Wet age-related macular degeneration (AMD) is an eye condition that threatens the middle of your eyesight. It’s caused when abnormal blood vessels in your eyes leak fluid, damaging the part of your eye that's responsible for the central part of your vision.
Treatments for wet AMD can help to preserve your eyesight. Their costs can range up to tens of thousands of dollars per year, depending on which treatment you get and your health insurance coverage. But there are programs that can help you get more affordable care.
What Are the Types of Wet AMD Treatments?
Your doctor will most likely prescribe eye injections to target the fluid leakage threatening your vision. For this treatment, your doctor injects medicine into your eyeball with a very small needle.
These eye injections usually involve a type of medicine called anti-VEGF, or anti-vascular endothelial growth factor therapy. It stops the growth of blood vessels that threaten your eyesight. Aflibercept (Eylea), bevacizumab (Avastin), brolucizumab (Beovu), and ranibizumab (Lucentis) are anti-VEGF drugs used to treat wet AMD. Another drug, faricimab-svoa (Vabysmo), also stops a second protein involved in forming blood vessels called angiopoietin-2 (Ang-2).
Photodynamic therapy (PDT) is another way to treat wet AMD. In this procedure, your doctor injects you with a medication that’s sensitive to light. The drug circulates throughout your body and reaches the blood vessels that are leaking fluid in your eye.
Your doctor then numbs your eye with eyedrops. With the help of a special contact lens, they aim a laser beam at the harmful blood vessels. The light-sensitive medicine causes blood clots to form and seals off the blood vessels.
Eye injections largely replaced photodynamic therapy as a wet AMD treatment in 2006. But you may still get photodynamic therapy alongside eye injections. You could also have it if the shots don't work well to treat your wet AMD.
It's not common, but doctors can also do an even older laser procedure called photocoagulation therapy, or "hot" laser surgery. It works similarly to photodynamic therapy, but the laser itself burns and seals the blood vessels, rather than the medication. It's not suitable for many people with wet AMD.
How Much Do Wet AMD Treatments Cost?
Most types of insurance cover treatments for wet AMD, but how much you pay out of pocket can vary widely. Keep in mind that, in addition to medication costs, you'll need to cover copays for doctor visits and any deductibles you have.
You might need eye injections as often as once a month. And you may have to keep getting them for years, perhaps indefinitely.
It's a good idea to call your insurer before you start treatment so you'll know how much you can expect to pay.
Aflibercept (Eylea). The FDA approved aflibercept to treat AMD in 2011. Its retail (before insurance) price is about $1,850-$2,000 a dose.
Bevacizumab (Avastin). This is a widely used and cost-effective drug for wet AMD injections. The FDA approved it to treat colon cancer in 2004. (It works by stopping the growth of new blood vessels.) But ophthalmologists regularly use the drug for off-label treatment of wet AMD. One dose costs around $55 retail, though you'll probably pay less if your insurance covers it.
Brolucizumab (Beovu). The FDA approved this longer-lasting drug to treat wet AMD in 2019. You get monthly shots for the first 3 months. But after that, you get injections only about every 2-3 months. According to drugs.com, its retail price is $1,997 per dose.
Ranibizumab (Lucentis). This drug was approved for wet AMD in 2006. A dose costs around $1,800-$2,000 before insurance.
Faricimab-svoa (Vabysmo). This newer drug, approved for wet AMD in 2022, lasts longer than many anti-VGEF medications. You can go around 3 months between Vabysmo injections. One study found about half of those who took it could go 4 months between shots. Its retail price is about $2,300 per dose.
Photodynamic therapy (PDT). The pre-insurance cost is around $2,500 for the medication, doctor’s fee, and imaging. You may need four PDT therapy treatments in the eye with wet AMD across a 3-year time span. Treatments decrease after that.
Laser photocoagulation surgery. One 2018 report showed that the amount Medicare will pay for this procedure ranged from $349 to $805 per session, depending on where the surgery was done.
Insurance Coverage May Require Prior Authorization
Insurers are more likely to cover more expensive eye injections if your medical history shows a cheaper option wasn't effective for you.
Say, for example, that your doctor starts treating your wet AMD with bevacizumab. The doctor gives you 5 injections of the drug, then does a test that scans the back of your eye. It shows that the damage is the same or perhaps worse than before treatments.
This shows that bevacizumab injections didn’t work to treat your wet AMD. Your doctor will try another drug – for example, ranibizumab. Your insurer may be more likely to cover the costlier drug because your medical history shows the cheaper one didn't work for you.
How to Get Help Paying for Wet AMD Treatments
Drugmakers offer financial support, called patient assistance programs, to patients who otherwise wouldn’t be able to afford their treatments.
Genentech, a drug company, makes bevacizumab, ranibizumab, and faricimab. This company helps patients cover the cost of their products through the Genentech Patient Foundation.
If you have private insurance, you may be eligible for Genentech’s copay programs for ranibizumab and faricimab that can reduce how much you pay for treatment. Those who don’t have insurance may qualify for financial help if they meet income requirements.
Bayer and Regeneron, the companies that make Eylea, also offer financial support for patients. You may qualify if you:
- Don't have insurance
- Have insurance that doesn't cover Eylea
- Live in the U.S.
- Show financial need based on your annual income
Novartis, the maker of Beovu, offers assistance to those who are uninsured or underinsured and meet income requirements through its Novartis Patient Assistance Program.
In addition, some nonprofit groups offer patient assistance programs to people who qualify, including:
- The Chronic Disease Fund
- The National Organization for Rare Disorders (NORD)
- The Patient Access Network (PAN) Foundation
Your doctor or pharmacist may also be able to point you to coupons, discount cards, and other programs that could help you save on out-of-pocket costs.
Show Sources
Photo Credit: pixdeluxe / Getty Images
SOURCES:
National Eye Institute: “Treatments for Wet AMD (Advanced Neovascular AMD),” “Injections to Treat Eye Conditions.”
CDC: “Prevalence of Age-Related Macular Degeneration (AMD).”
Beatrice Brewington, MD, assistant professor, Department of Ophthalmology, University of North Carolina at Chapel Hill.
Johns Hopkins Medicine: “Photodynamic Therapy for Age-Related Macular Degeneration.”
Saudi Journal of Medical and Pharmaceutical Sciences: “Exudative Age-Related Macular Degeneration: A Case Report and Review of the Literature.”
National Center for Biotechnical Information: “Photodynamic Therapy For The Eye.”
FDA: “Avastin (bevacizumab) Information,” “Highlights of Prescribing Information (Lucentis).”
American Academy of Ophthalmology Eye Wiki: “Bevacizumab.”
Health Affairs: “Switching To Less-Expensive Blindness Drug Could Save Medicare Part B $18 Billion Over A Ten-Year Period.”
American Academy of Ophthalmology: “Expensive Drugs.”
News release, Genentech.
Retinal Physician: “Economics of Intravitreal Medications For Neovascular AMD.”
U.S. Department of Health and Human Services Department of Inspector General: “Review of Medicare Part B Claims for Intravitreal Injections of Eylea and Lucentis.”
Medicare: “Macular Degeneration Tests & Treatment.”
Genentech: “Avastin, bevacizumab,” “Lucentis, Ranibizumab Injection,” “Vabysmo, Faricimab-Svoa,” “See If You Qualify.”
Eye on Copay: “Genentech Copay Program.”
Eylea: “Patient Support.”
American Society of Retina Specialists: “Patient Assistance Programs.”
Bright Focus: “Beovu: A Longer Lasting Drug for Wet AMD,” “What's New for Treating AMD?”
Ophthalmology: “Cost Evaluation of Early Vitrectomy versus Panretinal Photocoagulation and Intravitreal Ranibizumab for Proliferative Diabetic Retinopathy.”
Novartis: “Novartis Patient Assistance Foundation.”
Drugs.com: “Beovu Prices, Coupons and Patient Assistance Programs.”
