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    The effect of drug pricing on cataract surgery

    Dropless or less drops may improve cost, convenience, compliance


    Combined or lessdrops approach

    Just as dropless formulations have improved cost, convenience, and compliance for cataract surgery patients, combined drop formulations are doing the same for LASIK patients and other types of ocular surgeries, including cataract patients unable to attain dropless cataract surgeries.12 These formulations are compounded in Imprimis’ accredited pharmacies and can be customized to the needs of individual patients. Combining medications can reduce the necessary number of different drops patients need by 50 percent or more by decreasing from two separate bottles of antibiotics and steroids to just one combined antibiotic and steroid bottle to be used three times a day for post-operative LASIK patients.12 This not only enhances the patient experience, but improves compliance, alleviates instillation and dosage problems, and lessens confusion.12

    Related: How technology changed optometry's role in cataract comanagement

    These formulations are significantly less expensive when compared to traditional ocular therapies as well. While the Pred-Moxi formulation, for instance, costs $25 per 3 mL bottle and $50 per 6 mL bottle, branded and generic drops can be significantly more costly. For example, a branded Vigamox (moxifloxacin, Alcon) 3mL bottle can be as much as $180 for each bottle at our local Panama City, FL, CVS Pharmacies, a significant cost difference especially when many patients will need to pay this out-of-pocket. Without insurance-covered medications or samples from companies that can be provided for patients, it can be difficult for patients to obtain their necessary medications. Combination ophthalmic medications are shipped directly to the patient or surgical center, adding additional convenience because patients will have their medications on hand immediately after surgery.

    Comanaging optometrists should be aware that their surgeons may now be utilizing these new formulations. Currently, four proprietary formulation ophthalmic drops are available:

    • Pred-Moxi (prednisolone acetate and moxifloxacin hydrochloride)

    • Pred-Moxi-Ketor (prednisolone acetate, moxifloxacin hydrochloride, and ketorolac tromethamine)

    • Pred-Ketor (prednisolone acetate and ketorolac tromethamine)

    • Tri-Moxi (triamcinolone acetonide and moxifloxacin hydrochloride)

    Doctors can order these formulations at lessdrops.com. When ordering, there must be a patient name on every prescription, and it is a good idea to order at least a few days in advance. Early orders can be stored because the medication has three- to six-month shelf life. Less-drops medications are currently available in every U.S. state.

    Click here to check out the latest comanagement advice

    Bret Fisher, MD
    Bret Fisher, MD is a private practitioner in Panama City, Florida, USA.
    Gene Wong, OD, FAAO
    Gene Wong, OD, FAAO, practices at The Eye Center of North Florida in Panama City, FL.


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    Optometry Times A/V