Managed care professionals can assist ophthalmologists and retina specialists in personalizing anti-vascular endothelial growth factor (anti-VEGF) treatment to encourage patient adherence, according to a recent review of the literature on this topic.
Managed care professionals can assist ophthalmologists and retina specialists in personalizing anti-vascular endothelial growth factor (anti-VEGF) treatment to encourage patient adherence, according to a recent review of literature published in the Journal of Managed Care & Specialty Pharmacy.
Neovascular age-related macular degeneration (nAMD) remains a leading cause of blindness in the United States despite the introduction of 3 FDA-approved anti-VEGF drugs. Aflibercept and ranibizumab are 2 therapies that treat nAMD, while bevacizumab, a therapy for oncology indications, is increasingly used off-label in treating nAMD.
Despite the proven efficacy in clinical trials of all 3 treatments, there are significant challenges in administering the therapies in a real-world setting that many studies fail to note: these include delays in diagnosis and treatment approval, patient response to different anti-VEGF therapies, lapses in physician regimentation of anti-VEGF injection and monitoring, and inadequate patient adherence to treatment and monitoring.
In 1 study, over the period of 1 year, visual acuity (VA) scores, which measure the ability of the eye to distinguish details and shapes at a distance, on specialized charts, and the Early Treatment Diabetic Retinopathy Study (ETDRS) chart, increased significantly among patients who were administered ranibizumab.
The CATT trial compared outcomes of ranibizumab and bevacizumab when administered monthly or as needed. In a year, mean VA scores increased by a range of 5.9 letters in the bevacizumab cohort and 8.5 letters in the ranibizumab cohort.
The VIEW 1 and VIEW 2 trials were designed to compare ranibizumab to aflibercept. Patients with nAMD were randomly assigned doses of ranibizumab or aflibercept every 4 weeks or every 8 weeks. The results showed that there were no significant differences in outcomes between the 2 different dosing intervals of the drug.
The cost of managing nAMD can range from $65,000 to over $250,000 over 20 years. Previous studies have found bevacizumab to be more cost-effective than the other therapies. However, age, general health, and anatomic characteristics (including presence of retinal fluid leakage, hemorrhage, and fibrotic scarring) are all factors that underscore the importance of managing nAMD treatment on an individual level.
Patients are not likely to adhere to nAMD treatment due to fears of having injections in the eye, anticipating pain, or discomfort. Other determinants of health may be age-related (for example, difficulty arranging and traveling to appointments for treatment).
Retina specialists have responded to the burdens and high costs of anti-VEGF treatment by developing alternative regimens based on extended fixed intervals, as needed based on disease activity, and/or by a treat-and-extend strategy.
Managed care organizations can increase public awareness surrounding the condition through educational programs and resources. This can incentivize patients to modify lifestyle behaviors and reduce risks.
“The efficacy of anti-VEGF therapy for nAMD has been consistently demonstrated in clinical trials; however, real-world gaps and challenges can pose significant barriers to achieving treatment goals,” the authors concluded. “In collaboration with ophthalmologists and retina specialists, managed care professionals can play key roles in overcoming barriers associated with underdiagnosis of nAMD, delays between [choroidal neovascularization, CNV] growth and anti-VEGF treatment initiation, lack of awareness about AMD among the public, and the logistic, emotional, and financial burdens of frequent intravitreal injections.”
Competitive Pricing in Biosimilars: How Adalimumab Could Shape the Industry
Published: October 29th 2024 | Updated: October 29th 2024Sophia Humphreys, PharmD, MHA, BCBBS, of Sutter Health notes that although initial adoption of adalimumab biosimilars remained low in 2023, competitive pricing pressures have already benefited patients and the health care sector.
Biosimilars in America: Overcoming Barriers and Maximizing Impact
July 21st 2024Join us as we explore the complexities of the US biosimilars market, discussing legislative influences, payer and provider adoption factors, and strategies to overcome industry challenges with expert insights from Kyle Noonan, PharmD, MS, value & access strategy manager at Cencora.
Sandoz Report: A Unified Approach to Overcoming Drug Shortages
October 10th 2024A report from Sandoz emphasizes the need for collaboration among stakeholders to eliminate drug shortages impacting over 90% of hospital systems in the US, recommending policy changes and actions to address the ongoing issue, which has caused treatment delays and increased costs.
What AmerisourceBergen's Report Reveals About Payers, Biosimilar Pricing Trends
May 28th 2023On this episode of Not So Different, Tasmina Hydery and Brian Biehn from AmerisourceBergen discussed results from a recent survey, that were also presented at Asembia 2023, diving into the payer perspective on biosimilars and current pricing trends across the US biosimilar industry.
AAM Report: Despite Massive Savings, Patient OOP Costs on Biosimilars, Generics Remain High, Part 2
September 24th 2024Part 2 of our series diving into the Association for Accessible Medicines' (AAM) latest report discusses that while generics and biosimilars saved $445 billion in 2023, their potential is hindered by high patient costs, drug shortages, and ineffective policies, underscoring the need for reforms to fully realize their benefits.
AAM Report: Generics and Biosimilars Savings Reach $445 Billion in 2023, Part 1
September 18th 2024Savings from generic and biosimilar drugs totaled $445 billion in 2023, showing promise for the growth of both markets and highlighting the success of expansion policies for these products, according to a new report from the Association for Accessible Medicines (AAM).