By Pamela Miller, OD, FAAO, JD, FNAP
Nov. 15, 2017
There is a new potential threat to your patients’ eye health–and possibly your bottom line: Hubble, an online subscription service that is being marketed as a low-cost way to get daily disposable contact lenses.
The problem? The contacts won’t be the ones you have prescribed for the patient, but, rather, a generic daily disposable created especially for Hubble. The lenses are made of a version of methafilcon with a Dk/t of 18.8, rather than today’s standard of Dk/t over 80, which allows four times more oxygen to permeate the lens.
Whatever the quality of the lenses, the lure of inexpensive daily disposables may be hard for patients to resist. The site touts: “With your first shipment you’ll get 15 pairs of Hubble Lenses for free. Just cover the monthly $3 for shipping & handling.” After that first complimentary shipment, you can get 60 lenses per month for $30.
The site has a doctor locator to facilitate prescriptions especially for Hubble lenses by connecting the patient to doctors who have Hubble fitting sets, and are open to writing prescriptions specifically for Hubble’s product.
Educate Patients: “I Am Writing a Specific Contact Lens Prescription For You”
Patients may not understand that daily disposables are not interchangeable, and that there are significant differences in quality. With the rise of inexpensive (and often cheaply made, low-quality) eyewear, such as from Warby Parker, they may equate purchasing lower-cost daily disposables with getting less-expensive glasses online. It’s up to you to educate patients why there’s much more at stake when buying contact lenses. Unlike a cheap pair of glasses, contact lenses manufactured with less-advanced (i.e. cheap) materials, could endanger their eye health and comfort.
You might say: “The contact lenses you can purchase on Hubble are not the same as the contact lenses I have prescribed for you. To purchase the contacts that Hubble sells, I would have to write you a prescription specifically for those lenses, and that’s not something I’m comfortable doing. The lenses available through Hubble are made of outdated material–material that hasn’t been standard in contact lens design for 20 years. That means not as much oxygen will be available to your eyes, possibly causing damage to your cornea and discomfort to you. There’s a good chance you will experience dryness if I prescribe those contacts, and maybe long-term damage to your eyes.”
As the doctor who prescribed the contact lenses, you are ultimately responsible for the impact a contact lens has on a patient’s eyes. If you get a prescribing set from Hubble, and start prescribing Hubble for some of your patients, and the lenses adversely affect even one patient, that could spell potential legal trouble for your practice, as with any prescription without direct follow-up care.
Give Patients Other Options
The contact lenses sold by Hubble are not a good option for patients, but that doesn’t mean there aren’t many daily disposables for patients to choose from that would be considered acceptable choices from an eye health and comfort perspective. Underscore for the patient that the choice isn’t between the most and least expensive daily disposables, and that there are usually multiple brands to try and purchase. It isn’t Hubble or the most advanced (and expensive) lenses. There are many options between those two extremes to present.
In some cases, with the purchase of an annual supply, and manufacturer’s rebate, you may be able to come close to matching the price offered by Hubble.
Emphasize Ease & Convenience of Purchasing from You
In addition to promoting its lower cost, Hubble is positioning itself as a more convenient option for getting daily disposables. But many, if not most, optometrists no longer require patients to come into the office to order and pick up contact lenses. Be sure to explain to patients how easy it is to order from you: “Ordering from us is just as easy. Once you register your payment information with us, all you have to do is go on our web site, and click a couple of links to reorder your next supply, which can be shipped directly to your home.”
Hubble also doesn’t have the market cornered in subscription services, in which the patient pays by the month for their lenses. Services such as LensFerry S, and others, allow independent ODs to make it possible for patients to sign up to receive contacts at the same time automatically every month, paying monthly, for their lenses.
You also have the advantage of in-person exposure, and easy access, to the patient. Unlike buying contacts from a faceless online service, a patient who is experiencing discomfort in their lenses can pick up the phone and make an appointment to stop by your office for you to examine their eyes, and prescribe another lens, giving them diagnostic lenses to wear and scheduling appropriate follow-up care. Hubble offers one kind of daily disposable, and if it doesn’t work for a patient, they can cancel their subscription, but will not be given alternative lenses to try.
Emphasize Total Package of Buying from You
Many practices offer patients opportunities to purchase eyewear, like plano sunwear, at a discounted rate when also purchasing an annual supply of contact lenses. If you offer such a package, let patients know: “We want to make sure all of our patients’ eyes are protected and comfortable when wearing their contact lenses, so we offer 20 percent off any pair of quality-made, non-prescription sunglasses in our optical when you purchase an annual supply of contact lenses from us.”
It’s important for patients to understand the difference between buying contacts online from a business they don’t have a relationship with, and an eye doctor who has spoken to them about their needs, and has expressed caring for their overall eye health–not just the sale of the contacts.
Pamela Miller, OD, FAAO, JD, FNAP, has a solo optometric practice in Highland, Calif. She has a law degree, holds a therapeutic license, is California State Board-certified and glaucoma-certified to prescribe eye medications, and offers comprehensive vision care, contact lenses, visual therapy and low vision services. To contact her: firstname.lastname@example.org.