I have been using one for the last couple of months. My mare was getting melon sized dry spots at the withers. I probably was more concerned about them than she was, but the skin was starting to look sort of funny.
Since using the pad she is uniformly wet (sweaty) when I take off the saddle and pad.
It is very well made and I'm sure it will give me many years of use. It is almost the same color as my saddle. I have gotten many comments about how pretty my saddle is when actually its the pad

My only complaint was that they don't come in a rounded style (I checked) My saddle has a rounded skirt, I'm sure that's why it gets confused with the pad.
I did search for cheaper pads with the same cut out area as the PRS. I figure ol' Clinton has a patent on it since no one else has that design.