J Korean Ophthalmol Soc.  2018 Nov;59(11):1039-1048. 10.3341/jkos.2018.59.11.1039.

Final Impact of Anti-Vascular Endothelial Growth Factor Treatment in Age-related Macular Degeneration

• Yang J
• Shin SJ
• Suh JK
• Cho S
• Tchoe H
• Kang MJ
• Jee D

• KMID: 2426365
• DOI: http://doi.org/10.3341/jkos.2018.59.11.1039

Abstract

PURPOSE
To evaluate the effects of anti-vascular endothelial growth factor (VEGF) treatment on the healthcare-related finances of patients with age-related macular degeneration.
METHODS
Changes in health care financing due to newly introduced benefit standards were predicted over the coming 5-year period (2018-2022). We also analyzed the financial impact of scenarios in which agents similar to anti-VEGF, such as the over-licensed drug bevacizumab, were introduced. For this purpose, the future number of patients receiving anti-VEGF treatments was estimated for various scenarios based on National Health Insurance Corporation claims data followed by an estimate of the financial burden.
RESULTS
In the case of age-related macular degeneration, the current standard of care (14 times in a lifetime) was maintained in scenario 1. In 2018, the insurance budget for the coming 5-year period was estimated at approximately 440.3 billion won. The insurance cost for that period was estimated at approximately 560.1 billion won under the revised standard of December 2017 (scenario 2). For scenarios wherein, after 2020, similar treatments (scenario 3) and bevacizumab (scenario 4) were introduced, the estimated health insurance costs were 521 billion won and 419.7 billion won, respectively.
CONCLUSIONS
Health insurance costs are projected to increase substantially due to the elimination of the 14 time pay standard; however, the actual budget will only moderately increase, due to new limitations of visual acuity ≤ 0.1 or in case of scarring/ atrophic lesions. Clinically similar agents and bevacizumab could be considered as alternatives to anti-VEGF treatment for age-related macular degeneration.

Keyword

Age-related macular degeneration; Anti-vascular endothelial growth factor; Ranibizumab

MeSH Terms

Bevacizumab
Budgets
Delivery of Health Care
Endothelial Growth Factors*
Humans
Insurance
Insurance, Health
Macular Degeneration*
National Health Programs
Ranibizumab
Standard of Care
Visual Acuity
Bevacizumab
Endothelial Growth Factors
Ranibizumab

Reference

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