Early Eyedrop Refills

Patients should have the right to refill their eyedrop prescriptions early when they run out of medication. Current prescription laws often assume patients self-administer eyedrops under perfect conditions — but spills and other factors mean many patients, particularly older adults, run out before their refill is permitted.

The Academy believes timely access to prescription eyedrops is essential to quality eye care. This issue is only growing in importance as drug developers seek to make more treatments available in eyedrop form.

The Academy is spearheading a nationwide effort to ensure patients can access the sight-saving treatments they need. So far:

• 26 states have enacted legislation supporting early eyedrop refills.
• Our advocacy has also spurred the Centers for Medicare & Medicaid Services to adopt similar guidelines for the Medicare Part D program.

The Academy continues to work with ophthalmological societies in the remaining states to help lawmakers recognize how this proactive legislation ensures appropriate, equitable care for all Americans.

Many patients require prescription eyedrops for ongoing, in-home management of their eye conditions. When patients self-administer these drops, a certain amount inevitably goes unused due to spills, missed applications, or other factors. This is particularly common among older patients who may face dexterity or vision challenges.

Despite this reality, prescription refill laws in many states assume perfect administration — meaning patients cannot always refill their eye drops as soon as they run out. The result is gaps in treatment that can compromise vision outcomes and patient adherence. 

The Academy has developed model legislation (PDF) that states can adopt to address early eyedrop refill access. The draft language is as follows:

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; 
   2. or 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: 
   1. The refill requested by the insured does not exceed the number of additional quantities needed; and
   2. The prescription eye drops prescribed by the practitioner are a covered benefit under the policy or contract of the insured.