Intravitreal AntieVascular Endothelial Growth Factor Cost Savings Achievable with Increased Bevacizumab Reimbursement and Use

Purpose: To model Medicare Part B and patient savings associated with increased bevacizumab payment and use for intravitreal anti-vascular endothelial growth factor (VEGF) therapy. Design: Cost analysis. Participants: Intelligent Research in Sight (IRIS (R)) Registry data. Methods: Medicare claims and IRIS (R) 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. Results: 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. Conclusions: 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. (C) 2020 by the American Academy of Ophthalmology