Dr Paul Hahn Reviews Preferences of US vs International Retina Specialists

Every year, the American Society of Retina Specialists releases the results of its latest Preferences and Trends Survey at the annual meeting. This year, the survey highlighted some surprising differences between US and international retina specialists, including off-label medication use and what drives drug choices for patients, said Paul Hahn, MD, vitreoretinal surgeon at NJRetina.

Transcript

Have there been any major surprises with the results of the American Society of Retina Specialists' Preferences and Trends Survey in recent years?

So the Preferences and Trends Survey is really designed to capture the preferences and trends of retina specialists year over year. And I think for the most part, we have a pretty good handle on the pulse of retina specialists. So, I can't say there have been any major surprises. There are a couple of things that are of interest, though, or perhaps are surprising.

For example, if we compare US versus international retina specialists’ responses, we'll see that the majority of US retina specialists use an off-label medication for treatment of retinal diseases as first line, whereas international retina specialists, at least surprising to me, tend to use less of that off-label medication. It's surprising because in the US, we do have FDA-approved options that are very effective,, if not more effective for those retinal diseases. The etiology for this is unclear. The reason for this is unclear. I would personally suspect that this reflects differences in health care systems.

So, in the US this year, our survey asked a separate question, which was the No. 1 reason why retina specialists choose the drugs that they choose, and 25% of responding retina specialists reported that the most important factor in selecting drugs were insurance mandates, beating out, for example, efficacy and safety, which at least to me, should be No. 1. Internationally, that number was only 12%. So again, this probably reflects differences in health care delivery systems, probably accounting for that disparity.

Another surprising response was that in the US, we saw a lot of retina specialists reporting difficulty in hiring staff—not surprising in itself. There's been a pervasive labor shortage, probably across all markets over the past year or so. But surprisingly, internationally, we didn't see that same difficulty. And I'm not sure if there's a selection bias or what the reason for that is, but another interesting difference.