The rapid ageing of the European population has urged the need for prevention and proper treatment of age-related diseases. Amongst these priorities and priority diseases, Cataract is today the major cause of vision impairment of senior citizens worldwide, responsible of 48 % of blindness around the globe.
Cataract is the clouding of the lens of the eye (the Crystalline lens), which impedes the passage of light. There are today several different treatments for Cataract, all involving a sophisticated micro-surgery procedure by replacing the lens of the eye. Surgeries can range on one side from the traditional treatment that would require wearing corrective glasses following the surgery, and the use of innovative implantable technology, on the other side, allowing patients to have improved eyesight enabling them to have such good vision that the wearing of glasses will not be necessary even if they were long or short-sighted before the operation.
On the basis of the different existing surgeries offered to patients in the EU, there are different reimbursement practices for Cataract treatments. Traditional treatment generally enables patients to be reimbursed of Cataract surgery costs. For innovative implants (called Advanced Technology Intra-Ocular Lenses, or ATIOLs), the policies are much more fragmented. The reimbursement or funding is often limited to the traditional treatment only. And in most EU Member States, patients are even excluded from getting any reimbursement (including the one relating to the standard procedure) when opting for the advanced solution.
If patients were allowed to choose the advanced treatment without losing the reimbursement for the traditional treatment this would correspond to a shared billing procedure. The healthcare insurance would cover the traditional reimbursement, and the patient would have to cover the remaining costs due to the advanced implant and to the more complicated procedure. For Member States, this would be cost-neutral as they would not have to financially support the choice of the patient to benefit from an advanced treatment because all additional costs would be covered by the patient. Healthcare systems would also benefit from patients having the most optimal eyesight as this reduces the risks of falls or accidents. And, in addition to the obvious benefits for ageing patients in terms of eyesight and autonomy, this procedure could also be cost-neutral for patients. Considering that patients are most likely to require new glasses every few years, the one-off payment for a more innovative medical option and choice could indeed result in a long-term saving for the patient. Especially as most patients pay for glasses out of their own pocket already.
These arguments supporting the possibility for patients to make use of patient shared billing in cataract care are also raised in a challenging demographic context that needs to be taken into consideration. The rapid ageing of the population will necessarily lead to an important increase of patients in need for Cataract treatments. And further to it, those patients are also expected to live longer with their implants due to longer life expectancy throughout Europe. Shared billing for innovative implants associated to Cataract surgery would provide a cost-efficient solution to patients, tailored to their needs in a context of a growing population in need for such cares.
For those reasons, I strongly believe that the practice of shared billing should be applied more widely throughout Europe than it currently is. It would contribute to patients’ choice, in cooperation with their physician. And this without putting another burden on public expenditure nor on the patients.
A new Policy Recommendations Paper on ‘Healthcare and Active Ageing: Patient Choice in Cataract Care’ explains this point in more detail. This Paper, elaborated with the support of a number of medical experts and patients associations and supported also by Eucomed, was launched on 9 July, 2013 in the European Parliament under the co-hosting of MEP Heinz K. Becker and MEP Stephen Hughes. The belief of our Ophthalmology Sector Group is that these Policy Recommendations should further be promoted as they provide a solid argumentation on improving the current reimbursement practices in Europe for advanced Cataract treatment, which should allow patients to better access ATIOLs.
- Miguel Bernabeu, Chairman Ophthalmology Sector Group Eucomed