Retinal vein occlusion (RVO), estimated to affect 1.3 million U.S. adults aged 40 or older, is a retinal vascular disorder associated with macular edema (ME) and neovascularization and is the second-most-common cause of vision loss from retinal vascular diseases. No drug treatments can effectively reopen occluded retinal veins; thus, treatment targets the secondary complications of RVO that affect vision, including ME and neovascularization. Although nonpharmacological laser therapy has long been used to treat RVO, advances in the past decade now offer physicians a mix of pharmacological therapies for the treatment of ME secondary to RVO. These treatments include intravitreal injections of agents targeting vascular endothelial growth factor (VEGF)—i.e., Genentech’s Avastin (bevacizumab), Regeneron’s Eylea (aflibercept), and Genentech’s Lucentis (ranibizumab)—and intravitreal corticosteroid injections (triamcinolone) or implants (Allergan’s Ozurdex [dexamethasone implant]). Although formal U.S. guidelines for RVO treatment have yet to be developed, VEGF-targeting agents are typically favored over intravitreal corticosteroids owing to their better side-effect profile (e.g., steroids are associated with an increased risk of cataracts and raising intraocular pressure [IOP], a precursor to the development of glaucoma).
Using national patient-level claims data, the Treatment Algorithms in Retinal Vein Occlusion report explores the use of key therapies and drug classes among newly diagnosed and recently treated RVO patient populations. Among newly diagnosed patients, we provide a quantitative analysis of percentage drug-treated, time to treatment, treatment patterns, and share by line of therapy, as well as progression between lines, recent patient-share trends, and use of concomitant treatment. Among recently treated patients, we quantify each drug’s overall drug share, use in combination with other therapies, and source of business compared with its competitors, detailing which drugs precede others through an analysis of add-versus-switch patterns. Two additional claims database queries explore persistency and compliance by therapy.