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  • Treatment Patterns for Diabetic Macular Edema

    By Jean Shaw
    Selected By: Andrew P. Schachat, MD

    Journal Highlights

    Ophthalmology Retina, April 2019

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    Using a large national database, Moulin et al. evaluated the treatment patterns and the predictors of different treat­ment standards in patients who were recently diagnosed with diabetic mac­ular edema (DME). They found that intravitreal injections of anti-VEGF medications have become a mainstay of DME treatment—and that patients covered by private insurance received more injections than those covered by Medicaid or Medicare.

    For this retrospective cohort study, the researchers used claims data on more than 8 million diabetic patients who had commercial or government-provided health insurance and were treated between Jan. 1, 2007, and March 31, 2015.

    When exclusion criteria were applied, the final sample comprised 96,316 patients. These patients were then divided into yearly cohorts and followed for a full year after their index date (defined as the date of their first insurance claim with a diagnosis of DME).

    In 2009, anti-VEGF injections accounted for 11.6% of all DME treat­ments; this percentage rose to 61.9% in 2014. In contrast, corticosteroids dropped from 6.1% of all treatments in 2009 to 2.8% in 2014, and focal laser procedures dropped from 75.3% in 2009 to 24% in 2014. The share of patients diagnosed with DME andleft untreated declined from 55.8% to 50.1%.

    The researchers also found that those patients covered entirely by third-party insurance had 45%, 31%, and 12% more anti-VEGF injections than those in Managed Medicare, Med­icaid, and Medicare plans, respectively.

    The original article can be found here.