[Results of an expert survey on VEGF inhibitors in ophthalmology].

BACKGROUND

VEGF inhibition is an important treatment option for patients with eye diseases like wet AMD or diabetic eye diseases. Concerning VEGF inhibition in Germany's ophthalmology there is lack of health-care data.

METHODOLOGY

A standardised telephone survey addressing treating ophthalmologists in Germany was used to acquire information in terms of VEGF inhibitors in ophthalmology.

RESULTS

44.9 % considered ranibizumab (Lucentis®) and bevacizumab (Avastin®) as equal regarding efficacy and safety. Even so ranibizumab captured with 69.8 % regarding patients under treatment the greatest market share. 26.1 % estimated that less than 10 % of patients with diabetic eye diseases are under treatment while 23.4 % assumed that at present all treatable patients are under treatment. The integration of IVI into the EBM is recommended by only 9.4 %. Using the content of one vial for the treatment of more than one patient is challenged by 66.4 % of all participating ophthalmologists. 50.7 % of these would accept the splitting procedure on condition that proof of drug quality in terms of efficacy and safety is given.

DISCUSSION

The dominance of ranibizumab is based upon a forensic discussion about off-label use of drugs and liability of the treating physicians. In this connection it should not be forgotten that at the end of 2009 the approval of pegaptanib (Macugen®) and ranibizumab covers exclusively the indication "neovascular AMD". Since Novartis gained new indication for Lucentis in EU for vision loss due to diabetic macular edema (DME) it is to be expected that VEGF inhibition will become first line for patients with DME. The cost effectiveness of the anti-VEGF therapy in ophthalmology is based upon the treatment of several patients with one drug package. The integration of IVI into the EBM is not recommended by the majority of Germany's ophthalmologists because neither would the patients benefit nor would the health-care data transparency increase.

CONCLUSION

To evaluate the ophthalmological anti-VEGF market in Germany and to identify and secure the treatment quality a recurring acquisition of health-care data with following management actions is needed.