THE COSTOF LASIK

he price of laser refractive surgery in France varies from one centre to another. Addressing delegates at the annual meeting of the French Implant and Refractive Surgery Association (SAFIR) in Paris, Dan A Lebuisson MD, past president of SAFIR, in private practice in Paris, said that the current system of elective laser surgery is unregulated in terms of price, with differing centres offering a wide variety of tariffs and modalities of payment to potential customers.

“Very few French surgeons have a clear and concise economic model in refractive surgery and it is these colleagues who usually find themselves at the mercy of laser manufacturers and health insurance companies,” said Dr Lebuisson.

Looking at the price of LASIK surgery over the past decade, Dr Lebuisson noted that the prices quoted have remained stable despite the fact that costs have invariably risen. The average price (bilateral surgery) for photorefractive keratectomy (PRK) is €2,000, €2,400 for conventional LASIK, and €2,750 for femtosecond LASIK.

Comparing this with data from the USA, Dr Lebuisson said that in 2013 the average cost overall for laser vision correction was $2,073 per eye. About half of the refractive surgeons in the USA survey said they quote a single price for laser-based procedures, while the other half quote different prices depending on the technology used and/or the amount of vision correction required by the patient.

There is also considerable variation in the reimbursement rates practised by private health insurance providers in France, said Dr Lebuisson. Refractive surgery is not expensive in France.

In a survey of 15 patients operated in Paris for myopic LASIK in the first quarter of 2015, for one eye one had no reimbursement, six received between €150 and €300, five between €300 and €500 and three patients received more than €500. The impact of group purchasing sites on the internet such as Groupon was not at all helping to drive down prices for LASIK, said Dr Lebuisson. He also cited the initiative of Santeclair, an alliance of health insurers and associated partners, whose professed goal is to “democratise” LASIK by directing patients to one of 60 different refractive surgery centres at a set price of €1,500 for both eyes. However, the impact is poor because money is not the main argument for most customers who consider safety and technology as key points.

The wide disparity in prices offered from one refractive laser centre to another was shown by a recent survey in which two LASIK candidates contacted 30 different clinics in France, 13 in Paris and the surrounding region, and 17 in the provinces.

Dr Lebuisson said that 22 out of the 30 centres (public and private) proposed a reduction of between 10 per cent and 30 per cent on the initial quoted price. For two of the clinics the reduction was contingent on payment in cash and others were prepared to accept staggered payments over three-four months.

The variation in price was striking, remarked Dr Lebuisson, with the lowest price quoted at €900 and the highest in the range of €5,000 to €6,000.

Dan A Lebuisson: dalebuisson@gmail.com