J Korean Ophthalmol Soc.  2019 Jul;60(7):661-666. 10.3341/jkos.2019.60.7.661.

Use of Anti-vascular Endothelial Growth Factors for Diabetic Retnopathy: National Health Insurance Claims Data

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

• KMID: 2453017
• DOI: http://doi.org/10.3341/jkos.2019.60.7.661

Abstract

PURPOSE
To evaluate the current use of intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) in patients with diabetic retinopathy.
METHODS
We determined the current number of diabetic retinopathy patients and their medical expenditure using National Health Insurance Service claims data (2007-2016). We also analyzed the medical costs of patients with diabetic retinopathy who received anti-VEGF treatment, including ranibizumab and aflibercept. We then evaluated aspects of the use of anti-VEGF injections, such as frequency and intervals, in newly diagnosed diabetic retinopathy patients who received anti-VEGF treatment, along with their medical costs.
RESULTS
The number of patients with diabetic retinopathy was 397,956 in 2009 and 721,310 in 2016, a 1.8-fold increase over 8 years. Of these, the number of patients undergoing anti-VEGF therapy was 4,283 in 2015 and 4,270 in 2016. Of the diabetic retinopathy patients in 2016, the total medical cost of those treated with anti-VEGF was 1.5 billion won, and the average medical cost per person was 3,531,064 won.
CONCLUSIONS
Based on the National Health Insurance claims data, the use of ranibizumab and aflibercept is increasing. The results of this study suggest that diabetic retinopathy will become an important public health issue.

Keyword

Aflibercept; Anti-vascular endothelial growth factor; Diabetic retinopathy; Ranibizumab

MeSH Terms

Diabetic Retinopathy
Endothelial Growth Factors*
Health Expenditures
Humans
Intravitreal Injections
National Health Programs*
Public Health
Ranibizumab
Endothelial Growth Factors
Ranibizumab

Reference

1. Stefanini FR, Badaró E, Falabella P, et al. Anti-VEGF for the management of diabetic macular edema. J Immunol Res. 2014; 2014:632307.

2. Cheung GCM, Lai TYY, Gomi F, et al. Anti-VEGF therapy for neovascular AMD and polypoidal choroidal vasculopathy. Asia Pac J Ophthalmol (Phila). 2017; 6:527–534.

3. Mehta H, Tufail A, Daien V, et al. Real-world outcomes in patients with neovascular age-related macular degeneration treated with intravitreal vascular endothelial growth factor inhibitors. Prog Retin Eye Res. 2018; 65:127–146.

4. Campa C, Alivernini G, Bolletta E, et al. Anti-VEGF therapy for retinal vein occlusions. Curr Drug Targets. 2016; 17:328–336.

5. Bahrami B, Hong T, Gilles MC, Chang A. Anti-VEGF therapy for diabetic eye diseases. Asia Pac J Ophthalmol (Phila). 2017; 6:535–545.

6. Fogli S, Del Re M, Rofi E, et al. Clinical pharmacology of intravitreal anti-VEGF drugs. Eye (Lond). 2018; 32:1010–1020.

7. Miller K, Fortun JA. Diabetic macular edema: current understanding, pharmacologic treatment options, and developing therapies. Asia Pac J Ophthalmol (Phila). 2018; 7:28–35.

8. Ashraf M, Souka AAR. Aflibercept in age-related macular degeneration: evaluating its role as a primary therapeutic option. Eye (Lond). 2017; 31:1523–1536.

9. Villegas VM, Aranguren LA, Kovach JL, et al. Current advances in the treatment of neovascular age-related macular degeneration. Expert Opin Drug Deliv. 2017; 14:273–282.

10. Zhang Y, Chioreso C, Schweizer ML, Abràmoff MD. Effects of aflibercept for neovascular age-related macular degeneration: a systematic review and meta-analysis of observational comparative studies. Invest Ophthalmol Vis Sci. 2017; 58:5616–5627.

11. Gemenetzi M, Patel PJ. A systematic review of the treat and extend treatment regimen with anti-VEGF agents for neovascular age-related macular degeneration. Ophthalmol Ther. 2017; 6:79–92.

12. Al-Zamil WM, Yassin SA. Recent developments in age-related macular degeneration: a review. Clin Interv Aging. 2017; 12:1313–1330.

13. Jee D, Lee WK, Kang S. Prevalence and risk factors for diabetic retinopathy: the Korea National Health and Nutrition Examination Survey 2008–2011. Invest Ophthalmol Vis Sci. 2013; 54:6827–6833.

14. Park SJ, Cho SC, Choi NK, et al. Age, sex and time-specific trends in surgical approaches for rhegmatogenous retinal detachment: a nationwide, population-based study using the national claim registry. Retina. 2017; 37:2326–2333.

15. Ha YC, Kim HY, Jang S, et al. Economic burden of osteoporosis in South Korea: claim data of the National Health Insurance Service from 2008 to 2011. Calcif Tissue Int. 2017; 101:623–630.

16. Kim S, Ahn H, Shin SA, et al. Trends of thromboprophylaxis and complications after major lower limb orthopaedic surgeries in Korea: National Health Insurance claim data. Thromb Res. 2017; 155:48–52.

17. Lorence DP, Spink A. Regional variation in medical systems data: influences on upcoding. J Med Syst. 2002; 26:369–381.

18. Ziemssen F, Grisanti S, Bartz-Schmidt KU, Spitzer MS. Off-label use of bevacizumab for the treatment of age-related macular degeneration: what is the evidence? Drugs Aging. 2009; 26:295–320.