Ozurdex (dexamethasone 700mcg) sustained release ocular implant has received PHARMAC approval for diabetic macular oedema (DMO).
The long-acting intravitreal steroid, which is injected into the vitreous cavity, will be available and funded for eligible people in NZ with DMO. It will be listed in Section B (Community) and Part II of Section H (Hospital) of the Pharmaceutical Schedule, and available to patients with DMO who have had cataract surgery and for whom the currently available treatments are either ineffective or inappropriate.
DMO, which involves retina thickening, is a major complication of diabetic retinopathy, the leading cause of preventable blindness among adults aged 20–74 years. It is estimated that 15,000 New Zealanders suffer from DMO,1–3 and approximately 30 per cent of these patients are pseudophakic, one of the criteria for the reimbursement of Ozurdex injections.4–6
In New Zealand, approximately 6 per cent of the population over the age of 15 are living with diabetes and it is particularly prevalent in the Maori and Pacific Islander populations.
Many of these patients already inject insulin, so the additional burden of frequent injections for DMO can severely affect independence and quality of life
Many of these patients already inject insulin, so the additional burden of frequent injections for DMO can severely affect independence and quality of life.
Currently available treatments for DMO include anti-VEGFs, but a recent study showed that more than 35 per cent of patients with DMO fail to achieve ≥10-letter improvement in bestcorrected visual acuity (BCVA) after two years of first-line anti-VEGFs.7
References
1. NZ Stats (2017). National Population Estimates: At 30 June 2017. Viewed 18 Oct 2017. Available here.
2. Ministry of Health (2013). New Zealand Health Survey: Annual update of key findings 2012/2013. Wellington: Ministry of Health.
3. Yau JWY et al. Diabetes Care. 2012; 35(3): 556–64.
4. Pharmac. Pharmac Notification: Decision to fund dexamethasone implants (Ozurdex) (2017). Viewed 17 Oct 2017. Available from: https://www.pharmac.govt.nz/news/ notification-2017-10-13-dexamethasone-ocular-implants/
5. Boyer DS et al. Ophthalmol. 2014; 121(10): 1904–14.
6. Elman MJ et al. Ophthalmol. 2010; 117(6): 1064-1077.
7. Gonzalez VH et al. Am J Opthalmology. 2016; 172: 72–9.
