Eyeworld

EW NEWS & OPINION March 2017 29 possible so we as ophthalmologists can be successful with it. In fact, ASCRS, the Alliance, and others jointly worked hard and had success last year to reduce MACRA's regula- tory burden, and those joint efforts will continue again this year. These collective efforts seem to be paying off as it looks like all ophthalmolo- gists have a great chance to be suc- cessful and avoid penalties in year sional colleagues, many of whom we have developed good relationships with over the years. We need to stay focused on what is on the table, and for the moment, that's the ACA. If an opportunity arises to address other regulatory burdens (MACRA, MIPs, EHR, ICD-10, etc.), then we will absolutely look at the alterna- tives and voice our opinions. For the moment, though, MACRA is moving forward, and we have a responsibil- ity to all of us as physicians to help us succeed with it. The response that "ASCRS will remain 'neutral' on MACRA" is not correct. If quality reporting is a requirement for fee-for-service to be maintained, and if MACRA is the current quality reporting entity, then ASCRS will continue to advo- cate to make MACRA as workable as INDICATIONS AND USAGE PROLENSA ® (bromfenac ophthalmic solution) 0.07% is a nonsteroidal anti-infl ammatory drug (NSAID) indicated for the treatment of postoperative infl ammation and reduction of ocular pain in patients who have undergone cataract surgery. IMPORTANT SAFETY INFORMATION ABOUT PROLENSA ® • PROLENSA ® contains sodium sulfi te, a sulfi te that may cause allergic type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfi te sensitivity in the general population is unknown and probably low. Sulfi te sensitivity is seen more frequently in asthmatic than in non-asthmatic people. • All topical nonsteroidal anti-infl ammatory drugs (NSAIDs), including bromfenac, may slow or delay healing. Concomitant use of topical NSAIDs and topical steroids may increase the potential for healing problems. • There is the potential for cross-sensitivity to acetylsalicylic acid, phenylacetic acid derivatives, and other NSAIDs, including bromfenac. Use with caution in patients who have previously exhibited sensitivities to these drugs. • There have been reports that ocularly applied NSAIDs may cause increased bleeding of ocular tissues (including hyphemas) in conjunction with ocular surgery. Use with caution in patients with known bleeding tendencies or who are receiving other medications which may prolong bleeding time. • Use of topical NSAIDs may result in keratitis. Patients with evidence of corneal epithelial breakdown should immediately discontinue use of topical NSAIDs, including bromfenac, and should be closely monitored for corneal health. Patients with complicated ocular surgeries, corneal denervation, corneal epithelial defects, diabetes mellitus, ocular surface diseases (e.g., dry eye syndrome), rheumatoid arthritis, or repeat ocular surgeries within a short period of time may be at increased risk for corneal adverse events which may become sight threatening. Topical NSAIDs should be used with caution in these patients. Post-marketing experience with topical NSAIDs suggests that use more than 24 hours prior to surgery or use beyond 14 days post-surgery may increase patient risk for the occurrence and severity of corneal adverse events. • PROLENSA ® should not be instilled while wearing contact lenses. The preservative in PROLENSA ® , benzalkonium chloride, may be absorbed by soft contact lenses. Lenses may be reinserted after 10 minutes following administration of PROLENSA ® . • The most commonly reported adverse reactions in 3%-8% of patients were anterior chamber infl ammation, foreign body sensation, eye pain, photophobia, and blurred vision. Please see brief summary of full Prescribing Information for PROLENSA ® on adjacent page. References: 1. PROLENSA Prescribing Information, April 2013. 2. Data on fi le, Bausch & Lomb Incorporated. 3. Baklayan GA, Patterson HM, Song CK, Gow JA, McNamara TR. 24-hour evaluation of the ocular distribution of (14)C-labeled bromfenac following topical instillation into the eyes of New Zealand white rabbits. J Ocul Pharmacol Ther. 2008;24(4):392-398. PROLENSA is a registered trademark of Bausch & Lomb Incorporated or its affi liates. © Bausch & Lomb Incorporated. All rights reserved. Printed in USA. PRA.0188.USA.15 The PROLENSA ® Effect POWERED FOR PENETRATION Advanced Formulation to Facilitate Corneal Penetration 1-3 pH e ffect Hal og en a ti on e ffect PROLENSA ® delivers potency and corneal penetration with QD dosing at a low concentration 1-3 one. This is not neutral behavior. We are working as hard as possible within the confines of what we have to deal with. To be clear, ASCRS does not want MACRA, MIPS, or any of the other things that add more regulation to today's practice of medicine. Why would we? Unfor- tunately, it's the current law. ASCRS does not profit from MACRA nor has any financial gain with any of these regulations. In fact, there has been quite a bit of expense associat- ed with all of ASCRS's educational initiatives to help bring clarity to all of us as ophthalmologists so we can better understand the regulations and hopefully avoid penalties. All of the education is free for us as ASCRS members, a responsibility the ASCRS leadership doesn't take lightly. Would we like MACRA, MIPS, etc., gone? Of course we would. Of note, the majority of the leadership of ASCRS comes from private prac- tice. As a matter of fact, the last 10 presidents of ASCRS all came from private practice. We are real-world ophthalmologists practicing in the same trenches as the rest of you. In fact, we, the leadership, are you, and collectively we are all ASCRS. We are no different in our concerns, and we are all tired of the regulations associ- ated with today's medicine. Like most of you, I am in private practice and must contend with these same onerous ICD-10, EHR, MIPs, and MACRA changes every day. Like you, I also fail to see how they benefit our patients. We are on the same page. I certainly feel like I'm spending more time managing regulations than I am taking care of my patients. None of us want this. We want to and need to reduce the regulatory burdens that interfere with our practices and the important work of taking care of our patients. It's time for all of us to come together and get involved. We are much stronger together. We need your collective resources (financial and grassroots support) if we are to achieve any sort of success. While continued on page 30

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