Pharmacotherapy for Neovascular Age-Related Macular Degeneration: An Analysis of the 100% 2008 Medicare Fee-For-Service Part B Claims File
Pharmacotherapy for Neovascular Age-Related Macular Degeneration: An Analysis of the 100% 2008 Medicare Fee-For-Service Part B Claims File
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DOI：
10.1016/j.ajo.2010.11.017
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发表时间：
2011-05-01
影响因子：
4.2
通讯作者：
Caplan, Stuart
中科院分区：
文献类型：
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作者：
Brechner, Ross J.;Rosenfeld, Philip J.;Caplan, Stuart
目的：描述新血管性年龄相关性黄斑变性（AMD）在医疗保险服务收费受益人的药物治疗的使用模式。设计：回顾性分析2008年期间所有针对新生血管性AMD的医疗保险按服务收费B部分索赔。方法：确定接受过治疗的医疗保险受益人。为给定受益人的每次访问收集的数据包括年龄、种族、性别、医疗保险地区、居住的州/邮政编码、访问日期、受益人是否接受治疗、药物的类型和数量以及医疗保险支付的金额。主要结局指标为治疗次数和治疗率、治疗所用药物的种类以及这些药物的支付情况。结果：在222 886名独特受益人中，146 276名（64.4%）接受了贝伐单抗，80 929名（35.6%）接受了雷尼单抗。总共进行了824525次注射，其中48025次注射贝伐单抗（58%）和336898次注射雷尼单抗（41%）。贝伐单抗和雷尼单抗在全国每10万名按服务收费的医疗保险受益人中注射率分别为1506和1057。医疗保险的总支付额为贝伐单抗20 290 952美元，雷尼单抗536 642 693美元。在50个州中的39个州，贝伐单抗的注射率高于雷尼单抗。结论：2008年，贝伐单抗用于治疗新生血管性AMD的比例高于雷尼单抗。尽管贝伐单抗占所有注射量的58%，但医疗保险为雷尼单抗支付的费用比贝伐单抗多5.16亿美元。这些数据表明，尽管非标签性药物，玻璃体内贝伐单抗目前是美国新生血管性AMD的标准治疗方法。[J]中华眼科杂志，2011;51(1):887-895。出版：Elsevier Inc.)
PURPOSE: To describe the usage patterns of pharmacological treatments for neovascular age-related macular degeneration (AMD) in Medicare fee-for-service beneficiaries.DESIGN: Retrospective review of all Medicare fee-for-service Part B claims for neovascular AMD during 2008.METHODS: Medicare beneficiaries having undergone treatment were identified. The data collected for each visit for a given beneficiary included age, race, gender, Medicare region, state/zip code of residence, date of visit, whether or not the beneficiary had a treatment, the type and amount of drug, and dollars paid by Medicare. The main outcome measures were the number and rate of treatments, the types of drugs used for treatment, and the payments for these drugs.RESULTS: Of the 222 886 unique beneficiaries, 146 276 (64.4%) received bevacizumab and 80 929 (35.6%) received ranibizumab. A total of 824 525 injections were performed with 480 025 injections of bevacizumab (58%) and 336 898 injections of ranibizumab (41%). National rates of injections per 100 000 fee-for-service Part B Medicare beneficiaries for bevacizumab and ranibizumab were 1506 and 1057, respectively. Total payments by Medicare were $20 290 952 for bevacizumab and $536 642 693 for ranibizumab. In 39 out of 50 states, the rate of injection was higher for bevacizumab compared with ranibizumab.CONCLUSIONS: In 2008, bevacizumab was used at a higher rate than ranibizumab for the treatment of neovascular AMD. Even though bevacizumab accounted for 58% of all injections, Medicare paid $516 million more for ranibizumab than bevacizumab. These data suggest that despite its off-label designation, intravitreal bevacizumab is currently the standard-of-care treatment for neovascular AMD in the United States. (Am J Ophthalmol 2011;151:887-895. Published by Elsevier Inc.)