Studies show that, beginning this year and increasing for the foreseeable future, the supply of ophthalmologists is no longer sufficient to meet the demand for cataract removal and other surgical procedures. The number of new ophthalmology graduates has remained stagnant for some time, while demand for eye care is soaring. This leaves an incredible void and an opportunity we are wise to embrace: medical eye care.

Our profession has risen to the challenge admirably. Optometric colleges have been training new grads in medical therapeutics and clinical procedures since before we had the laws to perform them, and our legislative advocates have been tireless in pushing for the freedom to put those skills to use for the public.

Industry has stepped up and supported us, too. When I entered practice in the 1990s, it was still somewhat controversial for pharmaceutical companies to detail ODs and advertise their products to us in journals like this one. Not any more. Drug manufacturers (and forward-thinking ophthalmologists as well) have since realized that the enormous need for eye care services simply requires that optometrists provide most routine eye care so that ophthalmologists can concentrate on surgery.

Resources For Finding Affordable Meds
Finds the best price at local drug stores and automatically downloads any available coupons.
Provides downloadable discount cards and links to patient assistance programs available from drug manufacturers. 

Unfortunately, all this evolution and cooperation can be undone by one inescapable problem: even the best medication—prescribed with care and attention by a well-trained OD—is useless if patients can’t afford to get it. That “last mile” of getting the drop into their hands is often the toughest slog.

Restrictive insurance formularies shouldn’t undo all the care and attention you’ve given your patient in the exam room. Although generics are sometimes an option, they can still be expensive in many cases. For example, various generic steroids cost more than $100 to patients paying out of pocket.

Drug companies are seeking to ensure their pharmaceuticals are financially obtainable for a broad swath of patients. Most provide assistance to those in need. Here are some key programs we can take advantage of to help our patients:

• Bausch + Lomb offers an option whereby patients in need pay no more than $35 for their portfolio of medications, including Bepreve for allergic conjunctivitis at $10. The caveat: it won’t apply to patients who are enrolled in Medicare, and patients must fill their prescriptions at Walgreens or a participating independent pharmacy.

• Allergan has found that patients are paying high deductibles in the first few months of the year. In response, it has created a program that allows patients to pay next to nothing for their first three-month supply of Restasis.

• Shire has been able to place Xiidra on over 80% of commercial insurance plans within a year of its approval, which is relatively quick. The company also offers a free 60-vial tray to patients with their first prescription.

• Sun Pharmaceutical offers a program that essentially provides BromSite free to most first-time users.

• Alcon has a program for Pazeo for allergic conjunctivitis where qualifying patients pay no more than $10. This wouldn’t apply to patients enrolled in Medicare Part D, Medicaid or other government-sponsored healthcare programs with a pharmacy benefit.

• Akorn has an RxAssist program to help patients afford their antibiotic and glaucoma medications. Allergan, Alcon, Shire, B+L/Valeant and Sun also have patient assistance programs that allow indigent patients to access drugs at reduced cost or, in some cases, no charge.

Until healthcare costs are controlled in an all-encompassing way—and none of us should hold our breath waiting for that—it will fall to us to “work the system” on behalf of our patients.

Relevant financial disclosures: Akorn, Aerie Pharmaceutical, Alcon, Allergan, Bausch + Lomb, Shire, Sun Pharmaceuticals.