ANTI-VEGF Treatment Patterns in Neovascular Age-Related Macular Degeneration Patients in Portugal: A National and Regional LEVEL Analysis
Author(s)
Afonso-Silva M1, Rocha JV2, Marques A3, Macedo AF4, Laires PA5, Almeida AS5, Fernandes J5, Santana R2
1Novartis Farma, Produtos Farmacêuticos SA, Lisbon, 11, Portugal, 2NOVA National School of Public Health, Public Health Research Centre, Lisbon, Portugal, 3NOVA National School of Public Health, Public Health Research Centre, Lisboa, 11, Portugal, 4Linnaeus University, Kalmar, Sweden, 5Novartis Farma, Produtos Farmacêuticos SA, Porto Salvo, Portugal
OBJECTIVES Currently approved anti-vascular endothelial growth factors (anti-VEGF) for neovascular age-related macular degeneration (nAMD) have intravitreal injection frequencies that might impose scheduling challenges to some hospitals. This study aimed to assess anti-VEGF treatment patterns in nAMD patients at a national and regional level. METHODS This is an administrative database study using the universe of inpatient and day cases stays of national health service hospitals in Portugal between 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. Analyzes of intravitreal injections frequency used patient-level data (data available since 2014) and year was adjusted according to the date of patient's first procedure, in 12-month blocks. Patients were classified as newly-treated if, at the index (2014), there was no intravitreal procedure episode in the database. RESULTS The database included 100,168 intravitreal anti-VEGF injections through 2013-2018. The mean number of intravitreal injections per-patient-year was 2.7 in 2013 and 3.4 in 2018. A marked difference in the number of injections per-patient-year was observed among regions in 2018: Porto had a rate of 6.3 while Algarve had 2.2. During the first 12 months of treatment, newly-treated patients had a mean (SD) intravitreal injection frequency of 4.1 (2.8) with a mean (SD) 9.4 (6.9) week-interval among injections. After the first 12 months of treatment, a mean (SD) intravitreal injection frequency per year of 3.7 (2.6) with a mean (SD) interval between injections of 12.8 (11.4) weeks was observed. CONCLUSIONS This study suggests that overall there is a low frequency of intravitreal anti-VEGF injections in Portugal with marked regional discrepancies. Future studies are needed to understand the real impact of the low number of injections in clinical outcomes.
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PIH18
Topic
Health Service Delivery & Process of Care
Topic Subcategory
Treatment Patterns and Guidelines
Disease
Drugs, Geriatrics