Ophthalmology group challenges payers recommending biosimilars for eye disease treatment


The American Academy of Ophthalmology has asked CMS and HHS to prohibit health insurers from recommending biosimilars as alternative treatments for eye disease.

The request comes in the wake of a supply shortage of Avastin, a drug used to treat vision-threatening diseases like macular degeneration and neovascular glaucoma.

Health insurers including Aetna, Humana and UnitedHealthcare have suggested ophthalmologists use biosimilars Zirabev and Mvasi as alternatives. However, the American Academy of Ophthalmology said neither drug has been tested for treatment of eye disease and could lead to retinal toxicity.

"The Academy does not oppose the use of biosimilars or the use of drugs off-label in general. We are against the use of drugs in the eye that have never been tested for ophthalmic diseases," the group stated in a July 29 news release. "The Academy has told HHS and CMS it is inappropriate for plans to recommend or mandate use of these biosimilars for intravitreal injection without a prior clinical trial in eye disease and testing for retinal toxicity."

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