EyeWorld Asia-Pacific June 2018 issue

Reimbursement for MIGS pro- cedures utilizing devices remains a significant barrier for the adop- tion, according to Dr. Samuelson. “CyPass coverage is still difficult in my area, and XEN coverage is even more of a challenge,” he said. “Fortunately, our Schlemm’s canal- based surgery, such as the iStent, is now routinely covered.” He added that the CyPass recently received a favorable ruling in his region, so coverage for supraciliary surgery should improve. The XEN remains uncovered in Dr. Samuelson’s area. Initially all MIGS procedures have had this challenge, Dr. Brubak- er said. “After an initial battle, the iStent has developed great cover- age,” he said. “The CyPass and XEN Gel Stent have had their challenges as well.” He added that the coverage for the CyPass has improved greatly in his area, and the XEN has also improved as of late. “Reimburse- ment will always be a challenge with early adopters,” he said. “If I think a particular device is the best treatment for my patient, I usually have a detailed discussion about the benefits of the procedure and how it compares to the older, typically riskier but covered procedure. I give my patients a detailed cost break- down for the new procedure and let them decide what they would like to do. It is surprising how often my patients elect to pay out of pocket for the newer procedure.” Dr. Brubaker think it is im- portant to give patients all their options and let them decide what they would like to have done. “On the other hand, I think it is impor- tant to have multiple treatment options for one's patients,” he said. “If the only MIGS you know how to do is not covered by the patient’s particular carrier and they can’t afford to pay out of pocket, having an alternative MIGS option that is covered can greatly improve the care of patients.” EWAP Editors’ note: Dr. Brubaker has finan- cial interests with Alcon, Allergan, Glaukos, and New World Medical. Dr. Patterson has financial inter- ests with Allergan and New World Medical. Dr. Samuelson has finan- cial interests with Alcon, Allergan, Glaukos, Ivantis, MicrOptix (Wilton, Maine), New World Medical, and Sight Sciences (Menlo Park, Califor- nia). Dr. Huang has no financial interests related to her comments. Contact information Brubaker: jacobbrubaker@me.com Huang: physicians@glaucomainstitute.com Patterson: michaelp@ecotn.com Samuelson : twsamuelson@mneye.com June 2018 EWAP SECONDARY FEATURE 39 Precisely Designed Instruments to Provide Predictable and Consistent Outcomes BVI, BVI Logo and all other trademarks (unless noted otherwise) are property of Beaver-Visitec International, Inc. (“BVI”) © 2018 BVI Beaver-Visitec International, Inc. US: 1-866-906-8080 EU: 44 (0) 1865 601256 Call your local sales rep or customer service at 1-866-906-8080 For information on all BVI products, visit bvimedical.com Malosa ® Single-Use Instruments