Putting multifocals in the shop window
Peter Ivins has spent 40 years in optometry, mainly in commercial practice - but he has also been involved in clinical research and consultancy around the development of multifocal contact lenses. Presbyopia - or long-sightedness - affects many older people, but the industry has been slow to recognise the commercial potential for multifocal lenses in presbyopic patients. Peter will be speaking at the Nordic Contact Lens Forum (NCLF) in April to highlight the opportunity that multifocals offer practitioners globally.
Can you give us a bit of background to your work with multifocal contact lenses?
Peter Ivins: Up until eight years ago, I ran a chain of 30 practices across Scotland. Now we have one large practice in Glasgow with a high emphasis on the medical side of optometry - and contact lenses in particular.
We started the practice from scratch - with no patients - and it was a question of how do we build that practice up using what we’ve learned over the years? Increasingly multifocals are becoming a big part of the solutions we offer.
Around 60% of all our patients are presbyopic. That’s a figure that is roughly the same everywhere due to the demographics of the population. But if you look at the penetration rate of multifocal lenses within that group it’s only around 2-3% globally. So there is a huge disconnect in terms of what practitioners are offering as a presbyopic solution and the commercial opportunity presented by multifocals.
What are the commercial benefits of prescribing multifocals to presbyopic patients?
As with so many things in our industry, there is a fine balance between clinical perfection and commercial sense. I try to look at this issue both as a clinician AND a business owner.
But the bottom line is that presbyopic people are the highest value customers of all.
If you track commercial transactions, those patients have the potential to earn you three times as much money as a standard patient wearing single vision spectacles. The key is to offer a combination solution of bifocal spectacles and multifocal lenses. If you approach the consultation correctly, and offer all the practical benefits of wearing different things for different activities, the benefits should be clear.
Why so you think the penetration rate for multifocals is so low?
I’ve been around Europe lecturing for the last ten years, and in all the people we survey, we always ask the same question: What’s stopping you fitting multifocals? And the comments are always the same: They don’t work. They are not good enough, so it’s not worth even discussing it with patients. They are difficult to fit. Older people don’t like contact lenses as much as younger people. Older people don’t care about their appearances so are happy in glasses only. The list goes on.
That’s always been the mindset of many practitioners - and that’s what the manufacturers and developers are up against.
And without that advocacy from practitioners, the simple truth is that many customers simply don’t know these commercially accessible multifocal solutions even exist.
So how can those barriers be overcome?
The bottom line is that all of those preconceptions coming back in our surveys are simply wrong.
And that outdated mindset is what we need to shift. A commercially-aware practitioner should be thinking: If I have a presbyopic patient sitting in front of me, I need to consider a total solution for that person. Glasses for some things and contact lenses for others. That’s the best clinical solution for the patient, and the most lucrative for the practice.
And on the idea that “multifocals don’t work”... Technology has moved on. We used to have two options in multifocals - we now have seven or eight. The vast majority of presbyopic patients we talk to in our practice are only too happy to discuss contact lens options.
What are the commercial considerations for improving the take-up of multifocal lenses?
Raising the visibility of contact lenses as a category is important. When you walk into an optician’s store, you are typically faced with stacks of frames. You aren’t thinking about contacts unless someone specifically mentions them.
So, digital is a vital tool. Many smaller practices in rural areas are behind when it comes to multi-channel marketing, and that’s an easy win to put right.
I think we have reached the stage where your virtual practice is now more important than your shop window. Most consumers get the majority of their information online, so it’s vitally important your online presence reflects what you stand for and helps you to tell your story.
Digital provides a great opportunity to put multifocals in the forefront of people’s minds.
How has the take-up of multifocals been in your practice?
Our practice and others like us who have deliberately focussed on multifocals are already seeing significant success. Multifocal lenses - and daily disposables in particular - have been our fastest growing segment for the last four years, and we are well on track to hit our target of 25% penetration rate - versus that tiny 2% figure globally. So it is definitely possible. But we also know that there are still many presbyopic patients that are yet to enjoy the benefits multifocal lenses bring.
A key consideration is measurement. You don’t know if you’re succeeding if you can’t measure it. There are some simple metrics that will help practitioners understand the success of their multifocals strategy: How many multifocal trials have you done? What is your conversion rate? How much revenue have these sales provided? And what percentage of your presbyopic patients are converting to multifocals?
We are really confident that if more practitioners open a dialogue with their presbyopic patients, there are great benefits to be had both commercially and in terms of customer loyalty.