Article Date: 2/1/2008

DISPENSE Specialty Soft Lenses
contact lenses

DISPENSE Specialty Soft Lenses

Specialty soft lenses enhance practice profitability and your reputation as an eyecare expert.

ANGEL ALVAREZ, Coral Springs, Fla.

Like it or not, your practice is, in part, a retail business. In fact, optometric-practice audits by the Management & Business Academy, a professional education program that CIBA Vision and Essilor of America created to help eyecare practitioners develop financial success in their practices (MBA), reveal that nearly two-thirds of gross revenue in a typical practice results from the sale of merchandise. This is based on audits of more than 800 optometric practices. Of that, 15% to 20% typically results from contact-lens (CL) sales.

Retail executives spend a lot of time deciding on the right mix of goods to offer customers, as the right mix can maximize the revenue earned from each customer transaction and improve customer satisfaction and loyalty. Unfortunately, many of you spend little time thinking about your CL-product mix, choosing instead to focus solely on the medical portion of your practice. I've found that one of the most popular reasons for this is that many of you fear the retail portion of your practice will overshadow the medical portion, deeming you a salesman to patients, instead of an astute practitioner. As a result of this mentality, many of you choose to offer products with the least sticker-shock.

However, by not offering patients all the available CL options, you're not only doing a disservice to your practice revenue, but to your patients as well. They may be missing out on a CL that could greatly improve their quality of life. The truth is patients rely on your expertise to recommend products that will best meet their needs.

Another truth: Not offering premium CL products may actually lose you patients. This could occur if one of your patients talks to a friend who has ocular issues similar to his own, and that friend raves about a CL of which your patient has never heard. Your patient will assume that his friend's O.D. is more of an expert than you, and his friend's O.D. will become his new O.D.

The bottom line: The most successful eyecare practitioners (ECP), in terms of both patient loyalty and profitability, recommend premium eye wear they know will improve their patient's quality of life.

Here, I discuss the three categories of specialty soft CLs and how you can successfully dispense them. (See "Soft Specialty Contact Lenses".)

Soft torics

Soft toric CLs have had the highest growth rate of any soft CL segment nearly every year for the past decade, based on our (ABB CON-CISE) sales trends. (See "Specialty Lens Opportunity," below.) This is due to improvements in toric-design technology, which has made this CL more stable on the eye, and the development of affordable disposable versions. Also, the recent introduction of silicone-hydrogel torics has given an added boost to this growth rate. In fact, this CL already accounts for more than 40% of sales within the soft-toric CL segment, based on our sales during the fourth quarter of 2007.

Just three in 10 soft-lens patients are currently fit with specialty lenses. Practices that proactively present specialty lenses to patients are able to increase their specialty lens share to six-in-ten patients, according to ABB CON-CISE data.

Ten years ago, soft torics accounted for 14% of soft CL sales; today it's 21%, based on manufacturer sales audits. The potential for this segment, however, is easily 25% to 30% of the revenue mix. MBA data, for example, show that the 20% of practices with the highest ratio of soft-toric patients in their total soft-lens wearer base fit 30% of patients in this lens type. (See "Gross Profit Per Box".) So, how can you achieve this?

Trial-fit spherical-CL patients who have cylinder requirements of -0.50D to -1.00D with soft torics. Half the vision-correction population has astigmatism, according to a 1999 CIBA Vision study. Of that number, 51% are -1.00D cylinder or less, the same study says. A trial fit allows patients to evaluate the difference in vision between the spherical CL and the toric CL.

Educate astigmatic spectacle wearers that toric CLs are available. In the past, many ECPs avoided dispensing soft-toric CLs because of prescription limitations and poor success rates that resulted from excessive lens rotation. With the recent development of new designs and materials, however, it's time to make these patients aware of the stability and optimal vision this specialty CL offers. Do this by displaying promotional posters and pamphlets in your reception area and exam rooms and by talking with these patients about this CL during their eye exam.

Independent ECPs achieve a 51% gross-profit margin from soft torics — the highest margin of any major CL segment, based on retail pricing data from the our Soft Lens Retail Price Monitor. I believe this is because astigmatic patients are willing to pay a premium for their vision correction because they know it's complex.

Soft multi-focals

New designs in this specialty-CL segment have caused a surge in their usage through the past three years, based on our sales trends. More than nine million CL wearers are age 45 or older, but less than two million wear soft or GP bifocals and multi-focals, according to CIBA Vision wearer data. The aging of baby boomers swells the number of multi-focal candidates everyday, yet soft multi-focals account for just 4% of CL boxes our currently sells.

ECPs who specialize in fitting soft multi-focal CLs fit 15% to 20% of their soft-CL patients in this CL, according to MBA data. So, how can you successfully dispense a multi-focal CL?

Obtain education on the latest multi-focal CL technology. Many ECPs choose to shy away from this specialty CL segment due to the previous designs' low success rates. Previous designs often compromised near vision, which many patients couldn't tolerate. With the availability of new designs, however, many patients are achieving successful CL wear.

A small number of ECPs, who are early adopters of the latest multi-focal CL technology, are seeing double-digit growth in this specialty-CL segment, based on our sales records.

For these reasons, conduct research on the latest multi-focal CL offerings by attending the CL-related continuing education courses available at the several optometric meetings held throughout the year. Also, read the various optometric journals for the latest information on new designs.

Educate your baby-boomer patients about this CL. Recent Bausch & Lomb studies reveal that a majority of these patients prefer the vision they obtain from a multi-focal CL compared with their monovision CL. Further, emerging presbyopes currently wearing a soft-spherical CL provide the largest base of potential users, estimated to total five million people nationally, or more than 150 people in a typical practice, according to Practice Advancement Associates (PAA), a professional education and research company that specializes in eyecare business education. These people have a history of wearing soft lenses and want to continue to enjoy the benefits as their vision changes.

The gross profit that independent ECPs earn from each box of specialty lenses dispensed is substantially higher than that yielded by clear spherical lenses. These profit calculations are based on retail price and cost-of-goods audits ABB CON-CISE continuously conducts among independent ECPs.

Don't accept a low profit margin on multi-focal CLs. The national average gross-profit margin for the soft multi-focal segment is just 47%, compared with 51% for soft torics, according to ABB CON-CISE pricing research. Because multi-focal CL wearers are generally more affluent and therefore less price sensitive than clear-sphere wearers, this seems hard to justify.

Color lenses

This specialty CL segment has broad consumer appeal that many of you simply ignore. For instance, one third of women who wear a soft CL are interested in eye color change, but no more than 10% wear a color CL, based on PAA estimates.

Many ECPs think of color lenses primarily as opaque lenses that change dark eyes to lighter colors. A total of 76% of our's unit sales of CLs are opaque. But, CIBA Vision consumer surveys suggest that only about half the total U.S. population has dark eyes. The other half could achieve a more attractive look with color CLs that intensify the color of their naturally light eyes. Unfortunately, I've found that many ECPs ignore the opportunity to introduce these enhancer CLs to these patients.

To successfully dispense this specialty CL:

Let all your patients know that you welcome colored-CL requests. Many patients are reluctant to ask practitioners about the availability of cosmetic products. I've found two reasons for this: Patients feel that such requests may make the practitioner feel like a sales person, and they're concerned that revealing their vanity to a medical professional — someone who treats disease — will make them look bad. Let patients know you welcome requests for colored CLs by displaying informational posters or pamphlets in your reception area and exam rooms. Also, on your patient-history form include the question: "Have you ever wanted to see yourself with a different eye color?," or "Would you like to learn about colored CLs?" Both of these methods will invite inquiry from the patient and position the ECP as an expert, rather than a salesperson.

Practitioners who encourage interest in colored CLs routinely have 15% to 20% of their soft CL patients buying colors, based on MBA data. This is double or triple the penetration of practitioners who take a passive approach, this same data reveals.

Don't under-price these CLs. Many practitioners earn profit margins of 41% on this specialty-CL segment on average, according to our pricing audits. I see no reason why you can't increase this margin to 45% without losing business to alternate suppliers.

The benefits of increasing the ratio of dispensed specialty soft CLs:

► The retail pricing of specialty soft CLs can be considerably higher than clear, spherical CLs. This increases gross revenue per patient, with no increase in fixed costs.

► Profit margins earned from selling specialty soft CLs can be higher because companies who make them tend not to heavily advertise them, as opposed to popular brands of clear, spherical disposable CLs. This makes patients less price sensitive.

► Visual acuity is often improved with specialty CLs vs. spherical CLs, which may compromise astigmatic or presbyopic patients' vision.

► Fitting specialty CLs augments the image that you're the expert at solving complex vision problems. This can differentiate a practice and justify higher than average professional fees. Also, practitioners who solve problems that patients may regard as difficult or unsolvable are more likely to retain and generate patients.

To increase your practice's profits and garner patient loyalty and referrals, seize control of your CL product mix by offering specialty soft CLs. OM

Soft Specialty Contact Lenses

Soft Toric CLS:

Acuvue Advance for Astigmatism (Vistakon)
Biomedics Toric (CooperVision)
ClearSight 1-Day Toric (CooperVision)
C-VUE Custom Toric
Extreme H2O 54% Toric LC (Hydrogel Vision Corp.)
Extreme H2O 54% Toric MC (Hydrogel Vision Corp.)
Focus Dailies Toric (CIBA Vision)
Focus Toric (CIBA Vision)
FreshLook Colorblends Toric (CIBA Vision)
FreshLook Toric (CIBA Vision)
Frequency 55 Toric (CooperVision)
Frequency 55 Toric XR (CooperVision)
Hydrasoft Toric (CooperVision)
Optima Toric (Bausch & Lomb)
Preference Toric (CooperVision)
Preference Toric XR (CooperVision)
Proclear Toric (CooperVision)
Proclear Toric XR (CooperVision)
PureVision Toric (Bausch & Lomb)
SofLens Toric (SofLens 66 Toric) (Bausch & Lomb)
SpecialEyes Soft Toric (SpecialEyes)
Vertex Toric (CooperVision)
Vertex Toric XR (CooperVision)

Multi-focal CLs:
Acuvue Bifocals (Vistakon)
Biomedics EP (CooperVision)
C-VUE 55 Multifocal (Unilens Vision)
C-VUE 55 Disposable Multifocal (Unilens Vision)
C-VUE Multifocal Quarterly (Unilens Vision)
C-VUE 55 Toric Multifocal (Unilens Vision)
Focus DAILIES Progressives (CIBA Vision)
Focus Progressives (CIBA Vision)
Frequency 55 Multifocal (CooperVision)
Proclear Multifocal (CooperVision)
Proclear Multifocal Toric (CooperVision)
Proclear Multifocal XR (CooperVision)
PureVision Multifocal (Bausch & Lomb)
Quattro (Blanchard)
SofLens Multi-Focal (Bausch & Lomb)
SynergEyes Multifocal (SynergEyes)

Colored CLs:
Acuvue 2 Colours (Vistakon)
Cibasoft Softcolors (CIBA Vision)
Durasoft 2 Colors (CIBA Vision)
Durasoft 3 Colors (CIBA Vision)
Expressions (CooperVision)
Expressions Accents (CooperVision)
Focus 1-2 Week Softcolors (CIBA Vision)
Focus Monthly Softcolors (CIBA Vision)
FreshLook ONE-DAY Color Contact Lenses (CIBA Vision)
Natural Touch (CooperVision)
Vantage Accents (CooperVision)
Vantage Thin Accents (CooperVision)
Wild Eyes (CIBA Vision)

Mr. Alvarez is CEO of ABB CON-CISE, a large U.S. CL distributor that serves more than 15,000 independent ECPs in the United States.

Optometric Management, Issue: February 2008