COMMENTARY: Senator Bill Cassidy’s Contact Lens Cronyism

Contact lenses are already expensive, but Louisiana Senator Bill Cassidy (R-LA) wants to drive up the cost to an even further degree. How? By creating a strangle hold in the online contact industry.  This will send prices higher and further enrich the pockets of optometrists.

Before 2003, eye doctors held a virtual monopoly over the sale of contact lenses. That changed with the Republican-controlled Congress’ passage of The Fairness to Contact Lens Consumers Act (FCLCA). This legislation unleashed free market competition by requiring prescribers to provide patients with copies of their prescriptions, allowing them to shop for lenses online and at retail stores like Wal-Mart. As a result, online and retail sales now account for more than a third of the total U.S. market. This opening of the market has resulted in prices dropping to record lows, allowing more people to afford lenses than ever before.

Of course, this surge in competition has upset a lot of eye doctors, who are itching to gain back their unchecked market share. Since the passage of FCLCA, the Coalition for Patient Vision Care Safety — a group comprised of contact manufacturer Johnson & Johnson, the American Optometric Association, and other members of the medical lobby — has incessantly lobbied to scrap the bill’s free market reforms.

The cronies are undaunted.  They have Sen. Cassidy, a fellow doctor, in the Senate who sympathizes with their hatred for innovation. Cassidy’s bill, the Contact Lens Consumer Health Protection Act of 2016 (CLCHPA), would make it easier for doctors and contact lens suppliers to raise prices by limiting consumer choice.  This legislation would force all contact lens manufacturers to provide their phone number, fax number, and email address to prescribers so doctors can ask questions. Doctors would be allowed to hammer the lens companies with inquiries to indefinitely delay the sale of lenses from third party stores.

Pete Sepp, President of the National Taxpayers Union, recently summarized the worst attributes of the Cassidy bill as follows:

• Eye examiners could more easily block requests from lens retailers to verify patient prescriptions;
• New bureaucracies at the Department of Health and Human Services would have an expanded role in investigating these products. Adding more federal agencies into the mix for “oversight” of contact lenses is the last thing Americans need; and
• Startup online or mail-order outlets hoping to compete with established retailers would have more trouble entering a narrower market.

Congressional Quarterly reported on June 17, 2016 that the contact lens lobbyists have found a way to insert language into an appropriations bill to forward the cause.

A lobbying fight over contact lenses has popped up over language that was quietly tucked into the committee report accompanying the Senate Financial Services appropriations bill (S 3067).

That bill funds the Federal Trade Commission, which in 2004 issued a rule that requires eye doctors to provide contact lens prescriptions so that patients can shop around for their lenses, and potentially save money by choosing to buy lenses from someone else besides the prescribing optometrist. That is a common practice for most prescriptions from physicians in other specialties.

The paragraph in the report “encourages the agency to consider modifications that prioritize patient safety and strengthen enforcement mechanisms” aimed at preventing contact lens sales using expired or fake prescriptions.

Companies selling contact lenses believe that such changes would place burdensome prescription verification procedures on retailers, and would favor eye doctors, who earn a lot of money from sales of lenses and want to keep that business. The companies also allege that the pro-optometrist language was inserted by one of their own: Sen. John Boozman, R-Ark., a former optometrist who oversees the Appropriations Subcommittee on Financial Services and General Government.

Opponents of this report worry that optometrists who routinely refuse to offer prescriptions to their patients would be rewarded by this language.  Right now the Federal Trade Commission is reviewing the contact lens rule and this language will interfere with a dispassionate review of the rule.  Sen. Boozman and Cassidy are individuals who have practiced in this area and have a conflict of interest because they see this issue from the eyes of the optometrists who have an unfair advantage when they both prescribe and sell contact lenses in the same store.

The American Academy of Ophthalmology are pushing the false claim that keratitis, an infection in the eyes, is more prevalent with those who order online.  They ignore the fact that these consumers have to go to an eye doctor before they get a prescription and they are merely shopping on line or at another store for the purposes of not overpaying for contact lenses.

Purchasing contacts from a third party seller is no more dangerous than purchasing directly from a doctor’s office. In a letter written to Sen. Cassidy, Dr. Paul B. Donzis, a professor of ophthalmology at UCLA, made this point clear. “Based on…authoritative scientific articles, it appears that online sales of contact lenses have not contributed to any increase in the incidence of contact lens related [injury],” he said.

And the doctor is right. In Japan and most of Europe, consumers don’t even need a prescription to obtain contact lenses, and the statistics show that they have not experienced an increase in contact-related eye infections as a result. In fact, most countries that do not require a prescription to purchase lenses actually have lower contact incidence reports than does the United States.

Let’s hope the cronies in Washington, D.C. don’t win this fight.