Why Are Wheelchairs So Expensive? - Erik Kondo

Active manual wheelchairs in high income countries typically cost between $5,000 and $10,000+. This is a lot of money. Therefore, many people wonder “Why are they so expensive?”

I think this is the wrong question. To me, the critical question is not why these wheelchair cost as much as they do. The question is Why are there not more affordable wheelchairs available? This may sound like the same question, but it is not.

The question of why existing active wheelchairs are expensive can be answered by deconstructing their economics. Think of it as going to a high end restaurant. The gourmet meal you order is expensive because it is made of costly ingredients, is prepared using a slow cooking process by a well-paid chef, served by a skilled staff, in a high rent location filled with fancy décor. The system that has created your meal necessitates that it will be costly. The same goes for bespoke active wheelchairs. They are expensive as a result of the system of their creation.

There are also very cheap manual wheelchairs which are like fast food restaurant meals. In both these cases, the system is designed to create wheelchairs/meals of relatively low quality that are inexpensive, fast and convenient to prepare, sell and obtain. There is nothing bespoke about them.

Fast food restaurants and high-end restaurants are not in competition with each other in the same way hospital wheelchairs don’t complete with bespoke wheelchairs. They are completely different products. In the world of food, there are a tremendous number of options available for meals. There are restaurants and eateries of every price point. You can buy prepared food or purchase the ingredients to make your own meals or some combination of both.

Other the other hand, the world of manual wheelchairs has fast food style wheelchairs and bespoke style wheelchairs, and almost nothing in between. Where are all the other options? Why don’t they exist? Why is there only a very low end and a very high end? Where are the mid-priced wheelchairs? Why are there not wheelchair parts readily available for people to repair and build their own wheelchairs?

The bicycle world looks very much like the food world. There are many options available in every price range all across the world. In fact, wheelchairs are unique in their product price structure of very cheap or very expensive. It is possible to justify the poor quality of fast food style wheelchairs by their exceedingly low price. It is possible to justify the expense of bespoke style wheelchairs due to their relatively high performance characteristics, materials and manufacturing processes. It is not possible to justify the lack of mid-priced alternatives.

All of this gets back to the original question. The reason that active wheelchairs are so expensive is because of the nonexistence of mid-priced alternatives to bring down the average price. Without the midrange, there are no market pressures to lower the price. Keep in mind, hospital style wheelchairs are not competition for bespoke wheelchairs any more than McDonald’s competes with five star restaurants.

The lack of mid-priced wheelchair manufacturers is a result of the Wheelchair Industrial Complex (which is dominated by large companies owned by private equity) combined with the effects of government regulations and insurance reimbursement proactively preventing the development of the midrange market through monopolistic practices and regulatory burden.

In order for this situation to change, people need to become aware of the existence of this unique problem in the wheelchair world, which has adversely affected the lives of millions of wheelchair users. Next, steps must be taken to develop the midrange wheelchair market and provide alternatives for those who need them.