Abstract
Purpose :
Cornea specialists frequently report provider- and patient-level difficulties ordering or accessing specialty eye medications, and lack of urgent access to fortified antimicrobials for corneal infections may be a clinically important issue, but these barriers and their ramifications have not been closely examined. This study aimed to survey U.S. corneal specialists about obstacles encountered in obtaining specialty eye medications.
Methods :
An online survey was sent to practicing U.S. cornea and external disease specialists via the Cornea Society listserv (KeraNet). The survey inquired about types of specialty eye medications prescribed by cornea specialists (including serum tears, fortified antibiotics, natamycin, interferon, etc.) and frequency of prescribing; physician- and patient-level barriers to accessing medications such as cost, availability, and shipping difficulties; and certain difficulties accessing specific specialty medications. We also asked whether respondents believed lack of access to specialty eye medications negatively affected their patients' clinical outcomes. Results were analyzed in Stata using descriptive statistics.
Results :
A total of 120 United States corneal specialists responded to the survey. Several respondents reported difficulty accessing interferon (N=41, 34%) and natamycin (N=23, 19%), and 72 respondents (60%) stated that natamycin was only available for 0-25% of attempted orders. N=103 respondents (85.8%) cited high medication cost as a frequently encountered barrier to patients obtaining specialty eye medications (see Table 1). Only N=31 respondents (25.8%) reported that patients received fortified antimicrobials within 12 hours of urgent ordering 75-100% of the time (see Table 2). N=113 respondents (94.2%) believed lack of access issues negatively impacted patients’ clinical outcomes.
Conclusions :
This survey identified several barriers to accessing specialty eye medications in the United States. High medication costs pose a significant barrier to access in both emergent and non-emergent scenarios. Specific drugs such as interferon and natamycin have limited availability. When fortified antimicrobials are urgently required, many patients cannot start treatment promptly. Such barriers may be detrimental to patient outcomes. Additional studies are needed to ascertain root causes and potential solutions for barriers to medication access.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.