June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
A comparison of utilization and costs of fluocinolone acetonide and dexamethasone intravitreal implants for the treatment of non-infectious uveitis: A cross sectional study
Author Affiliations & Notes
  • Jong Park
    Ophthalmology, Stanford University School of Medicine, Stanford, California, United States
  • Bryce Hwang
    Ophthalmology, Stanford University School of Medicine, Stanford, California, United States
  • Ahmad Al Moujahed
    Ophthalmology, Stanford University School of Medicine, Stanford, California, United States
  • Amee D Azad
    Ophthalmology, Stanford University School of Medicine, Stanford, California, United States
  • Huy Nguyen
    Ophthalmology, Stanford University School of Medicine, Stanford, California, United States
  • Sunil K. Srivastava
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Prithvi Mruthyunjaya
    Ophthalmology, Stanford University School of Medicine, Stanford, California, United States
  • Footnotes
    Commercial Relationships   Jong Park, None; Bryce Hwang, None; Ahmad Al Moujahed, None; Amee Azad, None; Huy Nguyen, None; Sunil K. Srivastava, None; Prithvi Mruthyunjaya, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1421. doi:
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      Jong Park, Bryce Hwang, Ahmad Al Moujahed, Amee D Azad, Huy Nguyen, Sunil K. Srivastava, Prithvi Mruthyunjaya; A comparison of utilization and costs of fluocinolone acetonide and dexamethasone intravitreal implants for the treatment of non-infectious uveitis: A cross sectional study. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1421.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To compare the costs of fluocinolone acetonide (FA) and dexamethasone (DM) intravitreal implants with steroid-sparing systemic therapy in the treatment of non-infectious uveitis (NIU) and to determine the usage patterns and changes in cost over time of FA and DM implants.

Methods : Retrospective claims-based analysis of a study population in IBM MarketScan, a nationally-representative sample of commercial insurance beneficiaries, diagnosed with NIU from 2007-2016 who received intravitreal FA or DM implantation. Cost of procedure, total healthcare costs, follow up to ophthalmology and rheumatology, and number of repeat or crossover procedures (use of the other implant) were analyzed. Costs were also compared to NIU patients receiving steroid-sparing systemic therapy (SSST) with or without intraocular implants.

Results : Over 200,000 patients with NIU were found in the database, and a total of 109 FA patients, 417 DM patients, and 1060 SSST patients were identified. The total cost to the healthcare system of NIU patients who received FA implants was $57,272, DM implants was $21,810, and SSST without an implant was $37,697 at one year (p<0.001). The charged cost of implanting FA decreased from a peak in 2007 at $40,603 to $24,292 in 2016. The charged cost of implanting DM in NIU patients was stable over the study period with an average cost of $2,051. There were no differences in the number of follow up visits to an ophthalmologist or rheumatologist at one, two, or three years between patients with FA and DM. There were more repeat procedures than crossover procedures for both FA (33.0% vs 4.6% at one year, 53.1% vs 14.3% at three years) and DM (60.0% vs 2.9% at one year, 61.6% vs 7.2% at three years).

Conclusions : In NIU patients, total healthcare costs were highest in patients with FA implants, lower with SSST, and lowest with DM implants. FA intravitreal implant use and cost decreased over time, while DM intravitreal implant use increased with stable cost over time. These findings may help clinicians decide which therapies to use in patients with NIU.

This is a 2021 ARVO Annual Meeting abstract.

 

Total costs to the healthcare system of patients receiving DM implants, FA implants, and SSST for NIU at 1 year.

Total costs to the healthcare system of patients receiving DM implants, FA implants, and SSST for NIU at 1 year.

 

Cost of FA and DM implantation procedure by year in 2016 dollars, adjusted for inflation, in patients with NIU.

Cost of FA and DM implantation procedure by year in 2016 dollars, adjusted for inflation, in patients with NIU.

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