By Marge Axelrad
Editorial Director  

NEW YORK --2005 was quite the year--and 2006 is anticipated to be one of several more--in the contact lens business.

 

Sparked by a number of factors, the category is, in a word, hot.

 

Among these factors, according to industry executives interviewed by VM:

 

The rapid introduction of new materials and products, in particular the advent of silicone hydrogel lenses, which, in the course of just a few years, have grown to the point where they may account for as many as 40 to 50 percent of new fits and refits in the U.S. by the end of next year, market observers say.

 

An increase in consumer awareness about contact lenses, including new daily disposable options, solutions for dry eye, tinted or colored lenses, fueled by record spending in consumer advertising.

 

Tom Shone 

An expanding patient demographic that now ranges from young kids to teens and young adults to baby boomers, lured by disposable and weekly or bi-weekly wearing cycles and new -generation multifocals and torics.

 

A new receptivity on the part of ECPs to embrace their role as recommenders and fitters of specialty lenses.

 

The ‘endorsement’ of contact lenses as an FDA-monitored medical device. This was illustrated by the bill passed this summer by Congress and recently signed into law by President Bush which amends the “Federal Food, Drug and Cosmetic Act” to say that all contact lenses are considered medical devices, regardless of their use, including those that are mainly used in costumes or for decorative or cosmetic reasons.

 

Year-end numbers are not officially in and publicly-traded contact lens companies will not report their results for another month or so. But early indications are that contact lenses have experienced at least twice the growth rate of spectacles/eyeglasses over the past year. Compared to year-on-year eyeglass sales, which are on a track to grow by about 2 percent for 2005, the general assessment of contact lens sales in 2005 is that dollars will have grown somewhere between 6 and 8 percent, if not higher in certain segments of the market.

 

And it’s not just a single-year phenomenon, since the number of wearers has been growing consistently (among full time wearers, sparked also by part-time wearers--those who wear both eyeglasses and on-occasion contact lenses).

 

VisionWatch, conducted by Jobson and Vision Council of America (VCA), which continuously measures eyewear usage and attitudes among U.S. adults over the age of 18, shows that:

 

  The number of US residents 18+ wearing contact lenses any part of the time has increased by over 4,000,000 in the most recent 24 months.

 

  There’s an increase in those wearing contact lenses ‘all the time,’ ‘all day and sometimes when sleeping,’ as well as ‘all the time except when sleeping.’

 

And, there’s a likely correlation between trends in contact lens usage as it positively impacts some significant increases in plano , non-prescription sunglass usage. On a population gain of about 7,000,000 (18+) in the past 24 months, an additional 9,000,000 U.S. residents (18+) are using plano sunglasses.

 

New Momentum

Rick Weisbarth, OD, CIBA Vision’s vice president of professional affairs, points out, “We definitely know that the contact lens market is gaining momentum. Innovative products are now meeting the needs of practitioners and their patients. We hear that the market is ‘fun’ and ‘exciting’, and we’ve never heard those words used about contact lenses in the same sentence!”

 

He added, “Today’s contact lens options allow ECPs match up the lens with the patient’s particular needs, it allows the ECP to solve problems, and creates patient satisfaction, an unbeatable combination. Updating existing contact lens patients into new options still goes on, but new products allow the practitioner to hit some of those dropouts, and enter new patients into the category, because of new modalities and technologies.”

 

CooperVision’s Tom Shone, senior vice-president of strategic marketing, observes, “There has been a sea change. There was frustration out there among some practitioners who didn’t see opportunities to upgrade patients, but there are many reasons today for a new optimism. New materials and ad messages executed at the consumer level have driven patients into offices looking for contact lenses that offer them a better wearing experience. ECPs are more interested and more proactive in the category than we’ve seen in a long time.”

 

Adds Nikki Iravani, OD, Coopervision’s director of professional relations, “There was a period of  time when practitioners were not sure about what contact lenses could do for a practice, but we’ve learned that as ODs, we can really make a difference with the ultimate contact lens experence.”

 

Bausch & Lomb’s chairman and CEO, Ronald Zarella, recently told analysts, “In the late 90s, contact lenses were a commodity product. Today’s innovations are changing that.”

 

Part of the malaise, if it can be described that way, about the category, ironically emerged after the debut of disposable contact lenses changed the paradigm of the market, in the late 1990s. Disposables and more frequent-replacement wearing schedules sparked the category through consumer and doctor interest, but it also changed the economic picture for both patients and doctors.

 

A range of new disposable products continued to fuel sales and the market grew, but dropout percentages and compliance--still major issues within the contact lens industry for ECPs and patients--remained, and the dispensing management--the business-side of the equation-- become more complicated.

 

In addition, of course, the emergence of Lens Express, 1-800 Contacts and the internet, created huge challenges to traditional distribution and the independent ECP.

 

Managing the Business of Compliance

Some of those issues still continue. As Angel Alvarez, CEO of ABB Optical, the country’s largest contact lens distributor, explains it, “As a leader in the distribution channel, we like to say that ‘we don’t make the lenses, we make them better.’ The largest issue is still patient compliance. Patients are seeing the doctor, taking some of the product and the doctor still has to handle the ‘rest’ of the sale throughout the year. Think that with the current interest in replacement or disposable modalities, the average transaction, besides the doctor’s examination, today often consists of just two boxes of lenses for $15. And to follow up on the rest of the ‘annual’ sale, the average staff time spent per contact lens order can be 28 minutes, including the time spent to order lenses, receive and store them, call patients to confirm receipt, reconcile statements and deal with all suppliers. We help practitioners with this back-end support and offer an ‘invisible’ online component to how they interact with their patients.

 

“When you look at any large retailer, they have a big back-end office that helps with systems and support. We feel the distributor can perform that function for an ECP and we provide that, along with education and real-value programs, to practices across the country.

 

“We work with all the major contact lens companies and they’re great but they tend to focus on the product and on taking the message to the consumer. We go to the ECP and ask, ‘Doc, where’s the pain? We develop a plan. If you let us have your business, over 90 days we’ll get a snapshot. We show him a lens portfolio and how it compares with how industry is going, benchmark what they’re doing or could be doing and compare these to national averages, point out opportunities and create a real program to improve profitability and productivity.”

 

A Widening Range of Patients

The opportunities are becoming more apparent because the range of patients who are candidates for contact lenses continues to expand from traditional notions.

 

Jeff McLean, president of Cooper-Vision, North America, comments, “From a patient profile, a few years ago, when marketing folks used to sit in conference rooms, your targeted audience was 18-35. Then, because the safety profile improved with new wearing options, we saw more teenagers fit with contact lenses, so that bottom age of 18 went down, and now, we are now seeing kids of 10 or 12 and even younger being fit because practitioners and their parents are more confident in the safety and the wearing/hygiene options. So you’ve seen a real expansion of the market from the patient perspective.

 

“Then,” he continued, “new developments from a design perspective created new multifocals that work. Traditionally, people tried multifocals but they often didn’t   provide visual acuity and a good wearing experience, so the patient went back to spectacles and the doctors were frustrated.

 

“So, today, you’re looking at a patient base which has been wearing contact lenses for much of their life, are used to it and the resurgence of multifocals is keeping the 35 year old, and 40-, 45-, and 50-year-old patient in the game. The market now spans from ages 11 to 50, the patient influx or potential is almost doubled. 

 

McLean also remarks, “You have a large portion of the vision correction population today that wears contact lenses on an occasional-wear basis. From a modality perspective, daily-wear or single-use, seems to jive economically with what patients want to invest in it. A lot of people wear their spectacles during the week but on the weekends want a change. There’s a small base but robust growth for this group.

 

“From the ECP point of view, the improved patient experience helps them develop confidence about the category and they are then prescribing contact lenses more often.”

 

Changing lifestyles of patients create new demands and expectations for vision correction, too.

 

From the point of view of Vistakon, a division of Johnson & Johnson, Naomi Kelman, president of North America, states, “Our focus is on new wearers and stopping drop outs - the marketplace has spoken. Vistakon’s lenses are achieving those objectives. People are coming in at different entry points--we’re talking to teens, people who, regardless of age, have comfort challenges, and those who are dropping out. If you meet the end benefit need of any patient and increase patient satisfaction, you grow the category. It’s not just a view of demographics but of satisfying needs.”

 

Said Kelman, “We are very excited about what’s happening. We’re trying to drive category growth and pull new people into  contact lenses and create a situation for those who wear CLs to have better compliance. We’re developing products based on patient benefit needs as well as what doctors need. We spend a lot of time talking to doctors and patients to get insights into their concerns or barriers about what a patient might have towards contact lenses and try to address these.”

 

Cristina Schnider, OD, Vistakon’s director of professional education, also points out the new Acuvue Advance for Astigmatism. “There are almost as many astigmatic wearers as spheric wearers but the category is a fraction of the size now. Traditionally, torics, from a doctor’s perspective, can be challenging to fit and require additional chair time. The new product is fit more easily and quickly.

 

“A major question is will this be comfortable? In particular, for those who never tried lenses, the questions are, ‘Will I notice it or feel it, is it easy to put on, and the acid test--at the end of day--how will it feel?’”

 

Kelman adds, “There’s a presbyopic population that needs great lenses and as a company, we are focused on addressing this. We’re very excited about the role Acuvue Oasys is playing for this population, which speaks to patients who are concerned about contact lens-related dry eye.”

 

The advent of ‘Si-Hy’

“This is indeed a very exciting time to be involved in contact lenses. There have been several innovations in recent years, from daily disposables to new GPs, but the introduction of silicone hydrogel really changed the game again,” commented Karen Gough, president, CIBA Vision, North America.

 

Karen Gough


“Our numbers show that the silicone hydrogel segment has more than doubled in the first eight months of 2005, and Nielsen shows that they represent about 25 percent of the weekly/monthly volume through August. We projectsi-hy’s to be about a third of the volume by the end of 2005 and pretty much exceed 45 percent of the weekly/monthly segment by the end of ’06.”

 

Gough continues, “‘A healthy patient is a healty practice,’ as our mantra goes and silicone hydrogel is a better, healthier, more productive way to wear contact lenses.

 

“Night and Day, in particular, with 30 day wearing approval is a great alternative to refractive surgery. A certain segment of the population doesn’t want hassles from any form of vision correction.

 

“And in terms of occasional wear, that’s happening, too. In our attitude and usage research, most contact lens wearers, about 89 percent, will also have a pair of spectacle. If you look at our Focus Dailies, it’s a great option for people for either full-time or part-time wear and it’s a very hygienic way of wearing contact lenses. Our Focus Daily with Aqua Release, which we debuted in the fourth quarter of ’05, actually hydrates the eyes throughout the day and is a great option for those who don’t want a weekly or monthly lens. “

 

She added, “Our number one area of emphasis will be the O2Optix Toric for Astigmatism, with will debut in the second quarter this year. We’re also excited about the work being done in Fresh Look. We’ll introduce our Fresh Look disposable early next year and have a new campaign for that. It’s one of the most consumer-driven products within the contact lens business--people want to enhance the color of their eyes.”

 

At Bausch & Lomb, Angela Panzarella, vice president of global vision care, told the financial market at a recent presentation, “Silicone hydrogels are the biggest contact lens growth driver. We’ve seen rapid industry adoption and the practitioners tell us their perceptions are that the lenses are healthier and safer and offer greater long-term comfort.”

 

Paul Howes, senior vice president of B&L and president of the Americas region, added that B&L’s PureVision silicone hydrogel lens has had tremendous reception since its reintroduction in  the U.S. market and the company is very optimistic about the launch of the Pure Vision Toric which has just begun. Its plans call for the launch of a Pure Vision Multifocal by the first half this year.


 

Angel Alvarez 

Panzarella commented, “By mid-year 2006, we will be expanding the PureVision franchise to provide a full range of prescribing options. She also noted that B&L’s capacity for PV manufacturing has quadrupled in 2005 and will double again in 2006. Panzarella noted, “Most of our growth has been from specialty contact lenses, our SofLens Toric is the number one prescribed lens for astigmatism and our SofLens multifocal is the number one lens for people with presbyopia. Our latest innovation is the sports tint MaxSight lens, which is a co-marketing venture with Nike. It was recently named one of the most ‘Amazing Inventions of 2005’ by Time Magazine.”

 

Emphasis on Specialty Lenses

CooperVision’s McLean comments, “Because of silicones, you have a lot of refit going on out there and this is having a huge impact. Dr. Jones is sending out communications that say, ‘Hey, we have new materials that might work for you’ and patients come in and have dialogues about new contact lens options. Doctors can offer new multifocals and torics, maximizing the specialty contact lens portion of their practice in the premium sector and they are enjoying the benefits.”

 

He continues, “When silicone hydrogels, with a high DK feature, were introduced several years ago as a continuous wear lens, this was important because if you take a natural eye, overnight it will swell about four percent and with ‘si-hy’, you can contain the cornea and minimize swelling which is healthier for patients on continuous wear basis. Comfort wasn’t the primary end benefit, it was a 24/7 benefit, for the mom getting up at 2 a.m., for example, when it fulfilled an unmet need.”

 

McLean continues, “There are other issues of low wettablility and comfort pushed aside, if you will, for high DK. Today, in 2005, doctors still have a resistance to fitting continuous wear because they remember the events of the ‘80s and even with new approvals, they haven’t totally embraced the continuous wear modality, so there’s an emphasis on two-week extended wear for this higher DK material.

 

“It’s important to remember that 93 percent of patients today are fit in a daily-wear modality, only seven percent for fit in extended wear modality. That’s why at Cooper, our Biofinity, a second-generation silicone hydrogel targeted for July 2006, will offer a comfort profile that far surpasses other ‘si-hy’s in the market today if a doctor wants to prescribe extended wear.

 

“But for the 90-plus percent that fit daily-wear, we have our PC Hydrogels that that’ll be our strategic focus for years to come regardless of silicone hydrogels.

 

“In ’06 we’ll broaden our PC Hydrogel line --  in all the studies we’ve done it continues to outperform anything in the market today -- as well as our specialty products. Nobody in the industry can touch our line of specialty products. From a market perspective, we think the market will continue to grow at an attractive rate.”

 
Fighting the Myths

Gretchyn Bailey, NCLC, FAAO, editor-in-chief of Review of Cornea and Contact Lenses, a sister publication to VM, observes, “There still remain many myths and stereotypes out there. One myth is ‘I’ve got astigmatism and can’t wear contact lenses’ and today we see torics as one of the fastest-growing categories. Another myth is about multifocals - many patients think they don’t exist and some ECPs believe they don’t work. But these lenses are coming into their own. They require fitting expertise which is why education and training is important.”

 

Michael Pecora, CFO, Unilens  which has been a specialty contact lens company since 1989, has seen a 40 percent growth rate over the past fiscal year. “We are extremely optimistic about the category.

 

 Naomi Kelman

“Demand for our C-Vue Disposable multifocal lens continues to grow, and we are pleased with the performance of our new C-Vue55 Toric multifocal lens, which was introduced in January 2005.  The SoftCon EW and Aquaflex brands that we acquired from CIBA Vision at the end of February have been fully integrated into our marketing, manufacturing, and distribution system and should account for approximately 14% of sales during the quarter ended June 30, 2005.

 

“Training is a big part of what Unilens does. Our 12 sales representatives have the task of ‘reintroducing’ multifocals to the practitioner, many of them are used to using monovision and have concerns over past involvement with the category. We need to encourage them to try the new designs. The aging population is the most significant growth driver now. We believe the specialty contact lens market will continue to expand even faster than the overall contact lens market.”

 

On the Horizon

Other ideas are on the horizon.

 
Contact lens execs keep far out launch plans close to the vest.

 

At B&L, Panzarella’s analyst presentation showed that, in addition to the near-term pipeline for Pure Vision, the company is looking forward to a silicone hydrogel lens with advanced surface technology some time in 2007, she said.

 

And, at Optical Connection, adaptation of wavefront technology from the refractive surgery field is being developed into a new process for measuring and creating contact lenses for patients.


 
 
 
 
 
 
Vince Zuccaro, OD, CEO of Optical Connection, points out, “Sometimes we have a sense that there’d been a lessening of interest in contact lenses by many of my colleagues...some have relegated what they considered to be their domain - fitting - to others and have replaced that with interest in other areas such as glaucoma, cataracts, lasers and so forth. When you marry optometrists’ interest in expanding their scope with the addition of LASIK and new technologies, it can be a bit of a roller coaster ride. The line between optometry and ophthalmology has become blurred, they often look more like each other, with optometry looking at therapeutics and primary care and MDs now embracing dispensing, CLs included.

 

“But there’s a need for doctors of optometry to take contact lenses out of the commodity mode and put it back into more of a thinking mode. What we’ve been analyzing is how we can get practitioner interest again, by building better vision and help them retain patients in their practice, that’s where we’ve been going with our new technology.”

 

Optical Connection’s Zuccaro and senior VP sales and marketing, Kevin Bligh, have been working on applying new technology to the manufacturing process to develop a contact lens that adapts wavefront technology. “We felt that any new product we came up with needed to be unique enough to stimulate the practitioner to fit that product without being too nichy.

 

“We’ve suceeded in duplicating in a sense the LASIK procedure on a contact lens, to put hundreds corrections on the surface of a lens in matter of a few seconds. We’ve trademarked it as WaveTouch Process.

 

What’s required is that all aberrations have to be measured and those corrections placed on the surface of lens. We’ve struck a relationship with one company, Ophthonix, to use their aberrometer, there are others in the field now that could be adapted for contact lens use and we’ll strike relationships with others to provide them to the ECP to provide them with a whole system of measuring, individualizing the process. We are beta testing with about 12 offices now and are collecting and reaffirming data of our clinical work. If all goes according to plan we anticipte a limited rollout by the second quarter of this year.”