The efforts of a local doctor not only cleared the way for a breakthrough treatment to be placed on Medicare’s covered-medications list, but also improved the vision of two women previously considered legally blind.
Dr. Alexander Eaton, of Retina Health Center in Fort Myers, began petitioning the American Society of Retina Specialists nearly two years ago to support the use of the medication Avastin for patients with various eye conditions.
Once supported by the society, a retina specialist group with members throughout the world, state Medicare administrator First Coast Service Options also approved the drug after a year of collaboration between doctors in Tampa Bay and the Bascom Palmer Eye Institute in Miami.
“We pursued this policy based on the growing amount of literature demonstrating the benefits of this medication in treating a number of conditions other than macular degeneration,” said in a prepared statement. “Despite this growing body of evidence, Medicare frequently denied coverage. It was the right thing to do for our patients.”
The use of Avastin helped North Fort Myers resident Shirley Sheppard, 78, who was first administered the medication two years ago after waking up one morning without any vision in her left eye.
“They did say it was macular degeneration. I don’t have it really, really bad,” she said. “When you can’t see, it’s one of the worst things in the world and this has helped me so much.”
Some patients receiving Avastin are diagnosed with macular degeneration, an age-related disease of the retina where light-sensing cells eventually die.
According to The Macular Center in Palm Beach, macular degeneration is the leading cause of blindness for people over the age of 50.
Sheppard said that only hours after receiving her first dose of the drug through an injection to the eye, she regained vision in her left eye.
She has been back to see Eaton other times to continue treatment.
The announcement that Medicare is now covering Avastin will help Sheppard and other patients receive the medicine they need without having to pay nearly $250 per visit. Before they had to pay out of their own pocket.
“We did pay for a while and now they took over so we don’t have to pay for it. It was a little expensive, but well worth it,” Sheppard said.
Eaton and other doctors will prescribe Avastin “off-label,” according to a prepared statement from Retina Health Center.
This means a doctor is prescribing a drug or medical device for a purpose that was not approved by the Food and Drug Administration.
Avastin was originally approved by the FDA for treatment in colorectal cancer, but recent research has proved its success in treating problems in the eye.
A 55-year-old Cape Coral resident, Norma Velazquez, also received Avastin to treat diabetic vitreous hemorrhages as an alternative to eye surgery. Her condition also left her without the ability to see.
“My condition left me blind and unable to drive, work or cook for myself,” she said.
While she began receiving Avastin treatments, Velazquez is not a Medicare recipient. She had to pay for each treatment out-of-pocket and even though Medicare has now agreed to cover the medicine, her private insurance does not.
Velazquez has been advocating for private insurance companies to cover the use of Avastin for these purposes.
According to Eaton, it is likely that private insurance will follow suit.
“Once Medicare pays for a service, or drug, typically the private insurance companies will follow, so this has broad sweeping implications for patients,” he said.