June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Practice patterns of anti-VEGF injections among U.S. ophthalmologists
Author Affiliations & Notes
  • Stanford Taylor
    Visual Sciences, Washington University, St. Louis, MO
  • Brad Wilson
    Visual Sciences, Washington University, St. Louis, MO
  • Mae O Gordon
    Visual Sciences, Washington University, St. Louis, MO
  • David Vollman
    Visual Sciences, Washington University, St. Louis, MO
  • Footnotes
    Commercial Relationships Stanford Taylor, None; Brad Wilson, None; Mae Gordon, None; David Vollman, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 1514. doi:
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      Stanford Taylor, Brad Wilson, Mae O Gordon, David Vollman; Practice patterns of anti-VEGF injections among U.S. ophthalmologists. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1514.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To examine regional variations among U.S. ophthalmologists in the use of intravitreal injections against vascular endothelial growth factor (VEGF).

 
Methods
 

Analysis of the Centers for Medicare and Medicaid Services (CMS) 2012 publically available database for Medicare recipients. All ophthalmological uses of HCPCS codes J2778 (ranibizumab injection), J9035 (bevacizumab injection), and Q2046 (aflibercept injection) were reviewed. Data were obtained on multiple variables, including: injection type and number, provider location, and injection reimbursement.

 
Results
 

In the United States, 2,384 providers performed 1,294,973 injections in 2012 reimbursed by CMS. 44% of injections performed were with ranibizumab, 42% with bevacizumab, and 14% were with aflibercept. Overall, 60% of providers performed 300 or fewer injections, comprising 24% of all injections administered. As part of their practice, 25% of providers used ranibizumab and aflibercept but not bevacizumab, 24% used bevacizumab only, and 23% used all three anti-VEGF medications analyzed. There were regional differences in the use of bevacizumab when compared to providers in other regions (P<0.01). There was also a statistically significant difference in average injections per provider between regions (P<0.01). Per unit of medication, CMS reimbursed on average $317 for ranibizumab, $114 for bevacizumab, and $778 for aflibercept.

 
Conclusions
 

Nationally, a comparable number of ranibizumab and bevacizumab injections were given in 2012. The average number of total injections per provider varied across geographic regions (P<0.01). Furthermore, there were significant differences in providers’ choice of medication among geographic regions. In addition to quantifying the utilization of anti-VEGF injections among U.S. ophthalmologists, this study also highlights the complicated and multifactorial decision process involved in the selection of intravitreal injections.  

 
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