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S. W. Cousins, B. G. Hammill, K. G. Csaky, K. A. Schulman, L. H. Curtis; Baseline Characteristics of Medicare Beneficiaries Receiving Different Treatments for AMD Between 2005 and 2006. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2254. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the baseline characteristics of Medicare beneficiaries who received IV verteporfin with photodymanic therapy (PDT), pegaptanib, bevacizumab, or ranibizumab for age-related macular degeneration (AMD).
We used a 100% sample of Medicare beneficiaries from 2005 and 2006 with a diagnosis of AMD (ICD-9 diagnosis codes 362.52, 362.42, 362.43, or 362.16). Patients who had their first treatment after 7/1/05 were classified on the basis of the first treatment. The treatments of interest were PDT (HCPCS 67221) and intravitreal injection (CPT 67027) with pegaptanib, bevacizumab, or ranibizumab. IVT medications were defined using J-codes and C-codes from the index claim. We identified comorbidities from inpatient, outpatient, and professional service claims processed in the 6 months prior to the index date. We used Kruskal-Wallis tests to compare continuous variables and chi-square tests to compare categorical variables.
Between July 1, 2005, and December 31, 2006, 127,259 Medicare beneficiaries received treatment for AMD. 35,041 (28%) received PDT, 27,384 (22%) received pegaptanib, 43,687 (34%) received bevacizumab, and 21,147 (17%) received ranibizumab. Demographic characteristics were consistent across the 4 treatment groups (median age: 81 years, approximately 36% male, and approximately 3% non-white). The 4 groups were not different with respect to prior myocardial infarction (3%, p=0.05), peripheral vascular disease (14%, p=0.14), or cerebrovascular disease (11%, p=0.17) in the 6 months prior to treatment. Among patients receiving bevacizumab, prior stroke (6% versus 7% in other treatment groups, p=0.02) and coronary heart disease (25% vs. 26% in other treatment groups, p.001) were slightly less common, but diabetes was slightly more common (24% versus 22% in other treatment cohorts, p<.001).
Patients who received PDT, pegaptanib, bevacizumab, and ranibizumab were similar with respect to demographics and comorbidities observed in the 6 months prior to treatment. Although there were statistically significant differences across the treatment groups, absolute differences were small. There does not appear to be differential treatment selection on the basis of documented comorbidities at baseline. This database should be useful for comparison of adverse events among the different treatment groups.
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