Manufacturer payments may drive treatment decisions in AMD

Manufacturer payments to ophthalmologists appear to influence their choice of treatment for age-related macular degeneration (AMD), according to a study.

Ophthalmologists who accept these payments are less likely to prescribe the lower-cost bevacizumab, opting instead for higher-cost therapies like aflibercept and ranibizumab, even though bevacizumab has been shown to be clinically noninferior, which may contribute to increased spending in both Medicare and patient expenses.

The study, which analyzed Medicare Part B data from 2013 to 2019, included 21,584 ophthalmologists. Those accepting manufacturer payments prescribed bevacizumab (28.0% of patients) less compared to their non-recipient counterparts (45.8% of patients). Of note, ophthalmologists attending to dual-eligible beneficiaries were more inclined to choose bevacizumab, whereas those with patients possessing higher beneficiary risk scores showed a preference for other therapies.

Had ophthalmologists who accepted manufacturer payments followed the prescribing patterns of their non-recipient peers, Medicare spending on AMD treatments could have been $642,779,703.08 lower over the study period, constituting a 2.0% reduction in expenditure.

Reference
Dickson SR, James KE. Medicare Part B Spending on Macular Degeneration Treatments Associated With Manufacturer Payments to Ophthalmologists. JAMA Health Forum. 2023;4(9):e232951. doi: 10.1001/jamahealthforum.2023.2951. PMID: 37682553; PMCID: PMC10492178.