Answering to The Market
Hard questions on Fusarium and MoistureLoc and responses from professionals in the know.
Joseph T. Barr, OD, MS, FAAO: More than 1,800 optometrists were invited to attend this roundtable. Many of them have submitted questions that we will address today.
Q: Why did it take so much time to recall MoistureLoc, and why did you not recall the product completely when you withdrew it from Singapore and Hong Kong?
A: Angela Panzarella: About 3 months passed between the time we were informed of an increase in fungal cases in Asia in February and when we withdrew the product worldwide on May 15, 2006. Along the way, we worked as quickly as possible, guided by science, regulatory agencies, and our desire to do what we deemed necessary to protect the safety of patients.
Q: Once you recalled MoistureLoc, why did it take so long to get sufficient stocks of your other product, MultiPlus?
A: Angela Panzarella: Patient safety was our first priority. We immediately switched our manufacturing facilities over to producing more ReNu MultiPlus and the original ReNu Multi-Purpose solution, but it required some time to produce sufficient quantities.
Q: Are there other fungi or bacteria that are likely to attach more readily to the polymers in MoistureLoc?
A: Praveen Tyle, PhD: We have no evidence that Fusarium, or any other fungus or bacterium, attaches to these polymers more than to any other polymer.
Q: Do you think the combination of silicone hydrogel lenses and all-in-one solutions caused the infections?
|Gary Orsborn, OD|
A: Gary Orsborn, OD: There is no clinical, scientific or anecdotal evidence to support that theory.
Q: How can I recommend MultiPlus to my silicone hydrogel patients when scientific reports associate the solution with corneal staining?
A: Christopher Snyder, OD: I see some staining, I grade it, I note it, and I don't see that as being a bigger issue with MultiPlus than with other lens care products, based on my clinical experience. I've been looking for it because of these reports. I just can't seem to validate the reports.
Q: How much did this controversy cost Bausch & Lomb?
A: Angela Panzarella: We spent millions of dollars on the investigation, and we had hundreds of people working on it nonstop. Sales of ReNu with MoistureLoc last year were about $100 million. We certainly expect to offset a great deal of those lost sales with our other ReNu products. As we have told Wall Street, Bausch & Lomb has a very strong balance sheet, and we're going to invest what we need to invest to regain our brand equity and to develop new products. We're committed to continuing to be the leader in the lens care category.
Q: What will happen with the ReNu brand?
Christopher Snyder, OD
A: Angela Panzarella: The ReNu brand has terrific brand equity with consumers around the world, and we're committed to continuing to invest and support that brand. But we don't think we should simply return to business as usual. We know how important it is to let consumers and practitioners know they can be completely confident about the safety and efficacy of ReNu MultiPlus. And we are working to reinforce with consumers and practitioners the importance of good lens wear and care practices.
Q: When will Bausch & Lomb launch a new solution?
A: Angela Panzarella: Ideally, we intend to launch a new solution within the next 18 to 24 months as we continue to invest in product development. We have no plans to reintroduce the same MoistureLoc formulation, but we have learned an incredible amount that will help us in the development of new lens care products.
Q: Has news of the Fusarium and MoistureLoc issue led to noticeable increases in contact lens dropouts?
A: Jack Schaeffer, OD: On the contrary, I feel the contact lens market will grow. Doctors and patients are working together again to use contact lenses and lens care products properly.
Jack Schaeffer, OD
A: Dr. Snyder: We have seen increased awareness, prompting patients to come in for check-ups. It's started a dialogue that has had positive effects.
Q: Should this situation encourage the industry to return to a rub regimen of lens cleaning?
A: Dr. Schaeffer: I think most doctors have already returned to a rub regimen, especially with the advent of silicone hydrogel contact lenses, which attract lipid deposits.
A: Dr. Snyder: I've actually never really left the rub regimen. I would appreciate labeling that supports this recommendation. We know from studies of long ago that simply rubbing a lens removes 99.9+% of microbial bioburden, leaving very little for the solution to act on.