EyeWorld Asia-Pacific December 2015 Issue

43 EWAP CATARACT/IOL December 2015 been disruption in the market, and I think all the companies should be applauded for their efforts in innovation and helping our patients get the best outcomes possible in the most compliant, convenient, cost-effective way,” Dr. Parekh said. Because there is not one delivery system that’s right 100% of the time for 100% of patients, having increased options to choose from is important. “We’re going to have the ability to mix and match and adopt different technologies to get the best outcomes for our patients because there’s not one patient prototype, there are many patient prototypes; only when you customize care for each patient will all patients get the best outcomes,” he said. Dr. Parekh said these options allow cataract surgeons the ability to adjust the overall postop regimen load for some patients by giving them some medications intraoperatively, which may help reduce the need for the traditional 4–6 week period of postop drops. “I think ultimately that’s where the country is going to go—a hybrid approach of some medications given intraoperatively and some given postoperatively,” he said. The 3 Cs When determining which delivery method to prescribe to his patients, one of the things Dr. Parekh looks at is compliance potential in patients. Age and lifestyle can make a difference in compliance, resulting in missed or irregular doses. He also looks at whether the patient is at a high risk for severe inflammation and whether the patient is at high risk for ocular surface issues, he said. “The 3 Cs are important: compliance, convenience, and cost-effectiveness. We don’t want our patients burdened with $1,600 worth of drops postop, and we don’t want them to spend money out of their pocket because the majority of patients undergoing cataract surgery around the country are Medicare patients,” he said. One hurdle with new emerging technologies of delivering anti- inflammatories is “who’s going to pay for it,” Dr. Parekh said. There’s always a big push to put things in the premium channel, but the majority of Americans undergoing cataract surgery are not in the premium channel, they’re in the “routine channel,” where hopefully their benefits cover the cost not only of the surgery but of the postop medications. “It may be an option to push things into the premium channel but [in my area], in New Jersey, patients will say, ‘If it’s covered I’ll do it, if it’s not covered, I won’t.’ That’s the black eye for innovation.” EWAP Editors’ note: Dr. Parekh has no financial interests related to this article. Contact information Parekh: kerajai@gmail.com