The cost of this growing condition to patients and practices
While it was once perceived as a minor irritation, today dry eye disease (DED) is considered a “critical and significant public health issue” in the U.S., according to the Ophthalmology Times. An estimated 16 million Americans have been diagnosed with DED, but the actual number of people affected is much higher. Some studies show that nearly half of all U.S. adults experience dry eye signs and symptoms, which include watery, itchy, or burning eyes, sensitivity to light, and blurred vision—significantly impacting their quality of life.
Patients may not be aware that their symptoms have a name or solution, however. Even if they do, they may have bounced around from provider to provider, looking for someone who truly understands and treats this frustrating, painful, and often mismanaged condition. Doctors can’t afford to overlook dry eye patients any longer. Here’s why.
What dry eye costs patients
DED has always impacted more women than men, and women are more likely to experience greater pain and a worse quality of life due to dry eye, according to the Ophthalmology Times. However, DED is now showing up in younger patients, both male and female, largely due to the rise in smartphone and computer use. Research shows DED is affecting a growing number of people, the article reported. “As a result, the economic impact of DED cannot be understated.”
Decreased work productivity is the most significant indirect cost to dry eye patients, who spend as much as $1,267 annually on treatment according to one study.
A 2016 study estimated the total annual cost of ophthalmologist-managed care for 1,000 patients with DED at $782,673 in the U.S. “Decreased work productivity is the most significant indirect cost to DED patients, given that mild cases of DED will progress and become severe if left untreated, increasing patients’ dependence on artificial tears,” reported the Ophthalmology Times.
An earlier study on the economic burden of DED found that annual direct costs (i.e., medical care treatment costs) were $678 for patients with mild dry eye symptoms, $771 for patients with moderate dry eye symptoms, and $1,267 for patients with severe dry eye symptoms, according to Ocular Surgery News.
[bctt tweet=”Annual direct costs for DED are $678 for patients with mild dry eye symptoms, $771 for patients with moderate dry eye symptoms, and $1,267 for patients with severe dry eye symptoms, according to Ocular Surgery News.” username=”goRendia”]
The cost to practices
There is a cost to practices related to dry eye disease as well—namely, not addressing DED or not treating it effectively can cost you patients. Eye care practices’ profitability is already “under attack” from such sources as online dispensaries and decreasing vision plan reimbursement, wrote Doug Devries, O.D., in Optometric Management.
“You really only have two choices for protecting your revenue stream. You can either see more patients or you can do more for the patients you already have. Dry eye is a great opportunity to do more—to provide much-needed services for your existing patients.”
Eye doctors who began offering products to help their dry eye patients have found that it helped with adherence and also increased profits for the practice.
Claudine Courey, O.D., was fitting specialty contact lenses for patients with keratoconus and corneal abnormalities when she started getting referrals for patients needing scleral lenses for severe dry eye. She told the Optometry Times, “When I began treating them and saw how dry eye impacted their daily lives, and as optometrists we have the ability to make their quality of life so much better, it really hooked me.” Today Dr. Courey runs a dry eye specialty clinic in Montreal.
When she found that her patients were struggling to find the treatments that she had prescribed, she started an e-commerce business called The Eye Drop Shop. The website enables her patients in the rural community she serves to easily purchase specific products that she recommends, improving both patient adherence and practice revenues.
Dr. Devries also sells a variety of products in his practice to help dry eye patients manage their symptoms, such as eyelid cleansing pads, moisture chambers, artificial tears, and nutritional supplements. “Although our original intent was to bolster patient compliance by making carefully chosen products easily available, we learned that the merchandising adds significantly to our profit margin for dry eye-related care,” he said.
In the Optometric Management article, he lists examples of the services dry eye patients received and the revenue they generated. They range from a patient who required four visits, artificial tears, eyelid scrubs, and diagnostics (net $577) to a patient whose treatment encompassed six visits, punctal plugs, artificial tears, eyelid scrubs, diagnostics, BlephEx, LipiView, LipiFlow, and two Prokera products (net $3,272).
How patient education affects engagement and retention
It’s true that dry eye patients require more time and attention than other patients. This is where patient education comes in. “We made patient education a primary objective in our dry eye center,” wrote Whitney Hauser, O.D., in the Optometry Times. “Many practitioners think that leads to inefficiency and wasted time. Nothing could be further from the truth. A well-educated patient will often ask fewer and more pointed questions.” She adds that patient education does not have to fall solely on the provider; practice staff can share that task.
Patient education can improve engagement and retention of dry eye patients, who have often spent years going from doctor to doctor until they find one who meets their needs.
Digital tools can make this easier. For example, this video, “What is Dry Eye?” posted on your practice web site or Facebook page, is an easy way to teach patients or prospective patients about the condition.
Patient education can also impact retention. Many dry eye patients switch providers frequently. And since most of them are women, who tend to be the medical decision makers for their families, one dissatisfied dry eye patient who leaves your practice may take several patients with her.
“Their churn rate can be high because, some would argue, they are always chasing a ‘cure’,” wrote Dr. Hauser. In fact, they are looking for a provider who will partner with them and address their needs. “They want the straight scoop and reasonable expectations to be set. Patient retention comes through adequate (if not exceptional) education.”