Eyeworld

EW CATARACT 34 February 2016 popular pharmacies. "That's not an insignificant cost," he said. With 5,899 surgeries done in the research timeframe, they estimated a cumulative savings of $1,750,000 in pharmaceutical costs over 3 years, Dr. Vukich said. One factor to keep in mind is that some pharmaceutical com- panies are increasing the price of generic drugs, which could pinch consumers' pocketbooks yet again, Dr. Vukich said. However, this is an issue that Congress is reviewing. The practice where Dr. Vukich works plans to continue using gener- ic drugs for now based on the results of their due diligence. The case for branded meds John Wittpenn, MD, partner, Ophthalmic Consultants of Long Island, and associate clinical profes- sor, State University of New York, Stony Brook, N.Y., made the case for brand medications during his pre- sentation. There are very few head- to-head studies to compare brand versus generic medications, he said. However, tracking the efficacy of topical medications is more complex than systemic medications, and that can affect research done on branded versus generic topicals, he said. One major concern is medica- tion toxicity on the ocular surface, he said. "That's the primary refrac- tive surface of the eye. Our job is to protect and maximize vision. The effects can be severe and, very rarely, be permanent," he said. Dr. Wittpenn cited some of Dr. Vukich's presentation that showed some previous problems with generic ophthalmic medications, including a clogged dropper tip with prednisolone, an increased incidence of adverse events with diclofenac, a less efficacious generic version of timolol, and a generic formulation of latanoprost that had a higher pH than the brand form. There can also be confusion among patients over what is generic versus branded, Dr. Wittpenn said. He had a 73-year-old female patient with severe punctate keratopathy and a corneal melt after cataract sur- gery who thought she had been on branded prednisolone acetate and ketorolac; she was actually on gener- ics. The pharmacist had told her the drops were identical. "Technically in New York, that's illegal to say, but it happens. Ultimately, her best vision was 20/40," he said. She also had a residual scar. The patient is still wary about getting surgery on her other eye due to her bad experience. "She told me, 'Doctor, if someone had told me this would happen to me, I would have spent the extra money [for brand medications]," Dr. Wittpenn recounted. Although cost is a definite issue in the branded versus generic debate, Dr. Wittpenn thinks it is relative to the importance of one's vision. He surveyed area pharma- cies and found a $550 difference between branded versus generic medications typically prescribed after cataract surgery. However, the cost difference does not include re- bates, coupons, and other discounts that manufacturers may provide, he said. EW References 1. Pal S. Shifts in the generic-drug market: Trends and causes. US Pharm. 2013;38(6): 6–10. 2. Shrank WH, et al. Physician perceptions about generic drugs. Ann Pharmacother. 2011;45:31–8. Editors' note: Drs. Vukich and Wittpenn have no financial interests related to their comments. Contact information Vukich: javukich@gmail.com Wittpenn: jrwittpenn@aol.com Brand continued from page 32 SAFE • Patented Purion®Process gently dehydrates and terminally sterilizes the amniotic membrane while preserving essential growth factors, proteins and cytokines. EFFECTIVE • 70,000+ eyes successfully treated without any adverse effects. • Proven Purion®Technology retains more essential growth factors, proteins and cytokines than other products. SIMPLE • Easily applied onto a dry cornea and covered with a bandage contact lens. • Performed during a brief office visit without the need for taping the eye shut. COMFORTABLE • Well tolerated by patients. • No foreign body sensation. WELL REIMBURSED • Covered in the office environment under CPT code 65778. (Call our free hotline to determine the reimbursement in your area 888.700.9005). EXTENDED SHELF LIFE • 5 year shelf life at room temperature. • No special handling/shipping required. INSTRUMENTS • BIOLOGICS • DEVICES 800-225-1195 • 800-535-3545 • www.katena.com Why not help your patients today with IOP AmbioDisk ™ ? AD329-15A HELP FOR YOUR PATIENTS WITH Ocular Surface Disorders Do you treat patients with ocular surface issues? Do you see patients with corneal erosions or epithelial defects? Have you ever considered using IOP AmbioDisk ™ to help your patients?

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