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Reimbursement issues affect Austrian hospitals’ ability to meet demand for anti-VEGF treatment
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VIENNA — Hospitals alone are unable to meet the growing demand for anti-VEGF intravitreal injections in Austria, according to a 1-year analysis of hospital records.
“Intravitreal injections are not reimbursed in the private sector, even by private insurance companies. Since January this year, hospitals have also undergone heavy budget cuts,” Gerhard Kieselbach, MD, said at the American Society of Retina Specialists meeting here.
Gerhard Kieselbach
Data were collected for 2013 in all public hospitals in the country. The total number of intravitreal injections performed was 54,321 in 16,562 eyes. Almost all injections (96.7%) were performed in public hospitals. Of the total number of eyes, 66% were treated for age-related macular degeneration (AMD), 22% for diabetic macular edema (DME) and 12% for retinal vein occlusion (RVO). The mean number of injections per eye per year for all three diseases was 3.3.
“Visual acuity records were available from five centers and 6,547 injections, which is a limitation, but showed improvement in only 12% of the eyes, stabilization in 51% and loss of letters in 37%. No statistically significant difference was found between AMD and DME, while RVO had better outcomes,” Kieselbach said.
A positive correlation was found between best results and the 27% of eyes that received more than six injections.
“Our real life outcomes were inferior to those of clinical studies and confirm that hospitals alone cannot deal efficiently with the demand. All negotiations with the government to have reimbursement also outside public hospitals failed,” Kieselbach said. “Austria is the third richest country in Europe, but people do not have equal access to the full scope of ophthalmological services.” — by Michela Cimberle
Disclosure: Kieselbach reports no relevant financial disclosures.