Experts predict the compression hosiery market will grow exponentially in the next few years. Their reasoning is sound based on statistics that one in three Americans over the age of 45 is affected by vein disease, and of those, only 4% are being treated. This is most likely due to the unfortunate fact that vein disease is often ignored by both physicians and patients. With an estimated 20 to 25 million people suffering from some type of vein disorder, it is easy to see the market potential.

In addition to the vast target population, an added bonus is that compression hosiery is looked on as a lucrative cash market. Medicare, for the most part, does not cover hosiery, and many managed care plans are cutting back on hosiery benefits. As providers face imminent cutbacks in many areas of their businesses due to new government legislation/regulations and diminished reimbursement from many managed care organizations and third-party payors, the quest to diversify the product mix has intensified. Many providers are shifting their emphasis from selling traditional home health products that are insurance billable to merchandise that is primarily private pay. Compression products often meet these criteria.

One reason sales of compression hosiery are growing so rapidly is an increased effort on behalf of manufacturers to raise consumer awareness. Many people suffer from various venous disorders such as mild to moderate varicosities and edema, but they rarely seek medical help. They have no idea that there are inexpensive products readily available that can help them manage their condition and prevent more serious long-term problems. But when they see brochures featuring waitresses, schoolteachers, store clerks, and construction workers—people in professions that are susceptible to venous problems—they identify with them. The intent is that this literature will pique consumers’ interest enough to help themselves by investing in compression stockings, or by seeking medical advice for more serious conditions.

Nip, tuck, compress
Another factor in the rise of sales is due to physicians’ increased acceptance and use of medical compression hosiery as a viable and successful treatment option for their patients. Many clinical studies show the efficacy of using graduated compression stockings for the treatment and management of chronic venous and lymphatic diseases for which there is no known cure.

In addition, cosmetic surgery is burgeoning in the United States, and sclerotherapy is becoming more and more common. Many surgeons require their patients to wear compression pantyhose immediately following the surgery, the length of wear-time varying greatly by physician preference.

Lymphedema awareness has also had a significant impact on the increased use of compression stockings and arm sleeves. Although there are many compression therapy products to treat lymphedema, hosiery remains the most popular method of controlling and maintaining the results achieved using other therapeutic modalities, such as manual lymphatic drainage, pumps, bandaging, or other compression devices. This is largely due to the fact that stockings and arm sleeves are relatively inexpensive, easy to apply, and more cosmetically acceptable than bandaging.

Not Grandma’s Look
Last, but not least, is the changing consumer perception of medical compression hosiery. It is not the “grandma look” any more. Manufacturers have gone out of their way to change the image of compression stockings. Both the product and the marketing materials have undergone significant changes. Packaging is now contemporary, featuring savvy, successful, and sexy images of men and women. And the stockings have evolved into a product that is perceived as more cosmetically acceptable.

In addition to a variety of styles, you will now find a vast array of color and fabric selections. There are many options to choose from—sheer, opaque, and patterned fabrics; trouser, athletic, and casual socks; fashion pantyhose and stockings; diabetic and sensitive feet socks; and silver ion therapy socks. Having a greater selection of product available is important because more educated consumers and fashion-conscience Baby Boomers are demanding choices—and now we can more easily meet their demands.

Understanding the Market
It is generally accepted that the compression therapy market has excellent growth potential. But long-term success is going to depend largely on your commitment to and understanding of the marketplace. It is important to differentiate between medical and over-the-counter compression hosiery. Medical compression hosiery exerts a graduated pressure against the leg to reduce venous distension, increase venous and lymphatic return, and prevent venous and lymphatic pooling and swelling. The pressure is greatest at the ankle and decreases gradually as it moves towards the heart, gently compressing the limb with gradient pressure thereby limiting the amount of swelling and maintaining the reduction achieved following other treatments.

These products help control and prevent the progression of many chronic, recurrent disorders: blood clots, chronic venous insufficiency (CVI), deep vein thrombosis (DVT), edema, lymphedema, orthostatic hypotension, phlebitis, post-sclerotherapy, post-thrombotic syndrome, thrombophlebitis, varicose veins, and venous ulcers. Medical compression hosiery is generally understood to provide 18 mm of mercury compression (mm Hg) or greater, is usually prescribed by a physician, and is covered by many insurance plans.

Hosiery below 18 mm Hg is used primarily as a preventive measure for potential venous related problems, post-sclerotherapy, and tired, aching legs—in all, a population base that is virtually unlimited and largely untapped. Prescriptions are usually not required for this hosiery class. They are ideal for a retail environment, and are packaged for direct consumer purchase.

A typical customer would be someone whose job requires them to stand or sit in one place for long periods of time. In either case, venous circulation is restricted, and mild swelling can result. Customers shopping for these products are often candidates for the higher, more therapeutic compression hosiery. Therefore, it is important that you work with them, determine their diagnosis, and help them select the most appropriate product for their condition.

Cindy Ciardo, CO, is CEO of Knueppel HealthCare Services Inc, Milwaukee. She is a board member and education committee chair for the Wisconsin Association of Medical Equipment Services, and can be reached via e-mail: cciardo@knueppels.com.