Tuesday, March 23, 2010

Menu – Part 15: Updates and Several New Postings

Since the last menu posting in October, I have added four updates on Avastin vs. Lucentis; two updates on AMD; and five new original postings (actually one is a re-posting from another author). The new postings include a “first report” on the Oraya in-office X-ray treatment for AMD; two writeups on the First Ophthalmic Innovation Summit; a report on the Avedro microwave treatment for reshaping the cornea; and another “first report” on the Notal Vision at-home device for “monitoring” the progress of AMD via telemedicine.

First, the Avastin vs. Lucentis Updates:


In late October last year, the CMS surprised everyone by announcing that they would be repricing the reimbursement of Avastin, essentially cutting the reimbursement for doctors from about $50 per dose, to about $6.25. Update 32 described this announcement. Then, a few days later, I received the official wording for reinstating the higher reimbursement, but not effective until January 1st, leaving prescribing doctors in limbo for lost revenues if they continued using Avastin.


I discovered a new retina blog by Dr. David Khorram. On his blog, he reported on Dr. Dan Martin’s talk at the 2009 AAO about the status of the CATT Study and other international head-to-head studies. In this posting, I reproduced Dr. Khorram’s writeup.


The CMS finally got its act together and rescinded the ruling it had issued earlier. Physicians will now get reimbursed the full $50 for doses of Avastin, as they were previously allowed prior to October 1st, including reimbursement for lesser amounst billed during the interim.


In Update 31, I reported on IOP spikes following some Avastin injections for AMD, as reported by Dr. Malik Kahook in a talk he gave at the 2009 AAO Meeting. In this update, Dr. Kahook expounded on his previous remarks during a talk he gave at the Royal Hawaiian Meeting held in January, explaining he believed it was caused by large particulate matter found in some vials of the compounded drug.

And, the AMD Updates:


With the permission of the publishers of Retinal Physician, I was able to reproduce the excellent overview written by Dr. Philip Rosenfeld, of the drugs in development and in clinical trials for treating the dry form of AMD. This is an up-to-date treatise on all of the drugs known to be in the pipeline for dry AMD.


Thanks to a friend in an AMD support forum, I was able to make contact with the team running the London Project to Cure Blindness, and obtain an update on their status.

Next, the new postings:

A new company with a treatment for wet AMD came out of “stealth mode”, and allowed me to present information on how it’s system worked and the results of it’s initial clinical trials. Here is an in-depth presentation of the Oraya IRay radiotherapy system.


Just prior to last Fall’s AAO Meeting, I learned about this pre-AAO Meeting featuring small and developing ophthalmic companies, that was sponsored by a venture capital group. I was able to gather information about the 25 company presentations and put together this overview of what transpired.


In February of this year, I learned that a friend of mine had attended the OIS Meeting and had written up a comprehensive review of its proceedings. I obtained permission from the meeting’s sponsor to reproduce Larry Haimovitch’s writeup, and presented this updated version on my Journal.


In May of 2009, I first wrote about this company and its work in using microwaves to reshape the cornea. This report is a followup on new developments announced by the company in treating both keratoconus and the first clinical trials for altering refraction in normal, non-keratoconus eyes.


Finally, in late January, I came across a press release about Notal Vision receiving FDA approval for its device to monitor AMD patients in their homes. Since I had not previously heard of either Notal Vision or its monitoring device, I did a little research and got quite excited about the potential for this approach to detecting changes in vision of people suffering from AMD.

Upon discovering that I knew the president of the company, I requested permission to do an in-depth writeup of the device, how it works and its market potential. This report is the result.

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