Andrew Chang1,2,3, John Stokes4,5, Lindy Priestman6, Connor Holmes6, Peter Said7
Background: Persistence with anti-VEGF therapy is challenging, with drivers of non-adherence includ- ing maladaptive beliefs about illness, concerns about treatment, cost, access to therapy, and per- ceived efﬁcacy. SmartSight (Bayer/Atlantis Health- care) is an evidence-based multi-channel program for patients taking intravitreal aﬂibercept (IVT-AFL) that aims to uncover and address patients’ major drivers of non-adherence, including intentional non- adherence. Patients receive a range of tailored mate- rials, and individualised nurse support. To assess the effectiveness of the program, a third-party review was conducted (Prospection Pty Limited), and on-program persistence compared with patients not supported by SmartSight.
Methods: Persistence for patients with wet AMD on the SmartSight program was assessed and com- pared with a 10% PBS data sample. As 12.5% of patients prescribed aﬂibercept are on the SmartSight program, there is an overlap which may inﬂuence the comparator persistence.
Results: Two year persistence on therapy for the 10% PBS sample was 64%. Conservative modelling indicates persistence at 88% on the SmartSight pro- gram, with an 18% higher duration of therapy for SmartSight patients. Patients supported by the SmartSight program have only 1/3rd of the drop-out rate of unsupported patients.
Conclusion: The SmartSight program is designed to identify and address individual patients’ key drivers of non-adherence and cessation of therapy, and rein- forces the value of ongoing care and treatment for patients undergoing therapy with IVT-AFL. This analysis indicates substantial gains in persistence to therapy and duration of treatment. Further analysis will address questions of outcomes in differing patient segments, and with higher and lower levels of intervention.