ArticlePloS one2026
U.S. trends of anti-vascular endothelial growth factor use from 2017-2023: An analysis of medicare, medicaid, and commercial insurance.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Response to anti-VEGF injections for diabetic macular edema among patients on chronic exogenous insulin therapy.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026Article
- Special Issue: Molecular Mechanisms and Treatment of Retinal Diseases.International journal of molecular sciences · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAnti-vascular endothelial growth factor medications are a cornerstone in the treatment of many macular diseases in modern ophthalmology. These medications accrue significant economic burdens to individuals and health systems, and recent data on health-system level practice patterns involving agent selection is lacking. We sought to examine utilization of intravitreal anti-VEGF agents from 2017 to 2023 across various payors and diagnoses in the United States in order to analyze trends in usage.
methodsA retrospective cross-sectional study was performed. Data were obtained from the Epic Cosmos database, comprised of de-identified data from the electronic health record, Epic, of 238 million patients from all 50 states from January 1, 2017 to December 31, 2023. Encounters where a patient received an intravitreal injection in an ophthalmology clinic were categorized by intravitreal medication ordered, visit diagnosis, and primary insurance payor. The overall usage rates of each medication across different diagnoses and primary payor were compared. Total number of injections per year of anti-VEGF medication, the rate per 100000 ophthalmology encounters (OE), and the rate in different retinal conditions and with various insurance providers were the main outcome measures.
resultsFrom 2017-2023, there were 571,545 anti-VEGF injections administered, with 53.6% aflibercept 2 mg (306,247/571,545; 625.8/000 OE), 34.8% bevacizumab 1.25 mg (198,696/571,545; 414.7/100000 OE), 7.83% ranibizumab 0.3 mg and 0.5 mg (44,803/571,545; 99.2/100000 OE), and 3.43% faricimab 6 mg (19,624/571,545; 32.8/100000 OE). Brolucizumab 6 mg, ranibizumab-eqrn 0.5 mg, ranibizumab-nuna 0.5 mg, and aflibercept 8 mg accounted for <1% of all injections. From 2017-2023, the rate of aflibercept 2 mg increased from 361.3 injections/100000 OE to 913.1, bevacizumab increased from 274.1 to 538.1, and ranibizumab decreased from 92.4 to 64.0. The rate of faricimab increased from 37.9/100000 OE to 189.9 from 2022-2023. Patients with Medicare received aflibercept 2 mg at higher rates than bevacizumab (364.3/100000 OE vs 187.1, respectively) [t(6) = 5.67, p = 0.001] and faricimab (19.4/100000 OE), a pattern not seen in commercially insured [t(6)=2.07, p > 0.05] patients. Medicaid patients had a marginally significant difference in use of bevacizumab (M = 19.9/100000 OE, SD = 7.32) and aflibercept 2 mg (16.1/100000 OE, SD = 7.22) [t(6)]=2.95, p = 0.026].
conclusionsAflibercept 2 mg was the most common drug used overall from 2017-2023. Faricimab had the highest absolute and relative increase in utilization from 2022-2023. Patients with Medicare B or C were significantly more likely to receive aflibercept over bevacizumab.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.