Darrell E. White, MD, is the founder of Skyvision Centers in Ohio. His blog for Ocular Surgery News will focus on issues related to dry eye disease.

BLOG: Why samples matter

Becky Sauerbrunn would rule the prescribing world if she was as good at setting priorities for big pharma as she was at winning 50/50 balls. You’re familiar with the concept of the 50/50 ball, right? Come on. Don’t tell me you didn’t watch the U.S. Women’s Soccer team steamroll the rest of the soccer world in the 2019 Women’s World Cup. A 50/50 ball is a ball that two players theoretically have an equal chance of controlling for their team. Sauerbrunn won a ridiculously high percentage of the 50/50 balls she approached, a feat noted only by the cognoscenti but likely a major catalyst of the USWNT’s victorious run.

Samples of medications are the Becky Sauerbrunn of eye care.

Darrell E. White

Let’s face it, we have much less control over the specific medications our patients take for any of the disease states we treat, let alone dry eye. It would be comical if it weren’t so tragic. If we are being truly honest, and as you know the book on me is near-radical honesty, when we have the option of two or more choices within a particular category, we choose the product that has the easiest route to ultimately land on the ocular surface. That means the drug with the best insurance coverage and the lowest possibility of needing a prior authorization.

It’s in those situations that are like a 50/50 ball in soccer, where neither drug has a clear coverage/payment advantage, where samples make a difference. This is evident when we are prescribing complex or expensive medications like Restasis (cyclosporine ophthalmic emulsion 0.05%, Allergan) or Xiidra (lifitegrast ophthalmic solution 5%, Novartis), but it is also just as important when we want our dry eye disease patient to use a very specific type of artificial tear. Whether I am actually writing a prescription or just giving my patient a list of options for OTC treatments, the one where I can hand them a sample to get the ball rolling is the one they end up getting. I’ll bet that you have the same experience.

When I have control over the product my patient receives, the company that provides a sample gets almost all of the 50/50 balls.

If you are an eye doctor, what has your recent experience been with samples for medications and OTC products like tears? If you are anything like me, and I’ll bet you are, you are frustrated because tried and true products (Refresh Tears, anyone?) are no longer sampled. They’ve been tossed aside in favor of the latest flavor of the day. Or there’s a med that is going off patent, with or without a generic on the way to provide competition. Despite a healthy prescribing market for the medication, the supply of samples simply dries up. Don’t bother taking it out on your local rep; those decisions are way above their pay grade.

When you see the industry gobbersnoppers in San Francisco and they ask you to prescribe their products, bring up Becky Sauerbrunn and how critical winning those 50/50 balls was in her team’s ultimate success.

Disclosure: White reports he is a consultant to Allergan, Shire, Sun, Kala, Ocular Science, Rendia, TearLab, Eyevance and Omeros; is a speaker for Shire, Allergan, Omeros and Sun; and has an ownership interest in Ocular Science and Eyevance.