Ranibizumab and aflibercept account for approximately 12% of the annual Medicare Part B drug budget

This observational study estimated annual Medicare Part B spending on 2 anti-VEGF drugs.

Study design

The author analyzed intravitreal injection claims and calculated expenditures for ranibizumab and aflibercept between 2011 and 2015.

Outcomes

During the 5-year study period, the annual cost of ranibizumab averaged $1.3 billion, while aflibercept averaged $1.4 billion. Together, these 2 medications accounted for around 12% of the annual Medicare Part B drug spending. On average, Medicare spent $9,719 and $9,934 per year on each beneficiary of ranibizumab and aflibercept injections, respectively.

The number of Medicare Part B claims for ranibizumab decreased from 671,869 in 2011 to 573,796 in 2015, whereas claims for aflibercept rose from 518,836 in 2013 to 866,749 in 2015.

Limitations

This study was limited by its observational design and its use of diagnosis codes. The authors could not reliably calculate ophthalmic bevacizumab expenditure from the Medicare Part B spending data. The analysis excluded beneficiaries in the Medicare Advantage program.

Clinical significance

Anti-VEGF drugs account for a significant portion of Medicare part B expenditure. The savings associated with switching from aflibercept or ranibizumab to bevacizumab could potentially amount to billions of dollars annually. It should, however, be acknowledged that cost is just one of the many important factors influencing anti-VEGF medication choice.