Injection treatment in the eye

Injection treatment in the eye is relevant for patients with age-related macular degeneration (AMD), diabetic retinopathy, and vein occlusion. The two most commonly used medications have long been bevacizumab and aflibercept. Bevacizumab has a significantly lower cost and is the first choice in most places (Husum et al. 2023). Since May 2023, a new medication, faricimab, has been increasingly adopted.

Nationally, the number of contacts per year increased from 61,000 in 2015 to approximately 144,000 in 2024. Thus, the number of contacts more than doubled from 2015 to 2024. The number of patients receiving treatment increased by nearly 1,400 per year during the period 2015–2024, from 11,043 patients in 2015 to 23,465 patients in 2024. If the number of patients in treatment continues to rise in the coming years, there may be a need for changes in the organization of the service to ensure access to good and equitable treatment.

There is significant geographic variation in patient rates. This aligns with the findings of Husum et al. 2023, which suggest that the observed variation may be related to overtreatment in some areas and undertreatment in others. The authors point to a need for clearer governance, national guidelines, and a national quality registry in this field.

The analysis is based on activity data from the Norwegian Patient Register (NPR) for somatic specialist health services. The data includes activity in public hospitals and private hospitals that provide publicly funded services. Data from specialists under public funding contracts are not included, as this treatment is only provided in hospitals.

The sample consists of contacts for patients aged 50 years or older registered with a primary or secondary diagnosis of age-related macular degeneration, AMD (H35.3), venous occlusion (H34.8 or H34.9), or diabetic retinopathy (H36.0, E10.3, or E11.3) in combination with procedure code CKD05.

The drug aflibercept is identified using a særkode code and an ATC-code (1LA05, S01LA05), and faricimab using the ATC code S01LA09.

When a contact is registered with two or more of the relevant diagnosis codes (e.g., AMD as the primary condition and venous occlusion as the secondary condition), the primary diagnosis is chosen.

The place of treatment is divided into three categories:

• Local public, treated at one of the hospitals in the catchment area
• Other public, treated at a public hospital outside the catchment area
• Private, treated by a private hospital

In order to compare the catchment areas and between years, the rates have been adjusted for gender and age. The adjustment was done using the direct method with the population in 2023 as the reference population.

SKDE is solely responsible for the interpretation and presentation of the data provided by NPR. FHI/NPR is not responsible for analyses or interpretations based on the data.