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SPOTLIGHT ON THE PREMIUM CHANNEL: MARKET OVERVIEW
Elizabeth Yeu, MD
Spotlight on the Premium Channel
What is the penetration of Toric IOLs in US?
A. < 5%B. 6-8% C. 8-10%D. 10-15%E. 15-20%F. 20-25%G. >25%
What is the penetration of Presbyopia-correcting IOLs (combined) in US?
A. < 5%B. 6-8% C. 8-10%D. 10-15%E. 15-20%F. 20-25%G. >25%
Use of Premium IOLs-US Cataract Surgeons
Q4-
04
Q4-
05
Q4-
06
Q4-
07
Q4-
08
Q4-
09
Q4-
10
Q4-
11
Q4-
12
Q4-
13
Q4-
14
Q4-
15
0%
2%
4%
6%
8%
10%
12%
14%
16%
4.9%
PC-IOL Total
Perc
ent
of A
ll U
S IO
L Su
rger
ies
Source: Market Scope Surveys of US Cataract Surgeons Copyright 2016, Market Scope, LLC
• Premium IOLs Grew Rapidly After Market Introduction, but Share Has Leveled Off
• Presbyopia-Correcting IOLs in the 4-5% Range Since 2008
• Favorable Reimbursement in US-Most Patients Only Pay an Additional Amount
Prevalence of Astigmatism is High
Slide courtesy of Alcon
52-70% fall within range of a Toric IOL
Use of Premium IOLs-US Cataract Surgeons
Q4-
04
Q4-
05
Q4-
06
Q4-
07
Q4-
08
Q4-
09
Q4-
10
Q4-
11
Q4-
12
Q4-
13
Q4-
14
Q4-
15
0%
2%
4%
6%
8%
10%
12%
14%
16%
12.3%
4.9%
7.4%
Total Premium PC-IOL Total Toric
Perc
ent
of A
ll U
S IO
L Su
rger
ies
Source: Market Scope Surveys of US Cataract Surgeons Copyright 2016, Market Scope, LLC
• Premium IOLs Grew Rapidly After Market Introduction, but Share Has Leveled Off
• Presbyopia-Correcting IOLs in the 4-5% Range Since 2008
• Toric IOLs in the 6-8% Range Since 2010
• Favorable Reimbursement in US-Most Patients Only Pay an Additional Amount
Use of Premium IOLs-Rest of World
Source: Market Scope Estimates Copyright 2016, Market Scope, LLC
• Premium IOLs Have Also Been Successful OUS
• In Most Cases, OUS Patients Pay Directly for Entire Procedure at Private Pay Facilities
• Market Penetration for Premium IOLs Vary Based on Local Market Conditions and Reimbursement Policies
• However, There is Demand for Premium IOLs in All Markets
US-Femtosecond Laser Assisted Cataract Surgery (FLACS)
Source: Market Scope Surveys of US Cataract Surgeons Copyright 2016, Market Scope, LLC
Q3-201
2
Q4-201
2
Q1-201
3
Q2-201
3
Q3-201
3
Q4-201
3
Q1-201
4
Q2-201
4
Q3-201
4
Q4-201
4
Q1-201
5
Q2-201
5
Q3-201
5
Q4-201
50%
1%
2%
3%
4%
5%
6%
7%
8%
9%
10%
1.2%
9.5%
• Use of FLACS Growing
• Growth in US New FLACS Systems Has Slowed
• However, Systems in Use and Procedures per System Still Growing
• Learning Curve is Expanding Share
• Surgeon Efficiencies
• Marketing Expertise
Growth Stalled in Refractive Surgery Market
Source: Market Scope Surveys of US Refractive Surgeons, Rest of World-Market Scope Estimates Copyright 2016, Market Scope, LLC
2007 2008 2009 2010 2011 2012 2013 2014 2015 -
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
3,500,000
4,000,000
1,3
70,0
00
595
,404
2,6
03,0
00
2,7
88,3
85
US Excimer Rest of World ExcimerRest of World SMILE
Thou
sand
s of
Eye
s Tr
eate
d
• Global Refractive Procedures Declining Overall
• Markets in US, Europe, Japan Declining or Stable
• Still Some Growth in Emerging Markets Including China and India
Growth Stalled in Refractive Surgery Market
Source: Market Scope Surveys of US Refractive Surgeons, Rest of World-Market Scope Estimates Copyright 2016, Market Scope, LLC
2007 2008 2009 2010 2011 2012 2013 2014 2015 -
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
3,500,000
4,000,000
1,3
70,0
00
595
,404
2,6
03,0
00
2,7
88,3
85
US Excimer Rest of World ExcimerRest of World SMILE
Thou
sand
s of
Eye
s Tr
eate
d
• US Market Down From a Peak of 1.4 Million in 2007 to <600K in 2015
• SMILE Procedure Growing but Numbers Still Small-Estimates of 120K in 2015
• Corneal Inlays in Early Stages-But Little Impact to Date
Premium Market Channel
Why has adoption been less than robust? Technology limitations Support: industry, clinical staff ECP
Cash-based services Gaps: clinical, patient selection Emotional
