The disposable contact lens market has come a long way since 1987, when the first disposables intended for one week of continuous wear were introduced. Sold in a plastic clamshell box, the lenses came in lots of six. This meant that patients would need more than eight boxes per eye to allow them to wear these lenses as prescribed without interruption for one year. At the time, we were less concerned with a patient’s yearly lens supply and more apprehensive about sticking our toes back into the previously problem-filled waters of extended wear. 

The next lens on the market, which also had six lenses per box, was intended to be prescribed for two weeks of continuous wear, meaning a yearly supply consisted of less than five boxes per eye. It was at that time the “yearly supply” lightbulb went off for most of us and we started to recognize the patient (i.e., compliance) and practice (i.e., economic and logistic) benefits of prescribing and dispensing annual supplies of lenses.

Yet, for many of us, dispensing a year’s supply of lenses is still a challenge. The most common reason is that patients balk at the up-front cost. Much has been written about how to overcome this objection and various techniques have been developed to increase the rate of annual supply purchase, including informing the patient they have been pre-approved for a year’s supply and offering them a tiered price structure with a discount based on number of boxes purchased. Lens manufacturers also offer rebates in an effort to stimulate the frequency of annual supply purchase. While collectively some of these techniques may be moderately effective, they are all largely unnecessary.

The easier solution? A rubber band. That’s the secret.

Don’t Shortchange Your Patients
What would have happened if the first box of disposable one-week lenses had had seven lenses in it? What if it had had 11, 14 or 23? My guess is that doctors’ heads would have exploded, or they would have dispensed one, possibly two, boxes for each eye and waited for patients to call for more lenses, same as they did for the six-lens boxes. Similarly, what if the first box had 365 daily disposable lenses in it? The same thing would have happened, except that the patient would have called for replacements at a much later date. Manufacturers I’ve spoken to agree that putting more lenses into a single box helps with annual supply concerns and they agree that 365 daily lenses in a box is a great solution. But they also believe that many doctors would shy away from such a lens supply out of fear of price rejection from patients. That’s where they and I disagree, and the rubber band comes in.

I guarantee that no one reading this dispenses just the right lens and tells the patient to try it out for a few days before coming back to get the left eye fitted. The reason you fit both eyes at the same time, without even considering why, is because it’s perfectly logical to do so and rather silly not to. Plus, many of us would never consider doing otherwise because we’ve always done it this way and it works. 

So, how about the following logical and successful way to dispense more annual supplies without memorizing scripts, explaining rebates or trying to master tiered-pricing plans? Until the day comes when a manufacturer puts 365 daily disposable lenses into the box, simply put a rubber band around the appropriate number of boxes and present the annual supply of lenses as the default way that you dispense lenses in your practice. No apology necessary, no excuses needed. Just do it. Nine times out of 10, your patients will accept this as standard practice without argument. 

It’s better for patients, since it eliminates their incentive to stretch the lens replacement cycle beyond what you prescribed. It’s also more convenient for them than having to keep ordering more lenses throughout the year. And just like fitting both eyes at the same visit, once you get in the habit of always doing it this way, you’ll wonder why you never reached for the rubber band sooner.