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36 | EYEWORLD DAILY NEWS | MAY 5, 2023 ASCRS ANNUAL MEETING DAILY NEWS "For me, the payers are affect- ing the way I practice medicine, and I think they're affecting the way companies look at 'should I take a risk of trying to bring this drug to market,'" Dr. Holland said, explaining that he might want to offer a patient a therapy that he thinks is best suited for them, but often to get reimbursed the patient first needs to fail other therapies before moving on. Dr. Radcliffe later asked Emily Graham, vice president of Regulato- ry Affairs of Hart Health Strategics, when companies should get involved with a government affairs lobbyist. She said, early is best. "It's incredibly important to start working with Washington and take the blinders off. FDA approval is extremely important and a high bar, … but often we find groups forget about the reimbursement part, making assumptions that the process will be easy," Ms. Graham said. She added that reimbursement should be considered at the point of selecting endpoints in trials. "Invest early in a government affairs strategy." Editors' note: The speakers have finan- cial interests with the companies they represent. E yecelerator held its meeting ahead of the ASCRS Annual Meeting, with what ASCRS Executive Director Steve Speares said is a provocative, authen- tic, and sincere program co-chaired by Julie Schallhorn, MD, and John Berdahl, MD. An innovation that can be brought to market and is used around the world on a large scale is what we should be shooting for, said Eyecelerator Program Director Gil Kliman, MD, in his introduction of the meeting. The first sessions of the morning covered the "State of the Union" for ophthalmology and investments, a discussion on the opportunities and challenges of financing innovation in ophthalmology, and a panel that looked at how to craft a successful reimbursement strategy. Kristen Harmon Ingenito, Vice President of MarketScope, gave the "State of the Union." She said that some of the smaller market segments are seeing some large growth. Re- fractive surgery saw a jump after the COVID-19 decline in Q2 of 2020, but Ms. Ingenito said it's TBD whether that jump was pent up demand or change in consumer behaviors. She said we're looking to see what share the new phakic IOL will play in this sector and whether or not growth will be sustained throughout 2023. In the area of advanced tech- nology IOLs, Ms. Ingenito said that while presbyopia-correcting IOLs and toric IOLs are flattening in terms of penetration, with growth seen in the postop adjustable IOL and the enhanced monofocal IOL, when you look at use, volume is growing in these categories. Ms. Ingenito also covered investment sources and where investments are going in ophthalmology. The "We Love Ophthalmol- ogy, Does Anyone Else?" session featured two mini-keynotes from Neha Begwani, executive director of Healthcare Investment Banking, Morgan Stanley, and Peter Menziuso, company group chairman of Johnson & Johnson Vision, followed by a Q&A with the panel. One question Mr. Speares asked Jeffry Weinhuff, managing partner of Visionary Ventures, was whether there were categories that, as an investor, "you would roll your eyes, hold your nose, and walk away." Mr. Weinhuff said there are areas that would be difficult to leap on, such as an IOL product would be costly and difficult to fund. Dry eye assets, he said, would be difficult, too, unless there was something clearly superior or addressing an unmet need. Things that fall into the category of being a disruptive innovation or addressing a large, unmet need are those that will be of interest to investors, he said. Mr. Speares later asked Cynthia Yee, Principal of Vensana Capital, about devices—whether a new device to remove a cataract, for example, would even be appealing anymore. "It could be," she responded but added that it's hard to innovate in a space that's already so established. In order to do so successfully, the innovation needs to be more than incremental. "Something that's fun- damentally different both to patients and providers." A session moderated by Nathan Radcliffe, MD, took on the topic of reimbursement and when it should be considered in product develop- ment. He posed a question to Edward Holland, MD, about the reimburse- ment landscape from a physician perspective. Eyecelerator kickoff sessions: the market, investment opportunities/challenges, and reimbursement Dr. Radcliffe (left) moderated a session on reimbursement where Ms. Graham (right) advised getting government affairs consultants involved early in the product development process.

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