Eyedrop Bill Seen Clearly By Senate Committee

by Kyle Melinn, MIRS

Private insurance companies would not be able to deny an eyedrops refill after day 23 of a prescription, under House-passed legislation considered in a Senate committee today.
 
Rep. Julie CALLEY‘s  HB 4451, pushed by the Michigan Society of Eye Physicians and Surgeons, comes amid numerous anecdotal stories and some research that shows some blow through their eyedrops prescriptions early because of the “imperfect delivery system.”
 
“How many of you have tried to put eyedrops in your eyes and missed?” asked Dr. Theresa COONEY of the Kellogg Eye Center at the University of Michigan to the Senate Health Policy Committee.
 
More than half of the nine present members raised their hands.

How many tried and failed to get an eyedrop into the eye of an elderly loved one? A small child? Sen. Curtis HERTEL Jr. (D-East Lansing), for one, kept his hand up for all three questions.

He said his mother must take eyedrops for her glaucoma or she risks a blood pressure spike and permanent blindness. The drops don’t have addictive qualities. These aren’t opioids or something someone could or would abuse, Cooney said.

“They are actually quite painful and complicated to put in,” Hertel said.

Hertel’s mother, apparently, isn’t alone. Cooney told the Senate committee that her U-M colleague, Dr. Josh STEIN, estimated that between 2008 and 2015, nearly 335,000 patients — roughly the size of Washtenaw County — have been diagnosed with glaucoma.

At least 5% of these patients (17,000) run out of their glaucoma drops more than five times a year. Nearly 25% (84,000) run out at least once.

Unless these patients are covered by Medicare Part D, their health insurance company may not cover the cost of an early refill, forcing them to the choose between paying out of pocket for the expensive prescription or paying for groceries, Cooney said.

Medicare Part D allows early refills when patients are at 70% of their predicated days of use, or day 20 of a 30-day prescription. Cooney added that 26 states have adopted similar legislation.

“The cost of paying for early refills is very modest when compared to the cost of treating someone who loses their sight altogether,” she said.

Sen. Sylvia SANTANA (D-Detroit) asked if there’s a better way to get drops in eyeballs. The short answer was no.

Cooney said many of those who take eyedrops are older. They may have tremors or Parkinson’s. They may not see well. They could have arthritis. Regardless of how the bottle is designed, they risk dropping the prescription on the counter instead of their eyeball.

It happens to medical professional all the time, too.

Sen. Lana THEIS (R-Brighton) asked if eye doctors could prescribe larger doses so patients don’t have renew as often.

Cooney said she’s written such scripts in the past, but private insurance companies will inevitably only pay for 30-day supplies because the supply can be better managed on their end.

No vote was taken on today’s bill, but no committee member raised an objection over it and nobody turned in testimony opposing it. No one from the insurance industry spoke for or against the bill.

HB 4451 passed the House on June 19, 105-4.