Intravitreal Injection Rates for Neovascular Age-Related Macular Degeneration in Australia During the 2020 COVID-19 Lockdowns

ABSTRACT

Purpose

We investigate the impact of COVID-19 and lockdowns on anti-vascular endothelial growth factor (anti-VEGF) treatment for neovascular age-related macular degeneration (AMD) in Victoria (Australian state with highest burden of COVID-19 in 2020) and Australia, by examining anti-VEGF prescriptions supplied for AMD treatment between 2018 and 2020.

Methods

We performed a retrospective, population-based analysis of aflibercept and ranibizumab prescriptions supplied for the treatment of AMD in Victoria and Australia between 1 January 2018 and 31 December 2020, as recorded by the Pharmaceutical Benefits Scheme (PBS) and Repatriation PBS, the Australian Government program subsidising medication costs for Australian residents and veterans. Poisson models and univariate regression were used to descriptively examine trends in monthly anti-VEGF prescription rates with time and changes in monthly prescription rates (prescription rate ratios [RR]).

Results

In 2020, anti-VEGF AMD prescription rates in Victoria decreased by 18% during the nationwide lockdown between March and May (RR 0.82, 95% CI: 0.80–0.85, p < .001), and by 24% during the Victorian-specific lockdown between July and October (RR 0.76, 95% CI: 0.73–0.78, p < .001). In Australia, prescription rates tended to decrease between January and October 2020, reducing by 25% (RR 0.75, 95% CI: 0.74–0.77, p < .001) between these months, including between March and April (RR 0.94, 95% CI: 0.92–0.95, p < .001) but not April and May (RR 1.10, 95% CI: 1.09–1.12, p < .001).

Conclusion

In 2020, anti-VEGF prescriptions for AMD treatment decreased modestly in Victoria during both lockdowns and in Australia during the year. Decreases may represent reduced treatment because of COVID-19, including public health orders, patients’ self-limiting care, and ophthalmologists treating-and-extending to maximum intervals.

KEYWORDS:

• Age-related macular degeneration
• COVID-19
• injection
• intravitreal
• lockdown

Disclosure statement

None of the authors have any proprietary interests or conflicts of interest related to this submission.

This submission has not been published anywhere previously and is not simultaneously being considered for any other publication.

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.