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Patients, physicians have different views on anti-VEGF treatment

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LAS VEGAS — When choosing a treatment regimen, patients are most concerned about achieving a positive clinical outcome, a speaker said here.

 “All the new approaches that cost lots of money in research that focus on reducing the frequency of injections and/or visits are important, but patients don’t care as much about reducing injection frequency as they do about good outcomes, especially those that have been long-term patients,” Tarek S. Hassan, MD, told colleagues at the American Society of Retina Specialists meeting.

Tarek S. Hassan

A questionnaire was given to 151 consecutive patients, 90 women and 61 men, with wet age-related macular degeneration who had received at least 10 anti-VEGF injections of Avastin (bevacizumab, Genentech), Lucentis (ranibizumab, Genentech) or Eylea (aflibercept, Regeneron). Mean duration of total injection treatment was 32.9 months.

A questionnaire was also given to 16 industry professionals and 28 vitreoretinal surgeons.

Patients and physicians were asked questions regarding their expected disease outcomes, willingness to indefinitely continue injection treatment, concern over costs and insurance coverage, factors that affected their drug choice, the treatment of bilateral disease, and the value of new drugs and surgeries to decrease injection frequency.

According to the questionnaire, 91% of patients would agree to monthly injections for an indefinite amount of time as long as their visual acuity increased, whereas only 54% of retina specialists thought that this was a factor patients were willing to accept.

If all factors were treated equally, such as cost, visual outcomes and anatomic outcomes, 84% of patients said they would prefer to be treated with a more expensive drug that is approved by the U.S. Food and Drug Administration vs. a less expensive drug that is not approved by the FDA.

“Early in the treatment regimen, those that had less than 10 injections were more likely to expect a cure or better vision stability. They preferred [as-needed] vs. planned monthly injections, expect the frequency of the injections to decrease over time, and are more likely to change to another drug to have fewer injections,” Hassan said.

• Disclosure: Hassan is a consultant for Genentech, Regeneron, Eyetech and QLT Therapeutics.