Objective:
To evaluate the impact of start-and-switch decisions on healthcare costs in treatment-naïve wet AMD patients specifically.
Approach:
- 54% of nAMD patients began treatment with compounded bevacizumab.
- 26% switched to another agent within a year, increasing to 40% over 3 years, highlighting significant cost implications.
- Cost of care for patients switching from bevacizumab to branded agents rose from approximately $700 to $20,000 over 3 years.
- In the Medicare Advantage cohort, 70% started with bevacizumab, with over half switching, primarily to aflibercept.
- The study may not account for all factors influencing treatment decisions and costs, such as patient preferences and clinical guidelines.
- Real-world data may vary based on patient demographics and healthcare settings, which could impact generalizability.
Key Findings:
Interpretation:
Switching from low-cost bevacizumab to branded anti-VEGF agents significantly increases healthcare costs, with potential quality issues in compounded drugs contributing to high switch rates, which may also affect patient outcomes.
Limitations:
Conclusion:
Further investigation is needed to understand the reasons behind frequent switching and the potential benefits of an approved ophthalmic formulation of bevacizumab, which could stabilize treatment patterns and costs.
Sources:
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