Intravitreal Injections Among Medicare Part B Beneficiaries, 2012-2016

Abstract

Purpose: Intravitreal injection therapy (IVIT) has transformed the management of many chorioretinal diseases. Although these treatments are effective, they can also be expensive. Using the Medicare Provider and Utilization Data Report (MPUDR), we aim to quantify the costs of these drugs to Medicare and to project future cost trends. Methods: Data were harvested from the MPUDR for all ophthalmology providers who delivered intravitreal injections (IVT) (CPT code 67028) during the years 2012-2016. Linear regression utilizing the MPUDR data was used to analyze cost trends and to project Medicare costs out to year 2026. Results: From 2012 to 2016, the total number of IVTs increased from 2 286 593 to 2 936 274 ( R2 = 0.98; P = .001). The per-beneficiary Medicare cost rose significantly from $3,148 to $3,945 ( R2 = 0.92; P = .03). The total cost to Medicare for IVIT increased from $1.68 billion to $2.73 billion ( R2 = 0.99; P < .005). IVIT accounts for 37% of all ophthalmology Medicare reimbursements. At the current rate, IVIT costs will exceed $5 billion per year by 2026. Conclusions: The total number of injections and costs for IVIT rose significantly from 2012 to 2016. At the current rate, Medicare reimbursement for brand-name drugs will make up a large proportion of future costs.