Remote monitoring is one enabling technology that could potentially improve health care and lower costs. (Photo: Shutterstock)
Advances in eye health technology are redefining how beneficiaries will access eye care in 2021, and benefit managers can play an important role in supporting the emerging vision technologies—including gene therapy, sustained-release medications and remote monitoring—that have the potential to improve health outcomes, increase patient convenience and lower costs.
Gene therapies
Medicine continues to advance with new therapies, new procedures, new treatments and new medications. Though these advances are collectively often very effective, they also mean additional work for patients and physicians. This increased work is now referred to as "treatment burden," or how much work is involved in getting better.
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Gene therapies could potentially transform the treatment burden of retinal vascular degenerations, including diabetic retinopathy and macular degeneration, the leading causes of blindness in adults. These diseases are currently treated with periodic—often monthly—injections into the eye with a molecule called Vascular Endothelial Growth Factor Inhibitor (Anti-VEGF). This molecule retards the formation of abnormal blood vessels, which leak fluid and blood that degrade retinal function and lead to vision loss. This treatment is highly effective, but because it requires ongoing injections, the treatment burden to patients, physicians and society is high.
Through clinical trials, scientists are cultivating a gene that would allow the retina to make its own Anti-VEGF with just one injection. This treatment of potentially blinding retinal vascular disease would be less invasive, more convenient and more cost-effective than the current use of multiple, monthly injections.
Sustained-release medications
The management of glaucoma with multiple eyedrops is another example of a condition with a high treatment burden. A common practice for treating glaucoma includes eye drops patients administer on their own. However, topical therapies may be problematic in the management of glaucoma because of poor patient compliance due to factors like medication costs, forgetfulness, limited manual dexterity or side effects such as stinging, burning or tearing.
Fortunately, these obstacles could be potentially mitigated with sustained-release therapies. For instance, the FDA recently approved an implant that is injected into the eye to release glaucoma medication gradually over a period of four to six months, reducing the treatment burden of using multiple eyedrops while preserving vision.
Remote monitoring
Remote monitoring is another enabling technology that could potentially improve health care and lower costs. The treatment of glaucoma is a timely example. Glaucoma is associated with elevations in intra-ocular pressure that can lead to visual loss. Treatment is intended to lower this pressure to preserve sight. This commonly requires patients to see their eye doctor several times a year to have their pressure checked. It is recognized, however, that eye pressures may vary during the day and a single measurement a few times a year may not give the doctor an accurate picture of the disease.
Several companies are now in clinical trials for soft contact lenses that can continuously measure intra-ocular pressure. Through telemetry, these lenses will be able to send data in real time to a study center, which can analyze patients' pressure trends, perhaps with artificial intelligence algorithms, and send data to eye care professionals who can then better manage the course of this potentially blinding disorder.
Despite the many new technologies and therapies available to help treat eye disease, their availability can create uncertainty for payors, which traditionally pay for treatment costs as they fit into coverage, premiums and member enrollment plans. To ensure an accurate representation of available treatments and support member health, insurers and benefit managers must work together to grow awareness of these therapies, evaluate the opportunities they present to clients and incorporate the costs into future coverage plans. This process not only lowers financial burden and improves clinical performance for clients over time, but also sustains research and development of even better eye health innovations to come.
Dr. Mark Ruchman is chief medical officer at Versant Health.
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