Anti-VEGF monotherapy has higher cost than combination treatment for ROP
CHICAGO — Anti-VEGF monotherapy for treatment of retinopathy of prematurity was more expensive than anti-VEGF therapy combined with panretinal photocoagulation, according to a speaker here, but both modalities exhibited positive outcomes at the final examination.
“This study demonstrates the direct financial impact of ROP screening and treatment in infants. ... Monotherapy has marginal increased costs with escalating number of visits compared with treatment with laser,” Swati Agarwal-Sinha, MD, said at the American Society of Retina Specialists annual meeting.
Researchers retrospectively reviewed charts of 51 infants; 47 eyes of 26 infants were treated with anti-VEGF monotherapy and 48 eyes of 25 infants were treated with anti-VEGF and panretinal photocoagulation (PRP). The direct cumulative costs of inpatient and outpatient screening examinations, PRP, anti-VEGF injections, examinations under anesthesia, RetCam (Natus Newborn Care) fundus photography and fluorescein angiography were evaluated and calculated per CPT codes.
Costs were extrapolated to 65 weeks’ post-menstrual age in accordance with recently proposed guidelines by the American Academy of Pediatrics, Agarwal-Sinha said.
The average cost for all billed exams and procedures for anti-VEGF treatment was $20,076 compared with $17,129 for the combined treatment. Anti-VEGF monotherapy received an average Medicaid reimbursement of $2,452 compared with $2,071 for the combined treatment, a statistically significant difference (P = .005).
“This highlights the need for increased reimbursement, salary support from employers and increased [relative value units] to provide for quality ROP care,” Agarwal-Sinha said. – by Robert Linnehan
Agarwal-Sinha S. Economic impact of the use of anti-VEGF monotherapy or in combination with panretinal photocoagulation in the treatment of retinopathy of prematurity. Presented at: American Society of Retina Specialists annual meeting; July 27-30, 2019; Chicago.
Disclosure: Agarwal-Sinha reports no relevant financial disclosures.