Age Related Macular Degeneration: utilisation analysis
Page last updated: 30 October 2015
Drug utilisation sub-committee (DUSC)
June 2015
Abstract
Purpose
To assess the utilisation of PBS listed medicines for age related macular degeneration (AMD), including a 24 month predicted versus actual analysis of aflibercept (listed 1 December 2012).
Date of listing on the Pharmaceutical Benefits Scheme (PBS)
- Ranibizumab listed 1 August 2007
- Aflibercept listed 1 December 2012
Data Source / methodology
Data were extracted from the Department of Human Services (DHS) Medicare Pharmacy Claims database for the period August 2007 to December 2014, inclusive.
Key Findings
- In 2014, 36,739 patients received at least one treatment for AMD. A total of 249,772 injections of aflibercept and ranibizumab were supplied through the PBS at a cost to Government of about $250 million.
- Between 7,000 and 8,000 new patients start treatment for wet AMD each year. The number of new patients is relatively stable.
- The majority of patients remain on treatment for many years and therefore the total number of patients continues to grow. Approximately half of patients are treated for at least 4 years, and there are almost 3,000 patients who are in their seventh year of treatment.
- The average number of injections per treated patient increased between 2007 and 2010. From 2011 onwards the number of injections per patient appears to have stabilised, with new patients receiving an average of 8.4 injections in their first year of treatment, and continuing patients receiving an average of 7.1 injections per year.
- The rate of bilateral treatment appears to be increasing, although there is limited information available to estimate this use.
- There was rapid uptake of aflibercept following its PBS listing, reaching approximately 50% of the AMD market within 6 months. Aflibercept is used both in new patients and in prevalent patients who switched from ranibizumab.
- The number of injections of ranibizumab or aflibercept per patient appears to be similar. Patients who initiated AMD treatment between December 2012 and November 2013 and were only treated with one agent used an average of 9.30 injections of ranibizumab and 8.28 injections of aflibercept. For continuing patients, those who switched to aflibercept had a higher average number of injections in the next 12 months (8.71) than those who remained on ranibizumab (6.90).
- Utilisation of aflibercept and ranibizumab for wet AMD will continue to increase in to the future due to an ageing population, high rates of continuation on treatment and a high number of injections per patient per year.
