Health

Keeping eye treatments safe, accessible and available for British Columbians

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Health

Keeping eye treatments safe, accessible and available for British Columbians

Media Contacts
Ministry of Health
Communications
250 952-1887 (media line)
Media Contacts
Ministry of Health
Communications
250 952-1887 (media line)

Backgrounders

More details on the Retinal Diseases Program
Updated May 24, 2019, for clarification
  • The Provincial Retinal Diseases Treatment Program (PRDTP) was established in 2009 to provide treatments for one type of retinal disease called wet age-related macular degeneration (wet AMD), a leading cause of blindness in the elderly.
  • The program was later expanded to treat three retinal diseases, including wet AMD, diabetic macular edema and retinal vein occlusion.
  • The program provides sight-preserving and sight-saving treatments for about 20,000 British Columbians, serving individuals from ages 20 to 108 with a median age of 78 years. 
  • The program was established so that access could be provided to patients from all over the province through retinal specialists located throughout B.C. as well as through travelling clinics.
  • The program covers three drugs including coverage for bevacizumab (AvastinTM), ranibizumab (LucentisTM) and aflibercept (EyleaTM), which together are called anti-VEGF drugs since they work by suppressing proteins called the vascular endothelial growth factor.
  • The program also covers a fourth drug, verteporfin (VisudyneTM), with photodynamic therapy when indicated for wet AMD.
  • The program provides 100% coverage of these drug costs so patients do not incur the cost of these treatments. This is important for all people, but may be especially important, as the program for the most part, serves an older age group where living on a predictable income is important.
  • The program has been delivered through ophthalmologists who have additional fellowship training in retina diseases (retina specialists). After reviewing the patient's individual clinical circumstances and discussing with the patient, the retinal specialist identifies the best drug to use and the frequency of drug dosage. 
  • Off-label use of Avastin as anti-VEGF agent is common in Canada and worldwide, including U.S. (70% of all retinal drugs), New Zealand (90%), the region of Africa/Middle East (80%) and the region of Asia/Pacific (31%). The use of Avastin for wet AMD is also supported by clinical trials (for example, clinical comparative studies called IVAN and CATT). In Canada, all three anti-VEGF drugs are currently compounded by B.C. and several other provinces.
  • Studies have indicated that the use of any anti-VEGF agents can cause a transient increase in intra-ocular pressure and potentially lead to glaucoma. Glaucoma is progressive damage to the optic nerve, which is usually related to elevated pressure in the eye, which will lead to progressive loss of vision.  
  • Treatment of glaucoma may include eye drops and/or medications to lower pressure in the eye.
  • Uncontrolled, intra-ocular pressure or glaucoma may require a glaucoma procedure done in an office setting or a surgical procedure done in an operating room. 
  • Monitoring of quality data regarding the treatments are captured for 100% of PRDTP patients. In fact, the commitment to quality through this collection of quality related information and the ability to link this to other databases in B.C. means B.C. has a better ability to monitor than perhaps any other jurisdiction in the world. For example, B.C. has low adverse event rates and high visual preservation rates. Without drug treatment through PRDTP, the vision of the 20,000 PRDTP patients would either gradually deteriorate or would be lost altogether.
  • A joint accountability committee provides guidance to the program and includes retinal specialists, eye disease researchers, a glaucoma specialist, pharmacologists and program and ministry administrative staff.

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