AIMS: The recent emergence of antivascular endothelial growth factor (anti-VEGF) drugs has led to increased numbers of patients undergoing intravitreal injection for age-related macular degeneration (AMD). The aims of this study were to report on trends over time and geographical variation in intravitreal injection rates in England, and consider the implications for publicly funded health services of introducing new and expensive treatments. METHODS: Hospital episode statistics were analysed for annual treatment rates of intravitreal injection between the NHS financial years of 1989/1990 and 2008/1999. RESULTS: Annual injection rates increased from 0.4 episodes (95% CI 0.37 to 0.49) per 100,000 population in 1989/1990 to 10.7 (10.4-11.0) in 2006/2007. Rates then rose exponentially to 59.5 (58.8-60.2) in 2008/2009, with increasing use of multiple injections per person. The largest growth in injection rates was found in older people, and for AMD. Numbers of treatment episodes increased from 203 (1989/1990) to 30,458 (2008/2009). Geographical analysis showed a very wide variation across local authority areas in injection rates, from 0.9 (0.2-2.2) to 42.2 (38.9-45.7) people per 100,000 population in 2005-2008. CONCLUSION: Rates of intravitreal injection increased exponentially from 2006/2007. This followed the US Food and Drug Association licensing of ranibizumab for the treatment of neovascular AMD (2006), and its recommendation by National Institute for Health and Clinical Excellence (2008). This study demonstrates some of the major issues which arise with the emergence of expensive new treatments, including speed and cost of adoption, geographical variation in access, and implications for licensing, commissioning and health financing in an ageing society.
AIMS: The recent emergence of antivascular endothelial growth factor (anti-VEGF) drugs has led to increased numbers of patients undergoing intravitreal injection for age-related macular degeneration (AMD). The aims of this study were to report on trends over time and geographical variation in intravitreal injection rates in England, and consider the implications for publicly funded health services of introducing new and expensive treatments. METHODS: Hospital episode statistics were analysed for annual treatment rates of intravitreal injection between the NHS financial years of 1989/1990 and 2008/1999. RESULTS: Annual injection rates increased from 0.4 episodes (95% CI 0.37 to 0.49) per 100,000 population in 1989/1990 to 10.7 (10.4-11.0) in 2006/2007. Rates then rose exponentially to 59.5 (58.8-60.2) in 2008/2009, with increasing use of multiple injections per person. The largest growth in injection rates was found in older people, and for AMD. Numbers of treatment episodes increased from 203 (1989/1990) to 30,458 (2008/2009). Geographical analysis showed a very wide variation across local authority areas in injection rates, from 0.9 (0.2-2.2) to 42.2 (38.9-45.7) people per 100,000 population in 2005-2008. CONCLUSION: Rates of intravitreal injection increased exponentially from 2006/2007. This followed the US Food and Drug Association licensing of ranibizumab for the treatment of neovascular AMD (2006), and its recommendation by National Institute for Health and Clinical Excellence (2008). This study demonstrates some of the major issues which arise with the emergence of expensive new treatments, including speed and cost of adoption, geographical variation in access, and implications for licensing, commissioning and health financing in an ageing society.
Authors: Nur Afiqah Mohamad; Vasudevan Ramachandran; Patimah Ismail; Hazlita Mohd Isa; Yoke Mun Chan; Nor Fariza Ngah; Norshakimah Md Bakri; Siew Mooi Ching; Fan Kee Hoo; Wan Aliaa Wan Sulaiman Journal: Int J Ophthalmol Date: 2017-12-18 Impact factor: 1.779
Authors: Monica M Michelotti; Salwa Abugreen; Simon P Kelly; Jiten Morarji; Debra Myerscough; Tina Boddie; Ann Haughton; Natalie Nixon; Brenda Mason; Evangelos Sioras Journal: Clin Ophthalmol Date: 2014-04-15
Authors: Johanna M Colijn; Gabriëlle H S Buitendijk; Elena Prokofyeva; Dalila Alves; Maria L Cachulo; Anthony P Khawaja; Audrey Cougnard-Gregoire; Bénédicte M J Merle; Christina Korb; Maja G Erke; Alain Bron; Eleftherios Anastasopoulos; Magda A Meester-Smoor; Tatiana Segato; Stefano Piermarocchi; Paulus T V M de Jong; Johannes R Vingerling; Fotis Topouzis; Catherine Creuzot-Garcher; Geir Bertelsen; Norbert Pfeiffer; Astrid E Fletcher; Paul J Foster; Rufino Silva; Jean-François Korobelnik; Cécile Delcourt; Caroline C W Klaver Journal: Ophthalmology Date: 2017-07-14 Impact factor: 12.079