Purchase this article with an account.
R. E. Williams, Q. Fu; Anti-VEGF Treatment Patterns Among Wet AMD Patients Younger Than 65 Years Old. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4528.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
There is little understanding of the patterns of anti-VEGF injections for wet AMD in the U.S. This study describes anti-VEGF treatments among wet AMD patients younger than 65 years in the United States.
We identified patients <65 years old with an ICD-9 code 362.52 ("exudative senile macular degeneration") after July 1, 2006 from U.S. medical claims in the Integrated Healthcare Services (IHCIS) database, which is generally representative of the insured U.S. population <65 years old. Data was available through December 2008. Anti-VEGF treatment was identifed by National Drug Code (NDC) and Heathcare Common Procedure Coding System (HCPCS) codes for bevacizumab, ranibizumab, pegaptanib. We excluded patients with any cancer diagnosis as defined by ICD-9 codes.
Bevacizumab was used 2.7 times more than ranibizumab. There was an average of 3 (range 1-14) anti-VEGF injections in the first 12 months (n=214). After first injection (month 1), 35% got an injection in month 2, 24% in month 3, 21% in month 4, 16% in month 5, 17% in month 6, 11% in month 7, 11% in month 8, 11% in month 9, 12% in month 10, 12% in month 11, and 13% in month 12. Among patients with anti-VEGF, 33% had 1 injection, 22% had 2 injections, 16% had 3 injections, 9% had 4 injections, 6% had 5 injections, 3% had 6 injections, 5% had 7 injections, 2% had 8 injections, 4% had 9+ injections in the first year. Among patients with 18 months of follow-up (n=194), 49% had no injections after the 6th month of follow-up. Although this database is less representative of 65+ year olds, they had similar treatment patterns; 56% had 1-3 injections in first year compared to 51% of those <65 years old.
The applicability of using the small sample size identified from this database to understand injection treatment patterns of wet AMD patients may be limited as the more aged population (65 years of age and older) is less representative, the duration of follow-up is brief, and ocular outcomes data that may have informed treatment decisions are not available. Yet, these results suggest that patients are getting only an average of a few injections in the first year, bevacizumab is being used more frequently than ranibizumab, and the true pattern of these injections remains unclear.
This PDF is available to Subscribers Only