Newer drug delivery methods a disruptive change for physicians, patients and industry

A great deal of human and financial capital is being invested to develop alternatives to eye drops for treating many ocular diseases. We ophthalmologists have relied on drops to treat most every nonsurgical ocular problem for centuries. Why the sudden and growing interest in alternatives to drops? After all, we have very strong evidence that drops are safe and effective when used to treat many ocular problems. I believe there are several factors driving the energetic search for so-called “dropless” and “extended-release” ocular pharmacologic agent delivery methods. In this effort, we are not developing new innovative molecules, just new innovative delivery methods.The first driving force is the irrefutable fact that patients just do not take their drops as prescribed. Some cannot because of physical or mental disability, but most simply choose not to follow the recommended method of drop delivery and dosage regimen. Compliance with a prescribed drop in chronic therapy falls below 50% within 6 months and as low as 15% by 4 years in one recent study on glaucoma treatment. In addition, when multiple drops are prescribed, compliance falls even further. Finally, even when patients are highly motivated, many do not take their drops properly.