EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/78716
54 EW CATARACT March 2012 Cataract editor's corner of the world Presenting premium IOLs by Vanessa Caceres EyeWorld Contributing Editor Physician enthusiasm and patient expectations are as important as price T hese are not ordinary times. The level of volatility in global markets has been unusual. The willingness of the U.S. consumer to spend money on premium IOLs is likely to be influenced by macroeconomic conditions. The re- cent slowdown in the growth rate of or- thopedic elective surgeries is a telling example. Despite these economic risks, the implantation rate of presbyopia-cor- recting and toric IOLs continues to grow steadily (Marketscope data, Q4 2011). In order to understand why and how this is occurring, we asked two well-re- spected surgeons and two patients who recently had premium IOLs implanted to share their thoughts on the financial aspects of choosing these special lenses. Bonnie An Henderson, M.D., cataract editor P remium IOLs can be a dif- ficult option to market in these continuing tough economic times. However, some physicians have found effective ways to educate qualified patients about how pre- mium IOLs can change their vision —and they've managed to capture patients' interest. The first important step is get- ting out information about premium IOLs as often as possible, said James Loden, M.D., Nashville, Tenn. When Dr. Loden's office mails pre-appointment paperwork to pa- tients, they will include information on the lenses. When patients come in the office, they'll see posters about custom IOLs. The technician who works the patient up will dis- cuss having topography done to see if he/she is a candidate. If a patient expresses interest, Dr. Loden goes on to further discuss lens options. Dr. Loden uses femtosecond cataract surgery in addition to the premium lenses. Of course, Dr. Loden also has in- formation about premium IOLs on his website and in other advertising forms. Throughout his various loca- tions, the typical conversation rate at Dr. Loden's practice is 15-20%. The physician's and staff's en- thusiasm for premium IOLs are often more important than a pa- tient's ability to pay, believes Sandra Yeh, M.D., Springfield, Ill. Dr. Yeh is passionate about the benefits of pre- mium IOLs for qualified patients. In- stead of focusing on how the lenses work, she'll emphasize what they can do to better the vision for quali- fied patients. Her conversion rate is about 30%. "It's leveled off some, but we're still doing well," she said. Drs. Loden and Yeh shared some of their strategies to educate patients about premium IOLs. EyeWorld also spoke to two patients in the Boston area who have premium IOLs to find out what convinced them to make the purchasing leap. Prequalify Surgeons don't want to take up chair Source: Thomas Barwick/Stone/Getty Images time talking about premium IOLs with patients who are simply not in- terested or who don't have the money, Dr. Loden said. For this rea- son, his techs will ask during the ini- tial workup if the patient would like to pay $75 an eye for a topography exam to see if he/she is a candidate. Patients sign a consent form to con- firm their interest or to decline the topography exam. "This immedi- ately weeds out patients who don't have the money," he said. "We won't target someone with no money or who is not motivated." Forty-five percent of Dr. Loden's cataract patients elect to have the to- pography done. For similar time-related reasons, Dr. Yeh's techs will make a discreet note about a patient's interest in the chart before she enters the exam room. This can be a dollar sign to in- dicate if there are money issues or some other short note to indicate the patient is not motivated or is not a good candidate. All of these notations help Dr. Yeh prep in ad- vance for speaking about premium IOLs with the patient—or not. "I never go in cold," she said. Offer finance options that fit your market In Dr. Yeh's area, many of her pa- tients are homeowners. For this rea- son, the practice has a relationship with a local banker who can offer a home equity loan at 5% interest for qualified and motivated patients, she said. If this is not an option but the patient is still interested, Dr. Yeh and staff will ask if another time of the year might be better financially. For example, certain times of the year might be better for her area's farmers than others. Tax refunds and flexible spending accounts can also make a difference at certain times of the year. "We'll ask, 'If now is not a good time, is there a better time?'" she said. Although many practices may offer monthly payment plans, Dr. Yeh does not find that to be a popu- lar option with her credit-wary clients. Emphasize (possible) freedom from glasses The possibility of freedom from glasses entices many, Dr. Yeh said. Instead of asking, "Do you mind wearing glasses?," to which many people might reply that they don't mind, Dr. Yeh will ask, "Do you love wearing glasses?" The answer for most people is no, which opens a discussion on the cost of glasses over one's lifetime versus the IOLs. For many patients, the IOLs could save them in the long run or at least be a separate but equal allocation of their spending, she said. The glasses-versus-custom IOL issue is what convinced Robin Ziegler, Westford, Mass., to purchase outright a multifocal IOL. She had always had to pay extra for glasses because of her prescription. "I think the multifocal IOL offset the cost of glasses," Ms. Ziegler said. The same reasoning persuaded Patricia Keohane, Cambridge, Mass., whose severe astigmatism led her to consider toric IOLs. Like Mr. Ziegler, Ms. Keohane also purchased the IOLs outright versus with a payment plan. Don't make standard IOL patients feel slighted Despite the enthusiasm for premium IOLs, Dr. Loden said he is careful to not make patients feel shamed into getting the more expensive IOLs or feel as if standard cataract surgery and a monofocal IOL are problem-