VA Pilot studyThe shortcoming is the dearth of relevant studies in the US of NIV use for COPD. This, IMHO, is why the VA pilot study is critical for VMD.
As Hoyt said in March 2021 at the 2020 Q4 CC "we have a pilot program that we've been really in the beginning phases of for the past six months, that is now starting to take off. It's a program that's funded by the VA for us to enter patients into our system and treat them on non-invasive ventilation, it's for COPD patients, very similar to the way that we performed all three of our studies. The goal was to generate the same results that we've already proven in these three studies."
He described VMD's goals. "Our first phase goal is to show these savings and have the VA adopt NIV as the gold standard of care for their veterans struggling with COPD. The second phase would be to have the VA utilize VieMed to help nationwide with their hospitals at home initiatives."
Right now the dynamic is that VMD must train its sales to educate the medical community to send their patients when COPD is first diagnosed. If the first phase goal of the pilot is achieved, the tables turn and the medical community in the VA will be seeking out NIV providers. This is where VMD's pool of RTs becomes the asset that Hoyt often talks about.
He said in 2021 Q1, "It’s probably going to take us six to 12 months to really generate some real data that they can prove out and then from there you have to think about the national roll out." He also expressed some frustration: "It’s just, it’s slow moving, and it’s bloodying your nose out there for our Company but we’re taking the necessary steps and moving forward with VA Pilot Study."
He then said in 2021 Q2 aspects were delayed due to changes in VA administration but it is still moving forward. Let's hope the new administration wants some early cost savings victories.
Once the results of this study are available and if the VA establishes treatment cost savings to the VA expecially in rural areas where veterans have trouble accessing medical facilities, then VA will likely drive VMD's growth. Hoyt said the VA has 500,000 patients who would qualify.
Any positive VA study would also accelerate adoption of NIV for COPD outside the VA.
The US and Canada are laggards in regard to adoption of NIV to treat certain COPD. In Canada, a study was published in March 2021 that concluded: "This 2021 guideline update represents an important shift from the previous recommendation against the use of long-term NIV in most patients with COPD and chronic hypercapnia, toward its suggested use. Based on the reported survival and hospital readmission rate benefits, we suggest long-term NIV in highly selected patients with COPD and chronic hypercapnic respiratory failure along with the use of specific and closely monitored ventilatory strategies."
https://www.tandfonline.com/doi/full/10.1080/24745332.2021.1911218
The participants in the VA study will likely have useful data after 12 months in the study and so preliminary results will start coming in by the end of 2021 or early 2022.