Lockhart Catherine M, Barakat Mark R, Dunn Jeffrey D, Richardson Terry, Bratcher Tori, Greene Estay, Kobernick Michael, Schneider Doron, Wigginton Jeremy
AMCP and Biologics & Biosimilars Collective Intelligence Consortium (BBCIC), Alexandria, VA.
Retina Macula Institute of Arizona, Scottsdale.
J Manag Care Spec Pharm. 2025 Apr;31(4-a Suppl):S1-S11. doi: 10.18553/jmcp.2025.31.4-a.s1.
In September 2024, AMCP and Impact Education, LLC, held a virtual Market Insights summit with chief medical and pharmacy officers and other senior health care executives to discuss the management of retinal diseases in patients with diabetes. The summit aimed to explore the impact of current policies on treatment access and costs, identify best practices for anti-vascular endothelial growth factor (anti-VEGF) coverage, and address barriers related to social determinants of health (SDOH). Anti-VEGF therapy, although effective for conditions such as diabetic macular edema and age-related macular degeneration, may require monthly injections that impose a significant burden on patients and caregivers, affecting adherence and outcomes. Key topics included examining the impact of current policies on treatment access and total cost of care, exploring opportunities for management of patients at increased risk for blindness, outlining the benefits of durable treatment approaches, addressing strategies to overcome access barriers related to SDOH, and identifying best practices in coverage policies for anti-VEGF agents. Strategies for addressing barriers to care were explored, including the potential use of gold carding, contingent on establishing clearer definitions of good care in retinal disease management, understanding prescribing variation, gaining standardized of definitions or guidelines for good" care, and practical strategies for using extended dosing to support adherence and access. Health care executives reached agreement on the central role of ophthalmologists in preventing blindness in patients with diabetes and retinal diseases and the importance of timely access to appropriate treatments.
2024年9月，美国医学成本效益专业人士协会（AMCP）与Impact Education有限责任公司举办了一场虚拟市场洞察峰会，参会人员包括首席医疗官、首席药剂师以及其他高级医疗保健管理人员，会议旨在讨论糖尿病患者视网膜疾病的管理。此次峰会旨在探讨当前政策对治疗可及性和成本的影响，确定抗血管内皮生长因子（anti-VEGF）覆盖的最佳实践，并解决与健康的社会决定因素（SDOH）相关的障碍。抗VEGF疗法虽然对糖尿病性黄斑水肿和年龄相关性黄斑变性等病症有效，但可能需要每月注射，给患者和护理人员带来沉重负担，影响依从性和治疗效果。关键主题包括研究当前政策对治疗可及性和护理总成本的影响，探索管理失明风险增加患者的机会，概述持久治疗方法的益处，解决克服与SDOH相关的可及性障碍的策略，以及确定抗VEGF药物覆盖政策的最佳实践。会议探讨了消除护理障碍的策略，包括在视网膜疾病管理中明确“优质护理”定义的前提下，金卡制度的潜在应用，了解处方差异，获得“优质”护理的标准化定义或指南，以及使用延长给药方案以支持依从性和可及性的实用策略。医疗保健管理人员就眼科医生在预防糖尿病和视网膜疾病患者失明方面的核心作用以及及时获得适当治疗的重要性达成了共识。
