Wednesday, July 29, 2009

This is Not My Mother's Wheelchair (Part 2)

So the iBOT story does not have a happy ending...for now.
In December of 2008 I received, along with all the other iBOT owners, a most unwelcome letter. Due to the fact that the iBOT was not selling at an acceptable rate to support the business model, Independence Technology ceased production and sales of the device. Thankfully, they will support the iBOT with service and parts for a period of five years.

The letter indicated that a key reason for the failure of this business was that insurance companies, including the government owned entities like Medicare and Medicaid, were not reimbursing patients for these chairs. Independence Technology has not provided a firm number, but estimates are that they sold only a few hundred iBOTs. I've been all over the country in my iBOT for a year now, and have not yet happened upon another iBOT.

There are a few people, including Dean Kamen the inventor, who are lobbying Congress to rescue the iBOT by having Medicare and Medicaid reimburse qualified patients for the purchase of iBOTs. If Medicare and Medicaid comply then the private insurance companies may follow suit. Even then, there's no guarantee that the parent company of Independence Technology, Johnson & Johnson Inc., will restart the iBOT business. But it seems likely that either Johnson & Johnson or somebody else would jump at the chance to produce this life changing product if sales can be at least partially subsidized by the insurance companies. It's a difficult time to be lobbying the government to spend more money though (or is it, given all the stimulus spending).

In fairness, I should mention that the iBOT is not for everyone. Only a trained clinician can determine if the iBOT is a suitable fit for a particular patient. However, a large portion of the disabled community would be able to take advantage of this wheelchair if it was again available.

The iBOT represents a huge leap in technology. This is not tweaking. This is not optimizing. This is revolutionizing. It puts disabled individuals in a position to function in a world that is still, and will always be, largely inaccessible. The insurance companies have formulas to determine the value of a wheelchair. There are no factors in their equations for the benefits that the iBOT provides. The iBOT breaks the mold, but the insurance companies continue to evaluate it with outdated metrics. The iBOT is not the most expensive wheelchair in the marketplace. Medicare and Medicaid will often reimburse patients for much more expensive chairs- chairs that meet their narrow criteria.

This may be my last iBOT, because they may never be manufactured again, and because my continued disease progression may eventually make it impractical for me to operate one. Until I received the fateful letter, whenever someone stopped me and asked about the chair I spoke to them with as much conviction as the inventor of the iBOT or the CEO of Independence Technology would have. I was a huge advocate, and I spoke from my heart. Several folks questioned me about the iBOT on behalf of loved ones who were wheelchair users, and I felt great satisfaction in revealing this wonderful option to these families.

Now it's different. I still explain the chair's functions to folks, and tell them how it has changed my life. However, I don't do it with the enthusiasm that I once did, knowing that at some point in the conversation I'll need to explain to them that this device is no longer available. I don't want this to be the last iBOT for me, and for them. I sometimes imagine a day when I’m no longer stopped in the supermarket and asked how the heck I do that- because it just won't be that uncommon to see a wheelchair user zipping through the aisles on two wheels.

Great technological advances are not supposed to go away because of logistics, or red tape, or politics. It will be a tremendous shame if the iBOT just disappears. Here are a few websites and other links about the iBOT, and about the effort to breathe life back into this amazing invention.


  1. What a shame. The ibot sounds like a wonderful device and a real breakthrough. How can people help - who can we write - can organizations like the March of Dimes exert some influence? I'm really enjoing and learning from your blog.

  2. Kay, I don't have a good answer to your question right now, but I am attempted to get one. If I'm successful I'll post my answer here. Dean Kamen is a very busy man...

  3. This chair could be manufactured or custom built by any individual or company with the money and desire. It's humanitarian so the owning company would risk a public relations nightmare if they tried to retain all rights to it. All it needs is a sugar daddy to fund it. This happens to many good products. Usually another company or individual buys all the design rights and engineering data and goes back into production under another name. Is Johnson and Johnson willing to sell it? Maybe they just need an enthusiastic buyer. If not it could be reverse engineered.

  4. Chris, I wish I had more details. I'm trying to get them, but it's not easy. My understanding is that the licensing (patent rights, etc) has reverted back to the inventor, Dean Kamen. I think the technology would be marketable by any number of companies if only the insurance companies would pay for the device. It's hard to market a medical device without support by ins. companies. I think Johnson and Johnson would sell, but nobody will buy unless the ins. situation improves. These are my guesses about what is going on.