Intravitreal Anti–Vascular Endothelial Growth Factor Cost Savings Achievable with Increased Bevacizumab Reimbursement and Use


      To model Medicare Part B and patient savings associated with increased bevacizumab payment and use for intravitreal anti–vascular endothelial growth factor (VEGF) therapy.


      Cost analysis.


      Intelligent Research in Sight (IRIS®) Registry data.


      Medicare claims and IRIS® Registry data were used to calculate Medicare Part B expenditures and patient copayments for anti-VEGF agents with increasing reimbursement and use of bevacizumab relative to ranibizumab and aflibercept.

      Main Outcome Measures

      Medicare Part B costs and patient copayments for anti-VEGF agents in the Medicare fee-for-service population.


      Increasing bevacizumab reimbursement to $125.78, equalizing the dollar margin with aflibercept, would result in Medicare Part B savings of $468 million and patient savings of $119 million with a 10% increase in bevacizumab market share.


      Increased use of bevacizumab achievable with increased reimbursement to eliminate the financial disincentive to its use would result in substantial savings for the Medicare Part B program and for patients receiving anti-VEGF intravitreal injections.

      Abbreviations and Acronyms:

      ASP (average sales price), DME (diabetic macular edema), FFS (fee-for-service), IRIS® (Intelligent Research in Sight), MAC (Medicare administrative contractor), nAMD (neovascular age-related macular degeneration), PCV (polypoidal choroidal vasculopathy), RVO (retinal vascular occlusion), VEGF (vascular endothelial growth factor)
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