays, wound dressings and nursing time. Variations in estimated costs result from different definitions of pressure sores and difficulties in obtaining accurate data from home care patients.

In acute-care settings, 3% to 14% of all patients develop pressure sores, depending upon the type of facility and the demographics and conditions of the patient populations. In long-term care settings, the prevalence of sores ranges from 15% to 25% of all patients, estimates the NPUA Panel.

7 million people at risk

This means an estimated 7 million patients a year are at risk of developing pressure sores. At risk are patients who are immobile, inactive, malnourished, incontinent or have a decreased level of consciousness. Of those 7 million, approximately 2.5 million people develop pressure sores every year. Overlay manufacturers believe high treatment costs justify the use of overlays by and for patients potentially at risk of developing pressure sores.

Fifty or more suppliers are scrapping for a slice of the market. Two companies dominate the market: Gaymar Industries, Inc., Orchard Park, N.Y., and Huntleigh Healthcare, Manalapan, N.J., with more than 50% of the total market between them. Each is thought to have about half of that share. While sales to dealers and individual facilities account for the majority of sales with most overlay manufacturers, Gaymar is looking to win more national accounts through contracts with group purchasing organizations. Gaymar now has several GPO contracts.

65 or older at greater risk

Patients 65 or older account for 60% to 90% of the people who suffer from decubitus ulcers. The 65-and-older population is expected to grow 14.7% between now and the year 2010, up from the 11.7% growth rate it was experiencing between 1985 to the present.

The market is segmented into six sub-markets reflecting different applications of overlay technology. Sub-markets include overlays featuring static air, foam, water, gel, alternating air and low air-loss systems. Sales of foam, gel, water and static air overlays have dropped in recent years in favor of newer products. Sales of alternating air overlays and low air-loss overlays are increasing and are expected to rise in coming years as supplier competition and technology force prices lower, making them more affordable for users.

Since 1960, the cost of manufacturing pressure sore prevention overlays has dropped by as much as 90%. Vinyl products now cost less to produce than foam products, and improved engineering promises to reduce the cost of heat-sealing vinyl and the cost of vinyl itself in the future.

Foam, static sales drop

Sales of static air overlays have dropped as confidence has diminished in the effectiveness of the overlays. The factor keeping static air systems on the market is their low cost, but with sales dropping, many manufacturers have abandoned them, although one of the market leaders, Gaymar, still manufactures a static air overlay line. Another market leader, Huntleigh, does not manufacture a static air line because it says static air systems simply do not work.

Foam overlay sales have dropped because these overlays pose a disposal problem after becoming soiled or soaked with urine. Their effectiveness is also increasingly questioned, and they are often described as "comfort only" products.