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Manufacturers can encourage prescription verification
Contact Lenses and Eyewear
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Contact lens purchases via the Internet without a valid or current prescription continue to raise concern among contact lens manufacturers and eye care professionals.
Based on study results, Vistakon, a division of Johnson & Johnson Vision Care Inc., located in Jacksonville, Fla., concludes that it can have some control over requiring valid prescriptions for the sale of its contact lenses via mail-order channels.
Vistakon has created policies that require Internet and mail-order contact lens companies to verify prescriptions prior to the shipment of its Acuvue lenses. Eye care professionals who assisted Vistakon in the study say the policies also help their practices.
“In my practice, the policy created by Vistakon has given me an opportunity to reach my patients and encourage them to have examinations to renew their prescriptions. At the same time, I can continue to be involved in their eye health,” said Gary J. Morgan, OD, of Palatine, Ill., who assisted Vistakon in collecting data for the study.
Mail-order contact lenses
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In 2001, Vistakon was the last of four groups to settle a contact lens antitrust lawsuit. Vistakon agreed to allow its Acuvue lenses to be sold through mail-order channels provided those companies sell lenses to only those customers with valid prescriptions and comply with federal and state regulations.
Vistakon then announced specific agreements it made with Internet contact lens distributors. Under the terms of the agreements, mail-order/Internet retailers would require valid prescriptions from consumers prior to the shipment of Acuvue lenses. If a prescription is not available or is expired, 1-800 CONTACTS, along with other Internet mail-order companies, agreed to contact the patient’s eye care practitioner and allow the practitioner 8 business hours to either approve or deny the prescription. Vistakon said it forms these agreements when opening accounts with all mail-order distributors that want to sell Acuvue lenses.
“They want to buy contact lenses from us, and we want a process in place,” said Tom L. Harkleroad, Vistakon’s vice president of trade relations, in an interview. “So we began to validate whether they were verifying prescriptions or not. If they did, we opened up an account. If they didn’t, we said no.”
Skepticism surrounded the 8-hour deadline that a doctor would have to respond to the verification request. For instance, if an automated phone message is left at a practitioner’s office, would the prescription be sent before the practitioner had a chance to respond to the message?
“At first, I think doctors’ reactions were skeptical,” said Phil Keefer, president of Vistakon Americas. “Would mail-order or Internet companies really comply? And if they didn’t, would we really enforce it? Everyone agreed that if it worked, it would be a good thing, but we didn’t know if it was going to work.”
To address these questions, Vistakon designed a study to look at how contact lens prescriptions were being verified prior to shipment and how the process may vary among different manufacturers’ products.
Verifying prescriptions
Part of what makes Vistakon believe that its verification process does work is that it does not consider automated phone messages an appropriate way to verify prescriptions. “If a practitioner receives a phone call to validate an Acuvue prescription, 97% of the time, they are talking to a real person,” Mr. Harkleroad explained.
Prescriptions for Vistakon products are routinely validated by fax in his office, according to Judson Briggs, OD, of Dunwoody, Ga., who also participated in the Vistakon study. “These same forms can easily be faxed in return with the requested information,” he said. “This method also provides a copy of the request for our records.”
Practitioners are finding that the agreement between Vistakon and mail-order contact lens companies does increase the number of prescriptions verified before the shipment of Acuvue lenses. Dr. Morgan also finds that he most often receives a fax request for prescription verification prior to the shipment of Vistakon products.
“They will fax me a form letter that I can respond to by checking off the appropriate prescription and expiration for all Vistakon products,” Dr. Morgan said. “When it comes to other products, I do not receive a fax or phone call 90% of the time. When I am contacted, it is a fast-paced, confusing automated phone message that is very difficult to respond to.”
The study
As a result of the antitrust lawsuits in 2001, most contact lens brands, as well as private-label contact lenses, are available via mail order. Currently, approximately 35 mail-order companies are selling contact lenses in the United States, Mr. Harkleroad said. The largest five of these companies represent about 90% of the market, he added.
Vistakon’s study took these five companies into consideration.
The study involved 422 contact lens purchases from the five largest mail-order/Internet companies by testers who work for an independent company that specializes in investigations. The purchases were made between May 14 and June 30. Formal tracking systems were implemented at all 11 participating doctors’ offices from 10 different states.
For the study, all purchases were attempted with non-valid prescriptions. If contacted, doctors were instructed to indicate that the prescription was either expired or “not my patient.” All products received were therefore lacking proper prescription verification.
The data showed that when phone calls are made to verify Vistakon products, 97% of the time they are personal phone calls, compared to between 13% and 54% of the time for non-Acuvue lenses. Between 46% and 87% of the verification attempts for non-Acuvue lenses were automated phone messages.
For Vistakon’s products, 2% of the time no verification method was used, compared to 68% to 78% of the time for other manufacturers’ products.
The data collected from the study showed that 8% of Acuvue products were shipped without a valid prescription, while 89% to 96% of other brands were shipped without a valid prescription. All brands of contacts that were tested in the study had 100% product availability via the Internet, while private-label product availability was 78% of the time and shipped 90% of the time without prescription verification.
“After studying the verification process of products produced by manufacturers other than Vistakon, we were surprised that few attempts are made by suppliers to contact eye care practitioners,” Dr. Briggs told Primary Care Optometry News. “When contact is made for other manufacturer’s products, it is usually in the form of an automated call, which has proven to be a poor method of communication. Amazingly, when our response indicated that our patients’ prescriptions were expired or unauthorized, lenses were, in most cases, still shipped.”
Patients returning for eye exams
David W. Rouse, OD, who is in private practice with Rouse Family Eye Care in Sunrise, Fla., was one of the investigators who worked with Vistakon to ensure the accounts that were going to be opened were following the established guidelines for verification.
Dr. Rouse finds that with the established prescription verification guidelines in place, more patients with Acuvue contact lenses are returning for eye exams. “I’m hearing more and more that a patient is in the chair because he or she couldn’t get a prescription filled for Acuvue lenses,” he said. “We didn’t hear that a year ago. The verification process is working, and it is working for my practice.”
A protocol can also be in place at the practitioner’s office to handle the prescription verification requests and follow-up with necessary eye exams. “A well-organized office protocol is imperative in appropriately handling verification or authorization of patients’ prescriptions,” Dr. Briggs explained. “We find it beneficial to appoint a designated staff person to coordinate the authorization process and contact patients as needed.”
Prescription expiration does provide an opportunity for the eye care professional to monitor the eye health of patients, Dr. Briggs continued. “Due to the verification process established by Vistakon, we feel that patients who wear Vistakon lenses are more likely to return for their eye health exams,” he said.
For Your Information:
- Gary J. Morgan, OD, can be reached at 762 W. Euclid Ave., Palatine, IL 60067; (847) 991-3646; fax: (847) 991-8846. He has no direct financial interest in the products mentioned in this article, nor is he a paid consultant for the companies mentioned.
- Tom L. Harkleroad is vice president of trade relations for Vistakon. He can be reached at Vistakon, 7500 Centurion Pkwy., Jacksonville, FL 32256; (904) 443-1096; fax: (904) 443-1515.
- Phil Keefer is president of Vistakon Americas and can also be reached at Vistakon.
- Judson Briggs, OD, can be reached at 1637 Mt. Vernon Rd., Ste. 100, Dunwoody, GA 30338; (770) 396-3460; fax: (770) 668-0436. He has no direct financial interest in the products mentioned in this article, nor is he a paid consultant for the companies mentioned.
- David W. Rouse, OD, can be reached at 15908 W. State Rd. 84, Sunrise, FL 33326; (954) 384-6200; fax: (954) 384-0506. Dr. Rouse has no direct financial interest in the products mentioned in this article. He is a paid consultant for Vistakon.