In terms of prosthetic arms, long term costs are a real issue. If a prosthetic arm is built right, long term cost also means long term income.
However, there are some unidentified obstacles. As this is a biased website - I would like you to assume it just represents my personal views and opinions, and if you somehow believe that I share views with others you may well think that bu I would not really comment - I will not address all of the underlying real issues. There are very good reasons for that. But the cost - performance issue is an interesting problem anyone can sit down and study.
With that I am not just talking about long term costs of overuse. I recently learned that prosthetic component manufacturers usually are more than happy to have their clients suffer their prosthetic components - but if you do want to get rich you need to provide a minimal amount of true support.
Obviously that is mostly the case only in a very limited fashion. Most overpriced items - which include the whole myoelectric option as well as some other parts - are *particularly* un-functional. They are built to malfunction, they are built to frustrate, they are built to fail, they are even built to look weird.
My sharp eyes googling a pre-demo "performance" of a Michelangelo hand adds to that impression. How rigid and awkward any prosthetic arm - including the iLimb pulse - look, and how little the industry representative Bertolt Meyer actually acknowledges that, is shown in a recent panel discussion.
Price, performance and function do not add up. Market rules do not just not work within the extremely skewed market of prosthetic components - they are not even going anywhere, no, this is a completely reversed world.
And that then warrants the type of questions that are somewhat uncomfortable.
Prosthetic arm / gripping solutions and cost
|Method||One time cost||Annual maintenance||10 y est.||20 y est.|
|No prosthetic||0 CHF||200 CHF||2000 CHF||4000 CHF|
|Body powered||7000 CHF||1000 CHF||20000 CHF||60000 CHF|
|Myoelectric||70000 CHF||10000 CHF||350000 CHF||600000 CHF|
The cost of prosthetic arms is only one aspect to consider. The actual comfort and function (including their appearance if at all) play into the determination of their value, or, value against price.
Prosthetic components that I would buy again cost less per month. A lot less.
The below diagram shows the price per month in CHF (Swiss Francs) to get service free operation out of the product mentioned [y-axis]. I distinguish two groups of items - the ones I will buy again ('y', right side on x-axis) and the ones I will not buy again ('n', left side on x-axis) .
Details regarding the above diagram:
Sockets (carbon fiber, epoxy) are the most expensive part I am using that I will get replaced, or recommend buying again. Socket making indeed seems to be the art that keeps the prosthetic industry alive as long as body powered arms are being built.
However, sockets compete only with a new and risky method to anchor prostheses, osseointegration, and with 80'000 CHF for the operation and an average of 30 months of operation until a bolt breaks or is getting infected, monthly cost will be absolutely gargantuan (about 2600 CHF / month, not considering the huge amount of daily babysitting of a chronic wound that is constantly oozing). With that, sockets still are more affordable by a factor of 10-100, pending complications of osseointegration implants - not at all a cheap option, particularly as arm stumps are exposed to a lot - toilet cleaning, kitchen work, garden work, et cetera, the exposure to bacteria and fungi is usually extensive so 2600 CHF / month is an extremely conservative estimate. More expensive sockets thus are the most promising method to make more money for the prosthetic technician selling body powered arms.
Silicone liners are expensive, but only moderately so. If a prosthetic technician manages to sell custom liners they can increase their monthly income by quite a bit. However, the amount of money spent on Ossur liners that are made so they fail after about 1-2 years is considerable.
The V2P Prehensor is a product that grips nicely but has failing parts - the sliding mechanism is the part that fails there. Also, this part is built to be used up and not to last permanently.
Compared to that, Hosmer hooks and Becker hands are functionally superb and they have a cheap monthly rate - simply because their quality is great. As for the wrist units, our Puppchen wrist has been built with the same quality / price ratio in mind.
It is interesting to note that conventionally set up cables (left side) can be extremely expensive if they are used too often or to much. Only a revised and modified cable setup (right side) is worthwhile getting, wearing and buying. Still, cables are a wear-down product that simply requires some new parts every now and then.
Luxury products that are extremely expensive contain myoelectric components and sockets, as well as hand painted cosmetic arms. You could buy these but be aware that you do waste considerable amounts of money.
Cut-off value for price per month of service free operation
If you are buying a prosthetic component, evaluate the price using the following rates:
200 CHF / month - sockets and cosmetic arms as well as consumables (cable setup) range there. If you get a prosthetic hand that costs that much you should expect superior performance. Not good, not very good, but superior.
10-20 CHF / month - this is the cost range of well built prosthetic parts - Becker hands, Hosmer hooks, Puppchen wrist. You can go and refurbish your house, shovel snow, get your hands real dirty and still keep trucking service free.
Over 300 CHF / month - you are probably getting reamed. Check again. If it is ever possible, buy something else for your ego, like, a house or a car.
Function does not mean the part costs much. Conversely if it costs too much it is probably not worth it.
Function and price (write off per service free month) actually correlate negatively. That means that if you are wearing a piece of heavy junk, chances are good it also cost too much.
Now for the questions that arise.
I'll post these later. I think they are obvious. But let's give that time to settle here.