Medicare Part B Spending and Anti-VEGF Drugs
Ophthalmology Retina, August 2018
Patel set out to tally the annual Medicare Part B costs associated with anti–vascular endothelial growth factor (VEGF) medications used by ophthalmologists. He found that aflibercept and ranibizumab account for 12% of the Medicare Part B budget. In addition, he estimated that switching to bevacizumab might save more than $2 billion each year.
For this observational cohort study, the author analyzed data from 2011-2015 for intravitreal injections of aflibercept and ranibizumab. Comparable data on ophthalmology-specific injections of bevacizumab were not available, and this analysis excluded beneficiaries in the Medicare Advantage program, non-Medicare beneficiaries, and privately insured patients.
Annual Medicare Part B spending for ranibizumab was $1.43 billion for 671,869 injections in 2011; this dropped to $1.15 billion for 573,796 injections in 2015. For aflibercept, annual Medicare spending was $1.08 billion for 518,836 injections in 2013 (the first year that data were available for the drug); the cost grew to $1.81 billion for 866,749 injections in 2015. For each drug, beneficiaries received an average of 4.8 injections per year.
Although the author was unable to extract ophthalmology-specific data on bevacizumab spending, he noted that the numbers in his analysis could be used to estimate savings associated with switching to the less expensive medication. For instance, for 2015 alone, he determined that switching from aflibercept and ranibizumab to bevacizumab would have totaled $2.87 billion in Medicare savings.
Despite this cost differential, the author noted that the choice of anti-VEGF agent is a complex one—and that switching to bevacizumab raises a number of issues, including concerns about the drug’s efficacy for certain patients and the need to rely on compounding pharmacies.
The original article can be found here.