It's Time to Abandon “Premium” IOLs

Surgeons’ ability to bring technologically advanced lens implants to cataract patients grew significantly 5 years ago when the Centers for Medicare & Medicaid Services decided to allow physicians to offer IOLs that improve vision beyond monofocal distance correction. Surgeons may now correct and charge for two conditions that the Centers for Medicare & Medicaid Services previously did not cover— presbyopia and astigmatism. I believe that ophthalmologists promptly shot themselves in the foot, however, by marketing these lenses as “premium IOLs.”

WHAT DOES PREMIUM MEAN?
When used as an adjective, premium can mean high quality, but the word is just as likely to be understood as high priced. Consumers purchase premium gasoline, they prefer premium olive oil, and they pay for premium seating. Premium in the United States has become less about quality and more about price. In fact, I believe most consumers would say that, if the only adjective you apply to your extra-special product is premium, you may suffer from a lack of imagination and a penchant for trickery.

Where is the word vision in the description of these lenses? Isn’t the real promise of presbyopia- and astigmatism-correcting lenses found in the increased range of vision they provide? Isn’t the choice of lenses that surgeons are offering to their patients more about the vision patients would like to enjoy every day for the rest of their lives? Isn’t this option primarily about patients’ living without dependence on spectacles?

LIFESTYLE IOLS
Ophthalmologists will see explosive growth in the adoption of lifestyle IOLs when they stop presenting these lens implants as a choice between high price and no price and instead make the selection about a fuller range of vision versus single-range vision. Practitioners who have spent time in examination rooms with patients know that, if they are not motivated to be free of glasses during a majority of their day, they are not going to choose a presbyopia- correcting IOL. If a patient has not felt as though he or she has suffered for years and paid extra for glasses and contact lenses due to astigmatism, he or she is not going to choose a toric IOL. Practitioners should focus the conversation with patients on the real benefit of these IOLs—the vision. When patients believe in the value of the vision that lifestyle lenses can provide, their cost will cease to be an issue.

I hope within the year to I no longer see practices’ Web sites with premium IOL sections. I hope regional meeting agendas and ASCRS lecture topics no longer have premium IOLs in the headline, and I hope educational materials for patients are scrubbed of the word premium.

NEW VOCABULARY
Surgeons should eliminate premium, upgraded, new, and noncovered from their vocabulary. These adjectives describe only price and invite comparisons regarding insurance reimbursement. The way forward in ophthalmology is to focus on technological advances that provide a choice of vision that is independent of insurance reimbursement. Far better terms for educating and counseling patients are lifestyle IOLs, patient-preferred vision, full-range vision, zoom vision, natural-focus vision, multifocal vision, accommodating vision, adjusting vision, and progressive vision.

Surgeons should consider abandoning their premium IOL business before its too late and adopting lifestyle IOLs in order to revolutionize ophthalmic practice.

Kay Coulson, MBA, is president of Elective Medical Marketing, a consulting firm based in Boulder, Colorado, that helps surgeons grow their elective vision service lines. Ms. Coulson is teaching Lifestyle IOL Bootcamps for surgeons, administrators, and surgical counselors in cities across the United States in 2010. Visit www.electivemed.com to learn more or contact her at kay@electivemed.com.