Industry Insider is a timely chat with an ophthalmic industry thought leader.
Robert M. Foster serves as CEO of NuSight Medical, which launched its first product, the NuLids System, in June. Created by company founder John Olkowski, MD, the NuLids System is a handheld electronic device for at-home use to relieve the symptoms of dry eye patients.
Ophthalmology Management: For those who are unfamiliar, could you explain how the NuLids System works?
Robert M. Foster: The NuLids System is a unique, clinically validated, doctor prescribed, home-use treatment for meibomian gland dysfunction and blepharitis.
The NuLids Starter Kit, which includes the handpiece and a 30-day supply of NuLids Daily Disposable Soft-tips, can be purchased through participating ophthalmology offices, where doctors can provide the device directly to patients. Alternatively, patients with a doctor’s prescription for NuLids can order the starter kit directly from NuSight.
NuLids’ sub-sonic oscillating tip is applied for 15 seconds to each lid margin and/or eyelash margin, depending upon the doctor’s orders. After the one-minute treatment, the soft-tip is disposed of and replaced with a fresh soft-tip for the next day’s treatment.
OM: The NuLids System is intended to be used at-home — what do you see as the advantages for this kind of treatment?
RF: What makes NuLids so exciting is that it helps solve problems for both the doctor and the patient. Patients are constantly battling their DED [dry eye disease] symptoms and often have them return well before their next scheduled appointment.
Dry eye and blepharitis services are largely out-of-pocket for patients and, typically, have a much lower ROI than most services covered by Medicare of third-party insurance.
But, by moving this treatment to the home, NuLids helps both the patient and the doctor, giving patients daily relief from DED’s symptoms — and at a reduced cost due to a significant reduction in over-the-counter lubricant and warming mask use. Meanwhile, NuLids creates a new, high-margin revenue stream generated in the patients’ homes while freeing up valuable office space for other more critical treatments.
OM: What NuLids clinical trial data can you share?
RF: Data from our in-house NuLids I study was presented as a poster at ASCRS 2017. It showed statistically significant reductions in dry eye signs and symptoms; among these were an improved tear-film breakup time from 6 seconds to 10.8 seconds.
The NuLids II study, presented as a poster at ASCRS 2018, showed even more compelling data. It demonstrated an 81% increase in meibomian glands yielding liquid secretions, a 65% increase in tear-film breakup time and a twofold reduction in OSDI scores compared to pre-trial baseline. Further, 95% of subjects found NuLids to be easy and comfortable to use and were either satisfied or very satisfied following treatment.
OM: Do you think home treatment devices like NuLids will be more common in the future?
RF: I attended a presentation at ASCRS 2017 that analyzed the effect of declining reimbursement rates on eye-care physicians, and it found that a practice in 2017 looking to make the same revenue as it did in 2007 would need to see 47% more patients than it did 10 years ago.
We believe that our new paradigm of doctor-directed, at-home use will become a fundamental part of the ophthalmic landscape as it lets physicians send patients home with safe and effective treatments, creates greater efficiency in health-care delivery and allows practices to focus doctor and staff time on higher-margin procedures best performed in the office. Products like NuLids help “attach” a patient to a providing clinic, since they’re getting quick, reliable relief from that device.
In effect, NuSight Medical is helping doctors and their patients by creating a “borderless office” in which superior patient care is delivered to patients at a low cost while creating new, high-margin revenue streams for practices.
OM: As a newer company, what challenges has NuSight faced?
RF: Two of the big problems facing any new enterprise are product awareness and name recognition. To help address this challenge, we have hired an experienced team of sales management and business development professionals.
These are veterans of the eye-care device industry, who have both the long-standing relationships and the experience to make the NuLids System a well-supported mainstream treatment. While NuSight Medical and the NuLids system are not yet household words, hiring a great team is already proving to be a successful formula.
OM: Your previous work experience comes from long-standing companies, such as Zeiss and Topcon. What motivated you to join a new company like NuSight?
RF: All of us at NuSight Medical owe a lot to our former employers. That said, there were three key things about NuSight Medical that appealed to all of us. First is the start-up environment, where you have to innovate and execute quickly — or perish.
Second, NuSight has a unique commercial model and product. To our knowledge, there are no other FDA-registered, home-use electro-mechanical treatment devices in ophthalmology. Likewise, the doctor-directed, home-use model and the ways it benefits practices and their DED and blepharitis patients is truly innovative.
Third, NuSight Medical has a great team — our management team has more than 200 combined years of service to the eye-care industry, which gives us plenty of experience to draw upon. OM