Abstract
Purpose :
To date, there is no study on the treatment patterns of anti-vascular endothelial growth factor (anti-VEGF) therapy for neovascular age-related macular degeneration (nAMD) patients in China. In this database observational study, we aimed to investigate the patterns of anti-VEGF therapy for nAMD patients over the past 5 years in Shanghai, China, where the expense of anti-VEGF medicine was not covered by the governmental healthcare insurance.
Methods :
Data from 2012 to 2016 was collected from the Hospital Information System (HIS) claims database at Shanghai General Hospital, one of the major ophthalmology centers, which provides treatment for nearly half of all the nAMD patients seeking care in Shanghai. Patients with a diagnosis as age-related macular degeneration (H35.305) or macular degeneration (H35.300A) from January 1, 2012 to December 31, 2016 were searched in HIS. The intravitreal injection (330407001), ranibizumab (1Q01151401CH0053), conbercept (1Q01159001510181), optic coherence tomography (310300064) records of these patients from January 1, 2012 to December 31, 2016 were collected. The trends of anti-VEGF therapy, the frequency of clinic visits and intravitreal injections, and the discontinuation rate of therapy were compiled.
Results :
1258 nAMD patients commencing anti-VEGF therapy from 2012 to 2015 were included. This time frame ensured that all subjects had at least a year of follow-up. They received an overall 3932 injections during 7412 clinic visits from January 1, 2012 to December 31, 2016. There was a continuous increase in the total number of injections and clinic visits each year from 2012 to 2016. Mean age at first injection was 69.4 ± 9.7 years. The mean number of injections in the first year was 2.5 ± 1.8. The mean number of clinic visits in the first year was 4.3 ± 3.2 (Table 1). Discontinuation rate of clinic visits increased from 16.1% at 30 days to 68.0% at 1 year. Discontinuation rate of injections increased from 37.1% at 30 days to 80.6% at 1 year (Figure 1).
Conclusions :
In the current study, we describe the patterns of anti-VEGF therapy for nAMD patients over the past 5 years in Shanghai, China. The low frequency of injections and clinic visits and high rate of discontinuation remain a significant concern.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.