The treatment of wet AMD in Canada: access to therapy (policy review)

Age-related macular degeneration (AMD) is the leading cause of blindness in North America, affecting 2 million Canadians older than age 50 years. AMD is subdivided into 2 types: an atrophic form, so-called "dry" AMD, and an exudative or "wet" form, characterized by the presence of choroidal neovascularization (CNV). Since 2000, after decades with no effective therapy aside from thermal obliterative laser treatment of CNV, 3 new treatments have been approved, each offering significant therapeutic advances at increasingly higher prices, and in an increasingly cost-containment-oriented payer environment. Many of Canada's public drug plans have been relatively slow to fund evidence-based, approved treatments. This paper reviews the disease, as well as the current private and public coverage for wet AMD treatments.