Diabetic Macular Edema | Treatment Algorithms | Claims Data Analysis | US | 2015

Diabetic macular edema (DME) is a progressive ophthalmological comorbidity of diabetes that can threaten vision. In DME, fluid and lipids leak from abnormal, weak retinal blood vessels, causing swelling in the macula, which is the portion of the retina that is responsible for central visual acuity. Left untreated, DME can severely and permanently impair vision, particularly in the center of the visual field. For decades, the gold-standard treatment for DME was laser photocoagulation, which remains an important component of DME treatment plans, but the 2012 U.S. approval of Genentech’s vascular endothelial growth factor (VEGF)-targeting drug Lucentis prompted an increase in the use of drug therapies to treat DME. In addition to Lucentis, Genentech’s Avastin, which is not approved for the treatment of DME, and Regeneron’s Eylea, are VEGF-targeting agents that inhibit abnormal vascular growth in the retina and are commonly used to treat DME. Along with agents that target VEGF, drug treatment strategies also include corticosteroid injections or corticosteroid implants, such as Allergan’s Ozurdex, to inhibit inflammatory processes in the eye.

Using national patient-level claims data, this report analyzes physician adherence to the treatment guidelines by exploring the use of key therapies in the newly diagnosed and recently treated DME patient populations. 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. With respect to 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.

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