Abstract
Purpose :
To characterize trends amongst intraocular steroid (IOS) medications with changes in availability and supply distribution.
Methods :
A retrospective cohort study was performed at a large private retinal practice. The Institutional Review Board (Sterling) granted this study a waiver of authorization. All data was collected through the practice management of Retina Associates of Cleveland, Inc. Five medications were included analyzed: triamcinolone acetonide (TRI), dexamethasone intravitreal implant (DEX), fluocinolone acetonide intravitreal implant 0.18mg (FAc 0.18), fluocinolone acetonide intravitreal implant 0.19mg (FAc 0.19), and triamcinolone acetonide injectable suspension (TRIS). Quarterly reports of IOS dispensation were generated for each medication from January 2019 through November 2023. Total IOS injections and percents of total IOS injections were recorded and compared, between the earliest and latest 3 quarterly reports available for a given medication. FDA approval of new agents was researched and recorded if within one year of study parameters, as well as medication supply disruptions.
Results :
Over the 5-year study period, a total of 7,100 IOS injections were administered, increasing from 777 in 2019 to 1283 in 2023. The usage in TRI declined from 259 (33.33%) to 0 (0%) over five years. DEX increased in administration from 475 (61.13%) to 1,147 (89.40%). Usage of FAc 0.18 increased from 10 (12.87%) to 18 (14.03%). Dispensation of FAc 0.19 increased from 33 (4.25%) to 49 (3.81%). And utilization of TRIS increased from 0 (0%) to 49 (3.82%). New agents approved include TRIS (launched March 28, 2022) and FAc 0.18 (launched October 12, 2018). The only medication affected by supply disruption was TRI, reported by the American Society of Retinal Specialists on June 2, 2022, and currently remains unavailable.
Conclusions :
Overall, IOS injection utilization has increased over the 5-year study period. Results found a 1/3 of all IOS injections were with TRI, until supply chain disruption in June 2022, where it plummeted to 0, and has yet to recover. The gap left by TRI was filled by DEX, where it experienced a 28.27% boost in use. FAc 0.18 with a small overall utilization remained relatively stable. TRIS as a new agent has demonstrated rapid growth (0-3.82% of total IOS injections) over the one year of collected data.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.