Diabetic Macular Edema Diagnosis and Treatment in the Real World: An Analysis of Medicare Claims Data (2008 to 2010)
Abstract
BACKGROUND AND OBJECTIVE:
To characterize vascular endothelial growth factor (VEGF) inhibitor treatment patterns in patients with diabetic macular edema (DME) using a Medicare Standard Analytic Files Part B or Outpatient Claims database to understand treatment frequency and DME persistence.
PATIENTS AND METHODS:
A retrospective analysis of treatment patterns for patients diagnosed with DME receiving their first anti-VEGF injection was performed.
RESULTS:
The average number of anti-VEGF injection claims for DME per patient rose from 3.1 to 4.6 per year (mean: 4.2). Within 1 year of diagnosis, 46% of patients received their final DME diagnosis (mean: 1.9 anti-VEGF claims), and 65% of patients received their final anti-VEGF treatment for DME. Patients who received treatment for DME through years 2 and 3 submitted a mean of four and 7.2 anti-VEGF claims, respectively.
CONCLUSION:
VEGF inhibitor treatment was less frequent than in landmark trials, but did resolve DME in a proportion of patients.
[Ophthalmic Surg Lasers Imaging Retina. 2016;47:258–267.]
- 1.Chen E, Looman M, Laouri M, Burden of illness of diabetic macular edema: Literature review. Curr Med Res Opin. 2010; 26(7):1587–1597.
10.1185/03007995.2010.482503 Crossref Medline, Google Scholar - 2.Klein R, Klein B. Vision disorders in diabetes. In: , ed. Diabetes in America, 2nd ed. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1995:293–338. Google Scholar
- 3.Kanavos P, van den Aardweg S, Schurer W. LSE Health, London School of Economics. Diabetes expenditure, burden of disease and management in 5 EU countries. http://www.lse.ac.uk/LSEH-ealthAndSocialCare/research/LSEHealth/MTRG/LSEDiabetesReport26Jan2012.pdf. Published January 2012. Google Scholar
- 4.International Diabetes Federation. IDF Diabetes Atlas, 6th ed. http://www.idf.org/diabetesatlas/. Published 2013. Updated 2014. Accessed September 2, 2015. Google Scholar
- 5.King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care. 1998; 21(9):1414–1431.
10.2337/diacare.21.9.1414 Crossref Medline, Google Scholar - 6.Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004; 27(5):1047–1053.
10.2337/diacare.27.5.1047 Crossref Medline, Google Scholar - 7.LUCENTIS (ranibizumab injection) [package insert]. South San Francisco, CA: Genentech; 2014. Google Scholar
- 8.Ozurdex (dexamethasone intravitreal implant) [package insert]. Irvine, CA: Allergan; 2014. Google Scholar
- 9.ILUVIEN (fluocinolone acetonide intravitreal implant) [package insert]. Alpharetta, GA: Alimera Sciences; 2014. Google Scholar
- 10.EYLEA (aflibercept) Injection [package insert]. Tarrytown, NY: Regeneron Pharmaceuticals; 2014. Google Scholar
- 11.Nguyen QD, Brown DM, Marcus DM, Ranibizumab for diabetic macular edema: results from 2 phase III randomized trials: RISE and RIDE. Ophthalmology. 2012; 119(4):789–801.
10.1016/j.ophtha.2011.12.039 Crossref Medline, Google Scholar - 12.Bressler SB, Qin H, Beck RW, Factors associated with changes in visual acuity and central subfield thickness at 1 year after treatment for diabetic macular edema with ranibizumab. Arch Ophthalmol. 2012; 130(9):1153–1161.
10.1001/archophthalmol.2012.1107 Crossref Medline, Google Scholar - 13.Kiss S, Liu Y, Brown J, Clinical utilization of anti-vascular endothelial growth-factor agents and patient monitoring in retinal vein occlusion and diabetic macular edema. Clin Ophthalmol. 2014; 8:1611–1621.
10.2147/OPTH.S60893 Crossref Medline, Google Scholar - 14.Centers for Medicare and Medicaid Service (CMS). Original medicare (part A and B) eligibility and enrollment. http://www.cms.gov/Medicare/Eligibility-and-Enrollment/OrigMedicarePartABEligEnrol/. Accessed September 3, 2015. Google Scholar
- 15.Brown DM, Nguyen QD, Marcus DM, Long-term outcomes of ranibizumab therapy for diabetic macular edema: the 36-month results from two phase III trials: RISE and RIDE. Ophthalmology. 2013; 120(10):2013–2022.
10.1016/j.ophtha.2013.02.034 Crossref Medline, Google Scholar - 16.Korobelnik JF, Do DV, Schmidt-Erfurth U, Intravitreal aflibercept for diabetic macular edema. Ophthalmology. 2014; 121(11):2247–2254.
10.1016/j.ophtha.2014.05.006 Crossref Medline, Google Scholar - 17.Sohn HJ, Han DH, Kim IT, Changes in aqueous concentrations of various cytokines after intravitreal triamcinolone versus bevacizumab for diabetic macular edema. Am J Ophthalmol. 2011; 152(4):686–694.
10.1016/j.ajo.2011.03.033 Crossref Medline, Google Scholar - 18.U.S. Food and Drug Administration. FDA approves Lucentis to treat diabetic macular edema. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm315130.htm. Accessed September 3, 2015. Google Scholar
