Intravitreal Anti–Vascular Endothelial Growth Factor Cost Savings Achievable with Increased Bevacizumab Reimbursement and Use

To model Medicare Part B and patient savings associated with increased bevacizumab payment and use for intravitreal anti–vascular endothelial growth factor (VEGF) therapy. Cost analysis. Intelligent Research in Sight (IRIS®) Registry data. Medicare claims and IRIS® Registry data were used to calculate Medicare Part B expenditures and patient copayments for anti-VEGF agents with increasing reimbursement and use of bevacizumab relative to ranibizumab and aflibercept. Medicare Part B costs and patient copayments for anti-VEGF agents in the Medicare fee-for-service population. Increasing bevacizumab reimbursement to $125.78, equalizing the dollar margin with aflibercept, would result in Medicare Part B savings of $468 million and patient savings of $119 million with a 10% increase in bevacizumab market share. Increased use of bevacizumab achievable with increased reimbursement to eliminate the financial disincentive to its use would result in substantial savings for the Medicare Part B program and for patients receiving anti-VEGF intravitreal injections. Eliminating the financial disincentive to use of lower-cost anti-vascular endothelial growth factor agents would increase their utilization and significantly reduce Medicare Part B and patient out-of-pocket costs.