A remarkable ROI: Research preserves vision while lowering health care costs.
“We now have a faster, safer, more effective way to diagnose wet age-related macular degeneration, a devastating disease that causes blindness. This happened because our government invested in Optical Coherence Tomography (OCT) research,” says Dr. Philip Rosenfeld, a professor of ophthalmology at Bascom Palmer Eye Institute. OCT uses light waves to capture cross-section images of your retina.
In the process, taxpayers saved more than $11 billion.
In December 2017, Dr. Rosenfeld told a Congressional delegation that their $400 million research investment over the last two decades yielded $9 billion in Medicare savings. It also saved elderly patients more than $2 billion in copays.
“Technology advancements allow us to diagnose and treat wet AMD earlier, thereby preserving vision and reducing the number of office visits for patients. This lowers health care costs for Medicare and consumers,” he says.
Wet age-related macular degeneration (AMD) treatments involve injections of anti-VEGF, a drug that blocks vascular endothelial growth factor (VEGF), a protein causing abnormal blood vessel growth. Dr. Rosenfeld pioneered the use of anti-VEGF injections to slow the progression of wet AMD. The wet form of this disease occurs when the enlarged vessels leak blood and fluid, which leads to rapid vision loss. Wet AMD begins as the slower dry form in older individuals. Left untreated, both forms lead to permanent blindness.
In 2005, after years of study, Dr. Rosenfeld began using the cancer drug Avastin to block VEGF and improve sight in patients with wet AMD. “Developing Avastin into an AMD treatment saved taxpayers an additional $17.3 billion. This would not have occurred without AMD-specific research,” Dr. Rosenfeld says. By pioneering the use of Avastin in combination with OCT-guided therapy, he has preserved vision for countless patients.
The ripple effect
There is no cure for AMD, but early intervention allows ophthalmologists to slow its progress. “The investment in academic, biotech, and pharmaceutical research yields so much added value. By preventing blindness, we allow people to remain independent and not be a burden on society. We also create OCT manufacturing jobs. Investing in research creates a ripple effect that keeps growing.”
A game-changing tool
According to Dr. Rosenfeld, innovative, non-invasive Swept Source OCT (SS-OCT) will gradually become the gold standard of AMD diagnostics. The previous method, fluorescein angiography, requires injecting dye into a patient’s arm, then photographing its progress through blood vessels in the eye. Although the leading edge SS-OCT technology is not yet widespread, Bascom Palmer physicians are finding many uses for it. “We use it to gain information about the front and back of the eye. As an ophthalmologist working to preserve vision in patients with AMD, I’m trying to leverage these technologies. It’s better for patients and better for me.”
Billions saved makes lawmakers and taxpayers happy, but Dr. Rosenfeld is not content to stop there. “The earlier we can diagnose and treat AMD, the more effective we are at preserving vision and quality of life. That’s why I’m excited about the clinical trials underway at Bascom Palmer.”
He’s also optimistic about finding a way to stop AMD in the early stages. “SS-OCT allows us to study the choriocapillaris layer of the eye. We think that’s where AMD first develops. That’s the holy grail of AMD research. I’m focusing my efforts there, in the hopes of developing a treatment for dry AMD. When that’s achieved, I can retire,” says Dr. Rosenfeld, a 22-year veteran of the ophthalmology field.
To schedule an appointment at Bascom Palmer Eye Institute, call 800-329-7000 or click here.
Nancy Moreland is a contributor to UMiami Health News. She has written for several major health care systems and the Centers for Disease Control and Prevention. Her articles also appear in the Chicago Tribune.