Contact Lens Business
A "State of the Union" Report
Office visits and sales continue to rise -- and M.D.s are becoming an increasingly important part of the picture.
BY CHRISTOPHER KENT, SENIOR ASSOCIATE EDITOR

In order to decide where you want to go, it's helpful to take a careful look at where you've been. With that in mind, let's review some of the shifting trends in contact lens sales and usage during the past 3 years.

The numbers discussed in this article are based on survey data collected every quarter by Health Products Research, Inc. (HPR), a division of Ventiv Health, Inc. HPR tallies detailed responses regarding patient visits from more than 500 contact lens dispensing locations, including private ophthalmology and optometry practices, independent retail outlets and national chains. These numbers are projections based on that data, weighted to compensate for factors such as region, size of practice and type of practice.

OVERALL GROWTH

Both the number of contact lens wearers and number of office visits for contact lenses have been growing steadily, with a consistent yearly influx of patients new to contact lenses. In 1998, there were nearly 33 million contact lens wearers; in 2000, the number had grown to 35.4 million. During the same period, office visits for contact lenses climbed from 23.5 million to 26.9 million.

Soft lenses have played a major role in this growth, which isn't surprising given all the new options and modalities. While the total number of contact lens wearers has increased by 3% to 4% per year during the past 3 years, patient visits for soft lenses increased 6% from 1998 to 1999, and 8.4% from 1999 to 2000.

In contrast, statistics for hard lenses have fluctuated. The number of rigid gas permeable (RGP) lens wearers has been steadily shrinking -- but the number of visits for hard lenses has not. RGP-related office visits decreased by about 3% between 1998 and 1999, but rebounded dramatically between 1999 and 2000, increasing by nearly 16%, even though the number of RGP wearers continued to shrink. (See "A Few Noteworthy Statistics")

Bruce H. Koffler, M.D., medical director of the Kentucky Center for Vision and president-elect of CLAO, believes that the increase in visits, despite fewer RGP wearers, can be attributed to the increase in alternatives that are available. "New soft lens options are pulling a few RGP patients away from hard lenses, but RGP wearers have a lot of new options, including new bifocal designs and new materials. The patients who stay with RGPs have good reason to come in more often."

OPHTHALMOLOGY'S PIECE OF THE PIE

The changes in the contact lens marketplace are bound to affect M.D.s differently than others in the eyecare field, partly because of the shift toward more complex lenses (which seems to favor ophthalmologists), and partly because more and more M.D.s are adding dispensaries to their practices. (See chart)

For M.D.s, the number of pa-tient visits for soft contacts grew from 3.67 million to 5.34 million between 1999 to 2000 -- an im-pressive increase of 45.4%. (The number of lenses sold increased by 68.3%.) The number of office visits to M.D.s for RGP lenses increased even more: 58.6%.

In contrast, visits to O.D.s for soft and RGP lenses increased a mere 6.9% and 12.1%, respectively. Patient visits to independent retailers and chains for these lenses actually decreased from the year before.

In the category of soft lenses prescribed by an M.D., from 1999 to 2000:

• visits for bifocal lenses jumped 53.9%
• visits for toric lenses jumped 72.3%
• spherical lens visits increased by 41%.

Again, this contrasts sharply with the much lower numbers for independent retailers and chains. At the chains, an increase in bifocal and toric lenses visits was offset by losses in spherical lens-wearing patients, resulting in an overall loss of soft lens wearers.

As you can see from the graph on page 34, at least part of the dramatic increase in patient visits is the result of more M.D.s dispensing contact lenses. (The number of M.D.s dispensing soft lenses increased by more than 40% between 1999 and 2000.) And although the total number of contact lens wearers is increasing each year, some of the patients getting their lenses from M.D.s appear to have been pulled away from independent retailers and chains.

At the same time, the number of visits to many individual practices has been increasing as well. Dr. Koffler comments: "In my office, some of the increase in patient visits is the result of our ability to participate in vision care plans that are now being offered through traditional insurance carriers. These plans bring in patients who formerly would have been served by optometrists."

HOW DIFFERENT MODALITIES FARED IN 2000

Overall, patient visits for contact lenses increased by 8.8% in 2000. How did the different wearing modalities fare during this period?

• Patient visits for 1-day (soft) disposables were up 46.2%.
• Patient visits for other disposables (intended to be worn 2 days to 2 weeks) were up 10.9%.
• Patient visits for planned replacement lenses (to be replaced every 15 days to 6 months) were up 12.7%.
• Patient visits for rigid gas permeable lenses were up 15.8%.

In contrast, patient visits for traditional, long-term wear soft contact lenses were down 6.1%.

WILL THE BALL KEEP ROLLING?

Predicting the future is a tough proposition, given constantly changing technology and the growth of vision correction options such as laser-assisted in situ keratomileusis (LASIK) -- not to mention marketplace factors such as manufacturer mergers and economic factors like the current slowdown. However, if there's a limit to the growth of this market, it's not obvious at this time.

Even LASIK, which has grown steadily in recent years, hasn't put a damper on contact lens growth. And, according to HPR, first quarter figures for 2001 don't show any indication that contact lens visits or sales have slowed down. All in all, the outlook for the next few years is very positive.

Dr. Koffler comments: "These numbers are good news for ophthalmology. I'm amazed to see the remarkable increase in the number of M.D.s dispensing contact lenses and the number of patient visits.

"Actually, this is the same trend we saw during the nineties -- a slow but steady increase in contact lens wearers. The reality is, not everybody is ready for, or able to afford, refractive surgery. If we offer the right products, there will be a whole generation of new patients coming to us."