Article

Dry eye pharma sales are ≈ $1.6 billion

If adding value to your practice is necessary, going retail with dry eye products is a logical move.

Dry eye pharma sales are ≈ $1.6 billion

If adding value to your practice is necessary, going retail with dry eye products is a logical move.

By Vanessa Caceres, Contributing Editor

Ophthalmologists who are thinking about adding value to their practices may want to consider selling dry eye products, such as tears, supplements or goggles. Up to 50 million people in the United States contend with some form of dry eye disease, and its prevalence is ever increasing.1,2 The dry eye pharmaceutical market’s year-over-year growth is greater than 6%, with an estimate of $1.6 billion based on global sales estimates.3

Gregg J. Berdy, MD, FACS, of Ophthalmology Associates in St. Louis and assistant professor of clinical ophthalmology, Department of Ophthalmology, Washington University School of Medicine in St. Louis, has tested selling various products and medications directly to patients for nearly 25 years. He now sells supplements, eye masks and tears. He says the extra sales provide a financial boost while increasing convenience for patients who otherwise would go elsewhere to buy products. He also tried but stopped selling items that patients didn’t seem to find real value in buying directly from the practice.

David R. Hardten, MD, Minnesota Eye Consultants, Minneapolis, sells vitamins and hydrating and warming masks on his practice website. “The major reason we sell these was the overall confusion that our patients encountered in the marketplace trying to find products that met their needs.” It became easier, he says, to have everything available in one spot for them.

The challenge of retail

Although Dr. Berdy’s practice has established a well-known market among his patients, he admits that selling products can be a challenge for any physician. These challenges include educating staff so they are knowledgeable about products and stocking the right amount of inventory.

Robert Latkany, MD, agrees. “There’s a convenience factor, but I’m not sure it’s the best thing to do unless someone has compared [the products they would like to sell] head to head,” says Dr. Latkany, founder and director, Dry Eye Clinic, New York Eye and Ear Infirmary, New York.

However, an ophthalmologist who is passionate about dry eye would likely see the value in offering dry eye glasses or night shields, says Rebecca Petris, owner, The Dry Eye Company, Poulsbo, Wash. “Dry eye is a symptom disease, and managing day-to-day symptoms in moderate to severe cases is often extremely challenging for patients. Doctors who get this are more likely to understand the role of consumer devices.”

If you think selling dry eye products can add value to your practice, consider this advice.

Stay up to date

Ms. Petris’ business sells dry eye products online from various companies, so she gets a number of referrals from ophthalmologists. Although she appreciates the business, she would love to see physicians train technicians or opticians about the products. This kind of in-person education would be ideal for blepharitis patients who need a lid hygiene routine but often do not know how to go about it, Ms. Petris says. “Patients who are in pain are so appreciative of anyone who manages somehow to alleviate it.”

The 40+ employees at Dr. Berdy’s private practice range in age from 22 to over 60, and a number have dry eye, Dr. Berdy says. These staff members get the chance to try products sold at the practice so they can then talk about them knowledgeably with patients. “It’s nice when someone on staff can address their personal experience,” he says.

Get staff to buy-in

Once staff members know about the products you sell, empower them to take responsibility. “I believe that all eye MDs serious about their dry eye practice should designate a technician or someone in the optical shop who will become the resident expert on palliative consumer devices and other relevant products for dry eye patients,” Ms. Petris says. The designated staff member should, at a minimum, learn the ins and outs of night dry-eye protection and moisture reading glasses, sunglasses and goggles for daytime use.

Is there a conflict selling products?

Robert Latkany, MD, founder and director, Dry Eye Clinic, New York Eye and Ear Infirmary, New York, sold his own line of vitamins, eye drops and eye masks several years ago but has since stopped. “It almost felt like a conflict of interest for me, so I sold the company,” he says. “I wasn’t ever comfortable with it.”

Aside from his unease, he believes it limited his ability to recommend other kinds of vitamins, drops or masks that he may not have available. “I may sell product A, but what if the patient needs product B, C, D, or E?” he asks.

Dry eye patient advocate Rebecca Petris, owner, The Dry Eye Company, Poulsbo, Wash., agrees that a conflict could exist, depending on why the ophthalmologist’s practice has gone retail. For example, she’s uncomfortable with selling private-label supplements or lid scrubs just for a revenue stream. “It might be a money maker, but it assumes a certain naiveté on the patient’s part.”

In a 2001 study querying a small group of dermatologists and patients about the reasons why the one group sold and the other bought, the 30 dermatologists said it’s because their patients trust them, but the patients said they bought from their physicians because of their knowledge base.1

As for Art Caplan, the bioethicist at NYU Langone Medical Center, he says selling supplements or vitamins out of a physician’s office, is unethical — mostly, he claims, because Americans don’t need vitamins. “People who have a balanced diet or have as much food around as we do don’t really need to take multivitamins,” he says in a Medscape video.2

The torrent of comments to his comments are worth noting.

REFERENCES

1. Ogbogu P1, Fleischer AB Jr, Brodell RT, et al. Physicians’ and patients’ perspectives on office-based dispensing: the central role of the physician-patient relationship. Arch Dermatol. 2001 Feb;137:151-154.

2. Caplan, AL. Is it right for doctors to sell nutritional supplements? Medscape Multispecialty. April 22, 2014. http://www.medscape.com/viewarticle/823569. Accessed Sept. 15, 2015.

Keep up with inventory and storage

Dr. Berdy’s practice just added 2,000 square feet to one of its offices, and that extra space included three more storage areas for products. Rather than ordering the dry eye products when patients elect to purchase them, it’s crucial to keep plenty in stock, he says. “It can be a negative if you don’t,” he adds, with patients reluctantly returning to buy what they wanted to get during their first visit.

You also need to be prepared to keep some of your cash tied up in inventory, he says.

Consider front-desk impact

If selling dry eye products becomes a large part of your practice you’ll need to keep patient checkout moving — otherwise, patients may have to wait several more minutes than they would like when they check out after exam. Most of the patients at Ophthalmology Associates buy products for dry eye as well as other pre-op and post-op surgical needs. Therefore, the practice decided to expand from three checkout areas to four to help keep the checkout process moving quickly, Dr. Berdy says.

Stock product samples

Along with providing advice on products, Ms. Petris suggests handing out samples. This lets the patient look at and try them, she says. This can help with sales, but even practices that elect not to sell the products can offer samples.

Advertise your products and services

Make it easy for patients to find what you are selling. At Dr. Hardten’s practice, staff tell patients about the products and provide handouts. The practice’s website features a list of products.

Selling dry eye products in an ophthalmic practice may not be for everyone — but with the right intentions, inventory and interest, you may see a bump in sales and be able to guide patients to the dry eye products that you think round out their treatment. OM

REFERENCES

1. The epidemiology of dry eye disease. Report of the Epidemiology Subcommittee of the International Dry Eye Work Shop. Ocul Surf. 2007;5:93-107.

2. Gayton JL. Etiology, prevalence, and treatment of dry eye disease. Clin Ophthalmol. 2009;3:405-412. Epub Jul 14.

3. http://tinyurl.com/oftssol