In the 15 years that we have published this newsletter, we have witnessed a mismatch in the way new neuromodulation and neuroprosthetics products have been funded and commercialized. Neuromodulation products such as SCS systems for chronic pain have often been funded by traditional healthcare financing avenues. Investors put up money to finance device commercialization and then earn their money back after it reaches the market. The route to commercialization for neuroprosthetics products has generally been more challenging, in large part because the potential market of people with disabilities like paralysis and amputations is not as great.
Fortunately, this situation is changing as government agencies like DARPA, NIH, and NSF have funded worthwhile neuroprosthetics programs. We were also pleased to learn of a recently published neural engineering roadmap authored by the ClevelandNew organizing committee. The document, available at the clevelandnew.org website, outlines specific steps for achieving critical goals such as obtaining funding, fostering technological innovation, and getting new technology into clinical practice. Many of these issues were discussed during a panel on funding neuroprosthetics technology at the recent Neural Interfaces Conference in Baltimore [see conference report, p7]. The session, chaired by Kevin Otto of the University of Florida, featured panelists from the NIH, DARPA, the Nielsen Foundation, and GSK.
We’ve seen all too often the promise of exciting new neuroprosthetics technology go unrealized because of lack of funding or lack of reimbursement. When this happens, it hurts people with disabilities, who are eager to regain lost function and restore their place in society.
Perhaps what is needed is legislation that says that the government cannot deny funding or reimbursement for neuroprosthetics technology that stands to improve significantly the quality of life for people with disabilities. Unlike the original Americans with Disabilities Act, which mandated that businesses and public facilities modify their infrastructure to accommodate people in wheelchairs and then passed the cost onto the private sector, ADA2 would enable people with disabilities to acquire devices such as robotic exoskeletons or FES systems that allow them to conform to existing infrastructure—and provide the funding for it from taxpayers.
Of course the government could provide incentives to businesses, insurers, rehabilitation facilities, and device manufacturers who help underwrite the cost of the technology. The incentives would take the form of a percentage of the savings the taxpayers realize when people currently drawing funds from the government instead become tax-paying contributors.
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