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Retina

Medicare expenditure on anti-VEGF injections surges, highlighting disparities in access

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There was a significant increase in both utilization and expenditure on intravitreal injections of anti-VEGF agents among the Medicare population between 2014 and 2019, according to a study that found the increase is largely driven by the rising use of aflibercept.

The study, conducted using data from the Centers for Medicare and Medicaid Services Physician and Other Supplier Public Use File, found that between 2014 and 2019, 17,588,995 intravitreal injection claims were filed by 4218 US ophthalmologists. Medicare spending on anti-VEGF injections soared from 2.51 billion USD in 2014 to 4.02 billion USD in 2019.

Notably, the surge in expenditure was primarily driven by increased utilization of aflibercept. However, the study also found significant disparities in the utilization rates of these agents across different states.

According to the findings, increased availability of ophthalmologists at the state level was strongly associated with higher rates of anti-VEGF injection administration. Additionally, variations in reimbursement amounts were linked to disparities in injection rates, with an incremental increase in reimbursement correlating with a 6.8-fold variation in anti-VEGF injection rates across states in 2019.

Reference
Desai S, Sekimitsu S, Rossin EJ, Zebardast N. Trends in Anti-Vascular Endothelial Growth Factor Original Medicare Part B Claims in the United States, 2014-2019. Ophthalmic Epidemiol. 2024;1-10. doi: 10.1080/09286586.2024.2310854. Epub ahead of print. PMID: 38315793.

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