Within optometry, we face the tough scenario that many dry eye disease (DED) treatments are only in part covered by insurance, if at all. This can create patient non-compliance to our prescribed treatments. The good news: I’ve discovered three steps that can help increase both the likelihood that patients will obtain our prescribed treatments and comply with them. (See “More on DED Treatment,” below.)

1 DEFINE DRY EYE DISEASE

Discuss with the patient what dry eye is and its symptoms and/or clinical signs to establish the importance of treating it:

“This is a medical problem that can lead to progressive worsening of visual function, severe damage to the cornea, and a negative psychological impact. In your case, I’m seeing the decreased tears, and the excretion of toothpaste-like meibum from your eyelid glands, which are supposed to produce more of an olive oil secretion to promote the production of tears.”

2 EXPLAIN TREATMENT VALUE

Now, explain to the patient how the treatment(s) will address their DED, so they can see its (their) value:

“The drug I’m prescribing for you is a topical corticosteroid. It will decrease the inflammation of your condition, which is playing a substantial role in both your symptoms and clinical signs.”

I recommend writing the specific dosing, delivery (drop schedules with pictures are very useful), and duration of use. This way, the patient knows what is required for success. Another patient script:

“Warm compresses and lid hygiene must be done every day long-term, just like we brush our teeth.”

Regarding in-office DED treatments not yet covered by insurance, I have found success in discussing with the patient the treatments’ clinical importance and studies that back up their efficacy. (Remember that patients can apply for medical credit accounts and use their flexible spending accounts/health savings account for in-office treatments, as well as products purchased from your office.)

A caveat: Don’t apologize for a treatment’s cost. Instead, deliver a firm prescription. Apologizing places a spotlight on the patient’s financial responsibility, when the spotlight should be on the need for the treatment and its value.

3 GET THE TREATMENT IN THEIR HANDS

Next, make sure the patient can actually obtain the needed treatment(s). Carrying product in office can ensure the patient uses what you’ve prescribed.

Additionally, manufacturer coupons are often easily obtainable to distribute within clinic. Further, make patients aware of the patient assistance programs offered by the pharmaceutical companies that provide prescription access.

Finally, keep in mind that many e-prescribing systems provide notifications of the patient’s copay and their out-of-pocket cost at other pharmacies, providing cost savings. These same systems may allow you to quickly view, or even alert you to when a medication may have a cheaper alternative with the patient’s specific insurance. OM

MORE ON DED TREATMENT   

 

HOW CAN OPTOMETRISTS MANAGE DRY EYE DISEASE IN ALL PATIENT POPULATIONS?

bit.ly/OMDEDPopulations

 

WHAT IN-OFFICE DRY EYE TREATMENTS ARE AVAILABLE?

bit.ly/OMDEDAtHomeTreatments

 

HOW CAN OPTOMETRISTS GET ASYMPTOMATIC PATIENTS TO BUY IN TO TREATMENT?

bit.ly/OMDEDAsymptomaticPatients

 

HOW SHOULD ODs PROCEED WHEN FACED WITH END-STAGE DRY EYE DISEASE?

bit.ly/OMEndstageDED

 

DR. KOETTING practices at Hines-Sight in Denver, Colo. She is a fellow of the American Academy of Optometry, diplomate of the American Board of Optometry, an active member of AOA, and a speaker and consultant for multiple companies. Follow her on Instagram at Dr_Jazz_Hands, or email her at Dr.CeceliaKoetting@gmail.com.