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Antivascular endothelial growth factor treatments for neovascular age-related macular degeneration save sight, but does everyone get treated?

To the Editor: Neovascular age-related macular degeneration (NVAMD) is the most common cause of blindness in Australia.1 Current treatment to prevent further deterioration in vision, and an improvement in some, involves the antivascular endothelial growth factor (anti-VEGF) agents ranibizumab (Lucentis, listed on the Pharmaceutical Benefits Scheme [PBS] since August 2007) or bevacizumab (Avastin, used off-label for NVAMD).2

The Australian Macular Degeneration Foundation estimated the annual number of new cases of NVAMD to be 20 734 in 2010  in Australia, based on incidence figures from the Blue Mountains Eye Study, based on an Australian population.3

We used PBS data to investigate people accessing treatment for the first time (first prescription for ranibizumab) between 2008 and 2010, and found that 7501 people in 2008, 6979 people in 2009 and 6623 people in 2010 were treated with ranibizumab (indicated by a first and subsequent prescriptions).

Considering the predicted new cases of NVAMD at around 20 000 annually, there is a large gap between people receiving treatment…