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How Does Dropless Cataract Surgery Affect Healthcare Costs?

Avoiding post-op drops can also reduce patients' costly co-payments by billions, a new study finds.

Published: October 26, 2015

Dropless surgery could save Medicare and Medicaid billions of dollars over the next 10 years while also cutting patients' high co-payments for post-op drops, a new study from the non-profit Cataract Surgeons for Improved Eyecare (CSIE) finds.

According to the group, Medicare and Medicaid would save more than $7.1 billion over the next 10 years if cataract surgeons performed "dropless" procedures instead of standard surgery. Dropless surgery uses an intraoperative injection of medications that eliminates the need for patients to follow a strict post-op drop regimen.

Currently, post-op eye drop therapies cost Medicare an average of $323 per eye, the study found, while dropless surgery averages around $100. However, Medicare does not pay for dropless surgery and also does not allow patients to pay for it, instead expecting facilities to absorb the additional cost.

In addition to lower costs, the group also notes that cataract patients tend to be older and may have a harder time inserting 3 sets of drops several times a day for up to a month post-operatively in standard treatment. Moving to dropless surgery could reduce complications caused by non-compliance, lowering Medicare costs even further, according to CSIE.

It also could help patients save money. The study found that moving to dropless surgery could save patients more than $1.4 billion in out-of-pocket co-payment costs over the same 10-year period.

Despite the benefits, the study's authors write that there is still a "perverse disincentive" for facilities and surgeons to perform dropless surgery, since current policy dictates that they're on the hook for the costs associated with dropless therapy, but play no role in paying for the standard post-op regimen.

"This study clearly illustrates that the wider availability of dropless therapy would benefit not only cataract patients, but also our national healthcare system," says CSIE Executive Board member Eric Donnenfeld, MD, FACS, in a statement. "A change in policy to allow patient choice, either through Medicare reimbursement or at least the patients' right to pay, would save the federal government billions. This is one of the most easy-to-read prescriptions the American public will ever see."

The study was funded by Imprimis Pharmaceuticals.

Kendal Gapinski


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