Access to healthcare services for elderly patients with neovascular age-related macular degeneration

Background. Neovascular (nv) age-related macular degeneration (AMD) is the leading cause of blindness in Germany and is usually treated with monthly injections of anti-VEGF agents. The current level and the estimated need of service provision for nv-AMD were assessed. Methods. Current levels of service provision with ranibizumab (Lucentis) were documented in 3,633 patients in the WAVE study, the currently largest observational study in Germany on the use of anti-VEGF agents. The expected need was calculated using German population figures for 2010 and available prevalence data. Both were stratified by age and gender and descriptively analyzed. Results. A larger number of younger patients with nv-AMD (< 75 years) than expected were treated in the WAVE study. Expected need in the age groups 75-84 years and 84 years and older was much higher than the proportion of patients actually treated in these age groups (up to 3 times). Based on expected need, women accessed treatment less often than men. Conclusion. In the WAVE study, less elderly persons and in particular elderly women seemed to access treatment for nv-AMD than expected. Future studies should investigate barriers in accessing treatment for nv-AMD and how to address these problems.