In a recent retrospective, population-based cohort study, researchers investigated the association between statin use and prevention of vision-threatening diabetic retinopathy in patients with type 2 diabetes and dyslipidemia.
Studies have suggested that statins may reduce the risk of developing diabetic retinopathy, so the researchers wanted to see if there was, indeed, an effect from the drugs.
The study collected data between January 1, 1998, and December 31, 2013, from 37,894 Taiwanese patients (half in the statin group and half in the nonstatin group) with type 2 diabetes. There was a mean follow-up of 7.6 years for the statin group and 7.3 years for the nonstatin group.
Ultimately, 2,004 patients in the statin group (10.6 percent) and 2,269 patients in the nonstatin group (12 percent) developed diabetic retinopathy. Researchers say there was a statistically significantly lower rate of diabetic retinopathy (NPDR, PDR, vitreous hemorrhage, tractional retinal detachment and macular edema) in the statin group. Not only did those taking statins have a decreased risk of developing DR, but also a lower need for treatments. Even when treatment was needed, a smaller number of interventions was required than in patients not taking statins.
Researchers say that the effectiveness of statins as the primary means of preventing retinopathy in patients with diabetes remains uncertain. However, findings suggest that the therapy could slow the progression of vision-threatening DR.
JAMA Ophthalmology 2019;137:4:363-371.
Kang EY, Chen TH, Garg, S, et al.
Drug Prices in Australia vs. the United States
Researchers from multiple centers say that prices for certain drugs decreased at a greater rate in Australia than in the States.
The retrospective price-comparison study looked at the prices paid by government organizations in the United States (Medicare) and Australia (Pharmaceuticals and Benefits Scheme) for the drugs adalimumab (Humira; AbbVie), ranibizumab (Lucentis; Genentech) and aflibercept (Eylea; Regeneron). They collected data on the initial, final and change in medication price annually from 2013 to 2017 in inflation-adjusted, 2017 U.S. dollars. They took steps to ensure “an accurate comparison of prices between changes in inflation and currency exchange rates.” The study reported the following:
• The mean prices (U.S.-dollar prices unadjusted for inflation) in 2013 and 2017 in the U.S. were $1,114 ($1,053) and $1,818 ($1,818), respectively, for adalimumab; $2,102 ($1,988) and $1,904 ($1,904), respectively, for ranibizumab; and $2,074 ($1,961) and $1,956 ($1,956), respectively, for aflibercept.
• The mean (Australian dollar prices unadjusted for inflation) 2013 and 2017 prices in Australia were $1,854 (A $1,797) and $1,206 (A $1,574), respectively, for adalimumab; $2,157 (A $2,090) and $972 (A $1,268), respectively, for ranibizumab; and $2,030 ($1,967) and $996 ($1,300), respectively, for aflibercept.
• The estimated annual change in price for adalimumab was +12.8 percent in the U.S. compared with -11.1 percent in Australia, a difference of 23.9 percent per year (p<0.001). The annual change for ranibizumab was -2.6 percent in the U.S. compared with -18.5 percent in Australia, a difference of 15.9 percent per year (p=0.003). The annual change for aflibercept was -1.5 percent in the U.S. compared with -16.9 percent in Australia, a difference of 15.4 percent (p=0.001).
The researchers say the data shows that prices for the three drugs dropped significantly during the past five years in Australia compared with the United States, though the study couldn’t determine why such differences exist or what actions might affect future pricing in the countries.
JAMA Ophthalmol 2019;137:4:358-362.
Parikh R, Feng PW, Tainsh L.