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Tips, Trends & News You Can Use

practice pulse
Tips, Trends & News You Can Use

Contact Lens Rx Release Act Now Law

In December, President Bush signed the "Fairness to Contact Lens Consumers Act" into law and it went into effect on Feb. 4. Hailed by the American Optometric Association (AOA) as a way for the government to regulate the sale of contact lenses and to penalize those who violate it, the Act gives 36 million contact lens wearers the right to choose where they buy their lenses. It also provides the following benefits:

Automatic Prescription Release. Eyecare providers must give patients their prescriptions as soon as they've been fitted -- whether or not the patient asks for it. This includes custom or private-label lenses.

Prescription Verification. Creates a "workable and fair" prescription verification system for sellers and prescribers and addresses the practices of some online sellers who are remiss in verification. The Act requires all sellers to verify prescriptions and to give eyecare providers an opportunity to respond. If an eyecare provider fails to respond within eight business hours or "a similar time," then the seller presumes that the prescription is verified.

Minimum Expiration Period. Prescriptions will be valid for a minimum of one year or the minimum period required by state law, whichever is greater. The expiration period begins only after the eyecare provider gives the prescription to the consumer.

The Act also requires that, if applicable, the eyecare provider incudes the trade name of an equivalent brand lens on the prescription. However, most experts believe the Act will have a stronger impact on the readily available disposable and replacement lenses rather than specialty lenses.

The Act must still go through the rule-making process; the Federal Trade Commission (FTC) will begin a study of the industry and submit a report to Congress. J. Pat Cummings, O.D., immediate past president of the AOA, was quoted by the organization as saying the verification process will be one of the issues the study will address. Thus the "similar time" for verification specified in the act may still change, depending on the FTC's findings. "A lot of the issues that need to be ironed out in the verification process will take place during that [FTC study] process, so that we make sure we have a legitimate and valid process that is fair to the patient, to the doctor, and to the seller," Dr. Cummings said.

In the interest of fairness, the Act includes fines for sellers dispensing contact lenses without a prescription as well as prescribers who do not release a prescription after a lens fitting. "That was one of the deciding factors [for the AOA] in supporting this legislation," said Dr. Cummings.

The Act also requires the FTC to study the strength of competition in the prescription contact lens market. The FTC will report its findings in one year.

The Climbing Cost of Healthcare

Several reports recently addressed issues related to the rising cost of health care in the United States. Last year, 31% of Americans said they put off medical treatment because it was too expensive. Of those people, 57% said the medical problem was serious or somewhat serious.

The Reader's Digest Family Index, which reported this data, concluded that of all U.S. families last year, 18% experienced a serious health problem that they couldn't afford to treat.

According to a 2003 U.S. Census Bureau report, 43.6 million Americans have no health insurance and fewer employers are offering health coverage. The number of workers at corporations with more than 500 employees who lack health coverage increased by 50% since 1987, says the Commonwealth Fund, a research foundation.

Time magazine (Feb. 2, 2004) reports that Americans spent $162 billion on drugs in 2002, an increase of more than $62 billion from a decade ago. A portion of the increase can be attributed to increased prescriptions for children, an aging population and lifestyle drugs, but Time says that the disparity between the United States' and other countries' drug prices is becoming a "major sore point."



CIBA appoints new head of product development for Global Lens Business. Dr. Manohar K. Raheja joined CIBA Vision as its Global Head of Lens Research and Development. Dr. Raheja has 18 years of new product development experience in vision care, pharmaceutical and consumer product industries. He has previously held leadership positions at Hill Top Research and Bausch & Lomb.

Oakley promotes Bowers. Oakley promoted Scott Bowers to the newly created position of vice president of marketing worldwide.


CooperVision unveils lens-fitting calculator. CooperVision recently launched the MultiTrack, a new multifocal lens-fitting calculator for eyecare professionals. For more information, go to

Optical companies make Fortune's list. Vision Service Plan and Alcon made Fortune magazine's annual list of the "100 Best Companies to Work For." VSP made the list for the fifth consecutive year and Alcon for the sixth consecutive year.

Court rules in Allergan's favor. Allergan announced that the U.S. District Court for the Northern District of California ruled that the company's patent for the NSAID ketorolac tromethine ophthalmic solution 0.5% (Acular) was valid and enforceable.

The court also ruled that the proposed generic drug of one of the defendants, Apoptex Corp., infringed the Allergan patent.

Hoya and Eyefinity join forces. Hoya Vision Care and Eyefinity formed an e-commerce partnership to market Hoya's lens products and to develop an integrated prescription ordering program for Hoya customers.


Take the Time to Analyze Your Fees
By Bob Levoy, O.D.

Mistakes are part of the learning curve for every optometrist. A proven shortcut to success is to learn from the mistakes of others and to then avoid repeating them in your practice. Following are a few of the hard-learned lessons about fees from optometrists who've been there, done that.

  • I've yet to meet the O.D. whose profitability dropped as a result of a reasonable fee increase.
  • A 10% to 15% fee differential is almost never the reason that patients change from one practice to another. In many cases, they base their decisions on emotional factors including trust, confidence, rapport and perceived value.
  • Charge patients for what you do based on your overhead, time and especially your expertise. "Clinical expertise," says Jack Schaeffer, O.D., Birmingham, Ala., "is the most significant income-producing asset in your practice."
  • Make clinical decisions for patients -- not economic decisions. Reason: there's no way to predict what patients can afford or are willing to pay. Recommend what's best for patients. Let them decide if that's what they want.
  • After a seminar I conducted in Seattle, Alan Homestead, O.D., wrote: "Your suggestion to drop low-paying insurance plans was interesting. I dropped three plans on January l. That was approximately 35% of my patients. However, at the same time, I raised my fees. As a result, I am seeing 15% fewer patients and have a 12% increase in revenue this year."
  • If you never get complaints about fees, it means that either you and your staff are providing high-quality care and first-rate service and your patients think it's worth every penny -- or you're undercharging.
  • In all the years I've been surveying optometrists on the subject, I've met only a handful who raised their fees and later regretted it.


Contamac Unveils Optimum Lenses

At last month's Contact Lens and Eyecare Symposium (CLES) meeting in Orlando, Contamac announced its new Optimum materials:

  • Classic (Dk 26)
  • Comfort (Dk 65)
  • Extra (Dk 100)
  • Extreme (Dk 125).

These materials will become available this month and have good wettability. Extreme is the only lens material with a Dk of greater than 100 without surface treatment, according to Contamac. The company reports that Lobob Optimum solutions work best with its materials.


Survey Shows That LASIK Patients Are a Distinct Group

Vision Council of America's 2003 consumer survey indicates that about 5.9 million American adults have had laser refractive surgery. This portion of the U.S. population is mostly Caucasian (76%), female (59%), married individuals (58%) and full-time job workers (56%). Among the different age groups, the middle age bracket (35 to 49 years) leads the market, accounting for 40% of the total patient base, followed closely by those 50 years of age and older at 34%. Geography also seems to have a bearing on LASIK's appeal, as the accompanying chart demonstrates.

College-educated Americans comprised one-third of the market and individuals belonging to affluent households account for a considerable share of the pie. Twenty-eight percent of all patients come from households earning $75K annually and up; 25% are from households making $40K to $75K annually.

Nearly three out of four LASIK surgery patients cited nearsightedness as the reason why they underwent the procedure; 15% mentioned astigmatism, while 12% said they had farsightedness. Of all respondents who said they haven't had the surgery in the past, more than 30% are considering it in the future. A typical individual who is thinking about undergoing LASIK is a Caucasian, works a full time job, is married and is 50 years of age and older.

Ranks High, Receives Patent

The 2003 Pharmacy Times OTC Recommendation Survey showed that Bausch & Lomb's products were "overwhelming" first recommendations in three categories: ocular nutritional supplements, contact lens cleaners and contact lens solutions. More than 300,000 pharmacists nationwide were surveyed for each category.

In other business, B&L recently received a patent from the U.S. Patent and Trademark Office for Ocuvite PreserVision, the only dietary supplement demonstrated to preserve ocular health and vision in the National Eye Institute's (NEI) Age-Related Eye Disease Study. B&L co-developed the formula with the NEI and holds exclusive worldwide patent rights under a license agreement with the institute.


Study Shows That Uncorrected Computer Vision Can Affect Productivity

A double-masked, placebo-controlled study published in January's issue of the AOA Journal shows that even a slightly inaccurate vision prescription at the computer can have a significant negative impact on a worker's productivity. Investigators at the University of Alabama at Birmingham School of Optometry said that they found the following:

  • Uncorrected computer vision, even in cases where no symptoms appear, can affect employee productivity and accuracy.
  • A vision miscorrection of as little as .50D can affect productivity by approximately 9% and accuracy by 38%. "The greater the miscorrection, the greater the decrease in productivity," Kent Daum, O.D., Ph.D., and the study's chief investigator, said.
  • Uncorrected or inadequately corrected computer vision problems can have a significant financial impact on organizations that rely on employees using computers.

"The study is important because more than half of America's work force spend their workday in front of a computer," Dr. Daum said. It "gives employers hard evidence of the financial benefits of providing computer eyewear for employees who use computers."


Acuvue Advance Offers Lasting Comfort

Vistakon's Vice President of Professional Affairs, Dr. Pat Cummings, says that its new contact lens, the Acuvue Advance with Hydraclear, is the result of 2,565 patient interviews. The company "did its homework" before creating the lens to learn what patients wanted. The picture that emerged was that patients found contact lenses dry and uncomfortable by the end of the day.

After two years of research, Vistakon responded with Hydraclear technology, an internal wetting agent that functions as both lubricant and humectant (for more on the AcuVue Advance, read "Contact Lens Management" on page 96). The result is a lens that combines the best of both silicone and hydrogel lenses, the company says.

Next, Vistakon had an independent market research firm conduct a masked product evaluation. "Even the eyecare practitioners and patients who participated in the study had no idea who the manufacturer was," Dr. Cummings says. The evaluation of more than 700 patients in three products showed that 87% of experienced wearers were able to maintain comfortable daily lens wear with the Acuvue Advance for days lasting between nine and 18 hours, compared with only 77% of the Acuvue 2 wearers and 69% of wearers of another leading brand.

If you're still thirsting for more information after reading Optometric Management's coverage of this product, visit the company's Web site ( to learn even more.