Need for Anti-VEGF Therapy Expected to Grow by 50% Over Next 5 Years

Benjamin Sommer Thinggaard, MD

Credit: University of Southern Denmark

Treatment needs for ophthalmic conditions will grow by 50 percent over the next 5 years, according to forecasts of the growing demand for anti-vascular endothelial growth factor (VEGF) therapy in Denmark.¹

Projections indicate an equal increase in the number of anti-VEGF injections in patients with retinal vein occlusion (RVO) and neovascular age-related macular degeneration (nAMD), due to their association with age, but only a slight increase in patients with diabetic macular edema (DME), given improvements in anti-diabetic medications.

“We are witnessing a significant increase simply because we are getting older and older,” said Benjamin Sommer Thinggaard, MD, of the department of clinical research at the University of Southern Denmark.² “In recent years, we have observed a consistent number of individuals being newly diagnosed with conditions, such as wet AMD and eye blood clots, but patients are staying in treatment for increasingly longer periods.”

Now the gold standard for retinal diseases, the introduction of intravitreal anti-VEGF therapy dramatically altered the treatment landscape for retinal diseases. Analyses suggest the use of anti-VEGF therapy was associated with a significant reduction in the incidence of blindness due to AMD, with a 50% reduction among those aged ≥50 years.³

As life expectancy continues to increase, it is expected the number of patients receiving anti-VEGF therapy will subsequently increase and burden the healthcare system. Strategic planning will be necessary for future ophthalmological services. In this analysis, Thinggaard and colleagues assessed the current use of anti-VEGF therapy and estimated the growing demand for the therapies across Denmark.¹

The nationwide cohort study collected data from the Danish National Patient Register and the Danish Civil Registration System, including birth dates, diagnosis codes, and procedure codes for individuals ≥40 years between January 2007 - December 2022. Patients with nAMD, RVO, or DME were identified using ICD-10 codes for the first diagnosis in combination with ≥1 injection of intravitreal VEGF inhibitors. Then, investigators calculated the 5-year forecast for these injections as linear growth based on data from 2017 to 2022.

Over the study period, a total of 901,826 intravitreal anti-VEGF injections were given to 56,081 patients in Denmark. The population had a median age of 77 years and 32,505 (58.0%) were women. The median use rate was 9 injections per patient, including 11 per patient with nAMD, 7 injections per patient with RVO, and 6 injections per patient with DME. No diagnoses were identified for 4789 patients (8.5%).

Upon analysis, investigators observed an annual increase of ≥10,000 injections from 2019 onward, including 95,677 injections in 2019 and 131,010 injections in 2022. The incidence of patients with nAMD, RVO, or DME receiving anti-VEGF therapy remained consistent between 2019 and 2022. However, the overall injection count for nAMD increased from 12,992 in 2019 to 17,338 in 2022.

In extrapolating data from 2017 – 2022, investigators projected a 50% increase in the number of VEGF injections for nAMD, a 56% increase in injections for RVO, and a 24% increase in injections for DME by 2027. Overall, these data indicate an overall 50% increase in the total number of anti-VEGF injections.

Thinggaard and colleagues indicate these results may bring increased attention to a rapidly growing need for additional treatments in eye care, as well as the burden the healthcare system is facing due to an aging population.

“This is an excellent example of the prioritization challenges we face in the healthcare system, and it is evident to consider whether the treatment of other diseases, both within the field of ophthalmology and in other specialties, is experiencing similar increases,” Thinggaard said.²

References

1. Thinggaard BS, Pedersen F, Grauslund J, Stokholm L. Intravitreal Vascular Endothelial Growth Factor Inhibitor Therapy in Denmark and 5-Year Projections. JAMA Netw Open. 2023;6(9):e2335148. doi:10.1001/jamanetworkopen.2023.35148
2. Significant increase in the need for treatment of eye diseases. EurekAlert! September 26, 2023. Accessed October 12, 2023. https://www.eurekalert.org/news-releases/1002754.
3. Finger RP, Daien V, Eldem BM, et al. Anti-vascular endothelial growth factor in neovascular age-related macular degeneration - a systematic review of the impact of anti-VEGF on patient outcomes and healthcare systems. BMC Ophthalmol. 2020;20(1):294. Published 2020 Jul 17. doi:10.1186/s12886-020-01554-2