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Eleonora Lad, Bradley Hammill, Laura Qualls, Fang Wang, Scott Cousins, Lesley Curtis; Treatment Patterns in Neovascular Age-Related Macular Degeneration between 2005-2010. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3819.
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To describe the patterns of anti-VEGF therapy for 1 to 4 years following initial treatment for neovascular AMD (NVAMD) including the rate and frequency of treatment among Medicare beneficiaries.
We used claims from a 100% sample of Medicare beneficiaries diagnosed with NVAMD from 2005 to 2010. Anti-VEGF treatment was identified using claims for intravitreal injections (CPT 67028) of anti-VEGF with a supporting diagnosis of NVAMD (362.52). Identification of the specific medication received was determined using procedure codes and payment amounts.
We identified 501,702 Medicare patients with NVAMD who initiated anti-VEGF treatment between 2005 and 2010. The mean number of anti-VEGF injections following the initial injection was 4.3 in the first year and decreased to 1.9 in the second year, 1.6 in the third year and 1.1 in the fourth year. Among patients who received a high frequency of injections (7+) during the first year, only 29% received comparable high frequency treatment at year 2, and 14% received no injections. Of the patients who received a low frequency of injections (1-3) during the first year, 76% received no injections and 18% received low frequency treatment during the second year. Between 2005 and 2009, the frequency of anti-VEGF injections in the first year was unchanged for the patients in the low frequency and high frequency cohorts (Table 1).
There is no evidence that the frequency of injections has increased since intravitreal anti-VEGF therapy became available for clinical use in 2005. The frequency of injections is significantly less than in the CATT and HORIZON clinical studies, suggesting general undertreatment of patients with NVAMD.
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