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. 2026 Feb 24.
doi: 10.1038/s41433-026-04333-3. Online ahead of print.

Prevalence and patterns of anti-angiogenic treatment discontinuation in neovascular age-related macular degeneration-insights from health claims data

Nicolas S Bodmer  1   2   3 , Livia Faes  1   2   4   5 , Nico Gross  4   6 , Lucas M Bachmann  7   8 , Carola Huber  9 , Markus Näpflin  9 , Martin K Schmid  6   10
Affiliations

Prevalence and patterns of anti-angiogenic treatment discontinuation in neovascular age-related macular degeneration-insights from health claims data

Nicolas S Bodmer et al. Eye (Lond). .

Abstract

Purpose: To assess patterns and institutional variability of anti-angiogenic treatment discontinuation in neovascular age-related macular degeneration (nAMD) within Switzerland, and to examine the association of digital home monitoring with treatment persistence.

Methods: Retrospective observational analysis combined nationwide health insurance claims data (Helsana, n = 4840) and clinical data from a major tertiary centre (LUKS, n = 1932; nAMD subset n = 1387). Discontinuation was defined as no further injections for 31-365 days after the last intravitreal injection (IVI) and classified as supervised ( ≥ 1 follow-up visit in this period) or unsupervised (no follow-up visits in this period). Variability was evaluated among the 20 largest providers and across seven regions. Digital home monitoring's impact on non-persistence was assessed in the clinical cohort.

Results: Substantial heterogeneity was observed. Supervised discontinuation ranged from 20.7 to 45.7% (pooled proportion 32.0%, 95% confidence interval [CI] 30.2-33.9%) and unsupervised from 10.9 to 25.7% (pooled proportion 18.2%, 95%CI 16.8-19.8%) across centres. In the LUKS cohort, 1-year persistence was 93.7%, dropping to 72.7% by year 4, with unsupervised discontinuation rising from 3.0 to 12.5%. In 100 patients using voluntary digital home monitoring non-persistence was less likely (adjusted OR 0.59, 95%CI 0.35-0.98); among those who discontinued, home-monitoring users were more likely to remain under supervision (74% vs 54%).

Conclusions: Treatment discontinuation in nAMD is frequent and demonstrates striking institutional and regional variability. The heterogeneity in discontinuation patterns suggests that treatment persistence may be modifiable through targeted, systematic, and patient-centred interventions. Digital home monitoring may be a promising strategy to support engagement and reduce non-persistence.

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Conflict of interest statement

Competing interests: LMB is CEO of Oculocare Medical Inc. LF has received research support from Bayer AG, F. Hoffmann-La Roche AG and AbbVie, and meetings and travel support from Apellis Pharmaceuticals Inc. Patient consent: For the clinical dataset, inclusion required documented general consent allowing secondary research use of health data. Analysis of the insurance claims dataset used anonymised data, so informed consent was not required. For LUKS patients with linked health insurance claims, an exemption was granted according to Article 34 of the Swiss Human Research Act (HRA).

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