Novel ophthalmic pharmaceuticals drive innovation, improve outcomes

• Published in: Ophthalmology Times Vol. 46; no. 12; pp. 25 - 27
• Main Author: Nijm, Lisa M
• Format: Trade Publication Article
• Language: English
• Published: Monmouth Junction MultiMedia Healthcare Inc 15.07.2021
• Subjects: Cataracts; Drug delivery systems; Drugs; Eye surgery; FDA approval; Glaucoma; Innovations; Medical equipment; Medicare; Ophthalmology; Patients; Pharmaceuticals; Physicians; Reimbursement; Steroids; Technological change
• ISSN: 0193-032X; 2150-7333

Following the positive experiences reported by other surgeons, I've been administering Dexycu directly into the capsular bag, which has been helpful in keeping the drug depot reliably in place.3 Although the pivotal trials for Dexycu were conducted in cataract surgery, it is approved for any ocular surgery and has been used for postoperative inflammation control in minimally invasive glaucoma surgeries and even vitreoret-inal surgeries.4,5 Dextenza is inserted into the lower lid tear canaliculus at the end of cataract surgery, where it elutes dexamethasone onto the ocular surface, providing an ancillary benefit of punctal occlusion, and gradually resorbs after approximately 30 days.6 Regarding its potential benefit to the ocular surface, I am also currently conducting a clinical trial evaluating Dextenza in conjunction with the Systane iLux (Alcon) meibomian gland dysfunction treatment device. In both studies, Durysta reduced IOP by approximately 3096 from baseline over the 12-week primary efficacy period.71 find Durysta's capabilities very interesting, especially as a cornea specialist who has done considerable research into the interplay between dry eye and glaucoma.8 Reimbursement redux As positive data accumulate on these drugs, I've incorporated them into my practice-as I do with all new technologies that I deem worthwhile-by identifying patients I think will benefit from them. [...]reimbursement is typically average sales price plus 696. The budget for pass-through payments is set aside by CMS a year in advance. * Congress created pass-through payments to ensure that new drugs, devices, and bio-logics are available for patients and are paid for separately from a physician's bundled payment. * While a product has pass-through status, CMS evaluates utilization and claims data in an effort to decide whether it is an innovation that should eventually have its own reimbursement code. * If you have questions about whether a pass-through product is covered for a particular patient or any other concern regarding reimbursement or usage of these products, contact the manufacturer. * Generally, the companies that have a transitional pass-through product are eager to help practices affordably access these innovative treatments so that patients will get top-tier treatment and utilization rates will support a permanent reimbursement code.