Pensioners needing treatment for neovascular age-related macular degeneration (nAMD) pay up to 20% of their income on treatment and management of the disease, according to new figures released by Macular Disease Foundation Australia (MDFA).
Research undertaken by MDFA, in collaboration with the School of Optometry and Vision Science at the University of New South Wales, found that the median total cost for people living with macular disease who also receive sight-saving eye injections is 12% ($3,621)* of their annual government pension payment.
But for almost one in 10 Australians who receive eye injections the cost of living with their condition is more than $6,000 every year. This is around 20%* of the annual government pension payment.
The figures were released as part of MDFA’s federal election agenda, Fight for Sight, which proposes clear and practical recommendations that the next federal government can take to save the sight of thousands of Australians.
Endorsed by leading eye health organisations – including the Royal Australian and New Zealand College of Ophthalmologists (RANZCO), Optometry Australia, Orthoptics Australia, Vision 2020 Australia, and Advanced Pharmacy Australia – MDFA’s election agenda calls for greater government investment into making sight-saving treatments more affordable and accessible to people living with macular disease.
Fight for Sight… proposes clear and practical recommendations that the next federal government can take to save the sight of thousands of Australians.
Rising Prevalence
MDFA said 25 years ago, there were approximately 800,000 Australians living with age-related macular degeneration (AMD). Today, 1.9 million people live with AMD and other macular diseases. MDFA projects this number will reach 2.1 million by 2030, with the organisation saying the Australian health system is unprepared to cope with this increased demand.
“People are already delaying or giving up on having sight-saving treatment because it costs too much or they must travel a great distance to receive it,” said MDFA CEO Dr Kathy Chapman.
“If we don’t see systemic change in our current health system, this situation is only going to get worse as the number of those diagnosed grows.”
“The government has the opportunity to save the sight of thousands of Australians now, and ultimately make savings into the future, by adopting our recommendations.”
People living with AMD shouldn’t be forced into a position of going blind because they can’t afford treatment that could save their sight
Pensioners Feeling the Pinch
In Australia, there are more than 62,000 people with nAMD, 18,000 with diabetic macular oedema, and 11,000 with retinal vein occlusion who receive sight-saving eye injection treatments.1,2
MDFA said cost and access are the two main reasons why people delay or stop treatment. This includes challenges in accessing affordable or bulk-billed treatment for low-income earners, pensioners, and self-funded retirees.
Almost 1,500 Australians with macular disease completed MDFA’s detailed survey which found the median cost of annual intravitreal eye injections was 12%* ($3,621) of their annual government pension payment, with one in 10 paying more than $6,000 every year, or approximately 20%* of the annual government pension payment.
These costs – which include eye specialist appointments, eye injection treatments and vision aids – are leaving pensioners with less money in their bank accounts for rent, bills, food and other essential life expenses, MDFA said.
If people with certain macular diseases cannot afford to receive eye injection treatments, they will lose their vision.
Dr Chapman said treatment persistence is a significant problem in Australia, with approximately 50% of people with nAMD discontinuing treatment within five years of starting eye injections.2 The main reason for this is cost burden.
“People living with AMD shouldn’t be forced into a position of going blind because they can’t afford treatment that could save their sight,” said Dr Chapman.
“We are calling on the Australian Government to make the preservation of sight a national priority. Our Fight for Sight election agenda lays the blueprint to achieve more affordable and accessible treatments for all Australians living with our country’s leading cause of blindness.”
A key recommendation from MDFA is to provide financial relief for pension card holders through the introduction of treatment incentive programme. The aim of the programme is to encourage ophthalmologists to bulk bill pension card holders having eye injections for nAMD, and support those most at risk of stopping treatment due to burden of cost.
Under this proposal, Medicare could provide registered ophthalmologists with an additional $100 for eye injections performed on eligible nAMD patients. By targeting the most financially vulnerable people who need sight-saving treatment and encouraging more bulk billing, MDFA believes this programme would cost the government an estimated $11.1 million a year and ultimately save government $140 million a year.
Burden in Regional and Remote Australia
Accessing treatment nationally continues to be a significant challenge, MDFA said.
Across Australia, only a few metropolitan and larger regional public hospitals provide eye injection treatment.
MDFA said treatment is mainly provided by private ophthalmologists, with between 77% to 82% charging out-of-pocket fees. In addition, ophthalmologists providing eye injection treatment are extremely limited in regional areas. Most ophthalmologists are based in major cities (84%); the remaining 16% of ophthalmologists service the 28% of Australians (seven million people) who live in regional, rural, and remote communities. Limited access to public hospitals and bulk-billed private treatment has led to people in regional, rural and remote areas having to travel long distances to major cities to access public hospital outpatient treatment.
MDFA Patron, Ita Buttrose AC OBE said she was “deeply concerned that we live in a country where people are needlessly going blind because they cannot access or continue to afford their sight saving treatments”.
“Reasonable investment will not only help reverse this unacceptable situation, but it will also generate huge cost savings for the government,” said Ms Buttrose. “We must make it easier for vulnerable people who need eye injections to receive them.”
MDFA estimates that government investment in more affordable and accessible treatment could, over the next decade, help 22,000 more people persist with their treatment, preventing severe vision loss and blindness, while saving the government more than $2 billion, and reducing the financial impact on people with macular disease by more than $1 billion.
The Hon Jillian Skinner AM, former NSW Health Minister and MDFA ambassador who lives with AMD, said eye health should be the responsibility of both major parties.
“Tremendous gains have been made in Australia in tackling major health issues when we have taken a bi-partisan approach. I’m hopeful that all Members of Parliament, no matter their political allegiance, will support the recommendations of the Macular Disease Foundation,” Ms Skinner said.
“As a former NSW Health Minister, I know how important it is that government supports the health and wellbeing of our community. We can’t stand by and let people lose their sight because they can’t afford sight-saving therapies.
“I feel extremely fortunate to receive monthly sight-saving eye injections for my neovascular AMD, but sadly this is not the case for all of us in Australia living with macular disease. Eye injections ensure that I can retain my vision, maintain my independence, and keep living life to the fullest,” she said.
Tremendous gains have been made in Australia in tackling major health issues when we have taken a bi-partisan approach.
Professional Endorsement
Professor Mark Gillies, from the Save Sight Institute, University of Sydney and Head of the Medical Retina Unit at the Sydney Eye Hospital, said he fully endorsed the MDFA’s proposal.
“As director of the largest service in Australia that cares for people who need eye injections through the public health system, I can confirm that we are dangerously inundated
“We recognise that even a few thousand dollars a year in out-of-pocket costs to save sight is a barrier for some people, particularly in these difficult economic times. The payment will cover not just the injection but also the assessment and management of the patient by the doctor.”
“This genuine incentive to provide more affordable service to patients in real economic need will certainly boost the number of Australians country around the country who need ongoing eye injections, frequently for the rest of their lives, to keep their sight,” Prof Gillies said.
Other Fight for Sight Recommendataions
Other MDFA recommendations in the Fight for Sight document include investing in public-private partnerships to increase access to affordable eye injection treatment, and establishing national access to, and stronger government oversight of, public treatment of macular disease in all states and territories.
MDFA has also recommended continued investment into the professional development of eye care professionals managing macular disease patients, as well as non-clinical patient support programmes such as MDFA’s new Eye Connect service.
The full recommendations can be found in MDFA’s Fight for Sight document, available on the MDFA’s website.
* Calculation based on Services Australia information, the current total maximum fortnightly pension for a single person is: $1,144.40. Total annual pension: $1,144.40 X 26 = $29,754.40 and $3,621/$29,754.40 = 12%)] servicesaustralia.gov.au/how-much-age-pension-you-can-get?context=22526
- Butler M, Cheaper medicines from today (media release, 1 Jan 2023). Available at: health.gov.au/ministers/the-hon-mark-butler-mp/media/cheaper-medicines-from-today?language=en [accessed March 2024}
- Pharmaceutical Benefits Advisory Committee – Drug Utilisation Sub Committee (2018). Ranibizumab and Aflibercept: Analysis of Use for AMD, DMO, BRVO and CRVO., 2018. Available at: pbs.gov.au/pbs/industry/listing/participants/public-releasedocs/2018-05/ranibizumab_and_aflibercept__analysis_of_use_for_amd%2C_dmo%2C_b [accessed March 2025].
