OBJECTIVES

Since the reimbursement of anti­vascular endothelial growth factor (anti­-VEGF) intravitreal injections by the Portuguese national health service (NHS) that the number of treated patients with neovascular age-related macular degeneration (nAMD) has been rising. The objective of this study was to analyze the number of patients with nAMD treated with anti-VEGF drugs in the Portuguese NHS and evaluate possible regional differences.

METHODS

This is an administrative database study using the universe of inpatient and day cases stays of NHS hospitals in Portugal during 2013-2018. Cases were selected based on surgical codes (ICD-9-CM and ICD-10) for intravitreal procedures. These cases were used as proxies for intravitreal anti-VEGF injections. Patients were classified with nAMD if they had a principal or secondary diagnosis of nAMD. Patients with ages <50 years were excluded.

RESULTS

From 2013 to 2018, 20,547 patients with nAMD were treated with intravitreal anti-VEGF in the Portuguese NHS. The annual number of nAMD patients treated has been rising since 2013 at a mean rate of 9% per year, from 4,254 patients in 2013 to 6,496 patients in 2018. These patients are mostly (73%) between 70 and 89 years-old and 56% are women. In 2018, the majority of patients (54%) were treated in the metropolitan areas of Lisbon and Porto. The remaining treated patients are distributed by the central region of Portugal (27%), the northern region, excluding Porto (11%), Alentejo (6%) and Algarve (3%).

CONCLUSIONS

The number of patients treated with intravitreal anti-VEGF has been growing in the last years. However, regional discrepancies are still observed (45% of the population ≥50 years resides in Lisbon and Porto metropolitan areas vs 54% treated with intravitreal anti-VEGFs). This might suggest a heterogeneous level of access to disease information, which makes working closer to society extremely important to overcome possible access barriers among regions.