Abstract
Purpose :
It is postulated that Chronic Disease Foundation (CDF) funding plays a large role in the pharmaceutical choices of patients (Pts). Using a retrospective chart review, this study was meant to assess the impact that loss of CDF funding has on the maintenance of on-label pharmaceutical choices in a large retinal specialty practice.
Methods :
The practice management system of Retina Associates of Cleveland was used to track pharmaceutical use among foundation Pts during a time period of change from funded to a non-funded period (NFP). The NFP is defined as Nov. 16-29, 2022. Pharmaceuticals tracked included aflibercept(Afl), brolucizumab(Bro), ranibizumab(Rbz), bevacizumab(Bev), dexamethasone intravitreal implant(Dex), and faricimab(Fcb). The number of Pts with CDF funding prior to the NFP were queried to determine how many Pts continued their prior drug choice (PDC) despite lack of foundation funding and increased out of pocket cost. The % of Pts that maintained their PDC was calculated and compared to the number of Pts that changed to either a free sample injection (FS) or off-label Bev.
Results :
During the NFP, there were a total of 4,530 Pt visits with 2,507 intravitreal injections administered that included 331 injections to Pts with CDF approval. Of those 331 Pts, 260 Pts had received injections in a prior visit with foundation funding. These 260 Pts were tracked to determine their pharmaceutical injection during the funded period compared to the NFP. Of the 260 Pts tracked, 205 had a documented change of inventory type between the CDF funding period and the NFP (79%). Of the 9 Pts receiving Bro injections, 0 Pts continued PDC, 6 Pts switched to FS (67%), 1 Pt switched to a different on-label drug (11%) and 2 Pts switched to off-label Bev (22%). The results of the 193 Pts on Afl were 36 Pts(19%), 84 Pts(44%), 2 Pts(1%), and 71 Pts(37%), respectively. The results of the 13 Pts on Rbz were 1 Pt(8%), 9 Pts(69%), and 3 Pts(23%), respectively. The results of the 6 Pts on Dex were 2 Pts(33%), 3 Pts(50%), and 1 Pt(17%), respectively. The results of the 30 Pts on Fcb were 10 Pts(33%), 10 Pts(33%), and 10 Pts(33%), respectively.
Conclusions :
In response to losing funding from the CDF, 18% of Afl Pts, 8% of Rbz Pts, 33% of Dex Pts, and 33% of Fcb Pts maintained their PDC. It appears foundation funding has a high impact on maintaining pharmaceutical choice for intraocular injections.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.