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Michelle V Carle, Kathleen Wilson, Alice Huang, David Smith, Helen Varker, Stephen S Johnston, Adam Turpcu; A US Claims Analysis of Anti-VEGF Treatment Patterns in Neovascular Age-related Macular Degeneration, Retinal Vein Occlusion, and Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1405.
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Assess annual number of intravitreal injections and associated costs for patients with neovascular age-related macular degeneration (AMD) or central retinal vein occlusion (RVO) treated with intravitreal 2.0mg aflibercept (AFB) or 0.5mg ranibizumab (RBZ), and patients with diabetic macular edema (DME) treated with 0.3mg RBZ.
This study included patients who: initiated 1st-line treatment with RBZ or AFB (index date [ID]) from 11/18/2011 to 1/31/2014 for AMD, 9/21/2013 to 7/31/2014 for RVO, and 8/10/2012 to 1/31/2014 for DME, were aged ≥18y on the ID, had no evidence of bilateral disease, had ≥12 months continuous insurance prior to ID (baseline [BL] period), had a diagnosis of AMD, RVO or DME (ICD-9-CM 362.52, 362.35, or 362.07) during BL period or on ID and had 12 months of follow-up enrollment post-ID without changing treatments. No. of injections and associated costs were assessed at 12 months. Multivariate regressions compared injection frequency and costs for AFB vs RBZ, adjusting for potential confounders.
In AMD patients, AFB (N=316) and RBZ (N=875) recipients had similar unadjusted mean number of injections (5.6 vs 5.3, respectively) and anti-VEGF therapy-related costs ($11,372 vs $10,856, respectively) at 12 months. In regression analyses, neither number nor costs of injections differed significantly between AFB and RBZ patients (treating RBZ as reference: Incidence Rate Ratio [IRR]=1.05, 95% confidence interval [CI]=0.98-1.13, P=0.17; Cost Ratio [CR]=1.04, 95%CI=0.96-1.14, P=0.34).<br /> In RVO patients, AFB (N=55) and RBZ (N=154) recipients had similar mean number of injections (4.5 vs 5.0, respectively) and anti-VEGF therapy-related costs ($8219 vs $9733, respectively) at 12 months. In regression analyses, neither number nor costs of injections differed significantly between AFB and RBZ patients (treating RBZ as reference: IRR=0.91, 95% CI=0.76-1.10, P= 0.35; CR=0.89, 95% CI=0.72-1.11, P=0.31).<br /> In DME patients treated with 0.3 mg RBZ (N=92), the mean (SD) number of injections was 4.4 (2.9) and mean costs were $5289 ($3524) at 12 months.
Annual injection frequency and healthcare costs did not differ significantly between AFB and RBZ treatments in AMD and RVO patients. Results in DME patients treated with RBZ suggest that the annual costs of managing DME patients were lower than for AMD and RVO patients
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