NXStage in Canada....When???

[Red from Canada]

Does anyone know why NXStage is not available in Canada?   It was approved by Health Canada in 2005, but my unit has never even heard of it.

[Bill Peckham]

I don't know but I'll offer one guess - the boarder. I work for a company that sets up trade shows and sending anything related to commerce over the boarder is not easy. For our industry this means anything you might have in a booth at a trade show - even signage that talks about your product and even if you're not making actual sales from the booth.

Just based on that experience I wonder how NxStage's operating model would work? - would they be able to overnight dialysis machines up north as easily as they swap out a machine in Seattle? Would sending routine supplies be as easy?

I'm not at all an expert on international trade but I wonder if it is the boarder that makes it hard from NxStage to expand north.

The other possibility is that they're growing as fast as they can in the US ... but it seems to me that there has to be a price where it would be worth their attention - could the Canadian healthcare system meet that price? For instance how does $1,500USD a month fit into the Canadian reimbursement scheme? $2,000USD? There is an old saying: "No just means it's going to be expensive."

[Red from Canada]

You may be right about the border problems , Bill.  However, our Medicare does cover home machines like Gambro and since our dollar is pretty much par with yours, I wouldn't think that should be an obstacle. I am on temporary hemo waiting for a catheter fix to go back to peritoneal, but I know that down the road, I may have to go back to hemo, but would still want to travel by motorhome.  Hopefully if enough of us ask for the NXstage, it will become reality at some point.

[Razman]

My head office is in the US  and  we  bring turks across the border  2 to 3 times a week.  They don't even have to stop at the border.  If it is a regular shipment , things can be set up in advance and come across the border with no problem.  I think that the problem is money. The Canadian government controls health care.  That said, NxStage may not want to work with them because they would loose control and ability to set the price that they want.   Correct me if I am wrong but  I  also think that NxStage is limited to the amount of time that if can run. I do not thing that it can do  8 hours straight ( nocturnal hemo). 

[Bill Peckham]

My head office is in the US  and  we  bring turks across the border  2 to 3 times a week.  They don't even have to stop at the border.  If it is a regular shipment , things can be set up in advance and come across the border with no problem.  I think that the problem is money. The Canadian government controls health care.  That said, NxStage may not want to work with them because they would loose control and ability to set the price that they want.   Correct me if I am wrong but  I  also think that NxStage is limited to the amount of time that if can run. I do not thing that it can do  8 hours straight ( nocturnal hemo). 

I do "extended" overnight dialysis with the System One - there is some thought the the US FDA will recognize "nocturnal dialysis" as a specific marketing term, requiring specific marketing approval, so while I am dialyzing 8 hours while I sleep we don't use the term nocturnal.

It may be that NxStage charges more than Canada is willing to pay - there is good data on home hemo costs published by Pierratos but I can't seem to Google up a number. I found this full paper where he discusses the economics http://ndt.oxfordjournals.org/cgi/content/full/14/12/2835 but it doesn't give numbers. I would be surprised if Canada can deliver incenter hemodialysis for less than $200 per treatment, three times a week which means the NxStage would meet the economic hurdle. If economics are out and the boarder is out and a requirement to do long treatments is out then I don't know what the barrier is.

[kitkatz]

If you have been following the Nx stage threads, Nx stage is growing by leaps and bounds in the US and cannot keep up with demand and is having some quality control issues.  I think when they get the US stuff figured out then they will look at expanding outward.

[fluffy]

i hope we get it in canada soon. hemodialysis keeps me alive but it is slowly destroying me some days i just want all this shit to end.

[del]

Fluffy is home hemo an option for you??  Hubby does nocturnal home hemo with a fresinius macjhine. There are about 12 people in Newfoundland doing home hemo now with fresinius machines (not all are doing nocturnal) .  You can do short daily with our machine as well.  There are people in Ontario, and B.C as wel as in the rest of Canada using hemo machines for home dialysis.  The center that hubby was at didn't offer it.  Only place to be trained fro home hemo in Newfoundland is St. John's but it was well worth the 5 weeks away from home to do the training!  I'm not sure what province you are from but it would be worth checkng out. WE have a tech on  call 24/7 we we hace a problem with the dialysis machine or RO.  A dialysis nurse for home hemo is available to us weekdays.

[fluffy]

i think they have home hemo, but its the kind where you have to modify the piping and electricty to your home, and im moving out to an apartment with my fiancee in november, so im sort of stuck