Diabetic retinopathy (DR) is characterized by progressive damage to the blood vessels in the retina of a diabetic patient, from which fluid may leak causing the macula to swell. Swelling of the macula, referred to as diabetic macular edema (DME), can impact sharp vision in the center of the visual field and can occur at any stage of DR, although the prevalence increases with disease severity. Therapies targeting vascular endothelial growth factor (VEGF) have been shown to maintain and even improve visual acuity in DME patients. Genentech’s Lucentis became the first pharmacotherapy formally approved for the treatment of DME in 2012. Other VEGF-targeting therapies—specifically Genentech’s Avastin (compounded for ophthalmic use) and Regeneron Pharmaceuticals’ Eylea—are also frequently administered to patients diagnosed with DME. Treatment of DME may also include corticosteroid injections or corticosteroid implants, such as Allergan’s Ozurdex, to inhibit the inflammatory process in the eye.
Using longitudinal U.S. claims data, this report examines current trends in the treatment of DME for both newly diagnosed patients and patients filling a prescription for a key therapy in the second and third quarters of 2013. For newly diagnosed patients, the report provides a quantitative analysis of treatment patterns and share by line of therapy, as well as progression between lines, duration of treatment on each line, and use of concomitant treatment. For recently treated patients, the report quantifies a drug’s source of business compared with its competitors and details which drugs precede others through an analysis of add-versus-switch patterns. Additional analyses explore persistency and compliance by brand.