Q&A: Michael Lai, MD, PhD, on the impact of underfunding the Good Days program

Michael Lai, MD, at the 2025 ASRS meeting held in Long Beach, California.

Michael Lai, MD, PhD, a practicing retina physician with the Retina Group of Washington spoke with Ophthalmology Times at the Annual Scientific Meeting of the American Society of Retina Specialists (ASRS). This meeting was held in Long Beach, California from July 30 through August 2, 2025.

At the meeting, Lai presented data from a survey on the impact of underfunding to the Good Days program. Data were collected from ASRS members to help understand how this reduction in funding is impacting patients, providers, and practices.

Note: This conversation has been lightly edited for clarity.

Ophthalmology Times: You presented data from a recent survey regarding the underfunding of the Good Days program. Can you share some higlights from this survey?

Michael Lai, MD, PhD: This is a survey of all US-based ASRS members on the impact of the Good Days underfunding. The key [of the] survey is that the extent of the impact is severe. At least 94% of the respondents said that they've experienced a significant or moderate impact on their practice because of this underfunding. And actually somewhere around 74% to 78% of the respondents said that at least 25% of their Medicare-aged patients are unable to get their preferred therapy because of this underfunding.

OT: How was this survey conducted?

Lai: This was an electronic survey and was sent out over a 6-day period in April of this year (2025). Probably the most surprising finding was just the extent of the impact.

OT: Were there any surprising findings in these results?

Lai: We've always known that there's some patients that depend on copay assistance. But what we really didn't know was how many of them are out there, and it turns out that many of our respondents are reporting impact on their practice and on their patients. Probably the most surprising was the extent of the harm. Over 60% of our respondents reported that they have patients who have lost vision because of delay in access to care due to this underfunding.

OT: For anyone who may be unfamiliar, what is the Good Days organization and what do they provide to patients?

Lai: On the broad level, Good Days is a independent, national charitable organization, so it's registered as a 501c3 organization. It's been around for a long time, and actually has funds to support patients in different specialties. Within the ophthalmology space, there's been a fund that supports retina patients for many years, and these funds depend on donations, and the donations are not year marked or geared for any specific product, in order for this organization to do what they're able to do, and to do so in a way that's compliant and legal. Unfortunately, in this past year, there hasn't been enough funding to allow this organization to support all the patients that need the copay assistance.

OT: How might this survey help us to understand the current and future impact of this underfunding?

Lai: I'll highlight that when asked, "how has this underfunding impacted your practice," the most common responses are, switched to repackaged bevacizumab, use manufacture samples, delay or postpone injections, or continue to do the injection, but collect a 20% copay from the patient. The problem is, as a practicing retina specialist, I can tell you, none of those coping mechanisms are sustainable long term. Keep in mind that this survey was done in April. This is an ongoing problem, and it's very likely that that all those issues that we identified in the survey have become even worse over time.m