Adherence to Anti-VEGF Treatment of Patients With Age-Related Macular Degeneration of Exudative Type (nAMD) and Diabetic Macular Edema (DME) in Greece: Evidence From an Expert Panel
Author(s)
Platon Peristeris, Dr., Maria Katsara, Dr., Foteini Tsotra, PhD Candidate, KONSTANTINA BRIOLA, PhD Candidate, Athanassios Vozikis, Dr..
Department of Economics, Laboratory of Health Economics & Management, University of Piraeus, Athens, Greece.
Department of Economics, Laboratory of Health Economics & Management, University of Piraeus, Athens, Greece.
OBJECTIVES: Non-adherence or non-persistence to treatment proves in clinical practice to be an obstacle to achieving optimal health outcomes and expected treatment efficacy rates in patients with nAMD/DME and creates a situation of unmet need. The aim of this research was to identify and analyze the key factors contributing to non-adherence in patients with nAMD and DME, through the recording of the Greek clinical practice from a group of medical experts.
METHODS: Factors contributing to treatment non-adherence were identified through literature review and included in a questionnaire distributed to the participating physicians. The replies provided were based on the physicians’ overall estimation.
RESULTS: Eight centers (NHS, University, Private) treating 5,503 patients (4,070 nAMD, 1,433 DME) participated in the study. The annual average number of injections per patient and per Center shows a large variation: 1.1 to 6.3 (nAMD: 1.7, DME: 2.5). Concerning adherence, 10% of patients do not comply with treatment guidelines and 55% of injections are not performed within the time period foreseen by the treatment protocol with the highest rates being observed in NHS Centers. Monocular patients and patients in the 1st year of treatment demonstrate the highest and patients with visual acuity >5/10 and in the >4th year of treatment the lowest adherence. Concerning factors contributing to non-adherence, patients focused on the inability to set next appointments and the frequency of injections. Physicians focused on the time interval between prescription and final approval via the Preapproval Electronic System (PES) while their workload affects them moderately. The average rejection rate by the PES was 7.7% (0-30%) mostly for bureaucratic reasons.
CONCLUSIONS: These findings can initiate a meaningful dialogue between all stakeholders (physicians, patients and caregivers, payers and health policy decision makers) to create solutions that will optimize the daily clinical paradigm and deliver the optimised health outcomes.
METHODS: Factors contributing to treatment non-adherence were identified through literature review and included in a questionnaire distributed to the participating physicians. The replies provided were based on the physicians’ overall estimation.
RESULTS: Eight centers (NHS, University, Private) treating 5,503 patients (4,070 nAMD, 1,433 DME) participated in the study. The annual average number of injections per patient and per Center shows a large variation: 1.1 to 6.3 (nAMD: 1.7, DME: 2.5). Concerning adherence, 10% of patients do not comply with treatment guidelines and 55% of injections are not performed within the time period foreseen by the treatment protocol with the highest rates being observed in NHS Centers. Monocular patients and patients in the 1st year of treatment demonstrate the highest and patients with visual acuity >5/10 and in the >4th year of treatment the lowest adherence. Concerning factors contributing to non-adherence, patients focused on the inability to set next appointments and the frequency of injections. Physicians focused on the time interval between prescription and final approval via the Preapproval Electronic System (PES) while their workload affects them moderately. The average rejection rate by the PES was 7.7% (0-30%) mostly for bureaucratic reasons.
CONCLUSIONS: These findings can initiate a meaningful dialogue between all stakeholders (physicians, patients and caregivers, payers and health policy decision makers) to create solutions that will optimize the daily clinical paradigm and deliver the optimised health outcomes.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR13
Topic
Clinical Outcomes, Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance
Disease
No Additional Disease & Conditions/Specialized Treatment Areas