Loss of copayment assistance for drugs to treat neovascular age-related macular degeneration forces patients onto alternative, potentially less effective treatment strategies.Patients who switched to bevacizumab required significantly more frequent injections to maintain visual outcomes.Depletion of funding for copayment support has increased out-of-pocket costs that disproportionately affect lower-income patients.
Loss of copayment assistance for drugs to treat neovascular age-related macular degeneration (nAMD) significantly disrupted patient care, including switching to less costly (and perhaps less effective) therapy, reliance on samples, and higher out-of-pocket costs, a small prospective study showed.
Involving 110 older patients seen by a Northern California retina practice, the study showed that three-fourths of the patients lost copayment support following depletion of the Good Days Chronic Disease Fund (CDF). About half of the patients who lost copayment support switched from their current medication to bevacizumab, three of whom switched back because of persistent fluid accumulation, becoming dependent on samples or paying more out of pocket.
Disruption of existing care did not adversely affect visual acuity or retinal anatomy during 6 months of follow-up, but patients with worse baseline visual acuity and those who required more frequent injections had less improvement in vision, reported Soraya Rofagha, MD, MPH, of East Bay Retina Consultants in Oakland, California, and colleagues in JAMA Ophthalmology.
