Diabetic macular edema (DME) and neovascular age-related macular degeneration (nAMD) can lead to vision loss and subsequently poor quality of life for patients. Both diseases are caused by growth factors angiopoietin-2 (Ang-2) and vascular endothelial growth factor (VEGF)-A acting synergistically to destabilize mature vasculature, causing inflammation and leakage. While current intravitreal anti-VEGF medications have improved quality of life, patient adherence is low due to high treatment burdens such as frequency and cost. Managed care professionals have an important role in facilitating access to treatment options that reduce the injection burden of patients with nAMD and DME. New therapeutic targets or longer-lasting and sustained delivery formulations targeting both Ang-2 and VEGF-A pathways, which has proven more effective than targeting the VEGF growth factor alone, are currently under investigation and could reduce treatment frequency. Managed care professionals must prepare to review these treatment options, incorporate them into formularies, and develop cost-efficient administration plans to improve adherence, optimize patient outcomes, and limit adverse effects.
