A recent article compared the effectiveness of Eylea, Lucentis, and Avastin – all medications used as intravitreal injections to treat diabetic macular edema (eye swelling).
When we talk about intravitreal injections, we are referring to the application of injectable medications directly into the eye. These treatments are used most commonly for conditions including diabetic retinopathy, macular degeneration, and vein occlusions of the eye. For more information on the details of this therapy, please click here for an explanation I have written previously.
This article (click here) referenced a recent study by the Diabetic Retinopathy Clinical Research Network. The study concluded that diabetic patients with macular edema and mild vision impairment responded equally to all three drugs. On the other hand, patients with more significant vision loss regained more vision when treated with Eylea.
Currently, there are several medications that are commonly used as intravitreal injections. Some medications cost more than others. Research studies, such as the one referenced in this post, allow us to make evidence-based choices that are conscious of both quality and cost.
Ideally, a doctor would not need to consider cost when determining the “best” treatment plan for a patient. In the real world, however, many patients are responsible to pay for a portion of their medical care because of a deductible or co-insurance. As an example, a patient with Medicare Part B (and no supplemental coverage) might be responsible to pay for 20% of their medical expenses while Medicare pays for the other 80%. While a 20% payment on Avastin might cost a patient $10, for Eylea it could be close to $400! Because these treatments are sometimes repeated on a monthly basis, you can see how the cost might add up quickly.
Fortunately, the more affordable medication works great in many cases. For patients who stand to benefit from a more expensive therapy, there are several things that might limit out-of-pocket expense:
- Many insurance plans have an out-of-pocket maximum. If you reach this, insurance should cover 100% of your remaining medical expense for the year.
- Patients with Medicare often have the option of purchasing supplemental coverage. Once Medicare pays for the first 80% of treatment, the supplement should pick up the other 20%.
- Manufacturers of the branded drugs admit that they are expensive. Because of this, they offer co-payment assistance programs that can limit or eliminate a patient’s need to pay out-of-pocket.
I am not performing eye injections at this time. When I diagnose this condition, I am very happy to recommend a local retinal specialist who will provide expert care to my patients.