“Modest investment” to ensure people don’t abandon intravitreal injections for treatment of macular disease would save governments billions of dollars, according to economic modelling commissioned by Macular Disease Foundation Australia (MDFA).
The MDFA acknowledges that measures to increase treatment persistence would mean additional costs to the Medicare Benefits Scheme (MBS) and Pharmaceutical Benefits Scheme (PBS) in the short-term.
Supporting just 22,000 more people to stay with their treatment through improved health literacy results in net savings to government of billions
“But these costs will be substantially outweighed by the net cost benefit to patients, carers, and government,” MDFA CEO Dr Kathy Chapman said.
“We believe you can’t put a value on the heartbreaking impact of losing your sight to age-related macular degeneration, but thanks to this report we can put a price on saving it.”
Investing to Save Sight
The report by PwC, Investing to Save Sight: Health and Economic Benefits of Improving Macular Disease Treatment Persistence, was released by MDFA to coincide with the launch of its annual Macula Month public awareness campaign in May.
AMD is the leading cause of irreversible vision loss and blindness in Australia. The MDFA report said approximately 1.5m Australians have AMD. Treatment in the form of anti-VEGF injections is currently available to approximately 62,000 people who have late-stage neovascular AMD (nAMD).
At least half of these people will stop eye injection treatment within five years, putting themselves at risk of blindness, the MDFA report said. Factors cited for abandoning treatment include cost and access, and the perception that treatment isn’t beneficial.
“We have estimated that of the 446,000 people with neovascular AMD who will start treatment over the next decade (2023–32), 267,000 will discontinue their eye injections. Tragically, more than 160,000 – that is more than half of those who stop their treatment – will progress to severe vision loss or blindness in a little less than a decade,” the report said.
MDFA Solutions
In the report, MDFA outlined three key areas that can help people stay on treatment. These include improved health literacy, and improved affordability and accessibility.
MDFA said providing 25% of the currently treated population with tailored tools and support measures to improve health literacy would lead to 22,000 fewer people losing their sight. This would lead to cost savings to government of AU$2.02 billion, and savings to patients of $1.06 billion over the next decade.
MDFA’s economic modelling showed that eliminating out-of-pocket costs for an additional 10% of patients would lead to an additional 5,000 patients – who would otherwise stop therapy – continuing to receive treatment.
This initiative would cost an additional $40 million on the MBS and PBS, according to the MDFA report, but would result in cost savings to government of $442 million, and savings to patients of $241 million.
Investing to Save Sight also outlined the challenges in accessing treatment for people with nAMD who live in rural and remote Australia (Featured image).
“Our economic modelling analysed the impact of increasing treatment persistence in just 25% of the currently treated population. This was modelled on establishing treatment services in more accessible locations and reducing the travel burden where travel lengths exceed 100km.
“Increasing treatment persistence in 25% of current treatment recipients travelling long distances leads to an additional 22,000 patients continuing to receive treatment… which can save government $2.11 billion and patients $1.12 billion over the next decade,” the report said.
Huge Cost Benefits
Dr Chapman said it’s “incredible” to think that investments to achieve modest increases in treatment persistence can have “huge health and cost benefits for government and people with neovascular AMD”.
“Supporting just 22,000 more people to stay with their treatment through improved health literacy results in net savings to government of billions.
Increasing accessibility for 22,000 more people who live in rural and remote areas can yield similar health benefits and cost savings.
“And providing eye injections at no cost to just one in 10 more people on treatment can save 5,000 people from losing their sight and save government nearly $450 million dollars over the next decade,” Dr Chapman said.
The report is available on MDFA’s website at mdfoundation.com.au.
