Making Paralysis Count
One of the most important tasks in developing a market for medical products is to start with a reasonable estimate of the number of individuals who are candidates for your product. As Jennifer French points out in her article on page 1 of this issue, many neurotechnology firms have been relying on U.S. prevalence figures for paralysis that grossly underestimate the actual number of people living with paralysis.
One glaring example is the undercount of individuals paralyzed as a result of spinal cord injury, which appears to be off by a factor of nearly five. Given the woeful neglect this nation has shown individuals with SCI, and given investors’ fascination with market size as a key determinant of investment decisions, one can only wonder whether this undercount has had an effect on neurotech companies seeking funds to commercialize neuroprosthetic and neurorehabilitation systems for the SCI market. At least two commercial failures that we can think of, NeuroControl Corp. and Cyberkinetics Inc., were confronted with the relatively small potential market supposedly represented by SCI as a negative.
This is unfortunate for at least a few reasons. First of all, compared to other neurological diseases and disorders, SCI frequently affects younger people in the prime of their lives. Any useful prosthetic or rehabilitation device developed for these people would yield magnified productivity gains and healthcare cost savings over the life of the consumer. As we have argued in previous issues, a reimbursement policy that takes into account factors such as enhanced quality of life and healthcare cost savings resulting from greater independence would be a boon to both individuals with SCI and medical firms developing products for them. And the U.S. taxpayer would come out ahead too.
Second, as French points out in her article, individuals with SCI tend to be more likely to live in poverty, and thus fall through the cracks of our medical system. It would be tragic if the undercounting of individuals with paralysis represented one more means of perpetuating an underclass.
Finally, regardless of their age or economic status, individuals living with paralysis deserve our help whether they were paralyzed by a motor vehicle accident, industrial accident, violent crime, or war injury. A nation as willing as we are to provide a parking space or wheelchair ramp to those less fortunate than ourselves should surely be willing to invest in technology that can restore function to those who want to be productive again.
But to achieve this, we will have to do a better job of estimating the population we wish to serve. Just as states and counties underrepresented in the U.S. census pay a price in lost funding, so too do patient populations who are undercounted.
With our help, those with paralysis can stand up—and be counted.
Editor and Publisher