Insights into the FTC’s Contact Lens Rule

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The FTC is eyeing its Contact Lens Rule and has announced the agenda for a March 7, 2018, workshop, The Contact Lens Rule and the Evolving Contact Lens Marketplace.

In place since 2004, the Contact Lens Rule requires prescribers to automatically give patients their complete contact lens prescription after a fitting. The Rule also says that prescribers must verify the prescription – or provide it – in response to a request from an authorized third party. With this framework in place, consumers are empowered to comparison shop at a variety of traditional and online retailers for the lenses their healthcare professionals have prescribed, if they choose to do so.

We’re hosting the workshop in conjunction with the FTC’s regulatory review of the Contact Lens Rule. (A Notice of Proposed Rulemaking was issued in December 2016 announcing proposed changes.) So how is the Rule working? To what extent are consumers able to comparison shop under the Rule’s prescription release and verification framework? How have new technologies, including electronic health records, affected the prescription verification process, and what other innovations might be on the horizon? Would any modifications to the Rule foster additional competition and maximize the health and financial benefits to consumers? Are there particular medical or safety issues that should inform discussion of these topics?

To talk about those questions and more, we’re convening a public workshop on March 7th featuring healthcare professionals, industry members, consumer advocates, law enforcers, and others.

After introductory remarks by Thomas Pahl, Acting Director of the FTC’s Bureau of Consumer Protection, Panel #1 will offer an overview of the contact lens marketplace. Panel #2 will feature medical professionals sharing insights on the health and safety issues the Rule implicates. The topic on the table for Panel #3 will be competition in the contact lens marketplace. Panel #4 will examine the prescription verification process and Panel #5 will take on issues surrounding prescription release and consumer choice. The last panel of the day will look to the future. Are there potential market disruptors that may have an impact on competition, consumer protection, and the Rule?

The event is free and open to the public. Registration begins at 7:45 a.m. at the FTC’s Constitution Center Conference Center, 400 7th Street, S.W., in Washington, DC.

Can’t make it to Washington on March 7th? We’ll post a link on the event page just before 9:00 ET that morning so you can watch the webcast live.
 

Comments

I’m an eye doctor and I cannot tell you how many times I’ve had to explain to patients that they have lost vision (sometimes permanently) due to inappropriate contact lens wear. It happens almost daily. This increases exponentially when contact lenses are purchased online because 1) proper wear is not enforced 2) size and fit are not always appropriate 3) online vendors often send the incorrect products or substitutions. You are sticking a piece of plastic on your EYE...if it doesn’t fit appropriately it can cause permanent damage, pain, and vision loss. It’s a medical device.

Also, for the record, I do NOT sell contact lenses at my practice, nor do I benefit whatsoever from the sales of contact lenses.

I am currently an eye doctor and I have been practicing in varied offices. Patients are aware that they can purchase contact lenses wherever they would like in all offices I worked at. We also inform the patient that they are welcome to purchase contact lenses with us or they can get them wherever they please especially online. Some patients prefer to shop with us and not have to go through the hassle of ordering online especially when there is no prescription verification to make sure that patients are getting the correct contact lens RX. Also, online websites such as 1 800 contacts don't always send prescription verifications or send them during non business hours where we are unable to send a confirmation. So, patients end up with wrong RX or lenses that have no astigmatism when they need that correction to be able to see well. Annual corneal health evaluations are important to safely allow patients to wear contact lenses and prevent unnecessary vision loss from terrible contact lens related infections. It is my hope that the FTC will not put the patient's health at risk to promote competition. Also, having a patient have to come back to sign a paper acknowledging that they have received the RX creates more burden and red tape for patients and doctors when most practices and healthcare in general is trying to reduce paperwork and carbon footprint in general.

Contact lens complications are VASTLY under-reported because:
1. Many of these contact lens patients are self-pay or have no insurance.
2. Many of these patients use vision insurance for exams and vision insurances do not cover eye exams for medical diagnoses
3. Doctors are oftentimes out of network with the patient's insurance plan and so the insurance plan never sees the complication codes
4. Many eye doctors run small practices and there is a lot of time and overhead trying to keep up with BOTH vision insurances and medical insurances. As a result, many eye doctors do not take or file medical insurances.

The consequence of all of the above is that medical insurances just DO NOT see the vast majority of contact lens complications because the codes were never coded/filed to these insurances. Insurance companies only see a small fraction of actual coded contact lens compliations. So, to the eyes of insurances and the public, contact lenses are supposedly safe and carry ltitle risk.

But if anyone were to step into any eye doctor's office on any given day, you would see that we deal with contact lens adverse events EVERY SINGLE DAY. Multiple times a day. Most patients have no clue that contact lenses are a medical device. I have a lengthy talk with contact lens over-wearers multiple times a day.

I had a patient I saw in 2016 and fit with toric lenses at the time. She came in last month and now has keratoconus corneas. I asked her about her contact lens wear and she said she was able to order contact lenses through Hubble and had been using these lenses for the past year. Our office never received a request for the order. She was wearing non-astigmatism Hubble contacts. These contact lenses likely contributed to her keratoconus and now her best corrected vision was 20/40 in each eye (she was 20/20 2 years ago).

I do not sell contact lenses in my office and every patient leaves with a copy of their prescription. The public needs to be properly educated that contact lenses are a medical device or we will continue to see a rise in contact lens related adverse events.

The current system is broken and the proposed action only serves to waste the time of the doctors office. Contact lens patients already purchase wherever they want and will continue to do so, it is up to the FTC to ensure that CL retailers are filling the prescriptions legitimately.

I am an optometrist in St. Louis, Missouri. We see mostly children and teenagers, and fit a lot of contact lenses. All of my patients receive a copy of their contact lens prescription at the end of the exam. I do not care where they purchase their lenses. But, I do have concerns when online retailers change my prescription without my consent. I have seen patients purchase lenses that are designed for trials (retailer making money off of free trial product from the supplier), changed brands, and incorrect prescriptions.

Patients even on this comment thread mention that they have not had an eye exam in years; they merely call 1800 contacts and fill the same prescription from last year. How is 1800 contacts (and other online retailers) filling these expired prescriptions if they are operating under the law? Who is protecting citizens in this regard?

If you choose to tighten regulations to prescribing doctors, please also look into tightening regulations to online retailers, so they are held responsible for filling the Rx as it was intended. We make decisions in the best interest of the eye health of our patients, and that includes seeing them regularly to ward off potential dangers to their eyesight and eye health.

Last summer, one of my teen patients came in with a huge corneal ulcer from contact lenses obtained improperly from an online retailer. She spent several nights in the hospital receiving IV antibiotics and EVERY DAY for 6 weeks going in to see the corneal specialist, as they monitored her vision and attempted to save her eye. She now has a corneal scar that will never go away.

I have been wearing the same brand of monthly contact lenses over the past 3 years or so. I tend to wear them a lot longer than I should. I Had to go to a new doctor, that prescribed very expensive steroids and anihistimines (over 500 dollars). In addition to 200 dollars to glance in my left eye.. I had to stop wearing contacts for 2 weeks... Cost 120 dollars for the "cheap" glasses. I was patient for weeks in the uncomfortable glasses.. Yet I followed the doctors recommendations, Also Recommended daily disposables Torric Lenses so that I would not encounter a protein build up.. I was given my glasses prescription the second visit due to the mild irritation..Optomitrist wanted to ensure it was an accurate prescription. Dr Adams stated he wanted me to try the torric dailies for 5 days, after that time I would be given my contact lense prescription...Friday Made 2 weeks and my prescription is being held hostage. I was told someone at the office crossed out 5 days and wrote 1 month.. I refuse to pay 100 dollars a month- 1200 dollars a year!! I paid for a service and paid for the prescription. I have the right to purchase online. I would honestly rather pay for another prescription at another optomitrist...based on principale

Just received a verification from Hubble contacts. Can't understand anything on it, no callback number. Forwarding the recording to the FTC.

Anyone can buy contact lenses over the counter in Europe... The same exact ones the optometrist sells here for less money and no exam.. another case of inflated 'prescription prices' , we in the US pay over the fine people in Europe. Also, my medicine is 1/6 the price there than it is here. There really is NO harm in Buying you own lenses there as long as you get the exact same product you buy here. None what so ever ! So keep your mone,y travel to Europe enjoy, your life.

Also just received a verification from Hubble contacts. They did not identify themselves, and the recording was largely not understandable. At the end a number for a callback person was given - pretty quickly, but I did manage to write it down. Called the number and got a recording saying they would try to return the call with 48 hours. At this point I still had no identification for the company. I then did an online search for the number and found this website with a long list of complaints: https://www. Actually I have no problem with contact lens verifications generally, but there are a few companies that seem to deliberately make it difficult to verify rxs in a timely fashion, call to "verify" persons who are not clients seemingly hoping there won't be a timely response so they can "legitimately" fill an expired or non-Rx, or otherwise seem to treat present requirements as distasteful impediments.

The need for a valid prescription via law, even when I know what it is, is a huge detriment to us consumers, both financially and our time. My contact orders are being denied because I do not have a "non-expired" prescription. I now may be unable to see because of these ridiculous requirements. I know what my prescription is, yet cannot order it without spending hundreds of dollars to renew my prescription. This is absolutely ridiculous. Contacts are not a drug that needs to be regulated. Stop making me spend money to get a contact prescription simply because "it may cause eye trouble if you get the wrong one or use it wrong." Every item in every store could be used to gouge my eyes out and hurt my vision, if I want to buy contacts I know will work I should be able to get them without the financial and time difficulty caused by needing a valid prescription. I am now wearing contacts that are way past their viability date, causing more harm to my eyes, because of these stupid laws that are restricting me from getting an item that I have already bought in the past that allows me to see. I cannot believe people here who are in support of this regulation. I can get alcohol, marijuana, knives, or even a fricking gun quicker than I can get my contacts. This regulation needs to stop immediately. My contacts are being denied from Costco even while I'm taking the exact numbers off the box of the ones I was prescribed because I need this so called valid prescription. This is absurd.

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