December 15, 2016
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BLOG: The times they are a changin' — what to watch for in 2017

Eye care has sure seen a lot of changes in 2016, and a look to the year ahead tells us we will probably see more. Here are three continuing trends that are likely to impact the way most of us practice:

1. Drug and device company changes and consolidation. The largest manufacturers in ophthalmology have all changed hands at least once in the past 5 years. Allergan and Abbott Medical Optics seem to have found stable parent companies for now — Actavis and Johnson & Johnson, respectively. More changes in ownership are likely, though, for just about every other major eye care company in the months ahead. I have blogged previously about the reasons this happens. Essentially, the motivations that drive these transactions (creating efficiency, consolidating expertise) continue to motivate buyers, so this trend is unlikely to change in the near future. For most of us in practice, this means we’ll see new faces among sales reps, new marketing campaigns and hopefully renewed emphasis on bringing updated products to market.

2. FDA approvals will continue. Here may be the brightest spot. The past 12 months have seen more approvals of ophthalmic drugs and devices than perhaps the previous decade. (Think Xiidra, Humira, CyPass, VisuMax, Raindrop, Symfony and others.) Although some have doubts, many believe decreasing governmental regulations will yield an even more streamlined FDA. While the approval process is still far too stringent for some, we physicians are likely to see more choices in the products we offer to patients. As in Europe, we may move to a system in which our regulatory agency spends its effort ensuring safety of new products alone rather than both safety and efficacy. Once approved, new products will be subject to the judgment of the community of physicians as to how effective they really are.

3. Health care reform will bring changes to individual practices. The new president has promised a repeal of the Affordable Care Act, but major provisions may well remain. Containment of the outrageously increasing costs of health care will certainly continue to be a priority and will drive changes in the delivery of care. We can all expect to see managed care to continue challenging the way we practice medicine. Restrictions on prescribing, declining reimbursement and the administering burden that comes with both will continue to alter the way we and our staffs spend our time in practices. Those who “play the game” well will succeed by using office automation, measuring and reporting outcomes, and building relationships with payers. Margins will continue to grow smaller than we have ever experienced. Clearly, offering parallel fee-for-service procedures and products will continue to appeal to the public, who shares our frustration with the health care system’s inability to pay for improving technologies.

Changes in health care certainly will continue to present challenges to the way we physicians practice, but they will also reward what matters: Doctors who can provide high-quality outcomes without using excess resources will win. We will have to navigate a changing economic environment while we evaluate new products coming from an evolving community of industry players. Like many physicians, I have concerns, but I’m also excited about the challenges ahead. Whatever happens, it will never cease to be a privilege to help our patients to take care of their precious vision.

Disclosure: Hovanesian reports he is a consultant to Allergan, Abbott Medical Optics, Alcon, Shire and ReVision Optics.