Paul Mitchell AO1, James Fedorow2, Prabhjot Juneja2, Rebecca Schnabel3

Purpose: To understand utilisation of vascular endothelial growth factor (VEGF) inhibitors to treat central and branch retinal vein occlusion (RVO) in Australia.
Methods: Analysis of a randomised 10% longitudi- nal data sample of Pharmaceutical Benefits Scheme (PBS) prescriptions of all patients initiating VEGF inhibitors between June 2015 and December 2016, followed to June 2017. Utilisation data were extracted and analysed using the PBS sample and Department of Human Services Authority Codes.
Results: In the cohort, 681 patients completed one year of treatment for their RVO: 408 patients (60%) for BRVO and 305 (45%) for CRVO (5% had treat- ment for both). 36% received aflibercept and 84% received ranibizumab, with a trend towards an increasing initiation of aflibercept treatment. In their first year of treatment, 29% of patients received ≥
9 prescriptions, 35% received 6-8, 28% received 3-5, and 8% received < 3. Of the 353 patients with two-year follow-up data, 9% of patients received ≥ 9 prescriptions, 19% received 6-8, 40% received 3-5, and 32% received < 3 in the second year. The distribution was similar between BRVO and CRVO. There was a trend towards more patients with ≥ 6 prescriptions per year in patients ≥ 60 years, com- pared with younger patients. This trend was more pronounced in patients with CRVO than BRVO. Conclusions: Over 2/3 of patients do not achieve resolution of RVO despite receiving ≥6 injections in the first year. Of those needing further treatment, almost 1/3 require ≥ 6 injections in the second year.