Early Eyedrop Prescription Refills

Background

Many patients require prescription eyedrops for in-home treatment of their condition. When patients self-administer these eyedrops, a certain amount goes unused due to spills or other factors. This particularly affects our older patients. However, eyedrop prescription laws often assume patients administer eyedrops under perfect conditions. Because of these laws, patients can’t always refill their eyedrops as soon as they need. 

Academy position

Patients should have the right to refill their eye drop prescriptions early when they run out of the medicine. Access to these medicines is particularly important as drug developers seek to make more treatments available in eyedrop form. 

What we’re doing

We’re spearheading efforts nationwide to ensure our patients can get the sight-saving treatments they need.

• So far, 26 states have signed on to support this effort.
• Our leadership also spurred the Centers for Medicare & Medicaid Services to adopt similar guidelines for its Medicare Part D program.

The Academy is working with ophthalmology societies in the remaining states to help lawmakers recognize how this important step ensures appropriate quality care for all Americans. 

What you can do

Contact the Academy to find out if your state allows early eyedrop refills. If not, it’s easy to engage your lawmaker to advance this kind of proactive legislation. 

Resources

• Patient resource: EyeSmart glaucoma treatment page with video guide to inserting drops
• Story: How I Helped Change Tennessee’s Eyedrop Refill Law
• EyeNet: Patient Adherence

Draft Legislation

AN ACT relating to prescription eye drops.

Be it enacted by the State Legislature:

Any health benefit plan issued or renewed on or after the effective date of this Act that provides coverage for prescription eye drops shall not deny coverage for a refill of a prescription if:

1. For a thirty (30) day supply, the amount of time has passed after which a patient should have used 70 percent of the dosage units of the drug according to a practitioner's instructions, or twenty-one (21) days from:
1. The original date the prescription was distributed to the insured; or
2. The date the most recent refill was distributed to the insured; and
2. The prescribing practitioner indicates on the original prescription that additional quantities are needed, and:
3. The refill requested by the insured does not exceed the number of additional quantities needed, and;
4. The prescription eye drops prescribed by the practitioner are a covered benefit under the policy or contract of the insured.