Researchers are seeking to understand the variances in the use of bevacizumab and ranibizumab for the treatment of wet age-related macular degeneration (AMD) among Medicare beneficiaries. This retrospective cohort study was performed using a sample from a three-year span of 100% Medicare claims data.
The data were analyzed to determine whether ranibizumab or bevacizumab was administered after initial diagnosis. Overall, 35% of patients received ranibizumab after their initial diagnosis, although this percentage varied drastically depending on the geographic location of treatment (from 0.9% to 84.6%).
After the data were controlled for year of treatment, it was discovered that Black patients were 45% less likely to receive ranibizumab than non-Black patients. Patients in urban areas, higher-income areas, and New England and East South Central census regions had increased odds of receiving ranibizumab. Over the course of the study, the likelihood of receiving ranibizumab after initial diagnosis decreased for all groups.
In conclusion, the data collected provide varied statistics for the treatment of Medicare patients in the U.S. afflicted with wet AMD. The range of treatment administered varied over time and by patient geographic location and racial/ethnic background.
A call to action is made for further research regarding how geographic location and race/ethnicity affect Medicare patient treatment for wet AMD. Researchers must also study how this variation relates to treatment access and whether treatment choice affects patient prognosis .
Source: Gower, E. W., Stein, J. D., Shekhawat, N. S., Mikkilineni, S., Blachley, T. S., & Pajewski, N. M. (2017). Geographic and Demographic Variation in Use of Ranibizumab Versus Bevacizumab for Neovascular Age-related Macular Degeneration in the United States. American Journal of Ophthalmology, 184, 157–166. https://doi.org/10.1016/j.ajo.2017.10.010