Original articleTreatment Patterns for Neovascular Age-Related Macular Degeneration: Analysis of 284 380 Medicare Beneficiaries
Section snippets
Data Sources
We obtained outpatient and carrier standard analytic files and the corresponding denominator files from the US Centers for Medicare & Medicaid Services for January 1, 2004, through December 31, 2009, for all Medicare beneficiaries having any claim with a diagnosis for neovascular AMD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] diagnosis code 362.52). This time frame allowed for a 3-year study period with 1 year of history and 1 year of follow-up.
Results
Between January 1, 2005, and December 31, 2008, nearly 1 million Medicare beneficiaries had a diagnosis of AMD (Figure 1). More than 60% of these beneficiaries had a second diagnosis of AMD within 1 year, and approximately 60% of these had no neovascular AMD diagnosis in the previous year. Therefore, the study population included 284 380 Medicare beneficiaries with a diagnosis of neovascular AMD between January 1, 2006, and December 31, 2008. The source population from which the study
Discussion
In this analysis of a nationally representative cohort of 284 380 Medicare beneficiaries with newly diagnosed AMD, we observed an increase in the proportion of patients who received any treatment, as well as shifts in the types of treatments used between 2006 and 2008. During the 3-year study period, the proportion of patients receiving treatment increased from 68% to 75%, driven primarily by an increase in the proportion of patients receiving anti-VEGF injections. In tandem with the use of
Lesley H. Curtis, PhD, is an associate professor in medicine at the Duke University, Durham, North Carolina, and works primarily in the Duke Clinical Research Institute. A health services researcher by training, Dr Curtis oversees a portfolio of projects that use observational data to address questions related to clinical and comparative effectiveness, pharmacoepidemiology, health care delivery, and epidemiological trends. Her clinical areas of interest include heart failure, atrial
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2023, Canadian Journal of OphthalmologyCitation Excerpt :This is consistent with an analysis of 284 380 Medicare beneficiaries newly diagnosed with wet AMD that found that discontinuation of anti-VEGF therapy was common.31 The rate of discontinuation was 53.6% within 1 year and 61.7% within 18 months.31 The high treatment burden and resultant discontinuation of anti-VEGF therapy can threaten long-term visual outcomes for patients with wet AMD.17
Nonadherence or Nonpersistence to Intravitreal Injection Therapy for Neovascular Age-Related Macular Degeneration: A Mixed-Methods Systematic Review
2021, OphthalmologyCitation Excerpt :Treatment discontinuation before 12 months,30 study period,26,27 or permanently31 No treatment or visit at clinic for more than 4 months,32 6 months,15,33,34 or 12 months35,36 No follow-up by any ophthalmologist for 3 months28
Use of Bevacizumab and Ranibizumab for Wet Age-Related Macular Degeneration: Influence of CATT Results and Introduction of Aflibercept
2019, American Journal of OphthalmologyCitation Excerpt :Before the CATT trial, there was no strong level 1 evidence evaluating the safety or efficacy of ranibizumab vs bevacizumab for retinal disease. Factors that may have influenced ophthalmologists' decisions to use one agent vs the other included the results of earlier studies, costs of purchasing and storing these agents, reimbursement for administration of one agent vs the other, financial incentives for making bulk purchases or purchasing these medications using credit cards, the medicolegal environment where the ophthalmologist was practicing (given that only ranibizumab was approved by the FDA), input from pharmaceutical representatives, the location where the ophthalmologist did his or her fellowship training, preferences of the attendings who trained him or her, preferences of other ophthalmologists in the same practice or geographic community, insurance tiering and other policies, and/or whether the ophthalmologist's patients could afford the copays for the more expensive agent.1–3,17–23 The publication of CATT results offered strong evidence of similar efficacy and relatively similar safety profiles between bevacizumab and ranibizumab.
Loss to Follow-Up in Patients with Proliferative Diabetic Retinopathy after Panretinal Photocoagulation or Intravitreal Anti-VEGF Injections
2018, OphthalmologyCitation Excerpt :African Americans have been shown to have a lower probability of receiving an eye examination when compared with whites.13 There is also evidence to suggest African Americans with neovascular age-related macular degeneration receive fewer injections than recommended.14 However, other reports suggest that certain African American subgroups might be more compliant than their white counterparts.15
Gene Therapy in Neovascular Age-related Macular Degeneration: Three-Year Follow-up of a Phase 1 Randomized Dose Escalation Trial
2017, American Journal of Ophthalmology
Lesley H. Curtis, PhD, is an associate professor in medicine at the Duke University, Durham, North Carolina, and works primarily in the Duke Clinical Research Institute. A health services researcher by training, Dr Curtis oversees a portfolio of projects that use observational data to address questions related to clinical and comparative effectiveness, pharmacoepidemiology, health care delivery, and epidemiological trends. Her clinical areas of interest include heart failure, atrial fibrillation, eye diseases in older patients, and cancer.
Lisa D. DiMartino is currently with the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.