Evolution of Access to Treatment for Wet AMD/DME Therapies

EP: 1.Overview of Wet Age-Related Macular Degeneration (AMD) and Diabetic Macular Edema (DME)

EP: 2.How Do the Patient Populations Differ for Wet AMD vs DME?

EP: 3.Important Considerations Regarding Treatment Selection for Wet AMD and DME Patient Populations

EP: 4.Anti-VEGF and Gene Therapy Impacting Wet AMD and DME Treatment Landscapes

EP: 5.Variability of Frequency Dosing for Anti-VEGF Agents in the Treatment of Wet AMD

EP: 6.Faricimab: Mechanism of Action, Payers’ Perspective, and Real-World Experience

EP: 7.Faricimab Approved Label Dosing Interval

EP: 8.Clinical Considerations for Retreatment in Failed Anti-VEGF Therapy

EP: 9.Novel Treatment Mechanisms for Patients with DME and Wet AMD

EP: 10.Diagnostic Imaging Impacting DME and Wet AMD Treatment Landscape

EP: 11.Treatment Barriers Facing Patients With DME and Wet AMD

EP: 12.Utilization Management Strategies in Treatment of Wet AMD and DME

EP: 13.Wet AMD Resource Utilization Impacted by Medication Duration of Action

Now Viewing

EP: 14.Evolution of Access to Treatment for Wet AMD/DME Therapies

EP: 15.Payer Engagement With the Retina Community

EP: 16.Trajectory of Treatment Landscape for Wet AMD and DME

Jim Kenney, RPh, MBA: Dr Sheth, can you describe generically how has access to treatments changed over the past few years, and are there any initiatives you could suggest or ideas to expand access? Has it gotten worse, has it gotten better? It sounds like there have [been] more steps put in place, so maybe that’s not a great thing, but maybe you could describe how has access changed over the past few years.

Veeral Sheth, MD, MBA, FACS, FASRS: I think the other members of the panel will agree that overall access has not gotten any better. I think that it is narrowing more and more. There are more hoops to jump through. Things like these prior authorizations and these extra steps that we have to go through in order to get medications for our patients, it’s not only a burden for the patient, but it’s a burden for the staff, adding layers of cost and time and inefficiencies into the system. Generically speaking, I think that’s what we’ve seen as a pattern over the last few years. I think the anxiety that’s building up in a lot of us is, we’ve got newer treatments on the horizon. We’ve got biosimilars and potentially newer agents coming out. The question is, how are those going to be incorporated? What extra hoops are we going to have to jump through? Are there going to be multiple step edits? Because ultimately, that to me translates to worse outcomes for our patients. I think that’s why the anxiety in me is building with these newer treatments coming out.

To your second part of that question, what do we do about it? How do we expand access or improve some of these things? I think what we’re doing right now is important. Having these conversations, educating all the stakeholders involved is very important. To Caesar’s point, I think payers understand, everyone wants what’s best for these patients. Points like well, at year 3 they’re getting fewer injections, but there’s turnover. But there is turnover in both directions; you’re going to get these patients, you’re going to lose some of these patients. I think ultimately we do have to play the long game with some of these things. I know it’s hard to do when we’re looking at fiscal years and budgets and things like that. But at the end of the day, I think if we look at the long run for these patients, fewer injections over time, better visual outcomes, so less burden on society, and keeping people active and working and all of those things is going to be critical to making sure these things play out well.

Transcript edited for clarity.