Sleep apnea sufferers will now have to pay $500 for CPAP machines: Winnipeg health authority

Those suffering from sleep apnea who have to use a continuous positive airway pressure, or CPAP, machine will now have to pay $500 to get a good night's sleep.

The Winnipeg Regional Health Authority announced Tuesday it is adding a co-pay to the cost of using a CPAP machine.

"Most provinces across Canada require individuals to pay the full costs of both CPAP therapy equipment and supplies," said Krista Williams, chief health operations officer for the WRHA.

"Manitoba will offer one of only three co-payment models in Canada, alongside Saskatchewan and Ontario, requiring individuals to cost-share the purchase of equipment with the region."

The new co-payment will come into effect on Apr. 23, said Williams. It will cost patients $500 to purchase new and replacement CPAP machines.

Each machine costs roughly $1,300 in total, she said, and requires about $350 worth of additional supplies per year.

The program is expected to save the health authority roughly $4.9 million per year, Williams said.

A CPAP machine uses a hose and mask to deliver steady air pressure to the airways of sleep apnea sufferers when they sleep. Those who have the common sleep disorder stop breathing momentarily or have shallow breaths when they sleep. Sleep apnea has been linked to everything from heart disease to obesity and depression, and studies have shown it can be hereditary.

Patients in Manitoba using the machines will also  be responsible for paying for ongoing supplies required and "will remain eligible for a WRHA co-payment of replacement equipment every five years," said the WRHA in a press release.

'A cut, plain and simple' 

NDP health critic Andrew Swan slammed the change as a health-care service cut.

"This is a cut, plain and simple. Manitobans living with sleep apnea have just been handed a $500 bill to get treatment," said Swan.

"How are patients on limited incomes going to afford this? How are seniors on fixed incomes going to afford this? [Premier Brian] Pallister's government needs to reverse this decision and be there for Manitobans when they need it most."

Williams pointed to the availability of private health-care plans to help pay for the equipment, but agreed some people may not be able to pay.

"We recognize there may be clients who cannot afford the equipment co-payment and who have exceptional circumstances for consideration. An appeal process has been established to ensure they are heard."

She said the health authority encourages people to look into their insurance coverage.

"We're really recommending that individuals talk to their private insurance company if they have them, or their [employment income assistance] representative," she added.

Swan said that wasn't good enough.

"Pointing people towards private insurance isn't a solution, and the Pallister government knows this. Manitobans deserve better."

The balance of the cost, administrative fees and service fees will still be borne by the WRHA. Kids will still pay nothing.

Nothing more essential than sleep: CPAP user

Jo Davies has been using a CPAP machine since July of 2017 and said it changed her life. 

"I was falling asleep at my desk at work," she said. "I never felt awake. I always felt like I was in a fog. Always felt exhausted. It didn't matter how early I went to bed or how late I slept, I was always tired.

"You're gasping and choking, and it sounds awful.… It's painful to listen to because you know there's no way on Earth anyone could be getting a restful sleep like that. It's just so fundamental to your well-being, is having sleep."

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Davies, a frequent opinion columnist with CBC, said for those who suffer with sleep apnea, the machines are essential. 

"[Without it] it just means continued misery. I certainly was miserable when I was like this.… Napping doesn't help because I can't sleep. 

"The idea that they're going to say to people who can't afford this, that they're going to make it a little harder to afford it ... I don't think there's anything as essential as sleep to a human being."

Program still funded: Medigas

Roughly 16,000 people have CPAP equipment from the WRHA, Williams said, and about 2,800 new patients sign up per year. Some individuals may get the machines directly from suppliers.

Medigas Manitoba is one of two local companies that supply the machines to Manitobans, said spokesperson Ken Dufault.

He said his company supplies about 1,750 machines to new patients yearly, and there are about 14,000 patients in the company's database.

"I believe there's still a lot of people out there that have not been diagnosed," said Dufault.

"When we looked across Canada we knew that we were the only province left in Canada that had 100 per cent coverage of CPAP and CPAP supplies. So we knew that there was something that was going to change … we just didn't know to what extent.

"The upside to this is we still have a provincially funded program that is offering sleep testing, is still offering all the appointments necessary around education for the patients for the CPAP and their CPAP devices. And they still pay a substantial amount of the cost of CPAP."

Reaction to the announcement will be mixed, said Dufault, noting insurance will cover the cost of the machines for some users. He also praised the WRHA's willingness to listen to special circumstances.

"When I look to the rest of Canada, I think we still have a very strong program in Manitoba."