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Across the Pond | Feb 2009

Patient-Shared Billing for Multifocal IOLs

An ophthalmologist addressed the European parliament for the first time.

Modern medical device technology is an indispensable component in maintaining the health and quality of life of our patients. It is also a fundamental pillar of our health care system and a major player in the science-based economy. In fact, approximately €3.7 billion is invested in medical research and development each year, with nearly 500,000 products released into the market annually.1

In the complex environment of strictly regulated health care systems, the medical device industry faces the fundamental challenge of providing access to safe, reliable, innovative, and cost-effective products. But this access—which can be regarded as an expression of personal freedom—seems to be an endangered species these days, at least in Europe.

Medical device technology is not only a major contributor to the maintenance and restoration of individual health and quality of life, but it also remains one of the most cost-effective sectors in modern health care. The average current lifespan of a medical device is 18 months.1 Competent feedback from health care providers and patients is instrumental in improving medical products; only 7% of health care expenses are spent on medical supplies.1

ADDRESSING THE PARLIAMENT
In October 2008, scientists, physicians, spokespersons, and patients were given the rare opportunity to address the European Parliament and provide feedback on medical devices during the parliament's academic session on medical devices. Held under the patronage of Gunter Verheugen, European Union (EU) Commissioner for Enterprise and Industry, the MedTech Forum and General Assembly's medical devices session emphasized the benefits of modern medical equipment.

Gerd U. Auffarth, MD, PhD, Deputy Chairman of the University Eye Hospital Heidelberg, Germany, addressed the 400 members of parliament in attendance, stressing the potentials of modern cataract surgery. Professor Auffarth was the first ophthalmologist to address the European parliament. He discussed the limitations that most European patients currently face: In most of the EU, laws restrict access to multifocal and other premium IOLs because copayments are not permitted. The United States currently has a patient-shared billing system. In 2005, the US Centers for Medicare and Medicaid Services (CMS) ruled that cataract patients could pay the additional premium out of pocket for implantation of a premium IOL, such as a multifocal or accommodating IOL.2 The basic cataract surgery and basic IOL charge are still covered by Medicare. Across most of the EU, this same patient would lose his complete coverage for the entire cataract operation.

PATIENT-SHARED BILLING
Professor Auffarth explained the benefits of offering incentives for the use of innovative medical products, emphasizing the importance of universal availability. He also stressed the importance of a EU-wide, comprehensive, and consistent solution on patient-shared billing and reimbursement for innovative IOLs. He urged that such a solution be implemented as soon as possible, thus endorsing this technology's value for cataract patients. Some of the EU parliament members suggested this issue be brought forward to the relevant health issues committee.

Patients in the early 21st century are well informed and responsible. They deserve the opportunity to decide for themselves what medical devices may best meet their expectations, lifestyles, and concepts of well being. This freedom to choose is important when it comes to the most valuable sensory organ—the eye—and the care patients are entitled to by modern ophthalmology.

Sibylle Scholtz, PhD, is an international science correspondent based in Ettlingen, Germany. She states that she is a paid consultant to Advanced Medical Optics, Inc. Dr. Scholtz may be reached at e-mail: sibylle.scholtz@gmx.de.

Feb 2009