Macular Degeneration Treatment Cost

Typical costs:

• For patients covered by health insurance, out-of-pocket costs typically consist of doctor visit copays, prescription drug copays or coinsurance of 10%-50%. Treatment for macular degeneration typically is covered by insurance.
• For patients not covered by health insurance, treatment for macular degeneration typically costs about $9,000-$65,000, depending on which drug is used, for a two-year course of treatment with drugs injected into the eye to inhibit formation of and leakage from excess blood vessels. It typically costs up to $10,000 for two years of treatments with injection and photodynamic therapy, which works in a similar way. Laser treatment to burn leaky blood vessels, which is used much less frequently because only a small percentage of patients are candidates, typically costs about $1,700; it often needs to be repeated, and the procedure itself can cause vision loss.
• According to the American Macular Degeneration Foundation^[1] , a vial of the brand-name cancer drug Avastin, used off-label^[2] because it has not been approved by the FDA for macular degeneration, costs about $50 -- a total of $1,200 for monthly injections over the two years typically required -- while a vial of the brand-name drug Lucentis costs about $2,000 -- or a total of about $48,000 for monthly injections over the two years typically required; doctors also charge several hundred dollars or more for each injection. For example, Midwest Eye Care^[3] in Nebraska charges $380 for one treatment with Avastin -- or $9,120 for monthly treatments for two years. According to Retinal Consultants of San Antonio^[4] in Texas, a Visudyne injection with photodynamic therapy (PDT) costs about $2,000 per treatment -- or a total of $10,000 for five treatments over two years. And, according to Retinal Consultants of San Antonio^[5] , one treatment with Macugen costs about $1,250 -- or more than $21,000 for treatments every six weeks for two years. Midwest Eye Care^[6] charges $2,700 for one treatment with Lucentis.

• For dry macular degeneration^[7] , a doctor might recommend monitoring vision at home with an Amsler grid^[8] .
• For wet macular degeneration^[9] , in which a cluster of leaky blood vessels forms in the eye, a doctor might prescribe injections into the eye with bevacizumab^[10] (brand name Avastin), a chemotherapy drug that is used off-label, or pegaptanib^[11] (brand name Macugen) or ranibizumab^[12] (brand name Lucentis). All three drugs block blood vessel formation and leakage. Injections typically are required once a month to every six weeks, depending on the drug, for about two years. Or, the doctor might recommend treatment with verteporfin^[13] (brand name Visudyne) combined with photodynamic therapy^[14] (PDT). The drug typically is injected into a vein in the body, then the doctor shines a special laser into the eye, causing the drug to close off blood vessels in the eye. Several more treatments might be needed, usually every three months.
• In laser photocoagulation, which usually requires local anesthesia, a doctor uses a laser to burn and seal off blood vessels. According to WebMD^[15] , this treatment only can be used in about 15% of cases and has several other drawbacks.

• A National Eye Institute study^[16] found that patients with early-stage macular degeneration might be able to slow progression by taking certain antioxidants and zinc. Supplements formulated based on the study cost about $15 to $30 for a three-month supply.

• Many hospitals and doctors give discounts of up to 30% or more to uninsured/cash-paying patients. For example, Washington Hospital Healthcare System^[17] in California offers a 35% discount.
• Some drug manufacturers offer patient assistance programs. Any patient without prescription drug coverage who also is not eligible for Medicare typically qualifies for Together Rx Access^[18] , a discount card that offers 25%-40% off many brand-name drugs. Most companies also offer free drugs to patients who have no coverage and meet certain criteria.

• The American Academy of Ophthalmology provides an ophthalmologist locator^[19] .
• The first-year results from a clinical trial by the National Institutes of Health^[20] show the less expensive Avastin is as effective as Lucentis in treating macular degeneration. However, The U.S. Food and Drug Administration recently sent out an alert^[21] stating that some patients in Florida had gotten eye infections from the off-label use of Avastin, injected into the eye.

1.  www.macular.org/lucentis.html
2.  www.fda.gov/RegulatoryInformation/Guidances/ucm126486.htm
3.  www.midwesteyecare.com/SubSection/index.php?SectionID=7&SubSectionID=192&ParentID=58
4.  www.retinasanantonio.com/services/macular-degeneration/treatment-for-wet-macular-d...
5.  www.retinasanantonio.com/services/macular-degeneration/treatment-for-wet-macular-d...
6.  www.midwesteyecare.com/SubSection/index.php?SectionID=7&SubSectionID=192&ParentID=58
7.  www.macular.org/dry.html
8.  www.amd.org/living-with-amd/resources-and-tools/31-amsler-grid.html
9.  www.macular.org/wet.html
10.  www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000352/
11.  www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000406/
12.  www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000394/
13.  www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000409/
14.  www.webmd.com/eye-health/macular-degeneration/photodynamic-therapy-for-age-related...
15.  www.webmd.com/eye-health/macular-degeneration/laser-photocoagulation-for-age-relat...
16.  www.nei.nih.gov/amd/summary.asp
17.  www.whhs.com/about/washington-hospital-discount-policy-for-uninsured/
18.  www.togetherrxaccess.com/p/prescription-savings/about-together-rx-access/enroll.aspx
19.  www.aao.org/aao/find_eyemd.cfm
20.  www.nih.gov/news/health/apr2011/nei-28.htm
21.  www.fda.gov/Drugs/Drugsafety/ucm270296.htm

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