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D. L. Klein, D. Roth, M. Weiss; A Retina Center’s Experience With Patients’ Preferences of Bevacizumab versus Ranibizumab. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4584.
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Since late 2005, patients have been treated with an off-label use of intravitreal bevacizumab (AvastinTM) for age related macular degeneration (ARMD). When ranibizumab (LucentisTM) was introduced as an FDA approved therapy for ARMD in July of 2006, patients previously receiving bevacizumab now had a choice of drugs. One important factor in this decision is cost; the price of an intravitreal injection of ranibizumab can be 80 times that of bevacizumab. We provide a retina center’s data on bevacizumab-treated patients’ preferences of drug following ranibizumab’s approval.
Retrospective analysis of the 506 patients receiving intravitreal bevacizumab at this retina center before ranibizumab was offered to these patients (7/10/06). Patients who did not receive injections after 7/10/06 were excluded from the study. Dates of injections were obtained from the charts and it was noted whether the patient continued therapy with bevacizumab or switched to ranibizumab. Other details such as the number of injections and the date of the switch were recorded.
388 patients, 252 female (64.9%) and 136 male (35.1%), fit the study criteria. 272 patients switched to ranibizumab (70.1%); 116 did not switch (29.9%). The most common reason to not switch to ranibizumab was inadequate insurance coverage of ranibizumab injections. Of those who did switch 179 were female (65.8%) and 93 were male (34.2%). The mean age was 81.0. The mean # of bevacizumab injections was 2.8. The mean # of ranibizumab injections was 3.3. The mean total # of injections (bevacizumab + ranibizumab) was 6.1. The mean # of days past 7/10/06 that it took to switch to ranibizumab was 54.3 days. 5 patients switched back to bevacizumab after having taken ranibizumab (2 of them were convinced that bevacizumab had a better effect on their vison; another 2 were told that bevacizumab might have a longer effect hence requiring less frequent injections; the other patient's reason to switch back was unclear). Of those who did not switch: 73 were female (62.9%) and 43 were male (37.1%). The mean age was 75.6. The mean # of bevacizumab injections was 4.3. The mean # of bevacizumab injections before 7/10/06 was 1.8. The mean # of bevacizumab injections after 7/10/06 was 2.5.
A significant number of patients previously treated with bevacizumab continued to do so even after FDA-approved ranibizumab was offered to them.
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