Association Between Industry Payments and Anti-VEGF Use in Medicare Beneficiaries
Ophthalmology Retina, January 2017
Mahr et al. conducted a cross-sectional database study to test for associations between anti-VEGF industry payments to ophthalmologists who provide intravitreal injections (IVI) and specific anti-VEGF agent use. They found that such payments were associated with higher odds of ranibizumab and aflibercept use and lower odds of bevacizumab use; however, this association did not demonstrate cause and effect.
Participants in this study were U.S. fee-for-service Medicare beneficiaries and all ophthalmologists who submitted IVI claims for >10 Medicare beneficiaries between Aug. 1, 2013, and Dec. 31, 2013. The Sunshine Act Open Payments database was searched for all industry financial relationships in ophthalmology, and the Medicare Provider Utilization and Payment Database was searched for all IVI claims and anti-VEGF drug claims. The researchers used a novel algorithm to merge the 2 data sets and identify physician-specific associations between industry payments and use of anti-VEGF agents.
The researchers found that of 3,391 ophthalmologists who performed IVI, 1,187 (35%) received nonresearch payments from anti-VEGF industry. Of these, 422 (35%) received payments from Regeneron, 363 (31%) from Genentech, and 402 (34%) from both. When compared with ophthalmologists who perform IVI but do not receive anti-VEGF industry payments, those receiving Genentech payments (median, $90; interquartile range [IQR], $22-$149) were more likely to use ranibizumab (odds ratio [OR], 2.14); those receiving Regeneron payments (median, $55; IQR, $22-$131) were more likely to use ranibizumab (OR, 1.55) and aflibercept (OR, 1.23); those with payments from both manufacturers were more likely to use ranibizumab (OR, 2.69) and aflibercept (OR, 1.53); and all were less likely to use bevacizumab (OR, 0.33 to 0.64).
The researchers concluded that anti-VEGF industry payments to ophthalmologists who perform IVI are associated with a greater likelihood of use of higher-cost ranibizumab and aflibercept; they noted, however, that the findings demonstrate only an association. They suggested that their algorithm could be used in future studies of physician payments and product utilization and may increase our understanding of the role of payments on physician decision-making.
The original article can be found here.
Introducing Ophthalmology Retina
EyeNet now features summaries from the Academy’s Ophthalmology Retina, a new peer-reviewed journal focused exclusively on retina-related eye diseases and conditions. During 2017, Ophthalmology Retina will be issued bimonthly.