George A Williams, MD
The utilization of intravitreal injections and optical coherence tomography (OCT) procedures for age-related macular degeneration and other retinal vascular diseases increased explosively between 1999-2004. The United States Center for Medicare Services (CMS), which compiles utilization statistics for all diagnostic and therapeutic services received by patients on Medicare, determined that over this time period, OCT use has increased 20-fold, with 3 million OCT scans performed in 2004. Just 4472 intravitreal injections were performed in 1999, but more than 22,000 were performed in 2004. The growth in just these 2 procedures represents a significant increase in CMS ophthalmology expenditures for the period. In a veiled reference to the clinical trials now being conducted by the Diabetic Retinopathy Clinical Research network, Dr Williams stated that “physician innovation may act as a brake on the increasing costs of drugs” for treating retinal vascular diseases.
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