Article

Estimating Contact Lens Fees at the End of the Century

Estimating Contact Lens Fees at the End of the Century

A CONTACT LENS SPECTRUM STAFF REPORT
July 1999

Like last year's survey, over 40 percent of this year's practitioners indicated that they increased professional fees to counteract decreased material fees.

This year's edition, our 6th, is a report from 71 optometrists, 11 opticians and one ophthalmologist from a broad array of modes of practice from around the United States. They estimate that on average, about 10 percent of their contact lens income comes from RGP lenses and another 10 percent comes from soft conventional lenses, while just over 22 percent of their contact lens income comes from 1- to 3-month replacement lenses and over 30 percent of their contact lens income comes from 2-week disposable lenses. Nearly 10 percent of their contact lens income comes from soft toric contact lenses with bifocals accounting for only 3 percent.

Contact Lens Spectrum
Readers' Profile (n=233)

  • Nearly 65% see more than 40 patients per week

    Average = 44
  • Contact Lens Fittings / Refittings per week
    1-5 22%
    6-10 28%
    11-15 20%
    16-20 12%
    21+ 18%

    Average = 11.5

Contact Lens Practice Profit

Prior to last year, two-thirds of those who responded to our survey thought that spectacle-only patients were more profitable than contact lens patients (who also should purchase spectacles), but last year, this dropped to 45 percent. This year, only half of our respondents thought that spectacle-only patients were more profitable than contact lens patients. Numerous studies have demonstrated that contact lens patients are more loyal, have examinations more often and are more profitable than spectacle-only patients. Perhaps this is becoming an accepted belief; over the long term, successful contact lens patients are more profitable. And it's hard to provide the best care without profit.

Last year, our readers thought 40 percent of their income was from contact lenses. This year, the average estimate was 35 percent. Forty-three percent of the respondents increased professional fees in the past year (versus 44 percent in 1998), while 35 percent decreased material fees - up from 26 percent in 1998. Competition, mail order, managed care and seeing more patients were the most common reasons cited for these fee adjustments. It does appear that over the last few years there has been an expected reduction of fees for disposable contact lens materials due to competition and high volume, which is hopefully made up for by increased professional fees and greater volume.

TABLE 1  1996 & 1997 Average Fees For Soft Contact Lenses (excluding comprehensive examination fees)
PROFESSIONAL FEE MATERIAL FEE
1996 1997 1996 1997
Conventional Soft Daily Wear Spherical New Fit $75 $68 $65 $71
Refit 58 46 65 71
Extended Wear Spherical New Fit 88 70 81 89
Refit 62 48 79 90
Opaque Spherical Daily Wear New Fit 79 70 131 187
Refit 56 50 130 196
Toric Soft Daily Wear New Fit 97 91 149 168
Refit 68 64 149 166
Multifocal Soft Daily Wear New Fit 140 100 225 265
Refit 90 75 215 261
Monovision Soft Daily Wear New Fit 98 79 93 92
Refit 65 55 92 94
Planned Replacement Quarterly New Fit 70 70 89 108
Refit 53 53 89 106
Planned Replacement Toric Quarterly/Monthly New Fit 91/96 90 176/206 192/254
Refit - 65/68 - 196/255
Disposables for Daily Wear Weekly/Biweekly New Fit 84 75 140/235 134/238*
Refit 68 54 140/235 140/257
Daily Disposable New Fit 94 72 440 376**
Refit 67 51 440 394
* $21-28 per 6-pack ** $27-38 per 30-pack

Table 1 illustrates fees from our 1996 and 1997 surveys. Table 2 illustrates fees from our 1998 and 1999 surveys. Table 3 illustrates fees from our 1996 and 1997 surveys and Table 4 illustrates the 1998 and 1999 survey data. Note: these fees do not include comprehensive eye examination fees.

TABLE 2  1998 & 1999 Average Fees For Soft Contact Lenses (excluding comprehensive examination fees)
1998 1999
PROFESSIONAL FEE

MATERIAL FEE

PROFESSIONAL FEE

MATERIAL FEE

PLANNED REPLACEMENT (per box) (per.repl. sch.) (per box) (per.repl. sch.)
Spherical lenses for quarterly replacement New Fit $69 $53 $107 $68 $49 $93
Refit 51 53 107 54 55 73
Spherical lenses for monthly replacement New Fit 72 46 146 69 45 116
Refit 50 46 146 55 45 110
Spherical lenses with enhancing tint New Fit 71 60 133 68 45 103
Refit 50 60 133 54 47 86
Toric lenses for quarterly replacement New Fit 82 98 194 89 103 179
Refit 59 98 194 67 101 153
Toric lenses for monthly replacement New Fit 82 95 259 59 86 188
Refit 46 95 259 69 85 203
Multifocals New Fit 63 95 193 106 77 207
Refit 56 95 193 76 76 191
DISPOSABLE LENSES (per box) (per.repl. sch.) (per box) (per.repl. sch.)
Spherical lenses for two-week replacement New Fit $73 $26 $183 $69 $27 $90
Refit 54 26 183 55 26 88
Spherical lenses for weekly replacement New Fit 60 25 269 71 26 128
Refit 55 25 269 58 27 129
Spherical lenses for daily replacement New Fit 53 32 325 71 34 123
Refit 55 32 325 55 35 120
Spherical lenses with enhancing tint New Fit 69 38 234 71 39 95
Refit 55 38 234 56 44 93
Disposable opaque soft lenses New Fit 71 41 263 68 54 119
Refit 55 41 263 52 52 115
CONVENTIONAL SOFT LENSES
Spherical daily wear (clear visibility tint) New Fit $76 $56 $72 $63
Refit 76 65 52 60
Spherical extended wear (clear visibility tint) New Fit 78 66 77 72
Refit 78 81 54 73
Spherical lenses with enhancing tint New Fit 77 90 72 79
Refit 77 86 50 77
Spherical lenses with opaque tint New Fit 82 123 76 120
Refit 82 114 54 116
Toric daily wear (clear or visibility tint) New Fit 97 160 93 142
Refit 68 153 74 139
Toric extended wear (clear or visibility tint) New Fit 83 182 93 152
Refit 73 177 68 145
Toric lenses with enhancing tint New Fit 68 195 87 162
Refit 76 186 63 154
Toric lenses with opaque tint New Fit 91 231 85 197
Refit 74 224 64 187
Multifocals (daily or extended wear) New Fit 134 272 118 182
Refit 96 80 85 174
Monovision (daily or extended wear) New Fit 109 82 88 73
Refit 72 202 68 74

 

TABLE 3  1997 Average Fees For RGP Contact Lens (excluding comprehensive examination fees)
PROFESSIONAL FEE MATERIAL FEE
1996 1997 1996 1997
Spherical Daily Wear New Fit $89 $82 $112 $126
Refit 68 58 109 126
Spherical Extended Wear New Fit 101 79 129 150
Refit 73 58 124 149
Toric New Fit 112 95 174 200
Refit 90 70 172 195
Multifocal New Fit 135 110 245 270
Refit 102 89 240 260

 

TABLE 4  1998 & 1999 Average Fees For RGP Contact Lens (excluding comprehensive examination fees)
1998 1999
PROFESSIONAL FEE MATERIAL FEE PROFESSIONAL FEE MATERIAL FEE
Spherical Daily Wear New Fit $99 $118 $86 $119
Refit 83 82 64 101
Spherical Extended Wear New Fit 117 120 202 125
Refit 78 168 65 104
Toric/ditoric Daily Wear New Fit 129 158 97 153
Refit 99 179 76 153
Alternating vision Daily Wear multifocal New Fit 142 206 108 183
Refit 105 195 84 176
Simultaneous 148 206 109 186
91 203 83 182

Emerging Trends

There are few major trends to observe in the past years once you've accounted for variability in the data. There may be a trend toward lower fees for materials for soft torics and multifocal lenses, probably driven by the expansion of disposable contact lens availability.

The great variety of lenses available, the ever changing competition from various sellers of contact lenses and the vast array of modalities of wear make fee assessment more difficult than ever.

Fifty-five percent of our readers indicated over 30 percent of their patients are contact lens patients.

Our readers offer their contact lens candidates contact lenses always, 28 percent of the time and sometimes, 53 percent of the time. Two-thirds of our readers say they always offer contact lens prescriptions when asked.

There is essentially no increase in the offering or suggesting of contact lenses to patients who do not ask about them, despite our many studies which show better safety, more convenience and more profit with contact lens patients than with spectacle- only patients. The risk of greater chair time for contact lens patients seems to be the inhibitor.

We conclude that it is difficult to determine exactly what contact lens fees are and where they are headed at the end of the nineties decade due to the dynamic nature of the field and the vast competition and alternatives available. Overall, fees are stable. However, this could change with extended wear being reinvented and lower price pressures of daily disposables.

How much more will the new high Dk lens extended wear care cost the patient and reward the practitioner for the value of safer, uninterrupted vision? One could estimate at least $100. Is that enough to compete with the hundreds of dollars reward for co-managing a refractive surgery patient? We'll find out in the early part of the next century. Can practitioners in the USA find a way to talk about and promote the use of daily disposable lenses the way their British counterparts do? Daily disposable lens use in the USA can grow if practitioners talk about the cost as "about a dollar per day" and according to monthly cost, not annualized cost. Practitioners who encourage the purchase of an annual supply of contact lenses speak very favorably of this approach both for the patient's well-being and for their bottom line.

Income from contact lenses in many practices may increase in the next 5 years due to expected growth in specialty lens categories. Emphasizing to the patient that specialty lenses require more care due to their design and fitting requirements is the key to success. Keeping the patient in the practice by offering convenience and competitive fees along with valuable products and care is of greatest importance.