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February 14, 2023
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The authors report no relevant financial disclosures.
Long-acting anti-VEGF therapies that require fewer injections and clinic visits may offer a more cost-effective benefit to patients with age-related macular degeneration, a study suggests. Clinical Ophthalmology.
“Long-acting anti-VEGF therapies can vary not only in bulk purchase price, but also in the frequency of per-label injections and associated clinic visits.” Elana A. More, MD, MBA, wrote an ophthalmology resident at the University of California, San Francisco, and colleagues. “Taking into account the cost of travel distance and time may contribute to a more comprehensive view of the price difference between these treatments.”
The cost of travel to retina clinics contributes significantly to the total cost of anti-VEGF treatments for AMD. Source: Adobe Stock
To determine how travel time and distance contribute to the overall cost of long-acting anti-VEGF therapy for AMD treatment, Meer and colleagues performed a theoretical cost-effectiveness analysis using publicly available cost data for faricimab, ranibizumab, and the first 3 years of treatment. Afbercept therapy, as well as transportation costs from the Veteran’s Affairs Medical Center.
Researchers found that the price difference between treatments increased as the distance traveled increased: ranibizumab was $38,814 more expensive than faricimab when a patient traveled 25 miles for treatment, compared to $37,709 without travel.
In addition, ranibizumab was $31,350 more expensive outside travel and $32,133 within 25 miles to a clinic than faricimab was $6,359 more expensive outside travel and $6,681 more expensive within 25 miles of clinic.
According to researchers, the price difference continues to grow as the treatment distance increases from 25 miles to 50, 100 and 200 miles.
“Taking into account the distance and time costs of travel, we show that longer duration treatments may be more cost-effective than previously thought due to fewer injections and clinic visits,” Mayer and colleagues wrote. “We hope that this work will open up further issues in incorporating travel costs into cost-benefit analyses.”
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Lily Nguyen, OD, FAAO
Although anti-VEGF therapy is critical in reducing vision loss from neovascular AMD, it certainly imposes a financial burden on patients and their families. Patients with AMD are of retirement age but may face costs of nearly $2,000 per injection, depending on insurance and treatment. The amount of time and travel required by patients and their caregivers for these clinic visits also comes at a financial cost.
Clinical studies have shown similar visual effects among three FDA-approved anti-VEGF monotherapies, ranging from 12 injections to five per year.
If this is the case, ophthalmologists collaborating with ophthalmologists should consider cost-effective treatments such as the FDA-approved faricimab that require more frequent clinic visits and injections. Bevacizumab, while off-label, has also been shown to successfully manage neovascular AMD at a fraction of the cost. If possible, these choices can save our patients thousands of dollars in their long-term care.
Lily Nguyen, OD, FAAO
Clinical practice
San Francisco Bay Area
Descriptions: Nguyen reports no relevant financial disclosures.
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