The Federal Trade Commission (FTC) recently held a public workshop to explore issues regarding competition in the contact lens marketplace, consumer access to contact lenses and patient prescription release and portability. It held the workshop in conjunction with the regulatory review of their Contact Lens Rule.¹

Topics of discussion included the consumer’s ability to comparison shop for contact lenses; use of electronic health records, patient portals and other new technology to improve prescription portability; interaction between the Contact Lens Rule and emerging telehealth business models; the potential for new technologies to improve prescription verification; and possible changes to the Contact Lens Rule to help foster competition and maximize consumer benefits.¹ Unfortunately, abuses or violations to the current Contact Lens Rule that could impact patient safety seemed to be a relatively low priority for the FTC during the workshop. 

Over 60 optometrists and other eye care providers, as well as representatives from most major contact lens manufacturers, attended the workshop. American Optometric Association (AOA) representatives David Cockrell, OD, and Zachary McCarty, OD, teamed up with American Academy of Ophthalmology representative Tim Steinemann, MD, to share some sobering statistics on the matter. 

The group cited numerous abuses in filling and requesting prescription verifications, including surveys that reveal nearly a third of consumers still order and purchase lenses with an expired prescription (often more than a year beyond the expiration date). These surveys also show that many consumers were given lens brands other than what was prescribed by their eye care providers.² Robo-calls and faxes to these patients were filled with errors such as prescription requests for patients who had never seen a provider for contacts, meaning no prescriptions existed. Other verification requests were made and filled, even when inadequate follow-up or no follow-up was performed. 

The trio also provided evidence that prescriptions were filled at the end of the expiration date to carry the patients well beyond their yearly examination period.² In other words, many consumers are stretching their annual visits out to two years or beyond by filling a prescription early and again near the end of the prescription expiration date.

Some additional issues with the Contact Lens Rule involve its interaction with emerging telehealth business models and the possibility for new technology to improve the prescription verification process. The current passive verification model doesn’t seem to work and is teeming with potential for abuse. As such, this topic deserves attention, and hopefully new technology can ease the burden of this process.

A Proposed Rule Change
In December 2016, the FTC issued a Notice of Proposed Rulemaking to announce suggested changes to the Contact Lens Rule.¹ If approved, the rule changes may require providers to obtain a signed patient acknowledgement with each new contact lens prescription. The rule would also require prescribers to keep the signed document on file for at least three years. 

However, between 2011 and 2016, a Freedom of Information Act request from the AOA showed only 309 consumer complaints—out of roughly 200 million contact lens prescriptions—were related to obtaining a contact lens from a seller.² Also of interest, the recent omnibus spending bill includes language directing the FTC to abandon its proposed rule change and instead prioritize patient safety.³ 

Currently, the Contact Lens Rule does not live up to its intended purpose: to protect the consumer and provide access to contact lenses in both a safe and verifiable manner. To turn things around, the FTC should prioritize its efforts to rein in online and “big-box” tactics by sellers and retailers.

Let’s hope the FTC sees the new proposed rule change as an overreach, and instead zeroes in on the rampant abuses and violations of the Fairness to Contact Lens Consumer Act and the Contact Lens Rule by many retailers. After all, the first concern should always be patient safety.

1. The Contact Lens Rule and the Evolving Contact Lens Marketplace. FTC. www.ftc.gov/news-events/events-calendar/2018/03/contact-lens-rule-evolving-contact-lens-marketplace?utm_source=govdelivery. Accessed April 5, 2018. 2. Doctors of optometry make optometry’s case to Federal Trade Commission. AOA. www.aoa.org/news/advocacy/ftc-workshop-wrapup. Accessed April 5, 2018. 3. American Optometric Association First look. American Optometric Association. March 26, 2018. aoa.bulletinhealthcare.com/briefing?d=2018-03-26&doctypecode=aoa. Accessed April 1, 2018.