Contact Lens Business
Disposables: the Expense Factor
For many patients, cost matters. Presentation of the right options, in the right way, can make all the difference.
BY CHRIS H. RUSSELL, O.D. AND CHARLES B. SLONIM, M.D., FACS

In theory, daily disposable contact lenses should be an excellent option for most contact lens patients because of the low risk of ocular health problems associated with them. However, this isn't the only factor in the equation: Daily disposable lenses are at least three times as expensive as most frequent replacement lenses, including the new high-Dk extended-wear lenses. And the reality is that many of today's patients won't automatically follow your recommendation, especially when cost is an issue.

PRESENTING OPTIONS

Here are a few of the strategies we use in our practice to ensure that our contact lens patients get the best lenses possible and are most likely to comply with care and wearing protocols:

A Before making a recommendation, talk to the patient and get a sense of what his financial situation is. Base the options you offer on the price range the patient is likely to accept. (Be sure to determine how much his insurance will cover because this can be a major cost-cutting factor.) We never recommend daily disposables if cost is an issue.

• If you push too hard for daily disposables, your efforts may backfire. Put off by the expense, patients may simply not buy them, or they may wear them longer than they're supposed to.
• Don't recommend only a single option, unless health circumstances warrant a specific recommendation on your part or you believe the patient will comply better with one specific modality. Giving patients some choice lets them feel that they have some control -- that they're not being "railroaded." As a result, cost issues will be mitigated and you'll get better compliance.
• Don't confuse patients by offering too many choices. Most patients have no basis (other than preconceptions or cost concerns) to make an appropriate choice between modalities.
• When deciding to recommend a specific modality for a current contact lens wearer, ask about the patient's compliance with the current lenses. Most patients are honest about how they care for the lenses and how often they replace them. If a patient is doing well with one modality, have him stay with it. (If it ain't broke, don't fix it.)
• In general, daily disposables are particularly good for new wearers, partly because these patients are more likely to damage or lose a lens. They may also be open to more possibilities than experienced contact lens wearers.
• Patients may call your office before coming in to find out how much you charge for contact lenses. We train our front desk personnel never to give a specific price. Instead, they explain that contact lenses come in a broad range of modalities and prices, and the doctor's evaluation of the patient's eyes and lifestyle will determine which lens is most appropriate.
• The new high-Dk extended-wear lenses are more expensive than the average frequent replacement lenses, but still not as expensive as daily disposables. We primarily present this option to patients who need the higher level of oxygen permeability. We compare this option to daily disposables and position it as having greater health benefits than other frequent replacement lenses.

Despite the expense, many of our patients are trying these lenses. Con-venience is clearly a significant benefit.

A "SPECIALTY" LENS -- FOR NOW

Because of the cost, we usually only recommend daily replacement lenses to patients such as avid sports players, non-compliant patients, or patients with ocular health issues such as chronic allergies. The number of daily disposable lenses we prescribe has increased over time, but they have a long way to go before they make a significant dent in the frequent-replacement and extended-wear lens markets.

Charles B. Slonim, M.D., is a clinical professor of ophthalmology at the University of South Florida College of Medicine in Tampa, Fla. He's in private practice in Tampa, specializing in ophthalmic plastic surgery and contact lenses. Clarence "Chris" Russell III, O.D., is a primary care optometrist in Tampa, specializing in contact lenses. Both Drs. Slonim and Russell are clinical investigators for contact lens manufacturers.