Experts offer advice on fitting, pricing daily disposables

Optometry Times asked 15 contact lens experts how they would advise their colleagues in fitting daily disposable contact lenses as well as discussing price with patients.

The first question addressed clinical fitting, while the second tackled a stumbling block common to many practitioners: explaining the cost of daily disposables to patients.

Find out what the experts said, and up the fits of daily disposables in your practice.
 

What one piece of advice would you offer fellow ODs in fitting daily disposables?

Scott Schachter, ODPismo Beach, CA
Optometry Times Editorial Advisory Board member

Fitting is very straightforward. I have experienced ease of fit, consistent fit, and great comfort among most brands.

Milton Hom, OD, FAAO, FACAAI (Sc)Azusa, CA
Optometry Times Editorial Advisory Board member

Daily disposables are great, but remember that patients can still have problems with contact lens dryness. These lenses are not the be all, end all. The ocular surface may still need treatment, especially in severe cases.

David Geffen, OD, FAAOSan Diego
Optometry Times Editorial Advisory Board member

Tell the patient it will take a few days to adjust to a new lens. Any new lens will have different properties, and the eye needs several days to adjust. Then, you can assure the patient of the health benefits of daily disposables.

Mile Brujic, OD, FAAOBowling Green, OHOptometry Times Editorial Advisory Board member

A decade ago, we didn't have the options that we do now. Today, we are fortunate to have not only a wide range of spherical powers but also toric and multifocal options. This should be the part of the discussion for every contact lens patient.

Bill Townsend, OD, FAAOCanyon, TXOptometry Times Editorial Advisory Board member

Assume every patient wants daily disposables and they will ultimately have better comfort, convenience, and clarity daily disposable lenses. You can always back off and go to two-week or monthly lenses.

David Kading, OD, FAAOSeattleOptometry Times Editorial Advisory Board member

As I have traveled the world speaking on daily disposable lenses, I have never once spoken to someone who does not believe that daily lenses are the best for patients. In which case, they should be fit on every patient. There is a presbyopic lens and a toric lens for nearly every patient. The few exceptions do exist, but that is a rare 5 percent. We are at 95 percent daily disposables in our office.

Gregg Russell, OD, FAAOMarietta, GA

Let patients try them on and tell you that they are not interested. Daily disposable lenses don’t just solve problems. They help prevent them.

Diana Canto-Sims, ODChicagoOptometry Times Editorial Advisory Board member

Be very careful how you word and consult the patient when talking about (or prescribing) daily disposables. Don’t assume patient knows the difference. Some patients confuse “daily disposables” with “daily wear” and reuse disposable lenses.

Be clear and explain the difference with the health benefits of daily disposables versus daily wear lenses.

Leslie O’Dell, OD, FAAOYork, PAOptometry Times Editorial Advisory Board member

Do it! Providing the best care to our patients should be top priority, not cost of goods.

Justin Bazan, ODBrooklyn, NY
Optometry Times Editorial Advisory Board member

Just because daily disposables are fresh and clean each day, don’t forget that older materials often have low DKs that can lead to complications.

Related: Daily disposables deliver benefits for patients and practicioners 

Will Smith, ODJacksonville, FL

If I'm trying to mask a small amount of corneal cylinder, often I will choose a lens with a slightly higher modulus (MPa). Modulus of a material describes how well it resists deformation.

Charissa Young, OD, FAAO, FSLSSeattle

My colleague introduced me to the “Pepsi Challenge:” If you fit one eye in the patient’s habitual lens and the other eye in a daily disposable silicone hydrogel lens, the patient can immediately appreciate the difference in upgrading to the latest, healthiest technology.

Michael Cooper, ODWest Hartford, CTOptometry Times Editorial Advisory Board member

There are many reasons to fit daily disposables with the low-hanging fruit being ocular surface disease management. My clinical opinion and advice is to actively look for these patients because they tend to suffer through their contact lens wear due to bioburden and tear chemistry imbalance.

The reusable modality has a penchant for potentially causing increased discomfort and fluctuating vision by the end of the day. After the switch is made to single-use lenses, these challenges usually are minimized, which translates to a better patient experience/quality of life.

Chris Sindt, OD, FAAOIowa City, IA

Daily disposable lenses are practical for many unusual things, including putting on the front surface of a scleral lens when the scleral lens does not wet. Daily disposable lenses will also remove filaments when someone is suffering from filamentary keratitis. Place the lens on the eye for about 30 minutes; when it is removed, the filaments will be gone.

What one piece of advice would you offer fellow ODs in addressing the price conversation with patients?

Scott Schachter, ODPismo Beach, CAOptometry Times Editorial Advisory Board member

Spherical daily disposables start as low as less than a dollar per day, no solution costs, new lenses every day-it’s the safest way to wear contact lenses.

Milton Hom, OD, FAAO, FACAAI (Sc)Azusa, CAOptometry Times Editorial Advisory Board member

No more solutions, no more deposits, plenty of lenses, better comfort, fewer overall problems.

David Geffen, OD, FAAOSan DiegoOptometry Times Editorial Advisory Board member

With manufacturers rebates, daily disposable contact lenses are less expensive than utilizing a two-week modality when solutions are added in, and pricing is very comparable to monthly lenses. Reviewing the convenience and comfort benefits available for not much more money convinces most of my patients.

Mile Brujic, OD, FAAOBowling Green, OHOptometry Times Editorial Advisory Board member

Patients have come in increasingly asking about the environmental effects of contact lens waste, in particular for daily disposables. Fortunately, we have phenomenal recycling programs that address this concern.

Bill Townsend, OD, FAAOCanyon, TXOptometry Times Editorial Advisory Board member

I make a general statement emphasizing that because the patient is getting significantly more lenses, the cost will be higher and leave it at that. My staff is great at explaining the relative cost between the two modalities. We live in a convenience-driven society that attaches great worth to “simple, easy, and convenient.”

David Kading, OD, FAAOSeattleOptometry Times Editorial Advisory Board member

If a patient cleans his monthly or two-week lens in the manner prescribed, the cost of a daily disposable lens is about the same. If practitioners advocate that patients use replacement lenses rather than daily lenses because of the cost, practitioners are just advocating for non-compliance. Patients spread the cost of lens wear out by buying solution over the year. With the new systems of offering monthly or quarterly payment for lenses, daily disposable lenses are as affordable as they have ever been.

Related: 5 methods to drive contact compliance

Gregg Russell, OD, FAAOMarietta, GA

100 percent of the patients to whom you don’t offer daily disposable lenses for trial wear will also never buy the lenses from you.

Diana Canto-Sims, ODChicagoOptometry Times Editorial Advisory Board member

I always emphasize the value of disposable daily lenses. I explain why patients would benefit from fresh lenses daily for healthier eyes. I explain that new fresh lenses mean comfort and better vision than daily wear. We offer a six- to 12-month payment plan to our patients via Care credit if they qualify.

Leslie O’Dell, OD, FAAOYork, PAOptometry Times Editorial Advisory Board member

Don't hesitate, you are recommending ways to keep your patient seeing and feeling her best.

Justin Bazan, ODBrooklyn, NYOptometry Times Editorial Advisory Board member

Your workhorse daily disposable lens should be “less than a buck a day.” That is an easy figure for a large percentage of people.

Will Smith, OD
Jacksonville, FL

You must quickly discuss benefits of a daily disposable so the patient can make an informed decision. You don't get protein and bacteria build-up on a daily disposable lens like you do on an extended wear lens, significantly reducing contact lens complications.

Furthermore, I have found that a large majority of patients develop an allergy to extended wear contacts lenses. For about a dollar a day, I can help keep you comfortable in your lenses for a long time.

Charissa Young, OD, FAAO, FSLSSeattle

I keep up to date with our office’s pricing and industry rebates and remind patients that their annual supplies are eligible for great rebates that can often be submitted through their phones with a faster reimbursement turnaround.

Michael Cooper, ODWest Hartford, CTOptometry Times Editorial Advisory Board member

My advice is to confidently focus on the anatomy and ocular surface preservation because that will facilitate the value proposition to drive patients to buy into the price tag. If you don’t give them the “what’s in it for me,” the patient/consumer will smell blood in the water, causing him to shut down.

Chris Sindt, OD, FAAOIowa City, IA

Don’t worry about cost. The benefits and comfort are so superior that people will find a high value in the product.